Abstract
Parents of pediatric oncology patients have an increased prevalence of psychiatric symptoms. The feasibility of two short-term interventions (CBT with Biofeedback; Supportive Therapy and audio-visual relaxation, 9 sessions over 6 weeks in both arms) on reducing psychiatric morbidity was tested in 16 parents of pediatric oncology patients. Parents’ and children’s questionnaires and parents’ endocrinological and immunological parameters (blood count, cortisol levels, lymphocyte cells subpopulations) were evaluated before and after interventions. Parents had fewer post-traumatic stress disorder (PTSD) symptoms (d = 0.74) and lower dysfunction scores (r = -0.51) after interventions, lower cortisol levels and platelet count (d = 0.41 and d = 0.46), and higher CD16 cell numbers (d = -0.46). This pilot study demonstrates the benefit of short-term psychological interventions for parents of pediatric oncology patients, as they may reduce PTSD symptomatology in this population.
This is a preview of subscription content, log in via an institution to check access.
Data availability
Not applicable.
Code availability
Not applicable.
References
Bakula, D. M., Sharkey, C. M., Perez, M. N., Espeleta, H. C., Gamwell, K. L., Baudino, M., Delozier, A. M., Chaney, J. M., Alderson, R. M., & Mullins, L. L. (2020). The relationship between parent distress and child quality of life in pediatric cancer: A meta-analysis. Journal of Pediatric Nursing, 50, 14–19. https://doi.org/10.1016/j.pedn.2019.09.024
Benaroya-Milshtein, N., Apter, A., Yaniv, I., Yuval, O., Stern, B., Bengal, Y., Kodman, Y., Shemer, E., Pick, C. G., Buchval, I., & Valevski, A. (2014). Neuroimmunological function in parents of children suffering from cancer. Journal of Neural Transmission, 121(3), 299–306. https://doi.org/10.1007/s00702-013-1098-6
Birmaher, B., Khetarpal, S., Brent, D., Cully, M., Balach, L., Kaufman, J., & Neer, S. M. (1997). The Screen for Child Anxiety Related Emotional Disorders (SCARED): Scale construction and psychometric characteristics. Journal of the American Academy of Child & Adolescent Psychiatry, 36(4), 545–553. https://doi.org/10.1097/00004583-199704000-00018
Cohen, J. (1988). Statistical Power Analysis for the Behavioral Sciences (2nd ed.). Routledge. https://doi.org/10.4324/9780203771587
Depledge, M. H., Stone, R. J., & Bird, W. J. (2011). Can natural and virtual environments be used to promote improved human health and wellbeing? Environmental Science & Technology, 45(11), 4660–4665. https://doi.org/10.1021/es103907m
Eche, I. J., Yusufov, M., Isibor, D. A., & Wolfe, J. (2021). A systematic review and meta-analytic evaluation of psychosocial interventions in parents of children with cancer with an exploratory focus on minority outcomes. Pediatric Blood & Cancer, 68(12), e29328. https://doi.org/10.1002/pbc.29328
Harari, E. (2014). Supportive psychotherapy. Australasian Psychiatry, 22(5), 440–442. https://doi.org/10.1177/1039856214546674
Hori, H., & Kim, Y. (2019). Inflammation and post-traumatic stress disorder. Psychiatry and Clinical Neurosciences, 73(4), 143–153. https://doi.org/10.1111/pcn.12820
Keller, J., Gomez, R., Williams, G., Lembke, A., Lazzeroni, L., Murphy, G. M., & Schatzberg, A. F. (2017). HPA axis in major depression: Cortisol, clinical symptomatology and genetic variation predict cognition. Molecular Psychiatry, 22(4), 527–536. https://doi.org/10.1038/mp.2016.120
Law, E., Fisher, E., Eccleston, C., & Palermo, T. M. (2019). Psychological interventions for parents of children and adolescents with chronic illness. Cochrane Database of Systematic Reviews, 3. https://doi.org/10.1002/14651858.CD009660.pub4
Lindqvist, D., Mellon, S. H., Dhabhar, F. S., Yehuda, R., Grenon, S. M., Flory, J. D., Bierer, L. M., Abu-Amara, D., Coy, M., Makotkine, I., Reus, V. I., Aschbacher, K., Bersani, F. S., Marmar, C. R., & Wolkowitz, O. M. (2017). Increased circulating blood cell counts in combat-related PTSD: Associations with inflammation and PTSD severity. Psychiatry Research, 258, 330–336. https://doi.org/10.1016/j.psychres.2017.08.052
Ljungman, L., Cernvall, M., Ghaderi, A., Ljungman, G., von Essen, L., & Ljótsson, B. (2018). An open trial of individualized face-toface cognitive behavior therapy for psychological distress in parents of children after end of treatment for childhood cancer including a cognitive behavioral conceptualization. PeerJ, 11(6), e4570. https://doi.org/10.7717/peerj.4570
McCarthy, S. (2008). Post-traumatic Stress Diagnostic Scale (PDS). Occupational Medicine, 58(5), 379. https://doi.org/10.1093/occmed/kqn062
Meichenbaum, D. H., & Deffenbacher, J. L. (1988). Stress Inoculation Training. The Counseling Psychologist, 16(1), 69–90. https://doi.org/10.1177/0011000088161005
Naftolowitz, D. F., Donovan, S., & Frances, A. (1995). DSM-IV. CNS Drugs. https://doi.org/10.2165/00023210-199504010-00001
Norberg, A. L., & Boman, K. K. (2008). Parent distress in childhood cancer: A comparative evaluation of posttraumatic stress symptoms, depression and anxiety. Acta Oncologica (stockholm, Sweden), 47(2), 267–274. https://doi.org/10.1080/02841860701558773
Otte, C., Gold, S. M., Penninx, B. W., Pariante, C. M., Etkin, A., Fava, M., Mohr, D. C., & Schatzberg, A. F. (2016). Major depressive disorder. Nature Reviews Disease Primers, 2(1), 1–20. https://doi.org/10.1038/nrdp.2016.65
Padesky, C. A., & Mooney, K. A. (2012). Strengths-based cognitive-behavioural therapy: A four-step model to build resilience: Strengths-based CBT: Four steps to resilience. Clinical Psychology & Psychotherapy, 19(4), 283–290. https://doi.org/10.1002/cpp.1795
Poznanski, E. O., Freeman, L. N., & Mokros, H. B. (1985). Children’s depression rating scale—revised (September 1984). Psychopharmacology Bulletin, 21(4), 979–989.
Rocha, N. S., & Fleck, M. P. (2009). Validity of the Brazilian version of WHOQOL-BREF in depressed patients using Rasch modelling. Revista De Saúde Pública, 43(1), 147–153. https://doi.org/10.1590/S0034-89102009000100019
Rosenthal, R. (1994). Parametric measures of effect size. In The handbook of research synthesis (pp. 231–244). Russell Sage Foundation.
Shemesh, E., Lurie, S., Stuber, M. L., Emre, S., Patel, Y., Vohra, P., Aromando, M., & Shneider, B. L. (2000). A pilot study of posttraumatic stress and nonadherence in pediatric liver transplant recipients. Pediatrics, 105(2), E29. https://doi.org/10.1542/peds.105.2.e29
Shields, G. S., Spahr, C. M., & Slavich, G. M. (2020). Psychosocial Interventions and Immune System Function: A Systematic Review and Meta-analysis of Randomized Clinical Trials. JAMA Psychiatry, 77(10), 1031–1043. https://doi.org/10.1001/jamapsychiatry.2020.0431
Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the State-Trait Anxiety Inventory. Consulting Psychologists Press.
Varni, J. W., Seid, M., & Kurtin, P. S. (2001). PedsQLTM 4.0: Reliability and validity of the pediatric quality of life inventoryTM version 4.0 generic core scales in healthy and patient populations. Medical Care, 39(8), 800–12. https://doi.org/10.1097/00005650-200108000-00006
Warmerdam, J., Zabih, V., Kurdyak, P., Sutradhar, R., Nathan, P. C., & Gupta, S. (2019). Prevalence of anxiety, depression, and posttraumatic stress disorder in parents of children with cancer: A meta-analysis. Pediatric Blood & Cancer, 66(6), e27677. https://doi.org/10.1002/pbc.27677
Acknowledgements
The authors would like to thank the Israel Cancer Association and Oncology Memorial Fund for supporting the psycho-oncology research. The authors thank Shemer Eliya (The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem) for her invaluable help as a research assistant, and Cendrine Bursztein, PhD (Department of Psychological Medicine, Schneider Children's Medical Center of Israel, Petah Tikva, Israel) for her invaluable help in psychological interventions. The authors thank Adi Moka for her contribution in editing and proofreading. We thank Schneider’s Children Medical Centre physicians’ committee and editorial board for their help in proof-reading the article.
Funding
Funding was provided by the Israel Cancer Association and Oncology Memorial Fund.
Author information
Authors and Affiliations
Contributions
All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Noa Benaroya-Milshtein, Shiri Liber, Julia Katz and Yona Kodman. The first draft of the manuscript was written by Shiri Liber and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. The study was approved by the Institutional Review Board of the Rabin Medical Center, Petah Tikva, Israel.
Consent to participate
Written informed consent was obtained from all participants.
Consent for publication
All authors gave their consent for publication.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Conflicts of interest/Competing interests
The authors declare that they have no conflict of interest.
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
Liber, S., Oded, Y., Stern, B. et al. Brief report: the effect of two short psychological interventions on psychiatric morbidity in parents of pediatric hematology oncology patients, a feasibility study. Curr Psychol 42, 24175–24180 (2023). https://doi.org/10.1007/s12144-022-03510-3
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12144-022-03510-3