Abstract
Purpose: Chronic stress is associated with increased risk for maladaptive psychological responses during childhood, adolescence, and young adulthood. Adults exposed to chronic stress during childhood exhibit dysregulation of hypothalamic-pituitary-adrenal (HPA) axis activity and inflammation. There are no studies examining the impact of stress on biological stress responses and functional impairment in adolescents and young adults early after the onset of a stressor. Methods: The sample consisted of 59 offspring, aged 11–25 years, 33 of parents diagnosed with cancer and 26 controls from families with no cancer or severe chronic illness in parents or siblings. Cancer patients and their families were recruited within an average of 62 days (SD = 35.9) and followed at 6 and 9 months later. Functional impairment was assessed and hair cortisol concentrations (HCC), salivary cortisol, and inflammatory markers were measured. Mixed regression analyses were conducted. Results: The stress group showed higher functional impairment (β = −5.5, 95% CI (−10.4, −0.06), p = 0.03, d= −0.40) and HCC (β = 10.5, 95% CI (−5.5, −0.50), p < 0.001, d = 1.43). However, HCC were reduced over time in the stress group (β= −0.3, 95% CI (−0.04, −0.01), p < 0.001, d = −1.08). Higher total cortisol output was associated with increased functional impairment over time (β = −3.0, 95% CI (−5.5, −0.5), p = 0.02, d = −0.60). Conclusions: Parental cancer is associated with early increase in cortisol, which was associated with increased functional impairment in offspring. Clinicians need to assess and monitor psychiatric symptoms and functioning in these offspring early on following parental cancer diagnosis.
Highlights
Cancer is the second leading cause of death in the United States, with an estimated economic impact at over a hundred billion dollars annually for treatment and morbidityrelated expenses including disability [1] and loss of productivity [2]
The cancer and control groups were similar in terms of age, Socioeconomic status (SES), and body mass index (BMI); offspring in the stress group were more likely to be female compared to controls (78.1% vs. 34.6%, respectively, χ2 (1) = 11.2, p = 0.001, d = 0.98) (Table 1)
Offspring of parents diagnosed with cancer showed higher functional impairment within 2 months of parental diagnosis compared to controls, which continued throughout the year following diagnosis
Summary
Cancer is the second leading cause of death in the United States, with an estimated economic impact at over a hundred billion dollars annually for treatment and morbidityrelated expenses including disability [1] and loss of productivity [2]. An estimated three million children live with a parent who has been diagnosed with cancer in the United. Epidemiological studies have shown increased rates of depression, anxiety, and other clinical symptomatology among children of parents diagnosed with cancer [4]. Similar findings of increased psychiatric morbidity [5,6] as well as overall mortality [7] are reported in those who have experienced childhood parental death. Studies previously reported an increased risk for psychiatric disorders and functional impairment to extend several years following the parent’s death, potentially into adulthood [7,8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
