nach oben

International Journal of Behavioral Medicine

Erschienen in:

13.11.2017

The Pain of Ambivalence over Emotional Expression

verfasst von: Carol Wang, Celia C. Y. Wong, Qian Lu

Erschienen in: International Journal of Behavioral Medicine | Ausgabe 2/2018

Einloggen, um Zugang zu erhalten

Abstract

Purpose

Ambivalence over emotional expression (AEE) is defined as the desire to express emotion but failing to do so. Recent studies have revealed that AEE is associated with more pain. Pain is common among cancer survivors. This cross-sectional study investigated the association between AEE and pain, its underlying mechanism, and cultural relevance among cancer survivors.

Methods

Ninety-six Chinese American breast cancer survivors completed a questionnaire package assessing AEE and pain.

Results

AEE was positively associated with pain severity and pain interference. The association between AEE and pain interference was mediated by intrusive thoughts.

Conclusion

Cancer survivors who are ambivalent over emotional expression may experience high levels of intrusive thoughts, which results in high levels of symptom reports in their pain. The study confirmed the association between AEE and pain and its underlying mechanism among a group whose culture generally encourages emotional suppression. Findings suggest interventions focusing on reducing intrusive thoughts may be effective at reducing pain.

Carson JW, Keefe FJ, Lowry KP, Porter LS, Goli V, Fras AM. Conflict about expressing emotions and chronic low back pain: associations with pain and anger. J Pain. 2007;8(5):405–11. https://doi.org/10.1016/j.jpain.2006.11.004.CrossRefPubMed

King LA, Emmons RA. Conflict over emotional expression: psychological and physical correlates. J Pers Soc Psychol. 1990;58:864–77. https://doi.org/10.1037/0022-3514.58.5.864.CrossRefPubMed

Lu Q, Uysal A, Teo I. Need satisfaction and catastrophizing: explaining the relationship among emotional ambivalence, pain, and depressive symptoms. J Health Psychol. 2011;16:819–27. https://doi.org/10.1177/1359105310392092.CrossRefPubMed

Norman SA, Lumley MA, Dooley JA, Diamond MP. For whom does it work? Moderators of the effects of written emotional disclosure in women with chronic pelvic pain. Psychosom Med. 2004;66:174–83. https://doi.org/10.1097/01.psy.0000116979.77753.74.CrossRefPubMed

Porter LS, Keefe FJ, Lipkus I, Hurwitz H. Ambivalence over emotional expression in patients with gastrointestinal cancer and their caregivers: associations with patient pain and quality of life. Pain. 2005;117(3):340–8. https://doi.org/10.1016/j.pain.2005.06.021.CrossRefPubMed

Servaes P, Vingerhoets AJJM, Vreugdenhil G, Keuning JJ, Broekhuijsen AM. Inhibition of emotional expression in breast cancer patients. Behav Med. 1999;25:23–7. https://doi.org/10.1080/08964289909596735.CrossRefPubMed

Tucker JS, Winkelman DK, Katz JN, Bermas BL. Ambivalence over emotional expression and psychological well-being among rheumatoid arthritis patients and their spouses. J Appl Soc Psychol. 1999;29(2):271–90. https://doi.org/10.1111/j.1559-1816.1999.tb01386.x.CrossRef

West SG, Aiken LS. Toward understanding individual effects in multicomponent prevention programs: design and analysis strategies. In: Bryant KJ, Window M, West SG, editors. The science of prevention: methodological advances from alcohol and substance abuse research. Washington, DC: American Psychological Association; 1997. p. 167–209.CrossRef

Manne S, Ostroff J, Winkel G, Goldstein L, Fox K, Grana G. Posttraumatic growth after breast cancer: patient, partner, and couple perspectives. Psychosom Med. 2004;66:442–54.PubMed

10.

Stanton AL, Danoff-Burg S, Sworowski LA, Collins CA, Branstetter AD, Rodriguez-Hanley A, et al. Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. J Clin Oncol. 2002;20:4160–8. https://doi.org/10.1200/JCO.2002.08.521.CrossRefPubMed

11.

Gold DB, Wegner DM. Origins of ruminative thought: trauma, incompleteness, nondisclosure, and suppression. J Appl Soc Psychol. 1995;25:1245–61.CrossRef

12.

Horowitz MJ. Stress-response syndromes: a review of posttraumatic and adjustment disorders. Hosp Community Psychiatry. 1986;47(3):241–9.

13.

Lu Q, Man J, You J, LeRoy AS. The link between ambivalence over-emotional expression and depressive symptoms among Chinese breast cancer survivors. J Psychosom Res. 2015; https://doi.org/10.1016/j.jpsychores.2015.01.007.

14.

Ashing KT, Padilla G, Tejero J, Kagawa-Singer M. Understanding the breast cancer experience of Asian American women. Psycho-Oncology. 2003;12(1):38–58. https://doi.org/10.1002/pon.632.CrossRef

15.

Figueiredo MI, Fries E, Ingram KM. The role of disclosure patterns and unsupportive social interactions in the well-being of breast cancer patients. Psycho-Oncology. 2004;13:96–105. https://doi.org/10.1002/pon.717.CrossRefPubMed

16.

Sue DW, Sue D. Counselling the culturally diverse: theory and practice. 5th ed. New York: Wiley; 2008.

17.

Kim HS, Sherman DK, Ko D, Taylor SE. Pursuit of comfort and pursuit of harmony: culture, relationships, and social support seeking. Personal Soc Psychol Bull. 2006;32:1595–607. https://doi.org/10.1177/0146167206291991.CrossRef

18.

Lee B. Ambivalence over emotional expression and symptom attribution are associated with self-reported somatic symptoms in Singaporean school adolescents. Asian J Soc Psychol. 2013;16:169–80. https://doi.org/10.1111/ajsp.12005.CrossRef

19.

Parker G, Gladstone G, Chee KT. Depression in the planet’s largest ethnic group: the Chinese. Am J Psychiatr. 2001;158:857–64.CrossRefPubMed

20.

Lu Q, Stanton AL. How benefits of expressive writing vary as a function of writing instructions, ethnicity and ambivalence over emotional expression. Psychol Health. 2010;25:669–84. https://doi.org/10.1080/08870440902883196.CrossRefPubMed

21.

Zhou X, Dere J, Zhu X, Yao S, Chentsova-Dutton YE, Ryder AG. Anxiety symptom presentations in Han Chinese and Euro-Canadian outpatients: is distress always somatized in China? J Affect Disord. 2011;135(1–3):111–4. https://doi.org/10.1016/j.jad.2011.06.049.CrossRefPubMed

22.

Lepore SJ. A social-cognitive processing model of emotional adjustment to cancer. In: Baum A, Anderson B, editors. Psychosocial interventions for cancer. Washington, DC: American Psychological Association; 2001. p. 99–116.CrossRef

23.

Lepore SJ, Helgeson V. Social constraints, intrusive thoughts, and mental health in prostate cancer survivors. J Soc Clin Psychol. 1998;17:89–106. https://doi.org/10.1521/jscp.1998.17.1.89.CrossRef

24.

Lepore SJ, Silver RC, Wortman CB, Wayment HA. Social constraints, intrusive thoughts, and depressive symptoms among bereaved mothers. J Pers Soc Psychol. 1996;70:271–82.CrossRefPubMed

25.

Zakowski SG, Valdimarsdottir HB, Bovbjerg DH. Emotional expressivity and intrusive cognitions in women with family histories of breast cancer: application of a cognitive processing model. Br J Health Psychol. 2001;6:151–65.CrossRefPubMed

26.

Dupont A, Bower JE, Stanton AL, Ganz PA. Cancer-related intrusive thoughts predict behavioral symptoms following breast-cancer treatment. Health Psychol. 2014;33(2):155–63. https://doi.org/10.1037/a0031131.CrossRefPubMed

27.

McEwen BS, Seeman T. Protective and damaging effects of mediators of stress: elaborating and testing the concepts of allostasis and allostatic load. Ann N Y Acad Sci. 1999;896(1):30–47. https://doi.org/10.1111/j.1749-6632.1999.tb08103.x.CrossRefPubMed

28.

Chen SX, Cheung FM, Bond MH, Leung J. Decomposing the construct of ambivalence over emotional expression in a Chinese cultural context. Eur J Personal. 2005;19:185–204. https://doi.org/10.1002/per.538.CrossRef

29.

Horowitz MJ, Wilner N, Alvarez W. Impact of event scale: a measure of subjective stress. Psychosom Med. 1979;41:209–18.CrossRefPubMed

30.

Cleeland CS, Nakamura Y, Mendoza TR, Edwards KR, Douglas J, Serlin RC. Dimensions of the impact of cancer pain in a four country sample: new information from multidimensional scaling. Pain. 1996;67:267–73.CrossRefPubMed

31.

Wang XS, Mendoza TR, Gao S, Cleeland CS. The Chinese version of the brief pain inventory (BPI-C): its development and use in a study of cancer pain. Pain. 1996;67:407–16. https://doi.org/10.1016/0304-3959(96)03147-8.CrossRefPubMed

32.

Stephenson M. Development and validation of the Stephenson Multigroup Acculturation Scale (SMAS). Psychol Assess. 2000;12(1):77–88. https://doi.org/10.1037/1040-3590.12.1.77.CrossRefPubMed

33.

Hayes AF. Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. New York: The Guilford Press; 2013.

34.

Preacher KJ, Hayes AF. Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods. 2008;40:879–91.CrossRefPubMed

35.

Kelley JE, Lumley MA, Leisen JCC. Health effects of emotional disclosure in rheumatoid arthritis patients. Health Psychol. 1997;16:331–40. https://doi.org/10.1037/0278-6133.16.4.331.CrossRefPubMed

36.

Dere J, Sun J, Zhao Y, Persson TJ, Zhu X, Yao S, et al. Beyond “somatization” and “psychologization”: symptom-level variation in depressed Han Chinese and Euro-Canadian outpatients. Front Psychol. 2013;4:377. https://doi.org/10.3389/fpsyg.2013.00377.CrossRefPubMedPubMedCentral

37.

Emmons RA, Colby P. Emotional conflict and interpersonal processes: linking ambivalence and repression to social support. J Pers Soc Psychol. 1995;68:947–59.CrossRefPubMed

38.

King LA. Emotional expression ambivalence over emotional expression, and marital satisfaction. J Soc Pers Relat. 1993;10:601–17. https://doi.org/10.1177/0265407593104008.CrossRef

39.

Butler EA, Lee TL, Gross JJ. Does expressing your emotions raise or lower your blood pressure? J Cross-Cult Psychol. 2009;40:510–7. https://doi.org/10.1177/0022022109332845.CrossRefPubMedPubMedCentral

40.

Soto JA, Levenson RW, Ebling R. Cultures of moderation and expression: emotional experience, behavior, and physiology in Chinese Americans and Mexican Americans. Emotion. 2005;5:154–65. https://doi.org/10.1037/1528-3542.5.2.154.CrossRefPubMed

41.

Hill CL, Updegraff JA. Mindfulness and its relationship to emotional regulation. Emotion. 2012;12(1):81–90. https://doi.org/10.1037/a0026355.CrossRefPubMed

42.

Arch JJ, Craske MG. Laboratory stressors in clinically anxious and non-anxious individuals: the moderating role of mindfulness. Behav Res Ther. 2010;48(6):495–505. https://doi.org/10.1016/j.brat.2010.02.005.CrossRefPubMed

43.

Speca M, Carlson LE, Goodey E, Maureen A. A randomized, wait-list controlled clinical trial: the effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosom Med. 2000;62(5):613–22.CrossRefPubMed

44.

Feldman G, Greeson J, Senville J. Differential effects of mindful breathing, progressive muscle relaxation, and loving-kindness meditation on decentering and negative reactions to repetitive thoughts. Behav Res Ther. 2010;48(10):1002–11. https://doi.org/10.1016/j.brat.2010.06.006.CrossRefPubMedPubMedCentral

45.

Lu Q, Wong C, Gallagher M, Tou R, Young L, Loh A. Expressive writing among Chinese American breast cancer survivors: a randomized controlled trial. J Health Psychol. 2016; https://doi.org/10.1037/hea0000449.

46.

Banks SM, Kerns RD. Explaining high rates of depression in chronic pain: a diathesis-stress framework. Psychol Bull. 1996;119(1):95–110. https://doi.org/10.1037/0033-2909.119.1.95.CrossRef

Titel: The Pain of Ambivalence over Emotional Expression
verfasst von: Carol Wang
Celia C. Y. Wong
Qian Lu
Publikationsdatum: 13.11.2017
Verlag: Springer US
Erschienen in: International Journal of Behavioral Medicine / Ausgabe 2/2018
Print ISSN: 1070-5503
Elektronische ISSN: 1532-7558
DOI: https://doi.org/10.1007/s12529-017-9696-6

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 2/2018

Predictors of Daily Pain Medication Use in Individuals with Recurrent Back Pain

Validation of an Egyptian Arabic Version of Skindex-16 and Quality of Life Measurement in Egyptian Patients with Skin Disease

Perseverative Cognition as an Explanatory Mechanism in the Relation Between Job Demands and Sleep Quality

Type D Personality and Sleep Quality in Coronary Artery Disease Patients With and Without Obstructive Sleep Apnea: Mediating Effects of Anxiety and Depression

Correction to: Mild Depression in Low Back Pain: the Interaction of Thought Suppression and Stress Plays a Role, Especially in Female Patients

Sources of Variability in Physical Activity Among Inactive People with Multiple Sclerosis