The Role of Adverse Childhood Experiences and Attachment Style in Predicting Pain Perception in Women with Breast Cancer; The Mediating Role of Perceived Social Support

Breast cancer is the most common malignancy diseases which is the leading cause of death in women with more than two million deaths per year. Pain in cancer patients has a complex relationship with adverse childhood experiences, attachment and social support, the multiple relationships of which has not been studied to date. The present study was conducted aimed to investigate the multiple dimensions of this relationship.

In a cross-sectional study conducted in the form of a structural equation modeling, from July to September 2021 with 360 participants diagnosed with breast cancer who referred to three chemotherapy centers in Tehran were selected using purposeful sampling method and entered thestudy process after obtaining informed consent and fulfilling the assumed criteria. Four indicators of adverse childhood experiences, attachment style, pain, and perceived social support were completed by participants over a period of time. Data were analyzed using SPSS and Amos software version 25.

Data analysis showed that adverse childhood experiences mediated by perceived social support was associated with the perception of pain in women with breast cancer (P<0.05). But the relationship between avoidant (β=0.015), safe (β=-.023) and ambivalent (β=0.026) attachment styles with pain perception was not significant and attachment styles through perceived social support could not have a significant effect on pain perception (P>0.05).

Some of the findings of this study are in line with the research, indicating the relationship between adverse childhood experiences and pain perception and highlight the role of perceived social support. However, the relationship between attachment styles and pain perception is complex and requires further study.