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.


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