Is emotion regulation associated with cancer-related psychological symptoms?

Abstract

Objectives: This study examined the cross-sectional and prospective relationships between subjective (cognitive reappraisal, expressive suppression and experiential avoidance) and objective (high-frequency heart rate variability [HF-HRV]) measures of emotion regulation (ER) and a set of psychological symptoms (anxiety, depression, fear of cancer recurrence [FCR], insomnia, fatigue, pain, and cognitive impairments) among women receiving radiation therapy for non-metastatic breast cancer.

Design: Eighty-one participants completed a battery of self-report scales within 10 days before the start of radiotherapy (T1) and within 10 days after its end (T2; approximately 6 weeks after T1). HF-HRV at rest was measured at T1.

Results: Canonical correlation analyses revealed that higher levels of experiential avoidance and expressive suppression were cross-sectionally associated with higher levels of all symptoms, except pain, at T1 and at T2 (both p’s < 0.0001). Higher levels of suppression and reappraisal at T1 were marginally associated with reduced FCR and with increased depression and fatigue between T1 and T2 (p = 0.07). HF-HRV was not associated with symptoms cross-sectionally or prospectively.

Conclusions: Although preliminary, these results are consistent with the hypothesis that maladaptive ER strategies, assessed subjectively, may cross-sectionally act as a transdiagnostic mechanism underlying several cancer-related psychological symptoms.

Keywords:

• Breast cancer
• emotion regulation
• anxiety
• depression
• insomnia
• fear of cancer recurrence
• fatigue
• pain
• cognitive impairments
• heart rate variability

Acknowledgements

We sincerely thank the patients for their participation in this study, Fred Sengmueller for his assistance in the revision of the manuscript, as well as Catherine Poveda Perdomo, Véronique Massicotte, and Anny-Joëlle Goulet for their contribution to the project.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1 The expression ‘psychological symptoms’ is used broadly in this manuscript to also encompass symptoms that are generally considered to be somatic but have a strong psychological component (e.g. pain).

Additional information

Funding

This study was supported by scholarships from the Fonds de recherche du Québec - Santé and from the Psychosocial Oncology Research Training Program (Canadian Institutes of Health Research) held by the first author.