|Title / Titel||Posttraumatic stress disorder and quality of life in infants and toddlers suffering from cancer|
|Abstract (PDF, 14 KB)|
|Summary / Zusammenfassung||Background: The treatment of childhood cancer has been increasingly successful over the past decades. Improved survival has placed increasing emphasis on the late psychosocial consequences of childhood cancer. Several arguments support the hypothesis that posttraumatic stress may be a viable model for studying the impact of disease and treatment in pediatric cancer survivors. First, the diagnosis of a life-threatening illness is a shocking experience for both child and family and is cited as an example of a traumatic event, capable of precipitating PTSD, in the American Psychiatric Association’s diagnostic manual DSM-IV (American Psychiatric Association, 2000). Although the diagnosis can be traumatizing by itself, it may be circumstantial with infants and toddlers, since, due to cognitive development, their comprehension is limited. But second, the cancer treatment per se may be traumatising. Patients are confronted with several invasive, painful, and stressful procedures and have to accept difficult and long periods of hospitalisation. This may be especially difficult for very young children. While previous studies have reported posttraumatic stress symptoms and psychological adjustment problems in older children and adolescents, almost nothing is known about the behavioural adjustment and quality of cancer survivors under the age of 4 years.
Working hypothesis: It is hypothesized that a significant group of young children with cancer has symptoms of posttraumatic stress disorder and a compromised quality of life. Psychological adjustment and health-related quality of life in children with cancer are expected to be predicted by three group of variables: Illness- and treatment-related characteristics (e.g., diagnosis, type and intensity of treatment, length of hospitalisation), characteristics of the child (e.g., age and sex), and characteristics of the familial environment (e.g., family climate, parental psychological adjustment).
Specific aim: The aim of this study is twofold. First, posttraumatic stress disorder and health-related quality of life in infants and toddlers with cancer shall be assessed. Second, illness- and treatment-related, child, and familial determinants of PTSD and quality of life shall be examined.
Methods: Mothers and fathers of approximately 50 patients will be assessed with standardized instruments. Eligibility criteria for the study include a child age at assessment between 9 and 48 months and a time after diagnosis of at least 3 months. Mothers will be interviewed with the PTSD Semi-Structured Interview and Observational Record for Infants and Young Children (Scheeringa & Zeanah, 1994). In addition, mothers are requested to complete questionnaires assessing biographical information, current child health-related quality of life (TNO-AZL Preschool Children Quality of Life Questionnaire), child’s behavioral problems (Child Behavior Checklist 11/2-5), quality of family relationships (Family Relationsship Index), maternal PTSD (Posttraumatic Diagnostic Scale), and maternal psychopathology (Symptom-Checklist-27). Fathers are also assessed with questionnaires measuring paternal PTSD and psychopathology.
Relevance: In future, early identification of those very young patients with a higher risk of an unfavourable outcome would provide opportunities for psychosocial interventions in order to prevent or reduce later problems of psychosocial functioning.
|Publications / Publikationen||Graf, A., Irblich, D. & Landolt, M.A. (2008). Posttraumatische Belastungsstörungen bei Säuglingen und Kleinkindern. Praxis der Kinderpsychologie und Kinderpsychiatrie, 57, 247-263.|
|Keywords / Suchbegriffe||Posttraumatic stress disorder, infants, health-related quality of life, cancer, children|
|Project leadership and contacts /
Projektleitung und Kontakte
|Funding source(s) /
Oncosuisse, Claus Cramer Stiftung, Hermann-Klaus-Stiftung, Gönnervereinigung Kinderspital Zürich
|Duration of Project / Projektdauer||Mar 2007 to Jun 2009|