Correlates of Posttraumatic Stress in Cancer Patients and Their Family Caregivers Across Two Years Following Diagnosis

Purpose: A major illness is traumatic for patients and families, posing risk for disease-related posttraumatic stress symptoms (PTSS). There is little available information to identify the cancer patients and caregivers at greatest risk for PTSS. This study examines the risk factors of PTSS in colorectal cancer. Method: Patients with colorectal cancer and their caregivers (N=130 dyads) self-reported sociodemographic, psychosocial, and medical factors at diagnosis/treatment initiation (T1), at 1- (T2), and 2-years (T3) post-diagnosis. Cancer-related PTSS of intrusion, avoidance, altered arousal and reactivity (IES-R), and negative alterations in cognitions and mood (investigator-developed measure) were assessed. Path analysis examined associations between proposed correlates and PTSS. Results: : Among patients, higher neuroticism and greater physical symptom distress were concurrently associated with higher PTSS ( B s > 0.10, p s < .02); greater physical symptom distress at T1 and greater social support at T2 were associated with higher PTSS at T3 ( B s≥ 0.37, p s≤ .04). Among caregivers, female gender, higher neuroticism ( B s > 0.12, p s<.01), and lower social support ( B s < -0.24, p s < .02) were associated with higher concurrent PTSS; lower patient physical symptom distress and social support at T1 ( B s < -0.27, p s < .03) and longer hours spent for caregiving at T2 ( B = 0.03, p =.05) were associated with higher PTSS at T3. Conclusions: Findings identify cancer-specific risk factors (physical symptoms, hours caregiving) unique to cancer patients and caregivers, in addition to established risk factors (female, neuroticism, social support) in non-medical populations. Implications for Cancer Survivors: The identified subgroups should receive ongoing screening and psychosocial referral for cancer-related PTSS.