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Supportive Care in Cancer
Published in: Supportive Care in Cancer 11/2016

Open Access 01-11-2016 | Original Article

Predicting trajectories of behavioral adjustment in children diagnosed with acute lymphoblastic leukemia

Authors: Simone M. Sint Nicolaas, Peter M. Hoogerbrugge, Esther M. M. van den Bergh, José A. E. Custers, Sofia Gameiro, Reinoud J. B. J. Gemke, Chris M. Verhaak

Published in: Supportive Care in Cancer | Issue 11/2016

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Abstract

Purpose

Previous research showed that children with cancer are at risk for developing behavioral adjustment problems after successful treatment; however, the course of adjustment remains unclear. This study focuses on adjustment trajectories of children during treatment for acute lymphoblastic leukemia (ALL) and aims to distinguish subgroups of patients showing different trajectories during active treatment, and to identify sociodemographic, medical, and psychosocial predictors of the distinct adjustment trajectories.

Methods

In a multicenter longitudinal study, 108 parents of a child (response rate 80 %) diagnosed with ALL were assessed during induction treatment (T0), after induction/consolidation treatment (T1), and after end of treatment (T2). Trajectories of child behavioral adjustment (Child Behavior Checklist; CBCL) were tested with latent class growth modeling (LCGM) analyses.

Results

For internalizing behavior, a three-trajectory model was found: a group that experienced no problems (60 %), a group that experienced only initial problems (30 %), and a group that experienced chronic problems (10 %). For externalizing behavior, a three-trajectory model was also found: a group that experienced no problems (83 %), a group that experienced chronic problems (12 %), and a group that experienced increasing problems (5 %). Only parenting stress and baseline QoL (cancer related) were found to contribute uniquely to adjustment trajectories.

Conclusions

The majority of the children (77 %) showed no or transient behavioral problems during the entire treatment as reported by parents. A substantial group (23 %) shows maladaptive trajectories of internalizing behavioral problems and/or externalizing behavioral problems. Screening for risk factors for developing problems might be helpful in early identification of these children.
Appendix
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Metadata
Title
Predicting trajectories of behavioral adjustment in children diagnosed with acute lymphoblastic leukemia
Authors
Simone M. Sint Nicolaas
Peter M. Hoogerbrugge
Esther M. M. van den Bergh
José A. E. Custers
Sofia Gameiro
Reinoud J. B. J. Gemke
Chris M. Verhaak
Publication date
01-11-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 11/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3289-9

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