Posttraumatic Stress, Quality of Life, Depression, and Physical Health in Cancer Survivors: The Buffering Effect of Posttraumatic Growth

The current study attempted to use an online data collection system to replicate and extend our previous findings on the interaction of posttraumatic growth and post-traumatic stress disorder (PTSD) symptoms in predicting depressive symptoms and quality of life in cancer survivors (Morrill et al., 2008). Participants were 165 survivors of a diverse range of cancers who completed an Internet-based questionnaire designed to assess perceived stress, PTSD symptoms, and posttraumatic growth, and three health outcomes (distress about physical health symptoms, quality of life, and depressive symptoms). The results of this study suggest that the online questionnaire is a feasible, efficient, reliable, and "user-friendly" tool to assess bio-psychosocial health factors in cancer survivors. PTSD symptoms were associated with more distress about physical health symptoms, poorer quality of life, and more depressive symptoms; perceived stress was associated with more depressive symptoms; and posttraumatic growth was associated with better quality of life (p < .01) and fewer depressive symptoms (p < .01). Results failed to support the hypothesized buffering effect of posttraumatic growth. However, the interaction of PTSD symptoms and personal growth initiative accounted for a statistically significant (p < .05) amount of the variance in quality of life indicating a potential buffering effect of personal growth on the deleterious relation between posttraumatic stress and quality of life. Finally, of the 47 participants that reported clinically significant levels of depressive and/or PTSD symptoms only 27 (57%) reported being treated for a psychiatric disorder. Conclusions. The findings of the current study indicate that as many as 10% of those suffering from cancer may have clinically significant PTSD symptoms which are associated with poorer health outcomes. Only 57% of the cancer survivors in the current study who reported clinically significant symptoms of PTSD or depression reported receiving treatment for a psychiatric disorder. These results highlight the importance of screening for PTSD and depression in cancer patients and survivors in both research and clinical settings, followed by referral for diagnostic assessment and subsequent treatment when appropriate. Additionally, Internet-based data collection may have important implications regarding screening, referral, and ongoing assessment of psychological distress in clinical care.