Body Mindsets are Associated With Pain and Threat-Related Risk Factors for Pain in Survivors of Childhood Cancer

• Published in: The journal of pain Vol. 25; no. 1; pp. 165 - 175
• Main Authors: Dowling, Emily J, Simons, Laura E, Crum, Alia J, Spunt, Sheri L, Simon, Pamela, Webster, Sarah N, Brown, Matthew R D, Jhanji, Shaman, Chilcot, Joseph, Heathcote, Lauren C
• Format: Journal Article
• Language: English
• Published: United States 01.01.2024
• Subjects: Cancer Pain - etiology; Cancer Survivors - psychology; Child; Cross-Sectional Studies; Humans; Neoplasms - complications; Neoplasms - psychology; Risk Factors; Survivors - psychology; Bodily threat monitoring; Body mindsets; Pain; Childhood cancer survivors; Fear of cancer recurrence
• ISSN: 1526-5900; 1528-8447
• DOI: 10.1016/j.jpain.2023.07.030

Pain is a common consequence of childhood cancer. While most research has examined biomedical predictors of post-cancer pain, biopsychosocial conceptualisations such as the cancer threat interpretation (CTI) model hold promise for guiding comprehensive pain management strategies. Guided by the CTI model, this cross-sectional study evaluated correlates of post-cancer pain in childhood cancer survivors including threat-related risk factors (bodily threat monitoring, fear of cancer recurrence, help-seeking) and mindsets about the body. In the preceding three months, 21.8% of the survivors reported chronic pain (>3 months), and 14.3% experienced pain most days. Greater bodily threat monitoring, more fear of cancer recurrence, and more help-seeking were associated with more pain. There was heterogeneity in the mindsets that survivors of childhood cancer hold about their bodies. Holding the mindset that the 'body is an adversary' was associated with more pain, greater bodily threat monitoring, and more fear of cancer recurrence. Holding the mindset that the 'body is responsive' was associated with less bodily threat monitoring, while the mindset that the 'body is capable' was associated with greater help-seeking. A path model demonstrated a significant combined indirect effect of the 'body is an adversary' mindset on pain through bodily threat monitoring and fear of cancer recurrence. Overall, this study supported that a sub-group of childhood cancer survivors experience persistent and interfering pain and provided cross-sectional support for threat-related correlates for pain aligning with the CTI model. Body mindsets were associated with pain and threat-related correlates and may represent a novel target to support survivors with pain. PERSPECTIVE: This article presents associations of body mindsets, threat-related risk factors, and pain in survivors of childhood cancer (aged 11-25), guided by the Cancer Threat Interpretation model. The study indicates that body mindsets may be novel targets to embed in comprehensive post-cancer pain management approaches to support young survivors with pain.