Posttraumatic Stress Symptoms in Children and Parents Shortly After Pediatric Brain Tumor Diagnosis: Prevalence and Risk Factors

BACKGROUND: Posttraumatic stress symptoms (PTSS) are high amongst survivors of pediatric brain tumors and their parents; however, early prevalence is unknown. This study aimed to get insight into the prevalence and risk factors of child and parental PTSS shortly after diagnosis.

PROCEDURES: Sixty-five children with brain tumors (6-16 years old) and their parents participated. The prevalence of clinical child PTSS (CRIES-13 self- and proxy-report) and parental PTSS (PCL-5) was assessed 1-3 months after diagnosis, and compared to the general population (PCL-5; binomial test). Pearson's correlations between child and parental PTSS were calculated. Risk factors were explored with linear regression analyses (psychosocial risk assessed through PAT).

RESULTS: Clinical child PTSS scores were reported by 29.4% of the children (self-report) and 11.1% of their parents (proxy-report). Prevalence of clinical parental PTSS was not significantly higher than in the general population (mothers: 12.1%, p = 0.07; fathers: 6.0%, p = 0.20). Self-reported child PTSS scores were associated with proxy-reported child PTSS scores (r = 0.49, p < 0.001), but not with parental PTSS scores (mother r = 0.22, father r = 0.18). No associations were found between demographic factors and child or parental PTSS. Shorter time since diagnosis was associated with more self-reported child PTSS (β = -0.45, p = 0.01). Starting radiotherapy was associated with more mother PTSS (β = 1.04, p < 0.003). Family psychosocial risk was associated with more child PTSS (self-report β = 0.82, p = 0.02; proxy-report β = 0.81, p = 0.02) and mother PTSS (β = 1.33, p < 0.001).

CONCLUSIONS: Prevalence of PTSS in children with recently diagnosed brain tumors was high, highlighting the need for early psychosocial monitoring and targeted interventions to optimize health-related quality of life.