title: Coping strategies of retinoblastoma survivors in relation to behavioural problems.
abstract: OBJECTIVE
  To assess coping strategies of long-term retinoblastoma (RB) survivors and explore determinants of behavioural functioning, including medical, socio-demographic and coping variables.
  
  
  METHODS
  This population-based cross-sectional study included 117 RB survivors (12-35 years), registered in the Dutch national RB register. Survivors were asked to fill in coping, social support and behavioural questionnaires, and situational characteristics were obtained from medical archives and from an interview. Prevalence rates of coping strategies were computed based on self-reports. One-sample t-tests were applied to analyse differences in the use of coping strategies compared with healthy reference samples. Multiple regression analyses were performed to identify various determinants for behavioural problems within the RB sample.
  
  
  RESULTS
  RB survivors differed from their healthy reference group in one coping style, i.e. they showed significantly less emotion-oriented coping behaviour. Adolescents who came from a single-parent family and/or experienced lower social support and used more emotion-oriented coping reported more total problem behaviour. More internalizing problems were reported for adolescents who experienced less social support and less acceptance of the disease. For adults, more life events, emotion-oriented coping and lower social support explained more total problem behaviour, especially internalizing problems.
  
  
  CONCLUSIONS
  RB survivors showed less emotion-oriented coping behaviour compared with the reference group. Behavioural problems are best determined by emotion-oriented coping, social support, life events other than RB and acceptance of the disease, and not by medical variables. Therefore, these variables should be taken into consideration during interventions for this group.
authors.affiliation: Department of Medical Psychology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands. jennifer.vandijk@vumc.nl
authors.forename: J
authors.initials: J
authors.lastname: van Dijk
authors.forename: M A
authors.initials: MA
authors.lastname: Grootenhuis
authors.forename: S M
authors.initials: SM
authors.lastname: Imhof
authors.forename: P T
authors.initials: PT
authors.lastname: Cohen-Kettenis
authors.forename: A C
authors.initials: AC
authors.lastname: Moll
authors.forename: J
authors.initials: J
authors.lastname: Huisman
mesh_terms: D000223:Adaptation, Psychological; D000275:Adjustment Disorders / Q000175:diagnosis / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000523:psychology*; D003430:Cross-Sectional Studies; D003674:Defense Mechanisms; D005260:Female; D006801:Humans; D007389:Internal-External Control; D007406:Interview, Psychological; D008016:Life Change Events; D008297:Male; D010555:Personality Inventory / Q000706:statistics & numerical data; D011340:Problem Solving; D011594:Psychometrics; D019572:Retinal Neoplasms / Q000523:psychology* / Q000628:therapy; D012175:Retinoblastoma / Q000523:psychology* / Q000628:therapy; D015406:Single Parent / Q000523:psychology; D012917:Social Adjustment; D012944:Social Support; D017741:Survivors / Q000523:psychology*; D055815:Young Adult