Relative effects of treatment history and family environment on attention functioning in pediatric cancer survivors

Considering the stress of parenting a child through cancer and given prior findings that parental stress can affect children's neuropsychological functioning, the present study examined the relative effects of treatment and family environment on attentional functioning in pediatric cancer survivors. Our sample of survivors (N = 122; 40.9% female; 51.8% non-Hispanic White) was 3.77 ± 3.58 years post-treatment. Multiple linear regression analyses examined demographic, treatment, and family environment factors with respect to parent-reported, self-reported, and performance-based attention. Treatment factors did not significantly predict any form of attentional functioning. Lower socioeconomic status and less social support significantly predicted greater parent-reported hyperactivity and attention problems. Greater parental stress significantly predicted greater parent-reported attention problems, but not parent-reported hyperactivity. Family environment factors uniquely accounted for the most variance in predicted parent-report hyperactivity (total r_s² = .489) and attention problems (total r_s² = .686). Although non-significant, worse parental anxiety and depression also were associated with greater parent-reported hyperactivity and attention problems. Results suggest that family environment factors can strongly predict parent-reported hyperactivity and attention problems in pediatric cancer survivors. These findings highlight the importance of assessing parental stress and emotional functioning in future research on neuropsychological outcomes for pediatric cancer survivors, with potential implications for clinical interventions.