Long-term Predictors and Consequences of Optimal Psychological Outcomes in Childhood Cancer Survivors

The goal of this dissertation is to examine predictors and consequences of optimal psychological outcomes in childhood cancer survivors. This goal was pursued according to the following three specific aims: 1) to test whether posttraumatic growth (PTG) is distinct from life satisfaction, 2) to examine predictors of PTG and life satisfaction in adolescence, and 3) to assess effects of PTG and life satisfaction in adolescence on future psychological and health functioning later in emerging adulthood. A sample of 2802 childhood cancer survivors from the largest dataset of childhood cancer survivors lead by St Jude Research Hospital was followed for more than 10 years at three different time points: 1996, 2003, and 2007. Confirmatory Factor Analyses were performed to identify the relationship between PTG and life satisfaction while Structural Regression Modeling was performed to identify the predictors and outcomes of PTG and life satisfaction. Results of the study showed that PTG and life satisfaction were slightly correlated but formed distinct constructs. The significant predictors from adolescence of high amount of PTG were older age at diagnosis, having medical issues, facing recurrence of cancer, and being diagnosed with blood cancer. In addition, higher PTG forecasted lower health perception in 2007. However, all the effects were small. The significant predictors from adolescence of higher life satisfaction were lower mental health issues, lower medical issues, higher social skills, and blood cancer as a type of cancer diagnosis. Higher life satisfaction forecasted lower mental health issues, higher health perception, lower pain, and lower somatization. Therefore, this study brought more insight on the long-term effects of PTG and life satisfaction for childhood cancer survivors. In particular, these findings showed that being satisfied with life could help childhood cancer survivors to have less psychological issues and a better perception of health in the future. These relationships can provide guidance to mental health practitioners for therapies focusing on improving life satisfaction as a way to decrease anxiety, depression, somatization, and pain of childhood cancer survivors