Posttraumatic stress and psychological growth in children with cancer: has the traumatic impact of cancer been overestimated?
OBJECTIVE
To examine posttraumatic stress disorder and posttraumatic stress symptoms (PTSD/PTSS) in children with cancer using methods that minimize focusing effects and allow for direct comparison to peers without a history of cancer.


METHODS
Children with cancer (n = 255) stratified by time since diagnosis, and demographically matched peers (n = 101) were assessed for PTSD using structured diagnostic interviews by both child and parent reports, and survey measures of PTSS and psychological benefit/growth by child report.


RESULTS
Cancer was identified as a traumatic event by 52.6% of children with cancer, declining to 23.8% in those ≥ 5 years from diagnosis. By diagnostic interview, 0.4% of children with cancer met criteria for current PTSD, and 2.8% met lifetime criteria by self-report. By parent report, 1.6% of children with cancer met current criteria and 5.9% met lifetime criteria for PTSD. These rates did not differ from controls (all Ps >.1). PTSS levels were descriptively lower in children with cancer but did not differ from controls when all were referring to their most traumatic event (P = .067). However, when referring specifically to cancer-related events, PTSS in the cancer group were significantly lower than in controls (P = .002). In contrast, perceived growth was significantly higher in the cancer group when referring to cancer (P < .001).


CONCLUSIONS
These findings suggest no evidence of increased PTSD or PTSS in youths with cancer. Although childhood cancer remains a significant and challenging event, these findings highlight the capacity of children to adjust, and even thrive, in the face of such challenge.
Sean Phipps, James L. Klosky, Alanna Long, Melissa M. Hudson, Qinlei Huang, and Hui Zhang, St Jude Children's Research Hospital, Memphis, TN; and Robert B. Noll, University of Pittsburgh Medical Center, Pittsburgh, PA.
Sean
S
Phipps
James L
JL
Klosky
Alanna
A
Long
Melissa M
MM
Hudson
Qinlei
Q
Huang
Hui
H
Zhang
Robert B
RB
Noll
D000223:Adaptation, Psychological; D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002657:Child Development; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000523:psychology*; D057566:Self Report; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000209:etiology*; D013315:Stress, Psychological / Q000453:epidemiology* / Q000209:etiology*; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology