The relationship between hope, rumination response styles, rumination content and psychological adjustment among childhood cancer patients and survivors

Abstract

PURPOSE/OBJECTIVE: Two types of rumination response styles, brooding and reflective, were widely studied among trauma survivors but had not been investigated among childhood cancer survivors and patients. This study aimed at investigating whether hope, rumination response styles and rumination content were related with childhood cancer patients’ and survivors’ psychological adjustment after treatment. MATERIALS AND METHODS: 89 childhood cancer survivors, aged 17.2 to 31.3, were recruited from Children’s Cancer Foundation Survivors’ Club to complete The Hope Scale, The Chinese Cancer-related Rumination Scale (CCRRS), Chinese Responses Styles Questionnaire-Rumination sub-scale (RSQ-Rum), Beck Depression Inventory and Beck Anxiety Inventory through mailing survey. 18 childhood cancer patients, aged 8 to 16, who had just completed acute cancer treatment no more than three months and were in remission were recruited from hospital out-patient clinics to complete Children’s Hope Scale, Children’s Depression Inventory, State-Trait Anxiety Inventory for Children, CCRRS and RSQ-Rum. RESULTS: Correlational studies on survivors found that brooding but not reflective rumination correlated with depression (r = 0.47, p < 0.01) and anxiety (r = 0.358, p < 0.01). Rumination on negative cancer-related content correlated with depression (r = 0.376, p < 0.01) and anxiety (r = 0.333, p < 0.01). Hope correlated negatively with depression (r = -0.525, p < 0.01) and anxiety (r = -0.347, p < 0.01). Correlational studies among patients suggested brooding (r = 0.585, p < 0.05) and negative content rumination (r = 0.487, p < 0.05) correlated with anxiety but were unrelated to depression. Hope again correlated negatively with depression (r = -0.605, p < 0.01) and anxiety (r = -0.535, p < 0.05). CONCLUSIONS: Brooding and negative content rumination were associated with depression and anxiety among survivors and were related to anxiety among patients. Hope served as a protective factor for both survivors and patients. This finding would support fostering of hope and reduction in brooding and negative rumination in psychotherapy.