Division of Child and Adolescent Health Psychology, Department of Psychology, University of Zurich, Zurich, Switzerland.
Department of Psychosomatics and Psychiatry, University Children's Hospital Zurich, Zurich, Switzerland.
J Pediatr Psychol. 2024 Nov 1;49(11):818-826. doi: 10.1093/jpepsy/jsae077.
The way in which parental posttraumatic stress symptoms (PTSS) unfold in the first year after a cancer diagnosis in their child is poorly understood. The aims of this study were to identify parental PTSS trajectories and to examine couple-related predictors (dyadic coping and we-disease appraisals), sociodemographic predictors (education and sex), and medical predictors (child's physical impairment) of trajectory membership.
A 1-year prospective study was conducted, and 157 parents of children newly diagnosed with cancer were assessed. PTSS was measured with the Posttraumatic Diagnostic Scale for DSM-5 (PDS-5) at 3-6 weeks (T1), 6 months (T2), and 12 months (T3) after the diagnosis. The trajectories were identified with Latent Class Growth Analysis, the predictors were explored with binomial logistic regression.
Two distinct trajectories were found. The majority of parents (86.0%) followed a low PTSS trajectory, characterized by initially low scores that slightly decreased over 12 months. In contrast, 14.0% of parents displayed a stable, high PTSS trajectory. A high trajectory of child's physical impairment and low scores in parental dyadic coping were significantly associated with the likelihood of a high parental PTSS trajectory.
The findings provide new insights into the critical period of the first year after a child's cancer diagnosis. While most parents display a resilient, low PTSS trajectory, a minority consistently experience high PTSS levels. Child's physical impairment and dyadic coping should be considered as predictors for early identification of vulnerable parents. Incorporating dyadic coping in parental support following a childhood cancer diagnosis could be beneficial for parental mental health.
父母创伤后应激症状(PTSS)在孩子癌症诊断后第一年的发展方式尚不清楚。本研究旨在确定父母的 PTSS 轨迹,并探讨与夫妻相关的预测因素(夫妻应对和我们对疾病的评估)、社会人口统计学预测因素(教育和性别)以及与轨迹成员身份相关的医学预测因素(孩子的身体损伤)。
进行了为期 1 年的前瞻性研究,共评估了 157 名新诊断为癌症的儿童的父母。PTSS 使用 DSM-5 创伤后诊断量表(PDS-5)在诊断后 3-6 周(T1)、6 个月(T2)和 12 个月(T3)进行测量。使用潜在类别增长分析确定轨迹,使用二项逻辑回归探索预测因素。
发现了两种不同的轨迹。大多数父母(86.0%)表现出低 PTSS 轨迹,其特征是最初分数较低,在 12 个月内略有下降。相比之下,14.0%的父母表现出稳定的高 PTSS 轨迹。儿童身体损伤程度高和父母夫妻应对能力评分低与父母高 PTSS 轨迹的可能性显著相关。
这些发现为儿童癌症诊断后第一年的关键时期提供了新的见解。虽然大多数父母表现出有弹性的低 PTSS 轨迹,但少数父母始终经历高 PTSS 水平。儿童身体损伤和夫妻应对能力应被视为识别弱势父母的早期预测因素。在儿童癌症诊断后为父母提供支持时纳入夫妻应对能力可能对父母的心理健康有益。