ancer diagnosis and treatments can profoundly and, sometimes, irrevocably alter people's lives. The specter of death looms large at diagnosis, and the threat of c recurrence can evoke lasting concerns and distress. Cancer treatments are invasive, painful, and often create long-term negative side effects. Yet despite the dread, discomfort, and dysfunction associated with this disease, some individuals are able to maintain or quickly reestablish their precancer emotional equilibrium. Understanding this adjustment process is a primary goal of psychologists and health care providers who conduct psychosocial interventions with cancer patients (Andersen, 1992). By examining natural processes and predictors of adjustment in cancer patients, we can find clues to designing effective interventions.A primary predictor of emotional adjustment in people who have cancer is the quality of their interpersonal relationships in the recovery period. In particular, the availability of social support from close family and friends is associated with better adjustment (Glanz

The study examined how social constraints on discussion of a traumatic experience can interfere with cognitive processing of and recovery from loss. Bereaved mothers were interviewed at 3 weeks (T1), 3 months (T2), and 18 months (T3) after their infants' death. Intrusive thoughts at T1, conceptualized as a marker of cognitive processing, were negatively associated with talking about infant's death at T2 and T3 among socially constrained mothers. The reverse associations were found among unconstrained mothers. Controlling for initial level of distress, there was a positive relation between T1 intrusive thoughts and depressive symptoms over time among socially constrained mothers. However, higher levels of T1 intrusive thoughts were associated with a decrease in T3 depressive symptoms among mothers with unconstrained social relationships.

This article introduces the concept of social constraints on disclosure, puts it in a theoretical framework, and examines how it can affect adjustment to major life stressors using the exemplar of cancer. Cancer is a leading cause of death and disability worldwide. It is often life threatening, disfiguring, and unpredictable; hence, it can undermine people's basic and often positive beliefs and expectations about themselves, their future, and social relationships. For many people with cancer, it is important to come to terms psychologically with the illness -to make sense of or somehow accept the reality of it. People often do this by thinking about different aspects of the disease and its implications for their life, but also through socially processing, or talking about, their cancer-related thoughts, feelings, and concerns with others. When people experience social constraints on their disclosure of cancer-related thoughts and feelings, it can adversely affect how they think and talk about their illness, their coping behaviors, and psychological adjustment. In addition to discussing mechanisms and consequences of social constraints on disclosure, we discuss some of its determinants and future research directions.You seldom listen to me, and when you do you don't hear, and when you do hear you hear wrong, and even when you hear right you change it so fast that it's never the same.-Marjorie Kellogg, 1922Kellogg, -2005 Whenever we are compelled by others to regulate, restrict, or modify our thoughts, actions, or feelings, we are experiencing social constraints. From a sociological perspective, social constraints are objective, external circumstances, such as others' manner of acting, thinking, and feeling, which shape an individual's manner of acting, thinking, and feeling (Durkheim, 1982). Social constraints can be direct and coercive, as when police carry out laws through force, or indirect, as when individuals are shunned by neighbors for dressing or speaking in a particular way. This paper adopts 314 Social Constraints and Cancer a more social-psychological perspective on social constraints. According to this perspective, social constraints are the product of social facts -the actions, thoughts, and feelings of others -and individuals' psychological construal of those facts. Within the field of health psychology, the construct of social constraints is relatively new but is beginning to receive more attention as a predictor of stress, coping, and adjustment processes. This article examines social constraints on disclosure in the context of one major life stressor where it has been studied a good deal: coping with cancer. It is quite common for people to want to disclose thoughts and feelings related to cancer (Davison, Pennebaker, & Dickerson, 2000). If emotional disclosure is not possible or somehow discouraged, how does this influence coping, cognitive processing, and emotional reactions to cancer? Because cancer can be life threatening, disabling, and disfiguring, cancer survivors can experience difficulti...

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