Thought suppression is associated with psychological distress in homebound older adults: Thought Suppression in Homebound Older Adults
Open accessAbstract
BACKGROUND: Engaging in thought suppression as a coping mechanism has been associated with higher rates of anxiety and depressive disorders in younger adults. Homebound older adults are a population of elders experiencing poor health and high levels of depression and anxiety. It is unclear the extent to which psychological factors, such as thought suppression, are associated with distress, given that their health and disability status may be more salient. The aim of this study was to investigate thought suppression in relation to anxiety and depressive symptoms in homebound older adults. METHODS: Participants (N = 142) were clients of home-based case management services delivered by aging service agencies in Florida. Participants were administered a research interview that included the White Bear Suppression Inventory, Structured Clinical Interview for DSM-IV Diagnosis (SCID), Brief Symptom Inventory-18 (BSI-18), and Modified Mini-Mental Status Examination (3MS). Case managers provided standard assessments containing functional and health status of the participant. RESULTS: After controlling for physical health and cognitive functioning, thought suppression was significantly associated with higher likelihood of clinically significant somatic, depressive, and anxiety symptoms on the BSI-18. Thought suppression was also associated with meeting criteria for a SCID depressive or adjustment disorder. Engaging in thought suppression was associated with worse mental health in this sample of homebound older adults even after taking into account physical health, disability, and cognitive functioning. CONCLUSIONS: These findings suggest the need to develop and test interventions that may address thought suppression as a coping mechanism.
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Thought suppression is a dysfunctional coping strategy and a specific form of avoidance associated with an increased likelihood of somatic, depressive, and anxiety symptoms in older adults.
“a dysfunctional coping strategy and a specific form of avoidance which has been associated with an increased likelihood of somatic, depressive, and anxiety symptoms in older adults (Petkus et al., 2012).”
From Supported Web-Based Acceptance and Commitment Therapy for Older Family Caregivers (CareACT) Compared to Usual Care. (2022) · cites this paper as Petkus et al., 2012
The Results and Discussion report that thought suppression was associated with a higher likelihood of clinically significant somatic, depressive, and anxiety symptoms, and the Discussion describes it as a form of avoidance coping. The study examined homebound older adults, however, so its findings do not establish that association for older adults generally. (LLM, conf=0.85)
Experimental — accuracy not yet measuredAvoidant coping strategies, including thought suppression, have been found to be associated with elevated symptoms of depression and anxiety in older adults and family caregivers of persons with dementia.
“while avoidant coping strategies, including thought suppression, have been found to be associated with elevated symptoms of depression and anxiety in older adults (Petkus, Gum, & Wetherell, 2012) and family caregivers of persons with dementia (García-Alberca et al., 2012;Spira et al., 2007).”
From Supported Web-Based Acceptance and Commitment Therapy for Older Family Caregivers (CareACT) Compared to Usual Care. (2022) · cites this paper as Petkus, Gum, & Wetherell, 2012
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Cites
Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975) · Journal of Psychiatric Research · doi:10.1016/0022-3956(75)90026-6 · Cited by 88,282 · see citing works
The Measurement of Observer Agreement for Categorical Data
Landis, J. R., & Koch, G. G. (1977) · Biometrics · doi:10.2307/2529310 · Cited by 81,148 · see citing works
Hirono, N., Mori, E., Ikejiri, Y., Imamura, T., Shimomura, T., Hashimoto, M., Yamashita, H., & Ikeda, M. (1997) · PubMed · Cited by 21,010 · see citing works
Kok, J. S., Berg, I. J., & Scherder, E. J. A. (2013) · Dementia and Geriatric Cognitive Disorders Extra · doi:10.1159/000353441 · Cited by 20,589 · see citing works
Older Adults' Reasons for Using Technology while Aging in Place
Peek, S. T. M., Luijkx, K. G., Rijnaard, M. D., Nieboer, M. E., van der Voort, C. S., Aarts, S., van Hoof, J., Vrijhoef, H. J., & Wouters, E. (2015) · Gerontology · doi:10.1159/000430949 · Cited by 19,803 · see citing works
Sensitivity and False Alarm Rate of a Fall Sensor in Long-Term Fall Detection in the Elderly
Kangas, M., Korpelainen, R., Vikman, I., Nyberg, L., & Jämsä, T. J. (2014) · Gerontology · doi:10.1159/000362720 · Cited by 19,003 · see citing works
Emotion-regulation strategies across psychopathology: A meta-analytic review
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2009.11.004 · Cited by 6,686 · cited 2× · see citing works
“This finding is consistent with studies with younger adults that have demonstrated that engaging in thought suppression is also associated with anxiety.[23,39] One interpretation of these findings is that efforts to avoid distressing cognitions or emotions are associated with increased levels of distress, independent…”
BackgroundResultDepression in Late Life: Review and Commentary
Blazer, D. G. (2003) · The Journals of Gerontology Series A · doi:10.1093/gerona/58.3.m249 · Cited by 2,363 · see citing works
Toward a unified treatment for emotional disorders
Barlow, D. H., Allen, L. B., & Choate, M. L. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80036-4 · Cited by 1,430 · see citing works
Wegner, D. M., & Zanakos, S. (1994) · Journal of Personality · doi:10.1111/j.1467-6494.1994.tb00311.x · Cited by 1,245 · see citing works
Wenzlaff, R. M., & Wegner, D. M. (2000) · Annual Review of Psychology · doi:10.1146/annurev.psych.51.1.59 · Cited by 1,063 · see citing works
Perkowski, R., & Perkowski, A. (2000) · Cited by 889 · see citing works
Specificity of cognitive emotion regulation strategies: a transdiagnostic examination
Aldao, A., & Nolen-Hoeksema, S. (2010) · Behaviour Research and Therapy · doi:10.1016/j.brat.2010.06.002 · Cited by 860 · see citing works
Unützer, J. (1997) · JAMA · doi:10.1001/jama.1997.03540440052032 · Cited by 697 · see citing works
Lenze, E. J., Rogers, J. C., Martire, L. M., Mulsant, B. H., Rollman, B. L., Dew, M. A., Schulz, R., & Reynolds, C. F. (2001) · The American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200105000-00004 · Cited by 593 · see citing works
Toward a unified treatment for emotional disorders - republished Article
Barlow, D. H., Allen, L. B., & Choate, M. L. (2016) · Behavior Therapy · doi:10.1016/j.beth.2016.11.005 · Cited by 536 · see citing works
Risk factors for late-life suicide: A prospective community-based study
Turvey, C. L., Conwell, Y., Jones, M. P., Phillips, C., Simonsick, E., Pearson, J. L., & Wallace, R. (2002) · The American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200207000-00006 · Cited by 406 · see citing works
Major Depression in Elderly Home Health Care Patients
BRUCE, M. L., McAvay, G., Raue, P. J., Brown, E. L., Meyers, B. S., Keohane, D. J., Jagoda, D. R., & Weber, C. (2002) · American Journal of Psychiatry · doi:10.1176/appi.ajp.159.8.1367 · Cited by 360 · see citing works
Wilamowska, Z. A., Thompson-Hollands, J., Fairholme, C. P., Ellard, K. K., Farchione, T. J., & Barlow, D. H. (2010) · Depression and Anxiety · doi:10.1002/da.20735 · Cited by 314 · see citing works
Physical and Mental Health of Homebound Older Adults: An Overlooked Population
Qiu, W. Q., Dean, M., Liu, T., George, L., Gann, M., Cohen, J. T., & BRUCE, M. L. (2010) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2010.03161.x · Cited by 294 · see citing works
Porensky, E. K., Dew, M. A., Karp, J. F., Skidmore, E., Rollman, B. L., Shear, M. K., & Lenze, E. J. (2009) · The American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e31819b87b2 · Cited by 255 · see citing works
Sinoff, G., & Werner, P. (2003) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1004 · Cited by 197 · see citing works
Comorbidity of depression and anxiety disorders in later life
Lenze, E. J., Mulsant, B. H., Shear, M. K., Alexopoulos, G. S., Frank, E., & Reynolds, C. F. (2001) · Depression and Anxiety · doi:10.1002/da.1050 · Cited by 180 · see citing works
The Influence of Anxiety on the Progression of Disability
Brenes, G. A., Guralnik, J. M., Williamson, J. D., Fried, L. P., Simpson, C. F., Simonsick, E. M., & Penninx, B. W. J. H. (2004) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2005.53007.x · Cited by 177 · see citing works
Dotson, V. M., Resnick, S. M., & Zonderman, A. B. (2008) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181662a9c · Cited by 175 · see citing works
Quality of life in geriatric generalized anxiety disorder: a preliminary investigation
Loebach Wetherell, J., Thorp, S. R., Patterson, T. L., Golshan, S., Jeste, D. V., & Gatz, M. (2004) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2003.09.003 · Cited by 170 · see citing works
Self-citationThe Effect of Homebound Status on Older Persons
Cohen‐Mansfield, J., Shmotkin, D., & Hazan, H. (2010) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2010.03172.x · Cited by 123 · see citing works
Acceptance and Commitment Therapy With Older Adults: Rationale and Considerations
Petkus, A. J., & Wetherell, J. L. (2013) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2011.07.004 · Cited by 108 · cited 1× · see citing works
“Such transdiagnostic interventions for depression and anxiety in homebound older adults would potentially be more efficient than disorder-specific treatments[40] and is consistent with recent developments in psychotherapy research in younger adults with depression or anxiety.”
ResultSelf-citationA Profile of Older Americans: 2010
(2010) · PsycEXTRA Dataset · doi:10.1037/e572472012-001 · Cited by 98 · see citing works
Anxiety Symptoms as Predictors of Nursing Home Placement in Patients with Alzheimer's Disease
Gibbons, L. E., Teri, L. L., Logsdon, R. G., McCurry, S. M., Kukull, W. A., Bowen, J. D., McCormick, W. C., & Larson, E. B. (2002) · Journal of Clinical Geropsychology · doi:10.1023/a:1019635525375 · Cited by 78 · see citing works
Schmidt∗, R. E., Gay, P., Courvoisier, D. S., Jermann, F., Ceschi, G., David, M., Brinkmann, K., & der Linden, M. V. (2009) · Journal of Personality Assessment · doi:10.1080/00223890902935738 · Cited by 77 · see citing works
The Association Between Self-Reported Anxiety Symptoms and Suicidality
Diefenbach, G. J., Woolley, S. B., & Goethe, J. W. (2009) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e318196127c · Cited by 67 · see citing works
Dulin, P. L., & Passmore, T. (2010) · Journal of Traumatic Stress · doi:10.1002/jts.20512 · Cited by 63 · see citing works
Cukrowicz, K. C., Ekblad, A. G., Cheavens, J. S., Rosenthal, M. Z., & Lynch, T. R. (2008) · Aging & Mental Health · doi:10.1080/13607860801936714 · Cited by 56 · see citing works
Predictors of New Onset Depression in Medically Ill, Disabled Older Adults at 1 Year Follow-Up
Weinberger, M. I., Raue, P. J., Meyers, B. S., & BRUCE, M. L. (2009) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3181b0481a · Cited by 54 · see citing works
Petkus, A. J., Gum, A. M., Small, B., Malcarne, V. L., Stein, M. B., & Wetherell, J. L. (2010) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2377 · Cited by 54 · see citing works
Self-citationDetection of depression and anxiety disorders by home care nurses
Préville, M., Côté, G., Boyer, R., & Hébert, R. (2004) · Aging & Mental Health · doi:10.1080/13607860410001725009 · Cited by 44 · see citing works
Psychiatric comorbidity and depression in older adults
Gum, A. M., & Cheavens, J. S. (2008) · Current Psychiatry Reports · doi:10.1007/s11920-008-0006-5 · Cited by 40 · cited 1× · see citing works
“[17,18] Additionally, depression and anxiety commonly are comorbid in older adulthood.[19,20] Comorbid anxiety is associated with poorer outcomes such as longer time to respond to treatment for depression.”
BackgroundSelf-citationThought suppression and meaning in life: a longitudinal investigation
Krause, N. (2007) · The International Journal of Aging and Human Development · doi:10.2190/2044-390u-7106-5610 · Cited by 34 · see citing works
Behavioral health needs and problem recognition by older adults receiving home-based aging services
Gum, A. M., Petkus, A., McDougal, S. J., Present, M., King‐Kallimanis, B., & Schonfeld, L. (2009) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.2135 · Cited by 32 · see citing works
Self-citationMental Health Status of Home Care Elders in Michigan
Li, L., & Conwell, Y. (2007) · The Gerontologist · doi:10.1093/geront/47.4.528 · Cited by 32 · see citing works
Residual symptoms in older patients treated for major depression
Hybels, C. F., Steffens, D. C., McQuoid, D. R., & Krishnan, K. (2005) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1418 · Cited by 25 · see citing works
Thought suppression and treatment outcome in late-life depression
Rosenthal, M. Z., Cheavens, J. S., Compton, J. S., Thorp, S. R., & Lynch, T. R. (2005) · Aging & Mental Health · doi:10.1080/13607860512331334040 · Cited by 24 · see citing works
Flagged first, then by citations
1 of the 44 references couldn’t be matched to a known paper.
Research works printed but not linked: 1
- [33]First MB Spitzer RL Miriam G Williams JB Structured Clinical Interview for the DSM-IV-TR Axis I Disorders, Research Version, Patient Edition with Psychotic Screen New York Biometrics Research, New York State Psychiatric Institute 2002
Cited by
Sorted by citations
Acceptance and Commitment Therapy With Older Adults: Rationale and Considerations
Petkus, A. J., & Wetherell, J. L. (2013) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2011.07.004 · Cited by 108 · see citing works
Self-citationMiethe, S., Wigger, J., Wartemann, A., Fuchs, F. O., & Trautmann, S. (2023) · Journal of Psychopathology and Behavioral Assessment · doi:10.1007/s10862-023-10022-2 · Cited by 55 · see citing works
Lineback, S., Allender, M., Gaines, R., McCarthy, C. J., & Butler, A. M. (2016) · Educational Studies · doi:10.1080/00131946.2016.1231681 · Cited by 37 · see citing works
Lappalainen, P., Keinonen, K., Pakkala, I., Lappalainen, R., & Nikander, R. (2021) · Journal of Contextual Behavioral Science · doi:10.1016/j.jcbs.2021.04.005 · Cited by 34 · see citing works
Akbari, M., Seydavi, M., & Zamani, E. (2021) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.2685 · Cited by 31 · see citing works
Lappalainen, P., Pakkala, I., Lappalainen, R., & Nikander, R. (2022) · Clinical Gerontologist · doi:10.1080/07317115.2021.1912239 · Cited by 25 · see citing works
“Instead, the online intervention decreased the caregivers’ thought suppression (WBSI), a dysfunctional coping strategy and a specific form of avoidance which has been associated with an increased likelihood of somatic, depressive, and anxiety symptoms in older adults (Petkus et al., 2012).”
BackgroundEmotionsregulation bei Depression
Barnow, S., Aldinger, M., Ulrich, I., & Stopsack, M. (2013) · Psychologische Rundschau · doi:10.1026/0033-3042/a000172 · Cited by 23 · see citing works
Fernández-Fernández, V., Losada‐Baltar, A., Márquez‐González, M., Paniagua-Granados, T., Vara‐García, C., & Luque-Reca, O. (2020) · International Psychogeriatrics · doi:10.1017/s1041610219002084 · Cited by 25 · see citing works
Boss, L., Branson, S., Cron, S. G., & Kang, D.-H. (2016) · Religions · doi:10.3390/rel7050042 · Cited by 16 · see citing works
Emotion-regulation strategies in older people: a systematic review
Ramírez‐Ruiz, B., Quinn, K. M., & Ferreira, N. B. (2019) · Working with Older People · doi:10.1108/wwop-09-2019-0026 · Cited by 9 · see citing works
The Predictive and Mediating Role of Self-Compassion in Substance Use Disorders
Karlou, I., & Karakasidou, E. (2025) · European Journal of Counselling Psychology · doi:10.46853/001c.133794 · Cited by 4 · see citing works
Bruschetta, R., Latella, D., Formica, C., Campisi, S., Failla, C., Marino, F., Isidoro, S. I., Giambò, F. M., Bonanno, L., Cerasa, A., et al. (2024) · Bioengineering · doi:10.3390/bioengineering11080787 · Cited by 3 · see citing works
María, M.-G., Virginia, F.-F., Rosa, R.-M., & Andrés, L. (2013) · INFORMACIO PSICOLOGICA · doi:10.14635/ipsic.2014.105.3 · Cited by 3 · see citing works
de Guzman, A. B., Ibarrola, G. M. V., Idolog, C. L. J. I., & Ignacio, A. J. C. (2020) · Educational Gerontology · doi:10.1080/03601277.2020.1748798 · Cited by 3 · see citing works
Parra-Rizo, M. A., Cigarroa, I., Parra-Ortiz, M. C., González-Moreno, J., & Fajardo-Ramos, E. (2026) · Journal of Population Ageing · doi:10.1007/s12062-026-09554-8 · Cited by 3 · see citing works
Biopsychosocial factors associated with depression in the elderly: A systematic literature review
Hadiwiardjo, Y. H., & Damayanti, R. (2022) · F1000Research · doi:10.12688/f1000research.121710.1 · Cited by 2 · see citing works
Miethe, S., Wigger, J., Wartemann, A., & Trautmann, S. (2022) · doi:10.31234/osf.io/egv6t · Cited by 2 · see citing works
Biopsychosocial factors associated with depression in the elderly: A systematic literature review
Hadiwiardjo, Y. H., & Damayanti, R. (2024) · F1000Research · doi:10.12688/f1000research.121710.2 · Cited by 1 · see citing works
김효영, & Lee, H.-J. (2017) · Korean Journal of Health Psychology · doi:10.17315/kjhp.2017.22.1.006 · Cited by 1 · see citing works
Sharma, R., Dillon, K. E., Williams, S. E. E., & McIntosh, R. C. (2023) · Social Neuroscience · doi:10.1080/17470919.2023.2218619 · Cited by 1 · see citing works
Effects of adverse life events on mental health in single older adults in Japan
Murayama, Y., Yamazaki, S., Hasebe, M., & Kobayashi, E. (2023) · Psychogeriatrics · doi:10.1111/psyg.13007 · Cited by 1 · see citing works
Anxiety disorders in older adulthood
Petkus, A., Merz, C., & Wetherell, J. L. (2014) · The Wiley Handbook of Anxiety Disorders · doi:10.1002/9781118775349.ch29 · Cited by 2 · see citing works
Self-citationBarnow, S., Aldinger, M., Ulrich, I., & Stopsack, M. (2013)
Scarlett, L. H. (2016) · ERA
Magalhães, S., Rasteiro, I., Soeiro, I., Carvalheiras, C., Castro, S. L., Leal, T., & Limpo, T. (2025) · Current Psychology · doi:10.1007/s12144-025-08088-0 · Cited by 1 · see citing works
- Authors
- Petkus, A. J., Gum, A., & Wetherell, J. L.
- Affiliations
- San Diego State University (US)
- University of South Florida (US)
- University of California San Diego (US)
- Corresponding author
- Gum, Amber
- Venue
- Depression and Anxiety
- Publisher
- Hindawi Limited
- Published
- 2011-12-13
- Volume
- 29
- Issue
- 3
- Pages
- 219-225
- ISSN
- 1091-4269 (ISSN-L)
- PMC
- PMC4069281
- OpenAlex
- W1920949392
- Cited by
- 26
- References
- 44
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 2 · 2023: 3 · 2022: 2 · 2021: 3 · 2020: 2 · 2019: 2 · 2017: 1 · 2016: 3 · 2014: 1 · 2013: 3
- FWCI
- 2.06
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R34MH080151, R34MH086668)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Clinical Psychology › Psychology and Mental Health
- Keywords
- thought suppression, homebound older adults, psychological distress, anxiety symptoms, depressive symptoms, coping strategies, White Bear Suppression Inventory, adjustment disorder, somatic symptoms
- MeSH terms
- Adjustment Disorders, Aged, Aged, 80 and over, Anxiety Disorders, Depressive Disorder, Female, Florida, Humans, Male, Psychiatric Status Rating Scales, Repression, Psychology, Stress, Psychological, Thinking, Homebound Persons, Diagnostic and Statistical Manual of Mental Disorders
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