Survivors of childhood cancer and comparison peers: the influence of peer factors on later externalizing behavior in emerging adulthood.
OBJECTIVE
To examine group differences and predictors of externalizing behavior and substance use during the transition to emerging adulthood (i.e., ages 18-25) among survivors of childhood cancer and comparison peers.


METHODS
Peer acceptance and social behavior were assessed in classrooms of 55 children (ages 8-15) during cancer treatment. Children with cancer, comparison peers (n = 60), and parents completed measures of externalizing behavior and/or substance use during an initial home visit and soon after participants turned 18.


RESULTS
At follow-up, survivors and peers exhibited similar externalizing behaviors and substance use, except peers were more likely to use marijuana. Substance use was associated with earlier peer acceptance and social behavior. Survivors who were older at diagnosis were at greater risk for later externalizing behavior and substance use.


CONCLUSIONS
Mean externalizing behaviors and substance use generally fell within normative ranges for both survivors and peers. Some survivors may benefit from interventions to reduce risk behavior.
Thompson
Amanda L
AL
Center for Biobehavioral Health, The Research Institute at Nationwide Children's Hospital and The Ohio State University, Columbus, OH 43205-2696, USA.
Gerhardt
Cynthia A
CA
Miller
Kimberly S
KS
Vannatta
Kathryn
K
Noll
Robert B
RB