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

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.