Adjustment of Pediatric Brain Tumor Survivors

描述(申请人提供)：颅内肿瘤是第二种最常见的儿科癌症。与接受其他类型恶性肿瘤治疗的儿童相比，这些肿瘤的位置以及标准治疗对大脑完整性的风险可能会增加脑瘤(BT)幸存者的心理社会发病率。许多研究记录了接受BT治疗的儿童的认知缺陷，但较少关注他们的社会、情感、行为和家庭功能。现有数据表明，儿童BT的幸存者面临长期存在的社会和情感困难的风险。照顾Bt幸存者也可能影响父母的痛苦和家庭功能。然而，还没有工作确定导致这些儿童和家庭长期困难的具体途径。在经验性干预措施开始之前，有关可能调节儿童Bt影响的过程的信息是必不可少的。儿童困难的潜在中介因素可能包括社交技能、非社交属性(例如，外貌、运动能力)、同伴关系和健康状况。需要调查父母痛苦的中介因素包括儿童的健康状况和照顾者的负担。这项拟议的研究将评估完成Bt治疗的学龄儿童(8-15岁)。对于每个孩子，将招募一名相同种族、性别和年龄的同学作为对照(Comp)。所有参与者将从教室(教师、同伴、自我报告)和家庭(母亲、父亲和孩子报告)的多个来源获得相同的数据，以测试群体在社交、情感、行为和父母/家庭功能方面的差异。分析将检查群体差异，并开始确定可能调解结果差异的机制。这项工作将为更大规模的研究提供初步数据和方向，这些研究可以为预防或改善Bt幸存者长期心理社会疾病的临床试验设计做出重大贡献。具体目标1比较接受Bt治疗和人口统计学相似的COMP的儿童的社会、情感和行为功能。具体目标2比较接受Bt和COMP治疗的儿童的父母和家庭功能。特殊目标3探索可能调节接受Bt治疗的儿童及其家人在适应方面困难的发生的过程。特殊目标4开始识别基于背景特征(例如，年龄，性别)和疾病因素(例如，肿瘤类型或治疗)。

DESCRIPTION (provided by applicant): Intracranial tumors are the second most common form of pediatric cancer. The location of these tumors, and the risk to cerebral integrity posed by standard treatments, may increase psychosocial morbidity for brain tumor (BT) survivors compared to children treated for other types of malignancies. Numerous studies have documented cognitive deficits for children treated for BT, but less attention has focused on their social, emotional, behavioral, and family functioning. Existing data suggests that survivors of pediatric BT are at risk for longstanding social and emotional difficulties. Caring for BT survivors also may affect parental distress and family functioning. However, no work has identified specific pathways that lead to long-term difficulties for these children and families. Information about the processes that might mediate the impact of pediatric BT is essential before empirically derived interventions can begin. Potential mediators for difficulties in children might include social skills, nonsocial attributes (e.g., physical appearance, athletic ability), peer relationships, and health status. Mediators that warrant exploration for parental distress include the child's health status and caregiver burden. The proposed research will evaluate school aged (8-15 years) children who have completed treatment for BT. For each child, a classmate of the same race, gender, and age will be recruited as a comparison (COMP). Identical data will be obtained for all participants from multiple sources in classrooms (teacher, peer, self-report) and homes (mother, father, and child-report) to allow tests of group differences in social, emotional, behavioral, and parent/family functioning. Analyses will examine group differences as well as begin to identify mechanisms that may mediate differences in outcomes. This work will provide preliminary data and direction for larger scale studies that can make a significant contribution to the design of clinical trials to prevent or ameliorate long-term psychosocial morbidity in BT survivors.Specific Aim 1 Compare the social, emotional, and behavioral functioning of children who have received treatment for BT and demographically similar COMP.Specific Aim 2 Compare parent and family functioning for children treated for BT and COMP.Specific Aim 3 Explore processes that might mediate the occurrence of difficulties in adjustment among children treated for BT and their families.Specific Aim 4 Begin to identify moderators that categorize subgroups at higher risk for difficulties based on background characteristics (e.g., age, gender) and disease factors (e.g., type of tumor or treatment).