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01-07-2021 | Pediatric Cancer | Original Article

Adverse childhood experiences (ACEs) and medically traumatic events (TEs) in adolescents and young adults (AYAs) with cancer: a report from the Promoting Resilience in Stress Management (PRISM) randomized controlled trial

Authors: Samantha R. Scott, Alison G. O’Daffer, Miranda C. Bradford, Kaitlyn Fladeboe, Nancy Lau, Angela Steineck, Mallory Taylor, Joyce P. Yi-Frazier, Abby R. Rosenberg

Published in: Supportive Care in Cancer | Issue 7/2021

Abstract

Objective

In adolescents and young adults (AYAs) with cancer, we examined (1) the distribution and type of traumatic events (TEs) experienced prior to baseline assessment and (2) how a resilience intervention, Promoting Resilience in Stress Management (PRISM), impacted changes in patient-reported outcomes (PROs) for AYAs with and without TEs.

Methods

AYAs (12–25 years) within 1–10 weeks of diagnosis of new malignancy or ever diagnosed with advanced cancer were enrolled and randomly assigned to usual care (UC) with or without PRISM. To assess TEs, we screened medical records for traditionally defined adverse childhood experiences (ACEs) and medical traumatic events. Age-validated PROs assessed resilience, benefit-finding, hope, generic health-related quality of life (QoL), cancer-specific QoL, depression, and anxiety at enrollment and 6 months later. We calculated effect sizes (Cohen’s d) for PRISM vs. UC effect on PRO score change at 6 months for 1+ TEs and 0 TE groups.

Results

Ninety-two AYAs enrolled and completed baseline surveys (44-UC, 48-PRISM; N = 74 at 6 months, 38-UC, 36-PRISM); 60% experienced 1+ TEs. PROs at baseline were similar across groups. PRISM’s effect on score change was greater (Cohen’s d ≥ 0.5) for the 1+ TE group on domains of benefit-finding and hope; and similar (d < 0.5) on domains of resilience, depression, anxiety, and both generic and cancer-specific QoL.

Conclusions

In AYAs with cancer, TEs occurred at similar rates as the general population. PRISM may be particularly helpful for improving benefit-finding and hope for those who have experienced TEs.

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Title: Adverse childhood experiences (ACEs) and medically traumatic events (TEs) in adolescents and young adults (AYAs) with cancer: a report from the Promoting Resilience in Stress Management (PRISM) randomized controlled trial
Authors: Samantha R. Scott
Alison G. O’Daffer
Miranda C. Bradford
Kaitlyn Fladeboe
Nancy Lau
Angela Steineck
Mallory Taylor
Joyce P. Yi-Frazier
Abby R. Rosenberg
Publication date: 01-07-2021
Publisher: Springer Berlin Heidelberg
Keyword: Pediatric Cancer
Published in: Supportive Care in Cancer / Issue 7/2021
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-020-05888-x

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Abstract

Objective

Methods

Results

Conclusions

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