Somatization as an Indicator of Trauma Adaptation in Long-Term Pediatric Cancer Survivors

Abstract

The objective of this study was to assess the level of somatization symptoms in long-term pediatric cancer survivors and to measure associated functional correlates, trauma symptoms, and personality characteristics. Forty cancer survivors completed self-report questionnaires measuring somatization, trauma symptoms, personality traits and defenses, a general clinical interview, and a structured interview for PTSD. Half (51%) the eligible participants participated in the study. Their mean somatization score fell between a nonclinic patient population and a psychiatric population. Somatization scores correlated with general adjustment in the negative direction and with PTSD scores in the positive direction. The majority of participants met at least partial current PTSD symptoms. These survivors demonstrate high levels of restraint, repressive defensiveness, denial and impulse control, and a low level of reported distress. Somatization appears to serve as an indicator for other trauma-related disturbances. Years after treatment, the relatively high levels of current PTSD and trauma-associated symptoms reflect the long-term deleterious impact of having cancer as a child. Because these survivors demonstrate avoidance and a repressive adaptive style but admit somatoform symptoms, the latter may be an essential way to detect and treat trauma-related distress in this population.