Potential Effects of Breast Cancer on PTSD Symptoms in a Trauma-Exposed Population of African American Women Open Access

Abstract

Breast cancer accounts for approximately a quarter of all cancer cases in women, and the long-term effects of the stress from diagnosis and treatment can result in adverse mental health outcomes that range from fear of cancer recurrence to PTSD. There are numerous known risk factors for PTSD, but this study aimed to identify risk factors specific to trauma-exposed African American women with breast cancer. We performed a retrospective analysis to see how diagnosis features, treatment methods, and inflammatory biomarkers are associated with PTSD and depression symptoms. Of significance, we found that women diagnosed with early-stage breast cancer had greater PTSD hyperarousal symptoms, women who did not receive radiation had greater PTSD total, intrusive, and hyperarousal symptoms, women who did not receive chemotherapy had greater depression symptoms, women who have any form of systemic therapy have fewer PTSD total, PTSD avoidance, and depression symptoms, and obese women have greater PTSD intrusive symptoms. We also found that chemotherapy has a positive association with depression symptoms and years since diagnosis. Finally, we found serum chloride to have a quadratic relationship with depression symptoms. These findings were largely contrary to our hypotheses, but they suggest that many factors surrounding breast cancer diagnosis, treatment, and inflammation may uniquely modulate the fear response in African American women at high risk for PTSD.

Table of Contents

Introduction............................................................................................1

Methods..................................................................................................8

Participant recruitment

Medical record analysis

Statistical analyses

Results...................................................................................................10

Demographic and diagnosis factors

Cancer treatment

Inflammation: obesity and blood chemistry

Discussion..............................................................................................13

Limitations.............................................................................................20

Conclusions............................................................................................21

References .............................................................................................23

Tables and Figures

Table 1...........................................................................................34

Figure 1.........................................................................................34

Figure 2.........................................................................................35

Figure 3 ........................................................................................35

Figure 4.........................................................................................36

Figure 5.........................................................................................36

Figure 6.........................................................................................37

Figure 7.........................................................................................37

Figure 8.........................................................................................38

Figure 9.........................................................................................38

Figure 10.......................................................................................39

About this Honors Thesis

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School	Emory College
Department	Neuroscience and Behavioral Biology
Degree	B.S.
Submission	Honors Thesis
Language	English
Research Field	Biology, Neuroscience
Keyword	Breast Cancer PTSD
Committee Chair / Thesis Advisor	Jennifer Stevens, Emory University
Committee Members	Kim Wallen, Emory University Vasiliki Michopoulos, Emory University Jennifer Felger, Emory University Preeti Subhedar, Emory University

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