The Assessment of Posttraumatic Stress Disorder in Pediatric Cancer Patients and Survivors

Abstract

Investigated the incidence and severity of Posttraumatic Stress Disorder (PTSD) in childhood cancer using informant methodology. The parents of pediatric cancer patients (n = 30) and off-treatment survivors (n = 42) completed a modified version of the Posttraumatic Stress Disorder Symptom Scale (PSS) on their children (M age = 8.8: SD = 4.0), in addition to the Child Behavior Checklist (CBCL) and the Personality Inventory for Children (PIC). Medical treatment and demographic data were also collected for each child. The only variables that significantly identified the presence of symptoms of PTSD were being on treatment at the time of the evaluation or in the preparatory phase prior to bone marrow transplantation and not having received cranial irradiation. Results indicate that a full constellation of PTSD symptoms can occur in children over the course of cancer treatment. Within the off-treatment pediatric cancer survivors, however, the incidence of PTSD was no greater than epidemiological estimates from the general population. The concurrent validity of the PSS received support, and the results, while preliminary, suggest that extended periods of medical trauma during which emotional support is present may not excessively predispose children to PTSD.

Persistent psychological distress in long-term survivors of pediatric sarcoma: the experience at a single institution

“…Prevalence among pediatric cancer survivors is reported to range from rates of 5 to 10% both for children on treatment (Butler et al, 1996) and for healthy controls . Higher rates have been reported in young adult survivors --a finding consistent with ours (Stuber et al, 1996).…”

“…Field trials and studies that have examined the relationship between cancer survival and PTSD have found that a substantial number of survivors report symptoms consistent with PTSD (Alter et al, 1996;Stuber et al, 1996;Pelcovitz, 1998). Rates of PTSD appear to be lower in pediatric and adolescent cancer survivors (Butler et al, 1996;Erickson and Steiner, 2002;Kazak et al, 2004) than young adult samples, with about 20% of young adult childhood cancer survivors meeting PTSD criteria (Hobbie et al, 2000). Emerging evidence that the transition to early adulthood is a time of increased psychosocial vulnerability for childhood cancer survivors (Zeltzer et al, 1997;Glover et al, 2003;Recklitis et al, 2003) supports this finding.…”

Social and emotional adjustment in young survivors of childhood cancer

“…Measured with the Posttraumatic Stress Disorder Symptom Scale, completed by parents about their children, the incidence of PTS disorder (PTSD) was no greater in survivors of cancer than in the general population [6]. Pelcovitz et al [32] used the Structured Clinical Interview for DSM-PTSD.…”

Educational and social late effects of childhood cancer and related clinical, personal, and familial characteristics

“…adjustment [25][26][27][28][29][30] also have been assessed in childhood cancer survivors; and, although the results have been inconsistent, poorer outcomes for survivors generally are reported. In our own work, poorer physical and psychosocial quality of life was reported in survivors of childhood cancer who still were children and adolescents when they were studied compared with their age-matched and gender-matched counterparts from the general population.…”