Date of Degree
PhD (Doctor of Philosophy)
Susan K. Lutgendorf
Ovarian cancer is a malignancy characterized by poor prognosis, high levels of distress, and impaired quality of life (QOL). Investigation into the contributors to QOL is of psychological and prognostic significance in cancer. Contemporary stress theories and empirical accounts identify early life adversity and recent life stress as those sources which exert significant impact on physical and psychological health. To date, life stress research in cancer has yielded few designs which operationalize both indices of early life and recent life stress exposures. Moreover, despite the high-resolution stress data provided by the Life Events and Difficulties Schedule (LEDS) system, no studies to date comprehensively operationalize the early life adversity data obtained during each interview. Therefore, the proposed study is the first of its kind to comprehensively obtain ratings and examine effects of early life adversity data collected as part of the LEDS interview. It is also the first to examine independent influences of differentially timed life stress indices on psychological variables important to psychosocial functioning in ovarian cancer. Early life adversity was experienced by 43.1% of the sample. Adversity varied in content, number of occurrences, and severity. Ongoing difficulties, but not recent life events or early life adversity, were significantly associated with pre-surgical depression and QOL. Ongoing difficulties were also associated with lower depression, sleep, and QOL scores at all time-points. Early life adversity was associated with a poorer trajectory of sleep and QOL over the first year post-diagnosis. Findings are discussed with attention to behavioral and biological mechanisms. Applications to generative and cumulative theories of life stress are proposed. These findings lend support to the potential benefit of interventions aimed toward practical support and stress management in patients with ovarian cancer, as well as provide guidelines for use of early life adversity data obtained through the LEDS interview.
Depression, Early life adversity, Life stress, Ovarian cancer, Quality of life, Sleep
Copyright 2016 Lauren Angela Clevenger