title: Impact of prior traumatic life events on parental early stage reactions following a child's cancer.
abstract: BACKGROUND
  In pediatric oncology, effective clinic-based management of acute and long-term distress in families calls for investigation of determinants of parents' psychological response to the child's cancer. We examined the relationship between parents' prior exposure to traumatic life events (TLE) and the occurrence of posttraumatic stress symptoms (PTSS) following their child's cancer diagnosis. Factors mediating the TLE-PTSS relationship were analyzed.
  
  
  METHODS
  The study comprised 169 parents (97 mothers, 72 fathers) of 103 cancer diagnosed children (median age: 5,9 years; range 0.1-19.7 years). Thirty five parents were of immigrant origin (20.7%). Prior TLE were collated using a standardized questionnaire, PTSS was assessed using the Impact of Events-Revised (IES-R) questionnaire covering intrusion, avoidance and hyperarousal symptoms. The predictive significance of prior TLE on PTSS was tested in adjusted regression models.
  
  
  RESULTS
  Mothers demonstrated more severe PTSS across all symptom dimensions. TLE were associated with significantly increased hyperarousal symptoms. Parents' gender, age and immigrant status did not significantly influence the TLE-PTSS relationship.
  
  
  CONCLUSIONS
  Prior traumatic life-events aggravate posttraumatic hyperarousal symptoms. In clinic-based psychological care of parents of high-risk pediatric patients, attention needs to be paid to life history, and to heightened vulnerability to PTSS associated with female gender.
authors.affiliation: Department of Women's and Children's Health, Childhood Cancer Research Unit, Karolinska Institutet, Stockholm, Sweden. krister.boman@ki.se
authors.forename: Krister K
authors.initials: KK
authors.lastname: Boman
authors.forename: Ylva
authors.initials: Y
authors.lastname: Kjällander
authors.forename: Staffan
authors.initials: S
authors.lastname: Eksborg
authors.forename: Jeremy
authors.initials: J
authors.lastname: Becker
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005220:Fathers; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009035:Mothers; D009369:Neoplasms / Q000175:diagnosis; D010287:Parent-Child Relations; D010290:Parents / Q000523:psychology*; D012307:Risk Factors; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D011795:Surveys and Questionnaires; D013997:Time Factors; D055815:Young Adult