Posttraumatic stress symptoms after childhood cancer

Abstract.   The posttraumatic stress model has recently been appliedto understand the impact of life-threatening illness in adultsand in children. From 1991 to 2001, 20 studies have reportedposttraumatic stress symptoms and/or posttraumatic stressdisorder (PTSD) in childhood cancer survivors and/or theirparents. A review of these studies is proposed. Prevalence ofposttraumatic stress symptoms and/or PTSD in children and intheir parents has been estimated, across studies, between 2 and20 % in survivors and between 10 and 30 % in their parents, evenmany years after the end of cancer treatment. Time elapsed sincethe diagnosis of cancer is usually not predictive of persistentsymptoms. Subjective appraisal of life threat and illnessbeliefs are more important predictors than objective medicaldata. The presence of symptoms in survivors is not alwaysrelated to that in their parents. The posttraumatic stress modelrenews the approach and understanding of psychopathologicalreactions of children with cancer, regarding trauma features andthe role of parental responses. This model has importantimplications for individual and family clinical interventions. Areflection on the disruption of family functioning by childhoodcancer (an example being bone marrow transplantation with arelated donor) and on the recovery processes is needed.