The first goal of the proposed study is to document the extent to which women reporting significant distress following diagnosis and treatment of breast cancer meet full or sub-syndromal criteria for posttraumatic stress disorder (PTSD). The second goal is to determine the extent to which exposure to an earlier traumatic event increases the risk for developing post-cancer PTSD and other symptoms, and the mechanisms by which these phenomena might be linked. Specifically, it is proposed that earlier trauma will lead to extremes of feelings of control and extremes of coping, which will, in turn, predict development of PTSD symptoms. Subjects will be 200 women aged 25-65 recruited from two oncology settings 4 to 12 months post-treatment for early stage breast cancer. Women who consent will complete self-report questionnaires assessing trauma history, medical history, behavioral and psychological coping, symptom distress, meaning of illness, world assumptions, life events, PTSD symptoms, social adjustment, and social support. They will also participate in a structured interview to provide ratings on current and lifetime DSMIII-R diagnoses, family psychiatric history, and stress response symptoms as well as details of the traumatic events experienced. Data analyses will examine nature and incidence of PTSD symptoms and diagnoses in the sample, and test hypotheses about the prediction of these and other symptoms from extent and type of prior trauma. Curvilinear hypotheses regarding the relationships of coping and control with post-cancer adjustment will be examined, along with the extent to which prior trauma predicts functioning these domains. Later analyses will test comprehensive prediction models, including the primary study variables and other risk factors measured. Findings are likely to contribute not only to refinement of the stressor criterion for PTSD, but to our understanding of responses to life-threatening illness, promoting the development of more appropriate and specific treatments for distress following these events.
| Green, B L; Krupnick, J L; Rowland, J H et al. (2000) Trauma history as a predictor of psychologic symptoms in women with breast cancer. J Clin Oncol 18:1084-93 |
| Green, B L; Rowland, J H; Krupnick, J L et al. (1998) Prevalence of posttraumatic stress disorder in women with breast cancer. Psychosomatics 39:102-11 |
