Electronic Theses and Dissertations

Date

2019

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Psychology

Committee Chair

Kristoffer Berlin

Committee Member

Randy Floyd

Committee Member

Valerie Crabtree

Committee Member

Idia Thurston

Abstract

Patients with craniopharyngioma experience hypothalamic dysfunction, weight gain, disrupted sleep, excessive daytime sleepiness (EDS), fatigue, and psychosocial problems that negatively impact health-related quality of life (HRQoL). The extent of hypothalamic tumor involvement (HI) has been shown to be associated with higher rates of these impairments; however, the direct and indirect effects of these relations have yet to be investigated. The goal of the current study was to examine relations between HI, body mass index (BMI), sleep disruptions, EDS, fatigue, psychosocial problems, and HRQoL among youth with craniopharyngioma. 84 youth with craniopharyngioma (Mage =10.27 + 4.3 years, 53.6% female, 64.3% White) were assessed with actigraphy and multiple sleep latency testing prior to proton therapy. Caregivers completed measures of fatigue, psychosocial functioning, and HRQoL. Path analyses revealed direct effects between HI extent and BMI (Est. = 2.97, p = .003), as well as HI and EDS (Est. = 2.53, p = .01). Greater fatigue (Est. = -.29, p < .001) and less disrupted sleep (Est. = -.09, p = .001) predicted more psychosocial problems. Fatigue positively predicted HRQoL (Est. = .23, p = .001) and psychosocial problems negatively predicted HRQoL (Est. = -.34, p = .004). Significant indirect effects of disrupted sleep (Est. = .03, p = .04) and fatigue (Est. = .10, p = .02) on HRQoL through psychosocial problems were also found. Results of the current study suggest that youth with craniopharyngioma with greater HI may benefit from weight and EDS reduction interventions. Findings also suggest that youth craniopharyngioma should be prospectively monitored for fatigue and psychosocial problems, as these patients may benefit from interventions focused on enhancing fatigue with a goal of improving overall quality of life and psychosocial health.

Comments

Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest

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