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Onyedibe MCC. Social support moderates the relationship between emotion regulation and health-related quality of life in cancer patients. PSYCHOL HEALTH MED 2024; 29:1349-1361. [PMID: 38498978 DOI: 10.1080/13548506.2024.2325379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 02/26/2024] [Indexed: 03/20/2024]
Abstract
The relationship between emotion regulation (cognitive reappraisal and expressive suppression) and HRQoL in cancer patients is currently gaining momentum, yet, no research to date has investigated the nature of this relationship. The purpose of this study was to investigate the moderating role of social support in the relationship between ER and HRQoL in Nigerian cancer patients. Participants included 361 cancer patients (female = 56.79%, mean age = 41.61, SD 15.47) conveniently drawn from the oncology unit of the University Teaching Hospital, Nigeria. They completed the measures of Functional Assessment of Cancer Therapy-General (FACT-G), emotion regulation and Perceived Social Support. The moderated regression analysis via PROCESS procedures for SPSS Version 3 was used for data analysis. The results showed that cognitive reappraisal significantly predicted HRQoL (β = 2.12, t = 4.39, p = .000). Social support also significantly predicted HRQoL (β = .73, t = 4.57, p = .000). Most importantly, social support moderated the relationship between cognitive reappraisal and HRQoL (β = -.034, t= -4.23, p = .000), but not between expressive suppression and HRQoL (β = -.015, t= -1.61, p = .10). The moderation slope revealed that cognitive reappraisal significantly predicted HRQoL particularly at lower and moderate levels of social support. These findings reveal that the effect of emotion regulation on HRQoL depends much on an individual's level of perceived social support. It also means that social support boosted the positive impact of emotion regulation on HRQoL. The findings highlighted the importance of social-support and emotion regulation particularly, cognitive-reappraisal in improving health-related quality of life in cancer patients.
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Durosini I, Triberti S, Savioni L, Sebri V, Pravettoni G. The Role of Emotion-Related Abilities in the Quality of Life of Breast Cancer Survivors: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12704. [PMID: 36232004 PMCID: PMC9566755 DOI: 10.3390/ijerph191912704] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 05/29/2023]
Abstract
Breast cancer survivors have to deal with notable challenges even after successful treatment, such as body image issues, depression and anxiety, the stress related to changes in lifestyle, and the continual challenges inherent to health management. The literature suggests that emotional abilities, such as emotional intelligence, emotion management, mood repair, and coping play a fundamental role in such challenges. We performed a systematic review to systematize the evidence available on the role of emotional abilities in quality of life and health management in breast cancer survivors. The search was performed on three scientific databases (Pubmed, Scopus, and PsycINFO) and, after applying exclusion criteria, yielded 33 studies, mainly of a cross-sectional nature. The results clearly support the hypothesis that emotional abilities play multiple important roles in breast cancer survivors' quality of life. Specifically, the review highlighted that coping/emotional management plays multiple roles in breast cancer survivors' well-being and health management, affecting vitality and general adjustment to cancer positivity and promoting benefit findings related to the cancer experience; however, rare negative results exist in the literature. This review highlights the relevance of emotional abilities to promoting quality of life in breast cancer survivors. Future review efforts may explore other breast cancer survivors' emotional abilities, aiming at assessing available instruments and proposing tailored psychological interventions.
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Affiliation(s)
- Ilaria Durosini
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
| | - Stefano Triberti
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20123 Milan, Italy
| | - Lucrezia Savioni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20123 Milan, Italy
| | - Valeria Sebri
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20123 Milan, Italy
| | - Gabriella Pravettoni
- Applied Research Division for Cognitive and Psychological Science, IEO, European Institute of Oncology IRCCS, 20141 Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, 20123 Milan, Italy
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Xu C, Ganesan K, Liu X, Ye Q, Cheung Y, Liu D, Zhong S, Chen J. Prognostic Value of Negative Emotions on the Incidence of Breast Cancer: A Systematic Review and Meta-Analysis of 129,621 Patients with Breast Cancer. Cancers (Basel) 2022; 14:cancers14030475. [PMID: 35158744 PMCID: PMC8833353 DOI: 10.3390/cancers14030475] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/07/2022] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
Breast cancer (BC) is one of the common malignant tumors in women and affects 1.6 million new cases globally each year. Investigators have recently found that negative emotions (NEs) and their impacts have greatly influenced the incidence and risk of BC. The present study aims to provide an association between NEs and the incidence of BC with possible risk factors. A total of 9343 studies were screened; nine studies met all inclusion criteria that were considered for the meta-analysis. The qualitative studies were measured by the Newcastle-Ottawa Scale; the observational studies were included with relative risks (RR) and corresponding 95% confidence intervals (CI). Besides the NEs and BC, the possible risk factors were evaluated. We analyzed data from 129,621 women diagnosed with NEs of which 2080 women were diagnosed with BC and their follow-up year ranges were from 4–24 years. NEs were significantly (p < 0.0001) associated with a higher incidence of BC with RR = 1.59, 95% CI:1.15–2.19, with other high-risk factors including, geographical distribution, emotion types, standard diagnosis of NEs, and follow-up duration. This study suggests that NEs significantly increase the risk for the incidence of BC, which can be supportive of the prognosis of the disease.
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Affiliation(s)
- Cong Xu
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
| | - Kumar Ganesan
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
| | - Xiaoyan Liu
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
| | - Qiaobo Ye
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China;
| | - Yuenshan Cheung
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
| | - Dan Liu
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
| | - Shaowen Zhong
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
- Correspondence: (S.Z.); (J.C.); Tel.: +852-39-17-6479 (J.C.)
| | - Jianping Chen
- School of Chinese Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; (C.X.); (K.G.); (Y.C.)
- Department of Breast Surgery, Guangdong Provincial Hospital of Traditional Chinese Medicine, Guangzhou 510405, China; (X.L.); (D.L.)
- School of Basic Medical Sciences, Chengdu University of Traditional Chinese Medicine, Chengdu 610075, China;
- Shenzhen Institute of Research and Innovation, The University of Hong Kong, Shenzhen 518057, China
- Correspondence: (S.Z.); (J.C.); Tel.: +852-39-17-6479 (J.C.)
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Liu Y, Han Y, Wang X, Chen Y, Mo Q, Li L, Wang Y, Fan J, Yang Y, Soondrum T, Zhu X. Psychometric properties of the Chinese version of the Courtauld Emotional Control Scale in women newly diagnosed with breast cancer. Qual Life Res 2021; 31:865-876. [PMID: 34328583 DOI: 10.1007/s11136-021-02953-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Emotional control, the attempt to suppress the expression of negative effects, is an essential factor in the prevalence of psychological distress in women with breast cancer. The Courtauld Emotional Control Scale (CECS) is a commonly used self-report tool for assessing emotional suppression in both clinical and general groups. This study aimed to validate the Chinese version of the Courtauld Emotional Control Scale (CECS) in women newly diagnosed with breast cancer. METHODS The study involved 680 women newly diagnosed with breast cancer aged 25 to 76 (mean age = 48.19, standard deviation (SD) = 8.57) from Changsha (China). Data analysis included Cronbach's alpha coefficients, the intraclass correlation coefficient (ICC), Pearson's correlations, Independent-Samples T test, confirmatory factor analysis (CFA) and exploratory structural equation modeling (ESEM) were conducted to determine the optimal model. For the best fitting model stability was assessed with tests for invariance across age, educational level, and employment status. RESULTS Internal consistency (α = 0.987) and test-retest reliability (ICC = 0.715) of the CECS were presented. Results confirm the structure of the Chinese version of the CECS with 21 items divided into three dimensions, anger suppression (CECS_AG), depression suppression (CECS_MD), and anxiety suppression (CECS_AX). Convergent and known-groups validity were acceptable. Additionally, this model remained invariant across age, educational levels, and employment status. CONCLUSIONS The Chinese version of the CECS has good psychometric properties in terms of reliability and validity, remaining invariant across age, educational levels, and employment status in women newly diagnosed with breast cancer.
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Affiliation(s)
- Yao Liu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
- Medical Psychological Institute of Central South University, Changsha, China
| | - Yan Han
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Xiang Wang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Yaoxin Chen
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Qingqian Mo
- Department of Clinical Psychology, The Third Xiangya Hospital, Central South University, Changsha, China
| | - Lingyan Li
- School of Nursing, Nanchang University, Nanchang, China
| | - Yuping Wang
- School of Humanities and Social Science, Xi'an Jiaotong University, Xi'an, China
| | - Jie Fan
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Yanjie Yang
- School of Public Health, Harbin Medical University, Harbin, China
| | - Tamini Soondrum
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China
| | - Xiongzhao Zhu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Renmin Middle Road 139#, Furong District, Changsha, 410011, Hunan, China.
- Medical Psychological Institute of Central South University, Changsha, China.
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Ye Z, Chung MC, Di X. The co-existing relationship between child abuse, emotional suppression, interpersonal sensitivity and psychiatric co-morbidity among Chinese prisoners. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02060-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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6
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Baziliansky S, Cohen M. Emotion regulation and psychological distress in cancer survivors: A systematic review and meta-analysis. Stress Health 2021; 37:3-18. [PMID: 32720741 DOI: 10.1002/smi.2972] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 04/26/2020] [Accepted: 06/29/2020] [Indexed: 01/04/2023]
Abstract
Emotion regulation may affect the levels of psychological distress of cancer survivors, but inconsistencies exist among studies regarding the direction of this effect. The systematic review and meta-analysis sought to estimate the associations between emotion regulation patterns (repression, suppression, experiential avoidance and cognitive reappraisal) and psychological distress among cancer survivors. Fifteen studies met inclusion criteria for systematic review, and seven studies focussing on suppression were included in the meta-analysis. The systematic review pointed to a marked variability in associations among the emotion regulation patterns and psychological distress. The three meta-regressions of the relationships between suppression and psychological distress found significant fixed- and random-effect sizes (except marginal significance of a random-effect model for partial correlation). Subgroup analysis showed no moderation effect of time since diagnosis or study quality, but a significant difference (fixed-effect model only, p = 0.005) was found between correlative studies and those controlling for confounders. The current study suggests that suppression is related to elevated levels of psychological distress among cancer survivors, although large inconsistencies exist among studies and publication bias could not be ruled out. Further studies with large samples and a consistent approach are thus required to evaluate the associations of emotion regulation patterns and psychological distress.
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Affiliation(s)
| | - Miri Cohen
- School of Social Work, University of Haifa, Haifa, Israel
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Baziliansky S, Cohen M. Post-treatment Psychological Distress Among Colorectal Cancer Survivors: Relation to Emotion Regulation Patterns and Personal Resources. Int J Behav Med 2021; 28:591-601. [PMID: 33495979 DOI: 10.1007/s12529-020-09952-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/28/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Post-treatment psychological distress among colorectal cancer (CRC) survivors is common, but changes over time. However, data on the effects of emotional factors on changes in psychological distress over time remain limited. The study sought to describe the patterns of change in psychological distress among CRC survivors in the short-term after treatment completion and to identify predictors of the change in psychological distress experienced by CRC survivors. METHODS A total of 153 CRC survivors, stages II-III at diagnosis, who were 4-24 months post-diagnosis (participation rate 89.5%) completed the Emotion Regulation Questionnaire, Acceptance and Action Questionnaire, Resilience Scale-14, Self-Compassion Scale-Short Form, and Brief Symptom Inventory-18 (psychological distress scale) at Time 1 (T1). Psychological distress was assessed again at Time 2 (T2), 6 months later. RESULTS Two patterns of change in post-treatment psychological distress among CRC survivors were identified: One group of patients experienced higher psychological distress at T1, which decreased at T2. A second group experienced lower psychological distress at T1, which increased at T2. Self-compassion and personal resilience predicted higher psychological distress at T2. Lower suppression and self-compassion and higher personal resilience increased the likelihood of being in the increased psychological distress group. CONCLUSIONS Psychological distress evaluation of CRC survivors at different time-points post-treatment is warranted. In addition, awareness is needed that self-compassion may be individually related to psychological distress among participants.
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Affiliation(s)
| | - Miri Cohen
- School of Social Work, University of Haifa, Haifa, Israel
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8
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Dryman MT, Heimberg RG. Emotion regulation in social anxiety and depression: a systematic review of expressive suppression and cognitive reappraisal. Clin Psychol Rev 2018; 65:17-42. [DOI: 10.1016/j.cpr.2018.07.004] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Revised: 07/20/2018] [Accepted: 07/21/2018] [Indexed: 10/28/2022]
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9
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Samuel L, Cohen M. Expressive suppression and emotional eating in older and younger adults: An exploratory study. Arch Gerontol Geriatr 2018; 78:127-131. [DOI: 10.1016/j.archger.2018.06.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 06/10/2018] [Accepted: 06/21/2018] [Indexed: 11/16/2022]
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Montes-Nogueira I, Campos-Uscanga Y, Gutiérrez-Ospina G, Hernández-Pozo MDR, Larralde C, Romo-González T. Psychological Features of Breast Cancer in Mexican Women II: The Psychological Network. ADVANCES IN NEUROIMMUNE BIOLOGY 2018. [DOI: 10.3233/nib-170125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Iván Montes-Nogueira
- Área de Biología y Salud Integral, Instituto de Investigaciones Biológicas, Universidad Veracruzana, Mexico
- Doctorado en Psicología, Instituto de Investigaciones Psicológicas, Universidad Veracruzana, Mexico
| | | | - Gabriel Gutiérrez-Ospina
- Departamento de Biología Celular y Fisiología, Instituto de Investigaciones Biomédicas, Coordinación de Psicobiología, Facultad de Psicología Universidad Nacional Autónoma de México, Mexico
| | | | - Carlos Larralde
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Mexico
| | - Tania Romo-González
- Área de Biología y Salud Integral, Instituto de Investigaciones Biológicas, Universidad Veracruzana, Mexico
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Levkovich I, Cohen M, Alon S, Kuchuk I, Nissenbaum B, Evron E, Pollack S, Fried G. Symptom cluster of emotional distress, fatigue and cognitive difficulties among young and older breast cancer survivors: The mediating role of subjective stress. J Geriatr Oncol 2018; 9:469-475. [PMID: 29759914 DOI: 10.1016/j.jgo.2018.05.002] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 03/24/2018] [Accepted: 05/01/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To examine the nature of the symptom cluster of emotional distress, fatigue, and cognitive difficulties in young and older breast cancer survivors (BCS); To assess the mediating role of subjective stress and coping strategies (emotional control and meaning-focused coping) in the association between age and symptom cluster. MATERIALS AND METHODS Participants were 170 BCS, stages I-III, 1-12 months post-chemotherapy, filled-out the Fatigue, Emotional Control, Meaning-focused Coping, Emotional Distress and the Cognitive Difficulties Questionnaires. Statistical analyses included tests for difference between-groups Pearson correlations and Structural Equation Modeling for the assessment of the study model. RESULTS Older BCS (aged 60-82) reported lower levels of emotional distress (M = 0.87, SD = 0.87), fatigue (M = 3.85, SD = 2.38), and cognitive difficulties (M = 1.17, SD = 1.07) compared to the younger BCS (aged 24-59) (emotional distress M = 1.17, SD = 0.85, fatigue M = 5.02, SD = 2.32, and cognitive difficulties M = 1.66, SD = 1.23, p < .01-,05). The older survivors reported lower levels of subjective stress and used more emotional control strategies compared to the younger BCS. The empirical model had good fit indices (χ2 = 27.60, p = 0.20, χ2/df = 1.26; CFI = 0.98; TLI = 0.98; NFI = 0.95; RMSEA = 0.04 (90% CI = 0.00, 10) and showed that subjective stress, but not coping strategies, mediated the effect of age on symptom cluster severity. CONCLUSIONS Lower levels of subjective stress, but not coping strategies, mediated the association of age with the symptom cluster of emotional distress, fatigue and cognitive difficulties. Further research is needed to explore differences in subjective stress by age.
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Affiliation(s)
- Inbar Levkovich
- The Division of Family Medicine, The Ruth & Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
| | - Miri Cohen
- School of Social Work, Faculty of Social Welfare and Health Sciences, University of Haifa, Israel.
| | - Shirly Alon
- Oncology Department, Meir Medical Center, Israel.
| | - Iryna Kuchuk
- Oncology Department, Meir Medical Center, Israel.
| | | | - Ella Evron
- Tel Aviv Sourasky Medical Center, Affiliated to Tel Aviv University, Sackler Faculty of Medicine, Israel.
| | | | - Georgeta Fried
- Oncology Unit, Rambam Health Care Campus, Haifa, Israel.
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Chung MC, Symons C, Gilliam J, Kaminski ER. Posttraumatic stress disorder, emotional suppression and psychiatric co-morbidity in patients with chronic idiopathic urticaria: a moderated mediation analysis. J Ment Health 2018; 27:442-449. [PMID: 29431522 DOI: 10.1080/09638237.2018.1437601] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND There is evidence suggesting that posttraumatic stress disorder (PTSD) symptom severity and CIU severity are linked and partially mediated by the high-anxious defense mechanism. What is unclear is whether emotional suppression, as a defense serving the opposite purpose for high-anxious defense, can also act as a mediator and whether this mediational effect is partly influenced by time since trauma and trauma type. AIMS To investigate whether emotional suppression mediated the links between PTSD and CIU symptom severities, and PTSD and psychiatric co-morbid symptom severities. It then examined whether the mediating effect would be moderated by how long ago the trauma occurred and trauma type. METHODS One hundred CIU patients were compared with 60 allergy patients. They completed questionnaires measuring PTSD, psychiatric co-morbidity and emotional suppression. RESULTS Suppressing depression mediated the relationship between PTSD and psychiatric co-morbidity. How long ago the trauma occurred and trauma type moderated the mediational effect of suppressing depression. CONCLUSIONS Following a past trauma, CIU patients may develop PTSD symptoms which influence their psychological well-being through using different levels of emotional suppression, especially suppressing depression. The levels depend on the severity of PTSD symptoms, trauma history and whether they experienced interpersonal traumas.
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Affiliation(s)
- Man Cheung Chung
- a Department of Educational Psychology, Faculty of Education , The Chinese University of Hong Kong , Shatin NT , Hong Kong , and
| | - Christine Symons
- b Department of Clinical Immunology & Allergy , Derriford Hospital , Plymouth , UK
| | - Jane Gilliam
- b Department of Clinical Immunology & Allergy , Derriford Hospital , Plymouth , UK
| | - Edward R Kaminski
- a Department of Educational Psychology, Faculty of Education , The Chinese University of Hong Kong , Shatin NT , Hong Kong , and
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Chung MC, Shakra M, AlQarni N, AlMazrouei M, Al Mazrouei S, Al Hashimi S. Posttraumatic Stress Among Syrian Refugees: Trauma Exposure Characteristics, Trauma Centrality, and Emotional Suppression. Psychiatry 2018; 81:54-70. [PMID: 29494788 DOI: 10.1080/00332747.2017.1354620] [Citation(s) in RCA: 45] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVES This study revisited the prevalence of posttraumatic stress disorder (PTSD) and examined a hypothesized model describing the interrelationship between trauma exposure characteristics, trauma centrality, emotional suppression, PTSD, and psychiatric comorbidity among Syrian refugees. METHODS A total of 564 Syrian refugees participated in the study and completed the Harvard Trauma Questionnaire, General Health Questionnaire (GHQ-28), Centrality of Event Scale, and Courtauld Emotional Control Scale. RESULTS Of the participants, 30% met the cutoff for PTSD. Trauma exposure characteristics (experiencing or witnessing horror and murder, kidnapping or disappearance of family members or friends) were associated with trauma centrality, which was associated with emotional suppression. Emotional suppression was associated with PTSD and psychiatric comorbid symptom severities. Suppression mediated the path between trauma centrality and distress outcomes. CONCLUSIONS Almost one-third of refugees can develop PTSD and other psychiatric problems following exposure to traumatic events during war. A traumatized identity can develop, of which life-threatening experiences is a dominant feature, leading to suppression of depression with associated psychological distress.
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Apenteng BA, Hansen AR, Opoku ST, Mase WA. Racial Disparities in Emotional Distress Among Cancer Survivors: Insights from the Health Information National Trends Survey (HINTS). JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2017; 32:556-565. [PMID: 26801510 DOI: 10.1007/s13187-016-0984-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The purpose of this study was to examine the impact of race, cancer history, and their interaction on emotional distress among a nationally representative sample of US adults. Data utilized for this analysis were obtained from the first, second, and fourth iterations of the fourth cycle of the Health Information National Trends Survey (HINTS). The study sample included 3959, 3630, and 3677 respondents for the years 2011, 2012, and 2014, respectively, for a total sample size of 11,266. A multivariable ordered logistic regression model was used to assess the relationship between emotional distress, race, and cancer history. The effect of cancer history on emotional distress was found to be moderated by race. Specifically, emotional distress was significantly higher among African American cancer survivors. Factors found to be protective against emotional distress included healthy lifestyle, older age, and higher income. Factors associated with high levels of emotional distress included poor general health status, low self-efficacy, and being female. The authors recommend the design, advancement, and implementation of evidence-based culturally sensitive interventions aimed at effectively screening and managing psychological distress symptoms, particularly among African American long-term cancer survivor patient populations.
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Affiliation(s)
- Bettye A Apenteng
- Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA, 30460, USA
| | - Andrew R Hansen
- Department of Community Health Behavior and Education, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA, 30460, USA.
| | - Samuel T Opoku
- Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA, 30460, USA
| | - William A Mase
- Department of Health Policy and Management, Jiann-Ping Hsu College of Public Health, Georgia Southern University, P.O. Box 8015, Statesboro, GA, 30460, USA
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Wirkner J, Weymar M, Löw A, Hamm C, Struck AM, Kirschbaum C, Hamm AO. Cognitive functioning and emotion processing in breast cancer survivors and controls: An ERP pilot study. Psychophysiology 2017; 54:1209-1222. [PMID: 28432781 DOI: 10.1111/psyp.12874] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2016] [Revised: 02/07/2017] [Accepted: 03/15/2017] [Indexed: 01/13/2023]
Abstract
Diagnosis and treatment of breast cancer is a very emotionally aversive and stressful life event, which can lead to impaired cognitive functioning and mental health. Breast cancer survivors responding with repressive emotion regulation strategies often show less adaptive coping and adverse outcomes. We investigated cognitive functioning and neural correlates of emotion processing using ERPs. Self-report measures of depression, anxiety, and fatigue, as well as hair cortisol as an index of chronic stress, were assessed. Twenty breast cancer survivors (BCS) and 31 carefully matched healthy controls participated in the study. After neuropsychological testing and subjective assessments, participants viewed 30 neutral, 30 unpleasant, and 30 pleasant pictures, and ERPs were recorded. Recognition memory was tested 1 week later. BCS reported stronger complaints about cognitive impairments and more symptoms of depression, anxiety, and fatigue. Moreover, they showed elevated hair cortisol levels. Except for verbal memory, cognitive functioning was predominantly in the normative range. Recognition memory performance was decreased in cancer survivors, especially for emotional contents. In ERPs, survivors showed smaller late positive potential amplitudes for unpleasant pictures relative to controls in a later time window, which may indicate less elaborative processing of this material. Taken together, we found cognitive impairments in BCS in verbal memory, impaired emotional picture memory accuracy, and reduced neural activity when breast cancer survivors were confronted with unpleasant materials. Further studies and larger sample sizes, however, are needed to evaluate the relationship between altered emotion processing and reduced memory in BCS in order to develop new treatment strategies.
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Affiliation(s)
- Janine Wirkner
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - Mathias Weymar
- Department of Psychology, University of Potsdam, Potsdam, Germany
| | - Andreas Löw
- University of the Federal Armed Forces Hamburg, Hamburg, Germany
| | - Carmen Hamm
- Psycho-oncological Outpatient Unit, Greifswald, Germany
| | - Anne-Marie Struck
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
| | - Clemens Kirschbaum
- Department of Psychology, Faculty of Science, Technische Universität Dresden, Dresden, Germany
| | - Alfons O Hamm
- Department of Biological and Clinical Psychology, University of Greifswald, Greifswald, Germany
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Goldblatt H, Cohen M, Azaiza F. Expression of emotions related to the experience of cancer in younger and older Arab breast cancer survivors. ETHNICITY & HEALTH 2016; 21:564-577. [PMID: 26895181 DOI: 10.1080/13557858.2016.1143089] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
OBJECTIVES Researchers have suggested that older adults express less negative emotions. Yet, emotional expression patterns in older and younger breast cancer survivors, have barely been examined. This study aimed to explore types and intensity of negative and positive emotional expression related to the breast cancer experience by younger and older Arab breast cancer survivors. DESIGN Participants were 20 younger (aged 32-50) and 20 older (aged 51-75) Muslim and Christian Arab breast cancer survivors (stages I-III), currently free of disease. Data were gathered through in-depth semi-structured interviews. Mixed methods analyses were conducted, including: (1) frequency analysis of participants' emotional expressions; (2) content analysis of emotional expressions, categorized according to negative and positive emotions. RESULTS Three emotional expression modalities were revealed: (1) Succinct versus comprehensive accounts; (2) expression of emotions versus avoidance of emotions; (3) patterns of expression of positive emotions and a sense of personal growth. Younger women provided more detailed accounts about their illness experiences than older women. Older women's accounts were succinct, action-focused, and included more emotion-avoiding expressions than younger women. CONCLUSIONS Understanding the relationships between emotional expression, emotional experience, and cancer survivors' quality of life, specifically of those from traditional communities, is necessary for developing effective psycho-social interventions.
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Affiliation(s)
| | - Miri Cohen
- b School of Social Work , University of Haifa , Haifa, Israel
| | - Faisal Azaiza
- b School of Social Work , University of Haifa , Haifa, Israel
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Chung MC, Di X, Wan KH. Exploring the interrelationship between alexithymia, defense style, emotional suppression, homicide-related posttraumatic stress disorder and psychiatric co-morbidity. Psychiatry Res 2016; 243:373-81. [PMID: 27449006 DOI: 10.1016/j.psychres.2016.05.057] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 05/30/2016] [Accepted: 05/31/2016] [Indexed: 11/19/2022]
Abstract
This study investigated the interrelationship between alexithymia, defense style, emotional suppression, posttraumatic stress disorder (PTSD) following homicide and psychiatric co-morbidity. One hundred and fifty male homicide perpetrators and 156 male perpetrators of non-violent crime completed the Posttraumatic Stress Diagnostic Scale (except for non-violent perpetrators), the General Health Questionnaire-28, the Defense Styles Questionnaire, the Courtauld Emotional Control Scale and the Toronto Alexithymia Scale-20. The results showed that 44% of homicide perpetrators met the criteria for PTSD. No significant differences were found between groups in alexithymia, defense style and psychiatric co-morbidity. Homicide perpetrators suppressed depression significantly more than the non-violent group. PLS analyses showed that alexithymia was significantly correlated with defense style. Defense styles were significantly correlated with emotional suppression which, in turn, was associated with homicide-related PTSD and psychiatric co-morbidity. To conclude, perpetrators can experience PTSD reactions following the act of homicide. The severity of these reactions and other psychological problems were related to difficulty getting in touch with distressing emotions, the defenses they used to protect themselves psychologically and the way they suppressed their emotion.
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Affiliation(s)
- Man Cheung Chung
- The Chinese University of Hong Kong, Department of Educational Psychology, Ho Tim Building, Faculty of Education, Shatin NT, Hong Kong, People's Republic of China.
| | - Xiaohu Di
- Faculty of Law, Nanjing University, People's Republic of China
| | - King Hung Wan
- Adjunct Researcher, Institute of Crime Prevention & Control, Faculty of Law, People's Republic of China
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18
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Khalaila R, Cohen M. Emotional suppression, caregiving burden, mastery, coping strategies and mental health in spousal caregivers. Aging Ment Health 2016; 20:908-17. [PMID: 26077991 DOI: 10.1080/13607863.2015.1055551] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The main aim was to explore the multiple mediation effects of personal resources (mastery, engagement and disengagement coping strategies) between caregiving burden and depression in spousal caregivers, based on integrated stress process models. A further aim was to examine whether emotional suppression moderates the relationship between perceived burden and depression. METHOD Cross-sectional data were collected in 2010-2011 by structured interviews from a sample of 110 spousal caregivers. Coefficients strategy with bootstrapping tested the strength and significance of the conditional indirect effects of simultaneous multiple mediators; and the conditional effect of burden on depression at different emotional suppression values. RESULTS Caregiving burden was indirectly associated with depression, through mastery and disengagement coping, but not through engagement coping. Mastery was negatively associated with depression, while disengagement coping was positively associated with depression. Emotional suppression and functional disability were positively associated with depressive symptoms. A significant burden-by-emotional suppression interaction was found for predicting depressive symptoms. CONCLUSION The study supports the conditional indirect effect in which burden can affect depression by reducing the mastery and increasing the disengagement coping simultaneously. The study provides also initial support for the moderating effect of emotional suppression, which can increase the deleterious effects of burden on depression. Researchers and practitioners should be aware of these issues of family care in spousal caregivers.
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Affiliation(s)
- Rabia Khalaila
- a Nursing Department , Zefat Academic College , Zefat , Israel
| | - Miri Cohen
- b Department of Gerontology, Faculty of Social welfare and Health Sciences , University of Haifa , Haifa , Israel
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Brandão T, Tavares R, Schulz MS, Matos PM. Measuring emotion regulation and emotional expression in breast cancer patients: A systematic review. Clin Psychol Rev 2016; 43:114-27. [DOI: 10.1016/j.cpr.2015.10.002] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 08/25/2015] [Accepted: 10/16/2015] [Indexed: 01/17/2023]
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Abstract
Qualitative methods provide us with techniques to access the pain experience of patients in ways that provide explanation for apparent contradictions and idiosyncrasies that are difficult to access. In this article, I review three such strategies and the application of qualitative research to practice: (1) the analysis of the ways participants speak about agonizing pain using narrative inquiry, (2) comparisons of childbirth pain in two cultural groups using ethnography and (3) present a qualitative theory, the Praxis Theory of Suffering. This theory provides a theoretical explanation for behaviours that presently confound the understanding of distress using the Distress Thermometer. An alternative approach, 'reading' patients' behavioural manifestations of distress, is recommended.
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Affiliation(s)
- Janice M Morse
- College of Nursing, University of Utah, Salt Lake City, UT, USA
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21
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Abstract
Distress is commonly experienced by people with cancer. The National Comprehensive Cancer Network (NCCN) developed a guideline for screening and managing distress in 1999 and has updated the guideline on an annual basis ever since. Using the five-phase framework for translational research, this article summarizes research findings related to the guideline and associated distress thermometer for each phase of translational research. The NCCN Distress Management Guideline is a useful tool to screen for and manage distress. However, additional research is needed, particularly in the areas of impact on outcomes of importance to patients.
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Morse JM, Pooler C, Vann-Ward T, Maddox LJ, Olausson JM, Roche-Dean M, Colorafi K, Madden C, Rogers B, Martz K. Awaiting diagnosis of breast cancer: strategies of enduring for preserving self. Oncol Nurs Forum 2015; 41:350-9. [PMID: 24969245 DOI: 10.1188/14.onf.350-359] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE/OBJECTIVES To explicate the emotional experiences of women undergoing breast cancer diagnosis who are waiting for the results of breast biopsy. RESEARCH APPROACH Glaserian Grounded Theory. SETTING Urban area in western Canada. PARTICIPANTS 37 women aged 32-76 years. The breast cancer diagnosis was positive for 11 women, negative for 24 women, and two results were unclear. METHODOLOGIC APPROACH Unstructured, recorded telephone interviews. FINDINGS Undergoing breast cancer diagnosis is a profoundly distressing experience dictated by diagnostic processes and procedures. Women rapidly transitioned from wellness to frightening phases of facing cancer to continuing terror during the testing phase. While waiting to hear results, women controlled their emotions, which enabled them to get through the experience and highlighted the protective function of enduring and its necessity for survival. The basic social psychological process, preserving self, is the outcome of enduring. CONCLUSIONS A mid-range theory, Awaiting Diagnosis: Enduring for Preserving Self, was developed. This theory explicates the emotional responses of women who were undergoing diagnosis for breast cancer and provides a theoretical behavioral basis for responding to cues and signals of suffering. INTERPRETATION The Praxis Theory of Suffering enables nurses to recognize and respond according to the behaviors of suffering, and to endure with healthy, adaptive, and normalizing behaviors that enable preserving self.
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Affiliation(s)
- Janice M Morse
- College of Nursing, University of Utah in Salt Lake City
| | - Charlotte Pooler
- Edmonton Zone of the Alberta Health Services and Faculty of Nursing, University of Alberta in Canada
| | | | - Lory J Maddox
- College of Nursing, University of Utah, Salt Lake City
| | | | | | - Karen Colorafi
- College of Nursing and Health Innovation, Arizona State University in Phoenix
| | | | | | - Kim Martz
- School of Nursing, Boise State University in Idaho
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Estes JM, Karten C. Nursing Expertise and the Evaluation of Psychosocial Distress in Patients With Cancer and Survivors. Clin J Oncol Nurs 2014; 18:598-600. [DOI: 10.1188/14.cjon.598-600] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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