Purpose
Infertility is a frequent consequence of cancer therapy and is often associated with psychological distress. Although adult survivors prioritize fertility and parenthood, this issue remains unexplored among adolescent males. This study examined future fertility as a priority (relative to other life goals) at time of diagnosis for at-risk adolescents and their parents.
Methods
Newly diagnosed adolescent males (n=96; age=13.0-21.9 years) at increased risk for infertility secondary to cancer treatment prioritized eight life goals: to have school/work success, children, friends, wealth, health, a nice home, faith, and a romantic relationship. Patients' parents (fathers, n=30; mothers, n=61) rank-ordered the same priorities for their children.
Results
“Having children” was ranked as a “top 3” life goal among 43.8% of adolescents, 36.7% of fathers, and 21.3% of mothers. Fertility ranked 3rd among adolescents, 4th among fathers, and 5th among mothers. Future health was ranked the top priority across groups, distinct from all other goals (ps<.001), and fertility ranked higher than home ownership and wealth for all groups (ps<.001). For adolescents, low/moderate fertility risk perception was associated with higher fertility rankings than no/high risk perceptions (p=.01).
Conclusions
Good health is the most important life goal among adolescents newly diagnosed with cancer and their parents. In this relatively small sample, adolescents prioritized fertility as a top goal, parents also rated fertility as being more important than home ownership and financial wealth. Health care providers should communicate fertility risk and preservation options at diagnosis and facilitate timely discussion among families, who may differ in prioritization of future fertility.
Current research suggests the importance of anxiety sensitivity (AS) in the risk for PTSD, and a growing body of research has demonstrated that difficulties in emotion regulation may also play a role. This study examined the unique relationships between AS dimensions, difficulties in emotion regulation, and a probable PTSD diagnosis among a sample of inner-city crack/cocaine dependent patients in residential substance abuse treatment. Probable PTSD participants exhibited higher levels of the AS dimension of social concerns and emotion regulation difficulties. Emotion regulation difficulties reliably distinguished probable PTSD participants from non-PTSD participants above and beyond both anxiety symptom severity and the AS dimension of social concerns. Further, social concerns did not account for unique variance when difficulties in emotion regulation was entered into the model. Results provide support for the central role of difficulties in emotion regulation relative to AS dimensions in the prediction of PTSD within a crack/cocaine dependent population.
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