Top

Supportive Care in Cancer

Published in:

Open Access 01-09-2017 | Original Article

Posttraumatic growth and well-being among adolescents and young adults (AYAs) with cancer: a longitudinal study

Authors: O. Husson, B. Zebrack, R. Block, L. Embry, C. Aguilar, B. Hayes-Lattin, S. Cole

Published in: Supportive Care in Cancer | Issue 9/2017

Abstract

Purpose

This study examines posttraumatic growth (PTG) among adolescents and young adults (AYAs) with cancer, as well as its correlates and trajectories over time. The study also explores the buffering role of PTG on the associations between posttraumatic stress (PTS), health-related quality of life (HRQoL), and psychological distress.

Methods

A multicenter, longitudinal, prospective study was conducted among AYA cancer patients aged 14–39 years. One hundred sixty-nine patients completed a self-report measure of PTG (PTGI) and PTS (PDS) 6, 12, and 24 months after baseline (within the first 4 months of diagnosis). At 24-month follow-up, HRQoL (SF-36) and psychological distress (BSI-18) were also assessed.

Results

Among participants, 14% showed increasing PTG, 45% remained at a stable high PTG level, 14% showed decreasing PTG, and 27% remained at a stable low PTG level. AYAs who remained high on PTG were more often younger, female, and received chemotherapy. PTG level at 6-month follow-up was predictive of mental HRQoL (β = 0.19; p = 0.026) and psychological distress (β = −0.14; p = 0.043) at 24-month follow-up when corrected for PTS and sociodemographic and clinical covariates. No relationship between PTG and physical HRQoL was found. The interactive effects of PTS and PTG on outcomes were not significant, indicating that buffering did not take place.

Conclusion

This study indicates that PTG is dynamic and predicts mental well-being outcomes but does not buffer the effects of PTS. Psychosocial interventions should focus on promoting PTG and reducing PTS in order to promote the adjustment of AYAs diagnosed with cancer.

Adolescent and Young Adult Oncology Progress Review Group 2006. Closing the gap: research and care imperatives for adolescents and young adults with cancer. Bethesda, MD: National Institute of Health, National Cancer Institute, and Livestrong Young Ault Alliance, NIH Publication No. 06–6067

Haase JE, Phillips CR (2004) The adolescent/young adult experience. J Pediatr Oncol Nurs 21:145–149CrossRefPubMed

Arnett JJ (2000) Emerging adulthood. A theory of development from the late teens through the twenties. Am Psychol 55:469–480CrossRefPubMed

Thomas DM, Albritton KH, Ferrari A (2010) Adolescent and young adult oncology: an emerging field. J Clin Oncol 28:4781–4782CrossRefPubMed

Zebrack BJ (2011) Psychological, social, and behavioral issues for young adults with cancer. Cancer 117:2289–2294CrossRefPubMed

Smith AW, Bellizzi KM, Keegan TH et al (2013) Health-related quality of life of adolescent and young adult patients with cancer in the United States: the adolescent and young adult health outcomes and patient experience study. J Clin Oncol 31:2136–2145CrossRefPubMedPubMedCentral

Selye H (1956) The stress of life. McGraw-Hill, New York

Calhoun LG, Tedeschi RG (1999) Facilitating posttraumatic growth. A clinician’s guide. Lawrence Erlbaum Associates, Mahwah

Calhoun LG, Tedeschi RG (2002) Posttraumatic growth: the positive lessons of loss. In: Neimeyer RA (ed) Meaning reconstruction and the experience of loss. American Psychological Association, Washington, DC, pp 157–172

10.

Stanton AL, Bower JE, Low CA (2006) Posttraumatic growth after cancer. In: Calhoun LG, Tedeschi RG (eds) Handbook of posttraumatic growth: research and practice. Erlbaum Associates, Mahwah, New Jersey, pp 138–175

11.

Wicks L, Mitchell A (2010) The adolescent cancer experience: loss of control and benefit finding. Eur J Cancer Care (Engl) 19:778–785CrossRef

12.

Salsman JM, Garcia SF, Yanez B et al (2014) Physical, emotional, and social health differences between posttreatment young adults with cancer and matched healthy controls. Cancer 120:2247–2254CrossRefPubMedPubMedCentral

13.

Zebrack B, Kwak M, Salsman J et al (2015) The relationship between posttraumatic stress and posttraumatic growth among adolescent and young adult (AYA) cancer patients. Psychooncology 24:162–168CrossRefPubMed

14.

Monteiro S, Torres A, Morgadinho R, Pereira A (2013) Psychosocial outcomes in young adults with cancer: emotional distress, quality of life and personal growth. Arch Psychiatr Nurs 27:299–305CrossRefPubMed

15.

Love C, Sabiston CM (2011) Exploring the links between physical activity and posttraumatic growth in young adult cancer survivors. Psychooncology 20:278–286CrossRefPubMed

16.

Seitz DC, Hagmann D, Besier T et al (2011) Life satisfaction in adult survivors of cancer during adolescence: what contributes to the latter satisfaction with life? Qual Life Res 20:225–236CrossRefPubMed

17.

Calhoun LG, Tedeschi RG (1995) Trauma and transformation: growing in the aftermath of suffering. SAGE Publications, Thousand Oaks, CA

18.

Davis CG, Nolen-Hoeksema S, Larson J (1998) Making sense of loss and benefiting from the experience: two construals of meaning. J Pers Soc Psychol 75:561–574CrossRefPubMed

19.

Helgeson VS, Reynolds KA, Tomich PL (2006) A meta-analytic review of benefit finding and growth. J Consult Clin Psychol 74:797–816CrossRefPubMed

20.

Morrill EF, Brewer NT, O'Neill SC et al (2008) The interaction of post-traumatic growth and post-traumatic stress symptoms in predicting depressive symptoms and quality of life. Psychooncology 17:948–953CrossRefPubMed

21.

McCarthy MC, McNeil R, Drew S et al (2016) Psychological distress and posttraumatic stress symptoms in adolescents and young adults with cancer and their parents. J Adolesc Young Adult Oncol In press

22.

Kwak M, Zebrack BJ, Meeske KA et al (2013) Prevalence and predictors of post-traumatic stress symptoms in adolescent and young adult cancer survivors: a 1-year follow-up study. Psychooncology 22:1798–1806CrossRefPubMed

23.

Meeske KA, Ruccione K, Globe DR, Stuber ML (2001) Posttraumatic stress, quality of life, and psychological distress in young adult survivors of childhood cancer. Oncol Nurs Forum 28:481–489PubMed

24.

Tedeschi RG, Calhoun LG (1996) The posttraumatic growth inventory: measuring the positive legacy of trauma. J Trauma Stress 9:455–471CrossRefPubMed

25.

Gianinazzi ME, Rueegg CS, Vetsch J et al (2016) Cancer’s positive flip side: posttraumatic growth after childhood cancer. Support Care Cancer 24:195–203CrossRefPubMed

26.

Cordova MJ, Giese-Davis J, Golant M, Kronenwetter C, Chang V, Spiegel D (2007) Breast cancer as trauma: posttraumatic stress and posttraumatic growth. J Clin Psychol Med Settings 14:308–319CrossRef

27.

Widows MR, Jacobsen PB, Booth-Jones M, Fields KK (2005) Predictors of posttraumatic growth following bone marrow transplantation for cancer. Health Psychol 24:266–273CrossRefPubMed

28.

Jansen L, Hoffmeister M, Chang-Claude J et al (2011) Benefit finding and post-traumatic growth in long-term colorectal cancer survivors: prevalence, determinants, and associations with quality of life. Br J Cancer 105:1158–1165CrossRefPubMedPubMedCentral

29.

Sherbourne CD, Stewart AL (1991) The MOS social support survey. Soc Sci Med 32:705–714CrossRefPubMed

30.

Foa EB, Cashman L, Jaycox L, Perry K (1997) The validation of a self-report measure of posttraumatic stress disorder: the posttraumatic diagnostic scale. Psychol Assess 9:445–451CrossRef

31.

Ware JE, Snow KK, Kosinski M et al (1993) SF-36 health survey: manual and interpretation guide. Boston, MA, The Health Institute, New England Medical Center

32.

Derogatis LR (2001) Brief symptom inventory 18: administration, scoring, and procedures manual. Pearson, Bloomington

33.

Howlader N, Noone AM, Krapcho M et al (2011) SEER cancer statistics review, 1975–2008. Bethesda, National Institutes of Health

34.

Silva SM, Moreira HC, Canavarro MC (2012) Examining the links between perceived impact of breast cancer and psychosocial adjustment: the buffering role of posttraumatic growth. Psychooncology 21:409–418CrossRefPubMed

35.

Lelorain S, Bonnaud-Antignac A, Florin A (2010) Long term posttraumatic growth after breast cancer: prevalence, predictors and relationships with psychological health. J Clin Psychol Med Settings 17:14–22CrossRefPubMed

36.

Fife BL (1994) The conceptualization of meaning in illness. Soc Sci Med 38:309–316CrossRefPubMed

37.

Manne S, Ostroff J, Winkel G et al (2004) Posttraumatic growth after breast cancer: patient, partner, and couple perspectives. Psychosom Med 66:442–454PubMed

38.

Pakenham KI (2005) Benefit finding in multiple sclerosis and associations with positive and negative outcomes. Health Psychol 24:123–132CrossRefPubMed

39.

Bellizzi KM, Smith AW, Reeve BB et al (2010) Posttraumatic growth and health-related quality of life in a racially diverse cohort of breast cancer survivors. J Health Psychol 15:615–626CrossRefPubMed

40.

Park CL, Chmielewski J, Blank TO (2010) Post-traumatic growth: finding positive meaning in cancer survivorship moderates the impact of intrusive thoughts on adjustment in younger adults. Psychooncology 19:1139–1147CrossRefPubMed

41.

Salsman JM, Segerstrom SC, Brechting EH et al (2009) Posttraumatic growth and PTSD symptomatology among colorectal cancer survivors: a 3-month longitudinal examination of cognitive processing. Psychooncology 18:30–41CrossRefPubMedPubMedCentral

42.

Andrykowski MA, Cordova MJ, Studts JL, Miller TW (1998) Posttraumatic stress disorder after treatment for breast cancer: prevalence of diagnosis and use of the PTSD Checklist-Civilian Version (PCL-C) as a screening instrument. J Consult Clin Psychol 66:586–590CrossRefPubMed

43.

Stanton AL, Danoff-Burg S, Sworowski LA et al (2002) Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. J Clin Oncol 20:4160–4168CrossRefPubMed

44.

Antoni MH, Lehman JM, Kilbourn KM et al (2001) Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychol 20:20–32CrossRefPubMed

45.

Penedo FJ, Dahn JR, Molton I et al (2004) Cognitive-behavioral stress management improves stress-management skills and quality of life in men recovering from treatment of prostate carcinoma. Cancer 100:192–200CrossRefPubMed

46.

Wilkinson S, Kitzinger C (2000) Thinking differently about thinking positive: a discursive approach to cancer patients' talk. Soc Sci Med 50:797–811CrossRefPubMed

47.

Sawyer A, Ayers S, Field AP (2010) Posttraumatic growth and adjustment among individuals with cancer or HIV/AIDS: a meta-analysis. Clin Psychol Rev 30:436–447CrossRefPubMed

Title: Posttraumatic growth and well-being among adolescents and young adults (AYAs) with cancer: a longitudinal study
Authors: O. Husson
B. Zebrack
R. Block
L. Embry
C. Aguilar
B. Hayes-Lattin
S. Cole
Publication date: 01-09-2017
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 9/2017
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-017-3707-7

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Watch now

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras

Prof. Fabrice Barlesi

Developed by: Springer Medicine

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 9/2017

Confounding factors associated with oral mucositis assessment in patients receiving chemoradiotherapy for head and neck cancer

Voice rehabilitation after laryngeal cancer: Associated effects on psychological well-being

The prognostic performance of adding patient-reported outcomes to the MASCC risk index to identify low-risk febrile neutropenia patients with solid tumors and lymphomas

Effects of resistance exercise in prostate cancer patients: a meta-analysis

A scoring system to guide the decision for a new systemic treatment after at least two lines of palliative chemotherapy for metastatic cancers: a prospective study

A prospective study of aromatase inhibitor therapy initiation and self-reported side effects

Keynote webinar | Spotlight on antibody–drug conjugates in cancer