Appraisal of life threat and acute trauma responses in pediatric bone marrow transplant patients.

Although traumatic responses in children are well-documented following exposure to a variety of life-threatening circumstances, little is known about the subjective appraisal of children during the acute exposure. This paper presents both descriptive and quantifiable data regarding the responses of children during the acute phase of hospitalization for bone marrow transplantation, an extremely aggressive treatment for otherwise fatal illnesses. Children were able to appreciate the life-threatening nature of their illness and its treatment. They reported few symptoms consistent with a traumatic stress response. These findings are in contrast to recent data on survivors of childhood cancer, who generally report that they did not understand that their illness posed a threat to their lives, while reporting moderate levels of posttraumatic stress symptoms up to 10 years after completion of successful treatment. Implications of these findings are discussed.