Childhood maltreatment, psychological resources, and depressive symptoms in women with breast cancer

Abstract

Childhood maltreatment is associated with elevated risk for depression across the human lifespan. Identifying the pathways through which childhood maltreatment relates to depressive symptoms may elucidate intervention targets that have the potential to reduce the lifelong negative health sequelae of maltreatment exposure. In this cross-sectional study, 271 women with early-stage breast cancer were assessed after their diagnosis but before the start of adjuvant treatment (chemotherapy, radiation, endocrine therapy). Participants completed measures of childhood maltreatment exposure, psychological resources (optimism, mastery, self-esteem, mindfulness), and depressive symptoms. Using multiple mediation analyses, we examined which psychological resources uniquely mediated the relationship between childhood maltreatment and depressive symptoms. Exposure to maltreatment during childhood was robustly associated with lower psychological resources and elevated depressive symptoms. Further, lower optimism and mindfulness mediated the association between childhood maltreatment and elevated depressive symptoms. These results support existing theory that childhood maltreatment is associated with lower psychological resources, which partially explains elevated depressive symptoms in a sample of women facing breast cancer diagnosis and treatment. These findings warrant replication in populations facing other major life events and highlight the need for additional studies examining childhood maltreatment as a moderator of treatment outcomes.

Fatigue after breast cancer treatment: Biobehavioral predictors of fatigue trajectories.

“…Future research should interrogate the pathways linking risk factors with cancer-related fatigue, which will facilitate the development and deployment of targeted interventions for those most at risk. For example, we have recently shown that the association between childhood trauma and depressive symptoms in women with breast cancer is mediated by deficits in mindfulness and optimism (Kuhlman, Boyle, et al, 2017), suggesting a potential target for intervention (i.e., mindfulness-based therapy). Similarly, determination of risk factors and mechanisms for cancer-related fatigue could be used to help screen and provide early intervention for vulnerable patients, which should reduce the burden of fatigue in the growing population of breast cancer survivors.…”

Mediating Effects of Specific Types of Coping Styles on the Relationship between Childhood Maltreatment and Depressive Symptoms among Chinese Undergraduates: The Role of Sex

“…Coping, as defined by Lazarus and Folkman [7], is "constantly changing cognitive and behavioral efforts to manage specific external and/or internal requirements that are identified as taxing or exceeding the resources of the person". A healthy environment is a safe environment that enables children to develop emotionally and socially, thereby helping them to pay attention to the environment, and learn what they can expect from it and respond to it [8]. Research has indicated that children who live in stressful family environments (children who are raised in poverty or maltreated by their parents) are more likely to adopt avoidant emotion-focused strategies (i.e., reducing negative emotional responses due to stressors, but the role of solving the actual pressure source is small) than those who do not [9].…”

Patient perspectives on the causes of breast cancer: a qualitative study on the relationship between stress, trauma, and breast cancer development

“…For example, the experience of childhood emotional abuse is related to more intrusive breast cancer symptoms (Goldsmith et al, 2010 ), whereas women without stress or trauma history have been shown to have slower disease progression than those with a history of one or more incidents (Palesh et al, 2007 ). Moreover, childhood maltreatment is related to psychological distress symptoms and lower quality of life among women undergoing breast cancer treatment (Fagundes et al, 2012 ; Han et al, 2016 ; Janusek et al, 2012 ; Kuhlman et al, 2017 ).…”