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

  • Melissa A. AlderferEmail author
  • Beth A. Logan
  • Stephen DiDonato
  • Leela Jackson
  • Marie J. Hayes
  • Sandra T. Sigmon


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.


Pediatric oncology Siblings Adjustment Post-traumatic stress PTSD 



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.


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

Compliance with Ethical Standards

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.

Informed Consent

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


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Center for Healthcare Delivery ScienceNemours Children’s Health System/Alfred I. duPont Hospital for ChildrenWilmingtonUSA
  2. 2.Department of Pediatrics, Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaUSA
  3. 3.Division of Behavioral HealthNemours Children’s Health System/Alfred I. duPont Hospital for ChildrenWilmingtonUSA
  4. 4.Department of Child and Adolescent Psychiatry and Behavioral Sciences, The Children’s Hospital of Philadelphia & Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  5. 5.Department of PsychologyUniversity of MaineOronoUSA
  6. 6.Hillman Center for Pediatric TransplantationChildren’s Hospital of Pittsburgh at UPMC & University of Pittsburgh School of MedicinePhiladelphiaUSA
  7. 7.Community & Trauma Counseling Program at Thomas Jefferson UniversityPhiladelphiaUSA

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