The Cost of Bottling It Up: Emotion Suppression as a Mediator in the Relationship Between Anger and Depression Among Men with Prostate Cancer

Figures & data

Table 1 Demographic and Outcomes for Total Sample and by Emotion Suppression Grouping

		Total (N=100)	Emotion Suppression Group			Inferential
			Low (n=28)	Moderate (n=42)	High (n=30)	Statistic	p
Background variables
Age (years)	M (SD)	64.81 (7.17)	65.96 (6.35)	65.74 (7.60)	62.43 (6,95)	F=2.43	0.094
Current treatment	(%, n)	33.0 (33)	32.1 (9)	31.0 (13)	36.7 (11)	χ^2=0.27	0.873
Prostatectomy	(%, n)	54.0 (54)	46.4 (13)	69.0 (29)	40.0 (12)	χ^2=6.84	0.033
Androgen deprivation	(%, n)	18 (18)	17.9 (5)	23.8 (10)	10.0 (3)	χ^2=2.26	0.323
Active surveillance	(%, n)	22.0 (22)	21.4 (6)	22.7 (5)	36.7 (11)	χ^2=6.19	0.044
Past year diagnosis	(%, n)	35.0 (35)	21.4 (6)	35.7 (15)	48.3 (14)	χ^2=4.50	0.106
Years since diagnosis	M (SD)	4.59 (5.07)	5.79 (5.71)	4.83 (5.17)	4.59 (5.06)	F=2.12	0.127
Comorbidity	(%, n)	38.0 (38)	35.7 (10)	31.0 (13)	50.0 (15)	χ^2=2.78	0.249
Clinical variables
PHQ-9 Total	M (SD)	5.85 (5.57)	2.14 (2.65)	5.45 (5.29)	9.87 (5.46)	F=19.29	<0.001
Suicide ideation	(%, n)	14 (14)	0 (0)	28.6 (4)	33.3 (10)	χ^2=14.57	<0.001
Alcohol Use	M (SD)	2.51 (4.97)	0.96 (3.67)	2.07 (4.49)	4.57 (6.03)	F=4.37	0.015
Anger	M (SD)	3.53 (5.18)	1.32 (2.57)	2.48 (3.91)	7.07 (6.69)	F=12.88	<0.001
Emotion Suppression	M (SD)	8.73 (7.73)	0.64 (0.87)	7.05 (3.47)	18.63 (7.73)	F=232.79	<0.001
Drug Use	M (SD)	1.03 (3.24)	0.36 (1.06)	1.19 (3.84)	1.43 (3.64)	F=0.89	0.416
Somatic Symptoms	M (SD)	5.14 (5.35)	1.96 (3.70)	5.55 (5.44)	7.53 (5.24)	F=9.41	<0.001
Risk-Taking	M (SD)	1.30 (2.61)	0.36 (1.70)	1.05 (2.15)	2.53 (3.38)	F=5.92	0.004

Note: Bolded text denotes significant at p<0.05.

Abbreviations: M, Mean; SD, Standard deviation.

Table 2 Coefficients for Direct and Indirect Effects of Anger Predicting Depression Through Male-Specific Symptoms as Potential Mediators (99% CIs)

	B	SE	t	P
DV: Emotion Suppression
Anger	0.807	0.129	6.246	0.004
Active surveillance^#	1.889	1.929	0.979	0.330
Prostatectomy^#	0.525	1.599	0.743	0.743
Model summary	F(3, 96)=14.798, R^2=0.316, p<0.001
DV: Depression
Anger	0.285	0.111	2.580	0.012
Emotion suppression	0.327	0.063	5.176	<0.001
Drug use	0.223	0.122	1.838	0.070
Alcohol use	−0.157	0.082	−1.919	0.058
Somatisation	0.146	0.082	1.784	0.079
Risk-taking	0.083	0.203	0.411	0.682
Active surveillance^#	−0.761	1.186	−0.642	0.523
Prostatectomy^#	−1.743	0.973	−1.792	0.076
Model summary	F(8, 91)=15.740, R^2=0.581, p<0.001
	Bootstrap estimate
Indirect effects	Effect	SE	Lower CI	Upper CI
DV: Depression
Anger through Emotion suppression	0.241	0.078	0.058	0.470
Anger though Drug use	0.007	0.023	−0.051	0.094
Anger through Alcohol use	−0.036	0.033	−0.165	0.012
Anger through Somatic symptoms	0.060	0.044	−0.036	0.206
Anger through Risk-taking	0.027	0.087	−0.181	0.315

Notes: ^#covariate, N=100, CI=99% confidence interval (10,000 resamples), boldface text indicates statistically significant values at p<0.01.

Abbreviation: DV, Dependent variable.

Figure 1 Mean depression symptoms (with 95% CIs) by emotion suppression group including Bonferroni corrected post hoc tests.

Notes: ***p<0.001, **p<0.01, *p<0.05; Y-axis represents PHQ-9 response scale (over previous 2-weeks); 0=“Not at all”, 1=“Several days”, 2=“More than half the days”, 3=“Almost every day”. Several “apparent” group differences did not survive Bonferroni correction.