Posttraumatic Growth among Adult Children of a Parent Diagnosed with Cancer: Application of the Stress and Coping Model

Cancer-related morbidity and mortality are growing rapidly worldwide. In fact, cancer is expected to rank as the leading cause of death globally in the 21st century, and as the single most important barrier to increased life expectancy. Cancer is known as a stress factor and has negative effects not only on patients, but on their families as well. Although there is a growing body of research on the impact of parental cancer on young children and adolescents (0-18), surprisingly, there have been very few studies that focus on the effects of parental cancer on adult children (ages 20-40). A parent’s cancer during these years can be particularly challenging for adult children due to the dynamic nature of this life stage, during which they move out of their parents' houses and develop financial independence and other significant social connections. These developmental challenges may cause difficulties when coping with parental cancer.

Over the years, most of the research examining the impact of parental cancer on children has focused on negative psychological outcomes. However, there is a growing interest in examining positive outcomes, such as posttraumatic growth (PTG). So far, to the best of our knowledge, no study has examined PTG among adult children aged 19-40 of a parent diagnosed with cancer on the basis of a theoretical model. Therefore, the purpose of the current study is to expand the existing theoretical knowledge by examining the relationship between parental illness perception, coping strategies, optimism, and social support, on the one hand, and PTG on the other, among the aforementioned population. The theory of stress and coping (Lazarus & Folkman, 1984) provided a theoretical framework for the present study.

The current study included 109 adult children between the ages of 19 and 40 whose parent was diagnosed with cancer. The participants were recruited in several ways: (1) convenience sampling via social media and health-related internet forums, as well as snowball sampling; (2) flyers distributed at the Oncology Institute at Sheba Medical Center - Tel Hashomer; and (3) NGOs that provide support to cancer patients and their families. Participants answered a structured questionnaire that included several sections: PTG, illness perception, coping strategies, optimism, perceived social support, and sociodemographic information.

In accordance with the study's hypotheses, the study findings pointed to statistically significant relationships between illness perception, problem-focused coping strategies, and emotion-focused coping strategies, on the one hand, and PTG, on the other. It was found that the more participants perceived their parent's illness as threatening and reported the use of problem-focused coping strategies, the more they reported high levels of PTG.  Yet, contrary to our hypothesis that a negative relationship between emotion-focused coping strategies and PTG would be found, a significant positive relationship was found between these two variables. Thus, the more participants reported using emotion-focused coping strategies, the more they reported high levels of PTG. Furthermore, contrary to the research hypothesis, no statistically significant relationship was found between optimism and social support, on the one hand, and PTG, on the other.

According to the findings, emotion-focused coping strategies act as a partial mediator between illness perception and PTG. However, problem-focused coping strategies did not prove to be a mediating variable between illness perception and PTG. Moreover, optimism and social support were not found to be moderating variables between illness perception and PTG. Finally, an examination of the study model showed that gender, illness perception, problem-focused coping strategies, and emotion-focused coping strategies explained about 47% of the variance of the dependent variable, PTG.

In sum, this study has both theoretical and practical importance. Theoretically, it contributes to a deeper understanding of the factors that relate to PTG among adult children of a parent diagnosed with cancer. To the best of our knowledge, this study was the first to examine the relationships between the following factors – parental illness perception, coping strategies, optimism, and social support – and PTG among this population, using the theory of stress and coping as a theoretical basis. In fact, the findings of the current study strengthen and support the basic premise of the theory of stress and coping (Lazarus & Folkman, 1984).

Practically, this study emphasizes the need to construct unique intervention programs for adult children of a parent diagnosed with cancer. It is recommended that these intervention programs consider the subjective perceptions of adult children regarding the disease, examine their current coping strategies and the internal and external resources that are available to them, and take this information into account in order to improve their well-being and increase PTG among this unique population.