International Journal of Behavioral Medicine

, Volume 25, Issue 2, pp 216–222 | Cite as

The Pain of Ambivalence over Emotional Expression

  • Carol Wang
  • Celia C. Y. Wong
  • Qian Lu



Ambivalence over emotional expression (AEE) is defined as the desire to express emotion but failing to do so. Recent studies have revealed that AEE is associated with more pain. Pain is common among cancer survivors. This cross-sectional study investigated the association between AEE and pain, its underlying mechanism, and cultural relevance among cancer survivors.


Ninety-six Chinese American breast cancer survivors completed a questionnaire package assessing AEE and pain.


AEE was positively associated with pain severity and pain interference. The association between AEE and pain interference was mediated by intrusive thoughts.


Cancer survivors who are ambivalent over emotional expression may experience high levels of intrusive thoughts, which results in high levels of symptom reports in their pain. The study confirmed the association between AEE and pain and its underlying mechanism among a group whose culture generally encourages emotional suppression. Findings suggest interventions focusing on reducing intrusive thoughts may be effective at reducing pain.


Ambivalence over emotional expression Pain Breast cancer Intrusive thoughts Asian-American 


Funding Information

This study was funded in part by the American Cancer Society (MRSGT-10-011-01-CPPB, Principal Investigator: Qian Lu).

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the University of Houston Institutional Review Board.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© International Society of Behavioral Medicine 2017

Authors and Affiliations

  1. 1.Department of PsychologyUniversity of HoustonHoustonUSA

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