Childhood Trauma Predicts Cancer Treatment-Related Pain in Breast Cancer Survivors.
Grace A Kanzawa-Lee, Robert Knoerl, David A Williams and 6 others
PMID 30601264WHAT IT FOUND
Women who experienced childhood trauma without confiding in others reported significantly higher pain severity and interference 12 months after breast cancer surgery.
However, trauma history did not predict neuropathic symptom severity once other factors were included.
Key findings
01Participants with childhood trauma reported significantly higher pain severity, pain interference, and neuropathic symptom severity at 12 months compared to those without trauma.
02Childhood trauma was not a significant predictor of neuropathic symptom severity in the final model, which instead relied on baseline severity, helplessness, and age.
03Nonconfiders (those who experienced trauma but did not tell others) had significantly higher neuropathic symptom severity, sleep disturbance, and sleep-related impairment than trauma-free women.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPsWhat it means for RNs
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What it does not show
The study was a small pilot with only 44 participants and was not powered to detect all potential predictors. The sample was primarily well-educated, white women from a single comprehensive cancer center, limiting generalizability. Only four participants had likely neuropathic pain at baseline, and none developed new neuropathic pain, making it impossible to analyze trauma as a predictor of neuropathic pain incidence. The analysis excluded the only participant who had confided in others about their trauma, leaving no comparison group for 'confiders'. The study did not control for adult trauma, mental health services received, or years since the traumatic event.
Declared interests
The authors declared no conflicts of interest. The study was supported by the National Institutes of Health.
The easy way to misread this
Do not conclude that childhood trauma causes neuropathic pain. The study found that trauma predicted pain severity and interference, but it did not predict neuropathic symptom severity in the final adjusted model. Additionally, the study is a small pilot with a homogeneous sample, so these findings are exploratory and not evidence for a causal link.