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Experiential Avoidance and Rumination in Parents of Children on Cancer Treatment: Relationships with Posttraumatic Stress Symptoms and Symptoms of Depression
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Psychology in Healthcare.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Psychology in Healthcare.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Clinical Psychology in Healthcare.
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2016 (English)In: Journal of clinical psychology in medical settings, ISSN 1068-9583, E-ISSN 1573-3572, Vol. 23, no 1, 67-76 p.Article in journal (Refereed) Published
Abstract [en]

We conducted a cross-sectional survey study to investigate whether there is a relationship between experiential avoidance (EA), rumination, post-traumatic stress symptoms (PTSS), and symptoms of depression, in parents of children on cancer treatment. Data from 79 parents (55 mothers) of 79 children with a median of three months since their cancer diagnosis were included in cross-sectional analyses. EA and rumination were positively correlated with PTSS and symptoms of depression. EA and rumination did not provide incremental explained variance in PTSS over and above that explained by symptoms of depression, while controlling for symptoms of anxiety and demographic characteristics. However, EA and rumination provided incremental explained variance in symptoms of depression over and above that explained by PTSS, while controlling for symptoms of anxiety and demographic characteristics. Rumination and EA are important constructs in the understanding of PTSS and symptoms of depression in parents of children on cancer treatment. Future research should delineate the temporal relationships between these constructs.

Place, publisher, year, edition, pages
2016. Vol. 23, no 1, 67-76 p.
National Category
Pediatrics
Identifiers
URN: urn:nbn:se:uu:diva-234500DOI: 10.1007/s10880-015-9437-4ISI: 000371621600007PubMedID: 26462676OAI: oai:DiVA.org:uu-234500DiVA: diva2:756875
Conference
Conference of the Association-of-Psychologists-in-Academic-Health-Centers (APAHC), FEB, 2015, Atlanta, GA, USA
Funder
Swedish Research Council, K2008-70X-20836-01-3, K2011-70X-20836-04-4Swedish Cancer Society, 2010/276Swedish Childhood Cancer Foundation, PROJ08/010, PRO12/028
Note

Tidigare titel: Experiential avoidance and rumination in parents of children on cancer treatment: Relationships with posttraumatic stress symptoms and depression

Available from: 2014-10-20 Created: 2014-10-20 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Symptoms of Posttraumatic Stress in Parents of Children on Cancer Treatment: Factor Structure, Experiential Avoidance, and Internet-based Guided Self-help
Open this publication in new window or tab >>Symptoms of Posttraumatic Stress in Parents of Children on Cancer Treatment: Factor Structure, Experiential Avoidance, and Internet-based Guided Self-help
2014 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Having a child diagnosed with cancer is stressful and many parents of children on treatment for cancer report symptoms of posttraumatic stress (PTSS). The overall purpose was to, among parents of children on treatment for cancer, investigate the factor structure of PTSS; investigate the relationships between experiential avoidance (EA), rumination, PTSS and depression; and to develop, test, and evaluate a guided self-help intervention provided via the internet.

In a longitudinal study with three assessments (n = 249-203) results indicated that a four-factor solution of PTSS including the factors re-experiencing, avoidance, dysphoria, and hyper-arousal provided best fit and that the pattern and size of factor loadings were equivalent across the three assessments (Study I). In a case study with pre-, post-, and follow-up assessments a guided self-intervention was well received with clinical significant and reliable improvements in PTSS, depression, and quality of life (Study II). Furthermore, in cross-sectional analyses (n = 79) EA and rumination were positively associated with PTSS and depression and provided incremental explanation in depression while controlling for demographic characteristics, anxiety, and PTSS. In longitudinal analyses (n = 20), EA but not rumination predicted PTSS and depression while controlling for initial levels (Study III). Finally, in a randomized controlled trial with parents fulfilling the modified symptom criteria on the PTSD-Checklist allocated to guided self-help via the internet (n = 31) or to a wait-list control condition (n = 27) there was a significant intervention effect with a large effect size for the primary outcome PTSS. Similar results were observed for the secondary outcomes depression and anxiety, but not for EA and rumination. Exploratory analyses suggested that the relationships between EA and PTSS and between EA and depression were weakened in the intervention group (Study IV).

The studies included in the current thesis suggest that a four-factor solution should be used when assessing PTSS in parents of children on cancer treatment. Furthermore, rumination and EA in particular seem to be important constructs to consider when understanding PTSS and depression in this population. Finally, guided self-help via the internet shows promise in reducing PTSS and depression among parents of children on cancer treatment who report a high level of PTSS.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2014. 65 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1051
Keyword
Cancer and oncology, Children, Parents, Cognitive behavior therapy, Experiential avodiance, Posttraumatic stress symptoms, Depresssion
National Category
Pediatrics Psychology Cancer and Oncology
Identifiers
urn:nbn:se:uu:diva-234518 (URN)978-91-554-9098-0 (ISBN)
Public defence
2014-12-18, Room IX, Universitetshuset, Biskopsgatan 3, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2014-11-26 Created: 2014-10-20 Last updated: 2015-02-03

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