title: Coping in long-term survivors of childhood cancer: relations to psychological distress.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: University Medical Center, Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, Freiburg, Germany. kerstin.wenninger@uniklinik-freiburg.de
authors.forename: Kerstin
authors.initials: K
authors.lastname: Wenninger
authors.forename: Almut
authors.initials: A
authors.lastname: Helmes
authors.forename: Jürgen
authors.initials: J
authors.lastname: Bengel
authors.forename: Melchior
authors.initials: M
authors.lastname: Lauten
authors.forename: Susanne
authors.initials: S
authors.lastname: Völkel
authors.forename: Charlotte M
authors.initials: CM
authors.lastname: Niemeyer
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000175:diagnosis / Q000523:psychology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012959:Socioeconomic Factors; D013313:Stress Disorders, Post-Traumatic / Q000209:etiology* / Q000523:psychology; D013315:Stress, Psychological / Q000453:epidemiology / Q000209:etiology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D013997:Time Factors