Exploring emotion-regulation and autonomic physiology in metastatic breast cancer patients: Repression, suppression, and restraint of hostility

Abstract

We examined relationships between three emotion-regulation constructs and autonomic physiology in metastatic breast cancer patients (N = 31). Autonomic measures are not often studied in breast cancer patients and may provide evidence of an increase in allostatic load. Patients included participated as part of a larger clinical trial of supportive-expressive group therapy. Systolic and diastolic blood pressure and heart rate were assessed at a semi-annual follow-up. We averaged 3 resting assessments and used measures of Repression, Suppression, Restraint of Hostility, and Body Mass Index as predictors of autonomic response. We found that higher repression was significantly associated with higher diastolic blood pressure, while higher restraint of hostility was significantly associated with higher systolic blood pressure. A repressive emotion regulation style may be a risk factor for higher sympathetic activation possibly increasing allostatic load, while restraint of hostility may be a protective factor for women with metastatic breast cancer.Keywords emotion regulation; emotional expression; autonomic physiology; breast cancer; repression; suppression; hostility Studies have demonstrated that diminished emotional expressiveness is associated with health risks. For example, research has linked repression (low anxiety and high defensiveness) and suppression (deliberate withholding of the expression of negative emotions) with faster cancer progression and shorter survival (Bahnson, 1981;Fox, Harper, Hyner, & Lyle, 1994; GieseDavis & Spiegel, 2003;Greer, 1985;Greer & Morris, 1975;Gross, 1989;Kneier & Temoshok, 1984). In addition, an epidemiological study found that subjects likely to suppress anger were at greater mortality risk from all causes across age, sex, and education groups (Julius, E., Cottington, & Johnson, 1986). In the Julius study, suppressed anger significantly interacted with elevated blood pressure (BP) to predict the highest mortality risk (Julius et al., 1986). Three emotion inhibition processes may be associated with psychological and physiological indices of health in metastatic breast cancer patients: suppression, repression, and restraint of Corresponding Author: Janine Giese-Davis, Ph.D., 401 Quarry Rd., Rm 2318, Stanford, CA 94305-5718. (Phone) 650-498-5160. (Fax) 650-725-3762. jgiese@stanford.edu. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Repression is a defense mechanism in which a person is unable to remember or be cognitively aware of disturbing wishes, feelings, thoughts, or experiences ((Task Force on DSM-IV, 1994), pp. 756-757). ...

Characteristics of emotion regulation in recovered depressed versus never depressed individuals

“…psychophysiological variables (see Giese-Davis, Conrad, Nouriani, & Spiegel, 2008) to extend the findings. Because of the cross-sectional design, we cannot rule out alternative explanations for the findings, e.g., that differences between the groups may be the consequence of past depression in the sense of a scar effect or may even be due to symptom contamination as recovered depressed participants have experienced more intense emotion in the past than controls.…”

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).…”

Trait Mindfulness, Repression, Suppression, and Self‐Reported Mood and Stress Symptoms Among Women With Breast Cancer

“…One study comparing repressive versus nonrepressive cancer patients showed that repressors reported less severe chemotherapy‐induced side effects and less information exchange regarding their cancer with significant others (Ward, Leventhal, & Love, ), an example of a characterological repressive coping pattern. Despite few self‐reported health problems, repressors often exhibit aberrant autonomic physiology (Giese‐Davis, Conrad, Nouriani, & Spiegel, ) and diurnal cortisol secretion consistent with a stress response (Giese‐Davis, Sephton, Abercrombie, Duran, & Spiegel, ; Giese‐Davis, DiMiceli, Sephton, & Spiegel, ). These same physiological patterns have also been associated with early mortality in metastatic breast cancer patients (Sephton, Sapolsky, Kraemer, & Spiegel, ).…”