Vanderbilt Stress and Coping Lab | Neuroimaging of Social-Emotional Functioning of Pediatric Brain Tumor Survivors Study Description The diagnosis and treatment of pediatric cancer are major stressors that interrupt daily life and lead to distress for children diagnosed with the disease and their parents. Factors such as parent-child communication about the cancer and the child's level of cognitive development may influence how children cope with the diagnosis and treatment of cancer. This project examines how children's cognitive development, and specifically their level of executive function, is related to their coping and communication about their illness. Further, the project examines the match between parental communication and children's levels of executive function when parents and children discuss the child's cancer. We are especially interested in children’s working memory and cognitive flexibility, two domains of executive function that are important in understanding and managing complex information and solving problems. Families of children who are diagnosed with cancer are asked to complete questionnaires and a videotaped interaction as part of the overall Coping and Communication project. Families who complete those studies are then invited to participate in an assessment of the child’s cognitive and executive functioning. Findings from this study will contribute to better ways to help children and their parents communicate about and cope with the diagnosis and treatment of cancer. Funding This project is supported in part by grants from the National Cancer Institute (National Research Service Award for Individual Predoctoral Fellowships 1F31CA136284) and the Vanderbilt University CTSA from NCRR/NIH (grant 1 UL1 RR024975). Return to Projects Study Name: Prospective Study of Neurocognitive Effects in Pediatric Brain Tumor Patients Study Description Pediatric brain tumor patients are at increased risk for deficits in neurocognitive functioning as well as social and emotional health problems. This study prospectively examines the neurocognitive abilities of recently diagnosed pediatric brain tumor patients in relation to their socio-emotional functioning and adjustment. New patients (ages 1 month to 20 years-old) are identified by Dr. Matthew Pearson (pediatric neurosurgeon) or a member of the pediatric neuro-oncology team at the time of the child’s diagnosis for a brain tumor. Patients enrolled in the study complete five neurocognitive assessments administered at the following timepoints: 1) prior to surgery, 2) 6-8 weeks post-surgery/pre-adjuvant treatment, 3) 6-months post-diagnosis, 4) 12-months post-diagnosis, and 5) 24-months post-diagnosis. At each assessment, parents also provide questionnaire report measures about the family, their own adjustment, and the child’s neurocognitive functioning and psychosocial and emotional adjustment. Our goal is to describe the course of neurocognitive functioning in children with brain tumors from prior to surgery, throughout treatment, and during follow-up and to identify risk and protective factors within this population. Our long-term goal is to use these data to inform the development of interventions that will minimize neurocognitive deficits and psychosocial problems in pediatric brain tumor patients. Funding: This study is supported by gifts from the Justin and Valere Potter Foundation and Patricia and Rodes Hart. Click here for information about participating in this study. Other Links and Resources http://www.pbtfus.org/ http://www.theibta.org/index.html Publications Robinson, K.E., Kuttesch, J.F., Champion, J.E., Andreotti, C.F., Hipp, D.W., Bettis, A., Barnwell, A., & Compas, B.E. (2010). A quantitative meta-analysis of neurocognitive sequelae in survivors of pediatric brain tumors. Pediatric Blood & Cancer, 55, 525-531. Return to Projects Study Name: Neuroimaging of Social-Emotional Functioning of Pediatric Brain Tumor Survivors Study Description Deficits in executive functions, social information processing, and subsequently in social relationships have been reported in survivors of pediatric brain tumors (PBT), and research suggests that difficulties in social functioning are among the most often cited problems experienced by these children. Although research has these important late effects in survivors of PBT, the mechanisms underlying these deficits are not well understood. On the one hand, disruption in school attendance and participation in activities with peers may contribute to deficits in social function. However, another possible mechanism suggested by research in social cognitive neuroscience has implicated several brain regions as playing a role in deficits of this nature, including the DLPFC, VMPFC, and the ACC. Research to date has largely focused on reports of behavioral data, but utilization of functional neuroimaging methods to examine the potential role of neurological mechanisms underlying evidenced deficits has yet to be conducted. The purpose of this study is to examine neurocognitive and psychosocial late effects in survivors of pediatric brain tumors (PBT), and the role of coping and emotion regulation skills in the manifestation of these deficits. Out primary goals are to (a) develop and test the feasibility and acceptability of a novel paradigm of executive function tasks for use in functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) with survivors of PBT and healthy controls between 8 and 16 years of age; and (b) examine the association of task performance and regional activation during tasks in the scanner, performance on neurocognitive tests administered outside the scanner, and measures of coping and emotion regulation skills in PBT survivors and controls. Funding: This study is supported by gifts from the Justin and Valere Potter Foundation and Patricia and Rodes Hart. Click here for information about participating in this study. Related Publications Robinson, K.E., Kuttesch, J., Champion, J., Andreotti, C., Hipp, D., Bettis, A., Barnwell, A., & Compas, B.E. (2010). A quantitative meta-analysis of neurocognitive sequelae of pediatric brain tumors. Pediatric Blood and Cancer, in press. Robinson, K.E., Livesay, K.L., Campbell, L.K., Scaduto, M., Cannistraci, C.J., Anderson, A.W., Whitlock, J.A., & Compas, B.E. (2010). Working memory in survivors of childhood acute lymphocytic leukemia: Functional neuorimaging analyses. Pediatric Blood and Cancer, 54, 585-590. Campbell, L.L., Scaduto, M., Sharp, W., Dufton, L., Van Slyke, D., Whitlock, J.A., & Compas, B.E. (2007). A meta-analysis of the neurocognitive sequelae of treatment for childhood acute lymphocytic leukemia. Pediatric Blood and Cancer, 49, 65-73. Return to Projects Study Name: Pediatric Cancer and Family Adjustment Study Description The diagnosis of cancer in a child is a significantly stressful experience for not only the young cancer patient, but also family members and their relationships. Families may experience considerable conflict as they adapt to changes in roles and routines, make treatment decisions for the child, and attempt to cope with the stress of a potentially life-threatening illness within the family. In turn, interfamily conflict can hinder a family’s ability to work together to provide emotional support for the child and for each other following diagnosis and throughout the course of treatment. However, few empirical studies have investigated the role and nature of family conflict following a childhood cancer diagnosis and throughout the course of treatment. To address this gap in the literature, we will be using a multi-method approach to test a conceptual model in which it is predicted that the stress inherent in a cancer diagnosis and its treatment is associated with increased family conflict, which can consequently lead to poorer child and caregiver adjustment. We will additionally examine two potential buffering factors that we predict will protect cancer patients from the negative effects of family conflict – positive characteristics of the primary caregiver’s relationship with the patient and children’s emotion regulation abilities. This short-term prospective longitudinal study will be conducted in collaboration with the University of Washington and will use self-report, observational, and physiological methodology over a period of 12 months following diagnosis. Our goal is to identify the nature of conflict within the family, the vulnerable time points throughout treatment, and whether family conflict is associated with maladjustment in children with cancer and their caregivers. Funding Grant RO1CA134794 from the National Cancer Institute (Lynn Katz, PhD, University of Washington, PI) Click here for information about participating in this study. Other Links and Resources Dr. Deborah Friedman, Principal Investigator (Vanderbilt): http://pediatrics.mc.vanderbilt.edu/interior.php?mid=6120 Dr. Lynn Katz, Principal Investigator (Washington): http://web.psych.washington.edu/directory/person.php?PersonID=57 Return to Projects Current Projects - Parental Depression Study Name: Family Cognitive-Behavioral Prevention of Depression Study Description Children of depressed parents are at significantly increased risk for depression and other forms of psychopathology. Three psychosocial mechanisms are associated with increased risk for psychopathology in these children---stressful parent-child interactions and the ways that children respond to and cope with these stressful interactions. Specifically, parenting behavior that is characterized by intrusiveness and withdrawal and children's negative cognitive style are associated with increased problems in children. In contrast, children's use of secondary control coping (cognitive restructuring, acceptance, distraction) is related to lower problems. This study examines in a randomized clinical trial the efficacy of a family-based cognitive behavioral intervention to prevent the adverse effects of parental depression on offspring. Depressed parents, their spouses, and their children (ages 9 to 16-years-old) were randomly assigned to a multifamily cognitive behavioral group intervention or to a self-study control condition. The 12 session (8 acute and 4 follow-up) family cognitive behavioral intervention includes coping skills training for children and parenting skills training for depressed parents and their spouses. Families in the comparison condition received only written educational materials about depression and its effects on families. Measures administered at pre-, post- and 6-, 12-, 18-, and 24-month follow-ups include assessment of mood disorders and other psychiatric disorders, internalizing and externalizing problems in children. Possible mediators of the effects of the intervention are also evaluated, including parental depressive symptoms and episodes of depression, parental intrusiveness and withdrawal, and children's coping and stress responses. Our goal is to determine the efficacy of this intervention that is unique in its focus on helping children of depressed parents to cope with stressful interactions with their parents, and to improve the parenting skills of depressed parents. Funding: Grants R01MH069940 and R01 MH069928 from the National Institute of Mental Health Click here for information about participating in this study. Other Links and Resources Study Website: Raising Healthy Children Need help finding mental health treatment? Possible resources include: Mental Health Association of Middle Tennessee Publications Compas, B.E., Forehand, R., Keller, G., Champion, J.E., Rakow, A., Reeslund, K.L., McKee, L., Fear, J.M., Colletti, C.J.M., Hardcastle, E., Merchant, M.J., Roberts, L., Potts, J., Garai, E., Coffelt, N., Roland, E., Sterba, S.K., & Cole, D.A. (2009). Randomized controlled trial of a family cognitive-behavioral preventive intervention for children of depressed parents. Journal of Consulting and Clinical Psychology, 77, 1007-1020. PMCID: PMC2821830. McKee, L., Colletti, C. Rakow, A., Jones, D.J., & Forehand, R. (2008). Parent and child externalizing behaviors: Are the associations specific or diffuse? Aggressive and Violent Behavior: A Review Journal, 13, 201-215. McKee, L., Forehand, R., Rakow, A., Reeslund, K., Roland, E., Hardcastle, E., & Compas, B.E. (2008). Parenting specificity: An examination of the relation between three parenting behaviors and child problem behaviors in the context of a history of caregiver depression. Behavior Modification, 32, 638-658. Rakow, A., Forehand, R., McKee, L., Champion, J., Fear, J., & Compas, B.E. (2009). The relation of parental guilt induction to child internalizing problems when a caregiver has a history of depression. Journal of Child and Family Studies, 18, 367-377. PMCID: PMC2808109. Champion, J.E., Jaser, S.S., Reeslund, K.L., Simmons, L., Potts, J.E., Shears, A.R., & Compas, B.E. (2009). The cost of caring: Caretaking behaviors by adolescent children of mothers with a history of depression. Journal of Family Psychology, 23, 156-166. Colletti, C.J.M., Forehand, R., Garai, E., Rakow, A., McKee, L., Fear, J.M., & Compas, B.E. (2009). Parent depression and child anxiety: An overview of the literature with clinical implications. Child and Youth Care Forum, 183, 151-160. Fear, J., Forehand, R., Colletti, C., Roberts, L., Champion, J., Reeslund, K., & Compas, B.E. (2009). Parental depression and interparental conflict: Adolescents’ self-blame and coping responses. Journal of Family Psychology, 23, 762-766. Garai, E.P., Forehand, R., Colletti, C.J.M., Reeslund, K., Potts, J., & Compas, B.E. (2009). The relation of maternal sensitivity to children’s internalizing and externalizing problems within the context of maternal depressive symptoms. Behavior Modification, 33, 559-582. PMCID: PMC2799993. Compas, B.E., Jaser, S.S., & Benson, M. (2009). Coping and emotion-regulation: Implications for understanding depression during adolescence. In S. Nolen-Hoeksema (Ed.), Handbook of Adolescent Depression. In Press Compas, B.E., Champion, J.E., Forehand, R., Cole, D.A., Reeslund, K.L., Fear, J., Hardcastle, J., Keller, G., Rakow, A., Garai, E., Merchant, M.J., & Roberts, L. (In press). Mediators of 12-month outcomes of a family group cognitive-behavioral preventive intervention with families of depressed parents. Journal of Consulting and Clinical Psychology. Compas, B.E., Forehand, R., & Keller, G. (in press). Prevention of depression in families of depressed parents. In T. Strauman (Ed.), Prevention of Depression in Adolescent Girls. Duke University Press. Colletti, C., Forehand, R., Garai, E., McKee, L., Potts, J., Haker, K., Champion, J., & Compas, B.E. (in press). Associations of parent-child anxious and depressive symptoms when a caregiver has a history of depression. Journal of Child and Family Studies. Return to Projects Study Name: Neuorcognitive Bases of Coping and Emotion-Regulation Study Description The development of the capacity to cope with stress and adversity, including the ability regulate emotions under stress, is central for adaptation to both acute and chronic stress. Emerging evidence points to regions of the prefrontal cortex as central to the development of these skills, with some of the most striking aspects of development in these regions continuing through adolescence. Moreover, coping and emotion-regulation skills are built on more basic cognitive processes encompassed in the domain of executive functions that are also regulated by prefrontal regions. Insults to the prefrontal cortex can occur from a variety of sources and may disrupt development of these regions, resulting in impairment in the development of coping and self-regulatory skills. Two striking sources of such insults can occur during childhood and adolescence and have been the focus of two lines of research in our laboratory---side effects associated with some medical treatments and exposure to chronic stress. This study has been implemented to examine the feasibility and acceptability of a study with complex methodology as well as generate pilot data from a paradigm for examining functioning in the prefrontal cortex, executive functions, and coping/emotion-regulation in two groups of children that reflect acquired disabilities in the development of these processes: (a) survivors of pediatric acute lymphocytic leukemia (ALL) who have received high dose intrathecal chemotherapy for the treatment of their disease, and (b) children who have been exposed to chronic stress of living with a depressed parent. A control group is also being recruited as a comparison group. We hypothesize that (1) childhood survivors of ALL and children of depressed parents will show deficits in working memory and in the use of emotion-regulation and coping skills relative to healthy controls; (2) functional neuroimaging analyses will show that ALL survivors and children of depressed parents, as compared with healthy controls, will have relatively less activation in the dorsolateral prefrontal cortex (e.g., Broadman Areas 9, 46) in response to a standard working memory task (the n-back) and in response to instructions to cognitively reappraise an emotionally arousing stimulus. Data generated from this project will provide the basis for a larger project to examine acquired disabilities in the prefrontal cortex and the implications of these disabilities for understanding processes of coping and adaptation. Funding Funding for this project is provided by a Vanderbilt Kennedy Center Discovery Grant. Click here for information about participating in this study. Publications Compas, B.E. (2006). Psychobiological processes of stress and coping: Implications for resilience in childhood and adolescence. Annals of the New York Academy of Sciences, 1094, 226-234. Compas, B.E., Campbell, L.K., Robinson, K.E., & Rodriguez, E. (2009). Coping and memory: Automatic and controlled processes in responses to stress. In J. Quas & R. Fivush (eds.), Emotion and Memory in Development: Biological, Cognitive and Social Considerations. Oxford University Press. Return to Projects Study Name: Stress and Coping in College Students Study Description Research has shown that various types of coping responses are differentially related to psychological outcomes (Compas et al., 2001). Previously, the Responses to Stress Questionnaire (RSQ) has been validated in children, adolescents and adults across several age and cultural groups (Connor-Smith et al., 2000). In the decade since the original validation of the RSQ, considerable research in emotion regulation has been conducted and has expanded the field’s knowledge of how emotion regulation responses can be considered a part of coping with stress (e.g., Mauss & Gross, 2007; Ray, Wilhelm, & Gross, 2008). The aim of the current study is to revise and expand the RSQ to reflect updates in research in coping and emotion regulation so that the questionnaire fully captures a range of coping and regulation responses to stress that have been researched (Compas, Jaser, & Benson, 2009), validate this revised version of the RSQ (i.e., RSQ-II) in a sample of college students, and examine constructs that are expected to relate to coping in order to expand the field’s knowledge on how coping with stress is related to psychological, emotional, and behavioral functioning in a variety of ways. Study Name: Psychobiology of Attention and Social Stress Study Description One lab study currently in progress investigates the role of social stress in the development of automatic attentional processes directed towards threatening stimuli, and the possible bidirectional relationship between stress and attentional biases. Biological and physiological processes, including activation of the hypothalamic-pituitary-adrenal axis and release of neuroendocrine hormones such as cortisol, have been tied to the “fight-or-flight” response involved in aiding humans’ ability to overcome or avoid environmental stressors, and past research has found these processes to be altered in individuals exposed to chronic life stress as well as those suffering from various psychological disorders, including depression and anxiety. As such, neuroendocrine markers of hypothalamic pituitary adrenal axis activation as well as cardiovascular functioning are being used in addition to behavioral data in order to better understand how underlying neuropsychological, emotion regulation, and coping mechanisms may account for psychological and health related outcomes in individuals exposed to chronic stress during development. Click here for information about participating in this study. Other Links and Resources Student Mental Health Resources: Vanderbilt Psychological & Counseling Center: 615-322-2571 Vanderbilt Student Health Center: 615-322-2427 Mental Health Crisis Intervention Center: 615-244-7444 Return to Projects Other Links and Resources For more information for childhood cancer survivors: http://www.vicc.org/cancersurvivor/ Need help finding mental health treatment? Possible resources include: Mental Health Association of Middle Tennessee http://kc.vanderbilt.edu/rhc/about.html Return to Home Page

Neuroimaging of Social-Emotional Functioning of Pediatric Brain Tumor Survivors

Study Description

Deficits in executive functions, social information processing, and subsequently in social relationships have been reported in survivors of pediatric brain tumors (PBT), and research suggests that difficulties in social functioning are among the most often cited problems experienced by these children. Although research has these important late effects in survivors of PBT, the mechanisms underlying these deficits are not well understood. On the one hand, disruption in school attendance and participation in activities with peers may contribute to deficits in social function. However, another possible mechanism suggested by research in social cognitive neuroscience has implicated several brain regions as playing a role in deficits of this nature, including the DLPFC, VMPFC, and the ACC. Research to date has largely focused on reports of behavioral data, but utilization of functional neuroimaging methods to examine the potential role of neurological mechanisms underlying evidenced deficits has yet to be conducted.
The purpose of this study is to examine neurocognitive and psychosocial late effects in survivors of pediatric brain tumors (PBT), and the role of coping and emotion regulation skills in the manifestation of these deficits. Out primary goals are to (a) develop and test the feasibility and acceptability of a novel paradigm of executive function tasks for use in functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) with survivors of PBT and healthy controls between 8 and 16 years of age; and (b) examine the association of task performance and regional activation during tasks in the scanner, performance on neurocognitive tests administered outside the scanner, and measures of coping and emotion regulation skills in PBT survivors and controls.

Funding:

This study is supported by gifts from the Justin and Valere Potter Foundation and Patricia and Rodes Hart.

Click here for information about participating in this study.

Related Publications

Robinson, K.E., Kuttesch, J., Champion, J., Andreotti, C., Hipp, D., Bettis, A., Barnwell, A., & Compas, B.E. (2010). A quantitative meta-analysis of neurocognitive sequelae of pediatric brain tumors. Pediatric Blood and Cancer, in press.
Robinson, K.E., Livesay, K.L., Campbell, L.K., Scaduto, M., Cannistraci, C.J., Anderson, A.W., Whitlock, J.A., & Compas, B.E. (2010). Working memory in survivors of childhood acute lymphocytic leukemia: Functional neuorimaging analyses. Pediatric Blood and Cancer, 54, 585-590.
Campbell, L.L., Scaduto, M., Sharp, W., Dufton, L., Van Slyke, D., Whitlock, J.A., & Compas, B.E. (2007). A meta-analysis of the neurocognitive sequelae of treatment for childhood acute lymphocytic leukemia. Pediatric Blood and Cancer, 49, 65-73.

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