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10-06-2016

Implicit loneliness, emotion regulation, and depressive symptoms in breast cancer survivors

Auteurs: Brett Marroquín, Johanna Czamanski-Cohen, Karen L. Weihs, Annette L. Stanton

Gepubliceerd in: Journal of Behavioral Medicine | Uitgave 5/2016

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Abstract

Among individuals coping with cancer, emotional approach coping—expressing and processing emotions following negative events—has been identified as a potentially adaptive form of emotion regulation. However, its mental health benefits may depend on social-cognitive factors and on how it is implemented. This study examined loneliness as a determinant of emotion regulation associations with depressive symptoms in women with breast cancer. Loneliness was examined as an implicit social-cognitive phenomenon (i.e., automatic views of oneself as lonely), and emotional expression and processing were examined as both explicit and implicit processes. Approximately 11 months after diagnosis, 390 women completed explicit measures of coping through cancer-related emotional expression and processing; an implicit measure of expression and processing (an essay-writing task submitted to linguistic analysis); and an implicit association test measuring loneliness. Depressive symptoms were assessed 3 months later. Regardless of implicit loneliness, self-reported emotional expression (but not emotional processing) predicted fewer depressive symptoms, whereas implicit expression of negative emotion during essay-writing predicted more symptoms. Only among women high in implicit loneliness, less positive emotional expression and more causal processing during the writing task predicted more depressive symptoms. Results suggest that explicit and implicit breast cancer-related emotion regulation have distinct relations with depressive symptoms, and implicit loneliness moderates effects of implicit emotional approach. Findings support implicit processes as influential mechanisms of emotion regulation and suggest targets for intervention among breast cancer survivors.
Voetnoten
1
For the present purposes, we use the term “cancer survivor” as defined by both the American Cancer Society and the National Cancer Institute, which includes anyone diagnosed with cancer through the end of life, regardless of treatment or remission.
 
2
Dropout was significantly more frequent at UCLA (62 women; 21 %) than at the University of Arizona (8 women; 5 %); the 9-month sample thus included proportionally more women at the University of Arizona (40 %) versus UCLA (60 %) compared to study entry (Arizona 35 %, UCLA 65 %), χ2(1) = 20.80, p < .001. Dropouts were significantly younger, M = 52.5 years, SD = 13.9, than women retained at 9 months (see Table 1), t(450) = −2.75, p = .006, d = −0.36. Cancer stage among dropouts was (stages 1, 2, 3, and 4 respectively) 29 (42 %), 23 (33 %), 8 (12 %), and 9 (13 %), and differed significantly from retained participants, χ2(3) = 9.34, p = .025, with proportionally fewer stage 2 and 4 participants in the 9-month sample. Dropout and retained participants did not differ significantly in ethnicity, χ2(7) = 5.84, p = .56, relationship status, χ2(5) = 6.24, p = .28, education, χ2(5) = 3.69, p = .60, income, χ2(3) = 3.90, p = .27, or depressive symptoms at study entry, t(451) = 1.85, p = .07.
 
Literatuur
go back to reference American Cancer Society. (2013). Breast cancer facts & figures 2013–2014. Atlanta: American Cancer Society Inc. American Cancer Society. (2013). Breast cancer facts & figures 2013–2014. Atlanta: American Cancer Society Inc.
go back to reference Carver, C. S., Smith, R. G., Antoni, M. H., Petronis, V. M., Weiss, S., & Derhagopian, R. P. (2005). Optimistic personality and psychosocial well-being during treatment predict psychosocial well-being among long-term survivors of breast cancer. Health Psychology, 24, 508–516.CrossRefPubMed Carver, C. S., Smith, R. G., Antoni, M. H., Petronis, V. M., Weiss, S., & Derhagopian, R. P. (2005). Optimistic personality and psychosocial well-being during treatment predict psychosocial well-being among long-term survivors of breast cancer. Health Psychology, 24, 508–516.CrossRefPubMed
go back to reference Creswell, J. D., Lam, S., Stanton, A. L., Taylor, S. E., Bower, J. E., & Sherman, D. K. (2007). Does self-affirmation, cognitive processing, or discovery of meaning explain cancer-related health benefits of expressive writing? Personality and Social Psychology Bulletin, 33, 238–250. doi:10.1177/0146167206294412 CrossRefPubMed Creswell, J. D., Lam, S., Stanton, A. L., Taylor, S. E., Bower, J. E., & Sherman, D. K. (2007). Does self-affirmation, cognitive processing, or discovery of meaning explain cancer-related health benefits of expressive writing? Personality and Social Psychology Bulletin, 33, 238–250. doi:10.​1177/​0146167206294412​ CrossRefPubMed
go back to reference Cuijpers, P., Vogelzangs, N., Twisk, J., Kleiboer, A., Li, J., & Penninx, B. W. (2014). Comprehensive meta-analysis of excess mortality in depression in the general community versus patients with specific illnesses. American Journal of Psychiatry, 171, 453–462. doi:10.1176/appi.ajp.2013.13030325 CrossRefPubMed Cuijpers, P., Vogelzangs, N., Twisk, J., Kleiboer, A., Li, J., & Penninx, B. W. (2014). Comprehensive meta-analysis of excess mortality in depression in the general community versus patients with specific illnesses. American Journal of Psychiatry, 171, 453–462. doi:10.​1176/​appi.​ajp.​2013.​13030325 CrossRefPubMed
go back to reference DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 160, 2101–2107. doi:10.1001/archinte.160.14.2101 CrossRefPubMed DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 160, 2101–2107. doi:10.​1001/​archinte.​160.​14.​2101 CrossRefPubMed
go back to reference Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8, 430–457. doi:10.1207/S15328007SEM0803_5 CrossRef Enders, C. K., & Bandalos, D. L. (2001). The relative performance of full information maximum likelihood estimation for missing data in structural equation models. Structural Equation Modeling, 8, 430–457. doi:10.​1207/​S15328007SEM0803​_​5 CrossRef
go back to reference Giese-Davis, J., Collie, K., Rancourt, K. M., Neri, E., Kraemer, H. C., & Spiegel, D. (2011). Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: A secondary analysis. Journal of Clinical Oncology, 29, 413–420. doi:10.1200/JCO.2010.28.4455 CrossRefPubMed Giese-Davis, J., Collie, K., Rancourt, K. M., Neri, E., Kraemer, H. C., & Spiegel, D. (2011). Decrease in depression symptoms is associated with longer survival in patients with metastatic breast cancer: A secondary analysis. Journal of Clinical Oncology, 29, 413–420. doi:10.​1200/​JCO.​2010.​28.​4455 CrossRefPubMed
go back to reference Hann, D., Winter, K., & Jacobsen, P. (1999). Measurement of depressive symptoms in cancer patients: Evaluation of the Center for Epidemiological Studies Depression Scale (CES-D). Journal of Psychosomatic Research, 46, 437–443. doi:10.1016/S0022-3999(99)00004-5 CrossRefPubMed Hann, D., Winter, K., & Jacobsen, P. (1999). Measurement of depressive symptoms in cancer patients: Evaluation of the Center for Epidemiological Studies Depression Scale (CES-D). Journal of Psychosomatic Research, 46, 437–443. doi:10.​1016/​S0022-3999(99)00004-5 CrossRefPubMed
go back to reference Jaremka, L. M., Fagundes, C. P., Glaser, R., Bennett, J. M., Malarkey, W. B., & Kiecolt-Glaser, J. K. (2013). Loneliness predicts pain, depression, and fatigue: Understanding the role of immune dysregulation. Psychoneuroendocrinology, 38, 1310–1317. doi:10.1016/j.psyneuen.2012.11.016 CrossRefPubMed Jaremka, L. M., Fagundes, C. P., Glaser, R., Bennett, J. M., Malarkey, W. B., & Kiecolt-Glaser, J. K. (2013). Loneliness predicts pain, depression, and fatigue: Understanding the role of immune dysregulation. Psychoneuroendocrinology, 38, 1310–1317. doi:10.​1016/​j.​psyneuen.​2012.​11.​016 CrossRefPubMed
go back to reference Juth, V., Dickerson, S. S., Zoccola, P. M., & Lam, S. (2015). Understanding the utility of emotional approach coping: Evidence from a laboratory stressor and daily life. Anxiety, Stress, & Coping, 28, 50–70.CrossRef Juth, V., Dickerson, S. S., Zoccola, P. M., & Lam, S. (2015). Understanding the utility of emotional approach coping: Evidence from a laboratory stressor and daily life. Anxiety, Stress, & Coping, 28, 50–70.CrossRef
go back to reference Kroenke, C. H., Kwan, M. L., Neugut, A. I., Ergas, I. J., Wright, J. D., Caan, B. J., & Kushi, L. H. (2013). Social networks, social support mechanisms, and quality of life after breast cancer diagnosis. Breast Cancer Research and Treatment, 139, 515–527. doi:10.1007/s10549-013-2477-2 CrossRefPubMedPubMedCentral Kroenke, C. H., Kwan, M. L., Neugut, A. I., Ergas, I. J., Wright, J. D., Caan, B. J., & Kushi, L. H. (2013). Social networks, social support mechanisms, and quality of life after breast cancer diagnosis. Breast Cancer Research and Treatment, 139, 515–527. doi:10.​1007/​s10549-013-2477-2 CrossRefPubMedPubMedCentral
go back to reference Marroquín, B. M., Fontes, M., Scilletta, A., & Miranda, R. (2010). Ruminative subtypes and coping responses: Active and passive pathways to depressive symptoms. Cognition and Emotion, 24, 1446–1455. doi:10.1080/02699930903510212 CrossRef Marroquín, B. M., Fontes, M., Scilletta, A., & Miranda, R. (2010). Ruminative subtypes and coping responses: Active and passive pathways to depressive symptoms. Cognition and Emotion, 24, 1446–1455. doi:10.​1080/​0269993090351021​2 CrossRef
go back to reference Mitchell, A. J., Chan, M., Bhatti, H., Halton, M., Grassi, L., Johansen, C., & Meader, N. (2011). Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: A meta-analysis of 94 interview-based studies. Lancet Oncology, 12, 160–174. doi:10.1016/S1470-2045(11)70002-X CrossRefPubMed Mitchell, A. J., Chan, M., Bhatti, H., Halton, M., Grassi, L., Johansen, C., & Meader, N. (2011). Prevalence of depression, anxiety, and adjustment disorder in oncological, haematological, and palliative-care settings: A meta-analysis of 94 interview-based studies. Lancet Oncology, 12, 160–174. doi:10.​1016/​S1470-2045(11)70002-X CrossRefPubMed
go back to reference Muthén, L. K., & Muthén, B. O. (1998–2012). Mplus user’s guide (7th ed.). Los Angeles, CA: Muthén & Muthén. Muthén, L. K., & Muthén, B. O. (1998–2012). Mplus user’s guide (7th ed.). Los Angeles, CA: Muthén & Muthén.
go back to reference Nausheen, B., Carr, N. J., Peveler, R. C., Moss-Morris, R., Verrill, C., Robbins, E., & Gidron, Y. (2010). Relationship between loneliness and proangiogenic cytokines in newly diagnosed tumors of colon and rectum. Psychosomatic Medicine, 72, 912–916. doi:10.1097/PSY.0b013e3181f0bc1c CrossRefPubMed Nausheen, B., Carr, N. J., Peveler, R. C., Moss-Morris, R., Verrill, C., Robbins, E., & Gidron, Y. (2010). Relationship between loneliness and proangiogenic cytokines in newly diagnosed tumors of colon and rectum. Psychosomatic Medicine, 72, 912–916. doi:10.​1097/​PSY.​0b013e3181f0bc1c​ CrossRefPubMed
go back to reference Nausheen, B., Gidron, Y., Gregg, A., Tissarchondou, H. S., & Peveler, R. (2007). Loneliness, social support and cardiovascular reactivity to laboratory stress. Stress: The International Journal on the Biology of Stress, 10, 37–44. doi:10.1080/10253890601135434 CrossRef Nausheen, B., Gidron, Y., Gregg, A., Tissarchondou, H. S., & Peveler, R. (2007). Loneliness, social support and cardiovascular reactivity to laboratory stress. Stress: The International Journal on the Biology of Stress, 10, 37–44. doi:10.​1080/​1025389060113543​4 CrossRef
go back to reference Nosek, B. A., Greenwald, A. G., & Banaji, M. R. (2007). The implicit association test at age 7: A methodological and conceptual review. In J. A. Bargh (Ed.), Social psychology and the unconscious: The automaticity of higher mental processes (pp. 265–292). New York, NY: Psychology Press. Nosek, B. A., Greenwald, A. G., & Banaji, M. R. (2007). The implicit association test at age 7: A methodological and conceptual review. In J. A. Bargh (Ed.), Social psychology and the unconscious: The automaticity of higher mental processes (pp. 265–292). New York, NY: Psychology Press.
go back to reference Pennebaker, J. W., Booth, R. J., & Francis, M. E. (2007a). Linguistic inquiry and word count: LIWC [computer software]. Austin, TX: LIWC.net. Pennebaker, J. W., Booth, R. J., & Francis, M. E. (2007a). Linguistic inquiry and word count: LIWC [computer software]. Austin, TX: LIWC.net.
go back to reference Pennebaker, J. W., Chung, C. K., Ireland, M., Gonzales, A., & Booth, R. J. (2007b). The development and psychometric properties of LIWC2007 [LIWC manual]. Austin, TX: LIWC.net. Pennebaker, J. W., Chung, C. K., Ireland, M., Gonzales, A., & Booth, R. J. (2007b). The development and psychometric properties of LIWC2007 [LIWC manual]. Austin, TX: LIWC.net.
go back to reference Stanton, A. L., Danoff-Burg, S., Cameron, C. L., Bishop, M., Collins, C. A., Kirk, S. B., & Twillman, R. (2000a). Emotionally expressive coping predicts psychological and physical adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 68, 875–882. doi:10.1037/0022-006X.68.5.875 CrossRefPubMed Stanton, A. L., Danoff-Burg, S., Cameron, C. L., Bishop, M., Collins, C. A., Kirk, S. B., & Twillman, R. (2000a). Emotionally expressive coping predicts psychological and physical adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 68, 875–882. doi:10.​1037/​0022-006X.​68.​5.​875 CrossRefPubMed
go back to reference Stanton, A. L., Danoff-Burg, S., & Huggins, M. E. (2002). The first year after breast cancer diagnosis: Hope and coping strategies as predictors of adjustment. Psycho-Oncology, 11, 93–102. doi:10.1002/pon.574 CrossRefPubMed Stanton, A. L., Danoff-Burg, S., & Huggins, M. E. (2002). The first year after breast cancer diagnosis: Hope and coping strategies as predictors of adjustment. Psycho-Oncology, 11, 93–102. doi:10.​1002/​pon.​574 CrossRefPubMed
go back to reference Steiner, J. F., Cavender, T. A., Nowels, C. T., Beaty, B. L., Bradley, C. J., Fairclough, D. L., & Main, D. S. (2008). The impact of physical and psychosocial factors on work characteristics after cancer. Psychooncology, 17, 138–147. doi:10.1002/pon.1204 CrossRefPubMed Steiner, J. F., Cavender, T. A., Nowels, C. T., Beaty, B. L., Bradley, C. J., Fairclough, D. L., & Main, D. S. (2008). The impact of physical and psychosocial factors on work characteristics after cancer. Psychooncology, 17, 138–147. doi:10.​1002/​pon.​1204 CrossRefPubMed
go back to reference Vine, V., & Aldao, A. (2014). Impaired emotional clarity and psychopathology: A transdiagnostic deficit with symptom-specific pathways through emotion regulation. Journal of Social and Clinical Psychology, 33, 319–342. doi:10.1521/jscp.2014.33.4.319 CrossRef Vine, V., & Aldao, A. (2014). Impaired emotional clarity and psychopathology: A transdiagnostic deficit with symptom-specific pathways through emotion regulation. Journal of Social and Clinical Psychology, 33, 319–342. doi:10.​1521/​jscp.​2014.​33.​4.​319 CrossRef
Metagegevens
Titel
Implicit loneliness, emotion regulation, and depressive symptoms in breast cancer survivors
Auteurs
Brett Marroquín
Johanna Czamanski-Cohen
Karen L. Weihs
Annette L. Stanton
Publicatiedatum
10-06-2016
Uitgeverij
Springer US
Gepubliceerd in
Journal of Behavioral Medicine / Uitgave 5/2016
Print ISSN: 0160-7715
Elektronisch ISSN: 1573-3521
DOI
https://doi.org/10.1007/s10865-016-9751-9

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