A longitudinal study of two children undergoing stem cell transplant: Analyzing coping as a process of adaptive self-regulation

Based on the idea that self-development is an inherent part of the process of coping and adjustment, the present study aimed at exploring how two children that had been diagnosed with leukemia and were undergoing stem cell transplant dynamically re-positioned themselves vis-a-vis the unfolding of their treatments, as a process of adaptive self-regulation.; The idea of "adaptive self-regulation" proposed by Carver and Scheier (2000) is a major reference point for the present study, but differently from the theoretical elaborations made by these authors, the present study reflects an attempt to conceptually integrate two separate and well-established theoretical domains: (1) The dialogical notion of self-development, which was originally elaborated by Bakhtin (e.g., 1973; 1978; 1986; 1993) and which has been vastly imported to contemporary sociogenetic and discursive psychology (e.g., Fogel, 2001; Hermans & kempen, 1993; Markova, 1990; Wertsch, 1991); and (2) The cognitive-mediational model of stress and coping developed by Lazarus and colleagues (e.g. Folkman & Lazarus, 1980; Folkman, Lazarus, Dunkel-Schetter, DeLongis & Gruen, 1986; Lazarus & Folkman, 1984).; The present study is constituted by a longitudinal analysis of two cases, followed during a period of about 7 months. It involved interviews with the children and some of their significant others (parents, teachers from the hospital, primary nurse, "best buddies", and child life specialist), and interactions with the child and his/her significant others during semi-structured and open/regular activities within the hospital, outpatient clinic, and home settings.; Through the analysis of these children particular ways of positioning themselves in specific social and medical scenarios (their choices of actions and ways of responding to different aspects of their environment), a generic model of their systems of self-functioning was generated. This model basically highlighted the systemic relationship between a child's self-perception (sense of self and self awareness) with its manifestation in the world---specifically in terms of its social dimension (social orientation and manifestation of the self) and agency (self positioning and attitude).; The next step of the analysis was to longitudinally explore their systems of self-functioning (through the unfolding of their treatments). Such longitudinal analysis allowed the investigation of whether or not the events/situations that seemed to be appraised as particular sources of stress was related to their effect on (or disruption of) the child's developing sense of self. Moreover, it provided the ground for the identification of which alternative pathways seemed to be created by each child as attempts to support their sense of self when facing stressful situations (process of adaptive self-regulation). Finally, it also permitted the exploration of how different socio-cultural, situational and biological factors appeared to be affecting the child's process of adaptive self-regulation.