Commentary: The Psychological Impact of Pediatric Cancer Hardiness, the Exception or the Rule?a

This commentary was written as a result of our participation in the Symposium on the Psychosocial and Neurocognitive Consequences of Childhood Cancer in honor of our colleague, Raymond Mulhern, who was a major leader in the field. The commentary has two purposes: (a) to briefly review research findings regarding psychosocial functioning of children and adolescents with cancer and other severe chronic illnesses; and (b) to propose a theoretical rationale that could account for an increasingly compelling and consistent body of research that consistently does NOT identify psychopathology or dysfunction in these children despite exposure to major challenges and trauma. Since much of our research (R.B.N./M.J.K.) has already been published, we simply wanted to refer to the studies whose results suggest that most children with cancer adapt well in comparison to normative data; we have reported similar findings for other medical conditions such as sickle cell disease (Noll et al., 1996; Noll, Reiter-Purtill, Vannatta, Gerhardt, & Short, 2007), juvenile rheumatoid arthriti