Emotional disclosure and cognitive processing in couples coping with head and neck cancer

Abstract

Head and neck cancer (HNC) patients and their spouses experience communication problems and high rates of emotional distress. Couple-based interventions that encourage emotional disclosure hold promise for improving cognitive processing and distress in this population, but more research needs to examine when and for whom emotional disclosure is an effective coping strategy. In this observational study, 125 HNC patients (83% male) and their spouses were videotaped discussing a cancer-related concern in the laboratory. Discussions were coded with the specific affect coding system. Actor–partner interdependence models showed that patient expression of negative emotions (i.e., disdain, contentiousness, distress) was not related to his/her own or the spouse’s cognitive processing (assessed as reaction times to cancer and noncancer words on a computerized cognitive task administered immediately following the discussion). When spouses expressed support (e.g., interest, validation), they had better cancer- (effect size r = − 0.21) and noncancer-related cognitive processing (r = − 0.17), but patients did not. However, when spouses expressed disdain (e.g., contempt) and contentiousness (e.g., criticism, domineering), patients had poorer cancer- (r = 0.20–0.22) and noncancer-related cognitive processing (r = 0.19–0.26). Findings suggest consideration of the valence of affective expression and which partner is disclosing/listening before unilaterally encouraging HNC couples to openly express emotions as a means of alleviating distress.

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Acknowledgements

This work was supported by K07CA124668 (PI: Badr) and P30CA125123 (PI: Osborne).

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Correspondence to Hoda Badr.

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Jafar Bakhshaie, Mark Bonnen, Joshua Asper, Vlad Sandulache, and Hoda Badr declare that they have no conflict of interest.

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All procedures followed 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. Informed consent was obtained from all patients for being included in the study.

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Bakhshaie, J., Bonnen, M., Asper, J. et al. Emotional disclosure and cognitive processing in couples coping with head and neck cancer. J Behav Med 43, 411–425 (2020). https://doi.org/10.1007/s10865-019-00094-5

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Keywords

  • Head and neck cancer
  • Affective expression
  • Disclosure
  • Cognitive processing
  • Implicit measures
  • Cancer Stroop task