Childhood Adversity and Cumulative Life Stress: Risk Factors for Cancer-Related Fatigue
Open accessAbstract
Fatigue is a common symptom in healthy and clinical populations, including cancer survivors. However, risk factors for cancer-related fatigue have not been identified. On the basis of research linking stress with other fatigue-related disorders, we tested the hypothesis that stress exposure during childhood and throughout the life span would be associated with fatigue in breast cancer survivors. Stress exposure was assessed using the Stress and Adversity Inventory, a novel computer-based instrument that assesses for 96 types of acute and chronic stressors that may affect health. Results showed that breast cancer survivors with persistent fatigue reported significantly higher levels of cumulative lifetime stress exposure, including more stressful experiences in childhood and in adulthood, compared to a control group of nonfatigued survivors. These findings identify a novel risk factor for fatigue in the growing population of cancer survivors and suggest targets for treatment.
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Major life events, especially those involving interpersonal loss and social rejection, have been implicated in the onset, exacerbation, or progression of a variety of health problems, including asthma, rheumatoid arthritis, cardiovascular disease, chronic pain, and certain cancers.
“these stressors have been implicated not just in the development of depression but in the onset, exacerbation, or progression of a variety of health problems. These conditions include several that, like depression, are thought (or known) to be mediated at least in part by inflammation, such as asthma, rheumatoid arthritis, cardiovascular disease, chronic pain, and certain cancers”
From From stress to inflammation and major depressive disorder: A social signal transduction theory of depression. (2014) · cites this paper as Bower, Crosswell, & Slavich, 2014
The paper’s introductory discussion (section labeled Abstract; page unavailable) links major life events to the onset and severity of depression and acute stress to the onset of chronic fatigue syndrome. It also discusses childhood adversity and autoimmune disease, and stress and cancer-related fatigue. It does not establish the claimed links to the onset, exacerbation, or progression of asthma, rheumatoid arthritis, cardiovascular disease, chronic pain, or cancer, nor does it single out social rejection. (LLM, conf=0.87)
Experimental — accuracy not yet measuredThese conditions (asthma, rheumatoid arthritis, cardiovascular disease, chronic pain, and certain cancers) are thought or known to be mediated at least in part by inflammation.
“These conditions include several that, like depression, are thought (or known) to be mediated at least in part by inflammation, such as asthma, rheumatoid arthritis, cardiovascular disease, chronic pain, and certain cancers”
From From stress to inflammation and major depressive disorder: A social signal transduction theory of depression. (2014) · cites this paper as Bower, Crosswell, & Slavich, 2014
The Discussion (page unavailable) proposes inflammation as a pathway linking childhood stress to fatigue in cancer survivors, not as a mechanism mediating the listed diseases themselves. Searches for the disease list and for conditions mediated by inflammation found no passage addressing that claim. (LLM, conf=0.73)
Experimental — accuracy not yet measuredHigher Adult STRAIN scores have been associated with worse mental and physical health and poorer cognitive, biological, and clinical functioning across several studies and health contexts.
“Higher Adult STRAIN scores have also been associated with worse mental and physical health, as well as poorer cognitive, biological, clinical functioning across several different studies and distinct health contexts (e.g., Bower et al. 2014; Cuneo et al. 2017; Dooley et al. 2017; Goldfarb et al. 2017; Lam et al. 2019; Shields et al. 2017a, b; Slavich and Shields 2018; Toussaint et al. 2016).”
From Life stress and suicide in adolescents (2019) · cites this paper as Bower et al. 2014
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“This approach yielded eight preliminary studies, showing that the STRAIN predicts biological reactivity to acute stress (27), metabolic function (28), memory (29), diurnal cortisol levels in women diagnosed with ovarian cancer (30), depression and fatigue in women diagnosed with breast cancer (31,32), and self-reporte…”
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- Authors
- Bower, J. E., Crosswell, A. D., & Slavich, G. M.
- Affiliations
- University of California, Los Angeles (US)
- Venue
- Clinical Psychological Science
- Publisher
- SAGE Publications
- Published
- 2013-08-05
- Volume
- 2
- Issue
- 1
- Pages
- 108-115
- ISSN
- 2167-7026 (ISSN-L)
- 2167-7034
- PMC
- PMC3873097
- OpenAlex
- W2048095645
- Cited by
- 86
- References
- 56
- Citations by year
- 2026: 5 · 2025: 6 · 2024: 5 · 2023: 3 · 2022: 8 · 2021: 3 · 2020: 9 · 2019: 7 · 2018: 10 · 2017: 13 · 2016: 5 · 2015: 4 · 2014: 6 · 2013: 2
- FWCI
- 3.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Clinical Psychological Science (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (5t32gm084903-03)
- National Institute of Mental Health (K08MH103443)
- National Cancer Institute (R25CA087949, R01CA160427)
- National Institute of General Medical Sciences (T32-GM084903)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- childhood adversity, cancer-related fatigue, breast cancer survivors, stress exposure, risk factors for fatigue, chronic stressors
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