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Title page for ETD etd-05192018-142603


Type of Document Dissertation
Author Murphy, Alexandra K
URN etd-05192018-142603
Title The Structure of Maternal Communication in Childhood Cancer: Confirmatory and Exploratory Factor Analysis and Relation to Maternal Distress
Degree PhD
Department Psychology
Advisory Committee
Advisor Name Title
Bruce Compas Committee Chair
Kris Preacher Committee Member
Meg Saylor Committee Member
Sarah Jaser Committee Member
Keywords
  • cancer
  • parent-child communication
  • distress
  • factor analysis
  • parenting
Date of Defense 2017-04-05
Availability unrestricted
Abstract
The purpose of this study was to investigate maternal communication, an important source of risk and resilience in pediatric cancer, by examining its structure in a sample of families with new pediatric cancer diagnoses. Three competing, hierarchical models of maternal communication were proposed, based on a theoretical framework of maternal communication that draws on warmth and control. Warm and Structured Communication were specified as components of Positive Communication and Hostile/Intrusive and Withdrawn Communication were specified as components of Negative Communication. An initial test of this factor structure was also proposed by examining correlations between self-reported maternal distress and maternal communication in longitudinal analyses. The sample included 115 children (age 6-18) with newly diagnosed cancer (41% leukemia, 18% lymphoma, 6% brain tumor, and 35% other solid tumor) and their mothers. Mothers provided self-reports of their distress symptoms (anxiety, depression, and post-traumatic stress) three months after the child’s diagnosis (Time 1) and were observed communicating with their child about cancer three months later (Time 2). Maternal communication was double-coded by trained research assistants with the Iowa Family Interaction Ratings System. Results from confirmatory factor analysis demonstrated poor fit across proposed models. Exploratory factor analyses were conducted and suggested a 6-factor model with one factor representing Positive Communication, four factors representing negative communication (Harsh/Intrusive, Lecturing, Withdrawn, and Inconsistent), and one factor representing Negative Affect. Using structural equation modeling, several significant relations between maternal distress symptoms and maternal communication emerged, suggesting that while anxiety, depression, and PTSS may be uniquely related to different aspects of maternal negative communication, each may impair mothers’ ability to communicate positively with their children. Although the resulting structure is preliminary and needs to be tested in additional samples, clinical and theoretical implications are discussed. Future directions include examining this structure in samples outside of pediatric oncology, examining the relation between maternal communication and child outcomes, and targeting maternal communication in clinical interventions.
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