Improving the Recognition and Treatment of Cancer-Related Posttraumatic Stress Disorder

French-Rosas, Lindsay; Moye, Jennifer; Naik, Aanand D.

doi:10.1097/01.pra.0000400264.30043.ae

Cited by 56 publications

(44 citation statements)

References 18 publications

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“…Just as the 5-year postdiagnosis marker in oncology does not guaran tee that cancer will not recur, however, a 5-year marker for long-term survivorship does not imply that psychological or physical recovery is complete. Even many years after cancer diagnosis, long-term treatment toxicities can carry physical and psychological effects (Burkett & Cleeland, 2007;Foster et al, 2009;Mols et al, 2005;Syrjala, Martin, & Lee, 2012;Weaver et al, 2012).…”

Section: The Long-term S U Rvivo Rsh Ip P E Rio Dmentioning

confidence: 95%

“…Long-term survivorship characterizes the experience be yond 5 years after diagnosis (e.g., Gotay & Muraoka, 1998), by which time many survivors can expect to attain normative values on standard measures of health-related quality of life (Bloom, Petersen, & Kang, 2007;Foster, Wright, Hill, Hopkinson, & Roffe, 2009;Mols, Vingerhoets, Coebergh, & van de Poll-Franse, 2005). Just as the 5-year postdiagnosis marker in oncology does not guaran tee that cancer will not recur, however, a 5-year marker for long-term survivorship does not imply that psychological or physical recovery is complete.…”

Section: The Long-term S U Rvivo Rsh Ip P E Rio Dmentioning

confidence: 96%

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Life after diagnosis and treatment of cancer in adulthood: Contributions from psychosocial oncology research.

Stanton

Rowland

Ganz

2015

American Psychologist

186

148

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The number of individuals living with a history of cancer is estimated at 13.7 million in the United States and is expected to rise with the aging of the population. With expanding attention to the psychosocial and physical consequences of surviving illness, psychological science and evidence-based practice are making important contributions to addressing the pressing needs of cancer survivors. Research is demonstrating that adults diagnosed with cancer evidence generally positive psychosocial adjustment over time; however, a subset is at risk for compromised psychological and physical health stemming from long-term or late effects of cancer and its treatment. In this article, we characterize survivorship after medical treatment completion during the periods of reentry, early survivorship, and long-term survivorship. We describe the major psychosocial and physical sequelae facing adults during those periods, highlight promising posttreatment psychosocial and behavioral interventions, and offer recommendations for future research and evidence-based practice.

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Section: The Long-term S U Rvivo Rsh Ip P E Rio Dmentioning

confidence: 95%

Section: The Long-term S U Rvivo Rsh Ip P E Rio Dmentioning

confidence: 96%

Life after diagnosis and treatment of cancer in adulthood: Contributions from psychosocial oncology research.

Stanton

Rowland

Ganz

2015

American Psychologist

186

148

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“…Finally, these data are especially important in a therapeutic context. Clinicians may wish to be aware that distress is common in veterans following a diagnosis of cancer (French-Rosas, Moye, & Naik, 2011), but so too are strengths of previous coping and the experience of resistance to distress as well as transformative meaning making. These strengths and transformative opportunities provide rich pathways to support veterans during and after their cancer experience.…”

Section: Discussionmentioning

confidence: 99%

Distress and Resilience After Cancer in Veterans

Jahn

Herman

Schuster

et al. 2012

Research in Human Development

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Combat exposure and posttraumatic stress have the potential to affect distress in response to cancer, a common late-life stressor. Models of posttraumatic growth suggest that distress can produce varying avenues for resilience. A primarily male, veteran sample completed interviews regarding how combat exposure and posttraumatic stress relate to distress and growth in cancer survivors. While combat alone did not predict greater distress, combat veterans with current combat-related posttraumatic stress symptoms reported the greatest distress following cancer. These same veterans showed cancer-related growth. This is the first large-scale study examining the relationships among combat, posttraumatic stress, and emotional health following cancer.What is the lifespan developmental impact of combat trauma? Does early life exposure to combat increase the risk of distress when confronted with later life-threatening illness, or does survival following such exposure convey resilience? Combat exposure is associated with the risk of developing posttraumatic stress disorder (PTSD) (Aldwin, Levenson, & Spiro, 1994;Fontana & Rosenheck, 1998;Lee, Vaillant, Torrey, & Elder, 1995). At the same time, combat exposure may be associated with resilience and stress-related growth, conveying successful coping in the face of stressful life events (Aldwin et al., 1994;Fontana & Rosenheck, 1998;Jennings, Aldwin, Levenson, Spiro, & Mroczek, 2006). RESILIENCE ACROSS THE LIFE COURSEResilience is a term with different uses. Here we refer to resilience as a process or pattern of adaptation in the context of threats to individual life or function (Masten & Wright, 2010). Although there are multiple ways to conceptualize the pathways of resilience (Bonanno, 2004;Masten & Obradovic, 2008), three pathways are especially relevant to lifespan Address correspondence to Jennifer Moye, VA Boston Healthcare System, Brockton Division, 940 Belmont Street, Brockton, MA 02301. Jennifer.Moye@va.gov. (Masten & Wright, 2010): Resistance, a tendency to display a steady state following a stress or with no marked increase in distress; recovery, initial distress followed by positive adaptation; and transformation, in which adaptive functioning improves after trauma through transformational meaning making or posttraumatic growth (Tedeschi, Park, & Calhoun, 1998). Dynamic processes of change may occur between these trajectories (Aldwin, Levenson, & Kelly, 2009). For example, life course theorists recognize the potential of turning points (Elder & Shanahan, 2006), in the forms of positive social structures and idiosyncratic events, as opportunities for individuals on trajectories of vulnerability after initial trauma to experience stress-related growth in response to subsequent events. This growth may then steer such individuals onto pathways of more resilience (McAdams & Bowman, 2001). Combat veterans may be an ideal population in which to examine these trajectories in the context of life-threatening trauma (Clipp & Elder, 1996). Further, few studies have examined t...

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“…However, the designation of cancer as a potentially traumatic event is important to cue clinicians to consider screening for PTSD after cancer treatment (French-Rosas et al, 2011). The goal of such consideration is not to pathologize those who may be having a common reaction to the stress of cancer, but to offer intervention that may reduce distress and assist in recovery.…”

Section: Discussionmentioning

confidence: 99%

“…The diagnosis and treatment of cancer is an uncontrollable, negative, and often sudden life threatening event, features shared with other traumatic experience (Carlson & Dalenberg, 2000;French-Rosas, Moye, & Naik, 2011;Smith, Redda, Peyserb, & Vool, 1999). Cancer is a stressor that is occurring within the body and, therefore, is inescapable.…”

Section: Us Department Of Veterans Affairsmentioning

confidence: 99%

Cancer as a criterion a traumatic stressor for veterans: Prevalence and correlates.

Mulligan

Wachen

Naik

et al. 2014

Psychological Trauma: Theory, Research, Practice, and Policy

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The diagnosis of cancer is an uncontrollable stressor posing the threat of death and disfigurement, often followed by repeated exposure to aversive reminders in the form of noxious treatments, persisting side effects, reengagement at times of surveillance, and the threat of recurrence. The phenomenon of cancer as a traumatic stressor is explored in this study, with a focus on the prevalence and correlates of posttraumatic stress disorder (PTSD) Criterion A in a sample of 170 mostly male adults who received health care at VA Medical Centers in Boston or Houston. Participants were interviewed 6 months after diagnosis with head and neck, gastro-esophageal, or colorectal cancers. Approximately half-42.9% to 65.9% depending on cut-score used-perceived cancer to be a traumatic stressor involving actual/threatened death or injury or threat to physical integrity as well as fear, helplessness, or horror. Younger veterans and those with current combat PTSD symptoms were more likely to perceive cancer as a traumatic stressor, as were those who perceived their prognosis as uncertain; 12% had PTSD symptoms above a PCLC cut score of 50, which is similar to incidence rates of PTSD associated with other traumatic stressors. Cancer, therefore, appears to be a serious and for some, traumatic stressor, suggesting the importance of screening for cancer related PTSD in cancer survivors, particularly those most at risk. The authors have no conflict of interest relating to this study or this article. This article has not been published elsewhere and has not been submitted simultaneously for publication elsewhere. (American Cancer Society, 2012). Although the 5-year relative survival rate for all cancer has increased to 67% (American Cancer Society, 2012), some who are diagnosed will die, while others undergo significant surgical procedures such as removal of body parts (e.g., breasts, testicles, uterus, lung, colon) and toxic treatments (e.g., stem cell transplant). For these reasons, cancer is arguably a significant stressor for many, but is cancer a "traumatic stressor?" U.S. Department of Veterans AffairsAccording to DSM-IV-TR, a traumatic stressor has two parts, "Criterion A1" for "experiencing, witnessing, or being confronted with an event that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others," and "Criterion A2" for a response involving "intense fear, helplessness, and horror" (DSM-IV-TR; American Psychiatric Association, 2000). DSM-IV-TR lists "being diagnosed with a life threatening illness" as a potential traumatic stressor. In contrast, the DSM-5 proposal for posttraumatic stress disorder (PTSD) does not list illness as a potential stressor and does not include Criterion A2 (American Psychiatric Association, 2012). In this article we aim to further address the nature of cancer as a traumatic stressor by discussing features of cancer that are similar and dissimilar from traumatic stress, describing the literature on the prevalence and correlates of PTSD s...

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Improving the Recognition and Treatment of Cancer-Related Posttraumatic Stress Disorder

Cited by 56 publications

References 18 publications

Life after diagnosis and treatment of cancer in adulthood: Contributions from psychosocial oncology research.

Life after diagnosis and treatment of cancer in adulthood: Contributions from psychosocial oncology research.

Distress and Resilience After Cancer in Veterans

Cancer as a criterion a traumatic stressor for veterans: Prevalence and correlates.

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