The mediating roles of cancer-related rumination in the relationship between dispositional hope and psychological outcomes among childhood cancer survivors

Objective This study aimed to examine the effects of dispositional hope on psychopathology as well as self-perceived positive change in childhood cancer survivors through the potential mediation of cancer-related ruminations.

Methods: A cross-sectional design was used, and a group of childhood cancer survivors (N = 89; mean age = 23.2 years; age range = 17.2-31.3 years) were studied. Dispositional hope level was measured by the Hope Scale; positive and negative cancer-related ruminations were assessed by the Chinese Cancer-related Rumination Scale; depression symptoms were measured by Beck Depression Inventory; and anxiety symptoms were measured by Beck Anxiety Inventory. Positive adjustment outcome of posttraumatic growth (PTG) was assessed by the Chinese Post-traumatic Growth Inventory. Multiple regressions were used to analyze the relationship between dispositional hope and the outcome variables of PTG, anxiety and depression and the potential mediators of positive and negative cancer-related rumination. 

Results: Dispositional hope was positively related to PTG, and the correlation was specifically mediated by positive cancer-related rumination. Dispositional hope also correlated with lower levels of depression and anxiety, specifically mediated by negative cancer-related rumination. 

Conclusion: The present finding supported hope as a significant positive factor for childhood cancer survivors, which was associated with PTG and better psychological adjustment. The findings may inform development of therapeutic intervention programs aimed at increasing childhood cancer patients' hope levels, which may be correlated with more positive cancer-related thoughts and better adjustment. The present study, which examined survivors diagnosed at young age, may enrich existing studies on the effect of onset age and adjustment outcomes.