Posttraumatic stress disorder following cancer A conceptual and empirical review Maria Kangas, Jane L. Henry, Richard A. Bryant* School of Psychology, University of New South Wales, Sydney, New South Wales 2052, Australia Abstract Life-threatening illness has recently been recognized as a stressor that can precipitate posttraumatic stress disorder (PTSD). This development has raised questions over the extent to which the PTSD diagnosis is applicable to the psychological reaction to being diagnosed with cancer. This paper identifies the core conceptual issues pertaining to cancer-related PTSD, critically reviews the empirical literature on PTSD following cancer, and considers the possible mechanisms and course of PTSD following a diagnosis of cancer. Specific issues that need to be considered in the assessment and treatment of cancer-related PTSD are reviewed. This review highlights that there is a need for stronger empirical base to guide clinical management of PTSD in cancer patients. D 2002 Elsevier Science Ltd. All rights reserved. Keywords: Cancer; Posttraumatic stress disorder; Life-threatening illness Prior to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; American Psychiatric Association, 1994), life-threatening illness was explicitly excluded as a stressor that could precipitate posttraumatic stress disorder (PTSD). In contrast, DSM-IV recognized that it is possible for individuals to receive a PTSD diagnosis as a direct result of being traumatized by experiencing a life-threatening illness. This development has contributed to greater focus in recent years on the issue of PTSD following cancer. The applicability of a PTSD diagnosis secondary to cancer is potentially problematic because of ambiguity about the stressor, the nature of the psychiatric symptoms experienced, and the role of an ongoing, and sometimes deteriorating, medical condition. This review provides an 0272-7358/02/$ – see front matter D 2002 Elsevier Science Ltd. All rights reserved. PII:S0272-7358(01)00118-0 * Corresponding author. Tel.: +61-2-93853640; fax: +61-2-93853641. E-mail address: r.bryant@unsw.edu.au (R.A. Bryant). Clinical Psychology Review 22 (2002) 499 – 524