Adolescent daughters' response and adjustment to maternal breast cancer

描述（由申请人提供）：本研究的目的是确定母亲患有乳腺癌的青春期女儿所采用的不同应对策略，以及这与她们表现出的压力反应之间的关系。青少年年龄和他们与母亲的关系也将被检查与他们的应对有关。据报道，这组青春期的女儿比正常样本和儿子的压力反应率增加了25%，特别是焦虑和抑郁。此外，他们还报告了情绪困扰和担忧，害怕参加促进健康的活动。40%的青春期女儿最初被诊断患有抑郁症，就像那些母亲患有乳腺癌的女儿一样，会经历第二次抑郁症发作，其中70%的人会在成年后复发。青少年用来应对压力的策略是压力对当前和未来调整影响的潜在重要中介。例如，那些使用解决问题策略的人比那些使用回避策略的人有更好的心理健康结果。然而，对于青春期女儿面对母亲的乳腺癌时所采用的不同应对策略，以及这些策略如何调解这种影响，人们知之甚少。美国的许多癌症中心每年为20多万新诊断为乳腺癌的妇女提供心理社会支持服务。然而，没有任何支持性护理服务针对她们的青春期女儿应对她们母亲患乳腺癌的压力。在开发这些服务之前，我们需要更多地了解哪些应对策略可以调节母亲乳腺癌的压力，并将其纳入任何干预措施。随着这些女儿面临患乳腺癌的风险增加，对健康检查产生恐惧，并可能面临终身抑郁，这些都是重要的公共卫生问题，有必要更多地了解应对策略和因素，这些策略和因素可以调节这一事件的压力。这项横断面相关性研究将从纽约大学医学癌症中心和贝尔维尤医院癌症诊所招募90名患有乳腺癌的青春期女儿及其母亲。数据收集将包括针对青春期女儿的访谈时间表和工具，她们使用的不同应对策略，以及她们在诊断后一年内对产妇疾病的适应或痛苦程度。最终，从这项研究中获得的知识将导致针对这一弱势群体的应对和促进调整的干预措施的发展。这项关于青春期女儿对母亲乳腺癌的应对和适应的横断面相关研究解决了三个主要的公共卫生问题：在青春期发展抑郁症，这可能导致终生的心理健康问题；避免进行促进健康的筛查，如乳房自我检查，这有助于早期发现乳腺癌；由于缺乏有关乳腺癌风险的信息和恐惧，健康素养下降。更好地了解哪些应对策略可以调节母亲乳腺癌的压力影响，可以促进针对这一弱势群体这些问题的健康促进干预措施的发展。

DESCRIPTION (provided by applicant): The aims of this study are to determine the differential coping strategies used by adolescent daughters whose mothers have breast cancer, and how this relates to the stress responses they exhibit. Adolescent age, and their relationship with their mothers will also be examined in relation to their coping. This group of adolescent daughters has reported a 25% increased rate of stress responses, specifically anxiety and depression, than a normative sample and than sons. They additionally report emotional distress and worries, and fear engaging in health promoting activities. Forty percent of adolescent daughters who are initially diagnosed with depression, like those whose mothers have breast cancer, will experience a second bout of depression, and 70% of those will have a relapse in adulthood. The strategies that adolescents use to cope with stress are potentially important mediators of the impact of stress on current and future adjustment. For example those that use problem-solving strategies can have a better mental health outcomes than those that use avoidance strategies. Yet little is known about the differential coping strategies used when adolescent daughters are faced with their mothers' breast cancer, and how these mediate that impact. Many cancer centers in the United States provide psychosocial support services for the over 200,000 women newly diagnosed with breast cancer each year. There are no supportive care services however that targets the coping of their adolescent daughters with the stress of their mother's breast cancer. Before developing these services we need to understand more about which coping strategies can mediate the stress of mothers' breast cancer and be included in any interventions. With the increased risk that these daughters face of acquiring breast cancer, developing fear about health screening, and potentially facing life-long depression, all important public health concerns, it is imperative to understand more about the coping strategies and factors that can mediate the stressfulness of this event. This cross-sectional, correlational study will target 90 adolescent daughters and their mothers with breast cancer recruited through the New York University Medical Cancer Center and Bellevue Hospital cancer clinics. Data collection will include an interview schedule and instruments that target adolescent daughters, the different coping strategies they use, and their level of adjustment or distress with the maternal disease within the first year following diagnosis. Ultimately, the knowledge gained from this study will lead to the development of interventions that target coping and promote adjustment in this vulnerable group. This cross-sectional, correlational study of adolescent daughters' coping and adjustment to their mothers' breast cancer addresses three major pubic health concerns: developing depression in adolescence which can lead to lifelong mental health problems; avoidance of engaging in health promoting screening like breast-self exams, that can facilitate earlier identification of breast cancer; and decreased health literacy based on a lack of information and fear regarding their breast cancer risks. A better understanding of which coping strategies can mediate the stressful impact of their mothers' breast cancer can lead to the development of health promoting interventions that target these concerns in this vulnerable population.