(PS8-A22) A Longitudinal Examination of Effects of Parent Emotion Socialization on Child Psychopathology During Pediatric Cancer Treatment

Objective: The first year after a diagnosis of pediatric cancer can be a period of intense, uncontrollable stress for the entire family. Some children with cancer show elevated symptoms of psychopathology during the first year, with a subset in the at-risk or clinical range of internalizing symptoms. Previous studies indicate that greater parent awareness, acceptance, and coaching of emotions predict fewer child symptoms of psychopathology, but it is unknown whether the same pattern extends to the context of pediatric cancer or whether the effects of these behaviors differ based on the intensity of treatment. The current study assessed parent emotion socialization as a potential protective factor for child adjustment during the first year of pediatric cancer treatment and examined whether this association varied as a function of treatment intensity.

Method: Families of children newly diagnosed with cancer (N = 159; Mage = 5.6 years; range = 2-17 years) were recruited from two children’s hospitals to participate in a longitudinal study. Primary caregivers provided monthly questionnaire reports of child internalizing, externalizing, and post-traumatic stress symptoms for one year post-diagnosis. Data from medical charts were used to assign an Intensity of Treatment Rating (ITR-3). At month 3, the Parent Meta-Emotion Interview was used to assess emotion socialization (i.e., awareness and acceptance of their own negative emotions and awareness, acceptance, and coaching of their child’s negative emotions). Multilevel models were used to test whether each emotion socialization behavior was associated with the level and trajectory of child psychopathology, with treatment intensity as a moderator.

Results: Treatment intensity significantly moderated the associations between caregiver awareness (b = 5.23, p = .01) and acceptance (b = 5.77, p = .01) of their own emotions, as well as acceptance (b = 6.65, p = .006) and coaching (b = 6.36, p = .005) of child emotions and child internalizing symptoms at the end of the first year. At higher levels of treatment intensity, caregivers’ awareness of their own negative emotions predicted significantly greater child internalizing symptoms. At lower levels of treatment intensity, acceptance of own and children’s negative emotions and coaching of children’s negative emotions predicted significantly lower child internalizing symptoms. Treatment intensity did not moderate the association between emotion socialization and child externalizing or post-traumatic stress symptoms.

Conclusion: Although caregiver awareness, acceptance, and coaching of negative emotions seems to be adaptive for children undergoing less intense treatment, these approaches may be counterproductive in the face of high-intensity treatment. Alternatively, caregivers who engage more in these behaviors may be more responsive to their children’s emotions during times of intense treatment, resulting in greater recognition of children’s internalizing symptoms. Future research should examine the long-term impact of caregiver responses to emotions when managing intense stressors such as medical treatment to inform interventions that help caregivers effectively support their children.