Stressful cognitions as mediators between physical functioning and psychosocial health among childhood cancer survivors

The purpose of this study was to determine whether stressful cognitions mediate the relationship between physical functioning and psychosocial health for youth survivors of pediatric cancer. A sample of 62 youth were recruited during a survivorship clinic visit. Caregivers and children completed questionnaires to evaluate physical functioning, psychosocial health, depression, anxiety, and stressful cognitions. Greater endorsement of physical impairment was associated with lower psychosocial health. Analyses indicated that stressful cognitions partially mediated this association. Stressful cognitions also had a unique, negative association with psychosocial health unrelated to physical functioning. This suggests multiple paths for intervention, including cognitive restructuring to enhance positive thoughts and behavioral activation.