# Healing the Mind to Ease Pain and Fatigue: The Role of Attachment, Mindfulness, and Cognitive Emotion Regulation in Early‐Stage Breast Cancer Survivors

## TL;DR

This study explores how psychological factors like secure attachment, mindfulness, and emotion regulation can reduce pain and fatigue in early-stage breast cancer survivors.

## Contribution

The study identifies specific psychological predictors of pain and fatigue in breast cancer survivors and suggests targeted interventions.

## Key findings

- Secure attachment reduces symptoms while ambivalent attachment worsens them.
- Mindfulness, especially accepting without judgment, significantly predicts lower pain and fatigue.
- Adaptive emotion regulation strategies reduce symptoms, while maladaptive ones increase them.

## Abstract

Pain and cancer‐related fatigue (CRF) are common and debilitating symptoms among breast cancer survivors, significantly impairing quality of life. Psychological factors, including attachment styles, mindfulness skills, and cognitive emotion regulation strategies (CERS), are essential for symptom management.

This study examined the predictive roles of attachment styles, mindfulness skills, and CERS on pain perception and CRF severity in women with early‐stage breast cancer.

A descriptive‐correlational design was applied to 201 women recruited from Tehran Shohada Hospital. Participants completed the Adult Attachment Styles (AAS), Kentucky Inventory of Mindfulness Skills (KIMS), Cognitive Emotion Regulation Questionnaire‐Short (CERQ‐Short), McGill Pain Questionnaire (MPQ), and Fatigue Severity Scale (FSS). Regression analyses revealed that attachment styles accounted for 20% of the variance in pain perception and 24% in CRF, with secure attachment reducing and ambivalent attachment exacerbating symptoms. Mindfulness skills explained 45% of pain perception and 26% of CRF variance, with accepting without judgment being the strongest predictor. CERS contributed to 46% of the variance in pain perception and 21% in CRF, with adaptive strategies mitigating and maladaptive strategies amplifying symptoms.

Promoting secure attachment, cultivating mindfulness skills, particularly accepting without judgment, and training adaptive CERS can significantly alleviate pain and fatigue in breast cancer survivors. These findings underscore the value of psychological interventions in enhancing treatment outcomes and quality of life in this population.