Investigating Parent Reactions to Childrens Distress in the Context of Stressful Life Events and Childhood Cancer: A Person-Centered Approach

This study examined children’s perceptions of how caregivers reacted to their expression of distress resulting from their self-identified most stressful life event. Perceptions of parental reactions were first categorized according to children’s cancer history (cancer group versus healthy comparison group) and type of event (cancer- versus non-cancer-related event) before identifying profiles of perceived caregiver reactions. Participants included 159 children and adolescents with a history of cancer and 45 children and adolescents without history of serious illness (8-17 years of age). Children reported on their perception of their caregivers’ reaction to their stressful event-related distress, as well as their cumulative stressful life events, positive and negative affect, family functioning (conflict, cohesion, and expressiveness), distress resulting from the stressful event (posttraumatic stress symptoms [PTSS]), and challenge-related growth. Caregivers reported their own mental health (depression, anxiety, PTSS), cumulative stressful life events, positive and negative affect, and the quality of the parent-child relationship. Children with cancer history who self-identified a cancer-related event as most stressful perceived their caregiver as reacting with more support and override than either children with cancer identifying a non-cancer event or their healthy comparison peers. No significant differences emerged for children in the cancer versus healthy comparison group when reporting a non-cancer related event. Latent profile analysis revealed three profiles of child-reported parent reactions: Supportive (74%), Variety (14%), and Non-Response (12%). These profiles generally did not significantly relate to child, parent, and family functioning factors. However, profiles differed in mean levels of children’s PTSS and challenge-related growth. A supportive pattern of caregiver reactions was related to low PTSS and high challenge-related growth. Findings highlight caregiver supportive responding to children’s distress as a possible mechanism facilitating resilience and growth, with caregiver responding thus emerging as a candidate for interventions targeting children’s adjustment