| Chapter 1: | Introduction |
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An exception to these findings is the work of Kazak, Christakis, Alderfer, and Coiro (1994), who found that on virtually all measures of social adjustment, including self-worth, adolescents with cancer fell within normal limits. Collectively, these results suggest that the cancer experience may indeed alter self-perception at a time of critical development in an adolescent’s life.
A critical question is the extent to which a serious, life-threatening chronic illness in childhood potentially affects the process of relationship development. La Greca and Bearman (2000) aptly pointed out that pediatric chronic illness research needs to move beyond studies of peer acceptance and instead focus on studies which facilitate our understanding of how different pediatric conditions exert their influence on the formation and maintenance of close friendships and dating relationships. Problems with the development or maintenance of such peer relationships have been linked to poor school performance, loneliness, depressive symptoms, externalizing behaviors, and mental health problems later in adult life (e.g., Parker & Asher, 1993). Successful peer relationships, on the other hand, provide adolescents with an avenue in which to learn empathy, trust, compassion, and other such relationship-enhancing skills (Buhrmester & Furman, 1986). In essence, the acquisition of such skills sets the stage for the quality of intimate interpersonal relationships later in adulthood, which in turn influences directly and indirectly a given individual’s overall quality of life.
Data from the Childhood Cancer Survivor Study (CCSS), a retrospective national cohort study initiated to explore the late effects of childhood cancer, provides an illustration of the nature of cancer survivors’ relationships and overall quality of life and psychological distress outcomes. Notably, a preliminary description of marital status of cancer survivors found that, in general, the marriage rates of cohort members were lower than rates in the U.S. population (Rauck, Green, Yasui, Mertens, Robison, 1999).