title: Defining medical posttraumatic stress among young adult survivors in the Childhood Cancer Survivor Study.
abstract: OBJECTIVE
  To examine the implications of use of differential thresholds for studying medical Posttraumatic Stress Disorder (PTSD).
  
  
  METHODS
  Self-report data from 6,542 young adult survivors of childhood cancer and 374 of their siblings were used to create clearly differentially defined groups to compare prevalence, correlations and predictors of posttraumatic stress.
  
  
  RESULTS
  Prevalence of posttraumatic stress in survivors compared to siblings differed by definition used, ranging from an odds ratio of 4.21 (95% CI 2.11-8.38) when posttraumatic stress was defined as meeting full symptoms plus functional impairment to 1.42 (95% CI 0.79-2.56) for partial symptoms with functional impairment. Re-experiencing symptoms did not substantially contribute to the ability to identify functional impairment and emotional distress. Although most of the variables associated with posttraumatic stress symptoms and impairment were consistent across definitions of PTSD, marital status and employment demonstrated nonproportional relationships.
  
  
  CONCLUSIONS
  Choice of the definition used in studying posttraumatic stress after serious illness alters not only epidemiological findings, but also associations with correlates and predictors. This is important in the current debate about the criteria for PTSD in the upcoming DSMV. Further study is needed to determine if these findings are applicable to people exposed to other types of traumatic events.
authors.affiliation: David Geffen School of Medicine at the University of California, Los Angeles, CA, USA. mstuber@mednet.edu
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Stuber
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Meeske
authors.forename: Wendy
authors.initials: W
authors.lastname: Leisenring
authors.forename: Kayla
authors.initials: K
authors.lastname: Stratton
authors.forename: Lonnie K
authors.initials: LK
authors.lastname: Zeltzer
authors.forename: Kathryn
authors.initials: K
authors.lastname: Dawson
authors.forename: Anne E
authors.initials: AE
authors.lastname: Kazak
authors.forename: Bradley
authors.initials: B
authors.lastname: Zebrack
authors.forename: Ann C
authors.initials: AC
authors.lastname: Mertens
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Krull
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009369:Neoplasms; D012720:Severity of Illness Index; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000503:physiopathology; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*; D055815:Young Adult