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Which symptoms matter? Self-report and observer discrepancies in repressors and high-anxious women with metastatic breast cancer

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Abstract

Clinicians working with cancer patients listen to them, observe their behavior, and monitor their physiology. How do we proceed when these indicators do not align? Under self-relevant stress, non-cancer repressors respond with high arousal but report low anxiety; the high-anxious report high anxiety but often have lower arousal. This study extends discrepancy research on repressors and the high-anxious to a metastatic breast cancer sample and examines physician rating of coping. Before and during a Trier Social Stress Test (TSST), we assessed affect, autonomic reactivity, and observers coded emotional expression from TSST videotapes. We compared non-extreme (N = 40), low-anxious (N = 16), high-anxious (N = 19), and repressors (N = 19). Despite reported low anxiety, repressors expressed significantly greater Tension or anxiety cues. Despite reported high anxiety, the high-anxious expressed significantly greater Hostile Affect rather than Tension. Physicians rated both groups as coping significantly better than others. Future research might productively study physician-patient interaction in these groups.

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References

  • Altrocchi, J., Parsons, O. A., & Dickoff, H. (1960). Changes in self-ideal discrepancy in repressors and sensitizers. Journal of Social Psychology, 61, 67–72.

    CAS  Google Scholar 

  • Ansari, T., & Derakshan, N. (2011a). The neural correlates of cognitive effort in anxiety: Effects on processing efficiency. Biological Psychology, 86, 337–348.

    PubMed  Google Scholar 

  • Ansari, T., & Derakshan, N. (2011b). The neural correlates of impaired inhibitory control in anxiety. Neuropsychologia, 49, 1146–1153.

    PubMed  Google Scholar 

  • Asendorpf, J. B., & Scherer, K. R. (1983). The discrepant repressor: Differentiation between low anxiety, high anxiety, and repression of anxiety by autonomic-facial-verbal patterns of behavior. Journal of Personality and Social Psychology, 45, 1334–1346.

    CAS  PubMed  Google Scholar 

  • Bajk, Z., Szekeres, C.- C., Kovcs, K., Csap, K., Molnr, S., Soltsz, P., et al. (2012). Anxiety, depression and autonomic nervous system dysfunction in hypertension. Journal of the Neurological Sciences, 317, 112–116.

    Google Scholar 

  • Baker, R., Holloway, J., Thomas, P., Thomas, S., & Owens, M. (2004). Emotional processing and panic. Behaviour Research and Therapy, 42, 1271–1287.

    PubMed  Google Scholar 

  • Barger, S. D., Kircher, J. C., & Croyle, R. T. (1997). The effects of social context and defensiveness on the physiological responses of repressive copers. Journal of Personality and Social Psychology, 73, 1118–1128.

    CAS  PubMed  Google Scholar 

  • Barger, S. D., Marsland, A. L., Bachen, E. A., & Manuck, S. B. (2000). Repressive coping and blood measures of disease risk: Lipids and endocrine and immunological responses to a laboratory stressor. Journal of Applied Social Psychology, 30, 1619–1638.

    Google Scholar 

  • Barlow, D. H. (2002). Anxiety and its disorders: The nature and treatment of anxiety and panic (2nd ed.). New York: Guilford Press.

    Google Scholar 

  • Benight, C. C., Harper, M. L., Zimmer, D. L., Lowery, M., Sanger, J., & Laudenslager, M. L. (2004). Repression following a series of natural disasters: Immune and neuroendocrine correlates. Psychology and Health, 19, 337–352.

    Google Scholar 

  • Berntson, G. G., Bigger, J. T., Jr., Eckberg, D. L., Grossman, P., Kaufmann, P. G., Malik, M., et al. (1997). Heart rate variability: Origins, methods, and interpretive caveats. Psychophysiology, 34, 623–648.

    CAS  PubMed  Google Scholar 

  • Bonanno, G., Noll, J., Putnam, F., O’Neill, M., & Trickett, P. (2003). Predicting the willingness to disclose childhood sexual abuse from measures of repressive coping and dissociative tendencies. Child Maltreatment, 8, 302–318.

    PubMed  Google Scholar 

  • Broege, P. A., James, G. D., & Peters, M. (1997). Anxiety coping style and daily blood pressure variation of female nurses. Blood Pressure Monitoring, 2, 155–159.

    PubMed  Google Scholar 

  • Brosschot, J. F., & Janssen, E. (1998). Continuous monitoring of affective-autonomic response dissociation in repressors during negative emotional stimulation. Personality and Individual Differences, 25, 69–84.

    Google Scholar 

  • Brown, L. L., Tomarken, A. J., Orth, D. N., Loosen, P. T., Kalin, N. H., & Davidson, R. J. (1996). Individual differences in repressive-defensiveness predict basal salivary cortisol levels. Journal of Personality and Social Psychology, 70, 362–371.

    CAS  PubMed  Google Scholar 

  • Burns, J. W., Evon, D., & Strain-Saloum, C. (1999). Repressed anger and patterns of cardiovascular, self-report and behavioral responses: Effects of harassment. Journal of Psychosomatic Research, 47, 569–581.

    CAS  PubMed  Google Scholar 

  • Carré, J. M., Fisher, P. M., Manuck, S. B., & Hariri, A. R. (2012). Interaction between trait anxiety and trait anger predict amygdala reactivity to angry facial expressions in men but not women. Social Cognitive and Affective Neuroscience, 7, 213–221. doi:10.1093/scan/nsq101

    PubMed Central  PubMed  Google Scholar 

  • Coifman, K., Bonanno, G., Ray, R., & Gross, J. (2007). Does repressive coping promote resilience? Affective-autonomic response discrepancy during bereavement. Journal of Personality and Social Psychology, 92, 745–758.

    PubMed  Google Scholar 

  • Davis, P. J. (1990). Repression and the inaccessibility of emotional memories. In J. L. Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology, and health (pp. 387–403). Chicago: The University of Chicago Press.

    Google Scholar 

  • Denollet, J., Maas, K., Knottnerus, A., Keyzer, J. J., & Pop, V. J. (2009). Anxiety predicted premature all-cause and cardiovascular death in a 10-year follow-up of middle-aged women. Journal of Clinical Epidemiology, 62, 452–456.

    PubMed  Google Scholar 

  • Denollet, J., Martens, E., Nyklcek, I., Conraads, V., & de Gelder, B. (2008). Clinical events in coronary patients who report low distress: Adverse effect of repressive coping. Health Psychology, 27, 302–308.

    PubMed  Google Scholar 

  • Derakshan, N., & Eysenck, M. W. (1997a). Interpretive biases for one’s own behaviour and physiology in high-trait-anxious individuals and repressors. Journal of Personality and Social Psychology, 73, 1–10.

    Google Scholar 

  • Derakshan, N., & Eysenck, M. W. (1997b). Repression and repressors: Theoretical and experimental approaches. European Psychologist, 2, 235–246.

    Google Scholar 

  • Derakshan, N., & Eysenck, M. W. (2001). Effects of focus of attention on physiological, behavioural, and reported state anxiety in repressors, low-anxious, high-anxious, and defensive high-anxious individuals. Anxiety, Stress & Coping: An International Journal, 14, 285–299.

    Google Scholar 

  • Derakshan, N., Eysenck, M. W., & Myers, L. B. (2007). Emotional information processing in repressors: The vigilance-avoidance theory. Cognition and Emotion, 21, 1585–1614.

    Google Scholar 

  • DeWall, C. N., Buckner, J. D., Lambert, N. M., Cohen, A. S., & Fincham, F. D. (2010). Bracing for the worst, but behaving the best: Social anxiety, hostility, and behavioral aggression. Journal of Anxiety Disorders, 24, 260–268.

    PubMed  Google Scholar 

  • Ekman, P., & Friesen, W. V. (1978). Facial action coding system: A technique for the measurement of facial movement. Palo Alto, CA: Consulting Psychologists Press.

    Google Scholar 

  • Erickson, S. J., & Steiner, H. (2000). Trauma spectrum adaptation. Somatic symptoms in long-term pediatric cancer survivors. Psychosomatics, 41, 339–346.

    CAS  PubMed  Google Scholar 

  • Eysenck, M. W., & Derakshan, N. (1999). Self-reported and other-rated trait anxiety and defensiveness in repressor, low-anxious, high-anxious, and defensive high anxious groups. Anxiety, Stress & Coping, 12, 127.

    Google Scholar 

  • Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive performance: Attentional control theory. Emotion, 7, 336–353. doi:10.1037/1528-3542.7.2.336

    PubMed  Google Scholar 

  • Fleiss, J. L. (1981). Statistical methods for rates and proportions. New York: Wiley.

    Google Scholar 

  • Fox, E., Derakshan, N., & Shoker, L. (2008). Trait anxiety modulates the electrophysiological indices of rapid spatial orienting towards angry faces. NeuroReport, 19, 259–263.

    PubMed  Google Scholar 

  • Frasure-Smith, N., Lesperance, F., Gravel, G., Masson, A., Juneau, M., & Bourassa, M. G. (2002). Long-term survival differences among low-anxious, high-anxious and repressive copers enrolled in the Montreal heart attack readjustment trial. Psychosomatic Medicine, 64, 571–579. doi:10.1097/01.psy.0000021950.04969.f8

    PubMed  Google Scholar 

  • Fritz, G. K., Spirito, A., & Yeung, A. (1994). Utility of the repressive defense style construct in childhood. Journal of Clinical Child Psychology, 23, 306–313.

    Google Scholar 

  • Giese-Davis, J., Collie, K., Rancourt, K. M. S., 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.

    PubMed  Google Scholar 

  • Giese-Davis, J., Conrad, A., Nouriani, B., & Spiegel, D. (2008). Exploring emotion-regulation and autonomic physiology in metastatic breast cancer patients: Repression, suppression, and restraint of hostility. Personality and Individual Differences, 44, 226–237.

    PubMed Central  PubMed  Google Scholar 

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

    Google Scholar 

  • Giese-Davis, J., Sephton, S. E., Abercrombie, H., Duran, R. E. F., & Spiegel, D. (2004). Repression and high anxiety are associated with aberrant diurnal cortisol rhythms in women with metastatic breast cancer. Health Psychology, 23, 645–650.

    PubMed  Google Scholar 

  • Giese-Davis, J., & Spiegel, D. (2001). Suppression, repressive-defensiveness, restraint, and distress in metastatic breast cancer: Separable or inseparable constructs? Journal of Personality, 69, 417–449.

    CAS  PubMed  Google Scholar 

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

    Google Scholar 

  • Gil, A. (2005). Repressing distress in childhood: A defense against health-related stress. Child Psychiatry and Human Development, 36, 27–52.

    PubMed  Google Scholar 

  • Gold, M. A. (1964). Causes of patients’ delay in diseases of the breast. Cancer, 17, 564–577.

    CAS  PubMed  Google Scholar 

  • Gottman, J. M. (1995). What predicts divorce: The measures. Hillsdale, NJ: Lawrence Erlbaum Associates.

    Google Scholar 

  • Greer, J., Pirl, W., Park, E., Lynch, T., & Temel, J. (2008). Behavioral and psychological predictors of chemotherapy adherence in patients with advanced non-small cell lung cancer. Journal of Psychosomatic Research, 65, 549–552.

    PubMed  Google Scholar 

  • Groenvold, M., Petersen, M., Idler, E., Bjorner, J., Fayers, P., & Mouridsen, H. (2007). Psychological distress and fatigue predicted recurrence and survival in primary breast cancer patients. Breast Cancer Research and Treatment, 105, 209–219.

    PubMed  Google Scholar 

  • Hamer, M., Batty, G. D., Stamatakis, E., & Kivimaki, M. (2010). The combined influence of hypertension and common mental disorder on all-cause and cardiovascular disease mortality. Journal of Hypertension, 28, 2401–2406.

    CAS  PubMed  Google Scholar 

  • Hawkins, K., & Cougle, J. (2011). Anger problems across the anxiety disorders: Findings from a population-based study. Depression and anxiety, 28, 145–152.

    PubMed  Google Scholar 

  • Houtveen, J. H., Rietveld, S., Schoutrop, M., Spiering, M., & Brosschot, J. F. (2001). A repressive coping style and affective, facial and physiological responses to looking at emotional pictures. International Journal of Psychophysiology, 42, 265–277.

    CAS  PubMed  Google Scholar 

  • Hsu, L. M. (2004). Biases of success rate differences shown in binomial effect size displays. Psychological Bulletin, 9, 183–197.

    Google Scholar 

  • Jack, K., McLean, S., Moffett, J., & Gardiner, E. (2010). Barriers to treatment adherence in physiotherapy outpatient clinics: A systematic review. Manual therapy, 15, 220–228.

    PubMed Central  PubMed  Google Scholar 

  • Jamner, L. D., & Leigh, H. (1999). Repressive/defensive coping, endogenous opioids and health: How a life so perfect can make you sick. Psychiatry Research, 85, 17–31.

    CAS  PubMed  Google Scholar 

  • Jamner, L. D., Schwartz, G. E., & Leigh, H. (1988). The relationship between repressive and defensive coping styles and monocyte, eosinophile, and serum glucose levels: Support for the opioid peptide hypothesis of repression. Psychosomatic Medicine, 50, 567–575.

    CAS  PubMed  Google Scholar 

  • Jensen, M. R. (1987). Psychobiological factors predicting the course of breast cancer. Journal of Personality, 55, 317–342.

    CAS  PubMed  Google Scholar 

  • Kahn, M., & Schill, T. (1971). Anxiety report in defensive and nondefensive repressors. Journal of Consulting and Clinical Psychology, 36, 300.

    Google Scholar 

  • Kangas, M., Henry, J. L., & Bryant, R. A. (2005). The course of psychological disorders in the 1st year after cancer diagnosis. Journal of Consulting and Clinical Psychology, 73, 763–768.

    PubMed  Google Scholar 

  • King, A. C., Taylor, C. B., Albright, C. A., & Haskell, W. L. (1990). The relationship between repressive and defensive coping styles and blood pressure and general sympathetic activation in essential hypertension during stimulation. Journal of Psychosomatic Research, 34, 461–471.

    CAS  PubMed  Google Scholar 

  • Kirschbaum, C., Pirke, K. M., & Hellhammer, D. H. (1993). The ‘Trier Social Stress Test’—A tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology, 28, 76–81.

    CAS  PubMed  Google Scholar 

  • Kline, J. P., Schwartz, G. E., Fitzpatrick, D. F., & Hendricks, S. E. (1998). Repressive/defensive coping and identification thresholds for pleasant and unpleasant words. Imagination, Cognition, and Personality, 17, 283–291.

    Google Scholar 

  • Kraemer, H., & Kupfer, D. (2006). Size of treatment effects and their importance to clinical research and practice. Biological Psychiatry, 59, 990–996.

    PubMed  Google Scholar 

  • Kreitler, S., Chaitchik, S., & Kreitler, H. (1993). Repressivenes: Cause or result of cancer? Psychological Oncology, 2, 43–54.

    Google Scholar 

  • Landis, J. R., & Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 33, 159–174.

    CAS  PubMed  Google Scholar 

  • Lane, R. D., Merikangas, K. R., Schwartz, G. E., Huang, S. S., & Prusoff, B. A. (1990). Relationship between defensiveness and lifetime prevalence of psychiatric disorder. American Journal of Psychiatry, 147, 573–578.

    CAS  PubMed  Google Scholar 

  • Latini, D., Hart, S., Knight, S., Cowan, J., Ross, P., Duchane, J., et al. (2007). The relationship between anxiety and time to treatment for patients with prostate cancer on surveillance. The Journal of Urology, 178, 826–831.

    PubMed  Google Scholar 

  • Lehrer, P. M. (1998). Emotionally triggered asthma: A review of research literature and some hypotheses for self-regulation therapies. Applied Psychophysiology and Biofeedback, 23, 13–41.

    CAS  PubMed  Google Scholar 

  • Lehto, U.-S., Ojanen, M., Dyba, T., Aromaa, A., & Kellokumpu-Lehtinen, P. (2007). Baseline psychosocial predictors of survival in localized melanoma. Journal of Psychosomatic Research, 63, 9–15.

    PubMed  Google Scholar 

  • Levy, S. M., Herberman, R. B., Maluish, A. M., Schlien, B., & Lippman, M. (1985). Prognostic risk assessment in primary breast cancer by behavioral and immunological parameters. Health Psychology, 4, 99–113.

    CAS  PubMed  Google Scholar 

  • Martens, E., de Jonge, P., Na, B., Cohen, B., Lett, H., & Whooley, M. (2010). Scared to death? Generalized anxiety disorder and cardiovascular events in patients with stable coronary heart disease: The heart and soul study. Archives of General Psychiatry, 67, 750–758.

    PubMed  Google Scholar 

  • Mason, E. C., & Richardson, R. (2010). Looking beyond fear: The extinction of other emotions implicated in anxiety disorders. Journal of Anxiety Disorders, 24, 63–70.

    PubMed  Google Scholar 

  • Mauss, I. B., Wilhelm, F. H., & Gross, J. J. (2003). Autonomic recovery and habituation in social anxiety. Psychophysiology, 40, 648–653.

    PubMed  Google Scholar 

  • McEwen, B. (2006). Protective and damaging effects of stress mediators: Central role of the brain. Dialogues in Clinical Neuroscience, 8, 367–381.

    PubMed Central  PubMed  Google Scholar 

  • Melchers, L. J., Van Weert, E., Beurskens, C. H. G., Reintsema, H., Slagter, A. P., Roodenburg, J. L. N., et al. (2009). Exercise adherence in patients with trismus due to head and neck oncology: A qualitative study into the use of the Therabite. International Journal of Oral and Maxillofacial Surgery, 38, 947–954.

    CAS  PubMed  Google Scholar 

  • Mendolia, M. (1999). Repressors’ appraisals of emotional stimuli in threatening and nonthreatening positive emotional contexts. Journal of Research in Personality, 33, 1–26.

    Google Scholar 

  • Miovic, M., & Block, S. (2007). Psychiatric disorders in advanced cancer. Cancer, 110, 1665–1676. doi:10.1002/cncr.22980

    PubMed  Google Scholar 

  • Moise, J. R., Drotar, D., Doershuk, C. F., & Stern, R. C. (1987). Correlates of psychosocial adjustment among young adults with cystic fibrosis. Journal of Developmental and Behavioral Pediatrics, 8, 141–148.

    CAS  PubMed  Google Scholar 

  • Moscovitch, D., McCabe, R., Antony, M., Rocca, L., & Swinson, R. (2008). Anger experience and expression across the anxiety disorders. Depression and Anxiety, 25, 107–113.

    PubMed  Google Scholar 

  • Myers, L. B. (1996). The attributional style of repressive individuals. The Journal of Social Psychology, 136, 127–128.

    Google Scholar 

  • Myers, L. B. (2010). The importance of the repressive coping style: Findings from 30 years of research. Anxiety Stress Coping, 23, 3–17. doi:10.1080/10615800903366945

    PubMed  Google Scholar 

  • Myers, L. B., Brewin, C. R., & Power, M. J. (1992). Repression and autobiographical memory. In A. M. Conway, C. D. Rubin, H. Spinnler, & A. W. Wagenaar (Eds.), Theoretical perspectives on autobiographical memory. Dordrecht: Kluwer.

    Google Scholar 

  • Myers, L. B., Brewin, C. R., & Power, M. J. (1998). Repressive coping and the directed forgetting of emotional material. Journal of Abnormal Psychology, 107, 1–8.

    Google Scholar 

  • Myers, L. B., & Reynolds, D. (2000). How optimistic are repressors? The relationship between repressive coping, controllability, self-esteem and comparative optimism for health-related events. Psychological Health, 15, 677–687.

    Google Scholar 

  • Myers, L. B., & Vetere, A. (1997). Repressors’ responses to health-related questionnaires. British Journal of Health Psychology, 2, 245–257.

    Google Scholar 

  • Myers, L. B., Vetere, A., & Derakshan, N. (2004). Are suppression and repressive coping related? Personality and Individual Differences, 36, 1009–1013. doi:10.1016/s0191-8869(03)00196-x

    Google Scholar 

  • Neal, R., Pasterfield, D., Wilkinson, C., Hood, K., Makin, M., & Lawrence, H. (2008). Determining patient and primary care delay in the diagnosis of cancer—Lessons from a pilot study of patients referred for suspected cancer. BMC Family Practice, 9, 9.

    PubMed Central  PubMed  Google Scholar 

  • Newton, T. L. (1996). The face of repressive coping: Social context and the display of hostile expressions and social smiles. Journal of Nonverbal Behavior, 20, 3–22.

    Google Scholar 

  • Newton, T. L., & Contrada, R. L. (1992). Repressive coping and verbal-autonomic dissociation: The influence of social context. Journal of Personality and Social Psychology, 62, 159–167.

    CAS  PubMed  Google Scholar 

  • Olatunji, B. O., Ciesielski, B. G., & Tolin, D. F. (2010). Fear and loathing: A meta-analytic review of the specificity of anger in PTSD. Behavior Therapy, 41, 93–105.

    PubMed  Google Scholar 

  • O’Mahony, M., & Hegarty, J. (2009). Factors influencing women in seeking help from a health care professional on self discovery of a breast symptom, in an Irish context. Journal of Clinical Nursing, 18, 2020–2029.

    PubMed  Google Scholar 

  • Ostir, G., & Goodwin, J. (2006). High anxiety is associated with an increased risk of death in an older tri-ethnic population. Journal of Clinical Epidemiology, 59, 534–540.

    PubMed Central  PubMed  Google Scholar 

  • Painuly, N., Grover, S., Gupta, N., & Mattoo, S. (2011). Prevalence of anger attacks in depressive and anxiety disorders: Implications for their construct? Psychiatry and Clinical Neurosciences, 65, 165–174.

    PubMed  Google Scholar 

  • Pauls, C. A., & Stemmler, G. (2003). Repressive and defensive coping during fear and anger. Emotion, 3, 284–302.

    PubMed  Google Scholar 

  • Phipps, S., & Srivastava, D. K. (1997). Repressive adaptation in children with cancer. Health Psychology, 16, 521–528.

    CAS  PubMed  Google Scholar 

  • Phipps, S., & Steele, R. (2002). Repressive adaptive style in children with chronic illness. Psychosomatic Medicine, 64, 34–42.

    PubMed  Google Scholar 

  • Prasertsri, N., Holden, J., Keefe, F., & Wilkie, D. (2011). Repressive coping style: Relationships with depression, pain, and pain coping strategies in lung cancer out patients. Lung Cancer, 71, 235–240.

    PubMed Central  PubMed  Google Scholar 

  • Ristvedt, S., & Trinkaus, K. (2005). Psychological factors related to delay in consultation for cancer symptoms. Psycho-Oncology, 14, 339–350.

    PubMed Central  PubMed  Google Scholar 

  • Roy-Byrne, P., Davidson, K., Kessler, R., Asmundson, G. J. G., Goodwin, R., Kubzansky, L., et al. (2008). Anxiety disorders and comorbid medical illness. General Hospital Psychiatry, 30, 208–225.

    PubMed  Google Scholar 

  • Schwerdtfeger, A., & Derakshan, N. (2010). The time line of threat processing and vagal withdrawal in response to a self-threatening stressor in cognitive avoidant copers: Evidence for vigilance-avoidance theory. Psychophysiology, 47, 786–795.

    PubMed  Google Scholar 

  • Sephton, S. E., Sapolsky, R. M., Kraemer, H. C., & Spiegel, D. (2000). Diurnal cortisol rhythm as a predictor of breast cancer survival. Journal of the National Cancer Institute, 92, 994–1000.

    CAS  PubMed  Google Scholar 

  • Shea, J. D., Burton, R., & Girgis, A. (1993). Negative affect, absorption, and immunity. Physiological Behavior, 53, 449–457.

    CAS  Google Scholar 

  • Sherwood, A., Allen, M. T., Fahrenberg, J., Kelsey, R. M., Lovallo, W. R., & van Doornen, L. J. (1990). Methodological guidelines for impedance cardiography. Psychophysiology, 27, 1–23.

    CAS  PubMed  Google Scholar 

  • Smith, E. M., Gomm, S. A., & Dickens, C. M. (2003). Assessing the independent contribution to quality of life from anxiety and depression in patients with advanced cancer. Palliative Medicine, 17, 509–513.

    CAS  PubMed  Google Scholar 

  • Spencer, R., Nilsson, M., Wright, A., Pirl, W., & Prigerson, H. (2010). Anxiety disorders in advanced cancer patients: Correlates and predictors of end-of-life outcomes. Cancer, 116, 1810–1819.

    PubMed Central  PubMed  Google Scholar 

  • Spiegel, D., Giese-Davis, J., Taylor, C. B., & Kraemer, H. (2006). Stress sensitivity in metastatic breast cancer: Analysis of hypothalamic-pituitary-adrenal axis function. Psychoneuroendocrinology, 31, 1231–1244.

    CAS  PubMed Central  PubMed  Google Scholar 

  • Temoshok, L. (1985). Biopsychosocial studies on cutaneous malignant melanoma: Psychosocial factors associated with prognostic indicators, progression, psychophysiology and tumor-host response. Social Science Medicine, 20, 833–840.

    CAS  PubMed  Google Scholar 

  • Teunissen, S. C., de Graeff, A., Voest, E. E., & de Haes, J. C. (2007). Are anxiety and depressed mood related to physical symptom burden? A study in hospitalized advanced cancer patients. Palliative Medicine, 21, 341–346. doi:10.1177/0269216307079067

    CAS  PubMed  Google Scholar 

  • Trew, J., & Alden, L. (2009). Predicting anger in social anxiety: The mediating role of rumination. Behaviour Research and Therapy, 47, 1079–1084.

    PubMed  Google Scholar 

  • Turner, A., Williams, R., Sloan, A., & Haselkorn, J. (2009). Injection anxiety remains a long-term barrier to medication adherence in multiple sclerosis. Rehabilitation Psychology, 54, 116–121.

    PubMed  Google Scholar 

  • Watkins, L. L., Blumenthal, J. A., Babyak, M. A., Davidson, J. R. T., McCants, C. B., Jr., O’Connor, C., et al. (2010). Phobic anxiety and increased risk of mortality in coronary heart disease. Psychosomatic Medicine, 72, 664–671. doi:10.1097/PSY.0b013e3181e9f357

    PubMed Central  PubMed  Google Scholar 

  • Watson, D., & Clark, L. A. (1984). Negative affectivity: The disposition to experience aversive emotional states. Psychological Bulletin, 96, 465–490.

    CAS  PubMed  Google Scholar 

  • Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.

    CAS  PubMed  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.

    CAS  PubMed  Google Scholar 

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

    CAS  PubMed  Google Scholar 

  • Weinberger, D. A. (1989). The Weinberger Adjustment Inventory. Unpublished Manuscript.

  • Weinberger, D. A. (1990a). The construct validity of the repressive coping style. In J. L. Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology, and health (pp. 337–386). Chicago: University of Chicago Press.

    Google Scholar 

  • Weinberger, D. A. (1990b). Social-emotional adjustment in older children and adults: I. Psychometric properties of the Weinberger Adjustment Inventory. Unpublished Manuscript.

  • Weinberger, D. A., & Schwartz, G. E. (1990). Distress and restraint as superordinate dimensions of self-reported adjustment: A typological perspective. Journal of Personality, 58, 381–417.

    CAS  PubMed  Google Scholar 

  • Weinberger, D. A., Schwartz, G. E., & Davidson, R. J. (1979). Low-anxious, high anxious, and repressive coping styles: Psychometric patterns and behavioral and physiological responses to stress. Journal of Abnormal Psychology, 88, 369–380.

    CAS  PubMed  Google Scholar 

  • Whiteside, S., & Abramowitz, J. (2005). The expression of anger and its relationship to symptoms and cognitions in obsessive-compulsive disorder. Depression and Anxiety, 21, 106–111.

    PubMed  Google Scholar 

  • Whiteside, S., Port, J., & Abramowitz, J. (2004). A meta-analysis of functional neuroimaging in obsessive-compulsive disorder. Psychiatry Research, 132, 69–79.

    PubMed  Google Scholar 

  • Wieser, M., Pauli, P., Reicherts, P., & Mhlberger, A. (2010). Don’t look at me in anger! Enhanced processing of angry faces in anticipation of public speaking. Psychophysiology, 47, 271–280.

    PubMed  Google Scholar 

  • Wilhelm, F. H., Gerlach, A. L., & Roth, W. T. (2001). Slow recovery from voluntary hyperventilation in panic disorder. Psychosomatic Medicine, 63, 638–649.

    CAS  PubMed  Google Scholar 

  • Wilhelm, F. H., Grossman, P., & Roth, W. T. (1999). Analysis of cardiovascular regulation. Biomedical Sciences Instrumentation, 35, 135–140.

    CAS  PubMed  Google Scholar 

  • Willmann, M., Langlet, C., Hainaut, J.-P., & Bolmont, B. (2012). The time course of autonomic parameters and muscle tension during recovery following a moderate cognitive stressor: Dependency on trait anxiety level. International Journal of Psychophysiology, 84, 51–58. doi:10.1016/j.ijpsycho.2012.01.009

    PubMed  Google Scholar 

  • Zachariae, R., Jensen, A. B., Pedersen, C., Jorgensen, M. M., Christensen, S., Lassesen, B., et al. (2004). Repressive coping before and after diagnosis of breast cancer. Psycho-Oncology, 13, 547–561.

    PubMed  Google Scholar 

  • Zahn, T. P., Nurnberger, J. I., Berrettini, W. H., & Robinson, T. N. (1991). Concordance between anxiety and autonomic nervous system activity in subjects at genetic risk for affective disorder. Psychiatry Research, 36, 99–110.

    CAS  PubMed  Google Scholar 

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Acknowledgments

We presented portions of this study at the annual meetings of the International Psycho-Oncology Society Conference, Quebec City, May 25–29, 2010, American Psychosomatic Society, San Antonio, March 9–12, 2011, and The Canadian Association of Psycho-oncology, Toronto, May 4–6, 2011. This study was funded by NIA/NCI Program Project AG18784. It was also supported in part by grant 5 M01 RR000070 from the National Center for Research Resources, National Institutes of Health. Alberta Cancer Research Institute grants 24551 and 24397 for salary support to Janine Giese-Davis. In addition, we would like to thank project director Bita Nouriani, M.S., research assistants Manijeh Parineh, Ansgar Conrad, Nausheen Ali, Allyson DeLorenzo, Julie Hall, panel members for the TSST, Emotion coders (particularly Lara Rangel, Elisa Hernandez, Kristina Roos, and Priscilla Gonzalez), Kate Collie, Ph.D. for editing assistance, and the women who participated.

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Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5718, USA

    Janine Giese-Davis, Suzanne Twirbutt, Karen Piemme, Eric Neri, C. Barr Taylor & David Spiegel

  2. Department of Oncology, Division of Psychosocial Oncology, University of Calgary, 2202 2nd Street SW, Calgary, AB, Canada

    Janine Giese-Davis & Rie Tamagawa

  3. Department of Psychosocial Resources, Tom Baker Cancer Centre, Alberta Health Services, Holy Cross Site, 2202 2nd Street SW, Calgary, AB, Canada

    Janine Giese-Davis & Rie Tamagawa

  4. Department of Psychology, Palo Alto VA Health Care System, 3801 Miranda Ave, Palo Alto, CA, 94304, USA

    Maya Yutsis

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  1. Janine Giese-Davis
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  2. Rie Tamagawa
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Correspondence to Janine Giese-Davis.

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Giese-Davis, J., Tamagawa, R., Yutsis, M. et al. Which symptoms matter? Self-report and observer discrepancies in repressors and high-anxious women with metastatic breast cancer. J Behav Med 37, 22–36 (2014). https://doi.org/10.1007/s10865-012-9461-x

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  • DOI: https://doi.org/10.1007/s10865-012-9461-x

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