Emotional expression and psychological and physical well-being among early-stage breast cancer patients

Date of Award




Degree Name

Doctor of Philosophy (Ph.D.)



First Committee Member

Charles S. Carver - Committee Chair


This study examined the relationships between emotional expression processes and physical and psychological well-being among early-stage breast cancer patients. Participants were 128 women (average age = 50.09, average years of education = 15.17) diagnosed with early stage breast cancer. Participants completed assessments by mail 4--8 weeks after their surgery and at 3, 6, and 12 month follow-up. Following the initial assessment, women were randomly assigned to either a 10-week cognitive-behavioral stress management intervention or to a one day seminar control condition. At all four time points, participants completed measures assessing emotional expression, distress, benefit finding, cognitive change, physical health outcomes (e.g., number of illnesses, illness-related disruption, sleep quality), and optimism. Emotional expression processes were hypothesized to predict lower subsequent distress, greater subsequent benefit-finding, and better subsequent physical health outcomes. Analyses examined moderation and mediation of these relationships by cognitive change. Analyses also explored for moderation by optimism, participation in the intervention, and ethnicity. Although results failed to support many of the classic relationships found by emotional expression researchers, the findings reported here showed evidence of a more complex picture, with evidence of moderation by several important variables. The strongest evidence was found for cognitive change, supporting the notion that cognitive change must accompany emotional expression for the beneficial effects to emerge. Additional evidence was found for moderation by ethnicity, optimism, and participation in a group psychosocial intervention. The implications of these findings are explored and recommendations for further research are discussed.


Psychology, Clinical; Psychology, Physiological; Health Sciences, Oncology

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