MEASUREMENT OF ADAPTIVE STYLE IN CHILDREN WITH CANCER

癌症儿童适应性风格的测量

• 批准号: 6514077
• 负责人: Sean Phipps
• 金额: $ 16.31万
• 依托单位: ST. JUDE CHILDREN'S RESEARCH HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2000
• 资助国家: 美国
• 起止时间: 2000-04-01 至 2004-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6514077
• 关键词: adolescence (12-20); behavioral /social science research tag; blood pressure; child psychology; clinical research; cortisol; early experience; heart rate; human subject; longitudinal human study; middle childhood (6-11); muscle tension; pediatric neoplasm /cancer; psychological adaptation; psychological aspect of cancer; repression; stress

Description (adapted from investigator's abstract): The construct of adaptive style provides a heuristic model for understanding the frequently reported findings of lower self-reports of psychological distress in children with cancer, in comparison to healthy children. Assessment of adaptive style allows for differentiation between truly low anxious individuals, who accurately report low levels of distress, and repressors, who maladaptively avoid the perception of negative affect of distress. In adults, repressive adaptation has been associated with altered patterns of physiological response to stress, and is related to numerous adverse health outcomes. Such relationships have not yet been studied in children. Recent studies have demonstrated a significantly higher incidence of repressors in children with cancer relative to healthy children, which accounts, in part, for the lower levels of distress by self-report in these children. Given the higher incidence of repressive adaptation in children with cancer, adaptive style may be a particularly important predictor of health outcomes in this population. The present proposal aims to improve measurement of adaptive style in children by combining self-report and psychophysiological assessment techniques, while examining the clinical significance of adaptive style in children undergoing treatment for cancer. The specific aims of the project are: 1) To determine the physiological concomitants of adaptive style in healthy children and children with cancer; 2) To assess the concordance in measurement of adaptive style by self-report and physiological indices; and 3) to determine the relationship of adaptive style to tolerance of anti-cancer therapy in children with recently diagnosed malignancies. These aims will be accomplished through two related studies. Study 1 will use a two group, case control design, pairing children who have completed treatment for cancer with healthy children matched on age, race, and gender. Participants will complete a battery of self report measures assessing adaptive style and then undergo physiological monitoring (heart rate, blood pressure, muscle tension, skin conductance, salivary cortisol) in a laboratory stress assessment task. Study 2 utilizes a single group, short term longitudinal design to determine the significance of adaptive style as a predictor of tolerance to anti-cancer therapy in terms of treatment side effects, acute toxicities and medical complications. Newly diagnosed pediatric cancer patients will undergo an identical procedure of self-report measures, stress tasks, and physiological assessment to assess adaptive style, and then be followed prospectively for 6 months while on active therapy. This study will advance knowledge regarding adaptive style in children, which can help to improve identification of truly distressed and non-distressed children, as well as those who may be at high risk for adverse healthy outcomes as a function of adaptive style.

描述（改编自研究者的摘要）：适应性的构造 风格提供了一个启发式模型来理解经常报道的内容 研究发现，患有抑郁症的儿童的心理困扰自我报告率较低 与健康儿童相比，癌症。适应性风格的评估允许 区分真正的低焦虑个体，他们准确地 报告低水平的痛苦和抑制者，他们不适应地回避 对痛苦的负面影响的感知。在成年人中，压抑适应 与对压力的生理反应模式的改变有关，并且 与许多不良健康结果有关。这样的关系还没有 在儿童中进行了研究。最近的研究表明，显着 与健康儿童相比，癌症儿童中抑制因子的发生率更高 儿童，这在一定程度上是造成痛苦程度较低的原因 这些孩子的自我报告。鉴于镇压发生率较高 对于患有癌症的儿童来说，适应方式可能是一个特别重要的因素 该人群健康结果的重要预测因素。目前的建议 旨在通过结合以下方法来改进儿童适应性风格的测量 自我报告和心理生理评估技术，同时检查 适应风格在接受治疗的儿童中的临床意义 癌症。该项目的具体目标是： 1）确定生理学 健康儿童和癌症儿童的适应性风格的伴随物； 2） 通过自我报告和评估适应性风格测量的一致性 生理指标； 3）确定自适应风格的关系 最近诊断的儿童抗癌治疗的耐受性 恶性肿瘤。这些目标将通过两项相关研究来实现。 研究 1 将采用两组病例对照设计，将患有以下疾病的儿童配对 与年龄、种族和健康相匹配的健康儿童完成癌症治疗 性别。参与者将完成一系列自我报告措施评估 适应性风格，然后进行生理监测（心率、血 实验室中的压力、肌肉张力、皮肤电导、唾液皮质醇） 压力评估任务。研究 2 采用单组、短期 纵向设计以确定适应性风格作为 就治疗方面而言，抗癌治疗耐受性的预测因子 影响、急性毒性和医疗并发症。初诊儿科 癌症患者将接受相同的自我报告措施程序， 压力任务和生理评估来评估适应性风格，然后 在积极治疗期间前瞻性随访 6 个月。这项研究将 增进有关儿童适应性风格的知识，这有助于 还可以更好地识别真正陷入困境和未陷入困境的儿童 作为那些可能面临不良健康结果高风险的人 自适应风格。