Predicting deficits in social competence for pediatric brain tumor survivors

描述（由申请人提供）：尽管NCI的使命是减少癌症对幸存者的负担，但在减少儿童脑肿瘤幸存者（PBTS）的心理社会发病率方面几乎没有取得进展。社会缺陷以及医疗和神经认知障碍威胁到他们的短期和长期生活质量。在我们的研究中，同学们将PBTS描述为社交退缩，受害者和同龄人的排斥，不太喜欢，比对照组同学的朋友更少。接受辐射治疗的女孩和儿童的后果最严重，但社会损害并不限于他们。这些困难，特别是同龄人报告的，强烈预测了以后生活中的情感，行为和学术困难，PBTS在成年人中表现出比任何其他儿童癌症幸存者亚组更多的这些缺陷。不幸的是，我们缺乏行之有效的干预措施来帮助这些儿童。研究还没有确定具体的，可教的技能，当缺乏，占穷人的社会成果之间的PTBS。社会生态因素可能会缓和PTBS的社会后果，并有针对性的干预措施，但尚未检查这一人群。因此，我们的长期目标是通过制定针对性的干预措施来降低PBTS的发病率。这项建议的目的是确定社会信息的性质和范围 PBTS中的加工缺陷，并确定它们是否与社会生态因素一起沿着，导致社会困难的风险。我们将招募212名PBTS（年龄8-13岁，治疗后>1年）， 3家儿科医院混合方法（即，问卷调查、基于表现的和模拟的测量、与朋友的录像互动）和多个报告来源（同伴、老师、母亲、父亲、孩子）将在学校和家庭中被用来评估社会能力（即，社会信息处理技能、社会行为和互动、社会适应）和情境资源（即亲子关系和养育行为、友谊质量和学校环境）。每个PBTS将获得一名对照同学的相同数据，性别、种族和年龄匹配。其基本原理是，确定这些因素将允许选择和设计有效的干预措施， 针对哪些PBTS制定目标。我们的中心假设是，社会信息处理技能将解释PBTS的社会行为和调整的差异，而他们的家庭、友谊和学校资源将缓冲肿瘤和治疗对社会能力的影响。拟议的研究是重要的，因为它将使我们能够开发有效的服务，以尽量减少长期发病率在PTBS。

DESCRIPTION (provided by applicant): Despite the NCI's mission to reduce the burden of cancer on survivors, little progress has been made toward reducing psychosocial morbidity for pediatric brain tumor survivors (PBTS). Social deficits, as well as medical and neuro-cognitive impairment, threaten both their short and long-term quality of life. In our research, classmates have described PBTS as socially withdrawn, victimized and excluded by peers, less liked, and having fewer friends than control classmates. Girls and children treated with radiation have the worst outcomes, but social impairment is not limited to them. These difficulties, particularly as reported by peers, are strongly predictive of emotional, behavioral, and academic difficulties later in life, and PBTS demonstrate more of these deficits as adults than any other subgroup of pediatric cancer survivors. Unfortunately, we lack proven interventions to help these children. Research has yet to identify specific, teachable skills that, when deficient, account for poor social outcomes among PTBS. Social-ecological factors may moderate social outcomes for PTBS and could be targeted by interventions, but have not been examined for this population. Thus, our long- term goal is to reduce morbidity for PBTS by developing tailored interventions for them. The objective of this proposal is to identify the nature and extent of social information processing deficits in PBTS and determine if they, along with social-ecological factors, account for risk for social difficulties. We will recruit 212 PBTS (ages 8-13, >1 year post-treatment) from 3 pediatric hospitals. Mixed methods (i.e., questionnaires, performance- based and analog measures, video-taped interactions with friends) and multiple reporting sources (peer, teacher, mother, father, child) will be used in schools and homes to assess social competence (i.e., social information processing skills, social behavior and interactions, social adjustment) and contextual resources (i.e. parent-child relationship and parenting behavior, friendship quality, and school environment) that account for social competence. Identical data will be obtained for one control classmate per PBTS, matched for gender, race, and age. The rationale is that identifying these factors will allow the selection and design of effective interventions by knowing what to target for which PBTS. Our central hypothesis is that social information processing skills will account for differences in social behavior and adjustment for PBTS, and resources in their families, friendships, and schools will buffer the impact of the tumor and treatment on social competence. The proposed research is significant because it will enable us to develop effective services to minimize long-term morbidity in PTBS.