Abstract
The aim of the present meta-analysis was to compare levels of posttraumatic stress symptoms (PTSS) and the prevalence of posttraumatic stress disorders (PTSD) in individuals with and without pediatric chronic physical illnesses, and to analyze correlates of these symptoms. In total, 150 studies were identified that provided relevant data. On average, 11.5% of the participants with pediatric chronic physical illnesses met the criteria of PTSD (Odds Ratio 2.70). PTSS were also more common in this group than in control groups without chronic physical illnesses. While the PTSS levels did not differ across physical diseases, we found positive associations of PTSS with illness severity and duration/intensity of treatment, as well as negative associations with duration of illness, time since last treatment, treatment adherence, and family functioning. We conclude that individuals with pediatric chronic physical illnesses who experienced traumatic events should be screened for PTSS and receive psychological interventions when needed.
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Achenbach, T. M. (1991). Integrative guide for the 1991 CBCL/4_18, YSR, and TRF profiles. Burlington: Department of Psychiatry, University of Vermont.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Anderson, T. M., & Knight, R. G. (2010). The long-term effects of traumatic brain injury on the coordinative function of the central executive. Journal of Clinical and Experimental Neuropsychology, 32, 1074–1082. https://doi.org/10.1080/13803391003733560.
Barakat, L. P., & Wodka, E. L. (2006). Posttraumatic stress symptoms in college students with a chronic illness. Social Behavior and Personality, 34, 999–1006. https://doi.org/10.2224/sbp.2006.34.8.999.
Barakat, L. P., Kazak, A. E., Meadows, A. T., Casey, R., Meeske, K., & Stuber, M. L. (1997). Families surviving childhood cancer: A comparison of posttraumatic stress symptoms with families of healthy children. Journal of Pediatric Psychology, 6, 843–859. https://doi.org/10.1093/jpepsy/22.6.843.
Borenstein, M., Higgins, L., Hedges, J., & Rothstein, H. (2005). Comprehensive meta-analysis, version 2. Englewood: Biostat.
Boscarino, J. A. (2004). Posttraumatic stress disorder and physical illness: Results from clinical and epidemiologic studies. In R. Yehuda & B. McEwen (Eds.), Biobehavioral stress response: Protective and damaging effects (pp. 141–153). New York: New York Academy of Sciences.
Bruce, M. (2006). A systematic and conceptual review of posttraumatic stress in childhood cancer survivors and their parents. Clinical Psychology Review, 26, 233–256. https://doi.org/10.1016/j.cpr.2005.10.002.
Buckley, T. C., Green, B. L., & Schnurr, P. P. (2004). Trauma, PTSD and physical health: Clinical issues. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (2nd ed., pp. 441–465). New York: Guilford.
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159. https://doi.org/10.1037/0033-2909.112.1.155.
Duval, S., & Tweedie, R. (2000). Trim and fill: A simple funnel-plot-based method of testing and adjusting for publication bias in meta-analysis. Biometrics, 56, 455–463. https://doi.org/10.1111/j.0006-341X.2000.00455.x.
Ferro, M. A., & Speechley, K. M. (2009). Depressive symptoms among mothers of children with epilepsy: A review of prevalence, associated factors, and impact on children. Epilepsia, 50, 2344–2354. https://doi.org/10.1111/j.1528-1167.2009.02276.x.
Frederick, C., Pynoos, R., & Nader, K. (1992). Childhood posttraumatic stress reaction index—a copyrighted instrument. Los Angeles: University of California.
Graziano, S., Rossi, A., Spano, B., Petrocchi, M., Biondi, G., & Ammaniti, M. (2016). Comparison of psychological functioning in children and their mothers living through a life-threatening and non-life-threatening chronic disease: A pilot study. Journal of Child Health Care, 20, 174–184. https://doi.org/10.1177/1367493514563854.
Higgins, P. P., & Green, S. (2009). Cochrane handbook for systematic reviews of interventions. Version 5.02. Available online at http://handbook.cochrane.org/v5.0.2/ (retrieved 2017-05-23).
Jalmsell, L., Kontio, T., Stein, M., Henter, J. I., & Kreicbergs, U. (2015). On the child's own initiative: Parents communicate with their dying child about death. Death Studies, 39, 111–117. https://doi.org/10.1080/07481187.2014.913086.
Kahana, S., Feeny, N. C., Youngstrom, E. R., & Drotar, D. (2006). Posttraumatic stress in youth experiencing illnesses and injuries: An exploratory meta-analysis. Traumatology, 12, 148–161. https://doi.org/10.1177/1534765606294562.
Kaniasty, K., & Norris, F. H. (2008). Longitudinal linkages between perceived social support and posttraumatic stress symptoms: Sequential roles of social causation and social selection. Journal of Traumatic Stress, 21, 274–281. https://doi.org/10.1002/jts.20334.
Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980–988. https://doi.org/10.1097/00004583-199707000-00021.
Kazak, A. E., Barakat, L. P., Meeske, K., Christakis, D., Meadows, A. T., Casey, R., Penati, B., & Stuber, M. L. (1997). Post-traumatic stress, family functioning, and social support in survivors of childhood leukemia and their mothers and fathers. Journal of Consulting and Clinical Psychology, 65, 120–129. https://doi.org/10.1037/0022-006X.65.1.120.
Kazak, A. E., Alderfer, M. A., Streisand, R., Simms, S., Rourke, M. T., Barakat, L. P., et al. (2004). Treatment of posttraumatic stress symptoms in adolescent survivors of childhood cancer and their families: A randomized clinical trial. Journal of Family Psychology, 18, 493–504. https://doi.org/10.1037/0893-3200.18.3.493.
Kerkar, N., Annunziato, R. A., Foley, L., Schmeidler, J., Rumbo, C., Emre, S., et al. (2006). Prospective analysis of nonadherence in autoimmune hepatitis: A common problem. Journal of Pediatric Gastroenterology and Nutrition, 43, 629–634. https://doi.org/10.1097/01.mpg.0000239735.87111.
Kilpatrick, D. G., Ruggiero, K. J., Acierno, R., Saunders, B. E., Resnick, H. S., & Best, C. L. (2003). Violence and risk of PTSD, major depression, substance abuse/dependence, and comorbidity: Results from the National Survey of adolescents. Journal of Consulting and Clinical Psychology, 71, 692–700. https://doi.org/10.1037/0022-006X.71.4.692.
La Greca, A. (2004). Manual for the self care inventory. Coral Gables: Author.
Landolt, M. A., Vollrath, M., Ribi, K., Gnehm, H. E., & Sennhauser, F. H. (2003). Incidence and associations of parental and child posttraumatic stress symptoms in pediatric patients. Journal of Child Psychology and Psychiatry, 44, 1199–1207. https://doi.org/10.1111/1469-7610.00201.
Le Brocque, R. M., Hendrikz, J., & Kenardy, J. A. (2010). The course of posttraumatic stress in children: Examination of recovery trajectories following traumatic injury. Journal of Pediatric Psychology, 35, 637–645. https://doi.org/10.1093/jpepsy/jsp050.
Lipsey, M. W., & Wilson, D. B. (2001). Practical meta-analysis. Thousand Oaks: Sage.
Meentken, M. G., van Beynum, I. M., Lagerstee, J. S., Helbing, W. A., & Utens, W. J. (2017). Medically related post-traumatic stress in children and adolescents with congenital heart defects. Frontiers in Pediatrics, 5, 20. https://doi.org/10.3389/fped.2017.00020.
Moos, R., & Moos, B. (1994). Family environment scale manual: Development, applications, research (3rd ed.). Palo Alto: Consulting Psychologist Press.
Morina, N., Koerssen, R., & Pollet, T. V. (2015). Interventions for children and adolescents with posttraumatic stress disorder: A meta-analysis of comparative outcome studies. Clinical Psychology Review, 47, 41–54. https://doi.org/10.1016/j.cpr.2016.05.006.
O’Connor, S. S., Zatzick, D. F., Wang, J., Temkin, N., Koepsell, T. D., Jaffe, K. M., et al. (2012). Association between posttraumatic stress, depression, and functional impairments in adolescents 24 months after traumatic brain injury. Journal of Traumatic Stress, 25, 264–271. https://doi.org/10.1002/jts.21704.
Phipps, S., Klosky, J. L., Long, A., Hudson, M. M., Huang, Q., Zhang, H., & Noll, R. B. (2014). Posttraumatic stress and psychological growth in children with cancer: Has the traumatic impact of cancer been overestimated? Journal of Clinical Oncology, 32, 641–646. https://doi.org/10.1200/JCO.2013.49.8212.
Price, J., Kassam-Adams, N., Alderfer, M. A., Christofferson, J., & Kazak, A. E. (2016). A reevaluation and update of the integrative (trajectory) model of pediatric medical traumatic stress. Journal of Pediatric Psychology, 41, 86–97. https://doi.org/10.1093/jpepsy/jsv074.
Rodriguez, N., Steinberg, A., & Pynoos, R. S. (1998). UCLA post-traumatic stress disorder reaction index for DSM-IV, child, adolescent, and parent versions. Los Angeles: University of California at Los Angeles.
Sahler, O. J., Fairclough, D. L., Phipps, S., Mulhern, R. K., Dolgin, M. J., Noll, R. B., et al. (2005). Using problem-solving skills training to reduce negative affectivity in mothers of children with newly diagnosed cancer: Report of a multisite randomized trial. Journal of Consulting and Clinical Psychology, 73, 272–283. https://doi.org/10.1037/0022-006X.73.2.272.
Thompson, R. J., & Gustafson, K. E. (1996). Adaptation to chronic childhood illness. Washington, DC: American Psychological Association.
Tillery, R., Sharp, K. M. H., Okado, Y., Long, A., & Phipps, S. (2016). Profiles of resilience and growth in youth with cancer and healthy comparisons. Journal of Pediatric Psychology, 41, 290–297. https://doi.org/10.1093/jpepsy/jsv091.
Weiss, D. S., & Marmar, C. R. (1997). The impact of events scale—Revised. In J. P. Wilson & T. M. Keane (Eds.), Assessing psychological trauma and PTSD (pp. 399–411). New York: Guilford.
Werba, B. E., Hobbie, W., Kazak, A. E., Ittenbach, R. F., Reilly, A. F., & Meadows, A. T. (2007). Classifying the intensity of pediatric cancer treatment protocols: The intensity of treatment rating scale 2.0 (ITR-2). Pediatric Blood and Cancer, 48, 673–677. https://doi.org/10.1002/pbc.21184.
Yalug, I., Tufan, A. E., Doksat, K., & Yalug, K. (2011). Post-traumatic stress disorder and post-traumatic stress symptoms in parents of children with cancer: A review. Neurology, Psychiatry and Brain Research, 17, 27–31. https://doi.org/10.1016/j.npbr.2011.02.007.
Zimet, G. D., Dahlem, N. W., Zimet, S. G., & Farley, G. K. (1988). The Multidimensional Scale of Perceived Social Support. Journal of Personality Assessment, 52, 30–41. https://doi.org/10.1207/s15327752jpa5201_2.
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Pinquart, M. Posttraumatic Stress Symptoms and Disorders in Children and Adolescents with Chronic Physical Illnesses: a Meta-Analysis. Journ Child Adol Trauma 13, 1–10 (2020). https://doi.org/10.1007/s40653-018-0222-z
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DOI: https://doi.org/10.1007/s40653-018-0222-z