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    Sean Phipps, PhD



    Is "posttraumatic stress disorder" model wrong?

    The results of a study by St. Jude researchers call into question the current use of the term “posttraumatic stress disorder” (PTSD) to describe the impact that pediatric cancer has on children and their parents, despite the fact that its use is supported by the official psychiatric diagnostic manual.

    The results of previous studies of PTSD among patients and their parents varied depending on whether the survey included children both on and off active therapy; and whether posttraumatic stress symptoms (PTSS) in patients were assessed based on a parent’s report or the child’s own report, according to Sean Phipps, PhD, Behavioral Medicine. “Our own study was designed to address those issues,” he says. Phipps is the lead author of a report on this study that appears in the current online issue of Pediatric Blood and Cancer.

    The St. Jude team used standard psychological tests to assess four groups of patients (162 total) depending on time elapsed since diagnosis. Patients reported on their own symptoms, while parents reported on their own symptoms, as well as symptoms in their children.

    The investigators found that recently diagnosed patients had higher PTSS scores than survivors who were more than five years from diagnosis. However, the overall levels of PTSS were not significantly higher than children from the general population. In contrast, parents of recently diagnosed patients reported significantly higher levels of PTSS than did parents of healthy children in the general population, while parents of long-term survivors reported lower levels of PTSS, comparable to that in the general population.

    The findings suggest that the symptoms among parents and children actually reflect a response to ongoing acute stress, such as that due to the child undergoing cancer therapy, rather than a posttraumatic reexperiencing of past traumas, the researchers said.

    In addition, parents and patients reported nearly identical levels of patient PTSS. This suggests that accurate patient PTSS data can be obtained from either patient or parent with reasonable confidence that the information will be accurate, the researchers said.

    Other authors of the paper are Alanna Long, Behavioral Medicine; Melissa Hudson, MD, After Completion of Therapy clinic director; and Shesh Rai, PhD, Biostatistics.

     

    Last update: May 2005