Is expressive suppression harmful for Chinese American breast cancer survivors?
Open accessAbstract
Emotion regulation strategies are important for cancer survivors’ adjustment. A growing literature has found it maladaptive to use expressive suppression (ES), defined as the active effort of inhibiting the expressive component of an emotional response. These studies, however, have been limited to cross-sectional designs and primarily European American samples, without considering other theoretically relevant constructs. Chinese culture encourages emotion suppression to preserve interpersonal harmony and therefore it is important to understand what type of emotion suppression would be maladaptive and for whom. This study aimed to examine the unique longitudinal effects of ES, ambivalence over emotional expression (i.e., inner conflict over emotional expression), and cognitive reappraisal on quality of life (QOL) among Chinese breast cancer survivors. We hypothesized that AEE would predict QOL above beyond ES and cognitive reappraisal would buffer potentially harmful effect of ES on QOL. A total of 103 participants completed a questionnaire assessing ES, AEE, cognitive reappraisal, and QOL at baseline and a questionnaire assessing QOL eight weeks later. It was found that baseline AEE predicted follow-up QOL above beyond ES but not vice versa; baseline ES predicted follow-up QOL only among those with low cognitive reappraisal. These findings suggest that expressive suppression may not be maladaptive for Chinese breast cancer survivors. Interventions should be developed to help Chinese breast cancer survivors to reduce AEE and increase cognitive reappraisal. Understanding the moderators and other theoretically important variables provide beneficial implications for improving the quality of life of Chinese breast cancer survivors.
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Ambivalence over emotional expression is associated with lower follow-up quality of life beyond the effect of expressive suppression.
“Ambivalence over emotional expression was associated with lower follow-up quality of life beyond the effect of expressive suppression [70].”
From The Role of Emotion-Related Abilities in the Quality of Life of Breast Cancer Survivors: A Systematic Review (2022) · cites this paper as [70]
Improvements in physical quality of life were observed in studies that included treatment outcomes and/or adherence to physical exercise.
“Similarly, improvements in physical quality of life were observed in studies that included treatment outcomes and/or adherence to physical exercise [51,58,65,68,70,72]; conversely, dysfunctional emotional management appeared associated with lower physical QoL as well as with fatigue and lower adherence to exercise.”
From The Role of Emotion-Related Abilities in the Quality of Life of Breast Cancer Survivors: A Systematic Review (2022) · cites this paper as [70]
The Methods (Measures; page unavailable) say the study used a composite quality-of-life score that included physical well-being. The Results (Preliminary analysis and Regression analysis; pages unavailable) examine associations between emotional regulation and overall quality of life, but do not report improvements in physical quality of life linked to treatment outcomes or exercise adherence. Searches for those terms found no supporting passage. (LLM, conf=0.76)
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“Ambivalence over emotional expression was associated with lower follow-up quality of life beyond the effect of expressive suppression [70].”
BackgroundInfluentialChu, Q., Wong, C. C. Y., Chen, L., Shin, L. J., Chen, L., & Lu, Q. (2021) · Psycho-Oncology · doi:10.1002/pon.5590 · Cited by 33 · see citing works
“The present study utilized the baseline data of a larger longitudinal study that aimed to investigate stress coping and psychological well‐being among Chinese American breast cancer survivors.(23) The study received approval from the institutional review boards of University of Texas MD Anderson Cancer Center (protoco…”
MethodSelf-citation
- Authors
- Lu, Q., Tsai, W., Chu, Q., & Xie, J.
- Affiliations
- California State University, San Marcos (US)
- University of Houston (US)
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2018-06
- Volume
- 109
- Pages
- 51-56
- ISSN
- 0022-3999 (ISSN-L)
- PMC
- PMC8054769
- OpenAlex
- W2802926974
- Semantic Scholar
- a8727ef6d80b0b5e32aed3ff4ce483f46061e52f
- Cited by
- 29
- References
- 50
- Citations by year
- 2026: 3 · 2025: 4 · 2024: 2 · 2023: 1 · 2022: 7 · 2021: 4 · 2020: 5 · 2019: 2 · 2018: 1
- FWCI
- 1.13
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychosomatic Research (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Cancer Institute (CA180896)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Childhood Cancer Survivors' Quality of Life
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
- Keywords
- expressive suppression, breast cancer survivors, Chinese Americans, ambivalence over emotional expression, cognitive reappraisal, emotion regulation, quality of life, interpersonal harmony
- MeSH terms
- Cancer Survivors, Adult, Aged, Aged, 80 and over, Asian, Breast Neoplasms, Cross-Sectional Studies, Emotions, Female, Humans, Male, Middle Aged, Quality of Life
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