Category: Health Psychology / Behavioral Medicine - Child

PS10- #C96 - Maternal Stress, Parenting, and Child Internalizing Problems in Socioeconomically Disadvantaged Families After a Diagnosis of Cancer

Saturday, Nov 18
11:00 AM – 12:00 PM
Location: Indigo Ballroom CDGH, Level 2, Indigo Level

Keywords: Behavioral Medicine | Parenting | Risk / Vulnerability Factors

Having a child with cancer can be a significant stressor for families. Previous findings suggest that socioeconomically disadvantaged mothers faced with a pediatric cancer diagnosis experience higher stress levels than those with socioeconomic security. Additionally, higher stress levels in parents may contribute to poorer family dynamics and child adjustment. We hypothesized that socioeconomic disadvantage would predict internalizing problems among children a year post-diagnosis and that this association would be partially explained by mothers’ cancer-related stress and subsequent parenting.


Families (n=74) were recruited from two pediatric hospitals in the U.S. following a child’s initial diagnosis or relapse of cancer. At diagnosis (T1), mothers (age 27-72, M=41.4; 89% white) reported family demographic information used to calculate a cumulative risk factor reflecting socioeconomic disadvantage (i.e. single, a high school education or lower, not white, and an annual family income below $50,000). The risk factor ranged from 0-4 (0=40.5%, 1=21.6%, 2=29%, 3=8.1%, 4=0%). Mothers also reported on their cancer-related stress at T1. A year post-diagnosis (T2), children (age 9-17, M=13.3; 53.4% female; 86.5% white) reported mothers’ parenting (warmth, psychological/ behavioral control) and mothers reported on child internalizing problems. A serial mediation model examined the indirect effect of socioeconomic disadvantage on children’s internalizing problems via mother’s cancer-related stress and parenting.


The risk factor was positively associated with children’s internalizing problems (p=.03) and maternal cancer-related stress (p=.05), and negatively associated with maternal warmth (p=.02). Serial mediation models revealed a significant indirect effect of the risk factor on child internalizing problems through heightened maternal cancer-related stress (CI[0.01,1.14]). However, the effect of the risk factor on child internalizing problems via maternal cancer-related stress and the parenting subscales was not significant (warmth: CI[-0.07,0.4], psychological control: CI[-0.17,0.23], behavioral control: CI[-0.07,0.12]).


Our findings indicate that in the context of childhood cancer, socioeconomic disadvantage may be associated with greater cancer-related stress in mother’s and subsequent child adjustment. Surprisingly, maternal stress may more strongly influence children’s adjustment compared to mothers’ parenting. The implication that maternal stress is upsetting to children further elucidates the importance of effective interventions for socioeconomically disadvantaged families as they navigate a pediatric cancer diagnosis.

Amanda C. Ferrante

Research Assistant
The Research Institute at Nationwide Children’s Hospital and The Ohio State University

Katianne M. Howard Sharp

post-doc
Nationwide Children's Hospital

Adrien M. Winning

The Research Institute at Nationwide Children’s Hospital and The Ohio State University

Queen-Erin Watson

Research Assistant
The Research Institute at Nationwide Children’s Hospital and The Ohio State University

Kathryn Vannatta

The Research Institute at Nationwide Children’s Hospital and The Ohio State University

Bruce E. Compas

Patricia and Rodes Hart Professor of Psychology and Human Development
Vanderbilt University
Nashville, Tennessee

Cynthia A. Gerhardt

The Research Institute at Nationwide Children’s Hospital and The Ohio State University