The relationship of adverse childhood experiences and attachment styles with pain perception in patients with cancer

BACKGROUND: Breast cancer (BC) is the second most common malignancy worldwide and pain is an important problem and one of the most unstable symptoms in these patients. The present study was conducted to investigate the relationship between adverse childhood experiences and attachment styles with pain perception in patients with BC. METHODS: In a cross-sectional study in the form of a structural equation modeling (SEM), during the period from July to September 2021, 360 participants diagnosed with BC, who were referred to three chemotherapy centers in Tehran, Iran, were selected using a purposeful sampling method and entered into the research process after obtaining informed consent and fulfilling the necessary criteria. Four indices of adverse childhood experiences, attachment style, pain, and quality of life were completed by participants over some time. Data were analyzed using Amos software. RESULTS: Data analysis showed that adverse childhood experiences mediated by the quality of life were not associated with pain perception of women with BC (P > 0.05). However, the relationship between secure attachment style and pain perception mediated by the quality of life was observed as significant (P < 0.05, β = -0.06). But the relationship between avoidant (β = 0.026) and two-bilateral attachment (β = 0.028) attachment styles with pain perception was not significant (P > 0.05). CONCLUSION: Part of the findings of this study was in line with the research background indicating the relationship between secure attachment style and pain perception mediated by the quality of life. However, the association of adverse childhood experiences with pain perception is a complex one that requires further study.