Parents of Children with Cancer: Psychological Long-Term Consequences and Development of a Psychological Treatment for Parents of Survivors
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
The aims of this thesis were to increase the knowledge about the long-term psychological consequences in parents of children diagnosed with cancer, including parents of childhood cancer survivors (CCSs) and bereaved parents, and to take the first steps towards developing a psychological treatment for parents of CCSs.
Study I was a systematic review synthesizing the literature on psychological long-term consequences in parents of CCSs. Study II had a longitudinal design assessing posttraumatic stress symptoms (PTSS) from shortly after the child’s diagnosis (T1, N=259) up to five years after end of the child’s treatment or death (T7, n=169). Study I and II concluded that while most parents show resilience in the long-term, a subgroup report high levels of general distress and/or PTSS. In Study III, interview data from the last assessment in the longitudinal project (T7, n=168) was used. Participants described particularly negative and/or positive experiences in relation to their child’s cancer, and results pointed to the wide range of such experiences involved in parenting a child with cancer. In Study IV and V, parents of CCSs reporting cancer-related psychological distress were included (N=15). In Study IV, a conceptualization of this distress was generated by aggregation of individual behavioral case formulations. The conceptualization consisted of two separate but overlapping paths describing development and maintenance of symptoms of traumatic stress and depressive symptoms. In Study V, cognitive behavior therapy (CBT) based on the individual case formulations were preliminarily evaluated in an open trial. The CBT appeared feasible, and at post-assessment participants reported significant decreases in PTSS (p<.001), depression (p<.001), and anxiety (p<.01) with medium to large effect sizes (Cohen’s d=0.65-0.92).
Findings indicate that psychological long-term consequences in parents of children with cancer consist of a broad range of negative as well as positive experiences, and that while most parents show resilience in the long-term, a subgroup report high levels of psychological distress. For parents of CCSs this distress is suggested to primarily consist of symptoms of traumatic stress and depression, and a preliminary evaluation of CBT targeting hypothesized maintaining mechanisms showed promise in terms of feasibility and treatment effect.
Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2016. , 65 p.
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1273
Cancer and oncology, Children, Parents, Survivors, Cognitive behavior therapy, Posttraumatic stress symptoms, Depression, Positive psychological consequences
Medical and Health Sciences
Research subject Medical Science
IdentifiersURN: urn:nbn:se:uu:diva-306309ISBN: 978-91-554-9745-3 (print)OAI: oai:DiVA.org:uu-306309DiVA: diva2:1040612
2016-12-16, Auditorium minus, Museum Gustavianum, Akademigatan 3, Uppsala, 09:00 (Swedish)
Tillfors, Maria, Professor
von Essen, Louise, ProfessorLjótsson, Brjánn, DocentGhaderi, Ata, Professor
ProjectsBehandling av traumatisk stress hos föräldrar till cancerdrabbade barn med kognitiv beteendeterapi via internetFörekomst, utveckling och behandling av posttraumatiskt stressymptom hos föräldrar till barn med cancerUtveckling och utvärdering av ett webbaserat psykologiskt självhjälpsprogram för föräldrar till barn som tidigare behandlats mot cancer
FunderSwedish Research Council, K2011-70X-20836-04-4Swedish Research Council, K2008-70X-20836-01-3
List of papers