Aims: Treatment for pediatric cancer results in declines in patients’ quality of life (QOL). We examined the influence of pediatric cancer patients’ dispositional attributes on their QOL. Substantial evidence from research in developmental psychology suggests that children’s temperament and personality play important roles in how they adjust to life stressors. The study examined how differences in effortful control, an aspect of temperament associated with the ability to self-regulate emotions, and in ego-resilience, the ability to adapt to changing circumstances, affect QOL in pediatric cancer patients. We predicted that higher effortful control and ego-resilience would both be associated with higher QOL; and further, that the effects of effortful control on QOL would be mediated by ego-resilience.

Method:  Participants were 86 pediatric cancer patients (ages 3-12) who were in active treatment at two comprehensive cancer treatment centers. At baseline, parents completed Rothbart et al.’s (2001) measures of effortful control and Eisenberg et al.’s (1996) measure of ego-resilience on their children and a measure of social desirability (to control for response bias). Four to six months later, parents reported on their children’s QOL using Varni et al’s (2001) Pediatric Quality of Life measure.

Results: Effortful control was significantly and negatively correlated with QOL problems in the areas of cognitive difficulties, emotional functioning, social functioning, and worry (all ps≤.04). Ego-resilience was significantly and negatively associated with these same four problem areas, plus nausea, physical appearance and treatment anxiety (all ps<.03). Resilience significantly mediated the effects of effortful control on cognitive difficulties (n=5000 samples, b=-.20, SE=.06, 95% CI -.35, -.10,) and emotional functioning (b=.16, SE=.07, 95% CI -.31, -.04).

Conclusion; Temperament and personality play significant roles in individual differences in pediatric cancer patients’ QOL.  Data collected early in treatment on children’s dispositional attributes may help identify children at highest risk for QOL problems during treatment.