Symptoms of post-traumatic stress in children with cancer: does personality trump health status?

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Objective:To examine the symptoms of post-traumatic stress (PTSS) in children as a function of health status (cancer vs healthy) and adaptive style.Methods:Children with cancer (N=199) and healthy acquaintance control children (N=108) completed a standardized measure of PTSS. Measures of trait anxiety and defensiveness were obtained to characterize the adaptive style of respondents.Results:Within the cancer group, levels of PTSS did not differ as a function of diagnosis, time since diagnosis, or whether children were on- or off-treatment. The only cancer-related factor associated with elevated PTSS was a history or relapse or recurrence. Children with cancer reported significantly fewer symptoms of re-experiencing/intrusion than did healthy children, but also reported greater symptoms of numbing/avoidance. However, there were no differences in total PTSS scores between children with cancer and controls. In contrast, a significant effect of adaptive style on PTSS was observed, with children identified as repressors or low anxious obtaining lower scores on total PTSS and all PTSS subscales than high-anxious children, regardless of health status. Estimates of the number of children meeting criteria for post-traumatic stress disorder did not differ between children with cancer and healthy children, and were low in both groups.Conclusions:Children with cancer report levels of PTSS that are not higher than that of their healthy peers. Personality factors such as adaptive style are a much more salient determinant of PTSS than is health history. These findings raise further questions regarding the value of a traumatic stress model for understanding the experiences of children with cancer. Copyright © 2009 John Wiley & Sons, Ltd.

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