Post-traumatic stress disorder and cancer

Cordova, Matthew J; Riba, Michelle B; Spiegel, David

doi:10.1016/s2215-0366(17)30014-7

Cited by 442Cancer survivorship and carePosttraumatic Stress Disorder ResearchChildhood Cancer Survivors' Quality of Life

Post-traumatic stress disorder and cancer

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Cordova, Matthew J, Riba, Michelle B, Spiegel, David·2017·The Lancet Psychiatry

DOI 10.1016/s2215-0366(17)30014-7PMC PMC5676567

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Abstract

Being diagnosed with and treated for cancer is highly stressful and potentially traumatic. An extensive literature has evaluated the prevalence, predictors, and correlates of cancer-related post-traumatic stress disorder (PTSD) symptoms and diagnoses. In this qualitative review of cancer-related PTSD literature, we highlight conceptual, methodological, and diagnostic issues, and identify clinical implications and areas for future research. Cancer-related PTSD has been documented in a minority of patients with cancer and their family members, is positively associated with other indices of distress and reduced quality of life, and has several correlates and risk factors (eg, prior trauma history, pre-existing psychiatric conditions, poor social support). The literature on treatment of cancer-related PTSD is sparse. Existing literature on cancer-related PTSD has used DSM-IV-TR diagnostic criteria; the revised DSM-5 PTSD criteria have important implications for the assessment of cancer-related distress. Application of PTSD diagnosis to patients with cancer has been critiqued on conceptual and methodological grounds, and important differential diagnosis considerations should be taken into account. Psychosocial assessment of patients with cancer should include careful evaluation of pre-cancer diagnosis trauma and psychiatric history, and diagnostic interviewing should consider concurrent conditions (eg, adjustment disorder). Treatment of cancer-related PTSD should be approached with caution and be informed by existing evidence-based approaches for traumatic stress.

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Cancer experience often includes a succession of multiple stressful and potentially traumatic events, namely diagnosis, treatment and post-treatment/survivorship stages, which may be exacerbated by precancer psychological vulnerabilities.
“Cancer experience thus often includes a succession of multiple stressful and potentially traumatic events, namely diagnosis, treatment and post- treatment/survivorship stages (Cordova et al., 2017), which may be exacerbated by precancer psychological vulnerabilities (Connolly,2016).”
From Developing an emotion‐focused therapy model for fear of cancer recurrence: A case‐level task analysis. (2024) · cites this paper as Cordova et al., 2017
Cancer diagnosis and treatment have been conceptualized as traumatic stressors.
“Cancer diagnosis and treatment have been conceptualized as traumatic stressors [7]”
From Mindfulness, Experiential Avoidance, and Recovery From Hematopoietic Stem Cell Transplantation. (2019) · cites this paper as [7]
This patient population may be especially sensitive to the benefits of mindfulness and adverse effects of experiential avoidance.
“Considering Cordova's framework of cancer as a traumatic stressor [7] in the context of this intensive, high-risk treatment suggests that this patient population may be especially sensitive to the benefits of mindfulness and adverse effects of experiential avoidance.”
From Mindfulness, Experiential Avoidance, and Recovery From Hematopoietic Stem Cell Transplantation. (2019) · cites this paper as [7]
Considering the framework of cancer and treatment as a traumatic stressor, this type of approach to the painful and difficult internal experiences that inevitably occur may foster resilience.
“Considering the framework of cancer and treatment as a traumatic stressor [7], this type of approach to the painful and difficult internal experiences that inevitably occur may foster resilience.”
From Mindfulness, Experiential Avoidance, and Recovery From Hematopoietic Stem Cell Transplantation. (2019) · cites this paper as [7]

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[1]American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders 4 Text Revision Washington, DC American Psychiatric Association Press 2000
[5]Cordova MJ Andrykowski MA Responses to cancer: posttraumatic stress and posttraumatic growth Semin Clin Neuropsychiatry 2003 8 286 96 14613054

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Background
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Authors: Cordova, M. J., Riba, M. B., & Spiegel, D.
Affiliations: Palo Alto University (US)
University of Michigan (US)
Stanford Medicine (US)
Corresponding author: Spiegel, David
ORCID: Cordova, Matthew J
Spiegel, David
Venue: The Lancet Psychiatry
Publisher: Elsevier BV
Published: 2017-04
Volume: 4
Issue: 4
Pages: 330-338
ISSN: 2215-0366 (ISSN-L)
DOI: 10.1016/s2215-0366(17)30014-7
PMC: PMC5676567
OpenAlex: W2577877919
Semantic Scholar: 4c46e92fa1861fcd022cc7df99ccfd133cba0bbc
Cited by: 442
References: 105
Citations by year: 2026: 35 · 2025: 48 · 2024: 55 · 2023: 60 · 2022: 81 · 2021: 44 · 2020: 49 · 2019: 39 · 2018: 23 · 2017: 8
FWCI: 3.41
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: The Lancet Psychiatry (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Cancer Institute (U01CA197282)
Topics: Health Sciences › Medicine › Oncology › Cancer survivorship and care
Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
Keywords: PTSD diagnostic criteria, DSM-5 PTSD criteria, psychosocial distress, quality of life, social support, psychiatric comorbidity, adjustment disorder, PTSD treatment, relatives of cancer patients
MeSH terms: Cancer Survivors, Humans, Neoplasms, Quality of Life, Stress Disorders, Post-Traumatic, Comorbidity, Causality

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