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The factor structure of traumatic stress in parents of children with cancer: A longitudinal analysis
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Psykosocial onkologi och stödjande vård.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Psykosocial onkologi och stödjande vård.
Uppsala universitet, Medicinska och farmaceutiska vetenskapsområdet, Medicinska fakulteten, Institutionen för folkhälso- och vårdvetenskap, Psykosocial onkologi och stödjande vård.
2012 (Engelska)Ingår i: Journal of Pediatric Psychology, ISSN 0146-8693, E-ISSN 1465-735X, Vol. 37, nr 4, s. 448-457Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objectives To determine the factor structure of posttraumatic stress symptoms (PTSS) and assess its stability over time among parents of children diagnosed with cancer. 

Methods  Parents of children with cancer included in a longitudinal study completed the posttraumatic stress disorder (PTSD) Checklist–Civilian Version 2 weeks (n = 249) and 2 (n = 234) and 4 (n = 203) months after their child's diagnosis. Confirmatory factor analysis (CFA) was used to assess 3 models of the underlying dimensions of PTSD and invariance tests were used to assess stability over time. 

Results  A longitudinal CFA with the factors reexperiencing, avoidance, dysphoria, and hyperarousal provided best fit to the data. Invariance testing suggested that the pattern and size of loadings were equivalent across the three assessments. 

Discussions Findings tentatively suggest that PTSS among parents of children with cancer consist of four factors. Implications for research and clinical practice are discussed.

Ort, förlag, år, upplaga, sidor
2012. Vol. 37, nr 4, s. 448-457
Nyckelord [en]
assessment, cancer and oncology, children, longitudinal research, parent stress, psychosocial functioning
Nationell ämneskategori
Annan medicin och hälsovetenskap
Identifikatorer
URN: urn:nbn:se:uu:diva-161720DOI: 10.1093/jpepsy/jsr105ISI: 000303330600009OAI: oai:DiVA.org:uu-161720DiVA, id: diva2:457083
Anmärkning

Erratum in: Journal of Pediatric Psychology (2013), 38(2): 237–240. doi: 10.1093/jpepsy/jss125

Tillgänglig från: 2011-12-15 Skapad: 2011-11-16 Senast uppdaterad: 2017-12-08Bibliografiskt granskad
Ingår i avhandling
1. Symptoms of Posttraumatic Stress in Parents of Children on Cancer Treatment: Factor Structure, Experiential Avoidance, and Internet-based Guided Self-help
Öppna denna publikation i ny flik eller fönster >>Symptoms of Posttraumatic Stress in Parents of Children on Cancer Treatment: Factor Structure, Experiential Avoidance, and Internet-based Guided Self-help
2014 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
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.

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2014. s. 65
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1051
Nyckelord
Cancer and oncology, Children, Parents, Cognitive behavior therapy, Experiential avodiance, Posttraumatic stress symptoms, Depresssion
Nationell ämneskategori
Pediatrik Psykologi Cancer och onkologi
Identifikatorer
urn:nbn:se:uu:diva-234518 (URN)978-91-554-9098-0 (ISBN)
Disputation
2014-12-18, Room IX, Universitetshuset, Biskopsgatan 3, Uppsala, 09:15 (Engelska)
Opponent
Handledare
Tillgänglig från: 2014-11-26 Skapad: 2014-10-20 Senast uppdaterad: 2015-02-03

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Förlagets fulltexthttp://jpepsy.oxfordjournals.org/cgi/reprint/jsr105?ijkey=gaogaTmXQUeJMIN&keytype=ref

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