Mothers Coping with Childhood Cancer in the Context of Sociodemographic Disadvantage: Interactive and Longitudinal Effects on Depressive Symptoms

Abstract

The present study integrated and expanded upon two previously separate lines of research on stress and coping processes endemic to mothers faced with two significant sources of stress: mothers coping with a child’s cancer diagnosis and treatment within the context of sociodemographic disadvantage. Through the use of multiple interaction models, the goal of this study was to elucidate contextual and personal risk factors for psychological distress among mothers of children with cancer in order to effectively identify and assist families in need. Mothers of children with cancer (N = 209) completed measures of demographics, cancer-related stress, and secondary control coping both near the time of their child’s diagnosis (M = 2.04 months; time 1) and 12 months later (time 2). A cumulative sociodemographic disadvantage index was created to assess the cumulative impact of sociodemographic factors including single parenthood, income, and education. The interactive effects of these three variables on depressive symptoms were examined in both cross-sectional and longitudinal analyses.

At time 1, a three-way interaction emerged such that the greatest risk for depressive symptoms was associated with a combination of high sociodemographic disadvantage, high cancer-related stress, and low use of secondary control coping strategies. At time 2 there was no significant three-way interaction, however the moderating effect of coping persisted such that secondary control coping separately interacted with sociodemographic disadvantage and cancer-related stress to predict distress two-way interactions. In prospective analyses from time 1 to time 2, only significant main effects for mothers’ time 1 symptoms and secondary control coping were significant predictors of symptoms one year later.

This study highlights the importance of rigorously incorporating consideration of sociodemographic disadvantage into research among mothers facing a child’s cancer diagnosis and treatment. Further, results suggest that use of secondary control coping strategies serves as an effective buffer against the risk for psychological distress conferred by sociodemographic disadvantage and heightened cancer-related stress both near the time of diagnosis and 12 months later. Implications for screening, intervention, and policy are discussed.