Psychotherapy Targets for Comorbid Post-Traumatic Stress Disorder in Cancer Patients

The article describes the main psychotherapeutic targets and individual psychological characteristicsof cancer patients with comorbid post-traumatic stress disorder (PTSD), using the example of breast cancer, prostate cancer, and rectal cancer patients in remission following surgery (mastectomy, prostatectomy, and colostomy). The study was carried out at N. N. Petrov Research Institute of Oncology. The experimental group consisted of 40 patients with breast cancer, 32 patients with prostate cancer, and 19 patients with rectal cancer, in accordance with the selection criteria and based on a specialized questionnaire designed to detect symptoms of post-traumatic stress disorder (Trauma Screening Questionnaire). A control group, for comparison, was comprised of 51 women with breast cancer, 53 patients with prostate cancer, and 22 patients with rectal cancer who showed signs of constructively coping with cancer. The assessment of individual psychological characteristics of patients in these nosological groups was carried out using a battery of experimental psychological techniques. In order to enhance the adaptive capacity of the personality in patients with oncological diseases, to prevent the likelihood of developing PTSD, and develop the effectiveness of treatment, the following general psychotherapeutic targets were identified: intrapsychic maladaptive type of response to the disease, excessive fixation on the disease and care during illness; low risk tolerance manifested by patients’ reluctance to act in the absence of reliable guarantees of success; destructive and deficient personality functions; shortage of positive cognitive representations of the world and themselves; destructive guilt associated with the illness and family relationships; excessive desire for autonomy and independence that reduces the possibility of receiving social support.

Vagaytseva M. V., Karavaeva T. A., Vasilieva A. V., Chulkova V. A., Nosov A. K. Psychological mechanisms of formation of the relation to a disease at patients with cancer of a prostate gland after a radical prostatektomiya. Urologicheskie vedomosti, 2018, vol. 8 (3), pp. 53–66. (In Russian)

Vasilieva A. V., Karavaeva T. A., Lukoshkina E. P. Development of posttraumatic stress disorder in patients with oncological diseases. Onkopsikhologiia dlia vrachei-onkologov i meditsinskikh psikhologov: textbook. St. Petersburg, Voprosy onkologii. Publ., 2017, pp. 228–241. (In Russian)

Lukoshkina E. P., Karavaeva T. A., Vasilieva A. V. Etiology, epidemiology and psychotherapy of concomitant mental disorders in oncological diseases. Voprosy onkologii, 2016, vol. 6, pp. 774–784. (In Russian)

Tarabrina N. V. Post-traumatic stress in patients with life-threatening (oncological) diseases. Konsul’tativnaia psikhologiia i psikhoterapiia, 2014, vol. 1, pp. 9–13. (In Russian)

Tarabrina N. V., Vorona O. A., Kurchakova M. S., Padun M. A., Shatalova N. E. Onkopsikhologiia: posttravmaticheskii stress u bol’nykh rakom molochnoi zhelezy. Moscow, Institut psikhologii RAS Publ., 2010. 175 р. (In Russian)

Abbey G., Thompson S. B., Hickish T., Heathcote D. A. Meta-analysis of prevalence rates and moderating factors for cancer-related post-traumatic stress disorder. Psychooncology, 2015, vol. 24, pp. 371–381. https://doi.org/10.1002/pon.3654.

Einsle F., Kraft D., Koellner V. Post-traumatic stress disorder (PTSD) in cardiology and oncology — which diagnostic tools should be used. Journal of Psychosomatic Research, 2012, vol. 72 (6), pp. 434–438. https://doi.org/10.1016/j.jpsychores.2012.02.008.

Gil Moncayo F. L., Costa Requena G., Perez F. J., Salamero M., Sanchez N., and Sirgo A. Psychological adjustment and prevalence of psychiatric disorders in cancer patients. Med Clin (Bare) , 2008, vol. 130 (3), pp. 90102. https://doi.org/10.1157/13115354.

Kokoszka A., Bohaterewicz B., Jelenska K. Post-traumatic stress disorder among patients waiting for cardiac surgery. Archives of Psychiatry and Psychotherapy, 2018, vol. 2, pp. 20–25. https://doi.org/10.12740/ APP/91001.

Mehnert A., Koch U. Prevalence of acute and post-traumatic stress disorder and comorbid mental disorders in breast cancer patients during primary cancer care: a prospective study. Psychooncology, 2007, vol. 16, pp. 181–188. https://doi.org/10.1002/pon.1057.

Richter J. C., Waydhas C., Pajonk F. G. Incidence of posttraumatic stress disorder after prolonged surgical intensive care unit treatment. Psychosomatics, 2006, vol. 47, pp. 223–230. https://doi.org/10.1176/ appi.psy.47.3.223.

Oleinikova I. N., Gens G. P., Korobkova L. I., Moskochenko D. V., Sirota N. A. Diagnosis of posttraumatic stress disorder in patients with ovarian cancer. Voprosy onkologii, 2013, vol. 59 (3), pp. 12–25. (In Russian)

Cordova M. J., Giese-Davis J., Colant M., Kronenwetter K., Chang V., Spiegel D. Breast cancer as trauma: posttraumatic stress and posttraumatic growth. Journal of Clinical Psychology in Medical Settings, 2007, vol. 14, pp. 308‒319. https://doi.org/10.1007/s10880-007-9083-6.

Lee Y.-L., Santacroce Sh. J. Posttraumatic stress in long-term young adult survivors of childhood cancer: A questionnaire survey. General Hospital Psychiatry, 2007, vol. 29, pp. 251–256.

Vasileva A. V., Karavaeva T. A., Lukoshkina E. P., Karpov A. O. Socio-psychological risk factors for the development of posttraumatic stress disorder in patients with rectum cancer, who undergone colostomia. Obozrenie psikhiatrii i meditsinskoi psikhologii imeni V. M. Bekhtereva, 2018, vol. 2, pp. 44–53. https:// doi.org/10.31363/2313-7053-2018-2-44-53. (In Russian)

Passik S., Grumman K. Posttraumatic Stress Disorders. Phsyco-Oncology. New York, Oxford University Press, 1998, pp. 596–607.

Vasilieva A. V., Karavaeva T. A., Lukoshkina E. P., Weis E. E., Yakovleva Yu. A. PTSR at patients with a breast cancer after expeditious treatment (mastectomy). Clinical and psychological features. Obozrenie psikhiatrii i meditsinskoi psikhologii imeni V. M. Bekhtereva, 2018, vol. 4, pp. 83–92. (In Russian)

Green B. L., Krupnick J. L., Rowland J. H. et. al. Trauma history as a predictor of psychologic sympмtoms in women with breast cancer. Journal of clinical oncology, 2000, vol. 18, pp. 1084–1093.

Semenova N. V., Lashkovskaya S. V., Lysenko I. S., Chernov P. D. Analysis of results of application of cognitive psychotherapy for patients with cancer. Obozrenie psikhiatrii i meditsinskoi psikhologii imeni V. M. Bekhtereva, 2019, vol. 1, pp. 61–69. (In Russian)

Karavaeva T. A., Vasilieva A. V., Semiglazova T. U., Karitskaya, A. P., Lukoshkina E. P., Belyaev A. M. Algorithm for the diagnosis of anxiety disorders of neurotic level in cancer patients. Voprosy onkologii, 2016, vol. 2, pp. 355–360. (In Russian)

Laskovskaya S. V., Tashlykov V. A., Semenova N. V. Approaches to the definition and typology of targets of psychotherapy in the context of improvement of individual programs of psychotherapy. Obozrenie psikhiatrii i meditsinskoi psikhologii imeni V. M. Bekhtereva, 2017, vol. 1, pp. 89–98. (In Russian)

Brewin C. R., Rose S., Andrews B., Green J. et. al. Brief screening instrument for post-traumatic stress disorder. The British Journal of Psychiatry, 2002, vol. 181, pp. 158–162.

Tarabrina N. V. Praktikum po psihologii posttravmaticheskogo stressa. St. Petersburg, Piter Publ., 2001. 272 p. (In Russian)

Leont’ev D. A., Rasskazova E. I. Test zhiznestojkosti. Moscow, Smysl Publ., 2006. p. (In Russian)

Prihozhan A. M. Nauchno-metodicheskie osnovy ispol’zovaniia v shkol’noi psikhologicheskoi sluzhbe konkretnyh psikhodiagnosticheskih metodik: primenenie metodov priamogo otsenivaniia v rabote shkol’nogo psikhologa. Moscow, APN SSSR Publ., 1988. 166 p. (In Russian)

Klass E. T. Situational ahhroach to assessment of guilt: Development and validation of a self-report measure. Journal of Psychopathology and Behavioral Assesment, 1987, vol. 9 (1), pp. 35–48. (In Russian)

Tupicyn Yu. Ya., Bocharov V. V., Alhazova T. V., Brodskaya E. V. Ya-strukturnyj test G. Ammona: oprosnik dlia otsenki tsentral’nyh lichnostnyh funkcii na strukturnom urovne: textbook for doctors and psychologists. St. Petersburg, Nauchno-issledovatel’skii psikhonevrologicheskii institut imeni V. M. Bekhtereva Publ., 1998. 70 p. (In Russian)

Tupicyn Yu. Ya., Bocharov V. V., Iovlev B. V., Zhuk S. P. Metodika otsenki psikhicheskogo zdorov’ia MOPZ: textbook for doctors and psychologists. St. Petersburg, Nauchno-issledovatel’skii psikhonevrologicheskii institut imeni V. M. Bekhtereva Publ., 1999. 45 p. (In Russian)

Vasserman L. I., Iovlev B. V., Karpova E. B., Vuks A. Ya. Psikhologicheskaia diagnostika otnosheniia k bolezni: textbook for doctors. St. Petersburg, Nauchno-issledovatel’skii psikhonevrologicheskii institut imeni V. M. Bekhtereva Publ., 2005. 57 p. (In Russian)

Kazanceva T. V. Adaptation of the modified method «Experience of close relationships» K. Brennan, R. K. Frejli. Izvestiia Rossiiskogo gosudarstvennogo pedagogicheskogo universiteta im. A. I. Gercena, 2008, vol. 74 (2), pp. 139–143.