Repressive coping before and after diagnosis of breast cancer

The aim was to investigate to which extent emotional repression is a premorbid coping tendency of cancer patients and/or a coping response to the threat posed by a cancer diagnosis. The results of one previous study of breast cancer patients suggest the latter possibility, and our aim was to replicate and extend these findings.

Of 646 women referred to mammographic examination for breast cancer, 71 women were diagnosed with primary breast cancer. Repressive coping, defined as having high scores on defensiveness (Marlowe-Crowne Social Desirability Scale) and low scores on anxiety (Taylor Manifest Anxiety Scale), was measured (1) before, (2) 4 weeks after, and (3) 12 weeks after diagnosis. The women were not aware of their disease status before the examination, and there were no significant differences between groups in their perceived risk of having breast cancer.

Four weeks after diagnosis, increased repression (p < 0.01) was found in the group of women diagnosed with breast cancer but not in women without cancer, with women with a breast cancer diagnosis being 1.5 times more likely to be repressive than women with cancer. There were no group differences in defensiveness, anxiety, or repression before diagnosis and 12 weeks after diagnosis. When controlling for repressive coping prior to diagnosis, age, and other demographic factors with a multiple, logistic regression, only cancer diagnosis (odds ratio: 2.39; p< 0.05) and having biological children (odds ratio: 2.83; p< 0.02) emerged as significant predictors of repressive coping 4 weeks after diagnosis. Before diagnosis, only higher age predicted later diagnosis of breast cancer.

Previously found higher repression in cancer patients vs. controls could be a response to the threat associated with cancer diagnosis and may not necessarily reflect premorbid differences.