“The basic idea is very simple: that in general, it is better to express your emotions than to hold them in,” said Emery, also an investigator in Ohio State’s Institute for Behavioral Medicine Research. “The correlations in this paper are exactly what one would expect.”

And when the researchers then factored in how much the women knew about their illness, a clear link emerged between higher knowledge and more depressive symptoms in women who repressed their anger.

“These are women who would not want to deal with their negative emotions. I think the reason we’re seeing this pattern is that if you’re scared about your health condition, and you’re confronted with more and more information, that makes it more real to you,” Jackson said. “If you’re somebody who doesn’t want to acknowledge the emotion around the situation, it may result in reacting with greater negative emotion.

“In this particular study, depressive symptoms are where we see the effect.”

On the other hand, women who had trouble describing their emotions felt more anxious if they had less knowledge about their illness than did women with similar coping traits who had greater knowledge.

The study showed no indication that coping style and illness knowledge influenced the patients’ physical quality of life.

Emery noted that the education patients receive about an illness is critical to keeping them informed about the best ways to maintain their health. So ensuring that patients receive the information in a way that preserves their emotional health is likely to encourage greater compliance with doctors’ orders, he said.

“The longer-term purpose of this line of research is to better predict which patient is going to benefit from which kind of intervention,” he said. “Even with a high-denial patient, we would still embrace using knowledge. But we might identify non-aversive ways of presenting them with the knowledge.”

The researchers suggest in the paper that clinicians may want to consider using mindfulness strategies for patients who tend to repress anger or have trouble describing their feelings. This technique helps people monitor their emotional response and observe their thoughts without judgment, said Jackson, who has been trained to provide mindfulness-based interventions in a clinical setting.

“Mindfulness encourages people to be comfortable with living in the moment with whatever emotional experience they’re having,” she said. “If we can help patients do that, they might be more receptive to information about their condition, and might have a better quality of life in general.”

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Contact: Charles Emery, (614) 688-3061; .(JavaScript must be enabled to view this email address) or Jamie Jackson, (312) 695-2734; .(JavaScript must be enabled to view this email address)

Written by Emily Caldwell, (614) 292-8310; .(JavaScript must be enabled to view this email address)

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Ohio State University