Author ORCID Identifier
Document Type
Dissertation
Date of Award
2024
Degree Name
Doctor of Philosophy (PhD)
Department
Psychology
First Advisor
Beth Boyd
Abstract
Fear of cancer recurrence (FCR), which is broadly defined as “the fear that cancer could return or progress in the same place or in another part of the body” (Vickberg, 2003), is often identified as an unmet need among cancer survivors, with rates ranging from 20-79% (Simard et al., 2013). Pain, another symptom commonly endorsed in cancer survivorship, is positively associated with fear of cancer recurrence (Janz et al., 2011; van den Beuken-van Everdingen et al., 2008). The Cancer Threat Interpretation Model suggests that cognitive biases exist in interpreting threat appraisal and pain coping by increasing the saliency of pain as a threatening cue for worry about cancer recurrence (Heathcote & Eccleston, 2017). Additional models may explain how childhood maltreatment increases risk of elevated FCR due to enhanced stress response after cancer diagnosis among survivors with a history of childhood maltreatment (Bandinelli et al., 2017). Notably, childhood emotional abuse is associated with increased pain and emotion dysregulation in adulthood (Powers et al., 2014) and, among cancer survivors, childhood maltreatment is associated with elevated cancer-related distress (Goldsmith et al., 2010). Among adult survivors of childhood cancer, anticipated and experienced cancer-related pain was associated with high fear of cancer recurrence (Kelada et al., 2019). Adult cancer survivors who experienced childhood maltreatment may have elevated pain experiences that could contribute to high FCR. However, to date, no research has investigated these relations. Thus, the current study aimed to evaluate pain as a mediator of the childhood maltreatment-FCR relation using cross-sectional survey data provided by adult cancer survivors. Results of path analytic regression models that implemented 5000 bootstrapped samples indicated a significant indirect effect (abcs = .04, SE = .02, 95% CI [.0003, .08] of pain interference mediating the relation between childhood maltreatment and fear of cancer recurrence. Results suggest interventions targeting pain interference may be helpful among adult cancer survivors with childhood maltreatment in reducing FCR. Future studies may benefit from longitudinal methodologies and multimethod assessment of pain to elucidate biobehavioral pathways that support the Second Wave Hit Hypothesis Model.
Subject Categories
Clinical Psychology
Keywords
Fear of cancer recurrence
Number of Pages
128
Publisher
University of South Dakota
Recommended Citation
Kuo, Jennifer, "Pain Anxiety and Pain Interference as Mediating Factors in the Relation of Childhood Trauma and Fear of Cancer Recurrence" (2024). Dissertations and Theses. 231.
https://red.library.usd.edu/diss-thesis/231