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Comprehensive Handbook of Childhood Cancer and Sickle Cell DiseaseA Biopsychosocial Approach$
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Ronald T. Brown

Print publication date: 2006

Print ISBN-13: 9780195169850

Published to Oxford Scholarship Online: November 2020

DOI: 10.1093/oso/9780195169850.001.0001

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Posttraumatic Stress and Posttraumatic Growth in Childhood Cancer Survivors and Their Parents

Posttraumatic Stress and Posttraumatic Growth in Childhood Cancer Survivors and Their Parents

Chapter:
(p.279) 15 Posttraumatic Stress and Posttraumatic Growth in Childhood Cancer Survivors and Their Parents
Source:
Comprehensive Handbook of Childhood Cancer and Sickle Cell Disease
Author(s):

Margaret L. Stuber

Publisher:
Oxford University Press
DOI:10.1093/oso/9780195169850.003.0021

Few would disagree that a diagnosis of childhood cancer is shocking and frightening to the child and to the child’s family. In addition to the sudden and dreadful diagnosis, the intensive and often lengthy treatment is extremely stressful. The combination of diagnosis and subsequent treatment frequently leaves children and parents feeling helpless. However, life-threatening illness has historically been categorized as stressful but not “traumatic” in the way that interpersonal violence or natural disasters are traumatic. In fact, the third edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III) (American Psychiatric Association [APA], 1987) stated that “chronic medical illness” was specifically excluded as a potential precipitant of a formal psychiatric diagnosis of posttraumatic stress disorder (PTSD). This was important because PTSD is the only diagnosis in the DSM that includes a cause or precipitating event within the diagnostic criteria rather than simply offering a description of typical symptoms. Clinical observations challenging the perception that cancer was not sufficiently “traumatic” to precipitate the symptoms of PTSD began to be described in the psychiatric literature in the 1980s and prompted a series of field trials in preparation for the fourth edition of the DSM. A group of 24 adolescent cancer survivors and their mothers were interviewed, and findings revealed that a substantial minority of both groups met criteria for a diagnosis of PTSD (Alter et al., 1996). Life-threatening medical illness was subsequently included as a potential precipitating event for PTSD in the text of the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) in 1994. The accompanying text specified not only that the person experiencing the medical life threat might respond with posttraumatic stress but also that this might also be a precipitant for family members. This allowed a common framework for researchers to investigate posttraumatic stress responses to medical life threat in adult patients, spouses of patients, and childhood patients, their siblings, and their parents. In this chapter, we review the growing body of literature that has emerged regarding the epidemiology, correlates, and predictors of posttraumatic stress symptoms in those exposed to medical life threat.

Keywords:   adversarial growth, posttraumatic growth, posttraumatic stress, posttraumatic stress disorder (PTSD), posttraumatic stress symptoms (PTSS), selective serotonin reuptake inhibitors (SSRIs)

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