A narrative review of the occurrence of posttraumatic stress responses in adolescent and young adult cancer survivors

the ONA take:

Adolescent and young adult cancer survivors seem to be at risk for developing posttraumatic stress symptoms following cancer diagnosis or treatment, according to a review conducted by researchers at St. Jude Children’s Research Hospital in Memphis and Vanderbilt University in Nashville, TN, and published in the journal Clinical Oncology in Adolescents and Young Adults.

The review estimates posttraumatic stress disorder and posttraumatic stress symptoms may be experienced by 0% to 34.8% and 4.4% to 78%, respectively, of adolescent and young adult cancer survivors.

Moreover, researchers identified several unalterable risk factors that have been associated with the occurrence and development of posttraumatic stress response in adolescent and young adult cancer survivors. These risk factors include: female sex, diagnosis during adolescence, treatment intensity, unemployment, lower educational level, history of stressful events, medical late effects, experiencing a relapse or recurrence, and having general anxiety. Although these risk factors are fixed, clinicians may use them to determine which patients are most at risk for developing posttraumatic stress symptoms.

Treatments for posttraumatic stress disorder include pharmacotherapy and cognitive behavior therapy. One program, called Onco-STEP, is an internet-based cognitive behavior therapy intervention that utilizes an expressive writing technique to help patients develop coping strategies and combat fears. A pilot study demonstrated a significant reduction in posttraumatic symptoms and anxiety in 20 young adult cancer survivors.

Young adult cancer survivors may experience posttraumatic stress following cancer diagnosis or treatment.
Young adult cancer survivors may experience posttraumatic stress following cancer diagnosis or treatment.

Abstract: Adolescent and young adult cancer survivors may experience posttraumatic stress responses following cancer diagnosis or treatment.

The current paper reviews 23 studies reporting the occurrence of posttraumatic stress symptoms (PTSS) and posttraumatic stress disorder (PTSD), and associated predictors of these outcomes in adolescent and young adult cancer survivors. Results indicate considerable variability among prevalence estimates of PTSD (0%–34.8%) and PTSS (4.4%–78%).

Measurement inconsistencies limiting the ascertainment of reliable prevalence and risk estimates are discussed in the context of the reviewed literature.

Specifically, differences in assessment measures utilized, the timing of assessment relative to diagnosis, the criteria used to define the outcome, and identification of the precipitating traumatic event may account for discrepancies in prevalence and risk estimates across studies.

The application of specific PTSD diagnostic criteria to a survivorship population is discussed. Empirically supported interventions utilizing cognitive behavioral therapy approaches for the treatment of PTSS in adolescent and young adult cancer survivors are identified.

Keywords: posttraumatic stress, adolescent and young adult, cancer survivors.

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