Posttraumatic Stress Symptoms in Parents of Pediatric Cancer Patients: A Mediational Analysis

Prior research finds that anxiety and depression among parents of pediatric cancer patients are associated with posttraumatic stress symptoms in response to children's cancer. This study examined whether this relationship is mediated by parents' negative affective reactions in response to their children's cancer-related treatment procedures.

Participants were parents of 101 patients within six months of diagnosis who had completed at least two treatment-related procedures. Parents completed measures of trait anxiety and depression at baseline and posttraumatic stress symptoms at 3-month follow-up assessment. On the day of each treatment procedure, parents completed measures of state anxiety immediately before and negative mood and distress immediately after the procedure.

Trait anxiety was positively associated with state anxiety immediately before procedures and negative mood after procedures. Depression was positively associated with state anxiety immediately before procedures and negative mood and distress after procedures. Both trait anxiety and depression were positively associated with posttraumatic stress symptoms at 3-months follow-up. Parent state anxiety, negative mood, and distress partially mediated the effects of trait anxiety and/or depression on posttraumatic stress symptoms. Controlling for child age and social desirability did not affect these relationships.

Parents' trait anxiety and depression may influence cancer-related posttraumatic stress partially through their effect on parents' negative affective reactions at the time of their child's treatment procedures. These findings provide a more nuanced understanding of how parents' affect in response to procedures contributes to parent posttraumatic stress and suggest that interventions targeting treatment-related affective reactions of parents with high trait anxiety and/or depression may reduce the risk for longer-term distress and posttraumatic stress symptoms.