Stress post-traumatique et cancer chez l’enfant

Abstract

The post-traumatic stress model has been recently applied for understanding the impact of life-threatening illness in adults and in children. Since 1991, 17 studies have found post-traumatic stress symptoms in childhood cancer patients and/or their parents. Symptoms prevalence in children and in parents is various according to studies, but it is possible to identify it in a subset of children (from 5 to 20 % of them) many years after the end of cancer treatment. Time since the cancer diagnosis is not usually a predictor of persistent symptoms. Subjective appraisal of life threat and illness beliefs are more important as predictors than objective medical data. The presence of symptoms in children is not always correlated to their presence in parents. We will show how post-traumatic stress model renews the approach and the understanding of psychopathological reactions of children with cancer with the role of parental responses, trauma features and also indirect transgenerational traumatic effects. This model has important implications for individual and familial clinical interventions. A reflection on interactions between trauma and somatization processes, on disruption of family functioning by childhood cancer (with bone marrow transplantation with related donor as an example) and on recovery processes is needed.