Responses to messages about health behaviors: The influence of repressive coping

The relationship between two types of impaired emotion processing: repressive coping and alexithymia

The constructs of repressive coping and alexithymia are both related to impaired emotion processing, yet individuals with a repressive coping style (repressors) score lower than controls on standard self-report measures of alexithymia. A large body of evidence indicates that repressors avoid negative affect. Therefore, the current study examined the relationship between repressive coping and alexithymia by using independently-rated interviews with the aim of bypassing repressors’ tendency of avoiding negative affect. Results showed that repressors scored high on alexithymia, similar to anxious individuals on the independently-rated interview, but scored low on alexithymia on a questionnaire measure. Our findings confirm a link between alexithymia and repressive coping and stress the need for non-standard measures in exploring the nature of the relationship between repressive coping and alexithymia.

The Psychological Evaluation of Patients with Chronic Pain: a Review of BHI 2 Clinical and Forensic Interpretive Considerations

Pain is the most common reason why patients see a physician. Within the USA, it has been estimated that at least 116 million US adults suffer from chronic pain, with an estimated annual national economic cost of $560-635 billion. While pain is in part a sensory process, like sight, touch, or smell, pain is also in part an emotional experience, like depression, anxiety, or anger. Thus, chronic pain is arguably the quintessential biopsychosocial condition. Due to the overwhelming evidence of the biopsychosocial nature of pain and the value of psychological assessments, the majority of chronic pain guidelines recommend a psychological evaluation as an integral part of the diagnostic workup. One biopsychosocial inventory designed for the assessment of patients with chronic pain is the Battery for Health Improvement 2 (BHI 2). The BHI 2 is a standardized psychometric measure, with three validity measures, 16 clinical scales, and a multidimensional assessment of pain. This article will review how the BHI 2 was developed, BHI 2 concepts, validation research, and an overview of the description and interpretation of its scales. Like all measures, the BHI 2 has strengths and weaknesses of which the forensic psychologist should be aware, and particular purposes for which it is best suited. Guided by that knowledge, the BHI 2 can play a useful role in the forensic psychologist's toolbox.

Fact or artefact: an item response theory analysis of median split based repressor classification

OBJECTIVE

Many studies have investigated the phenomenon of repression. Repressors are defined as individuals who deny or avoid the experience of negative affect. A common method for the identification of repressors is a median split approach using questionnaires that measure anxiety and social desirability. The present study aimed to evaluate this most frequently used procedure using a psychometric model.

DESIGN

We applied item response theory using model assumptions comparable with those of the median split approach to detect repressors and examine the appropriateness of the median split procedure.

METHODS

A mixed sample of 655 students and members of the general public completed the two scales usually used to identify repressors, namely the Taylor Manifest Anxiety Scale and the Marlowe-Crowne Social Desirability Scale.

RESULTS

Employing item response theory mixture-model analyses, we were unable to replicate the median split solution on a latent level.

CONCLUSIONS

Our results did not support the identification of repressors via dichotomization of the two scales. The median split approach does not appear to detect repressors satisfactorily. The implications of the results for the conceptualization and assessment of repressors are discussed.

Could repressive coping be a mediating factor in the symptom profile of individuals diagnosed with schizophrenia?

Despite a relatively high prevalence, and the enduring patronage of the disorder by psychiatry and the pharmaceutical industry, innovative conceptualization of schizophrenia in a client-empowering and quality of life-enhancing way appears to represent a vacuum within the clinical agenda, certainly taking second place to 'patient management'. However, against this bland background of medicalization of what is clearly a poorly understood and complex multifactorial syndrome, innovative treatment approaches aimed at symptom control, in particular, the stress vulnerability model (SVM), have been developed. However, the SVM is an incomplete model of patient experience and says little of aetiological note. One area of psychological function that may give further insight into the symptom experience associated with schizophrenia within the context of stress vulnerability concerns the mechanisms of repression. Ironically, the notion of repression will for many represent the epitome of nonevidence-based psychiatric theory and related psychodynamic therapy practice. However, more contemporary work within the psychological literature has aimed to make the concept both measurable and observable. No longer occluded by the context of psychoanalysis, cognitive science accounts of repression may be of value in facilitating understanding of the variability and predictability of symptoms of schizophrenia and may provide a dimension of therapeutic engagement allied to the SVM.

The importance of the repressive coping style: findings from 30 years of research

During the last three decades there has been substantial research exploring the repressive coping style as defined by Weinberger, Schwartz, and Davidson. As "repressors," who score low on trait anxiety and high on defensiveness, account for up to 50% of certain populations, they are an essential group for psychologists to study. However, there are methodological issues in identifying repressors as well as considerable evidence that repressors avoid negative self-relevant information. Possible methods of addressing these difficulties are discussed in this review. Importantly, there is a body of evidence linking repressive coping and poor physical health, including heart disease and cancer. However, some preliminary findings suggest that repressors compared to non-repressors may be better at health behaviors that they perceive as under their personal control. This needs more extensive investigation as such behaviors are only one aspect of health and other factors may contribute to repressors' poor physical health. Possible future directions of research are discussed including: the need for systematic empirical research of a new theory of repressive coping--the Vigilance-Avoidance Theory--more longitudinal health studies, and an in-depth exploration of the physiological mechanisms which may underlie repressive coping.