Cordova Matthew J, Andrykowski Michael A
VA Palo Alto Health Care System, CA 94304, USA.
Semin Clin Neuropsychiatry. 2003 Oct;8(4):286-96.
The diagnosis and treatment of cancer can be an extremely stressful, and possibly traumatic, experience. Not surprisingly, there is considerable research documenting the potential negative psychosocial sequelae of malignant disease. More recently, however, research has documented that a broad range of both positive and negative psychosocial outcomes might follow cancer diagnosis and treatment. This suggests that a sole focus on distress and dysfunction could paint an incomplete and potentially misleading picture of the cancer experience. Evidence suggesting that cancer could be a traumatic stressor for some patients is reviewed, as is evidence suggesting that it might precipitate both posttraumatic stress and posttraumatic growth, at times within the same individual. We conclude by offering a conceptual model of cancer as a psychosocial transition. Rather than viewing cancer as a trauma with uniformly negative effects on quality of life, it might be more appropriate to view cancer as a psychosocial transition with the potential for both positive and negative outcomes.
癌症的诊断和治疗可能是一段极具压力、甚至可能造成创伤的经历。毫不奇怪,有大量研究记录了恶性疾病潜在的负面心理社会后遗症。然而,最近的研究表明,癌症诊断和治疗之后可能会出现一系列广泛的积极和消极心理社会结果。这表明,仅关注痛苦和功能障碍可能会描绘出一幅不完整且可能产生误导的癌症经历图景。本文回顾了表明癌症可能对某些患者构成创伤性应激源的证据,以及表明它可能引发创伤后应激和创伤后成长(有时在同一个体内)的证据。我们通过提供一个将癌症视为心理社会转变的概念模型来得出结论。与其将癌症视为对生活质量具有统一负面影响的创伤,或许更合适的做法是将癌症视为一个可能产生积极和消极结果的心理社会转变。