Coping Strategies in Adolescents of Parents with Cancer: An Analysis of Theoretically Informed Influencing Factors

Abstract

Purpose/Aims: This dissertation examined the impact of adolescents' individual psychological characteristics and parental psychological distress on adolescents' coping strategies when facing newly diagnosed maternal breast cancer. This study aimed to: 1) describe adolescents’ active, negative, and avoidant coping strategies in the study sample; 2) examine the effect of adolescents’ age, sex, depressed mood, and anxiety on adolescents’ active and negative/avoidant coping strategies; 3) examine the effect of adolescents’ self-esteem on adolescents’ active and negative/avoidant coping strategies; and 4) examine the effect of ill mothers’ depressed mood and anxiety on adolescents’ active and negative/avoidant coping strategies when facing the mother’s recently diagnosed breast cancer. Methods: This research involved secondary analysis of baseline data obtained from the Enhancing Connection (EC) Study, a completed Phase III randomized controlled trial (n = 94) of early adolescent-mother dyads recruited from six states in the United States. Three independent studies were completed. Measures of central tendency were computed for each coping strategy. Multiple regression analyses were used to test predictive relationships in the first and third studies; simple linear regression was used in the second study. Results: Results from Study 1: Adolescents reported greater use of avoidant coping than active coping. Adolescents' depressed mood significantly predicted less use of active coping, and anxiety significantly predicted greater use of active coping. Negative/avoidant coping was significantly predicted by adolescents’ anxiety. Results from Study 2: Adolescents' negative self-esteem significantly predicted greater use of negative/avoidant coping. Results from Study 3: Counter to expectation, maternal depressed mood did not significantly predict either active or negative/avoidant coping. However, parental anxiety significantly predicted greater use of adolescent active coping. Conclusion: Adolescent anxiety was a significant predictor of greater use of both active coping and negative/avoidant coping. Adolescents’ depressed mood and self-esteem were additionally identified as risk factors for greater reliance on negative/avoidant coping. The finding that maternal distress (anxiety and depressed mood) was not significantly associated with adolescent coping deserves further study. Findings highlight the clinical importance of assessing and targeting adolescent anxiety, depressed mood, and self-esteem in psychosocial interventions to support adolescents’ coping with newly diagnosed maternal breast cancer.