Skip to main content
Log in

Self-Report and Linguistic Indicators of Emotional Expression in Narratives as Predictors of Adjustment to Cancer

  • Published:
Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Emotional expression and cognitive efforts to adapt to cancer have been linked to better psychological adjustment. However, little is known about the relationship between linguistic indicators of emotional and cognitive coping efforts and corresponding self-report measures of related constructs. In this study, we sought to evaluate the interrelationships between self-reports of emotional suppression and linguistic indicators of emotional and cognitive coping efforts in those living with cancer. Seventy-one individuals attending a community cancer support group completed measures of emotional suppression and mood disturbance and provided a written narrative describing their cancer experience. Self-reports of emotional suppression were associated with more rather than less distress. Although linguistic indicators of both emotional expression and cognitive processing were generally uncorrelated with self-report measures of emotional suppression and mood disturbance, a significant interaction was observed between emotional suppression and use of cognitive words on mood disturbance. Among those using higher levels of emotional suppression, increasing use of cognitive words was associated with greater levels of mood disturbance. These findings have implications for a) the therapeutic use of emotion in psychosocial interventions and b) the use of computer-assisted technologies to conduct content analysis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1.

Similar content being viewed by others

References

  • Alpers, G. W., Winzelberg, A. J., Classen, C., Roberts, H., Dev, P., Koopman, C., and Taylor, C. B. (2005). Evaluation of computerized text analysis in an Internet breast cancer support group. Comp. Human Behav. 21: 343–358.

    Article  Google Scholar 

  • Cassileth, B. R., Lusk, E. J., Brown, L. L., and Cross, P. A. (1985). Psychosocial status of cancer patients and next of kin: Normative data from the Profile of Mood States. J. Psychosoc. Oncol. 3: 99–105.

    Article  Google Scholar 

  • Cella, D. F., Tross, S., and Orav, E. J. (1989). Mood states of patients after the diagnosis of cancer. J. Psychosoc. Oncol. 7: 45–54.

    Article  Google Scholar 

  • Classen, C., Koopman, C., Angell, K., and Spiegel, D. (1996). Coping styles associated with psychological adjustment to advanced breast cancer. Health Psychol. 15: 434–437.

    Article  PubMed  Google Scholar 

  • Classen, C., Butler, L. D., Koopman, C., Miller, E., DiMiceli, S., Giese-Davis, J., et al. (2001). Supportive-expressive group therapy reduces distress in metastatic breast cancer patients: A randomized clinical intervention trial. Arch. Gen. Psychiat. 58: 494–501.

    Article  PubMed  Google Scholar 

  • Cohen, J., Cohen, P., West, S. G., and Aiken, L. S. (2003). Applied multiple regression/correlation analysis for the behavioral sciences (3rd ed.) Lawrence Erlbaum Associates: Mahwah, NJ.

    Google Scholar 

  • Cohn, M. A., Mehl, M. R., and Pennebaker, J. W. (2004). Linguistic markers of psychological change surrounding September 11, 2001. Psychol. Sci. 15: 687–693.

    Article  PubMed  Google Scholar 

  • Cordova, M. J., Giese-Davis, J., Golant, M., Kronnenwetter, C., Chang, V., McFarline, S., et al. (2003). Mood disturbance in community cancer support groups: The role of emotional suppression and fighting spirit. J. Psychosom. Res. 55: 461–467.

    Article  PubMed  Google Scholar 

  • Creamer, M., Burgess, P., and Pattison, P. (1992). Reactions to trauma: A cognitive processing model. J. Abnorm. Psychol. 101: 452–459.

    Article  PubMed  Google Scholar 

  • Esterling, B. A., L’Abate, L., Murray, E. J., and Pennebaker, J. W. (1999). Empirical foundations for writing in prevention and psychotherapy: Mental and physical health outcomes. Clinical Psychol. Rev. 19: 79–96.

    Article  Google Scholar 

  • Fobair, P., Koopman, C., Dimiceli, S., O’Hanlan, K., Butler, L. D., Classen, C., Drooker, N., Davids, H. R., Loulan, J., Wallsten, D., and Spiegel, D. (2002). Psychosocial intervention for lesbians with primary breast cancer. Psycho. Oncol. 11: 427–438.

    Article  Google Scholar 

  • Folkman, S., and Greer, S. (2000). Promoting psychological well-being in the face of serious illness: When theory, research and practice inform each other. Psycho. Oncol. 9: 11–19.

    Article  Google Scholar 

  • Giese-Davis, J., Koopman, C., Butler, L. D., Classen, C., Cordova, M., Fobair, P., Benson, J., Kraemer, H. C., and Spiegel, D. (2002). Change in emotion-regulation strategy for women with metastatic breast cancer following supportive-expressive group therapy. J. Consult. Clin. Psychol. 70: 916–925.

    Article  PubMed  Google Scholar 

  • Giese-Davis, J., Koopman, C., Butler, L. D., Joss, J., Classen, C., Roberts, J., Rosenbluth, R., Morrow, G. R., and Spiegel, D. (2004). The Stanford Emotional Self-Efficacy Scale–Cancer: Reliability, validity, and generalizability. In Nyklícek, I., Temoshok, L., and Vingerhoets, A. (Eds.), Emotional expression and health: advances in theory, assessment and clinical applications: Hove (pp. 204–222). UK and New York; Brunner-Routledge.

    Google Scholar 

  • Giese-Davis, J., Piemme, K. A., Dillon, C., and Twirbutt, S. (2005). Macro-variables in affective expression in women with breast cancer participating in support groups. In Harrigan, J., Scherer, K. R., and Rosenthal, R. (Eds.), Nonverbal behavior in the affective sciences: A handbook of research methods (pp. 399–445). Oxford: Oxford University Press.

    Google Scholar 

  • Giese-Davis, J., and Spiegel, D. (2003). Emotional expression and cancer progression. In Davidson, R. J., Scherer, K. R., and Hill Goldsmith, H. (Eds.), Handbook of affective sciences (pp. 1053–1082). Oxford: Oxford University Press.

    Google Scholar 

  • Greenberg, L. S., Rice, L. N., and Elliott, R. (1993). Facilitating emotional change: The moment-by-moment process. New York: The Guilford Press.

    Google Scholar 

  • Gross, J. (1989). Emotional expression in cancer onset and progression. Soc. Sci. Med. 28: 1239–1248.

    Article  PubMed  Google Scholar 

  • Ho, S. M., Chan, C. L. W., and Ho, R. T. H. (2004). Posttraumatic growth in Chinese cancer survivors. Psycho. Oncol. 13: 377–389.

    Article  Google Scholar 

  • Horowitz, M. J. (1997). Stress response syndromes (3rd ed.). New York: Aronson.

    Google Scholar 

  • Izard, C. E. (2001). Emotional intelligence of adaptive emotions? Emotion 1: 249–257.

    Article  PubMed  Google Scholar 

  • Katz, R. C., Flasher, L., Cacciapaglia, H., and Nelson, S. (2001). The psychosocial impact of cancer and lupus: A cross-validational study that extends the generality of “benefit-finding” in patients with chronic disease. J. Behav. Med. 24: 561–571.

    Article  PubMed  Google Scholar 

  • Klemm, P., Hurst, M., Dearholt, S. L., and Trone, S. R. (1999). Gender differences on Internet cancer support groups. Comp. Nurs. 17: 65–72.

    Google Scholar 

  • Kraemer, H. C., and Blasey, C. M. (2004). Centring in regression analyses: A strategy to prevent errors in statistical inference. Int. J. Meth. Psychiat. Res. 13(3): 141–151.

    Article  Google Scholar 

  • Kring, A. M., Smith, D. A., and Neale, J. M. (1994). Individual differences in dispositional expressiveness: Development and validation of the Emotional Expressivity Scale. J. Pers. Soc. Psychol. 66: 934–949.

    Article  PubMed  Google Scholar 

  • Krippendorf, K. (2004). Content analysis. Thousand Oaks, CA: Sage Publications.

    Google Scholar 

  • Lazarus, R. S., and Folkman, S. (1984). Stress, appraisal, and coping. New York: Springer.

    Google Scholar 

  • Low, C. A., Stanton, A. L., and Danoff-Burg, S. (2006). Expressive disclosure and benefit-finding among breast cancer patients: Mechanisms for positive health effects. Health Psychol. 25: 181–189.

    Article  PubMed  Google Scholar 

  • Manne, S., Ostroff, J., Winkel, G., Goldstein, L., Fox, K., and Grana, G. (2004). Posttraumatic growth after breast cancer: Patient, partner, and couple perspectives. Psychosom. Med. 66: 442–454.

    Article  PubMed  Google Scholar 

  • McNair, D. M., Lorr, M., and Droppleman, L. F. (1992). Edits manual for the Profile of Mood States. San Diego: Educational and Industrial Testing Service.

    Google Scholar 

  • Owen, J. E., Klapow, J. C., Roth, D. L., and Tucker, D. C. (2004). Use of the internet for information and support: Disclosure among persons with breast and prostate cancer. J. Behav. Med. 27: 491–505.

    Article  PubMed  Google Scholar 

  • Pennebaker, J. W., and Francis, M. E. (1999). Linguistic Inquiry and Word Count. Mahwah, NJ: Erlbaum.

    Google Scholar 

  • Pennebaker, J. W., and King, L. A. (1999). Linguistic styles: Language use as an individual difference. J. Pers. Soc. Psychol. 77: 1296–1312.

    Article  PubMed  Google Scholar 

  • Schmidt, J. E., and Andrykowski, M. A. (2004). The role of social and dispositional variables associated with emotional processing in adjustment to breast cancer: An internet-based study. Health Psychol. 23: 249–266.

    Article  Google Scholar 

  • Stanton, A. L., Danoff-Burg, S., Cameron, C. L., Bishop, M., Collins, C. A., Kirk, S. B., Sworowski, L. A., and Twillman, R. (2000). Emotionally expressive coping predicts psychological and physical adjustment to breast cancer. J. Consult. Clin. Psychol. 68: 875–882.

    Article  PubMed  Google Scholar 

  • Stanton, A. L., Danoff-Burg, S., Sworowski, L. A., Collins, C. A., Branstetter, A. D., Rodriguez-Hanley, A., Kirk, S. B., and Austenfeld, J. L. (2002). Randomized, controlled trial of written emotional expression and benefit finding in breast cancer. J. Clin. Oncol. 20: 4160–4168.

    Article  PubMed  Google Scholar 

  • Stemler, S. (2001). An overview of content analysis. Prac. Assess. Res. Eval. 7: 17.

    Google Scholar 

  • Temoshok, L. (1987). Personality, coping style, emotion, and cancer: Towards an integrative model. Can. Surv. 6: 545– 567.

    Google Scholar 

  • Trierweiler, L. I., Eid, M., and Lischetzke, T. (2002). The structure of emotional expressivity: Each emotion counts. J. Pers. Soc. Psychol. 82: 1023–1040.

    Article  PubMed  Google Scholar 

  • Urcuyo, K. R., Boyers, A. E., Carver, C. S., and Antoni, M. H. (2005). Finding benefit in breast cancer: Relations with personality, coping, and concurrent well-being. Psychol. Health 20: 175–192.

    Article  Google Scholar 

  • Watson, M., and Greer, S. (1983). Development of a questionnaire measure of emotional control. J. Psychosom. Res. 27: 299–305.

    Article  PubMed  Google Scholar 

  • Weihs, K. L., Enright, T. M., Simmens, S. J., and Reiss, D. (2000). Negative affectivity, restriction of emotions, and site of metastases predict mortality in recurrent breast cancer. J. Psychosom. Res. 49: 59–68.

    Article  PubMed  Google Scholar 

  • Zakowski, S. G., Ramati, A., Morton, C., Johnson, P., and Flanigan, R. (2004). Written emotional disclosure buffers the effects of social constraints on distress among cancer patients. Health Psychol. 23: 555–563.

    Article  PubMed  Google Scholar 

Download references

ACKNOWLEDGEMENTS

Carol Kronenwetter, Ph.D. now at California Pacific Medical Center, San Francisco. This research was funded by California Breast Cancer Research Program grants #1FB-0383, #4BB-2901, and #5FB-0036, the John D. and Catherine T. MacArthur Foundation, and the Kozmetsky Global Collaboratory, Stanford. Parts of this analysis were presented at the Annual meeting for the Society of Behavioral Medicine, 2000, in Nashville, TN. We would like to acknowledge the contributions of Michael States from TWC, research assistants Casey Alt, Sanjay Chakrapani, Barbara K. Symons, and Rebecca Caldwell, and the efforts of data manager Sue DiMiceli. We would also like to acknowledge the contributions of the many men and women who participated.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jason E. Owen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Owen, J.E., Giese-Davis, J., Cordova, M. et al. Self-Report and Linguistic Indicators of Emotional Expression in Narratives as Predictors of Adjustment to Cancer. J Behav Med 29, 335–345 (2006). https://doi.org/10.1007/s10865-006-9061-8

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10865-006-9061-8

KEY WORDS

Navigation