Department of Psychology, St. Jude Children's Research Hospital.
Department of Biostatistics, St. Jude Children's Research Hospital.
Health Psychol. 2022 Apr;41(4):256-267. doi: 10.1037/hea0001132. Epub 2021 Dec 2.
Childhood cancer represents a potentially traumatic experience for both patients and caregivers. We examined trajectories of posttraumatic stress symptoms (PTSS) across a 5-year period in children with a history of cancer and their parents/caregivers. Medical, demographic, and dispositional variables were examined as predictors of PTSS trajectories.
Using a longitudinal design, children with cancer history ( = 254, age 8-17 years at baseline) and one parent or caregiver ( = 255) completed measures of PTSS at baseline, and 1-, 3-, and 5-years poststudy entry. Children and caregivers completed dispositional measures including optimism, positive or negative affect, and Five-Factor Inventories. Latent class growth analysis (LCGA) was used to identify latent trajectories of PTSS, and univariate logistic regression models were conducted to predict LCGA class membership from medical, demographic, and disposition factors Results: Very similar trajectories were observed in children and caregivers, with two-class solutions providing the best fit: a "resilient" class, with low PTSS at baseline, which declined significantly over time (83.5% in children; 71.5% in parents), and an "elevated PTSS" class, which was moderately high at baseline and increased significantly over time. There was a small, but significant relationship between child and caregiver trajectories. Latent trajectories observed in children and parents were more strongly associated with dispositional variables than medical factors.
Resilience, depicted by low PTSS, is by far the most common outcome observed in both children and caregivers. However, the smaller subset with elevated PTSS do not show recovery over time, and are identified as a group in need of targeted interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
儿童癌症对患者和照顾者来说都是一种潜在的创伤经历。我们研究了患有癌症病史的儿童及其父母/照顾者在 5 年内创伤后应激症状 (PTSS) 的轨迹。检查了医学、人口统计学和性格变量作为 PTSS 轨迹的预测因素。
使用纵向设计,有癌症病史的儿童(n=254,基线时年龄为 8-17 岁)及其一位父母或照顾者(n=255)在基线时以及研究开始后 1、3 和 5 年完成了 PTSS 测量。儿童和照顾者完成了性格测量,包括乐观、积极或消极情绪以及五因素人格量表。潜类别增长分析(LCGA)用于识别 PTSS 的潜在轨迹,并使用单变量逻辑回归模型从医学、人口统计学和性格因素预测 LCGA 类别成员。结果:儿童和照顾者的轨迹非常相似,两类别解决方案提供了最佳拟合:一个“有弹性”类别,基线时 PTSS 较低,随时间显著下降(儿童中 83.5%;父母中 71.5%),另一个“PTSS 升高”类别,基线时中度较高,随时间显著增加。儿童和照顾者的轨迹之间存在小但显著的关系。在儿童和父母中观察到的潜在轨迹与性格变量的关系比医学因素更密切。
迄今为止,在儿童和照顾者中观察到的最常见结果是恢复力,表现为低 PTSS。然而,具有较高 PTSS 的较小亚组不会随着时间的推移而恢复,并且被确定为需要有针对性干预的群体。(PsycInfo 数据库记录(c)2022 APA,保留所有权利)。