Predicting deficits in social competence for pediatric brain tumor survivors

描述（由申请人提供）：尽管NCI的使命是减轻癌症幸存者的负担，但在减少儿童脑肿瘤幸存者（PBTS）的心理社会发病率方面进展甚微。社会缺陷，以及医疗和神经认知障碍，威胁着他们的短期和长期生活质量。在我们的研究中，同学们将PBTS描述为社交孤僻，受到同伴的伤害和排斥，不受欢迎，比对照组的同学朋友更少。接受放射治疗的女孩和儿童的结果最糟糕，但社交障碍并不仅限于他们。这些困难，尤其是同龄人报告的困难，强烈地预示着以后生活中的情感、行为和学业困难，而PBTS在成年后比其他儿童癌症幸存者亚组表现出更多的这些缺陷。不幸的是，我们缺乏有效的干预措施来帮助这些孩子。研究尚未确定具体的、可教的技能，如果缺乏这些技能，就会导致PTBS的社会结果不佳。社会生态因素可能会调节PTBS的社会结果，并可能成为干预措施的目标，但尚未对该人群进行检查。因此，我们的长期目标是通过为PBTS制定量身定制的干预措施来降低发病率。这一建议的目的是确定社会信息的性质和范围

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 In our research, classmates have described PBTS as socially withdrawn, victimized and excluded by peers, less liked, and having fewer friends than control classmates.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.