Stress‐related mental disorders in childhood cancer survivors

Schrag, Nicole M.; McKeown, Robert E.; Jackson, Ken; Cuffe, Steven P.; Neuberg, Ronnie W.

doi:10.1002/pbc.21285

Cited by 50 publications

(40 citation statements)

References 40 publications

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“…16,28 Most studies employed a cross-sectional design, with only four studies using a longitudinal design. 17,35,37,38 Only nine studies included a comparison or control group. 16,17,21,28,29,31,34,36,37 Seven self-report measures, including the Adolescent Dissociative Experiences Scale-II (A-DES), 39 Posttraumatic Stress Diagnostic Scale (PDS), 40 University of California at Los Angeles Posttraumatic Stress Disorder Index (PTSDI), 41 Posttraumatic Stress Checklist-Civilian Version (PCL-C), 42 Child Posttraumatic Stress Reaction Index -Revision 2 (CPTS-RI), 43 Trauma Symptom Checklist for ChildrenAlternate version (TSCC-A), 44 Posttraumatic Stress Disorder Reaction Index (PTSD-RI), 41 and one interview (Impact of Traumatic Stressors Interview Schedule [ITSIS]) 33 were used to measure PTSS.…”

Section: Study Methodologiesmentioning

confidence: 99%

“…29 With regard to the heterogeneity of diagnoses, the majority of studies examined survivors of all cancers, with seven studies excluding central nervous system malignancies, 17,19,22,25,31,34,38 and only one focusing on Hodgkin's lymphoma survivors. 29 The majority (number [n] =14) of studies examined both PTSS and PTSD outcomes; five assessed PTSD alone 16,18,25,36,37 and four evaluated PTSS alone. 22,27,34,38 Sample sizes ranged from 23-6,542, with ten samples of less than 100, 17,19,[23][24][25][30][31][32]36 eleven samples between 100 and 350, 18,20,22,26,29,[33][34][35]37,38 and two samples exceeding 6,500.…”

Section: Study Methodologiesmentioning

confidence: 99%

“…29 The majority (number [n] =14) of studies examined both PTSS and PTSD outcomes; five assessed PTSD alone 16,18,25,36,37 and four evaluated PTSS alone. 22,27,34,38 Sample sizes ranged from 23-6,542, with ten samples of less than 100, 17,19,[23][24][25][30][31][32]36 eleven samples between 100 and 350, 18,20,22,26,29,[33][34][35]37,38 and two samples exceeding 6,500. 16,28 Most studies employed a cross-sectional design, with only four studies using a longitudinal design.…”

Section: Study Methodologiesmentioning

confidence: 99%

“…[31][32][33][34][35][36][37][38] The reported ages of participating survivors ranged from 7 years 21 to 71 years. 29 With regard to the heterogeneity of diagnoses, the majority of studies examined survivors of all cancers, with seven studies excluding central nervous system malignancies, 17,19,22,25,31,34,38 and only one focusing on Hodgkin's lymphoma survivors.…”

Section: Study Methodologiesmentioning

confidence: 99%

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A narrative review of the occurrence of posttraumatic stress responses in adolescent and young adult cancer survivors

Vuotto¹,

Perez²,

Krull³

et al. 2015

COAYA

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Adolescent and young adult cancer survivors may experience posttraumatic stress responses following cancer diagnosis or treatment. The current paper reviews 23 studies reporting the occurrence of posttraumatic stress symptoms (PTSS) and posttraumatic stress disorder (PTSD), and associated predictors of these outcomes in adolescent and young adult cancer survivors. Results indicate considerable variability among prevalence estimates of PTSD (0%-34.8%) and PTSS (4.4%-78%). Measurement inconsistencies limiting the ascertainment of reliable prevalence and risk estimates are discussed in the context of the reviewed literature. Specifically, differences in assessment measures utilized, the timing of assessment relative to diagnosis, the criteria used to define the outcome, and identification of the precipitating traumatic event may account for discrepancies in prevalence and risk estimates across studies. The application of specific PTSD diagnostic criteria to a survivorship population is discussed. Empirically supported interventions utilizing cognitive behavioral therapy approaches for the treatment of PTSS in adolescent and young adult cancer survivors are identified.

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Section: Study Methodologiesmentioning

confidence: 99%

Section: Study Methodologiesmentioning

confidence: 99%

Section: Study Methodologiesmentioning

confidence: 99%

Section: Study Methodologiesmentioning

confidence: 99%

See 2 more Smart Citations

A narrative review of the occurrence of posttraumatic stress responses in adolescent and young adult cancer survivors

Vuotto¹,

Perez²,

Krull³

et al. 2015

COAYA

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“…Similar impairments in function have also been described in people with PTSD within the general population (5, 7). Subsequent studies of PTSD in adult survivors of childhood cancer with sample sizes ranging from 45 to 368 have reported prevalence rates from 13% to 19% (8,9,10). PTSD has been associated with female gender, being unemployed, lower educational level, cancer of the central nervous system, and severe late effects or health problems (11).…”

Section: Abstract Childhood Cancer; Young Adultmentioning

confidence: 99%

Prevalence and predictors of posttraumatic stress disorder in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

Stuber

Meeske

Zebrack

et al. 2009

JCO

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Objective-Recent studies have found that a subset of young adult survivors of childhood cancer report posttraumatic stress symptoms in response to their diagnosis and treatment. However, it is unclear if these symptoms are associated with impairment in daily functions and/or significant distress, thereby resulting in a clinical disorder. Furthermore, it is unknown whether this disorder continues into very long-term survivorship, including the 3 rd and 4 th decades of life. This study hypothesized that very long-term survivors of childhood cancer would be more likely to report symptoms of posttraumatic stress disorder, with functional impairment and/or clinical distress, compared to a group of healthy siblings.Patients and Methods-6,542 childhood cancer survivors over the age of 18 who were diagnosed between 1970 and 1986 and 368 siblings of cancer survivors completed a comprehensive demographic and health survey.Results-589 survivors (9%) and 8 siblings (2%) reported functional impairment and/or clinical distress in addition to the set of symptoms consistent with a full diagnosis of Posttraumatic Stress Disorder (PTSD). Survivors had more than a four-fold risk of PTSD compared to siblings (OR=4.14, 95%CI: 2.08-8.25). Controlling for demographic and treatment variables, increased risk of PTSD was associated with educational level of high school or less (OR=1.51, 95% CI=1.16-1.98), being unmarried (OR=1.99, 95% CI=1.58-2.50), annual income less than $20,000Address correspondence to Margaret L. Stuber at UCLA Semel Institute, 760 Westwood Plaza, Los Angeles, CA 90024-1759. Telephone: 310 825-5213, Fax: 310 206-4446, mstuber@mednet.ucla (4), one symptom of re-experiencing, three avoidance symptoms, and two symptoms of increased arousal must be present. In addition, symptoms must be severe enough to cause clinical distress or functional impairment. Symptoms must also be in response to an event that ended at least one month prior to assessment, was perceived as a threat to life or body integrity of self or a loved one, and elicited feelings of horror, intense fear or helplessness.Previous studies of PTSD in childhood cancer survivors have found a minority of survivors reporting significant symptoms, with as few as 3% of survivors 8 to 20 years old (1) to 20% in young adult survivors (2). Compared to a rate of 8.6% in a recent study of 965 adults attending a primary care clinic (5), young adult survivors, but not younger survivors, appeared to have a significantly increased prevalence of PTSD symptoms. Although no formal assessment of clinical distress or functional impairment was done as a part of the diagnosis, the young adult survivors who reported symptoms of PTSD were less likely to be married, and reported more psychological distress and poorer quality of life across all domains (6). Similar impairments in function have also been described in people with PTSD within the general population (5, 7).Subsequent studies of PTSD in adult survivors of childhood cancer with sample sizes ranging from 45 to 368 ha...

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A Multimodal Lifestyle Psychosocial Survivorship Program in Young Cancer Survivors

von Grundherr,

Elmers,

Koch

et al. 2024

JAMA Netw Open

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ImportanceThere is a lack of trials examining the effect of counseling interventions for child, adolescent, and younger adult (CAYA) cancer survivors.ObjectiveTo assess lifestyle habits and the psychosocial situation of CAYAs to determine the efficacy of needs-based interventions in the CARE for CAYA program (CFC-P).Design, Setting, and ParticipantsThe CFC-P was conducted as a multicenter program in 14 German outpatient clinics, mainly university cancer centers. Recruitment began January 1, 2018; a randomized clinical trial was conducted until July 15, 2019; and intervention was continued as a longitudinal cohort study until March 31, 2021. Data preparation was conducted from April 1, 2021, and analysis was conducted from August 14, 2021, to May 31, 2022. Herein, predefined confirmatory analyses pertain to the RCT and descriptive results relate to the overall longitudinal study. Data analysis was based on the full analysis set, which is as close as possible to the intention-to-treat principle.InterventionA comprehensive assessment determined needs in physical activity, nutrition and psychooncology. Those with high needs participated in 1 to 3 modules. In the RCT, the IG received 5 counseling sessions plus newsletters, while the control group CG received 1 counseling session.Main Outcomes and MeasuresThe primary outcome was the change in the rate of CAYAs with high needs at 52 weeks. Secondary outcomes were feasibility, modular-specific end points, satisfaction, quality of life, and fatigue.ResultsOf 1502 approached CAYAs aged 15 to 39 years, 692 declined participation. Another 22 CAYAs were excluded, resulting in 788 participants. In the randomized clinical trial, 359 CAYAs were randomized (intervention group [IG], n = 183; control group [CG], n = 176), and 274 were followed up. In the RCT, the median age was 25.0 (IQR, 19.9-32.2) years; 226 were female (63.0%) and 133 male (37.0%). After 52 weeks, 120 CAYAs (87.0%) in the IG and 115 (86.5%) in the CG still had a high need in at least 1 module (odds ratio, 1.04; 95% CI, 0.51-2.11; P = .91). Both groups reported reduced needs, improved quality of life, reduced fatigue, and high satisfaction with the CFC-P.Conclusions and RelevanceIn this randomized clinical trial, the implementation of a lifestyle program in this cohort was deemed necessary, despite not meeting the primary outcome. The interventions did not alter the rate of high needs. The results may provide guidance for the development of multimodal interventions in the follow-up care of CAYAs.Trial RegistrationGerman Clinical Trial Register: DRKS00012504

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Stress‐related mental disorders in childhood cancer survivors

Cited by 50 publications

References 40 publications

A narrative review of the occurrence of posttraumatic stress responses in adolescent and young adult cancer survivors

A narrative review of the occurrence of posttraumatic stress responses in adolescent and young adult cancer survivors

Prevalence and predictors of posttraumatic stress disorder in adult survivors of childhood cancer: A report from the Childhood Cancer Survivor Study

A Multimodal Lifestyle Psychosocial Survivorship Program in Young Cancer Survivors

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