Parenting stress in pediatric oncology populations.

The experience of childhood cancer can be one of the most severe stressors that parents endure. Studies using illness-specific measures of parental stress indicate that moderate-to-severe parenting stress is quite common in the first year of childhood cancer treatment, and as many as 5% to 10% of these parents go on to develop posttraumatic stress disorder. This review of the literature suggested that although parenting stress symptoms may be relatively transitory for most parents dealing with childhood cancer, the impact of these stress symptoms on parent and child functioning is substantive and worthy of therapeutic attention. The stresses entailed in childhood cancer should be viewed as complex and varied across stages of diagnosis and treatment. Factors associated with increased risk of parental posttraumatic stress symptoms include poor social support, adverse experience with invasive procedures, negative parental beliefs about the child's illness and/or associated treatment, and trait anxiety. For those parents with risk factors that might forebode more severe and enduring stress reactions to their children's cancer, therapeutic strategies are proposed to ameliorate their stress and reduce the development and/or maintenance of posttraumatic stress symptoms.

Interactive effects of anger expression and ET-1 Lys198Asn polymorphism on vasoconstriction reactivity to behavioral stress.

BACKGROUND: Ineffective anger expression has been associated with essential hypertension (EH) and with blood pressure (BP) reactivity to stress. The ET-1/Lys198Asn polymorphism has been associated with increased resting BP and exaggerated vasoconstrictive mediated BP reactivity. African Americans (AAs) are at particular risk for development of EH, report greater anger difficulties, and exhibit greater vasoconstrictive reactivity than their European American (EA) counterparts. PURPOSE: The objective is to investigate a gene-environment model of stress reactivity in which anger expression, particularly in combination with ET-1 T allele carrier status and AA ethnicity, would be associated with the greatest vasoconstrictive reactivity in response to a behavioral stressor. METHODS: One hundred ninety-one AA and 197 EA normotensive young adults (M age=18.8+/-2.5 years) participated in the study. Total peripheral resistance index (TPRI) reactivity was assessed during a 10-min video game challenge. Anger expression was measured using Spielberger's Anger Expression Scale. RESULTS: A multiple regression model with TPRI reactivity as the dependent variable revealed a three-way interaction effect for anger management (i.e., AM=anger control minus anger out scores), ethnicity, and ET-1 polymorphism. Specifically, AA carriers of the ET-1 polymorphism with poor AM skills exhibited the greatest TPRI reactivity. CONCLUSIONS: Individuals with a genetic predisposition for exaggerated vasoconstriction who also display low AM skills may be at particular risk for development of stress-induced EH. Such individuals may particularly benefit from anger management training.