Pain and Intolerance of Uncertainty among Adolescent and Young Adult Cancer Survivors

Adolescent and young adult (AYA) cancer survivors commonly experience worry about new or recurrent pain as a potential sign of cancer recurrence. Those with higher intolerance of uncertainty (IU) may be more likely to interpret bodily sensations as threatening, thus amplifying their pain experience and interference with regular activities. This study examined the relationship between IU and pain among AYA cancer survivors. AYA cancer survivors (N=89, aged 11-25 years, Mage=18, 53.8% female) who completed cancer treatment for a range of childhood cancer diagnoses completed self-report assessments of pain, IU, and perceived threat of bodily sensations (Bodily Threat Inventory; BTI). Descriptive statistics were performed to characterize pain prevalence, and Pearson correlations assessed associations between IU and pain variables. Mediation analyses assessed whether IU and average pain were associated through BTI. Analyses were performed in SPSS. Pain was common, with 81.8% reporting some pain in the previous three months (23.5% for >3 months) and 69.7% reporting pain interference. Higher IU was associated with higher average pain intensity (r=.327, p=.002), pain interference (r=.272, p=.010), and BTI (r=.513, p<.001). There was an indirect effect of IU on average pain intensity via BTI. IU and BTI both significantly predicted average pain intensity (IU B=.066, p<.01; BTI B=.019, p<.05). The indirect effect of IU on average pain intensity via BTI (unstandardized, computed for 5,000 bootstrapped samples) was B=(1.36)*(.019)=.025 and statistically significant (95% CI=.001-.057) and suggested full mediation. Pain is common and can be interfering among AYA cancer survivors. IU may play a role in the post-cancer pain experience, and further work is needed to examine causal associations between pain and IU. In particular, the perception of bodily sensations as threatening may act as a mechanism linking pain and IU and thus may be a helpful intervention target.