Post-traumatic Stress Disorder and Post-traumatic Growth in Breast Cancer Patients - a Systematic Review

Abstract

Breast cancer (BC) is potentially a traumatic stressor which may be associated with negative outcomes, such as post-traumatic stress disorder (PTSD) or positive changes, such as post-traumatic growth (PTG). This study aims to identify the core issues of BC related PTSD, PTG and psychological distress by interrogating the literature in BC survivors. We have also highlighted issues related to the assessment, diagnosis and clinical management of PTSD and PTG. The authors systematically reviewed studies published from 1985 to 2014 pertaining to PTSD, psychological distress and PTG in BC survivors with particular attention paid to incidence rates and causative factors. Multiple studies intimated that women with BC have evidence of PTSD at the initial stages of diagnosis, whereas PTG develops once patients undergo treatment. Early diagnosis and treatment of PTSD/PTG is paramount from literature review but the previously mentioned relationship between PTSD and PTG in BC patients could not be verified. It is evident from the literature that a small percentage of BC patients experience PTSD, while the majority experience PTG after BC diagnosis and treatment. Future research should include prospective studies focusing on high-risk patients, causative factors and the development of psychological interventions.

Perceived stress is associated with a higher symptom burden in cancer survivors

“…43 The experience of a diagnosis of cancer and its related treatments reportedly can lead to symptoms of posttraumatic stress in 7.3% to 35.2% of patients with cancer. 44 In the current study, cancer-specific stress (ie, total score on the IES-R) uniquely explained approximately 3.2% of the variance in symptom burden. Similarly, among survivors of leukemia, higher levels of cancer-specific stress were associated with higher levels of depressive symptoms, sleep problems, and fatigue interference.…”

“…The experience of a diagnosis of cancer and its related treatments reportedly can lead to symptoms of posttraumatic stress in 7.3% to 35.2% of patients with cancer . In the current study, cancer‐specific stress (ie, total score on the IES‐R) uniquely explained approximately 3.2% of the variance in symptom burden.…”

Patterns of posttraumatic stress disorder and posttraumatic growth among breast cancer patients in China: A latent profile analysis

“…A systematic review of 47 articles found that BC patients simultaneously reported PTSS and PTG, which evidenced PTSS and PTG often coexist in BC patients . Many research investigations in the field of trauma psychology has focused on the relationship between PTSS and PTG, with positive association, negative association, U‐shaped curvilinear association, and no association reported across studies.…”

Relationships between family resilience and posttraumatic growth in breast cancer survivors and caregiver burden

“…A recent term for the positive psychological changes individuals experience following stressful events, coined by Tedeschi and Calhoun, is posttraumatic growth (PTG). Posttraumatic growth is defined as “the experience of positive change that occurs as a result of the struggle with highly challenging life crises.” Evidence suggests that PTG is relatively common among women with breast cancer and exhibits an increasing tendency among early‐stage breast cancer survivors over a 6‐month period . Posttraumatic growth has many related factors, such as age, education, economic status, treatment, social support, and support from significant others …”