Trauma and Growth in Pediatric Cancer

小儿癌症的创伤和生长

基本信息

批准号：
8212475
负责人：
Sean Phipps
金额：
$ 33.81万
依托单位：
ST. JUDE CHILDREN'S RESEARCH HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2010
资助国家：
美国
起止时间：
2010-03-03 至 2015-01-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8212475
关键词：
Accounting Address Adult Affect Algorithms Cancer Control Cancer Survivor Child Childhood Data Sources Development Diagnosis Diagnostic Ensure Environment Evaluation Event Family Frequencies Government Growth Health Status Incidence Intervention Interview Life Literature Malignant Childhood Neoplasm Malignant Neoplasms Measures Medical Medical History Modeling Outcome Parenting behavior Parents Participant Pathway interactions Patient Self-Report Patients Personality Persons Population Post-Traumatic Stress Disorders Psychology Psychopathology Recording of previous events Relative (related person)Reporting Research Research Design Risk Risk Factors Screening procedure Sensitivity and Specificity Stress Structure Symptoms Trauma base cancer diagnosis catalyst clinically significant comparison group design experience improved novel optimism peer predictive modeling primary outcome public health relevance resilience secondary outcome theories

项目摘要

DESCRIPTION (provided by applicant): Childhood cancer is widely viewed as a traumatic event, and application of traumatic stress models has become the dominant approach in pediatric psychooncology research. This approach to understanding the experiences of children with cancer presupposes 'cancer as trauma', and focuses on psychopathology rather than adjustment. These biases have influenced research design, and contribute to proliferation of deficit- oriented models, despite the fact that the majority of studies have not shown an increased incidence of post- traumatic stress disorder (PTSD) or of subclinical levels of post-traumatic stress symptoms (PTSS) in children with cancer. This proposal is based on the assumption that the diagnosis of cancer represents a significant life event that is not only a potential trauma, but also a potential catalyst for growth and positive change, calling for examination of positive outcomes such as post-traumatic growth (which we now refer to as challenge-related growth) and benefit-finding (CRG), constructs that have been studied primarily in adults with cancer but not in children. The proposed study will address several gaps in our understanding of PTSD outcomes in pediatric cancer, while broadening the focus to include simultaneous assessment of positive outcomes. Guided by positive psychology theory, we will examine determinants of PTSD and CRG outcomes, focusing on several resilience-related personality variables, including adaptive style, optimism, and dispositional positive affect. The aims of this proposal will be addressed with a two-group (cancer and healthy control), cross-sectional design, using patient self-report, parent-report, and structured diagnostic interviews as the primary sources of data. A frequency matching approach will be used to ensure demographic comparability of the cancer and healthy comparison groups. Measures of child PTSS and CRG along with dichotomous PTSD diagnosis will be obtained as primary outcomes. Measures of parental PTSS/PTSD and CRG will be obtained as secondary outcomes. Determinants of child PTS and CRG outcomes will be identified from child personality factors, life events history, medical factors (within the cancer group), parental PTSS/CRG, and parenting behavior. Separate predictive models will be developed for PTSS/PTSD and CRG outcomes. These analyses will advance our understanding of risk factors for the development of PTSD, which will improve targeting of intervention efforts to those most in need, while identification of factors associated with resilient, or growth outcomes will inform the development of intervention strategies and approaches. PUBLIC HEALTH RELEVANCE: This study will address gaps in our understanding of the traumatic effects of childhood cancer, while simultaneously examining positive outcomes such as growth and benefit-finding. Determinants of posttraumatic stress and posttraumatic, or 'challenge-related' growth outcomes will be examined, focusing on resilience-promoting factors. Separate predictive models will be developed for posttraumatic stress and growth outcomes. These analyses will advance our understanding of risk factors for the development of posttraumatic stress disorder, which will improve targeting of intervention efforts to those most in need, while identification of factors associated with resilient, or growth outcomes will inform the development of novel intervention strategies and approaches.

描述（由申请人提供）：儿童癌症被广泛视为一种创伤事件，创伤应激模型的应用已成为儿科心理肿瘤学研究的主导方法。这种理解癌症儿童经历的方法以“癌症作为创伤”为前提，并侧重于精神病理学而不是调整。这些偏见影响了研究设计，并导致了以赤字为导向的模型的激增，尽管大多数研究并未表明创伤后应激障碍（PTSD）或亚临床水平的创伤后应激症状的发生率增加(PTSS) 患有癌症的儿童。该提案基于这样的假设：癌症的诊断代表着重大的生活事件，不仅是潜在的创伤，而且是成长和积极变化的潜在催化剂，呼吁检查积极的结果，例如创伤后成长（其中我们现在将其称为挑战相关生长）和利益发现（CRG），这些结构主要在患有癌症的成人中进行研究，但尚未在儿童中进行研究。拟议的研究将解决我们对儿科癌症 PTSD 结果的理解中的几个差距，同时扩大重点以包括对积极结果的同步评估。在积极心理学理论的指导下，我们将研究 PTSD 和 CRG 结果的决定因素，重点关注几个与复原力相关的人格变量，包括适应风格、乐观和性格积极情感。该提案的目标将通过两组（癌症和健康对照）、横断面设计来解决，使用患者自我报告、家长报告和结构化诊断访谈作为主要数据来源。将使用频率匹配方法来确保癌症组和健康对照组的人口统计学可比性。儿童 PTSS 和 CRG 的测量以及二分 PTSD 诊断将作为主要结果。父母 PTSS/PTSD 和 CRG 的测量将作为次要结果获得。儿童 PTS 和 CRG 结果的决定因素将从儿童人格因素、生活事件史、医疗因素（癌症组内）、父母 PTSS/CRG 和养育行为中确定。将为 PTSS/PTSD 和 CRG 结果开发单独的预测模型。这些分析将增进我们对 PTSD 发展的风险因素的理解，这将提高干预措施对最需要的人的针对性，同时识别与弹性或增长结果相关的因素将为干预策略和方法的制定提供信息。公共卫生相关性：这项研究将解决我们对儿童癌症创伤性影响的理解上的差距，同时检查成长和利益发现等积极成果。将研究创伤后应激和创伤后或“挑战相关”成长结果的决定因素，重点关注促进复原力的因素。将为创伤后应激和成长结果开发单独的预测模型。这些分析将增进我们对创伤后应激障碍发展的风险因素的理解，这将提高对最有需要的人的干预工作的针对性，同时识别与弹性或成长结果相关的因素将为制定新的干预策略和接近。

项目成果

期刊论文数量（27）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

Cancer as a stressful life event: Perceptions of children with cancer and their peers.

癌症作为一种生活压力事件：癌症儿童及其同龄人的看法。

DOI：
10.1002/cncr.30741
发表时间：
2017
期刊：
Cancer
影响因子：
6.2
作者：
Sharp,KatianneMHoward;Lindwall,JenniferJ;Willard,VictoriaW;Long,AlannaM;Martin-Elbahesh,KarenM;Phipps,Sean
通讯作者：
Phipps,Sean

The Influence of Early Childhood Temperament on Later Social-Emotional Functioning in Youth with Cancer.

早期儿童气质对癌症青少年后期社会情感功能的影响。