Stuber M L, Kazak A E, Meeske K, Barakat L
Neuropsychiatric Institute, University of California, Los Angeles, USA.
Child Adolesc Psychiatr Clin N Am. 1998 Jan;7(1):169-82.
The application of a trauma model to understanding the impact of life-threatening illness has been informative. In the case of childhood cancer patients, it appears clear that a full PTSD syndrome is not the normative response either during or after treatment. Some aspects of cancer diagnosis and treatment, however, are experienced as traumatic by a subset of children, some of whom report symptoms of posttraumatic stress. There is some evidence that children may respond to cancer treatment as a repeated trauma, with the result of more subtle changes in affect modulation, world view, and interpersonal relationships. This area requires further investigation. The trauma model is also useful in understanding parental responses to childhood cancer. The epidemiologic data to date regarding posttraumatic stress symptoms in parents of childhood cancer survivors is consistent with the trauma literature regarding responses to moderate-magnitude traumatic exposure. These findings have important implications for clinical interventions for families of childhood cancer patients. More research is needed in the prediction and prevention of the long-term distress reported by so many parents of children who have undergone successful treatment for life-threatening illness.
将创伤模型应用于理解危及生命的疾病的影响已颇具启发性。就儿童癌症患者而言，很明显，无论是在治疗期间还是治疗后，完整的创伤后应激障碍综合征都不是常态反应。然而，癌症诊断和治疗的某些方面会被一部分儿童视为创伤性经历，其中一些儿童报告有创伤后应激症状。有证据表明，儿童可能会将癌症治疗视为反复的创伤，结果在情感调节、世界观和人际关系方面出现更细微的变化。这一领域需要进一步研究。创伤模型在理解父母对儿童癌症的反应方面也很有用。迄今为止，关于儿童癌症幸存者父母创伤后应激症状的流行病学数据与创伤文献中关于对中度创伤暴露反应的研究结果一致。这些发现对儿童癌症患者家庭的临床干预具有重要意义。对于众多子女成功治愈危及生命疾病的父母所报告的长期痛苦的预测和预防，还需要更多的研究。
