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Change Across Time in Cancer-Related Traumatic Stress Symptoms of Siblings of Children with Cancer: A Preliminary Investigation

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Abstract

This pilot study examined changes in cancer-related post-traumatic stress symptoms (PTSS) across time for siblings of children with cancer. Siblings (N = 32; aged 8–18) completed a measure of anxiety, the Child PTSD Symptom Scale (CPSS), and the PTSD section of the Structured Clinical Interview for DSM-IV-TR (SCID) at twelve (SD = .9) and eighteen months (SD = 1.3) post-diagnosis. Moderate-to-severe PTSS was reported by 12 siblings (38%) at T1 and 7 (22%) at T2. Cluster analysis of PTSS data revealed five patterns: Few symptoms, stable across time (31%, n = 10); Mild symptoms, decreasing across time (16%, n = 5); Mild, stable symptoms (28%, n = 9); Moderate/severe symptoms, decreasing across time but remaining moderate (19%, n = 6); and Moderate/severe, stable symptoms (6%, n = 2). SCID data and anxiety scores distinguished siblings in the final two clusters from those with more favorable PTSS levels/trajectories. Additional research with larger samples is needed to validate these trajectories and examine factors that distinguish siblings with consistently elevated cancer-related PTSS from those with mild or significantly improving symptoms.

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References

  • Aldenderfer, A. S., & Blashfield, R. K. (1984). Cluster analysis. Newbury Park, CA: Sage.

    Book  Google Scholar 

  • Alderfer, M. A., & Kazak, A. E. (2006). Family issues when a child is on treatment for cancer. In R. Brown (Ed.), Pediatric hematology/oncology: A biopsychosocial approach (pp. 53–74). New York: Oxford University Press.

    Google Scholar 

  • Alderfer, M. A., Labay, L., & Kazak, A. E. (2003). Does posttraumatic stress apply to siblings of childhood cancer survivors? Journal of Pediatric Psychology,21, 281–286.

    Article  Google Scholar 

  • Alderfer, M. A., Long, K. A., Lown, E. A., Marsland, A., Ostrowski, N., Hock, J., & Ewing, L. (2010). Psychosocial adjustment of siblings of children with cancer: A systematic review. Psycho-Oncology,19, 789–805.

    Article  Google Scholar 

  • Alderfer, M. A., & Noll, R. (2006). Identifying and addressing the needs of siblings of children with cancer. Pediatric Blood & Cancer,47, 537–538.

    Article  Google Scholar 

  • Bayne, R., Beauchamp, J., Begovich, C., & Kane, V. (1980). Monte Carlo comparisons of selected clustering procedures. Pattern Recognition,12, 51–62.

    Article  Google Scholar 

  • Copeland, W. E., Keeler, G., Angold, A., & Costello, E. J. (2007). Traumatic events and posttraumatic stress in childhood. Archives of General Psychiatry,64, 577–584. https://doi.org/10.1001/archpsyc.64.5.577.

    Article  PubMed  Google Scholar 

  • Everitt, B., Landau, S., & Leese, M. (2001). Cluster analysis. New York: Oxford University.

    Google Scholar 

  • First, M., Spitzer, R., Gibbon, M., & Williams, J. (1995). Structured clinical interview for DSM-IV. New York: Biometrics Research Department, New York State Psychiatric Institute.

    Google Scholar 

  • Foa, E. B., Johnson, K. M., Feeny, N. C., & Treadwell, K. R. H. (2001). The Child PTSD Symptom Scale: A preliminary examination of its psychometric properties. Journal of Clinical Child Psychology,30, 376–384. https://doi.org/10.1207/S15374424jccp3003_9.

    Article  CAS  PubMed  Google Scholar 

  • Gerhardt, C., Lehmann, V., Long, K. A., & Alderfer, M. A. (2015). Supporting siblings as a standard of care in pediatric oncology. Pediatric Blood & Cancer,62, S678–S732.

    Article  Google Scholar 

  • Goenjian, A. K., Walling, D., Steinberg, A. M., Karayan, I., Najarian, L. M., & Pynoos, R. (2005). A prospective study of posttraumatic stress and depressive reactions among treated and untreated adolescents 5 years after a catastrophic disaster. The American Journal of Psychiatry,162, 2302–2308.

    Article  Google Scholar 

  • Kaplan, L. M., Kaal, K. J., Bradley, L., & Alderfer, M. A. (2013). Cancer-related traumatic stress reactions in siblings of children with cancer. Families, Systems, & Health,31, 205–217.

    Article  Google Scholar 

  • Kazak, A. E., Alderfer, M. A., Rourke, M. T., Simms, S., Streisand, R., & Grossman, J. R. (2004). Posttraumatic stress symptoms and Posttraumatic Stress Disorder in families of adolescent cancer survivors. Journal of Pediatric Psychology,29, 211–219. https://doi.org/10.1093/jpepsy/jsh022.

    Article  PubMed  Google Scholar 

  • Le Brocque, R. M., Hendrikz, J., & Kenardy, J. A. (2010a). The course of posttraumatic stress in children. Journal of Pediatric Psychology,35, 637–645. https://doi.org/10.1093/jpepsy/jsp050.

    Article  PubMed  Google Scholar 

  • Le Brocque, R. M., Hendrikz, J., & Kenardy, J. A. (2010b). Parental response to child injury. Journal of Pediatric Psychology,35, 646–655. https://doi.org/10.1093/jpepsy/jsq035.

    Article  PubMed  Google Scholar 

  • Long, K. A., Lehmann, V., Marsland, A., Gerhardt, C., & Alderfer, M. A. (2018). Psychosocial functioning and risk factors among siblings of children with cancer: An updated systematic review. Psycho-Oncology,27(6), 1467–1479. https://doi.org/10.1002/pon.4669.

    Article  PubMed  Google Scholar 

  • Mandara, J. (2003). The typological approach in child and family psychology: A review of theory, methods, and research. Clinical Child and Family Psychology Review,6, 129–146.

    Article  Google Scholar 

  • Mojena, R. (1977). Hierarchical grouping methods and stopping rules—An evaluation. Computer Journal,20, 359–363.

    Article  Google Scholar 

  • Packman, W., Crittenden, M., Schaeffer, E., Bongar, B., Rieger Fischer, J., & Cowan, M. (1997). Psychosocial consequences of bone marrow transplantation in donor and nondonor siblings. Journal of Developmental and Behavioral Pediatrics,18, 244–253. https://doi.org/10.1097/00004703-199708000-00004.

    Article  CAS  PubMed  Google Scholar 

  • Packman, W., Fine, J., Chesterman, B., VanZutphen, K., Golan, R., & Amylon, M. (2004). Camp Okizu: Preliminary investigation of a psychological intervention for siblings of pediatric cancer patients. Children’s Health Care,33, 201–215. https://doi.org/10.1207/s15326888chc3303_3.

    Article  Google Scholar 

  • Poder, U., Ljungman, G., & von Essen, L. (2008). Posttraumatic stress disorder among parents of children on cancer treatment: A longitudinal study. Psychooncology,17, 430–437.

    Article  Google Scholar 

  • Price, J., Kassam-Adams, M., Alderfer, M. A., Christofferson, J., & Kazak, A. E. (2016). Systematic review: A re-evaluation and update of the Integrative (Trajectory) Model of Pediatric Medical Traumatic Stress. Journal of Pediatric Psychology,41(1), 86–97.

    Article  Google Scholar 

  • Reynolds, C. R., & Richmond, B. O. (1985). Revised Children’s Manifest Anxiety Scales (RCMAS). Los Angeles: Western Psychological Services.

    Google Scholar 

  • Sharp, K. M. H., Lindwall, J. J., Willard, V. W., Long, A. M., Martin-Elbahesh, K. M., & Phipps, S. (2017). Cancer as a stressful life event: Perceptions of children with cancer and their peers. Cancer,123, 3385–3393. https://doi.org/10.1002/cncr.30741.

    Article  PubMed  Google Scholar 

  • Smith, D. M., Schwarz, N., Roberts, T. R., & Ubel, P. A. (2006). Why are you calling me? How study introductions change response patterns. Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation,15, 621–630. https://doi.org/10.1007/s11136-005-4529-5.

    Article  Google Scholar 

  • Strack, F., Martin, L., & Schwarz, N. (1988). Priming and communication: Social determinants of information use in judgments of life satisfaction. European Journal of Social Psychology,18, 429–442. https://doi.org/10.1002/ejsp.2420180505.

    Article  Google Scholar 

  • Ward, J. (1963). Hierarchical grouping to optimize an object function. Journal of the American Statistical Association,58, 236–244.

    Article  Google Scholar 

  • Ward, E., DeSantis, C., Robbins, A., Kohler, B., & Jemal, A. (2014). Childhood and adolescent cancer statistics, 2014. CA: A Cancer Journal for Clinicians,64, 83–103.

    Google Scholar 

  • Wijnberg-Williams, B. J., Kamps, W. A., Klip, E. C., & Hoekstra-Weebers, J. E. H. M. (2006). Psychological adjustment of parents of pediatric cancer patients revisited: Five years later. Psycho-Oncology,15, 1–8. https://doi.org/10.1002/pon.927.

    Article  PubMed  Google Scholar 

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Acknowledgements

The authors thank the families who participated; Janet M. Hock, Ph.D. for her support; and Craig Lodis, Ph.D., Caroline Stanley, Ph.D., Joanna Cohen, Ph.D., and Hinette (Shelby) Rosario for their assistance on the project.

Funding

This work was supported by US Army Medical Research and Materiel Command research contract USAMRMC No. 0704400, PI: J.M. Hock.

Author information

Author notes

  1. Beth A. Logan

    Present address: Hillman Center for Pediatric Transplantation, Children’s Hospital of Pittsburgh at UPMC & University of Pittsburgh School of Medicine, Philadelphia, PA, USA

  2. Stephen DiDonato

    Present address: Community & Trauma Counseling Program at Thomas Jefferson University, Philadelphia, PA, USA

Authors and Affiliations

  1. Center for Healthcare Delivery Science, Nemours Children’s Health System/Alfred I. duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE, 19803, USA

    Melissa A. Alderfer & Stephen DiDonato

  2. Department of Pediatrics, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Melissa A. Alderfer

  3. Division of Behavioral Health, Nemours Children’s Health System/Alfred I. duPont Hospital for Children, Wilmington, DE, USA

    Beth A. Logan

  4. Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children’s Hospital of Philadelphia & Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA

    Leela Jackson

  5. Department of Psychology, University of Maine, Orono, ME, USA

    Marie J. Hayes & Sandra T. Sigmon

Authors
  1. Melissa A. Alderfer
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Corresponding author

Correspondence to Melissa A. Alderfer.

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Conflict of interest

Melissa A. Alderfer, Beth A. Logan, Stephen DiDonato, Leela Jackson, Marie J. Hayes, and Sandra T. Sigmon declare that they have no conflicts of interest.

Human and Animal Rights

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

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Informed consent or assent was obtained from all individual participants included in the study.

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Alderfer, M.A., Logan, B.A., DiDonato, S. et al. Change Across Time in Cancer-Related Traumatic Stress Symptoms of Siblings of Children with Cancer: A Preliminary Investigation. J Clin Psychol Med Settings 27, 48–53 (2020). https://doi.org/10.1007/s10880-019-09618-2

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  • DOI: https://doi.org/10.1007/s10880-019-09618-2

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