Jennifer Allen1, Victoria W Willard2, James L Klosky1, Chenghong Li3, D Kumar Srivastava3, Leslie L Robison4, Melissa M Hudson4,5, Sean Phipps1. 1. Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 740, Memphis, TN, 38105, USA. 2. Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 740, Memphis, TN, 38105, USA. victoria.willard@stjude.org. 3. Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA. 4. Departments of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA. 5. Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA.
Abstract
PURPOSE: The majority of research examining posttraumatic stress symptoms/disorder (PTSS/PTSD) among adult survivors of childhood cancer has been oriented to cancer, assuming that cancer has been the most traumatic experience in their lives. Whether that assumption is valid, and how it might impact assessment of PTSS, is unknown. METHODS: Survivors in the St. Jude Lifetime Cohort study completed an assessment of PTSS without cancer orientation, global psychological functioning, perceived stress, and cancer-related anxiety. RESULTS: Participants (n = 2969; Mage = 32.5 ± 8.5 years, 24.1 years since diagnosis, 49.1% female) obtained a mean score on the PTSD Checklist of 27.7, which is comparable to a normative population. Using established cutoffs, 11.8% obtained scores in the at-risk range. Multivariable modeling indicated that psychological factors [global distress (p < 0.0001), perceived stress (p = 0.001), cancer-related anxiety (p < 0.0001)] and demographic variables [female gender (p < 0.0001), survivors with less than a college education (p = 0.002)] were risk factors for increased PTSS. Only 14.5% identified a cancer-related traumatic event, and there was no difference in PTSS scores between those who identified cancer vs. non-cancer events as most stressful (28.4 ± 12.6 vs. 28.5 ± 12.7, p = 0.93). CONCLUSION: One in eight adult long-term survivors of childhood cancer had PTSS above the cutoff, though subgroups (e.g., females and those with lower education) report more distress symptoms. Most adult survivors do not identify cancer as their most stressful event. IMPLICATIONS FOR CANCER SURVIVORS: Screening for distress in survivorship clinics should not assume that distress is directly related to the survivor's cancer experience.
PURPOSE: The majority of research examining posttraumatic stress symptoms/disorder (PTSS/PTSD) among adult survivors of childhood cancer has been oriented to cancer, assuming that cancer has been the most traumatic experience in their lives. Whether that assumption is valid, and how it might impact assessment of PTSS, is unknown. METHODS: Survivors in the St. Jude Lifetime Cohort study completed an assessment of PTSS without cancer orientation, global psychological functioning, perceived stress, and cancer-related anxiety. RESULTS:Participants (n = 2969; Mage = 32.5 ± 8.5 years, 24.1 years since diagnosis, 49.1% female) obtained a mean score on the PTSD Checklist of 27.7, which is comparable to a normative population. Using established cutoffs, 11.8% obtained scores in the at-risk range. Multivariable modeling indicated that psychological factors [global distress (p < 0.0001), perceived stress (p = 0.001), cancer-related anxiety (p < 0.0001)] and demographic variables [female gender (p < 0.0001), survivors with less than a college education (p = 0.002)] were risk factors for increased PTSS. Only 14.5% identified a cancer-related traumatic event, and there was no difference in PTSS scores between those who identified cancer vs. non-cancer events as most stressful (28.4 ± 12.6 vs. 28.5 ± 12.7, p = 0.93). CONCLUSION: One in eight adult long-term survivors of childhood cancer had PTSS above the cutoff, though subgroups (e.g., females and those with lower education) report more distress symptoms. Most adult survivors do not identify cancer as their most stressful event. IMPLICATIONS FOR CANCER SURVIVORS: Screening for distress in survivorship clinics should not assume that distress is directly related to the survivor's cancer experience.
Entities:
Keywords:
Adult survivors; Cancer survivorship; Posttraumatic stress; St. Jude Lifetime Cohort (SJLIFE)
Authors: Iris M Engelhard; Marcel A van den Hout; Jos Weerts; Arnoud Arntz; Joop J C M Hox; Richard J McNally Journal: Br J Psychiatry Date: 2007-08 Impact factor: 9.319
Authors: Ronald C Kessler; Patricia Berglund; Olga Demler; Robert Jin; Kathleen R Merikangas; Ellen E Walters Journal: Arch Gen Psychiatry Date: 2005-06
Authors: Roger J Packer; James G Gurney; Judy A Punyko; Sarah S Donaldson; Peter D Inskip; Marilyn Stovall; Yutaka Yasui; Ann C Mertens; Charles A Sklar; H Stacy Nicholson; Lonnie K Zeltzer; Joseph P Neglia; Leslie L Robison Journal: J Clin Oncol Date: 2003-09-01 Impact factor: 50.717
Authors: Philip E Wolfson; Julane Andries; Allison A Feduccia; Lisa Jerome; Julie B Wang; Emily Williams; Shannon C Carlin; Evan Sola; Scott Hamilton; Berra Yazar-Klosinski; Amy Emerson; Michael C Mithoefer; Rick Doblin Journal: Sci Rep Date: 2020-11-24 Impact factor: 4.379
Authors: Donghao Lu; Yadav Sapkota; Unnur A Valdimarsdóttir; Karestan C Koenen; Nan Li; Wendy M Leisenring; Todd Gibson; Carmen L Wilson; Leslie L Robison; Melissa M Hudson; Gregory T Armstrong; Kevin R Krull; Yutaka Yasui; Smita Bhatia; Christopher J Recklitis Journal: Transl Psychiatry Date: 2022-08-23 Impact factor: 7.989