Coping in long-term survivors of childhood cancer: relations to psychological distress.

OBJECTIVE: The goal of this study was to describe coping strategies and their associations with psychological distress in young adult survivors of childhood cancer.
METHODS: One hundred and sixty-four childhood cancer survivors, at least 7 years after diagnosis, completed questionnaires assessing demographics, health information, psychological distress, and different ways of coping (return rate: 61%). The Brief Symptom Inventory-18 (BSI-18) and the Post-traumatic Diagnostic Scale's (PDS) eight-item short form were used to measure psychological distress. Coping was assessed with the Cognitive Control Strategies Scale (CCSS), the Illness Perception Questionnaire-Revised (IPQ-R), and the White Bear Suppression Inventory (WBSI).
RESULTS: Higher levels of distress were associated with the female sex, not being in a relationship, and with the presence of medical late effects. These predictors explained 12% of the variance in psychological distress. When coping variables were also entered into the equation, the amount of explained variance increased to 50%. The most important determinants of psychological distress in our sample were a tendency to suppress negative thoughts and a low level of optimism.
CONCLUSION: These results contribute to a better understanding of the correlates of difficulties in long-term psychological adjustment after childhood cancer. Cognitive strategies, which are associated with or may increase the risk for concurrent psychological distress, in specific, avoidance of negative thoughts and a lack of positive future expectations, should be addressed in psychological counseling with survivors suffering from symptoms of distress.