Lung Cancer Diagnosis and Treatment as a Traumatic Stressor in DSM-IV and DSM-5: Prevalence and Relationship to Mental Health Outcomes

• Published in: Journal of traumatic stress 2015-06, Vol.28 (3), p.206-213
• Main Authors: Andrykowski, Michael A., Steffens, Rachel F., Bush, Heather M., Tucker, Thomas C.
• Format: Article
• Language: English
• Subjects: Adaptation, Psychological; Adult; Age Factors; Aged; Carcinoma, Non-Small-Cell Lung - diagnosis; Carcinoma, Non-Small-Cell Lung - psychology; Carcinoma, Non-Small-Cell Lung - therapy; Diagnostic and Statistical Manual of Mental Disorders; Female; Humans; Lung cancer; Lung Neoplasms - diagnosis; Lung Neoplasms - psychology; Lung Neoplasms - therapy; Male; Mental disorders; Mental Health; Middle Aged; Sex Factors; Stress Disorders, Traumatic - diagnosis; Stress Disorders, Traumatic - etiology; Stress, Psychological - diagnosis; Stress, Psychological - etiology; Survivors - psychology; Trauma
• ISSN: 0894-9867; 1573-6598
• DOI: 10.1002/jts.22005

Little research has examined how lung cancer survivors whose cancer experience met the Diagnostic and Statistical Manual of Mental Disorders (DSM) traumatic stressor criterion differ with regard to posttreatment mental health status from survivors whose cancer experience did not. No research of which we are aware has examined the impact of the revised DSM‐5 traumatic stressor criterion on this question. Non‐small‐cell (NSC) lung cancer survivors (N = 189) completed a telephone interview and questionnaire assessing distress and growth/benefit‐finding. Survivors were categorized into Trauma and No Trauma groups using both the DSM‐IV and DSM‐5 stressor criterion. Using the DSM‐IV criterion, the Trauma group (n = 70) reported poorer status than the No Trauma group (n = 119) on 10 of 10 distress indices (mean ES = 0.57 SD) and better status on all 7 growth/benefit‐finding indices (mean ES = 0.30 SD). Using the DSM‐5 stressor criterion, differences between the Trauma (n = 108) and No Trauma (n = 81) groups for indices of distress (mean ES = 0.26 SD) and growth/benefit‐finding (mean ES = 0.17 SD) were less pronounced. Those who experience cancer as a traumatic stressor show greater distress and growth/benefit‐finding, particularly when the more restrictive DSM‐IV stressor criterion defines trauma exposure. Resumen Escasa investigación ha examinado cómo los sobrevivientes de cáncer pulmonar cuya experiencia con el cáncer cumple el criterio de estresor traumático del DSM difieren con respecto al estado de salud mental, de aquellos cuya experiencia con el cáncer no lo cumplían. Ninguna investigación ha examinado el impacto del criterio revisado del DSM‐5 para estresor traumático sobre esta pregunta. Sobrevivientes de cáncer pulmonar de células no‐pequeñas (N=189) completaron una entrevista telefónica y un cuestionario que evaluó sufrimiento y crecimiento postraumático. Los sobrevivientes fueron categorizados en grupos de Trauma y No Trauma usando los criterios de estresor tanto del DSM‐IV como del DSM‐5. Usando el criterio del DSM‐IV, el grupo Trauma (n=70) reportó peor estado que el grupo No Trauma (N=119) en 10 de 10 índices de sufrimiento (tamaño de efecto promedio [ES] = 0.57 desviaciones estándar [SD]) y mejor estado en la totalidad de los 7 indices de crecimiento postraumático (ES promedio = 0.30 SD). Usando el criterio de estresor del DSM‐5, las diferencias entre el grupo Trauma (n=108) y el No Trauma (n=81) para los índices de sufrimiento (ES promedio=0.26 S