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Affect regulation as a moderator of intentions for breast cancer chemoprevention

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Abstract

Women at high risk for breast cancer (BC) may consider chemoprevention for risk reduction, but uptake is low. This study examined the role of affect regulation (the attempt to alter or control one’s emotions) in decision-making about BC chemoprevention. A cross-sectional, single group design was used. High-risk women (N = 81) were surveyed. Moderation analyses specified cancer-specific distress as the independent variable, affect regulation (cognitive reappraisal or expressive suppression) as the moderator, and chemoprevention intentions (yes = 1, unsure = 0, no = -1) as the dependent variable. Cognitive reappraisal significantly moderated the relationship between cancer-specific distress and chemoprevention intentions (p = 0.03), but expressive suppression did not (p = 0.31). For the 44% of participants who were highest on reappraisal, higher cancer-specific distress was associated with greater intentions for chemoprevention. For the remaining 56%, there was no relationship between cancer-specific distress and chemoprevention intentions. Cognitive reappraisal may play an important role in decisions regarding uptake of chemoprevention.

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Data availability

Anonymized data that support the findings of this study are available in the Open Science Framework at osf.io/438p9 and will be made available by the corresponding author upon reasonable request.

References

  • Baziliansky, S., & Cohen, M. (2021). Emotion regulation and psychological distress in cancer survivors: A systematic review and meta-analysis. Stress and Health, 37, 3–18.

    Article  Google Scholar 

  • Cella, D. F., Mahon, S. M., & Donovan, M. I. (1990). Cancer recurrence as a traumatic event. Behavioral Medicine, 16, 15–22.

    Article  CAS  Google Scholar 

  • Conley, C. C., Agnese, D. M., Vadaparampil, S. T., & Andersen, B. L. (2019). Factors associated with intentions for breast cancer risk management: Does risk group matter? Psycho-Oncology, 28, 1119–1126.

    PubMed  Google Scholar 

  • Cutuli, D. (2014). Cognitive reappraisal and expressive suppression strategies role in the emotion regulation: An overview on their modulatory effects and neural correlates. Frontiers in Systems Neuroscience, 8, 175.

    Article  Google Scholar 

  • Cuzick, J., Sestak, I., Cawthorn, S., Hamed, H., Holli, K., Howell, A., & Investigators, I.-I. (2015). Tamoxifen for prevention of breast cancer: Extended long-term follow-up of the IBIS-I breast cancer prevention trial. The Lancet Oncology, 16, 67–75.

    Article  CAS  Google Scholar 

  • Decruyenaere, M., Evers-Kiebooms, G., Welkenhuysen, M., Denayer, L., & Claes, E. (2000). Cognitive representations of breast cancer, emotional distress and preventive health behaviour: A theoretical perspective. Psycho-Oncology, 9, 528–536.

    Article  CAS  Google Scholar 

  • den Heijer, M., Seynaeve, C., Vanheusden, K., Timman, R., Duivenvoorden, H. J., Tilanus-Linthorst, M., & Tibben, A. (2013). Long-term psychological distress in women at risk for hereditary breast cancer adhering to regular surveillance: A risk profile. Psycho-Oncology, 22, 598–604.

    Article  Google Scholar 

  • Dillard, A. J., Scherer, L., Ubel, P. A., Smith, D. M., Zikmund-Fisher, B. J., McClure, J. B., & Fagerlin, A. (2013). Breast cancer anxiety’s associations with responses to a chemoprevention decision aid. Social Science & Medicine, 77, 13–19.

    Article  Google Scholar 

  • Fernandes, M. A., & Tone, E. B. (2021). A systematic review and meta-analysis of the association between expressive suppression and positive affect. Clinical Psychology Review, 88, 102068.

    Article  Google Scholar 

  • Ferrer, R. A., Green, P. A., & Barrett, L. F. (2015). Affective science perspectives on cancer control: Strategically crafting a mutually beneficial research agenda. Perspectives on Psychological Science, 10, 328–345.

    Article  Google Scholar 

  • Ferrer, R. A., Klein, W. M., Avishai, A., Jones, K., Villegas, M., & Sheeran, P. (2018). When does risk perception predict protection motivation for health threats? A person-by-situation analysis. PloS one, 13, e0191994.

    Article  Google Scholar 

  • Fisher, L., Hessler, D., Polonsky, W., Strycker, L., Bowyer, V., & Masharani, U. (2019). Toward effective interventions to reduce diabetes distress among adults with type 1 diabetes: Enhancing emotion regulation and cognitive skills. Patient Education and Counseling, 102, 1499–1505.

    Article  Google Scholar 

  • Freedman, A. N., Graubard, B. I., Rao, S. R., McCaskill-Stevens, W., Ballard-Barbash, R., & Gail, M. H. (2003). Estimates of the number of US women who could benefit from tamoxifen for breast cancer chemoprevention. Journal of the National Cancer Institute, 95, 526–532.

    Article  CAS  Google Scholar 

  • Gail, M. H., Brinton, L. A., Byar, D. P., Corle, D. K., Green, S. B., Schairer, C., & Mulvihill, J. J. (1989). Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. Journal of the National Cancer Institute, 81, 1879–1886.

    Article  CAS  Google Scholar 

  • Gross, J. J. (1998). The emerging field of emotion regulation: An integrative review. Review of General Psychology, 2, 271–299.

    Article  Google Scholar 

  • Gross, J. J. (2002). Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology, 39, 281–291.

    Article  Google Scholar 

  • Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85, 348.

    Article  Google Scholar 

  • Hay, J. L., Buckley, T. R., & Ostroff, J. S. (2005). The role of cancer worry in cancer screening: A theoretical and empirical review of the literature. Psycho-Oncology, 14, 517–534.

    Article  Google Scholar 

  • Hayes, A. F. (2017). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. Guilford Press.

    Google Scholar 

  • Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of event scale: A measure of subjective stress. Psychosomatic Medicine, 41, 209–218.

    Article  CAS  Google Scholar 

  • Kangas, M., & Gross, J. J. (2020). The affect regulation in cancer framework: Understanding affective responding across the cancer trajectory. Journal of Health Psychology, 25, 7–25.

    Article  Google Scholar 

  • Lazarus, R. S., & Folkman, S. (1984). Stress, appraisal, and coping. Springer Publishing Company.

    Google Scholar 

  • Leroy, T., Christophe, V., Penel, N., Clisant, S., & Antoine, P. (2011). Participation in randomised clinical trials is linked to emotion regulation strategies. Contemporary Clinical Trials, 32, 32–35.

    Article  Google Scholar 

  • Mauss, I. B., Cook, C. L., Cheng, J. Y., & Gross, J. J. (2007). Individual differences in cognitive reappraisal: Experiential and physiological responses to an anger provocation. International Journal of Psychophysiology, 66, 116–124.

    Article  Google Scholar 

  • McRae, K. (2016). Cognitive emotion regulation: A review of theory and scientific findings. Current Opinion in Behavioral Sciences, 10, 119–124.

    Article  Google Scholar 

  • Meiser, B., Wong, W. T., Peate, M., Julian-Reynier, C., Kirk, J., & Mitchell, G. (2017). Motivators and barriers of tamoxifen use as risk-reducing medication amongst women at increased breast cancer risk: A systematic literature review. Hereditary Cancer in Clinical Practice, 15, 1–9.

    Article  Google Scholar 

  • National Comprehensive Cancer Network (NCCN). (2020). Breast Cancer Risk Reduction (Version 1.2020). Retrieved June 18, 2020 from https://www.nccn.org/professionals/physician_gls/pdf/breast_risk.pdf

  • Pinsky, P. F., Miller, E., Heckman-Stoddard, B., & Minasian, L. (2018). Use of raloxifene and tamoxifen by breast cancer risk level in a Medicare-eligible cohort. American Journal of Obstetrics and Gynecology, 218(6), 606.

    Article  Google Scholar 

  • Politi, M. C., & Street, R. L. (2011). The importance of communication in collaborative decision making: Facilitating shared mind and the management of uncertainty. Journal of Evaluation in Clinical Practice, 17, 579–584.

    Article  Google Scholar 

  • Rogers, H. L., Siminoff, L. A., Longo, D. R., & Thomson, M. D. (2017). Coping with pre-diagnosis symptoms of colorectal cancer: A study of 244 recently diagnosed individuals. Cancer Nursing, 40, 145.

    Article  Google Scholar 

  • Ropka, M. E., Keim, J., & Philbrick, J. T. (2010). Patient decisions about breast cancer chemoprevention: A systematic review and meta-analysis. Journal of Clinical Oncology, 28, 3090.

    Article  Google Scholar 

  • Sheppes, G., Scheibe, S., Suri, G., Radu, P., Blechert, J., & Gross, J. J. (2014). Emotion regulation choice: A conceptual framework and supporting evidence. Journal of Experimental Psychology: General, 143, 163.

    Article  Google Scholar 

  • Thewes, B., Meiser, B., & Hickie, I. B. (2001). Psychometric properties of the impact of event scale amongst women at increased risk for hereditary breast cancer. Psycho-Oncology, 10, 459–468.

    Article  CAS  Google Scholar 

  • Visvanathan, K., Fabian, C. J., Bantug, E., Brewster, A. M., Davidson, N. E., DeCensi, A., & Khan, S. A. (2019). Use of endocrine therapy for breast cancer risk reduction: ASCO clinical practice guideline update. Journal of Clinical Oncology, 37, 3152–3165.

    Article  CAS  Google Scholar 

  • Watson, M., Pettingale, K. W., & Greer, S. (1984). Emotional control and autonomic arousal in breast cancer patients. Journal of Psychosomatic Research, 28, 467–474.

    Article  CAS  Google Scholar 

Download references

Funding

This research was supported by the American Psychological Association (Dissertation Research Award; PI: Conley) and the National Cancer Institute (T32CA090314; PIs: Brandon & Vadaparampil).

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Authors and Affiliations

  1. The Ohio State University, Columbus, OH, USA

    Claire C. Conley, Doreen M. Agnese & Barbara L. Andersen

  2. H. Lee Moffitt Cancer Center, Tampa, FL, USA

    Susan T. Vadaparampil

  3. Lombardi Comprehensive Cancer Center, Georgetown University, 2115 Wisconsin Ave NW, Suite 300, Washington, DC, 20007, USA

    Claire C. Conley & Suzanne C. O’Neill

Authors
  1. Claire C. Conley
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  2. Doreen M. Agnese
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  3. Susan T. Vadaparampil
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  4. Suzanne C. O’Neill
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  5. Barbara L. Andersen
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Contributions

CCC: conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, visualization, writing – original draft; DMA: conceptualization, resources, writing – review & editing; STV: conceptualization, funding acquisition, writing – review & editing; SCO: conceptualization, writing – review & editing; BLA: conceptualization, funding acquisition, methodology, supervision, writing – review & editing.

Corresponding author

Correspondence to Claire C. Conley.

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Conflict of interest

All authors declare that they have no conflicts of interest to report.

Human and animal rights

All procedures were approved by the Ohio State University Institutional Review Board (IRB #2015C0148). Study procedures were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.

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Written informed consent was obtained from all persons prior to study participation.

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Not applicable.

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Conley, C.C., Agnese, D.M., Vadaparampil, S.T. et al. Affect regulation as a moderator of intentions for breast cancer chemoprevention. J Behav Med 45, 490–496 (2022). https://doi.org/10.1007/s10865-022-00289-3

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  • DOI: https://doi.org/10.1007/s10865-022-00289-3

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