SPEAK UP and LIVE LONGER
by Annette L. Stanton, Ph.D. and Colleagues
Women's use of coping through emotional expression, such as
talking about their fears, following primary treatment for breast cancer is
associated with less distress and a better health outlook than for women who
avoid expressing their emotions, according to a new study of breast cancer
patients. The benefits of this type of coping are apparent even several
months following diagnosis and are associated with fewer medical
appointments for problems related to cancer and its treatment. The findings
appear in the October 2000 issue of the American Psychological Association's
(APA) Journal of Consulting and Clinical Psychology.
Lead author Annette L. Stanton, Ph.D., and other researchers from the
University of Kansas say their study of 92 women diagnosed with Stage I or
II breast cancer suggests that by expressing a sense of loss of control, for
example, "one may begin to distinguish what one can and cannot control to
channel energy toward attainable goals, and to generate alternate pathways
for bolstering control." The findings also suggest that repeated expression
of emotions may decrease negative emotions and the physiological arousal
that comes with it, leading cancer patients to think that their situation is
not as dire as originally thought and also find some benefit from their adversity.
The women participating in the study were recruited within 20 weeks after
completing primary treatment (surgery, chemotherapy, radiation) for breast
cancer. This time period was chosen to minimize the influence of the
different types of medical treatments and because of the increased distress
experienced during this time. Following their initial involvement in the
study, a three-month follow-up was conducted.
The findings imply that psychological training in coping skills designed to
facilitate emotional expression may bolster adjustment for women confronting
breast cancer, said the authors. For example, women may be more likely to
seek out support groups or develop other areas for expression, such as
writing. They add that these psychological and social interventions may
also lead to better physical health outcomes as the breast cancer patients
make more efficient use of medical care.
The researchers caution that there may be a point at which prolonged coping
through emotional processing becomes counterproductive. The study found
that although coping through emotional expression in recently diagnosed
women appears to facilitate psychological adjustment and reduce related need
for medical care over time, women who coped through emotional processing at
the beginning of the study became more distressed three months later. More
research is needed, say the authors, but "perhaps active engagement in the
attempt to understand one's emotions that continues from the time of
diagnosis through treatment termination reflects cognitive rumination
(chronically and passively thinking about feelings) which has been
demonstrated to exacerbate distress."
Article Citation: "Emotionally Expressive Coping Predicts Psychological and Physical
Adjustment to Breast Cancer," Annette L. Stanton, Ph.D., Sharon Danoff-Burg,
Ph.D., Christine L. Cameron, Ph.D., Michelle Bishop, Ph.D., Charlotte A.
Collins, Ph.D., Sarah B Kirk, Ph.D., and Lisa A. Sworowski, Ph.D.,
University of Kansas and Robert Twillman, Ph.D., University of Kansas
Medical Center; Journal of Consulting and Clinical Psychology, Vol. 68, No. 5.