Pathways linking treatment intensity and psychosocial outcomes among adult survivors of childhood leukemia

Edith Chen*, Lonnie K. Zeltzer, Peter M. Bentler, Julianne Byrne, H. Stacy Nicholson, Anna T. Meadows, James L. Mills, Riccardo Haupt, Thomas R. Fears, Leslie L. Robison

*Corresponding author for this work

Research output: Contribution to journalArticle

18 Scopus citations

Abstract

To determine the pathways between treatment intensity (age at diagnosis, dosage of chemotherapy [intrathecal methotrexate; IT-MTX] and cranial radiation [CRT]) and various psychosocial outcomes, review of medical records and structured interviews were carried out in 510 adult survivors of childhood leukemia. Structural equation modeling revealed that higher treatment intensity during childhood (indicated by treatment with high-dose CRT, low-dose IT-MTX, and adjusted by younger age at diagnosis) predicted more health-compromising behaviors as adults through lower educational achievement. Additionally, higher childhood treatment intensity predicted current negative mood both directly and via changes in perceived limitations. The present study's findings suggest that higher treatment intensity during childhood may serve as a risk factor for adult survivors' health-compromising behaviors through neuropsychological deficits that arise from cancer treatment.

Original languageEnglish (US)
Pages (from-to)23-38
Number of pages16
JournalJournal of Health Psychology
Volume3
Issue number1
DOIs
StatePublished - Jan 26 1998

Keywords

  • Childhood leukemia
  • Education
  • Health behavior
  • Long-term survivors
  • Mood
  • Treatment effects

ASJC Scopus subject areas

  • Applied Psychology

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    Chen, E., Zeltzer, L. K., Bentler, P. M., Byrne, J., Nicholson, H. S., Meadows, A. T., Mills, J. L., Haupt, R., Fears, T. R., & Robison, L. L. (1998). Pathways linking treatment intensity and psychosocial outcomes among adult survivors of childhood leukemia. Journal of Health Psychology, 3(1), 23-38. https://doi.org/10.1177/135910539800300102