Ambivalence over emotional expression, intrusive thoughts, and posttraumatic stress symptoms among Chinese American breast cancer survivors
Abstract
Objective Posttraumatic stress symptoms (PTSS) are common among breast cancer survivors. However, the association and the underlying mediating mechanism between psychosocial factors and PTSS were rarely investigated among breast cancer survivors. Previous studies have suggested the importance of emotional expression in cancer survivors' PTSS. This study examined the association between ambivalence over emotional expression (AEE; defined as the conflict between the desire to express feelings and the fear of its consequences) and PTSS, and proposed intrusive thoughts as the mediators in such an association. We tested this proposed mediation model among Chinese breast cancer survivors whose culture discourages emotional expression.Methods Participants were 118 Chinese-speaking breast cancer survivors in the USA, who were diagnosed with breast cancer of stages 0-III within the past 5 years. They completed questionnaires measuring their levels of AEE, PTSS, and intrusive thoughts.Results AEE was positively associated with intrusive thoughts (r = 0.43, p < 01), which were positively associated with the arousal and avoidance subscales of PTSS (r = 0.68 and r = 0.62, respectively, p < .01). Path analysis supported a partial mediation model with an indirect effect from AEE to the latent variable of PTSS (with both arousal and avoidance as indicators) via intrusive thoughts (β = 0.29; 95% CI= 0.18, 0.42) and the direct effect from AEE to the latent variable of PTSS (β = 0.21, 95% CI = 0.07, 0.35), all p < .001.Conclusions Those who are highly ambivalent about emotion expression tend to have higher PTSS, and this may be partially due to the lack of opportunities to discuss emotional events, thereby increasing the repetitive cancer-related negative thoughts. Intervention for PTSS should consider helping cancer patients to develop adaptive emotional regulation strategies to reduce the detrimental effects of cancer-related intrusive thoughts.
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The PSS-SR was reliable and valid among Chinese cancer patients.
“The scale was reliable and valid among Chinese cancer patients [27].”
From Associations between COVID-19 Work-Related Stressors and Posttraumatic Stress Symptoms among Chinese Doctors and Nurses: Application of Stress-Coping Theory (2022) · cites this paper as [27]
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She, R., Li, L., Yang, Q., Lin, J., Ye, X., Wu, S., Yang, Z., Guan, S., Zhang, J., Ling, R. H. Y., et al. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19106201 · Cited by 8 · see citing works
“The scale was reliable and valid among Chinese cancer patients [27].”
Background
- Authors
- Lu, Q., Yeung, N., Man, J., Gallagher, M. W., Chu, Q., & Deen, S. H.
- Affiliations
- University of Houston (US)
- Venue
- Supportive Care in Cancer
- Published
- 2017-05-12
- Volume
- 25
- Issue
- 10
- Pages
- 3281-3287
- ISSN
- 0941-4355 (ISSN-L)
- 1433-7339
- OpenAlex
- W2612160676
- Cited by
- 17
- References
- 50
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 1 · 2022: 4 · 2021: 3 · 2020: 1 · 2019: 2 · 2018: 2 · 2017: 1
- FWCI
- 0.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Supportive Care in Cancer (publishedVersion)
- PubMed (publishedVersion)
- Funders
- American Cancer Society (MRSGT-10-011-01-CPPB)
- National Cancer Institute (3 U01 CA114640-02S5 Pilot project)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Keywords
- ambivalence over emotional expression, intrusive thoughts, posttraumatic stress symptoms, breast cancer survivors, Chinese Americans, mediation, emotional expression, emotion regulation, avoidance, arousal
- MeSH terms
- Cancer Survivors, Adult, Affect, Agonistic Behavior, Arousal, Asian, Avoidance Learning, Breast Neoplasms, Cognition, Conflict, Psychological, Fear, Female, Humans, Middle Aged, Surveys and Questionnaires, Stress Disorders, Post-Traumatic, Thinking, Expressed Emotion, Emotional Intelligence
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