Posttraumatic stress and growth in adolescent childhood cancer survivors: Links to quality of life

Abstract

Pediatric cancer can be considered an event potentially leading to posttraumatic stress symptoms (PTSS) as well as posttraumatic growth (PTG). While clinically significant levels of PTSS are rare in childhood cancer survivors, PTG is common in this population. However, the relationship of PTG to overall adaptation and quality of life (QOL) in pediatric cancer patients is not clear. Therefore, our study aims to analyse the relationships of PTSS and PTG with QOL in childhood cancer survivors. In this study, 172 childhood cancer survivors completed measures of quality of life (Minneapolis-Manchester Quality of Life Scale; child and adolescent version), posttraumatic stress (UCLA PTSD Reaction Index for DMS-IV) and posttraumatic growth (Benefit Finding Scale for Children). Correlation analyses were carried out separately for the child (up to 13 years, N = 47) and adolescent (more than 13 years, N = 125) groups and each QOL dimension. In the adolescent group, the relationship of PTSS and PTG with QOL was further verified by regression analyses while controlling for age, gender, and time off treatment. In children, negative relationships between PTSS and QOL were found, but the relationships between QOL and PTG were not significant. In adolescents, significant relationships were found for all dimensions of QOL and PTSS and also for several dimensions of QOL and PTG. The relationships between PTSS and QOL dimensions were negative in both groups, and the relationships between PTG and QOL in the adolescent group were weakly positive. In adolescents, regression analyses controlling for age, gender and time off treatment were performed and confirmed a negative relationship of PTSS with all QOL dimensions except for social functioning. For PTG, regression analyses revealed a significant positive relationship with QOL dimensions of social functioning, outlook on life and intimate relations. While the relationship between PTSS and QOL is negative for almost all QOL dimensions in children and adolescents, the nature of the relationship between PTG and QOL appears to be more complex and changing over time. PTG in children may reflect different processes with different outcomes than PTG in adolescents.

Ajuste y adaptación psicosocial de adultos jóvenes supervivientes de un cáncer en etapa pediátrica: Revisión sistemática

“…Los estudios que abordan la prevalencia (12,19,21) , coinciden en afirmar que aparece en supervivientes tiempo después del diagnóstico. Sin embargo, no ocurre en proporciones muy altas.…”

“…En la investigación de Okado et al (19) , con una muestra de 209 participantes, se observan síntomas de EPT en, aproximadamente, el 30%. Por último, en el trabajo de Koutná et al (12) , con una muestra de 125 participantes, el porcentaje de EPT es mucho menor, en torno al 0,55%. De acuerdo con este último, los factores de riesgo para una mala adaptación y desarrollo de EPT a raíz del cáncer son: ser mujer, tener antecedentes familiares de problemas psicológicos y haber padecido un tumor en el SNC.…”

“…Esto es llamado crecimiento postraumático (CPT) (10) y se define como un cambio psicológico positivo resultante de haber superado una situación potencialmente traumática, o circunstancias vitales especialmente difíciles, lo que podría promover una mejor adaptación y un logro exitoso de las tareas del desarrollo (11) . Se trata de un tipo de respuesta resiliente que puede aparecer acompañada de mayor madurez psicológica (12) , mayor conciencia del propósito de vida y del valor de las relaciones personales, autopercepción positiva y confianza en uno mismo (13) .…”

Research hotspots and theme trends in post-traumatic growth: A co-word analysis based on keywords

“…Some studies suggested that quality of life was positively correlated with PTG, indicating that quality of life can be improved by developing PTG [ 52 , 53 ]. Nevertheless, a few studies have found null or negative relations between them [ 54 , 55 ]. The reasons for these differences may be related to the following factors: i) different traumatic events may have different effects on PTG and quality of life, ii) some unidentified potential variables may change the relationship between PTG and quality of life, and iii) differences in sampling methods and research design methods between different studies lead to the inability to directly compare the results of various studies.…”

EMDR in pediatric hospital setting: a case report of an adolescent with cancer

“…It evokes a sense of threat to a person's sense of vulnerability, or a loss of control, a sense of helplessness (Mercadante et al, 2004;Carlsson et al, 2019). Growing body of research indicates that posttraumatic stress disorder (PTSD) and symptoms (PTSS) are some of the most important psychological consequences for those affected by childhood cancer (Portigliatti Pomeri et al, 2021), as well as their parents and siblings (Tremolada et al, 2016;Koutná et al, 2022). The traumatic experience of cancer illness usually starts at diagnosis communication, continuing throughout the course of care until the end of treatment and beginning of the survivorship phase .…”