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Grant Details

Grant Number: 5R21CA173163-02 Interpret this number
Primary Investigator: Schnur, Julie
Organization: Icahn School Of Medicine At Mount Sinai
Project Title: Cancer Treatment Retraumatization in Sexual Abuse Survivors
Fiscal Year: 2015


Abstract

DESCRIPTION (provided by applicant): The statistics on sexual abuse (SA) are staggering: 1 in 4 women and 1 in 6 men have experienced abusive sexual experiences before the age of 18. Healthcare procedures, even those that may seem minor or routine, share similarities with childhood sexual abuse (e.g., insertion of objects into the body, exposure, vulnerability, pain, powerlessness). Due to these similarities, SA survivors can feel retraumatized by healthcare procedures. Not surprisingly, to avoid this retraumatization, SA survivors may avoid healthcare (e.g., delay or cancel treatment). Despite the often invasive/intimate medical procedures involved in cancer treatment, and the serious consequences of cancer treatment avoidance, there has been no empirical study to date of the relationship between cancer treatment retraumatization and cancer treatment avoidance in sexually abused cancer (SACA) patients. Objectives: The overall goal of the project is to develop a greater understanding of SACA patients experiences of cancer treatment, how this suffering relates to treatment avoidance, and which SACA patients are most at risk for cancer treatment retraumatization and avoidance. Specific Aims are to: 1) test the hypothesis that increased cancer treatment retraumatization will be associated with increased cancer treatment avoidance in SACA individuals; 2) test the hypotheses that increased cancer treatment retraumatization and avoidance will be associated with: a) SA severity (e.g., duration, force), b) exposure to other types of childhood abuse, and c) exposure to pre-cancer traumatic life events; and, 3) explore the influence of gender and cancer characteristics on study outcomes. Methodology: The study is guided by the Healthcare Retraumatization Avoidance (HRA) model. Aims 1-3 will be accomplished through an online survey administered to 600 SACA patients (300 men, 300 women) recruited from SA survivor support websites, a cancer support website, and a crowdsourcing website (Amazon Mechanical Turk). The online approach will improve patient experience by providing anonymity, and will improve the generalizability of the project by allowing for nationwide recruitment. Path analysis will be used for study analyses. Long-term goals: The proposed study is a critical first step toward improving quality of care and quality of life of SACA patients undergoing cancer treatment. The project will advance scientific knowledge and will aid the cancer care community in understanding the difficulties SACA patients experience during cancer treatment. Results will serve as a foundation for a program of research including the development of interventions and assessment tools to reduce cancer treatment retraumatization and avoidance in this vulnerable population. Connection to NIH/NCI mission: This project is consistent with the Healthy People 2020 goal of improving quality of life of cancer patients and survivors.



Publications

Cancer treatment experiences among survivors of childhood sexual abuse: A qualitative investigation of triggers and reactions to cumulative trauma.
Authors: Schnur J.B. , Dillon M.J. , Goldsmith R.E. , Montgomery G.H. .
Source: Palliative & supportive care, 2018 12; 16(6), p. 767-776.
EPub date: 2017-08-15.
PMID: 28809134
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Interest and Attitudes about Hypnosis in a Large Community Sample.
Authors: Montgomery G.H. , Sucala M. , Dillon M.J. , Schnur J.B. .
Source: Psychology of consciousness (Washington, D.C.), 2018 Jun; 5(2), p. 212-220.
PMID: 30035144
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The Patient Perspective on Radiogenomics Testing for Breast Radiation Toxicity.
Authors: Rattay T. , Symonds R.P. , Shokuhi S. , Talbot C.J. , Schnur J.B. .
Source: Clinical oncology (Royal College of Radiologists (Great Britain)), 2018 03; 30(3), p. 151-157.
EPub date: 2017-12-26.
PMID: 29287972
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Cancer Victim Identity for Individuals with Histories of Cancer and Childhood Sexual Abuse.
Authors: McDonnell G.A. , Sucala M. , Goldsmith R.E. , Montgomery G.H. , Schnur J.B. .
Source: Journal of rational-emotive and cognitive-behavior therapy : RET, 2017 Dec; 35(4), p. 402-412.
EPub date: 2017-03-04.
PMID: 29230080
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Development of the Healthcare Triggering Questionnaire in adult sexual abuse survivors.
Authors: Schnur J.B. , Chaplin W.F. , Khurshid K. , Mogavero J.N. , Goldsmith R.E. , Lee Y.S. , Litman L. , Montgomery G.H. .
Source: Psychological trauma : theory, research, practice and policy, 2017 Nov; 9(6), p. 714-722.
EPub date: 2017-04-27.
PMID: 28447815
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Cognitive-Behavioral Therapy Plus Hypnosis for Distress During Breast Radiotherapy: A Randomized Trial.
Authors: Montgomery G.H. , Sucala M. , Dillon M.J. , Schnur J.B. .
Source: The American journal of clinical hypnosis, 2017 Oct; 60(2), p. 109-122.
PMID: 28891772
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Hypnosis for Symptom Control in Cancer Patients at the End-of-Life: A Systematic Review.
Authors: Montgomery G.H. , Sucala M. , Baum T. , Schnur J.B. .
Source: The International journal of clinical and experimental hypnosis, 2017 Jul-Sep; 65(3), p. 296-307.
PMID: 28506144
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The Use of a Brief 5-Item Measure of Family Satisfaction as a Critical Quality Indicator in Advanced Cancer Care: A Multisite Comparison.
Authors: Ornstein K.A. , Penrod J. , Schnur J.B. , Smith C.B. , Teresi J.A. , Garrido M.M. , McKendrick K. , Siu A.L. , Meier D.E. , Morrison R.S. .
Source: Journal of palliative medicine, 2017 07; 20(7), p. 716-721.
EPub date: 2017-02-10.
PMID: 28186833
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The Necessity of the Nipple: Redefining Completeness in Breast Reconstruction.
Authors: Weissler E.H. , Schnur J.B. , Lamelas A.M. , Cornejo M. , Horesh E. , Taub P.J. .
Source: Annals of plastic surgery, 2017 Jun; 78(6), p. 646-650.
PMID: 27845965
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