Zebrack Brad, Kwak Minyoung, Salsman John, Cousino Melissa, Meeske Kathleen, Aguilar Christine, Embry Leanne, Block Rebecca, Hayes-Lattin Brandon, Cole Steve
University of Michigan School of Social Work, 1080 S. University, Ann Arbor, MI, USA.
Psychooncology. 2015 Feb;24(2):162-8. doi: 10.1002/pon.3585. Epub 2014 Jun 11.
Theories of posttraumatic growth suggest that some degree of distress is necessary to stimulate growth; yet, investigations of the relationship between stress and growth following trauma are mixed. This study aims to understand the relationship between posttraumatic stress symptoms and posttraumatic growth in adolescent and young adult (AYA) cancer patients.
165 AYA patients aged 14-39 years at diagnosis completed standardized measures of posttraumatic stress and posttraumatic growth at 12 months following diagnosis. Locally weighted scatterplot smoothing and regression were used to examine linear and curvilinear relationships between posttraumatic stress and posttraumatic growth.
No significant relationships between overall posttraumatic stress severity and posttraumatic growth were observed at 12-month follow-up. However, curvilinear relationships between re-experiencing (a posttraumatic stress symptom) and two of five posttraumatic growth indicators (New Possibilities, Personal Strengths) were observed.
Findings suggest that re-experiencing is associated with some aspects of posttraumatic growth but not others. Although re-experiencing is considered a symptom of posttraumatic stress disorder, it also may represent a cognitive process necessary to achieve personal growth for AYAs. Findings call into question the supposed psychopathological nature of re-experiencing and suggest that re-experiencing, as a cognitive process, may be psychologically adaptive. Opportunities to engage family, friends, cancer survivors, or health care professionals in frank discussions about fears, worries, or concerns may help AYAs re-experience cancer in a way that enhances their understanding of what happened to them and contributes to positive adaptation to life after cancer.
创伤后成长理论表明，一定程度的痛苦对于刺激成长是必要的；然而，关于创伤后压力与成长之间关系的研究结果并不一致。本研究旨在了解青少年和青年（AYA）癌症患者创伤后应激症状与创伤后成长之间的关系。
165名确诊时年龄在14 - 39岁的AYA患者在确诊后12个月完成了创伤后应激和创伤后成长的标准化测量。使用局部加权散点图平滑法和回归分析来检验创伤后应激与创伤后成长之间的线性和曲线关系。
在12个月的随访中，未观察到总体创伤后应激严重程度与创伤后成长之间存在显著关系。然而，观察到闯入性重现（一种创伤后应激症状）与五个创伤后成长指标中的两个（新的可能性、个人优势）之间存在曲线关系。
研究结果表明，闯入性重现与创伤后成长的某些方面相关，但与其他方面无关。尽管闯入性重现被认为是创伤后应激障碍的一种症状，但它也可能代表AYA患者实现个人成长所需的认知过程。研究结果对闯入性重现所谓的精神病理学本质提出了质疑，并表明作为一种认知过程，闯入性重现可能具有心理适应性。让家人、朋友、癌症幸存者或医护人员参与关于恐惧、担忧或关切的坦诚讨论，可能有助于AYA患者以一种增强他们对自身经历的理解并促进对癌症后生活的积极适应的方式重新体验癌症经历。
