Defense Mechanisms and Repressive Coping Among Male Breast Cancer Patients.

Objectives: The concept of defense mechanisms has undergone extensive revision and expansion since Freud first described these processes. Initially formulated as an unconscious repression of unpleasant memories, with further development focusing on the role of defense mechanisms in the regulation of internal conflicts, the concept shifted and evolved to incorporate the adaptation to external demands, including intrapsychic and interpersonal handling of burden of illness. In addition to defense mechanisms, coping provides another perspective on human adjustment to difficult life events. While there is substantial research on both coping and defense mechanisms in various psychiatric and somatic diseases, including cancer, little is known about defensive regulation, coping, and their interaction in male breast cancer patients. Methods: The present study is part of the N-Male project conducted between 2016 and 2018 in Germany (Male breast cancer: patients' needs in prevention, diagnosis, treatment, rehabilitation, and follow-up care). Semi-standardized interviews with 27 male breast cancer patients were analyzed with regard to defense mechanisms. In addition, fear of progression and repressive coping was assessed by self-report. Results: There was considerable variety in levels of defensive functioning as well as repressive coping in our sample. We found no difference in overall levels of defensive functioning between men with vs. without repressive coping. However, patients with repressive coping demonstrated a decopupled association between fear of progression and defensive functioning as compared to patients without repressive coping. Discussion: The study provides the first evidence of disease processing in male breast cancer patients Knowledge of patients' defense patterns and repressive coping seems promising for better planning targeted intervention strategies.

Repressive coping among British college women: A potential protective factor against body image concerns, drive for thinness, and bulimia symptoms.

Repressive coping, as a means of preserving a positive self-image, has been widely explored in the context of dealing with self-evaluative cues. The current study extends this research by exploring whether repressive coping is associated with lower levels of body image concerns, drive for thinness, bulimic symptoms, and higher positive rational acceptance. A sample of 229 female college students was recruited in South London. Repressive coping was measured via the interaction between trait anxiety and defensiveness. The results of moderated regression analysis with simple slope analysis show that compared to non-repressors, repressors reported lower levels of body image concerns, drive for thinness, and bulimic symptoms while exhibiting a higher use of positive rational acceptance. These findings, in line with previous evidence, suggest that repressive coping may be adaptive particularly in the context of body image.

Repressive coping and cardiovascular reactivity to novel and recurrent stress.

BACKGROUND AND OBJECTIVES: Repressors tend to report less negative emotion and to describe challenges as less stressful, yet tend to exhibit higher rates of cardiovascular disease. While repressive coping has been shown to be associated with exaggerated physiological reactivity to novel stress, we sought to establish if elevated responses persisted across repeated exposure. DESIGN AND METHODS: In a sample of 86 healthy female adults, a verbal-autonomic response dissociation index of repressive coping was computed. Participants were exposed to two consecutive stress tasks, with analyses based on comparisons of consecutive stress responses. RESULTS: Analysis of covariance demonstrated significant differences across the study on diastolic blood pressure and cardiac output, as a function of repressive coping. Repressors showed elevated reactions to both stress tasks; however, cardiac output responses to the second task were more muted indicating that repressive coping was associated with successful adaptation to recurrent stress. Nevertheless, repressive copers maintained an exaggerated cardiovascular responses to recurrent stress. CONCLUSIONS: The present study identifies that repressive coping may be associated with increased risk of cardiovascular disease development through elevated cardiovascular reactions to both novel and recurrent stress.

Repressive coping, stigmatization, psychological distress, and quality of life among behavioral weight management participants.

Repressive coping has been associated with elevated risk of disease and negative health outcomes in past studies. Although a prior study of healthy men found that repression was associated with lower body mass index (BMI), no study has examined repressive coping among obese individuals. This study examined the relationship of repressive coping with BMI and obesity-relevant psychosocial factors among 104 overweight and obese participants in a behavioral weight management program. Participants completed questionnaires assessing repressive coping, stigmatization, psychological distress, and quality of life. BMI was objectively measured. Repressors reported lower stigmatization, anxiety, and depression as well as higher emotional and weight-related quality of life. Repressors and non-repressors had equivalent BMI and reported similar impairment in physical quality of life, but stigmatization moderated the relationship between repressive coping and physical quality of life (b=0.31, p=0.039), reflecting better physical quality of life among non-repressors with lower stigmatization. Obese individuals who engage in repressive coping may tend to underreport psychological symptoms, social difficulties, and impairments in quality of life. Higher physical quality of life among non-repressors with lower stigmatization may reflect a combined influence of coping and social processes in physical quality of life among obese individuals.

A longitudinal investigation of repressive coping and ageing.

OBJECTIVES: Two studies investigated the possibility that repressive coping is more prevalent in older adults and that this represents a developmental progression rather than a cohort effect. Study 1 examined repressive coping and mental health cross-sectionally in young and old adults. Study 2 examined whether there was a developmental progression of repressive coping prevalence rates in a longitudinal sample of older adults. METHOD: Study 1 compared younger adults (mean age 27.6 years) with older adults (mean age 74.2 years) on inventories of mental health and well-being and examined the prevalence of repressive coping in both samples. Study 2 re-tested a sample of older adults previously reported following an interval of 7 years. RESULTS AND CONCLUSION: Study 1 - in line with previous research older adults demonstrated greater psychological well-being and had a higher prevalence of repressive coping than younger adults (at 30% vs. 12% respectively). Study 2 - the data indicated that the prevalence of repressive coping rose from 41% at the first time of testing (2002) to 56.4% at the second testing interval (2009). These results suggest that repressive coping may increase across the lifespan in certain individuals and continue to increase throughout older adulthood. Furthermore, this increase in repressive coping with age appears to result in better well-being in those older adults who become repressive copers.

The ecological validity of the autonomic-subjective response dissociation in repressive coping.

BACKGROUND AND OBJECTIVES: Repressive coping has been associated with elevated cardiovascular reactivity and diminished self-reported negative affect (so-called autonomic-subjective response dissociation, ASRD) in response to laboratory stressors. However, there is a lack of knowledge regarding the ecological validity of this response pattern. DESIGN: An ambulatory assessment strategy was applied in order to analyze associations between ASRD and repressive coping throughout a day. METHODS: A sample of 114 individuals was recruited. Heart rate was recorded via ECG and subjective reports of negative affect as well as the experience of demand and control (as indicators of stress) and situational characteristics were assessed several times a day via mobile electronic devices. RESULTS: Repressive coping relative to other coping dispositions was accompanied by elevated ASRD during stressful episodes in daily life, thus supporting previous laboratory research. CONCLUSIONS: The findings suggest that repressive coping is associated with a discrepancy between subjective reports of negative affect and autonomic responding to stressful encounters in everyday life, which might impact health.

The relationship between two types of impaired emotion processing: repressive coping and alexithymia.

The constructs of repressive coping and alexithymia are both related to impaired emotion processing, yet individuals with a repressive coping style (repressors) score lower than controls on standard self-report measures of alexithymia. A large body of evidence indicates that repressors avoid negative affect. Therefore, the current study examined the relationship between repressive coping and alexithymia by using independently-rated interviews with the aim of bypassing repressors' tendency of avoiding negative affect. Results showed that repressors scored high on alexithymia, similar to anxious individuals on the independently-rated interview, but scored low on alexithymia on a questionnaire measure. Our findings confirm a link between alexithymia and repressive coping and stress the need for non-standard measures in exploring the nature of the relationship between repressive coping and alexithymia.

To suppress, or not to suppress? That is repression: controlling intrusive thoughts in addictive behaviour.

Research to understand how individuals cope with intrusive negative or threatening thoughts suggests a variety of different cognitive strategies aimed at thought control. In this review, two of these strategies--thought suppression and repressive coping--are discussed in the context of addictive behaviour. Thought suppression involves conscious, volitional attempts to expel a thought from awareness, whereas repressive coping, which involves the avoidance of thoughts without the corresponding conscious intention, appears to be a far more automated process. Whilst there has been an emerging body of research exploring the role of thought suppression in addictive behaviour, there remains a dearth of research which has considered the role of repressive coping in the development of, and recovery from, addiction. Based on a review of the literature, and a discussion of the supposed mechanisms which underpin these strategies for exercising mental control, a conceptual model is proposed which posits a potential common mechanism. This model makes a number of predictions which require exploration in future research to fully understand the cognitive strategies utilised by individuals to control intrusive thoughts related to their addictive behaviour.

Interpretive bias, repressive coping, and trait anxiety.

OBJECTIVES: According to vigilance-avoidance theory, repressors have an avoidant interpretive bias, i.e., they interpret ambiguous self-relevant situations in a nonthreatening fashion. This study sought to demarcate the range of situations associated with avoidant interpretive bias in repressors. DESIGN: Four groups of participants, representing the four combinations of low- and high-trait anxiety and defensiveness, were identified. Those low in trait anxiety and high in defensiveness were categorized as repressors. METHODS: Participants (N = 163) rated their likelihood of making both threatening and nonthreatening interpretations of 32 ambiguous scenarios over four domains: social, intellectual, physical, and health. Half the scenarios were self-relevant and half were other relevant. Brief measures of state anxiety were taken after each likelihood rating. RESULTS: Repressors displayed an avoidant interpretive bias for ambiguous threats in the social and intellectual domains but not the health or physical domains. This was due to repressors' low level of trait anxiety rather than their high defensiveness. CONCLUSIONS: Individuals high in trait anxiety are especially sensitive to situations involving social evaluation but not those characterized by danger to their health or physical well-being.

Self-serving episodic memory biases: findings in the repressive coping style.

Individuals with a repressive coping style self-report low anxiety, but show high defensiveness and high physiological arousal. Repressors have impoverished negative autobiographical memories and are better able to suppress memory for negatively valenced and self-related laboratory materials when asked to do so. Research on spontaneous forgetting of negative information in repressors suggests that they show significant forgetting of negative items, but only after a delay. Unknown is whether increased forgetting after a delay is potentiated by self-relevance. Here we asked in three experiments whether repressors would show reduced episodic memories for negative self-relevant information when tested immediately versus after a 2-day delay. We predicted that repressors would show an exaggerated reduction in recall of negative self-relevant memories after a delay, at least without anew priming of this information. We tested a total of 300 participants (experiment 1: N = 95, experiment 2: N = 106; experiment 3: N = 99) of four types: repressors, high-anxious (HA), low-anxious, and defensive HA individuals. Participants judged positive and negative adjectives with regard to self-descriptiveness, serving as incidental encoding. Surprise free-recall was conducted immediately after encoding (experiment 1), after a 2-day delay (experiment 2), or after a 2-day delay following priming via a lexical decision task (experiment 3). In experiment 1, repressors showed a bias against negative self-relevant words in immediate recall. Such a bias was neither observed in delayed recall without priming nor in delayed recall with priming. Thus, counter to our hypothesis, negative information that was initially judged as self-relevant was not forgotten at a higher rate after a delay in repressors. We suggest that repressors may reinterpret initially negative information in a more positive light after a delay, and therefore no longer experience the need to bias their recall after a delay.

Relación entre estrés postraumático, afrontamiento represivo y rumiación en estudiantes universitarios chilenos / The relationship between post-traumatic stress, epressive coping and ruminationn among Chilean university students

Los desastres naturales pueden tener distinto tipo de impactos en el bienestar psicológico y salud mental. Una de las respuestas que se ha asociado con mayor frecuencia a los desastres es la denominada sintomatología postraumática. El impacto psicológico de los desastres naturales está infuido por distintos factores. Un factor individual que probablemente puede infuir es la forma de afrontamiento empleada por cada persona. Objetivo: La presente investigación evaluó la relación entre estrés postraumático y dos formas de afrontamiento, el estilo represivo y la rumiación. Material y método: muestra de 314 estudiantes universitarios que vivieron el terremoto y tsunami del 27 de febrero de 2010 en la zona centro-sur de Chile, quienes respondieron una batería de instrumentos de autoinforme. Se realizó análisis bivariado y multivariado. Resultados: Se observaron asociaciones inversas entre el afrontamiento represivo y estrés postraumático y asociaciones directas entre rumiación y estrés postraumático. El afrontamiento represivo y la rumiación mostraron ser variables con una relación inversa entre sí. Conclusiones: Estos resultados son de interés para una mejor comprensión de la relación entre el tipo de respuesta de afrontamiento empleadas por las personas y su susceptibilidad a responder en forma negativa a situaciones traumáticas como los desastres naturales. El afrontamiento represivo puede no ser una respuesta negativa y podría contribuir a una menor rumiación, la que sí muestra ser un factor que se asocia a una mayor sintomatología postraumática.

Natural disasters have different impacts on people’s psychological well-being and mental health. One of the most frequent consequences is the post-traumatic symptomatology. The psychological impact of disasters might be influenced by several factors. The coping style is one of the personal factors that infuence the psychological impact of disasters. Objective: The current research assessed the relationship between post-traumatic stress and two ways of coping, repressive style and rumination in a sample of 314 undergraduate students that lived the earthquake and tsunami in the central region of Chile and that answered self-informed tools. Results: An inverse relationship between repressive coping and post-traumatic stress was found, as well as direct relationship between rumination and post-traumatic stress. Repressive coping and rumination showed an inverse relationship. Conclusion: These results allow a better understanding of the relationship between coping responses and person’s propensity to answer negatively to traumatic experiences such as natural disasters. Repressive coping may not be a negative response and so could contribute to a decreased rumination, which is a factor that is associated to a greater post-traumatic symptomatology.