title: Relations between posttraumatic stress and posttraumatic growth in long-term survivors of childhood cancer: a report from the Childhood Cancer Survivor Study.
abstract: OBJECTIVE
  Contemporary models of trauma suggest that posttraumatic stress and growth should be related and that symptoms of stress resulting from a perceived trauma (e.g., childhood cancer) are prerequisite for posttraumatic growth (PTG) to occur. However, empirical data regarding the relationship of posttraumatic stress and growth have been equivocal. The purpose of this study is to examine the relationship between posttraumatic stress symptoms (PTSS) and PTG among adult survivors of childhood cancer.
  
  
  METHODS
  Survey methods were used to collect data from 6,162 survivors participating in the Childhood Cancer Survivor Study (CCSS). Nonparametric correlation was examined pairwise between PTG and PTSS using Spearman's correlation coefficient with 95% confidence intervals, with nonlinear canonical correlation analysis being conducted to examine relationships between subscales. A multivariable partial proportional odds model was also fit for PTG total quartiles focusing on associations with PTSS total quartiles while adjusting for sociodemographic and medical variables.
  
  
  RESULTS
  Examination of unadjusted PTSS and PTG total scores revealed a Spearman correlation of 0.11 (p < .001), with coefficients ranging from 0.03 to 0.17 between total and subscale scores. The nonlinear canonical correlation analyses resulted in two dimensions with eigenvalues of 0.15 and 0.14, resulting in a fit value of 0.30 and evidence that little variability in the data (15%) was explained by the weighted combinations of the variables.
  
  
  CONCLUSIONS
  Although statistically significant, these results do not indicate a robust relationship between PTSS and PTG among adult survivors of childhood cancer. Theories suggesting that PTSS is a prerequisite for PTG should be reconsidered.
authors.affiliation: Department of Psychology.
authors.forename: James L
authors.initials: JL
authors.lastname: Klosky
authors.affiliation: Department of Epidemiology and Cancer Control.
authors.forename: Kevin R
authors.initials: KR
authors.lastname: Krull
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center.
authors.forename: Toana
authors.initials: T
authors.lastname: Kawashima
authors.affiliation: Clinical Research Division, Fred Hutchinson Cancer Research Center.
authors.forename: Wendy
authors.initials: W
authors.lastname: Leisenring
authors.affiliation: Department of Psychology.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Randolph
authors.affiliation: School of Social Work, University of Michigan.
authors.forename: Brad
authors.initials: B
authors.lastname: Zebrack
authors.affiliation: David Geffen School of Medicine, University of California Los Angeles.
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Stuber
authors.affiliation: Department of Epidemiology and Cancer Control.
authors.forename: Leslie L
authors.initials: LL
authors.lastname: Robison
authors.affiliation: Department of Psychology.
authors.forename: Sean
authors.initials: S
authors.lastname: Phipps
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology*; D013313:Stress Disorders, Post-Traumatic / Q000523:psychology*; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data; D013997:Time Factors; D055815:Young Adult