Abstract
Purpose
Cancer is a stressful life event that can lead to specific posttraumatic reactions. Posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) are two main posttraumatic reactions that are related to each other, and both have different correlates.
Methods
The linearity of the relationship between PTG and PTSS and the different socio-demographic, cancer-related, emotional, and psychological correlates were analyzed in patients with cancer (N = 126).
Results
The relationship between PTG and PTSS was found to be more curvilinear than linear. PTSS was more strongly related to psychological factors (e.g., anxious preoccupation, hope-helplessness, and resilience) while PTG was strongly related to existential factors (e.g., self-transcendence and religiosity).
Conclusion
The results show that cancer-related PTSS and PTG are specifically related constructs which are related differently to particular correlates. Specifically, the greatest differences were observed in the psychological variables. In the early phases, therapeutic interventions focused on variables related to PTSS can lead to the reduction of PTSS. In follow-up phases, the therapeutic intervention focused on the increase of the level of variables related to PTG can help the development of PTG.
Similar content being viewed by others
Data availability
The data, additional tables, and descriptions that support the findings of this study are openly available in osf repository at osf.io/npfsj/.
Code availability
The analytical script can be found at osf.io/npfsj/.
References
Salsman JM, Segerstrom SC, Brechting EH et al (2009) Posttraumatic growth and PTSS symptomatology among colorectal cancer survivors: a 3-month longitudinal examination of cognitive processing. Psychooncology 18:30–41. https://doi.org/10.1002/pon.1367
Nathan PC, Nachman A, Sutradhar R et al (2018) Adverse mental health outcomes in a population-based cohort of survivors of childhood cancer. Cancer 124:2045–2057. https://doi.org/10.1002/cncr.31279
Ng HS, Roder D, Koczwara B, Vitry A (2017) Comorbidity, physical and mental health among cancer patients and survivors: an Australian population-based study. Asia Pac J Clin Oncol 14:181–192. https://doi.org/10.1111/ajco.12677
Leano A, Korman MB, Goldberg L, Ellis J (2019) Are we missing PTSS in our patients with cancer? Part I. Can Oncol Nurs J = Rev Can Nurs Oncol 29:141–146
Abbey G, Thompson SBN, Hickish T, Heathcote D (2014) A meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder. Psychooncology 24:371–381. https://doi.org/10.1002/pon.3654
APA (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association, Washington, DC
Dekel S, Ein-Dor T, Solomon Z (2012) Posttraumatic growth and posttraumatic distress: a longitudinal study. Psychol Trauma Theory Res Pract Policy 4:94–101. https://doi.org/10.1037/a0021865
Tedeschi RG, Shakespeare-Finch J, Taku K, Calhoun LG (2018) Posttraumatic growth: theory, research, and applications. Routledge
Tedeschi RG, Calhoun LG (1995) Trauma and transformation: growing in the aftermath of suffering. Sage, Thousand Oaks, CA
Marziliano A, Tuman M, Moyer A (2020) The relationship between post-traumatic stress and post-traumatic growth in cancer patients and survivors: a systematic review and meta-analysis. Psychooncology 29:604–616. https://doi.org/10.1002/pon.5314
Shakespeare-Finch J, Lurie-Beck J (2014) A meta-analytic clarification of the relationship between posttraumatic growth and symptoms of posttraumatic distress disorder. J Anxiety Disord 28:223–229. https://doi.org/10.1016/j.janxdis.2013.10.005
Maarten CE, Lenferink LIM, Stroebe MS et al (2019) No pain, no gain: cross-lagged analyses of posttraumatic growth and anxiety, depression, posttraumatic stress and prolonged grief symptoms after loss. Anxiety Stress Coping 32:231–243. https://doi.org/10.1080/10615806.2019.1584293
Zebrack B, Kwak M, Salsman J et al (2014) The relationship between posttraumatic stress and posttraumatic growth among adolescent and young adult (AYA) cancer patients. Psychooncology 24:162–168. https://doi.org/10.1002/pon.3585
Coroiu A, Körner A, Burke S et al (2016) Stress and posttraumatic growth among survivors of breast cancer: a test of curvilinear effects. Int J Stress Manag 23:84–97. https://doi.org/10.1037/a0039247
Kleim B, Ehlers A (2009) Evidence for a curvilinear relationship between posttraumatic growth and posttrauma depression and PTSS in assault survivors. J Trauma Stress 22:45–52. https://doi.org/10.1002/jts.20378
Taku K, Tedeschi RG, Shakespeare-Finch J et al (2021) Posttraumatic growth (PTG) and posttraumatic depreciation (PTD) across ten countries: global validation of the PTG-PTD theoretical model. Pers Individ Dif 169:110222. https://doi.org/10.1016/j.paid.2020.110222
Tiamiyu MF, Gan Y, Kwiatkowski D et al (2016) Relationships between latent factors of posttraumatic stress disorder and posttraumatic growth. J Nerv Ment Dis 204:344–348. https://doi.org/10.1097/nmd.0000000000000490
Shand LK, Cowlishaw S, Brooker JE et al (2015) Correlates of posttraumatic stress symptoms and growth in cancer patients: a systematic review and meta-analysis. Psychooncology 24:624–634. https://doi.org/10.1002/pon.3719
Casellas-Grau A, Ochoa C, Ruini C (2017) Psychological and clinical correlates of posttraumatic growth in cancer: a systematic and critical review. Psychooncology 26:2007–2018. https://doi.org/10.1002/pon.4426
Casellas-Grau A, Vives J, Font A, Ochoa C (2016) Positive psychological functioning in breast cancer: an integrative review. The Breast 27:136–168. https://doi.org/10.1016/j.breast.2016.04.001
Cordova MJ, Riba MB, Spiegel D (2017) Posttraumatic stress disorder and cancer. Lancet Psychiatry 4:330–338. https://doi.org/10.1016/s2215-0366(17)30014-7
Dahl AA, Østby-Deglum M, Oldenburg J et al (2016) Aspects of posttraumatic stress disorder in long-term testicular cancer survivors: cross-sectional and longitudinal findings. J Cancer Surviv 10:842–849. https://doi.org/10.1007/s11764-016-0529-4
Liu Z, Doege D, Thong MSY, Arndt V (2020) The relationship between posttraumatic growth and health-related quality of life in adult cancer survivors: a systematic review. J Affect Disord 276:159–168. https://doi.org/10.1016/j.jad.2020.07.044
Ochoa AC, Casellas-Grau A, Vives J et al (2017) Positive psychotherapy for distressed cancer survivors: posttraumatic growth facilitation reduces posttraumatic stress. Int J Clin Health Psychol 17:28–37. https://doi.org/10.1016/j.ijchp.2016.09.002
Pranjic N, Bajraktarevic A, Ramic E (2016) Distress and PTSS in patients with cancer: cohort study case. Materia Socio Medica 28:12. https://doi.org/10.5455/msm.2016.28.12-16
Ochoa AC, Sánchez N, Sumalla, EC, Casellas-Grau A (2019) Stress and growth in cancer: mechanisms and psychotherapeutic interventions to facilitate a constructive balance. Front Psychol 10:177. https://doi.org/10.3389/fpsyg.2019.00177
Watson M, Law MG, dos Santos M et al (1994) The Mini-MAC. J Psychosoc Oncol 12:33–46. https://doi.org/10.1300/j077v12n03_03
Holland JM, Currier JM, Coleman RA, Neimeyer RA (2010) The Integration of Stressful Life Experiences Scale (ISLES): development and initial validation of a new measure. Int J Stress Manag 17:325–352. https://doi.org/10.1037/a0020892
Smith BW, Dalen J, Wiggins K et al (2008) The Brief Resilience Scale: assessing the ability to bounce back. Int J Behav Med 15:194–200. https://doi.org/10.1080/10705500802222972
Wong PTP, Kjell O, Peacock E et al (2017) Self-Transcendence Measure-Brief (STM-B). Retrieved from http://www.drpaulwong.com/wp-content/uploads/2018/08/Self-Transcendence-Measure-Brief-STM-B-Wong-Kjell-Peacock-Ivtzan-Lomas-2017.pdf
Huber S, Huber OW (2012) The Centrality of Religiosity Scale CRS. Religions 3:710–724. https://doi.org/10.3390/rel3030710
Mullan F (1985) Seasons of survival: reflections of a physician with cancer. N Engl J Med 313:270–273. https://doi.org/10.1056/NEJM198507253130421
Pedhazur EJ & Schmelkin LP (1991) Measurement, design, and analysis: an integrated approach (Student ed.), Lawrence Erlbaum Associates, Inc., New Jersey
Cann A, Calhoun LG, Tedeschi RG et al (2010) A short form of the Posttraumatic Growth Inventory. Anxiety Stress Coping 23:127–137. https://doi.org/10.1080/10615800903094273
Weathers FW, Litz BT, Keane TM et al (2013) The PTSS Checklist for DSM-5 (PCL-5). Scale available from the National Center for PTSS at www.PTSS.va.gov
Grassi L, Buda P, Cavana L et al (2005) Styles of coping with cancer: the Italian version of the Mini-Mental Adjustment to Cancer (Mini-MAC) scale. Psychooncology 14:115–124. https://doi.org/10.1002/pon.826
Van Buuren, Groothuis-Oudshoorn K (2011) mice: multivariate imputation by chained equations in R. J Stat Softw 45:1–67. https://doi.org/10.18637/jss.v045.i03
Ben-Shachar M, Lüdecke D, Makowski D (2020) effectsize: estimation of effect size indices and standardized parameters. J Open Source Softw 5:2815. https://doi.org/10.21105/joss.02815
Morey RD, Rouder JN (2018) BayesFactor: computation of Bayes factors for common designs R package version 0.9.12–4.2. https://CRAN.R-project.org/package=BayesFactor
R Core Team (2021). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/
Dougall AL, Swanson J, Kyutoku Y et al (2017) Posttraumatic symptoms, quality of life, and survival among lung cancer patients. J Appl Biobehav Res 22:12065. https://doi.org/10.1111/jabr.12065
Arpawong TE, Oland A, Milam JE et al (2013) Posttraumatic growth among an ethnically diverse sample of adolescent and young adult cancer survivors. Psychooncology 22:2235–2244. https://doi.org/10.1002/pon.3286
Tedeschi RG, Calhoun LG (2004) Target article: “posttraumatic growth: conceptual foundations and empirical evidence.” Psychol Inq 15:1–18. https://doi.org/10.1207/s15327965pli1501_01
Silva SM, Crespo C, Canavarro MC (2012) Pathways for psychological adjustment in breast cancer: a longitudinal study on coping strategies and posttraumatic growth. Psychol Health 27:1323–1341. https://doi.org/10.1080/08870446.2012.676644
De Padova S, Grassi L, Vagheggini A et al (2021) Post-traumatic stress symptoms in long-term disease-free cancer survivors and their family caregivers. Cancer Med 10:3974–3985. https://doi.org/10.1002/cam4.3961
Levine EG, Eckhardt J, Targ E (2005) Change in posttraumatic stress symptoms following psychosocial treatment for breast cancer. Psychooncology 14:618–635. https://doi.org/10.1002/pon.882
Whitaker KL, Brewin CR, Watson M (2008) Intrusive cognitions and anxiety in cancer patients. J Psychosom Res 64:509–517. https://doi.org/10.1016/j.jpsychores.2008.02.009
Funding
This study was supported by the Research Grant Agency of the Ministry of Education, Science, Research and Sport of the Slovak Republic and the Slovak Academy of Science [VEGA 1/0305/18] as well as the Slovak Research and Development Agency [APVV-17–0418].
Author information
Authors and Affiliations
Contributions
GB: conceptualization, project administration, methodology, resources, formal analysis, data curation, writing—original draft, writing—review and editing. LV: data curation, writing—original draft, writing—review and editing. MD: investigation, resources, funding acquisition, writing—review and editing.
Corresponding author
Ethics declarations
Ethics approval
Study was approved by the Ethics Committee at Trnava University (resolution No. 1/2018).
Consent to participate
All participants have provided their written informed consent.
Consent for publication
Not applicable.
Conflict of interest
The authors declare no competing interests.
Supplementary information
Data, analytical script, and other materials supported the results of this study could be found at osf.io/npfsj/.
Additional information
Publisher's note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Baník, G., Dědová, M. & Vargová, L. Cancer-related posttraumatic growth and posttraumatic stress: how are they connected and what are their correlates?. Support Care Cancer 30, 8183–8192 (2022). https://doi.org/10.1007/s00520-022-07252-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00520-022-07252-7