The relationship of resiliency to decision making and risk behaviors of cancer-surviving adolescents

Abstract

Adolescents with a history of cancer frequently engage in risk behaviors. The purpose of this correlational study was to explore factors that affect decision making and risk behaviors (smoking, alcohol use, and illicit drug use) of cancer-surviving adolescents. A sample of 52 teen survivors participated at two cancer centers. In addition to a medical record review and IQ testing, several psychosocial measures were administered in a semistructured interview with the teen survivor. Three antecedent factors (cognitive function, resiliency, and role modeling of risk behaviors by parents and peers) were examined in a hierarchical regression model to predict decision making. These same factors, with an additional mediating variable (decision making), were examined in a hierarchical logistic regression model to predict risk behaviors in teen survivors. In the decision-making model, adjusted for demographic covariates, resiliency was a marginally significant predictor of decision making. As non-resiliency increases, quality of decision making may decrease for teen survivors. In the model to predict risk behaviors, four factors (cognitive function, resiliency, role modeling, and decision making) were added to the basic model, controlling for the same covariates. Resiliency and decision making were highly significant predictors of one or more risk behaviors. Non-resilient teen survivors with poor-quality decision making are more likely to engage in risk behaviors of substance use and need intervention that is aimed at improving decision-making skills to reduce these behaviors.

Substance Use Risk Behaviors and Decision-Making Skills Among Cancer-Surviving Adolescents

“…The most effective range of stress is the intermediate range; too little or too much reduces adherence to quality decision-making procedures. Hollen, Hobbie, Finley, and Hiebert (2001) found that less resilient teen cancer survivors with poorer decision-making skills engaged in more risk behaviors. Additionally, Cox, McLaughlin, Steen, and Hudson (2006) found that teen survivors in higher grade levels, those who felt more susceptible to late effects of cancer treatment, and those who worried more about their cancer and its treatment were more likely to engage in risk behaviors.…”

Smoking Rates and the State of Smoking Interventions for Children and Adolescents With Chronic Illness

“…130 Other cognitive variables such as reduced problem-solving and poor decision-making skills has also been found to influence the likelihood of adolescent substance use. 131,132 For example, Hollen et al 132 surveyed 52 adolescent cancer survivors and found that nonresiliency and poor decision-making were highly significant predictors of Ն1 risky health behaviors including tobacco use. Pediatric patients whose illness and/or therapies place them at risk for cognitive impairments (eg, patients with brain tumors who receive cranial radiation, those with cerebrovascular insults, and those with SCD) that can adversely impact their behavioral choices as well as their understanding of the consequences of their behavior may be at greater risk for smoking.…”

Predicting and Modifying Substance Use in Childhood Cancer Survivors: Application of a Conceptual Model

“…Overall, young adult survivors of cancer are less likely than their sibling controls to experiment with smoking but are less likely to quit after having started (Tao et al). Some characteristics of cancer survivors who smoke have been identifi ed and include not being African American, not having graduated from high school, having a yearly household income less than $20,000, aged 10 years or older at cancer diagnosis, exposure to brain irradiation, and having members in their immediate social network who smoke (Emmons et al, 2002;Hollen, Hobbie, Finley, & Hiebert, 2001).…”

“…Although the literature reports a lower incidence of alcohol consumption (Larcombe, Mott, & Hunt, 2002;Mulhern et al, 1995;Verrill, Schafer, Vannatta, & Noll, 2000) among pediatric cancer survivors than among siblings or case control peers, alcohol consumption among young survivors is cause for concern because early onset of drinking robustly predicts lifetime drinking (Grant, 1998). Hollen and Hobbie (1996) noted that survivors began drinking at approximately the same age as their peers (10-19 years of age versus 11-21 years of age, respectively); 44% of teen survivors and 58% of their peers reported having had fi ve or more drinks on one occasion within the previous 12 months; and teens with poor decision-making skills were more likely to abuse substances (Hollen et al, 2001).…”