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Childhood cancer and its treatment have been identified as significant stressors for individuals and families. The impact of this experience on healthy siblings has not been clearly determined. This study was designed to assess siblings regarding their adjustment and their perceptions of their families following a sick sibling's treatment. Standardized measures were used to facilitate comparisons. Siblings of children who survived cancer (n=25) were compared with siblings of children who died of cancer (n=24) so as to understand the complexities of the experience relative to treatment outcome. Subjects were 49 siblings, ranging in age from 10 to 20 years, and their parents. Results indicate that siblings reported levels of behavioral disturbance which did not significantly differ from those of a contrast group of children referred for psychological services. However, siblings did not differ significantly from a normative group in terms of self-image adjustment. Minimal adjustment differences were found between bereaved siblings and nonbereaved siblings with bereaved siblings reporting poorer adjustment only in the area of body image. Similarly, no significant gender effects on sibling adjustment were found. Results suggest a preponderance of similarity in adjustment for bereaved and nonbereaved siblings. (Author/RJM)

Studies of parents of children treated for cancer have rarely included adequate samples of fathers or couples. Further, bereaved parents have been over-represented as compared to parents of cancer survivors. This study investigated the personal and interpersonal effects of having a child treated for cancer on 124 parents. Twenty-seven married couples were bereaved and 33 married couples were nonbereaved. Four bereaved parents without spouses were also included. All survivors had been off-treatment for at least 6 months and the average time since diagnosis was 6 years. Effects at the personal level-psychological distress-were assessed by self-report on one global scale and 7 subscales of the Brief Symptom Inventory (BSI). Effects at the interpersonal level-marital satisfaction-were assessed by self-report on the summary scale and 2 factors of the Martial Adjustment Test. Mothers and fathers reported higher levels of psychological distress than nonpatient norms, but lower levels than outpatient psychiatric norms. Fathers reported lower levels of marital satisfaction than nonreferred male norms; mothers did not differ from norms on marital satisfaction. Matched pairs t-tests on 60 couples demonstrated no differences between mothers and fathers in terms of levels of psychological distress and marital satisfaction. Bereaved and nonbereaved mothers did not differ on reported levels of psychological distress after controlling for the effects of time since diagnosis. This time effect appeared to be more salient for mothers, with mothers of more recently diagnosed children reporting higher levels of distress. Bereaved fathers did report higher levels of psychological distress on several BSI subscales than did nonbereaved fathers; no effect of time since diagnosis was observed for fathers. After a median split into high and low on the distress dimension, bereaved mothers reporting higher psychological distress also reported lower satisfaction with their marriages. Fathers reporting higher levels of psychological distress also reported lower marital satisfaction, but this was true of both bereaved and nonbereaved fathers. The results reveal some areas of similarity in outcome for bereaved and nonbereaved parents and for mothers and fathers of children treated for cancer. There are suggestions, however, of differential processes for mothers and fathers in terms of the effects of time since diagnosis, treatment outcome, and personal distress on satisfaction with the marital relationship. The results are suggestive of the complexities of parental coping with childhood cancer and the need for greater specificity and continued study. (Author)

Whereas aggressive multimodal therapies are responsible for improved survival rates of children and adolescents diagnosed with cancer, concern has grown regarding the potential for adverse and delayed developmental effects resulting from these treatments. In light of this concern, this study assessed 207 adult survivors of childhood cancer in terms of their resolution of developmental stage conflicts and capacity for intimacy. The research marked the first large scale study of the developmental impact of the diagnosis and treatment of childhood cancer on long-term survivors. Results suggest that adult survivors followed an essentially normal developmental profile. Older male long-term survivors, however, were experiencing developmental disruptions when compared to the other age and gender groups. These disruptions included a focus on short-term gratification, little investment in long-term goals, low satisfaction with life, and the belief that life has been characterized by lost opportunities. The older male survivor profile also suggests a perception of the world as unsafe and threatening, and they reported feeling distrustful and isolated. Although findings agree with prior reports of essentially normal functioning and adjustment in adult long-term survivors, older male survivors appear to be reporting developmental distress in numerous areas. (RJM)

Self-initiation of activities by individuals may have an affect on their mood. To study the relationship between the appraisal of self-initiated activities and dimensions of positive or negative affect 36 graduate students (22 female and 14 male) engaging in a total of 202 activities appraised dimensions of the activities and responded to a 60-adjective Mood Checklist (M. A. Zevon and A. Tellegen) before and after each activity. Activities reported were academic, leisure, work related, daily living, and miscellaneous pursuits. Results showed that the expectation of pleasure and control over participation appraisal dimensions were important in accounting for post-activity positive affect but not for post-activity negative affect. The subject's usual level of enjoyment in the activity was not an important contributor to post-activity positive affect. Overall, the results lend support to the distinction between self-initiated and prompted engagement in activity and their effects on mood. (BH)

This study was conducted to examine the influence of medical, psychological, and familial factors on the coping of pediatric cancer patients. Participants were 36 pediatric cancer patients and their families under active treatment at Roswell Park Memorial Institute, a comprehensive cancer research and treatment center in Buffalo, New York. The Coping Inventory, Ways of Coping Scale, Locke-Wallace Marital Adjustment Inventory, and a Medical Index were used to assess patient's coping competence and medical experience as well as each parent's coping strategies and marital satisfaction ratings. The results revealed that coping competence was positively related to age among males while coping among females appeared to be independent of age. Self-coping among patients appeared to be strongly and negatively affected primarily by treatment side effects. The quality of the parents' marital relationship was significantly related to the child's coping competence, while parental coping strategies appeared to have much less influence. The findings raise questions about the potential benefits of intervening solely at the level of parental coping, at least when the intent is to improve the child's adjustment to illness. The results suggest that family health interventions need to be specific with regard to target outcomes at the individual, family sub-unit, and overall family levels. (NB)

High levels of stress experienced by primary care oncology nursing staff, and the competency impairment which results from such stress, has become a matter of much concern in health care settings. This study was conducted to identify the coping strategies employed by oncology nurses, and to relate these strategies to differential indices of stress and burnout. Oncology nurses (N=133) at a comprehensive cancer center completed the Ways of Coping (WC) Checklist, the Job-Related Tension Index, the Emotional Exhaustion Scale, the Role Conflict scale, the Job Involvement scale, and the Home-Work Conflict scale. The Job Involvement scale showed a clear and positive relationship to five of the eight WC scales (Self-Controlling, Seeking Social Support, Accepting Responsibility, Planful Problem-Solving, and Positive Reappraisal), all of which contained coping responses characterized by constructive engagement. Role conflict, stress, and burnout indices were most strongly and positively associated with the WC scales of Confrontive Coping, Distancing, Accepting Responsibility, and Escape-Avoidance scales, and negatively associated with the Planful Problem-Solving scale. Type of coping response was differentially related to the level of reported stress and burnout. Increased use of emotional-focused coping responses was related to increased reports of stress and burnout. (NB)

The study investigated the family environment of 19 noninstitutionalized learning disabled children (mean age 12 years). Parents of Ss completed a demographic data form and the Family Environment Scale (FES), a published inventory which assesses the social climate of a family. A major finding was the lack of any significant stress or disorder. Families were characterized by a substantially below average score on conflict, by a strong emphasis on ethical and religious values, by a below average emphasis on active recreation, and by a moderate emphasis on family cohesion and support. The mean incongruence score indicated a greater agreement in perceived family climate than was typical of the standardization sample. FES profiles are appended. (SB)

Mood induction procedures have been widely used as laboratory analogues of depression. This study evaluated the effectiveness of the Velten depression mood induction (VMI) procedure and a personal recall depression induction (PRI) procedure. In contrast to prior research, mood was assessed in terms of two independent dimensions: positive affect and negative affect. College students (N=31) were assigned to one of two groups. Group I completed the VMI and then, one week later, completed the PRI. Subjects in Group II participated in the PRI first and the VMI one week later. Subjects completed the Mood Checklist and were assessed at three points (preinduction, immediately postinduction, and one hour after induction). Analyses showed that both mood induction procedures were equally effective. Significant differences were found, however, for the two affect dimensions with positive affect more reactive than negative affect at the immediate posttest and one hour posttest assessments. These results clearly support the importance of the positive affect dimension in the study of depression. (Author/NB)