Posttraumatic stress disorder and sub-syndromal trauma symptoms in cancer patients treated with autologous hematopoietic stem cell transplant and standard dose chemotherapy

This study sought to advance our understanding of how factors, both positive (such as social support) and negative (such as social constraint, avoidant coping, and pretreatment psychological distress) were associated with patients' experience after being diagnosed and treated for cancer with standard dose chemotherapy (SDC) and/or autologous hcmatopoietic stem cell transplant (AHSCT). The specific patient experience examined was development of trauma symptomatology in the AHSCT population when compared to patients receiving SDC for cancer. Further, the study sought to determine if there was an overall PTSD "dose-effect" associated with AHSCT patients, who must also have received SDC during their overall course of treatment. Participants were 57 AHSCT patients (28 male, 29 female) and 34 SDC patients (15 male, 19 female) who received treatment and were considered to be disease free an average of 29 months (SD = 20.03, range = 2-72) prior to completing study measures. Information regarding patient psychological and medical status was assessed using standardized self-report measures and patient chart review. No significant difference between AHSCT and SDC patients in reported PTSD, Subsyndromal PTSD (Sub-PTSD), or symptom severity was found. Eleven percent of all patients met criteria for current PTSD based on the DSM-IV-TR scoring method on the Posttraumatic Stress Disorder Checklist-Civilian Version and an additional 5.5% reported Sub-PTSD. Participants reported an average of two to three symptoms of PTSD (SD = 3.61, range = 0-16). Analyses confirmed that greater social constraint and use of avoidance coping were associated with higher levels of PTSD symptomatology. Regression analysis found that these factors accounted for a large percentage (34%) of the variance in trauma severity scores. This study concluded that A14SCT and SDC patients experience equal levels of traumatic stress following treatment.