Emotional disclosure and cognitive processing in couples coping with head and neck cancer
- 6 Downloads
Head and neck cancer (HNC) patients and their spouses experience communication problems and high rates of emotional distress. Couple-based interventions that encourage emotional disclosure hold promise for improving cognitive processing and distress in this population, but more research needs to examine when and for whom emotional disclosure is an effective coping strategy. In this observational study, 125 HNC patients (83% male) and their spouses were videotaped discussing a cancer-related concern in the laboratory. Discussions were coded with the specific affect coding system. Actor–partner interdependence models showed that patient expression of negative emotions (i.e., disdain, contentiousness, distress) was not related to his/her own or the spouse’s cognitive processing (assessed as reaction times to cancer and noncancer words on a computerized cognitive task administered immediately following the discussion). When spouses expressed support (e.g., interest, validation), they had better cancer- (effect size r = − 0.21) and noncancer-related cognitive processing (r = − 0.17), but patients did not. However, when spouses expressed disdain (e.g., contempt) and contentiousness (e.g., criticism, domineering), patients had poorer cancer- (r = 0.20–0.22) and noncancer-related cognitive processing (r = 0.19–0.26). Findings suggest consideration of the valence of affective expression and which partner is disclosing/listening before unilaterally encouraging HNC couples to openly express emotions as a means of alleviating distress.
KeywordsHead and neck cancer Affective expression Disclosure Cognitive processing Implicit measures Cancer Stroop task
This work was supported by K07CA124668 (PI: Badr) and P30CA125123 (PI: Osborne).
Compliance with ethical standards
Conflict of interest
Jafar Bakhshaie, Mark Bonnen, Joshua Asper, Vlad Sandulache, and Hoda Badr declare that they have no conflict of interest.
Human and animal rights and informed consent
All procedures followed were in accordance with ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. Informed consent was obtained from all patients for being included in the study.
- Ackerman, R. A., Donnellan, M. B., & Kashy, D. A. (2011). Working with dyadic data in studies of emerging adulthood: Specific recommendations, general advice, and practical tips. In F. Fincham & M. Cui (Eds.), Romantic relationships in emerging adulthood (pp. 67–100). New York: Cambridge University Press.Google Scholar
- Beck, A., & Emery, G. (1985). Anxiety disorders and phobias: A cognitive perspective. New York: Basic Books.Google Scholar
- Bhayani, M. K., Hutcheson, K. A., Barringer, D. A., Lisec, A., Alvarez, C. P., Roberts, D. B., et al. (2013). Gastrostomy tube placement in patients with oropharyngeal carcinoma treated with radiotherapy or chemoradiotherapy: Factors affecting placement and dependence. Head and Neck, 35, 1634–1640.CrossRefGoogle Scholar
- Coan, J. A., & Gottman, J. M. (2007). The specific affect coding system (SPAFF). In J. Coan & J. Allen (Eds.), Handbook of emotion elicitation and assessment (pp. 267–285). New York, NY: Oxford University Press.Google Scholar
- Derogatis, L. R. (1992). The brief symptom inventory (BSI): Administration, scoring and procedures manual-II. Baltimore: Clinical Psychometric Research.Google Scholar
- Goldsmith, D. J., Miller, L. E., & Caughlin, J. P. (2007). Openness and avoidance in couples communicating about cancer. Communication Yearbook, 31, 62.Google Scholar
- Gordis, E. B., & Margolin, G. (2000). The family coding system: Studying the relation between marital conflict and family interaction. In P. K. Kerig & K. M.Lindahl (Eds.), Family observational coding systems: Resources for systemic research (pp. 123–138). Mahwah, NJ: Lawrence Erlbaum Associates, Inc.Google Scholar
- Gottman, J. M. (1994). What predicts divorce? The relationship between marital processes and marital outcomes. Hillsdale, NJ: Erlbaum.Google Scholar
- Gottman, J. M., McCoy, K., Coan, J., & Collier, H. (1996). The specific affect coding system (SPAFF) for observing emotional communication in marital and family interaction. Mahwah, NJ: Erlbaum.Google Scholar
- Kenny, D. A. (2017). APIM_MM: A web-based package for estimating the actor–partner interdependence model by multilevel modeling.Google Scholar
- Kenny, D. A., Kashy, D., & Cook, W. (2006). The analysis of dyadic data. New York: Guilford.Google Scholar
- Lee, Y., Lin, P.-Y., Chien, C.-Y., Fang, F.-M., & Wang, L.-J. (2018). a comparison of psychological well-being and quality of life between spouse and non-spouse caregivers in patients with head and neck cancer: A 6-month follow-up study. Neuropsychiatric Disease and Treatment, 14, 1697.CrossRefGoogle Scholar
- Manne, S., Ostroff, J., Rini, C., Fox, K., Goldstein, L., & Grana, G. (2004). The interpersonal process model of intimacy: The role of self-disclosure, partner disclosure, and partner responsiveness in interactions between breast cancer patients and their partners. Journal of Family Psychology, 18, 589–599.CrossRefGoogle Scholar
- Milbury, K., & Badr, H. (2010). Development and implementation of a cancer Stroop task to assess biased cognitive processing in couples coping with head and neck cancer. Annals of Behavioral Medicine, 39, S165.Google Scholar
- Milbury, K., Tsao, A. S., Liao, Z., Owns, A., Engle, R., Gonzalez, E. A., et al. (2018). A research protocol for a pilot randomized controlled trial designed to examine the feasibility of a couple-based mind–body intervention for patients with metastatic lung cancer and their partners. Pilot and Feasibility Studies, 4, 37.CrossRefGoogle Scholar
- Rehman, U. S., Janssen, E., Newhouse, S., Heiman, J., Holtzworth-Munroe, A., Fallis, E., et al. (2011). Marital satisfaction and communication behaviors during sexual and nonsexual conflict discussions in newlywed couples: A pilot study. Journal of Sex and Marital Therapy, 37, 94–103.CrossRefGoogle Scholar
- Stanton, A. L. (2011). Regulating emotions during stressful experiences: The adaptive utility of coping through emotional approach. In S. Folkman & P. Nathan (Eds.), The Oxford handbook of stress, health, and coping (pp. 369–386). New York, NY, Oxford.Google Scholar