Pain Anxiety Mediates the Relation of Physical Child Abuse and Fear of Cancer Recurrence

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pain anxiety mediates, physical child abuse, caner recurrence


Fear of cancer recurrence, defined as “the fear that cancer could return or progress in the same place or in another part of the body (Simard et al., 2010, p. 361),” is often identified as an unmet need among cancer survivors, with rates of 20 to 79% of cancer survivors indicating fear of cancer recurrence as an unmet need (Simard et al., 2013). Fear of cancer recurrence is associated with low quality of life, high physical symptom burden, high distress, intrusive thoughts, negative metacognitions, and high posttraumatic stress symptoms (Smith et al., 2018; van de Wal et al., 2016). Experiencing physical abuse during childhood is associated with increased hypervigilance to threat in adulthood (Sandre et al., 2018), as well as pain and pain catastrophizing (Sansone et al., 2013). However, these relations have not been evaluated in a population of cancer survivors with respect to hypervigilance involved in fear of cancer recurrence. Elevated pain, in turn, is associated with increased risk of fear of cancer recurrence (Janz et al., 2011; van den Beuken-van Everdingen et al., 2008). Yet to date no research has established the mediating role of pain anxiety in the relation of childhood trauma and fear of cancer recurrence. Thus, the current study aimed to clarify these relations using cross-sectional survey data provided by adult cancer survivors (N = 33, Female = 28, Mage = 52.36, SDage = 15.91, Range = 18-84). Results of path analytic regression models that implemented 5000 bootstrapped samples indicated a small effect size (abcs = .11, SE = .10, 95% CI [-.12, .30] pain anxiety did not mediate the relation of childhood physical abuse and fear of cancer recurrence (b = .63, SE = .63, 95% CI [-.74, 1.82]). Childhood physical abuse did not predict pain anxiety (b = .97, SE = .90, 95% CI [-.88, 2.82]). Pain anxiety was associated with fear of cancer recurrence (b = .63, SE = .63, 95% CI [-.74, 1.82]). Childhood physical abuse did not predict fear of cancer recurrence (b = 1.49, SE = 1.07, 95% CI [-.61, 3.58]). Theoretical and clinical implications will be discussed.

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Christopher Berghoff

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