Pediatric cancer can be considered an event potentially leading to posttraumatic stress symptoms (PTSS) as well as posttraumatic growth (PTG). While clinically significant levels of PTSS are rare in childhood cancer survivors, PTG is common in this population. However, the relationship of PTG to overall adaptation and quality of life (QOL) in pediatric cancer patients is not clear. Therefore, our study aims to analyse the relationships of PTSS and PTG with QOL in childhood cancer survivors. In this study, 172 childhood cancer survivors completed measures of quality of life (Minneapolis-Manchester Quality of Life Scale; child and adolescent version), posttraumatic stress (UCLA PTSD Reaction Index for DMS-IV) and posttraumatic growth (Benefit Finding Scale for Children). Correlation analyses were carried out separately for the child (up to 13 years, N = 47) and adolescent (more than 13 years, N = 125) groups and each QOL dimension. In the adolescent group, the relationship of PTSS and PTG with QOL was further verified by regression analyses while controlling for age, gender, and time off treatment. In children, negative relationships between PTSS and QOL were found, but the relationships between QOL and PTG were not significant. In adolescents, significant relationships were found for all dimensions of QOL and PTSS and also for several dimensions of QOL and PTG. The relationships between PTSS and QOL dimensions were negative in both groups, and the relationships between PTG and QOL in the adolescent group were weakly positive. In adolescents, regression analyses controlling for age, gender and time off treatment were performed and confirmed a negative relationship of PTSS with all QOL dimensions except for social functioning. For PTG, regression analyses revealed a significant positive relationship with QOL dimensions of social functioning, outlook on life and intimate relations. While the relationship between PTSS and QOL is negative for almost all QOL dimensions in children and adolescents, the nature of the relationship between PTG and QOL appears to be more complex and changing over time. PTG in children may reflect different processes with different outcomes than PTG in adolescents.

Department of Psychology Faculty of Arts Masaryk University Brno Czechia

Institute of Psychology Czech Academy of Sciences Brno Czechia

Zobrazit více v PubMed

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders, 5th Edn. Arlington, VA: American Psychiatric Association.

Berkman A. M., Robert R. S., Roth M., Askins M. A. (2020). A review of psychological symptoms and post-traumatic growth among adolescent and young adult survivors of childhood cancer. J. Health Psychol. 27 990–1005. 10.1177/1359105320971706 PubMed DOI

Bhatia S., Jenney M. E. M., Bogue M. K., Rockwood T. H., Feusner J. H., Friedman D. L., et al. (2002). The Minneapolis-Manchester quality of life instrument: Reliability and validity of the adolescent form. J. Clin. Oncol. 20 4692–4698. 10.1200/JCO.2002.05.103 PubMed DOI

Bhatia S., Jenney M. E. M., Wu E., Bogue M. K., Rockwood T. H., Feusner J. H., et al. (2004). The Minneapolis-Manchester quality of life instrument: Reliability and validity of the youth form. J. Pediatr. 145 39–46. 10.1016/j.jpeds.2004.02.034 PubMed DOI

Blatný M., Jelínek M., Sobotková V., Kepák T. (2013). The influence of developmental stage on the relationship between severity of late effects of anticancer therapy and perceived quality of life of childhood cancer survivors. SAGE Open 3:2158244013500678. 10.1177/2158244013500678 DOI

Blatný M., Kepák T., Vlèková I., Jelínek M., Tóthova K., Pilát M., et al. (2011). Quality of life of childhood cancer survivors: Handicaps and benefits. Èeskoslovenská Psychol. 55 112–125.

Bruce M. (2006). A systematic and conceptual review of posttraumatic stress in childhood cancer survivors and their parents. Clin. Psychol. Rev. 26 233–256. 10.1016/j.cpr.2005.10.002 PubMed DOI

Calhoun L. G., Tedeschi R. G. (2006). “The foundations of posttraumatic growth: An expanded framework,” in Handbook of posttraumatic growth: Research & Practice, eds Calhoun L. G., Tedeschi R. G. (Mahwah, NJ: Lawrence Erlbaum Associates Publishers; ), 3–23. 10.1371/journal.pone.0214678 DOI

Casellas-Grau A., Ochoa C., Ruini C. (2017). Psychological and clinical correlates of posttraumatic growth in cancer: A systematic and critical review. Psychoncology 26 2007–2018. 10.1002/pon.4426 PubMed DOI

Harila M. J., Salo J., Lanning M., Vilkkumaa I., Harila-Saari A. H. (2010). High health-related quality of life among long-term survivors of childhood acute lymphoblastic leukemia. Pediatr. Blood Cancer 55 331–336. 10.1002/pbc.22531 PubMed DOI

Helgeson V. S., Reynolds K. A., Tomich P. L. (2006). A meta-analytic review of benefit finding and growth. J. Consult. Clin. Psychol. 74 797–816. 10.1037/0022-006X.74.5.797 PubMed DOI

Howard Sharp K. M., Rowe A. E., Russell K., Long A., Phipps S. (2015). Predictors of psychological functioning in children with cancer: Disposition and cumulative life stressors. Psychooncology 24 779–786. 10.1002/pon.3643 PubMed DOI PMC

Husson O., Zebrack B., Block R., Embry L., Aguilar C., Hayes-Lattin B., et al. (2017). Posttraumatic growth and well-being among adolescents and young adults (AYAs) with cancer: A longitudinal study. Support. Care Cancer 25 2881–2890. 10.1007/s00520-017-3707-7 PubMed DOI PMC

Klosky J. L., Krull K. R., Kawashima T., Leisenring W., Randolph M. E., Zebrack B., et al. (2014). Relations between posttraumatic stress and posttraumatic growth in long-term survivors of childhood cancer: A report from the Childhood Cancer Survivor Study. Health Psychol. 33 878–882. 10.1037/hea0000076 PubMed DOI PMC

Koutná V., Blatný M., Jelínek M. (2021). Posttraumatic stress and growth in childhood cancer survivors: Considering the pathways for relationship. J. Psychosoc. Oncol. 39 105–117. 10.1080/07347332.2020.1789907 PubMed DOI

Kwak Y., Kim Y., Choi E. S., Im H. J. (2021). Self-efficacy, post-traumatic growth, and quality of life of pediatric cancer survivors: A cross-sectional study. Eur. J. Oncol. Nurs. 54:102019. 10.1016/j.ejon.2021.102019 PubMed DOI

Liu Z., Doege D., Thong M. S. Y., Arndt V. (2020). The relationship between posttraumatic growth and health-related quality of life in adult cancer survivors: A systematic review. J. Affect. Disord. 276 159–168. 10.1016/j.jad.2020.07.044 PubMed DOI

Lown E. A., Phillips F., Schwartz L. A., Rosenberg A. R., Jones B. (2015). Psychosocial follow-up in survivorship as a standard of care in pediatric oncology. Pediatr. Blood Cancer 62 S514–S584. 10.1002/pbc.25783 PubMed DOI PMC

Marzilliano A., Tuman M., Moyer A. (2019). The relationship between post-traumatic stress and post-traumatic growth in cancer patients and survivors: A systematic review and meta-analysis. Psychooncology 29 604–616. 10.1002/acr.22212 PubMed DOI

Meeske K. A., Ruccione K., Globe D. R., Stuber M. L. (2001). Posttraumatic stress, quality of life, and psychological distress in young adult survivors of childhood cancer. Oncol. Nurs. Forum 28 481–489. PubMed

Meyerson D. A., Grant K. E., Carter J. S., Kilmer R. P. (2011). Posttraumatic growth among children and adolescents: A systematic review. Clin. Psychol. Rev. 31 949–964. 10.1016/j.cpr.2011.06.003 PubMed DOI

Michel G., Taylor N., Absolom K., Eiser C. (2009). Benefit finding in survivors of childhood cancer and their parents: Further empirical support for the Benefit Finding Scale for Children. Child Care Health Dev. 36 123–129. 10.1111/j.1365-2214.2009.01034.x PubMed DOI

Patenaude A. F., Kupst M. J. (2005). Psychosocial functioning in pediatric cancer. J. Pediatr. Psychol. 30 9–27. 10.1093/jpepsy/jsi012 PubMed DOI

Phipps S., Long A. M., Ogden J. (2007). Benefit Finding Scale for Children: Preliminary findings from a childhood cancer population. J. Pediatr. Psychol. 32 1264–1271. 10.1093/jpepsy/jsl052 PubMed DOI

Prati G., Pietrantoni L. (2009). Optimism, social support, and coping strategies as factors contributing to posttraumatic growth: A meta-analysis. J. Loss Trauma 14 364–388. 10.1080/15325020902724271 DOI

Pynoos R., Rodriguez N., Steinberg A., Stuber M., Frederick C. (1998). Scoring worksheet for UCLA PTSD index for DSM-IV, revision 1. Available online at: https://arfamiliesfirst.com/wp-content/uploads/2013/05/UCLA-PTSD-Index-Score-Sheets-.pdf (accessed March 7, 2018).

Sawyer A., Ayers S., Field A. P. (2010). Posttraumatic growth and adjustment among individuals with cancer or HIV/AIDS: A meta-analysis. Clin. Psychol. Rev. 30 436–447. 10.1016/j.cpr.2010.02.004 PubMed DOI PMC

Steinberg A. M., Brymer M. J., Decker K. B., Pynoos R. S. (2004). The University of California at Los Angeles post-traumatic stress disorder reaction index. Curr. Psychiatry Rep. 6 96–100. 10.1007/s11920-004-0048-2 PubMed DOI

Taïeb O., Moro M. R., Baubet T., Revah-Lévy A., Flament M. F. (2003). Posttraumatic stress symptoms after childhood cancer. Eur. Child Adolesc. Psychiatry 12 255–264. 10.1007/s00787-003-0352-0 PubMed DOI

Tomich P. L., Helgeson V. S. (2012). Posttraumatic growth following cancer: Links to quality of life. J. Trauma. Stress 25 567–573. 10.1002/jts.21738 PubMed DOI

Turner J. K., Hutchinson A., Wilson C. (2018). Correlates of post-traumatic growth following childhood and adolescent cancer: A systematic review and meta-analysis. Psychooncology 27 1100–1109. 10.1002/pon.4577 PubMed DOI

Ward E., Desantis C., Robbins A., Kohler B., Jemal A. (2014). Childhood and adolescent cancer statistics, 2014. CA Cancer J. Clin. 64 83–103. 10.3322/caac.21219 PubMed DOI

Yallop K., McDowell H., Koziol-McLain J., Reed P. W. (2013). Self-reported psychosocial wellbeing of adolescent childhood cancer survivors. Eur. J. Oncol. Nurs. 17 711–719. 10.1016/j.ejon.2013.06.007 PubMed DOI

Zoellner T., Maercker A. (2006). Posttraumatic growth in clinical psychology–a critical review and introduction of a two component model. Clin. Psychol. Rev. 26 626–653. 10.1016/j.cpr.2006.01.008 PubMed DOI