Exploring the Effects of Cancer as a Traumatic Event on Italian Adolescents and Young Adults: Investigating Psychological Well-Being, Identity Construction and Coping Strategies
2. Materials and Methods
2.1. Data Collection
- TRI. Test of Interpersonal Relations (Bracken, 1993; Italian validation by Inaes, 1996): It was designed to assess the adequacy of children’s interpersonal relationships in the social domain, i.e., in relation to peers, in school, in relation to teachers, and in the family in relation to the relationship with parents. It consists of 35 items, each rated on a 5-point Likert scale from “strongly agree” to “strongly disagree”. In this work, we specifically used scales related to adolescents’ perceptions of the quality of their relationship with their mother and father. The questionnaire had good internal consistency (Cronbach’s alpha ranged from 0.93 to 0.96).
- KIDSCREEN-27 (Italian validation by The KIDSCREEN GROUP, 2004): Allows the assessment of well-being and health related to quality of life. It consists of 27 items and measures five Rasch-scaled dimensions: (1) Physical well-being, (2) Psychological well-being, (3) Autonomy and relationship with parents, (4) Peers and social support, (5) School environment. Each item is scored on a 5-point Likert scale ranging from 1 for “not at all” to 5 for “very much”. Higher scores indicate better quality of life and social support. Construct validity was assessed by calculating Cohen’s effect size (ES = 0.54). The questionnaire had good internal consistency (Cronbach’s alpha > 0.70).
- Centrality of Events Scale (CES; Berntsen and Rubin, 2006; Italian validation by Ionio, Mascheroni, and Di Blasio, 2018): a self-report measure designed to assess the extent to which the memory of a stressful and traumatic event was central to one’s (a) life history, (b) personal identity, and (c) attribution of meaning to other personal life events. These three factors are assessed using 20 items on a 5-point Likert scale ranging from 1 for “strongly disagree” to 5 for “strongly agree”. The questionnaire has good internal consistency (Cronbach’s alpha = 0.94).
- Trauma Symptom Checklist for Children (TSCC-A; Briere, 2011; Italian validation by Di Blasio, Piccolo, Traficante, 2011): used to assess post-traumatic stress and related psychological symptoms. This instrument is particularly suitable for assessing children and adolescents aged 11 to 16 years who have experienced traumatic events. Each item is rated on a 4-point Likert scale ranging from 0 for “never” to 3 for “almost always”. We used the 44-item version, which does not include references to sexual issues. The questionnaire consists of the following five clinical scales: (1) Anxiety, which captures general fear, overexcitement, worry, specific fears (e.g., of men, women, or both, of the dark, of being killed), episodes of free-floating fear, and a sense of impending danger. (2) Depression: feelings of sadness, unhappiness, and loneliness, episodes of weepiness, depressive cognitions such as guilt and self-denial, and self-harm and suicidality. (3) Anger, which deals with angry thoughts, feelings, and behaviors, such as feeling angry, being mean and hating others, having difficulty de-escalating anger, wanting to yell at or hurt people, arguing, or fighting. (4) Post-traumatic stress, which captures post-traumatic symptoms such as intrusive thoughts, sensations, and memories of painful past events, nightmares, anxiety, and cognitive avoidance of painful feelings; and (5) Dissociation, which examines dissociative symptoms such as derealization, thought emptiness, emotional numbing, pretending to be another person or place, daydreaming, memory problems, and dissociative avoidance. We chose to use the TSCC-A because our clinical sample was not in treatment, and this may have influenced the results of the Sexual Concerns scale. The questionnaire showed good internal consistency (Cronbach’s alpha = 0.83).
3.1. Psychological Well-Being and Effects of the Traumatic Event on Adolescents
3.2. Effects of the Traumatic Event on the Family System
4.1. Psychological Well-Being and Effects of the Traumatic Event on Adolescents
4.2. Effects of the Traumatic Event on the Family System
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
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|Factor I||Clinical group||53.36||8.98||2.450||0.017||64.873|
|Factor II||Clinical group||55.86||8.11||4.686||0.000014||65.742|
|Factor III||Clinical group||54.39||9.88||3.146||0.003||56.123|
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Ionio, C.; Bigoni, F.; Sacchi, M.; Zecca, M.; Bergami, E.; Landoni, M.; Ciuffo, G.; Rovati, A.; Rizzi, D. Exploring the Effects of Cancer as a Traumatic Event on Italian Adolescents and Young Adults: Investigating Psychological Well-Being, Identity Construction and Coping Strategies. Pediatr. Rep. 2023, 15, 254-262. https://doi.org/10.3390/pediatric15010021
Ionio C, Bigoni F, Sacchi M, Zecca M, Bergami E, Landoni M, Ciuffo G, Rovati A, Rizzi D. Exploring the Effects of Cancer as a Traumatic Event on Italian Adolescents and Young Adults: Investigating Psychological Well-Being, Identity Construction and Coping Strategies. Pediatric Reports. 2023; 15(1):254-262. https://doi.org/10.3390/pediatric15010021Chicago/Turabian Style
Ionio, Chiara, Francesca Bigoni, Maddalena Sacchi, Marco Zecca, Elena Bergami, Marta Landoni, Giulia Ciuffo, Anna Rovati, and Damiano Rizzi. 2023. "Exploring the Effects of Cancer as a Traumatic Event on Italian Adolescents and Young Adults: Investigating Psychological Well-Being, Identity Construction and Coping Strategies" Pediatric Reports 15, no. 1: 254-262. https://doi.org/10.3390/pediatric15010021