Correlates of post-traumatic stress symptoms and growth in cancer patients: a systematic review and meta-analysis: Correlates of PTSS and PTG
Open accessAbstract
OBJECTIVE: The aim of this study is to examine the relationships among demographic, medical, and psychosocial factors and post-traumatic stress symptoms (PTSS) and post-traumatic growth (PTG) in oncology populations. METHOD: A systematic search identified k = 116 relevant studies published between 1990 and 2012. Meta-analyses synthesized results from studies that reported data on correlates of PTSS (k = 26) or PTG (k = 48). A meta-analysis was performed for k = 5 studies reporting the correlation between PTSS and PTG. RESULTS: Post-traumatic stress symptoms were associated with depression (r = 0.56), anxiety (r = 0.65), distress (r = 0.62), social support (r = -0.33), and physical quality of life (r = -0.44). PTG was associated with age (r = -0.08), gender (r = -0.15), distress (r = -0.16), depression (r = -0.06), social support (r = 0.30), optimism (r = 0.27), positive reappraisal (r = 0.46), spirituality (r = 0.33), and religious coping (r = 0.36). There was a small positive relationship between PTSS and PTG (r = 0.13). CONCLUSIONS: Post-traumatic stress symptoms and PTG appear to be independent constructs, rather than opposite ends of a single dimension. This is reflected in a small relationship between these variables and different psychosocial correlates. PTSS were strongly associated with variables reflecting a general state of negative affect. Optimism, spirituality, and positive coping styles were associated with PTG. It remains unclear how they are associated with PTSS, given the lack of relevant studies. Longitudinal research is required to examine how psychosocial factors influence the relationship between PTSS and PTG.
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Posttraumatic growth inversely correlates with depression and psychological distress among cancer patients.
“PTG is important and should be emphasized as a positive psychological characteristic among cancer patients because it inversely correlates with depression and psychological distress [14, 15].”
According to Shand et al.'s meta-analysis, psychological growth following HSCT should be positively related to optimism and negatively related to poor mental health.
“According to the meta-analysis of Shand et al. [18], psychological growth following HSCT should be positively related to optimism and negatively related to poor mental health.”
Shand et al.'s meta-analysis found a small positive relationship between PTSD and post-traumatic growth in cancer patients (r = 0.13).
“In their meta-analysis, Shand et al. [18] found a small and positive relationship between PTSD and post-traumatic growth in cancer patients (i.e. r = 0.13).”
Growth assessed by PTGI is mainly related to positive thoughts and feelings such as happiness and a personality trait (extraversion), whereas growth measured prospectively is only predicted by acceptance.
“If growth assessed by PTGI is mainly related to positive thoughts and feelings such as happiness [18] and a personality trait (i.e. extraversion [23];), then growth measured prospectively is, however, only predicted by a characteristic of psychological flexibility, namely acceptance.”
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“There are also discussions about the differentiation between PTG as an outcome and PTG as a positive illusionary coping strategy (which may not reflect positive changes in all aspects)(1,3); however, a few meta-analyses have found that PTG and other coping variables (eg, coping resources and strategies) are correlated…”
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“As for the relationship with PTG, previous studies revealed that perceived social support contributes to increased PTG(11,18) and seeking social support was directly related to PTG.(15,22) Coping strategies are also important for PTG.”
ResultZhang, Z., Leong Bin Abdullah, M. F. I., Shari, N. I., & Lu, P. (2022) · PLoS ONE · doi:10.1371/journal.pone.0267887 · Cited by 46 · see citing works
“PTG is important and should be emphasized as a positive psychological characteristic among cancer patients because it inversely correlates with depression and psychological distress [14, 15].”
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“…of a stressful or traumatic event, often referred to as “posttraumatic growth” or “benefit finding” (Barskova & Oesterreich, 2009; Cordova & Andrykowski, 2003; Danhauer et al., 2013; Helgeson, Reynolds, & Tomich, 2006; Morris & Shakespeare-Finch, 2011; Shand et al., 2015; Tomich & Helgeson, 2004).”
Langford, D. J., Morgan, S. B., Cooper, B. A., Paul, S. M., Kober, K. M., Wright, F., Hammer, M. J., Conley, Y. P., Levine, J. D., Miaskowski, C. A., et al. (2020) · Psycho-Oncology · doi:10.1002/pon.5377 · Cited by 44 · see citing works
“The ability to cope effectively with a cancer diagnosis and associated treatments can positively impact psychological outcomes.(1) Moreover, effective stress management may mitigate stress-related immune dysregulation that can promote disease progression.”
BackgroundCoping and rumination as predictors of posttraumatic growth and depreciation
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“Social support constitutes another important factor as far as positive and negative psychological changes in cancer patients are concerned (Shand et al., 2015).”
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A Meta-analytic Review of the Relationship Between Posttraumatic Growth, Anxiety, and Depression
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“Studies showed that e.g. social support and positive appraisal are important factors in the development of PTG (Lelorain et al., 2012; Shand et al., 2015).”
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Examining posttraumatic growth and mental health difficulties in the aftermath of Hurricane Sandy.
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Depression, Anxiety and Post-traumatic Growth Among Bereaved Adults: A Latent Class Analysis
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Gender Differences in Psycho-Social-Spiritual Healing
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“Men (n = 90) 0 (0) 4 (4) 21 (23) 39 (43) 26 (29) 0.”
Tirone, V., Orlowska, D., Lofgreen, A. M., Blais, R. K., Stevens, N. R., Klassen, B., Held, P., & Zalta, A. K. (2021) · European Journal of Psychotraumatology · doi:10.1080/20008198.2021.1883925 · Cited by 31 · see citing works
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Self-citationChen, H., Chen, V. C., Hsiao, H., Weng, Y.-P., Hsu, Y.-T., Weng, J., Su, J., & Chen, Y. (2019) · Neuropsychiatric Disease and Treatment · doi:10.2147/ndt.s218450 · Cited by 33 · see citing works
“Numerous studies have examined the potential risk factors for PTSD or associated symptoms after cancer diagnosis.(11,12,16) Impaired psychosocial functioning, negative life events, health problems, and high emotional reactivity were considered predictors of PTSD.”
BackgroundResultWen, K., McGrath, M., Acarturk, C., Ilkkursun, Z., Fuhr, D. C., Sondorp, E., Cuijpers, P., Sijbrandij, M., & Roberts, B. (2020) · Journal of Migration and Health · doi:10.1016/j.jmh.2020.100010 · Cited by 32 · see citing works
Distinct Stress Profiles Among Oncology Patients Undergoing Chemotherapy
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“In addition to the level of distress, age and gender also correlate with PTG in cancer patients.(18) Regarding the demographic factors, gender, age and education are related to the resilience of cancer survivors.”
BackgroundLeong Abdullah, M. F. I., Hami, R., Appalanaido, G. K., Azman, N., Mohd Shariff, N., & Md Sharif, S. S. (2019) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2019.1574946 · Cited by 30 · see citing works
Career Adaptability of Trauma Survivors: The Moderating Role of Posttraumatic Growth
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Posttraumatic stress in breast cancer survivors diagnosed at a young age
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“A qualitative review by Cordova et al(14) and a metaanalysis by Shand et al including broad cancer populations confirmed associations between PTSD and less social support, as well as anxiety.(39) In contrast to other studies that have found a relationship between more advanced disease and PTSD,(1,35) we only found mor…”
ResultPark, C. L., Wilt, J. A., Russell, B. S., & Fendrich, M. (2021) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2021.12.040 · Cited by 31 · see citing works
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Making meaning of cancer: A qualitative analysis of oral-digestive cancer survivors’ reflections
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“…survivors of cancer (Liu et al., 2020; Marziliano et al., 2020; Zebrack et al., 2015; Ochoa Arnedo et al., 2019; Yi & Kim, 2014; Koutna et al., 2021; Klosky et al., 2014; Parikh et al., 2015; Shand et al., 2015) and the potential relationship between PTG and resilience (Seiler & Jenewein, 2019).”
BackgroundPosttraumatic Growth, Personality Factors, and Social Support Among War-Experienced Young Georgians
Panjikidze, M., Beelmann, A., Martskvishvili, K., & Chitashvili, M. (2019) · Psychological Reports · doi:10.1177/0033294118823177 · Cited by 30 · see citing works
Less Mindful, More Struggle and Growth
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Yin and Yang of Psychological Health in the Cancer Experience: Does Positive Psychology Have a Role?
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Posttraumatic stress disorder: from gene discovery to disease biology
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“In addition, a meta-analysis of studies of PTG in cancer patients revealed that optimism is only weakly correlated with PTG (Shand et al., 2015).”
BackgroundMethodResultInfluentialAderhold, C., Morawa, E., Paslakis, G., & Erim, Y. (2019) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2019.1631931 · Cited by 26 · see citing works
Cancer as a Source of Posttraumatic Growth: A Brief Review.
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Benefit finding in long-term prostate cancer survivors
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Posttraumatic growth in breast cancer survivors: Are depressive symptoms really negative predictors?
Romeo, A., Tella, M. D., Ghiggia, A., Tesio, V., Torta, R., & Castelli, L. (2019) · Psychological Trauma Theory Research Practice and Policy · doi:10.1037/tra0000508 · Cited by 28 · see citing works
“This additional statistical analysis has been conducted as the available evidence shows an association between age and psychological growth (Mystakidou et al., 2008; Shand et al., 2015).”
Religiousness and meaning making following stressful life events
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“The 2 concepts of BF and PTG share related characteristics, so the terms are often used interchangeably (16,29-31).”
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“Two recent systematic reviews have confirmed feelings of personal growth in patients with cancer.(13,14) Transplantation is a rich experience with complex psychological implications that includes aspects of PTG process.”
BackgroundTrevino, K., Naik, A., & Moye, J. (2015) · Psychology of Religion and Spirituality · doi:10.1037/rel0000030 · Cited by 21 · see citing works
“…M anuscript A uthor M anuscript Burney, & Ricciardelli, 2015), others suggest that perceived growth may be associated with lower levels of depression (Leong Abdullah et al., 2015; Shand et al., 2015; Wang, Chang, Chen, Chen, & Hsu, 2014) and higher levels of anxiety (Leong Abdullah et al., 2015).”
BackgroundPredictors of posttraumatic growth among university students who experienced a recent earthquake
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“PTSD was the most powerful variable for PTG in this study, which is consistent with findings of a previous study showing a statistically significant relationship between PTSD severity and PTG (Lee, 2001; Morris et al., 2005; Shand et al., 2015).”
ResultMottola, F., Gnisci, A., Kalaitzaki, A., Vintilă, M., & Sergi, I. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1154502 · Cited by 23 · see citing works
“Most studies have found that higher PTG levels are associated with fewer depressive symptoms (Shand et al., 2015).”
BackgroundJirek, S. L., & Saunders, D. G. (2018) · Journal of Aggression, Maltreatment & Trauma · doi:10.1080/10926771.2017.1420720 · Cited by 25 · see citing works
“, 2015; Taku & Cann, 2014) and extraversion (Sheikh, 2004; Tedeschi & Calhoun, 1996), persons receiving greater social support (McMillen, Smith, & Fisher, 1997; Mohr & Rosén, 2017; Shand et al., 2015), individuals who rely upon adaptive coping styles (e.”
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“Perceptible changes are reported in personal value priorities after a cancer diagnosis, and can lead individuals to restructure their values and the way they perceive life [20, 21].”
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“Moreover, in a systematic review [16], authors demonstrated that positive changes after the disaster were associated with psychological distress, depression, positive reappraisal, spirituality, and religious coping.”
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Trauma- und Gewaltfolgen – psychische Auswirkungen
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“5 First sample: adults who completed the PTGI in previous studies (to help identify items)[60] Second samples: college students (to verify psychometric properties) α = 0.”
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“In a systematic review and meta-analysis among people with cancer, there was a weak but statistically significant association between BF and lower depression and between BF and lower distress, but no relation of BF to anxiety (Shand et al., 2015).”
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“Family caregiving may be indicative of improved social support, which has consistently been associated with greater posttraumatic growth, benefit finding, and perceived positive changes (Shand et al., 2015; Moreno & Stanton, 2013; Harding et al., 2014; Pascoe & Edvardsson, 2013; Pinquart et al., 2007).”
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“This way of experiencing empowerment is more akin to theories of post-traumatic growth wherein people who have suffered highly adverse, traumatic events derive benefit from cultivating a stronger sense of self (Occhipinti et al., 2015; Shand et al., 2015).”
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- Authors
- Shand, L. K., Cowlishaw, S., Brooker, J. E., Burney, S., & Ricciardelli, L. A.
- Affiliations
- Deakin University (AU)
- University of Bristol (GB)
- Cabrini Hospital (AU)
- Corresponding author
- Brooker, Joanne E.
- Venue
- Psycho-Oncology
- Publisher
- Wiley
- Published
- 2014-11-12
- Volume
- 24
- Issue
- 6
- Pages
- 624-634
- ISSN
- 1057-9249 (ISSN-L)
- OpenAlex
- W1915047932
- Cited by
- 280
- References
- 56
- Citations by year
- 2026: 15 · 2025: 25 · 2024: 16 · 2023: 36 · 2022: 33 · 2021: 31 · 2020: 30 · 2019: 33 · 2018: 24 · 2017: 18 · 2016: 9 · 2015: 10
- FWCI
- 1.40
- Type
- journal article
- Language
- en
- Open access
- green
- figshare.com
- Locations
- Psycho-Oncology (publishedVersion)
- PubMed (publishedVersion)
- Deakin Research Online (Deakin University) (submittedVersion)
- Figshare (submittedVersion, cc-by)
- Bristol Research (University of Bristol) (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Health › Religion, Spirituality, and Psychology
- Keywords
- posttraumatic stress symptoms, posttraumatic growth, cancer patients, depression, anxiety, psychological distress, social support, optimism, spirituality, religious coping, positive reappraisal, quality of life, psychosocial factors
- MeSH terms
- Adaptation, Psychological, Anxiety, Depression, Humans, Neoplasms, Quality of Life, Religion and Psychology, Sex Factors, Social Support, Stress Disorders, Post-Traumatic, Stress, Psychological, Spirituality
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