Posttraumatic stress and growth in adolescent childhood cancer survivors: Links to quality of life.

Pediatric cancer can be considered an event potentially leading to posttraumatic stress symptoms (PTSS) as well as posttraumatic growth (PTG). While clinically significant levels of PTSS are rare in childhood cancer survivors, PTG is common in this population. However, the relationship of PTG to overall adaptation and quality of life (QOL) in pediatric cancer patients is not clear. Therefore, our study aims to analyse the relationships of PTSS and PTG with QOL in childhood cancer survivors. In this study, 172 childhood cancer survivors completed measures of quality of life (Minneapolis-Manchester Quality of Life Scale; child and adolescent version), posttraumatic stress (UCLA PTSD Reaction Index for DMS-IV) and posttraumatic growth (Benefit Finding Scale for Children). Correlation analyses were carried out separately for the child (up to 13 years, N = 47) and adolescent (more than 13 years, N = 125) groups and each QOL dimension. In the adolescent group, the relationship of PTSS and PTG with QOL was further verified by regression analyses while controlling for age, gender, and time off treatment. In children, negative relationships between PTSS and QOL were found, but the relationships between QOL and PTG were not significant. In adolescents, significant relationships were found for all dimensions of QOL and PTSS and also for several dimensions of QOL and PTG. The relationships between PTSS and QOL dimensions were negative in both groups, and the relationships between PTG and QOL in the adolescent group were weakly positive. In adolescents, regression analyses controlling for age, gender and time off treatment were performed and confirmed a negative relationship of PTSS with all QOL dimensions except for social functioning. For PTG, regression analyses revealed a significant positive relationship with QOL dimensions of social functioning, outlook on life and intimate relations. While the relationship between PTSS and QOL is negative for almost all QOL dimensions in children and adolescents, the nature of the relationship between PTG and QOL appears to be more complex and changing over time. PTG in children may reflect different processes with different outcomes than PTG in adolescents.

Longitudinal bidirectional effects between sleep quality and internalizing problems.

INTRODUCTION: The current study tested the longitudinal bidirectional links between changes in sleep quality and two measures of internalizing problems, depressive and anxiety symptoms, and whether these links differed between males and females. METHODS: Longitudinal data were collected from 570 early adolescents (58.6% female; Mage = 12.43 years, SD = 0.66 at Time 1) who were assessed four times over the course of 1.5 years. RESULTS: Cross-lagged panel models were hypothesized and tested the bidirectional links between sleep quality and both depressive and anxiety symptoms; multigroup tests were used to test for sex differences. Sleep quality and developmental changes in sleep quality were negatively associated with developmental changes in depressive symptoms as well as anxiety symptoms over time, and vice versa. These associations did not differ between male and female early adolescents. CONCLUSIONS: Study findings provide evidence that the relationship between poor sleep quality and depressive symptoms as well as anxiety symptoms are likely bidirectional and consistently intertwined. Clinicians might consider both problems to better guide case conceptualization and treatment.

Does Self-control Outdo IQ in Predicting Academic Performance?

Duckworth and Seligman's seminal work found that self-discipline (self-control) was more salient for academic achievement than intelligence. Very little replication work exists, including in different cultures; the current study addressed these gaps. Data were collected from 6th and 7th grade cohorts of early adolescents (N = 589; age: Mean = 12.34 years, and SD = 0.89; 58% female) over two years. The study tested whether self-control was a stronger predictor than intelligence in explaining academic performance two years later as well as in explaining developmental changes over the course of two years. Path analyses provided evidence that both self-control and intelligence longitudinally predicted teacher-reported academic competence as well as school-reported grades; however, intelligence was a significantly stronger predictor than self-control. In addition, only intelligence predicted developmental changes in each measure of academic performance over time, self-control did not.

Concordance of Child Self-Reported and Parent Proxy-Reported Posttraumatic Growth in Childhood Cancer Survivors.

This article aimed to analyze concordance of parent- and child-reported child posttraumatic growth (PTG) following pediatric cancer, the influence of the parents' own level of PTG on the level of concordance and the influence of the parents' and the child's own level of PTG on the parents' proxy reports of PTG in the child. The sample included 127 parent-child dyads. The children provided self-reports of PTG and the parents provided reports of their own as well as the child's PTG. Overall, the results showed poor parent-child agreement on the child PTG, with the parents proxy-reporting higher levels of PTG than the children. The parents' proxy reports of the child PTG were the most accurate at the lowest levels of the parents' own level of PTG. The parents' own level of PTG was a stronger predictor of the parents' proxy reports than the child self-reported PTG. The results suggest that parents are not very accurate reporters of PTG in the child; therefore, their reports should be completed with child self-reports whenever possible.

Sleepless: The developmental significance of sleep quality and quantity among adolescents.

The current study tested the developmental significance of both early adolescent sleep quantity and quality for academic competence and internalizing and externalizing problems over the course of 2 years. As part of an accelerated longitudinal study, data were collected from N = 586 Czech adolescents (Mage = 12.34 years, SD = .89, 58.4% female). Data analyses included a series of logistic regressions that controlled for adolescent sex, age, family structure, and socioeconomic status. Findings showed that sleep quality at Wave 1 predicted developmental changes 1 year later (Wave 3) in depression, anxiety, and low self-esteem (ORrange = 1.7-1.8) and 2 years later (Wave 5) in externalizing behaviors (OR = 2.6). Importantly, despite the associations observed with Wave 3 anxiety and deviance, Wave 1 sleep quantity was unrelated to subsequent developmental changes in adjustment measures, both 1 and 2 years later. No sleep effects at all were observed on a variety of measures of academic competence. Study findings underscore the developmental significance of sleep and indicate greater salience of sleep quality vis-à-vis sleep quantity. They also replicate some of the observed relationships found in previous longitudinal work on the sleep-mood link but extend the sleep-adolescent adjustment literature in a number of important ways. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Posttraumatic stress and growth in childhood cancer survivors: Considering the pathways for relationship.

PURPOSE: This study aims to contribute to the clarification of posttraumatic stress symptoms (PTSS) and growth (PTG) in childhood cancer survivors, taking into account the possibility of a nonlinear relationship and using a clinical approach to analyzing PTSS. METHODS: Childhood cancer survivors (n = 167) aged 11-27 completed measures of posttraumatic stress (UCLA_PTSD) and posttraumatic growth (BFSC). Based on the clinical analysis of UCLA_PTSD symptoms, the sample was divided into three PTSS severity groups (no, mild, moderate). These groups were compared in the mean level of PTG. Correlation analysis was performed to analyze the relationship of PTG with overall PTSS as well as its subscales. The analysis was completed using the curve estimation procedure evaluating linear and quadratic curve fit. RESULTS: There was no significant difference in the mean PTG scores between the three PTSS severity groups and no significant correlation of PTG with overall PTSS score and its clusters (re-experiencing, avoidance and increased arousal). PTG was positively associated with the fear of cancer recurrence. CONCLUSION: We did not find support for the direct relationship of PTG and PTSS but we suggest the possibility of connection between the two through the specific nature of PTSS in cancer survivors and their future-oriented intrusive thoughts overlapping with fear of cancer recurrence. These findings offer a novel perspective for future research on PTSS and PTG relationship.

Socialization of Coping in Pediatric Oncology Settings: Theoretical Consideration on Parent-Child Connections in Posttraumatic Growth.

This theoretical article aims to summarize the results of studies relevant to parental influence on coping with childhood cancer and provide implications for future research focused on parent-child connections in posttraumatic growth (PTG) following childhood cancer. Parental influence on child coping described by the socialization of coping and socialization of emotions theories has already been studied in connection with posttraumatic stress, but the role of parents in the process of PTG in the child has not been clearly described yet. Several studies focused on PTG in childhood cancer survivors and their parents simultaneously, but only two studies explicitly included a parent-child connection in PTG in statistical analysis. Studies suggest that child PTG may be facilitated through parental coping advice supporting emotion expression and that parent-child connection in PTG may be mediated by the child's subjective perception of the parents' PTG. More research is needed to describe specific strategies proposed by parents and leading to child PTG and design tailored interventions for the use in the clinical care of childhood cancer survivors and their family.

Neighborhood effects on internalizing and externalizing problems, and academic competence: a comparison of Roma and non-Roma adolescents.

OBJECTIVES: The current study tested the extent to which the neighborhood context influenced Roma youth adjustment (internalizing and externalizing problems, and academic competence) and whether ethnicity moderated these links and explained unique variance. METHODS: Cross-sectional data were collected from 369 Roma and non-Roma early and middle adolescents. RESULTS: Roma youth reported significantly lower SES, school grades, and academic aspirations. Perceived fear or concerns about neighborhood safety predicted all three internalizing problems, for both Roma and non-Roma adolescents; neighborhood acquaintanceship density and nighttime social activities predicted externalizing behaviors, for both ethnic groups; and finally, both ethnicity and nighttime social activities predicted school grades, while only ethnicity predicted academic aspirations. No significant by ethnicity interaction effects were found. CONCLUSIONS: Roma youth reported lower grades and academic aspirations, but no mean level differences were found in internalizing or externalizing problems by ethnicity. On the other hand, neighborhood variables were important for both groups of youth, and with the exception of measures of academic competence, ethnicity did not explain unique variance. Thus, developmental processes, the links between neighborhood variables and measures of adjustment, were highly similar in Roma and non-Roma youth.

Bulimia symptoms in Czech youth: prevalence and association with internalizing problems.

OBJECTIVE: Although clinical studies suggest that bulimia symptoms are common in youth, research on the prevalence of such symptoms and of their association with comorbid internalizing problems in the general population has been limited. This study aimed to evaluate the gender-specific prevalence of bulimia symptoms in Czech youth and explored the association between a clinical level of self-reported bulimia symptoms (CLBS) and internalizing problems by gender, controlling for age, socio-economic status and puberty status. METHOD: The study was conducted on a representative national sample of Czech youth (N = 4430, 57.0% female) using self-report scales. Multivariate analysis of covariance (MANCOVA) was used to examine the associations. RESULTS: The 3-month CLBS prevalence was higher in girls (11.4%) than in boys (3.8%) and in both genders a CLBS was associated with higher levels of comorbid internalizing problems. DISCUSSION: Timely recognition of bulimia symptoms and associated risk factors is important for early prevention and intervention strategies. LEVEL OF EVIDENCE: V, cross-sectional descriptive study (according to Oxford (UK) CEBM Levels of Evidence, 2011).

Diffusion Tensor Imaging And Tractography In Autistic, Dysphasic, And Healthy Control Children.

BACKGROUND: Diffusion tensor imaging (DTI) is a powerful tool for investigating brain anatomical connectivity. The aim of our study was to compare brain connectivity among children with autism spectrum disorders (ASD), developmental dysphasia (DD), and healthy controls (HC) in the following tracts: the arcuate fasciculus (AF), inferior frontal occipital fasciculus (IFOF), inferior longitudinal fasciculus (ILF), and uncinate fasciculus (UF). METHODS: Our sample consisted of 113 children with a mean age 8.7±2.2 years (77 boys, 36 girls), divided into three subgroups: ASD (n=39), DD (n=36), and HC (n=38). The International Classification of Diseases, 10th ed. was used to make clinical diagnoses. DTI images were collected using a 1.5 T Phillips Achieva MR imaging system. RESULTS: Detailed analyses of fractional anisotropy (FA) revealed significant differences among the ASD, DD, and HC groups in the left AF (p=0.014) and right AF (p=0.001), the left IFOF (p<0.001) and right IFOF (p<0.001), the left ILF (p<0.001) and right ILF (p<0.001), but not in the UF. Post-hoc analyses revealed three patterns of FA differences among the groups: (1) in the right AF, right IFOF, and right ILF, FA was significantly lower in the ASD group compared to the DD and HC groups; however, there was no difference in FA between DD and HC; (2) in the left AF and left IFOF, FA was significantly lower in the ASD than in the HC group, but there were no differences between DD vs HC nor DD vs ASD; and (3) in the left ILF, no difference in FA was seen between ASD and DD, but FA in both was significantly lower than in the HC. CONCLUSION: Microstructural white matter properties differed between ASD vs DD and HC subjects. The tract where FA impairment in ASD and DD subjects was the most similar was the left ILF.

Somatic symptoms and internalizing problems in urban youth: a cross-cultural comparison of Czech and Russian adolescents.

Background: Although the association between somatic complaints and internalizing problems (anxiety, somatic anxiety and depression) is well established, it remains unclear whether the pattern of this relationship differs by gender and in different cultures. The aim of this study was to examine cross-cultural and gender-specific differences in the association between somatic complaints and internalizing problems in youth from the Czech Republic and Russia. Methods: The Social and Health Assessment, a self-report survey, was completed by representative community samples of adolescents, age 12-17 years, from the Czech Republic (N = 4770) and Russia (N = 2728). Results: A strong association was observed between somatic complaints and internalizing psychopathology. Although the levels of internalizing problems differed by country and gender, they increased together with and largely in a similar way to somatic complaints for boys and girls in both countries. Conclusion: The association between somatic symptoms and internalizing problems seems to be similar for boys and girls across cultures.

Community violence exposure and substance use: cross-cultural and gender perspectives.

The negative effects of community violence exposure on child and adolescent mental health are well documented and exposure to community violence has been linked both to a number of internalizing and externalizing symptoms. Our aim was, therefore, to investigate cross-cultural and gender differences in the relationship between community violence exposure and substance abuse. A self-report survey was conducted among 10,575, 12-18 year old adolescents in three different countries, Czech Republic (N = 4537), Russia (N = 2377) and US (N = 3661). We found that in all three countries both substance use and problem behavior associated with it increased similarly along with severity of violence exposure and this association was not gender-specific. It was concluded that in spite of the differences in the levels of violence exposure and substance use cross-culturally and by gender, the pattern of their association is neither culturally nor gender bound.

Predictors of Posttraumatic Stress and Posttraumatic Growth in Childhood Cancer Survivors.

This longitudinal study aims to analyze predictors of posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among gender, age, objective factors of the disease and its treatment, family environment factors and negative emotionality. The sample consisted of 97 childhood cancer survivors (50 girls and 47 boys) aged 11-25 years who were in remission 1.7 to seven years at T1 and four to 12.5 years at T2. Survivors completed a set of questionnaires including the Benefit Finding Scale for Children and the University of California at Los Angeles Posttraumatic Stress Disorder Index. Regression and correlation analyses were performed. The relation between PTSS and PTG was not proven. A higher level of PTSS (T2) was associated with higher levels of negative emotionality (T1). A higher level of PTG (T2) was connected to a higher level of warmth in parenting (T1), female gender and older age at assessment. Medical variables such as the severity of late effects and the time from treatment completion did not play a significant role in the prediction of PTSS and PTG. PTG and PTSS are more influenced by factors of parenting and emotional well-being of childhood cancer survivors than by objective medical data.

Loneliness and its association with psychological and somatic health problems among Czech, Russian and U.S. adolescents.

BACKGROUND: Loneliness is common in adolescence and has been linked to various negative outcomes. Until now, however, there has been little cross-country research on this phenomenon. The aim of the present study was to examine which factors are associated with adolescent loneliness in three countries that differ historically and culturally-the Czech Republic, Russia and the United States, and to determine whether adolescent loneliness is associated with poorer psychological and somatic health. METHODS: Data from a school survey, the Social and Health Assessment (SAHA), were used to examine these relations among 2205 Czech, 1995 Russian, and 2050 U.S. male and female adolescents aged 13 to 15 years old. Logistic regression analysis was performed to examine if specific demographic, parenting, personal or school-based factors were linked to feeling lonely and whether lonely adolescents were more likely to report psychological (depression and anxiety) or somatic symptoms (e.g. headaches, pain). RESULTS: Inconsistent parenting, shyness, and peer victimisation were associated with higher odds for loneliness in at least 4 of the 6 country- and sex-wise subgroups (i.e. Czech, Russian, U.S. boys and girls). Parental warmth was a protective factor against feeling lonely among Czech and U.S. girls. Adolescents who were lonely had higher odds for reporting headaches, anxiety and depressive symptoms across all subgroups. Loneliness was associated with other somatic symptoms in at least half of the adolescent subgroups. CONCLUSION: Loneliness is associated with worse adolescent health across countries. The finding that variables from different domains are important for loneliness highlights the necessity of interventions in different settings in order to reduce loneliness and its detrimental effects on adolescent health.

Personality predictors of successful development: toddler temperament and adolescent personality traits predict well-being and career stability in middle adulthood.

The aim of the study was to predict both adaptive psychological functioning (well-being) and adaptive social functioning (career stability) in middle adulthood based on behaviors observed in toddlerhood and personality traits measured in adolescence. 83 people participated in an ongoing longitudinal study started in 1961 (58% women). Based on children's behavior in toddlerhood, three temperamental dimensions were identified - positive affectivity, negative affectivity and disinhibition. In adolescence, extraversion and neuroticism were measured at the age of 16 years. Various aspects of well-being were used as indicators of adaptive psychological functioning in adulthood: life satisfaction, self-esteem and self-efficacy. Career stability was used as an indicator of adaptive social functioning. Job careers of respondents were characterized as stable, unstable or changeable. Extraversion measured at the age of 16 proved to be the best predictor of well-being indicators; in case of self-efficacy it was also childhood disinhibition. Extraversion in adolescence, childhood disinhibition and negative affectivity predicted career stability. Findings are discussed in the context of a theoretical framework of higher order factors of the Big Five personality constructs, stability and plasticity.

Correlates of weapon carrying in school among adolescents in three countries.

OBJECTIVES: To determine the factors associated with weapon carrying in school among Czech, Russian, and US adolescents. METHODS: Logistic regression was used to analyze data drawn from the Social and Health Assessment (SAHA). RESULTS: Violent behavior (perpetration / victimization) was linked to adolescent weapon carrying in all countries. Substance use was associated with weapon carrying among boys in all countries. Greater parental warmth reduced the odds for weapon carrying among Czech and Russian adolescents. Associating with delinquent peers was important for weapon carrying only among US adolescents. CONCLUSIONS: Factors associated with weapon carrying in school vary among countries although violent behavior and substance use may be associated with weapon carrying across countries.

Psychometric properties of the Temperament and Character Inventory-Revised (TCI-R) in Czech adolescent sample.

The psychometric properties of the TCI-R method were investigated in a cohort of 15-year-old adolescents (n = 787). This is the lowest recommended age for using the adult version of the method. A factor analysis of the temperament and character scales was carried out on the basis of Principal Component Analysis with Varimax rotation. We compared our results with a previous TCI version which was used in the pilot study of 15-year-olds (n = 171), with established norms for the Czech adolescents and adults, and in regard to gender differences. The principal component analyses for all scales with eigenvalues ≥ 1 resulted in only a 6 factor structure, in contrast to the 7 factor structure postulated by Cloninger. But the factor solution, computed separately for temperament (4F) and character (3F), approximately reflected the Cloninger's model except for the temperament subscales NS1 (Exploration Excitability), RD1 (Sentimentality) and RD4 (Dependence), which load multiple factors, and the character subscale SD 4 (Self-acceptance), which loads the Cooperativeness factor. The internal consistency of the main TCI-R scales was excellent; the Cronbach's alpha varied from .83 (NS) to .89 (HA). However, for some subscales (NS4, RD4, and CO5) the consistency was rather weak. In our research, the previous version of TCI showed less satisfying psychometric properties than TCI-R did. In terms of gender differences, girls scored higher in NS, RD, HA, CO and ST, whereas boys scored higher in PS; no statistically significant differences for SD were found. In general, our results support the Cloninger's postulated 7 factor personality structure and the appropriateness of the TCI-R usage for 15-year-old adolescents.

Brief report: significant differences in perceived odor pleasantness found in children with ASD.

The aim of our study was to explore possible differences in estimation of odor pleasantness in children with autism spectrum disorders (ASD) compared to controls. Thirty-five patients with Asperger's syndrome and high functioning autism (mean age 10.8 ± 3.6 years; 31 boys) were compared with 35 healthy control subjects (mean age 10.4 ± 2.4 years; 28 boys). Odor pleasantness was assessed on a 5-point scale using the Sniffin' Sticks test (Identification part of the test). Patients with ASD, compared to healthy controls, perceived the smell of cinnamon and pineapple as significantly less pleasant (p < 0.05); at the trend level, the same was true of cloves (p < 0.1). The possibility of olfactory dysfunctions as an autism biomarker is discussed.

Perceptions of aging across 26 cultures and their culture-level associates.

College students (N=3,435) in 26 cultures reported their perceptions of age-related changes in physical, cognitive, and socioemotional areas of functioning and rated societal views of aging within their culture. There was widespread cross-cultural consensus regarding the expected direction of aging trajectories with (a) perceived declines in societal views of aging, physical attractiveness, the ability to perform everyday tasks, and new learning; (b) perceived increases in wisdom, knowledge, and received respect; and (c) perceived stability in family authority and life satisfaction. Cross-cultural variations in aging perceptions were associated with culture-level indicators of population aging, education levels, values, and national character stereotypes. These associations were stronger for societal views on aging and perceptions of socioemotional changes than for perceptions of physical and cognitive changes. A consideration of culture-level variables also suggested that previously reported differences in aging perceptions between Asian and Western countries may be related to differences in population structure.

Weight gain associated with atypical and typical antipsychotics during treatment of adolescent schizophrenic psychoses: A retrospective study.

OBJECTIVES: The aim of the study was to assess weight changes associated with certain atypical (AAP) and typical (TAP) antipsychotic drugs in patients with early-onset schizophrenia and other related psychotic disorders. METHODS: Our retrospective study included 109 patients (52 boys, 57 girls) with a mean age of 15.8 +/- 1.6 years. The patients were evaluated based to their medical records prior to starting therapy, and then after 1, 3, and 6 weeks of treatment. RESULTS: During the first week of treatment, the AAP group (n = 85; risperidone, olanzapine, ziprasidone, and clozapine) gained 1.5% of baseline weight whereas the TAP group (n = 24; haloperidol, perphenazine, and sulpiride) gained only 0.2% (p = 0.049). Differences in relative changes between the two groups were not significant at weeks 3 and 6. Expressed as absolute values, patients in our sample gained an average of 3.4 kg (SD 3.2) on AAP and 2.0 kg (SD 3.9) on TAP during 6 weeks of treatment (p = 0.335). Only the risperidone, olanzapine, and clozapine groups had sufficient numbers of patients to allow a comparison at the endpoint of the study (week 6). The patients gained, on average, 3.6 kg (SD 2.6) on risperidone, 4.4 kg (SD 2.5) on olanzapine, and 2.1 kg (SD 4.0) on clozapine during the six weeks of treatment (p = 0.286). CONCLUSIONS: In our study, we did not find a difference in weight gain between the AAP and TAP groups, as large as has been described in the literature. It also seems plausible that the unique and variable weight changes associated with individual AAPs in the pediatric population are different from those observed in the adult population.