Childhood Adversity and Inflammation in Breast Cancer Survivors

Abstract

Objective Elevated inflammation predicts behavioral symptoms, disease progression, and mortality in patients with breast cancer and breast cancer survivors, although predictors of inflammation remain largely unknown. Adverse experiences in childhood have been associated with higher rates of psychological and physical illness, and elevated inflammatory activity in studies of healthy adults. However, little research has examined the association between childhood adversity and inflammation in the context of cancer, where inflammation is particularly relevant for health. Methods The current study examined the association between three types of childhood adversity—abuse, neglect, and a chaotic home environment—and inflammatory markers (interleukin [IL]-6 and C-reactive protein), in breast cancer survivors who had completed primary cancer treatment 1 year earlier (n = 152). Results The combined measure of childhood adversity was associated with elevations in plasma levels of IL-6 (B = 0.009, p = .027, η2 = 0.027, after controlling for age, body mass index, ethnicity, alcohol use, and cancer treatment (surgery, radiation, and/or chemotherapy). Examination of individual types of adversity demonstrated a positive association between abuse and IL-6 (B = 0.043, p = .030, η2 = 0.026), chaotic home environment and IL-6 (B = 0.031, p = .005, η2 = 0.043), and chaotic home environment and soluble tumor necrosis factor receptor type II (B = 0.012, p = .009, η2 = 0.037), after controlling for relevant confounds. Conclusion Childhood adversity was associated with elevated markers of inflammation in breast cancer survivors, with potential negative implications for health and well-being. In particular, chaotic home environment showed unique links with inflammatory outcomes.

Early Childhood Adversity and its Associations With Anxiety, Depression, and Distress in Women With Breast Cancer

“…(17) The three subscales of Abuse (2 questions), Neglect (3 questions), and Chaotic Home Environment (4 questions) exist within the RFQ as defined in a paper by Crosswell et al in 2014. (14)…”

“…(7, 14) ECA predisposes a person to have heightened stress reactivity in response to emotional stimuli. (15) ECA has been linked to neuronal dysregulation in the development of coronary artery disease(16), cancer-related fatigue(17), and sleep difficulties with even with mild stressors(18).…”

“…Its measures have been correlated with inflammatory biomarkers that have also been correlated with depression and anxiety in cancer. (14, 26, 27) Therefore, our study measured ECA using the RFQ and correlated its results directly with measures that are commonly used to screen for distress, depression, and anxiety in the cancer setting. This exploratory study proposed that ECA would be significantly associated with depression, similar to non-cancer populations and with meeting screening criteria for depression, anxiety, or psychological distress in patients with breast cancer.…”

“…It also sought to evaluate the association between ECA and anxiety or psychological distress. As depression appears to have greater evidence for a biological signature (i.e., correlation of serotonin transporter gene polymorphism (19) and neural activation dysregulation) (10, 14) than anxiety, ECA was thought to preferentially lead to depression over distress or anxiety in women with breast cancer.…”

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

“…Depressive symptoms remain elevated during the year after breast cancer diagnosis and can interfere with effective treatment, reduce quality of life, and impair recovery after treatment completion (Antoni et al, 2006; Giese-Davis et al, 2011; Stanton et al, 2005, 2015; Stanton & Bower, 2015). Further, childhood adversity has been linked to important outcomes in women with breast cancer, including depression (McFarland et al, 2016; Witek Janusek, Tell, Albuquerque, & Mathews, 2013), but also fatigue (Bower, Crosswell, & Slavich, 2014), inflammation (Crosswell, Bower, & Ganz, 2014), and cancer-related distress (Fagundes, Lindgren, Shapiro, & Kiecolt-Glaser, 2012; Goldsmith et al, 2010). …”