Pediatric burn survivors experience increased risk for bullying, stigmatization, body image concerns, and problematic social functioning. Although coping behaviors are associated with engagement in social supports and positive self-concept in multiple pediatric illness populations, their relation has not been examined in pediatric burns. This study examined coping in relation to social functioning and self-concept in 51 pediatric burn survivors aged 7–17years (M=12.54; SD=2.65). Survivors and their caregivers completed the Child Coping Strategies Checklist (CCSC; youth report); the Burn Injury Social Questionnaire (BISQ; parent and youth report); and the Piers-Harris Children’s Self-Concept Scale-2 (PH-2; youth report). Associations between coping, social functioning, self-concept, demographic features, and burn injury characteristics were examined via bivariate correlations. Hierarchical linear regressions examined whether coping strategies predicted social functioning and youth self-concept beyond burn injury and demographic variables. Social functioning concerns were positively correlated with total body surface area (TBSA; r=0.63 and 0.40, respectively). TBSA was the only significant predictor of parent-reported social concerns (β=0.65, p<0.001). Greater distraction coping predicted fewer youth-reported social concerns (β=−0.39, p=0.01). Greater active coping (B=0.67, p=0.002) and lower avoidance coping (B=−0.36, p=0.03) predicted better youth-reported self-concept. This study advances our understanding of coping as potentially protective for psychosocial adjustment. Clinicians working with child burn survivors should incorporate active coping interventions into treatment. Further research including larger and more diverse samples is needed to understand the role of coping approaches on psychological adjustment during burn healing.

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Introduction Burn survivors can experience challenges in social functioning (e.g., bullying, stigmatization) and self-concept (e.g., body image concerns). Use of coping strategies is associated with engagement in social supports and positive self-concept in pediatric oncology and physical injury populations; however, their relation has not been examined in pediatric burn survivors. This study aims to explore coping as it relates to social functioning and self-concept in these youth. Methods Fifty-one pediatric burn survivors aged 7–17 years (M=12.53; SD=2.68), and their primary caregiver participated. Youth and caregivers completed questionnaires, including the Child Coping Strategies Checklist (CCSC; youth report); the Burn Injury Social Questionnaire (BISQ; parent & youth report; higher scores = more social problems); and the Piers-Harris Children’s Self-Concept Scale-2 (PH-2; youth report). Associations between the BISQ, coping strategies (Active, Avoidance, Distraction, Support), self-concept, yearly family income, and burn injury characteristics (e.g., total body surface area; TBSA, participant grafting) were examined via bivariate correlations. Hierarchical linear regression was used to examine whether coping strategies (with significant bivariate correlations) predicted BISQ and PH-2 scores above and beyond burn injury and demographic variables. Three hierarchical regression models were run, one each for parent- and youth-report BISQ and youth-report PH-2 scores. Results Our sample is predominantly male (62.7%) and Caucasian (82.4%) with average TBSA of 8.74% (SD=11.02). Parent- and youth-reports on the BISQ were positively correlated with TBSA (r=.61 and .37, respectively) and negatively correlated with family income (r=-.37 and -.36, respectively). Parents of youth who had a skin graft reported higher BISQ scores (rho=.34). Distraction coping was significantly associated with youth-reported BISQ scores (r=-.31); no coping strategies were correlated with parent-report BISQ scores. In regression models, TBSA significantly predicted of parent-report BISQ (B=.27, p< .001). Higher family income (B=-.40, p=.04) and greater distraction coping (B=-3.41, p=.004) significantly predicted better youth-report BISQ scores. Greater active coping significantly predicted better self-concept (B=6.21, p=.01). Conclusions Results suggest that use of positive coping strategies relates to better youth-reported social functioning and youth-reported self-concept after burn injury in addition to injury characteristics and socioeconomic variables.