Trajectories of Resilience and Posttraumatic Stress in Childhood Cancer: Consistency of Child and Parent Outcomes

• Published in: Health psychology 2022-04, Vol.41 (4), p.256-267
• Main Authors: Sharp, Katianne, Tillery, Rachel, Long, Alanna, Wang, Fang, Pan, Haitao, Phipps, Sean
• Format: Article
• Language: English
• Subjects: Adolescent; Cancer; Caregiver burden; Caregivers; Child; Childhood; Childhood Development; Childhood Neoplasms; Demographic Characteristics; Demography; Family; Female; Human; Humans; Male; Negative Emotions; Neoplasms; Neoplasms - psychology; Optimism; Parents; Parents & parenting; Parents - psychology; Personality; Positive emotions; Post traumatic stress disorder; Posttraumatic Stress; Resilience; Resilience (Psychological); Stress Disorders, Post-Traumatic - psychology
• ISSN: 0278-6133; 1930-7810; 1930-7810
• DOI: 10.1037/hea0001132

Objective: 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. Method: Using a longitudinal design, children with cancer history (n = 254, age 8-17 years at baseline) and one parent or caregiver (n = 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. Conclusions: 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.