The Effects of Pediatric Acute Lymphoblastic Leukemia on Social Functioning

130 Pages·2017·1.26 MB·English

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All Graduate Theses and Dissertations Graduate Studies
5-2012
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Rachel L. Duchoslav
Utah State University
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Investigation Into the First Year of Treatment" (2012). All Graduate Theses and Dissertations. 1256.
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THE EFFECTS OF PEDIATRIC ACUTE LYMPHOBLASTIC LEUKEMIA ON

SOCIAL FUNCTIONING: AN INVESTIGATION INTO THE

FIRST YEAR OF TREATMENT

by

Rachel L. Duchoslav

A dissertation submitted in partial fulfillment
of the requirement for the degree

of

DOCTOR OF PHILOSOPHY

in

Psychology

Approved:

Clinton E. Field, Ph.D. M. Scott DeBerard, Ph.D.
Major Professor Committee Member

Gretchen G. Peacock, Ph.D. David M. Stein, Ph.D.
Committee Member Committee Member

J. Dennis Odell, M.D. Mark R. McLellan, Ph.D.
Committee Member Vice President for Research and
Dean of the School of Graduate Studies

UTAH STATE UNIVERSITY
Logan, Utah

2012
ii
Copyright © Rachel L. Duchoslav 2012

All Rights Reserved
iii
ABSTRACT

The Effects of Pediatric Acute Lymphoblastic Leukemia on Social Functioning:
An Investigation into the First Year of Treatment

by

Rachel L. Duchoslav, Doctor of Philosophy
Utah State University, 2012

Major Professor: Clinton E. Field, Ph.D.
Department: Psychology

Cancer is currently the leading cause of death by disease in children under the age
of 15 in the US. While the number of childhood cancer survivors continues to grow,
psychological research on this population has lagged. Existing research on the
psychosocial effects of childhood cancer is marked by inconsistent conclusions as well as
methodological limitations. However, the effect of childhood cancer on social
functioning is one area with relatively more consistency. Existing research suggests that
childhood cancer can lead to deficits in prosocial skills as well as the emergence of social
problems. The present study investigated individual change in social functioning for five
children diagnosed with Acute Lymphoblastic Leukemia ALL) over the first year of
treatment compared to healthy control peers. Children with cancer demonstrated a
iv
decrease in social activity as well as an unexpected increase in social skills not
demonstrated by healthy control children.
(129 pages)
v
PUBLIC ABSTRACT

The Effects of Pediatric Acute Lymphoblastic Leukemia on Social Functioning:
An Investigation into the First Year of Treatment

by

Rachel L. Duchoslav, Doctor of Philosophy
Utah State University, 2012

Cancer is currently the leading cause of death by disease in children under the age
of 15 in the US. While the number of childhood cancer survivors continues to grow,
psychological research on this population has lagged. Existing research on the
psychosocial effects of childhood cancer is marked by inconsistent conclusions as well as
methodological limitations. However, the effect of childhood cancer on social
functioning is one area with relatively more consistency. Existing research suggests that
childhood cancer can lead to deficits in prosocial skills as well as the emergence of social
problems.
The present study investigated individual change in social functioning for five
children diagnosed with Acute Lymphoblastic Leukemia (ALL) over the first year of
treatment compared to healthy control peers. This investigation sought to answer the
following research questions.
1. Following diagnosis and during the first year of treatment, do children with
Acute Lymphoblastic Leukemia (ALL) display diminished levels of prosocial skills?
vi
2. Following diagnosis and during the first year of treatment, do children with
Acute Lymphoblastic Leukemia (ALL) display increased levels of social problems?
3. Do children with Acute Lymphoblastic Leukemia (ALL) display patterns of
social functioning that are different relative to control children during their first year of
treatment?
Children with cancer demonstrated a decrease in social activity as well as an
unexpected moderate increase in social skills not demonstrated by healthy control
children. If substantial future research supports these initial findings, encouraging data
could be presented to families of children with cancer. The knowledge that a diagnosis of
cancer is not equivalent to likely future social deficits may allay parent and child
concerns, and may allow for more natural, less stressful, interactions throughout the
cancer experience. This current research was unfunded.
vii
ACKNOWLEDGMENTS

Thank you to my wonderful husband, Jon. You have helped me every step of the
way down this very long road. I am so blessed to have you in my life. For the
unwavering support of my loving family and excellent friends—thank you for everything.
Thank you to my committee members, for your invaluable guidance, support, and
expertise during the completion of this dissertation. I am truly grateful. Also, thank you
Dr. Paul Colte for your enthusiastic collaboration and for making access to this pediatric
oncology population possible.
Rachel Lynn Duchoslav
viii
CONTENTS

Page

ABSTRACT ................................................................................................................... iii

PUBLIC ABSTRACT ................................................................................................... v

ACKNOWLEDGMENTS ............................................................................................. vii

LIST OF TABLES ......................................................................................................... x

LIST OF FIGURES ....................................................................................................... xi

CHAPTER

I. INTRODUCTION .......................................................................................... 1

II. REVIEW OF LITERATURE ......................................................................... 6

Introduction to Childhood Cancer .................................................................. 6
General Psychological Effects of Childhood Cancer ...................................... 8
Social Functioning .......................................................................................... 17
Effects of Childhood Cancer on Social Functioning ...................................... 24
Summary and Conclusions ............................................................................. 35

III. METHODOLOGY ......................................................................................... 38

Participants ...................................................................................................... 38
Measures ......................................................................................................... 40
Procedure ........................................................................................................ 42
Analysis........................................................................................................... 44

IV. RESULTS ....................................................................................................... 46

Empirical Question #1 .................................................................................... 47
Empirical Question #2 .................................................................................... 53
Empirical Question #3 .................................................................................... 56

V. DISCUSSION ................................................................................................. 75

Prosocial Skills ............................................................................................... 76
Social Problems .............................................................................................. 81
ix
Page

Additional Findings ........................................................................................ 83
Limitations ...................................................................................................... 87
Implications and Future Research ................................................................... 88

REFERENCES .............................................................................................................. 91

APPENDIX .................................................................................................................... 96

CURRICULUM VITAE ................................................................................................ 111