Emotional Suppression Tendencies as Predictors of Symptoms, Mood, and Coping Appraisals During AC Chemotherapy for Breast Cancer Treatment

Abstract

Tendencies to suppress negative emotions have been shown to predict adjustment to cancer and cancer progression. We examined whether emotional suppression, in terms of both general and emotion-specific tendencies, predict symptom reports, mood states, and coping appraisals during adriamycin/doxorubicin, cyclophosphamide/cytoxan chemotherapy for breast cancer. Forty participants completed a measure yielding scores for anxiety suppression, anger suppression, depression suppression, and total emotional suppression. They then reported their experiences of 34 physical symptoms, mood, and coping efficacy on a daily basis for the duration of treatment (84 days). Mixed model analyses revealed that emotional suppression predicted lower reports of symptoms that are vague, well-known, and potentially embarrassing side effects of chemotherapy (e.g., fatigue and constipation). Emotional suppression and particularly anger suppression predicted higher reports of symptoms relating to immune function and cardiovascular arousal (e.g., mouth sores and heart palpitations) and with appraisals of poorer coping. The three suppression tendencies exhibited distinctive patterns of relationships with symptoms, mood, and coping appraisals, suggesting that anxiety suppression, anger suppression, and depression suppression have partially independent relationships with symptomatic and mood processes. The findings highlight the potential importance of emotional suppression for understanding symptom and coping responses during chemotherapy.

Measuring emotion regulation and emotional expression in breast cancer patients: A systematic review

“…However, other studies found that emotion suppression or dampening (as measured by the CECS) was not significantly related to psychological distress, autonomic physiology, or survival Giese-Davis et al, 2008;Goodwin et al, 2004;Nakatani et al, 2014;Watson et al, 1999).Emotional dampening, as measured by the WCQ, was associated with longer survival times (Andreu et al, 2012;Classen et al, 1996;Reynolds et al, 2000;Schlatter et al, 2010;Tamagawa et al, 2013).…”

“…A majority of studies have used the CECS as an overall scale to measure "control of emotions" or "suppression of emotions". It has been the most common scale used to evaluate emotion control in the context of breast cancer and presented good internal consistency with α's ranging from .83 to .95 Andreu et al, 2012;Cameron et al, 2007;Classen et al, 1996;Giese-Davis et al, 2002, 2006bIwamistu et al, 2003Iwamistu et al, , 2005aIwamistu et al, , 2005bSchlatter et al, 2010) and reliability with 3-4 month testretest reliability = .95 . The CECS has been used with a wide variety of populations (see Table 1 for data on the number of publications describing the use of the CECS and all the measures reviewed) and has shown similar levels of reliability.…”

The Relationship Between Emotional Suppression and Psychological Distress in Breast Cancer Patients After Surgery

“…A diagnosis of breast cancer can be worrying (3) and is frequently associated with anxiety and depression (4), but breast cancer patients also experience psychological distress after surgery due to the psychological burden of longterm treatments (5) such as chemotherapy, radiotherapy and endocrine treatment. These therapies can have debilitating side effects (6)(7)(8)(9)(10)(11). Furthermore, patients undergoing treatments also experience psychological distress from a fear of recurrence.…”

Mental health as a clinical hallmark of cancer

“…Other studies have confirmed that further to extreme anger, suppression, repression or restraint of anger are emotions generally exhibited by breast cancer patients [2]. Epidemiological studies have reported that participation in psychological support groups is associated with better health outcomes for these patients, calling for an integration of such a modality in cancer management and treatment [3].…”