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Most Kids With Cancer Well-Adjusted

Children With Cancer Resilient, 'Flourishing' Psychologically
WebMD Health News
Reviewed by Louise Chang, MD

Sept. 21, 2007 - The amazing resilience of most children with cancer isn't an illusion -- psychologically, they're doing better than most kids.

That's the surprising conclusion of St. Jude's Children's Hospital psychologist Sean Phipps, PhD.

"We see them as a flourishing population that has adapted to the stress of having cancer and undergoing treatment," Phipps says in a news release. "They become quite resilient to the long- and short-term emotional and physical effects of their disease and the treatments."

Phipps investigated why kids with cancer report unusually low levels of depression and report fewer physical complaints than kids without cancerreport. Certainly, he thought, these self-reports were really self-illusion.

At least that was Phipps' original theory. He found that kids with cancer tend to adapt to the stresses of their situation by adopting a "repressive adaptive style" in which they think of themselves as well-adjusted, self-controlled, and content. Their behavior becomes organized around protecting this self-image.

Such children aren't just "faking good," Phipps found. In fact, they underreport physical symptoms and minimize their severity or impact.

"Is there a physiological price to pay for the low distress reported by those children with a repressive adaptive style? Based on these preliminary findings, the answer appears to be a tentative 'No,'" Phipps writes in the advance online edition of the Journal of Pediatric Psychology.

Instead, Phipps finds this style to be one of the pathways to resilience.

"Repressive coping is identified as a specific pathway to resilience, among others, including hardiness, self-enhancement, and the transient experience of positive emotion," he notes.

That helps explain why we so often find inspiration in the way children deal with life-threatening cancer.

"People coping successfully with severe stress seek naturally to create positive emotional states, both to gain relief from stress and to gather strength to face adversity," Phipps writes. "There may be aspects of the childhood cancer experiences in general that are associated with an increased frequency of positive affects, even if these are transitory, and embedded in a context that is also threatening."

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