Symptoms of posttraumatic stress in young adult survivors of childhood cancer

Purpose: This study assessed the prevalence of posttraumatic stress symptom s in young adult survivors of childhood cancer and the association of postt raumatic Stress with anxiety, adjustment, perceptions of illness and treatm ent, and medical data extracted from oncology records. Patients and Methods: Seventy-eight young adults (ages 18 to 40 years) who had been treated for childhood cancer completed questionnaires and psychiat ric interviews assessing posttraumatic stress, anxiety, perceptions of thei r illness and treatment, and symptoms of psychologic distress. Delta on tre atment intensity and severity of medical late effects were collected via ch art review. Results: Of the patient sample, 20.5% met American psychiatric Association Diagnostic and Statistical Manual criteria for posttraumatic stress disorde r (PTSD) at some paint since the end of their treatment. Clinically signifi cant levels of intrusive (9%) and avoidant (16.7%) symptoms were reported, Participants also reported elevated state and trait anxiety. Participants w ith PTSD reported higher perceived current life threat, more incense treatm ent histories, and higher (and clinically significant) levels of psychologi c distress than those who did not have PTSD. Conclusion: One-fifth of this sample of young adult survivors of childhood cancer met criteria for a diagnosis of PTSD, with clinically significant sy mptoms of intrusion and avoidance reported. As in other samples, PTSD in yo ung adult survivors was associated with anxiety and other psychologic distr ess. Survivors' perceptions of treatment and its effects were more highly a ssociated with posttraumatic stress than were more objective medical data. The data suggest that cancer-related posttraumatic stress may emerge in you ng adulthood and may affect the achievement of developmental milestones and orientation toward health care. J Clin Oncol 18:4060-4066. (C) 2000 by Ame rican Society of Clinical Oncology.