title: Emotional distress in parents of long-term survivors of childhood acute lymphoblastic leukemia.
abstract: OBJECTIVE
  The current study investigated the occurrence of emotional distress in parents of long-term survivors of childhood acute lymphoblastic leukemia (ALL) and identified factors associated with parent emotional distress symptoms.
  
  
  METHODS
  Parents of 127 long-term survivors of childhood ALL treated on a chemotherapy-only protocol at St. Jude Children's Research Hospital participated in the study. Parents completed standard ratings of emotional distress, caregiver strain, and child physical, emotional, and psychosocial functioning. Multivariable hierarchical linear regression analyses were used to examine associations between symptoms of caregiver strain, survivor functioning, and parent emotional distress. Covariates included parent education, survivor age, survivor sex, and time since childhood cancer diagnosis.
  
  
  RESULTS
  On average, few parents reported significant symptoms of emotional distress. Clinically significant levels of anxiety and depression were reported by 7.1% and 3.1% of parents, respectively. Only 3.9% of parents endorsed significant symptoms of posttraumatic stress. Perceived caregiver strain was significantly associated with symptoms of parent anxiety, depression, and posttraumatic stress. Parent-report of child emotional functioning was significantly associated with symptoms of parent anxiety.
  
  
  CONCLUSIONS
  Most parents of long-term survivors of ALL exhibit low levels of emotional distress in the context of rates observed in the general population. Perceived caregiver strain was significantly associated with parent emotional distress. Further research is required to examine specific sources of caregiver strain, as well as other risk and protective factors associated with parent emotional distress symptoms.
authors.affiliation: Department of Psychology, Rhodes College, Memphis, TN, USA.
authors.forename: Adele V
authors.initials: AV
authors.lastname: Malpert
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Cara
authors.initials: C
authors.lastname: Kimberg
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Joshua
authors.initials: J
authors.lastname: Luxton
authors.affiliation: Department of Psychology, Oklahoma State University, Stillwater, OK, USA.
authors.forename: Larry L
authors.initials: LL
authors.lastname: Mullins
authors.affiliation: Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Ching-Hon
authors.initials: CH
authors.lastname: Pui
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.|Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.|Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Krull
authors.affiliation: Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.|Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Tara M
authors.initials: TM
authors.lastname: Brinkman
mesh_terms: D000293:Adolescent; D001007:Anxiety / Q000453:epidemiology; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D002648:Child; D003863:Depression / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000523:psychology* / Q000628:therapy; D012044:Regression Analysis; D012307:Risk Factors; D013315:Stress, Psychological / Q000453:epidemiology*; D017741:Survivors / Q000523:psychology / Q000706:statistics & numerical data; D013997:Time Factors
keywords: ALL; emotional distress; parents; survivorship