Mother-Child Communication and Maternal Depressive Symptoms in Families of Children With Cancer: Integrating Macro and Micro Levels of Analysis

OBJECTIVES: This study examines associations between maternal depressive symptoms and macro- and micro-level aspects of mothers' communication about their children's cancer. METHODS: Mothers reported depressive symptoms after diagnosis or relapse (child mean age = 10.4 years; 53% male). Mother-child dyads (N = 94) were subsequently observed discussing the child's cancer and maternal communication was coded. RESULTS: Macro-level indicators (positive and negative communication) were associated with certain micro-level indicators of communication (topic maintenance, reflections, reframes, and imperatives). Higher depressive symptoms predicted lower positive communication and higher negative communication. Maternal reflections and imperatives predicted positive communication, and topic maintenance and reframes predicted negative communication, beyond child age, family income, and depressive symptoms. CONCLUSIONS: Findings suggest concrete targets for improving communication in families after diagnosis or relapse.