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Published on: October 17, 2025
Emotion regulation, internalizing symptoms and somatic complaints in pediatric survivors of acute lymphoblastic
Lynn Fainsilber Katz1, Charlotte Heleniak1, Joy Kawamura1
1Department of Psychology, University of Washington, Seattle, WA, USA.
Objectives:
This study aimed to examine whether respiratory sinus arrhythmia (RSA)-a physiological index of children's emotion regulation-moderates the relation between cancer diagnosis and internalizing problems in children.
Methods:
Participants were twenty-two 7-12-year survivors of acute lymphoblastic leukemia and 20 age-matched controls. RSA was calculated from cardiac interbeat interval using spectral time-series analysis. t-Scores on the Child Behavior Checklist Anxious/Depressed, Withdrawn/Depressed, and Somatic Complaints subscales were computed.
Results:
Respiratory sinus arrhythmia moderated the relation between diagnostic status and both child somatic complaints and withdrawn/depressed symptoms. The positive association between diagnostic status and somatic complaints was significant for children with low RSA but not significant for children with high RSA. This association was also significant for withdrawn/depressed symptoms. Low RSA was associated with more somatic complaints and withdrawn/depressed symptoms for children with cancer but not for control participants.
Conclusions:
Children who have poor emotion regulation abilities may be more vulnerable to the range of stressors associated with the diagnosis, treatment, and survivorship of cancer. Behavioral interventions targeting emotion regulation skills may reduce internalizing symptoms in this population.
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