Skip to main content

Advertisement

Log in

Posttraumatic Stress Symptoms and Disorders in Children and Adolescents with Chronic Physical Illnesses: a Meta-Analysis

  • ORIGINAL ARTICLE
  • Published:
Journal of Child & Adolescent Trauma Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Achenbach, T. M. (1991). Integrative guide for the 1991 CBCL/4_18, YSR, and TRF profiles. Burlington: Department of Psychiatry, University of Vermont.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

    Book  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

  • Borenstein, M., Higgins, L., Hedges, J., & Rothstein, H. (2005). Comprehensive meta-analysis, version 2. Englewood: Biostat.

    Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Google Scholar 

  • Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155–159. https://doi.org/10.1037/0033-2909.112.1.155.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Frederick, C., Pynoos, R., & Nader, K. (1992). Childhood posttraumatic stress reaction index—a copyrighted instrument. Los Angeles: University of California.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • La Greca, A. (2004). Manual for the self care inventory. Coral Gables: Author.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Lipsey, M. W., & Wilson, D. B. (2001). Practical meta-analysis. Thousand Oaks: Sage.

    Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • Moos, R., & Moos, B. (1994). Family environment scale manual: Development, applications, research (3rd ed.). Palo Alto: Consulting Psychologist Press.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  PubMed Central  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Martin Pinquart.

Ethics declarations

Conflict of Interest

The author states that there is no conflict of interest.

Electronic Supplementary Material

ESM 1

(DOCX 83 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40653-018-0222-z

Keywords

Navigation