Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-23T11:42:58.112Z Has data issue: false hasContentIssue false

Emotional Suppression and Breast Cancer: Validation Research on the Spanish Adaptation of the Courtauld Emotional Control Scale (CECS)

Published online by Cambridge University Press:  10 January 2013

Estrella Durá
Affiliation:
Universidad de Valencia (Spain)
Yolanda Andreu
Affiliation:
Universidad de Valencia (Spain)
Maria José Galdón
Affiliation:
Universidad de Valencia (Spain)
Elena Ibáñez
Affiliation:
Universidad de Valencia (Spain)
Sandra Pérez
Affiliation:
Universidad de Valencia (Spain)
Maite Ferrando*
Affiliation:
Universidad de Valencia (Spain)
Sergio Murgui
Affiliation:
Universidad de Valencia (Spain)
Paula Martínez
Affiliation:
Universidad de Valencia (Spain)
*
Correspondence concerning this article should be adressed to Maite Ferrando. Departamento de Personalidad, Evaluación y Tratamientos Psicológicos. Facultad de Psicología. Universidad de Valencia. Avda Blasco Ibañez, 21. 46010 Valencia. (Spain). Phone: +34-963864389. Fax: +34-963864669. E-mail: [email protected]

Abstract

Emotional suppression has played an important role in the research on psychosocial factors related to cancer. It has been argued to be an important psychological factor predicting worse psychosocial adjustment in people with cancer and it may mediate health outcomes. The reference instrument in the research on emotional suppression is the Courtauld Emotional Control Scale (CECS). The present study analysed construct validity of a new Spanish adaptation of the CECS in a sample of 175 breast cancer patients. The results confirmed the proposal by Watson and Greer claiming that the CECS is composed of three subscales that measure different dimensions, but not independent, from emotional control. The present Spanish version of the CECS showed high internal consistency in each subscale as well as the total score. According to Derogatis (BSI-18) criteria, emotional suppression predicts clinically significant distress. In short, our results support the reliability, validity and utility of this Spanish adaptation of the CECS in clinical and research settings.

La supresión emocional ha jugado un papel importante en la investigación de los factores psicosociales relacionados con el cáncer. Se ha discutido que es un importante factor psicológico que predice un peor ajuste psicosocial en las personas que sufren cáncer y que puede mediar los resultados médicos. El instrumento de referencia en la investigación acerca de la supresión emocional es el Courtauld Emotional Control Scale (CECS). El presente estudio analiza la validez de constructo de una nueva adaptación española del CECS en una muestra de 175 pacientes con cáncer de mama. Los resultados confirman la estructura propuesta por Watson y Greer para el instrumento, compuesta de tres subescalas que evalúan distintas dimensiones no independientes, del control emocional. La presente versión española del CECS mostró una elevada consistencia interna de cada una de las subescalas y de la puntuación total. Además la supresión emocional predice el distrés clínico significativo, según criterios de Derogatis (BSI-18). En resumen, nuestros resultados respaldan la fiabilidad, validez y utilidad de la adaptación española del CECS en contextos clínicos y de investigación.

Type
Research Article
Copyright
Copyright © Cambridge University Press 2010

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Anarte, M. T., Esteve, R., Ramírez, M., López, A. E., & Amorós, F. J. (2001). Adaptación al castellano de la Escala Courtauld de control emocional en pacientes con cáncer. Psicothema, 13, 636842.Google Scholar
Andreu, Y. (1998). Personalidad tipo C. Historia y validez del concepto. Boletin de Psicología, 59, 75104.Google Scholar
Carlson, L. E., Angen, M., Cullum, J., Goodey, E.Koopmans, J., Lamont, L., MacRae, J. H., Martin, M., Pelletier, G., Robinson, J., Simpson, J. S., Speca, M., Tillotson, L., & Bultz, B. D. (2004). High levels of untreated distress and fatigue in cancer patients. British Journal of Cancer, 90, 22972304.CrossRefGoogle ScholarPubMed
Classen, C., Koopman, C., Angell, K., & Spiegel, D. (1996). Coping styles associated with psychological adjustment to advanced breast cancer. Health Psychology, 15, 434437.CrossRefGoogle ScholarPubMed
Contrada, R. J., Leventhal, H., & O'Leary, A. (1990). Personality and health. In Pervin, L. A. (Ed.), Handbook of personality. Theory and research (pp. 638669). New York: The Guilford Press.Google Scholar
Cordova, M., Giese-Davis, J., Golant, M., Kronnenwetter, C., Chang, V., McFarlin, S., & Spiegel, D. (2003). Mood disturbance in community cancer support groups. The role of emotional suppression and fighting spirit. Journal of Psychosomatic Research, 55, 461467.CrossRefGoogle ScholarPubMed
Ho, D. H., & Silberfarb, P. M. (1998). Psychological factors: Do they influence breast cancer? In Cooper, L. (Ed.), Stress and breast cancer (pp. 2762). New York: John Wiley & Sons Ltd.Google Scholar
Derogatis, L. R. (2000). BSI-18: Administration, scoring and procedures manual. Minneapolis, MN: NCS Pearson.Google Scholar
Fawzy, F. I., Cousins, N., Fawzy, N. W., Kemeny, M. E., Elashoff, R., & Morton, D. (1990). A structured psychiatric intervention for cancer patients, I. Changes over time in methods of coping and affective disturbance. Archives of General Psychiatry, 47, 720725.CrossRefGoogle ScholarPubMed
Fox, B. (1988). Psychogenic factors in cancer, especially its incidence. In Maes, S., Spielberger, C. D., Defares, P. B., & Sarason, I. G. (Eds.), Topics in health psychology (pp. 3755). New York: John Wiley & Sons Ltd.Google Scholar
Fox, B. (1995). The role of psychological factors in cancer incidence and prognosis. Oncology, 9, 245255.Google ScholarPubMed
Galdón, M. J., Durá, E., Andreu, Y., Ferrando, M., Murgui, S., Pérez, S., & Ibáñez, E. (2008). Psychometric properties of the Brief Symptoms Inventory 18 (BSI-18) in a Spanish breast cancer sample. Journal of Psychosomatic Research, 65, 533539.CrossRefGoogle Scholar
Garssen, B. (2004). Psychological factors and cancer development: Evidence after 30 years of research. Clinical Psychology Review, 24, 315338.CrossRefGoogle ScholarPubMed
Giese-Davis, J., & Spiegel, D. (2001). Suppression, repressive-defensiveness, restraint, and distress in metastasic breast cancer: Separable or inseparable constructs?, Journal of Personality, 69, 417449.CrossRefGoogle ScholarPubMed
Grassi, L., Watson, M., & Greer, S. (1985). La Courtauld Emotional Control Scale (CECS) di Watson. Bollettino di Psicologia Applicata, 176, 310.Google Scholar
Grassi, L., & Molinari, S. (1988). Pattern of emotional control and psychological reactions to breast cancer: A preliminary report. Psychological Reports, 62, 727732.CrossRefGoogle ScholarPubMed
Greer, S., & Morris, T. (1975). Psychological attributes of women who develop breast cancer: A controlled study. Journal of Psychosomatic Research, 19, 147153.CrossRefGoogle ScholarPubMed
Greer, S., & Watson, M. (1985). Towards a psychobiological model of cancer: Psychological considerations. Social Science & Medicine, 20, 773777.CrossRefGoogle ScholarPubMed
Gross, J. (1989). Emotional expression in cancer onset and progression. Social Science & Medicine, 28, 12391248.CrossRefGoogle ScholarPubMed
Hair, J. F., Anderson, R. E., Tatham, R. L., & Black, W. C. (1999). Análisis multivariante (5th ed.). Madrid: Prentice Hall Iberia.Google Scholar
Ho, R., Chan, C., & Ho, S. (2004). Emotional control in Chinese female cancer survivors. Psycho-Oncology, 13, 808817.CrossRefGoogle ScholarPubMed
Hu, L., & Bentler, P. M. (1999). Cutoff criteria in fix indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 155.CrossRefGoogle Scholar
Ibáñez, E., Romero, R., & Andreu, Y. (1992). Personalidad tipo C. Una revisión crítica. Boletin de Psicología, 35, 4979.Google Scholar
Iwamitsu, Y., Shimoda, K., Abe, H., Tani, T., & Okawa, M. (2002). The relationship between suppression of negative emotion in breast cancer patients and emotional distress after diagnosis. Japanese Journal of General Hospital Psychiatry, 14, 916.Google Scholar
Iwamitsu, Y., Shimoda, K., Abe, H., Tani, T., Kodama, M., & Okawa, M. (2003). Differences in emotional distress between breast tumour patients with emotional inhibition and those with emotional expression. Psychiatry and Clinical Neurosciences, 57, 289294.CrossRefGoogle ScholarPubMed
Iwamitsu, Y., Shimoda, K., Abe, H., Tani, T., Okawa, M., & Buck, R. (2005a). The relation between negative emotional suppression and emotional distress in breast cancer diagnosis and treatment. Health Communication, 18, 201215.CrossRefGoogle ScholarPubMed
Iwamitsu, Y., Shimoda, K., Abe, H., Tani, T., Okawa, M., & Buck, R. (2005b). Anxiety, emotional suppression, and psychological distress before and after breast cancer diagnosis. Psychosomatics, 46, 1924.CrossRefGoogle ScholarPubMed
Kennedy-Moore, E., & Watson, J. C. (2001). How and when does emotional expression help? Review of General Psychology, 5, 187212.CrossRefGoogle Scholar
Levi, S. M. (1983). Host differences in neoplastic risk: Behavioral and social contributors to disease. Health Psychology, 2, 2144.CrossRefGoogle Scholar
Low, C. A., Stanton, A. L., & Danoff-Burg, S. (2006). Expressive disclosure and benefit finding among breast cancer patients: Mechanisms for positive health effects. Health Psychology, 25, 181189.CrossRefGoogle ScholarPubMed
McKenna, M. C., Zevon, M. A., Corn, B., & Rounds, J. (1999). Psychosocial factors and the development of breast cancer: A meta-analysis. Health Psychology, 18, 520531.CrossRefGoogle ScholarPubMed
Messick, S. (1995). Standards of validity and the validity of standards in performance assessment. Educational Measurement: Issues and Practice, 14(4), 58.CrossRefGoogle Scholar
Morris, T., & Greer, S. (1980). A “Type C” for cancer? Low trait anxiety in the pathogenesis of breast cancer. Cancer Detection and Prevention, 3, 102.Google Scholar
Morris, T., Greer, S., Pettingale, K. W., & Watson, M. (1981). Patterns of expression of anger and their psychological correlates in women with breast cancer. Journal of Psychosomatic Research, 25, 111117.CrossRefGoogle ScholarPubMed
Pennebaker, J. W. (1980). Opening up. The healing power of confiding in others. New York: William Morrow.Google Scholar
Pennebaker, J. W. (1999). The effects of traumatic disclosure on physical and mental health: The values of writing and talking about upsetting events. International Journal of Emergency Mental Health, 1, 918.Google ScholarPubMed
Pennebaker, J. W., Mayne, T. J., & Francis, M. E. (1997). Linguistic predictors of adaptative bereavement. Journal of Personality and Social Psychology, 72, 864871.CrossRefGoogle ScholarPubMed
Schmitt, F. F. (1995). Truth: A primer. In Lehrer, K., & Daniels, N. (Eds.), Series: Focus (pp: xi251). Boulder, CO: Westview Press.Google Scholar
Sellick, S. M., & Crooks, D. L. (1999). Depression and cancer: an appraisal of the literature for prevalence, detection, and practice guideline development for psychological interventions. Psycho-Oncology, 8, 315333.3.0.CO;2-G>CrossRefGoogle ScholarPubMed
Spiegel, D., Bloom, J. R., & Yalom, I. (1981). Group support for patients with metastatic cancer. A randomized outcome study. Archives of General Psychiatry, 38, 527533.CrossRefGoogle ScholarPubMed
Spiegel, D., Morrow, G. R., & Classen, C. (1999). Group psychotherapy for recently diagnosed breast cancer patients: A multicenter feasibility study. Psycho-Oncology, 8, 482493.3.0.CO;2-W>CrossRefGoogle ScholarPubMed
Stanton, A. L., Danoff-Burg, S., Cameron, C. L.Bishop, M., Collins, C. A., Kirk, S. B., Sworowski, L. A., & Twillman, R. (2000). Emotionally expressive coping predicts psychological and physical adjustment to breast cancer. Journal of Consulting and Clinical Psychology, 68, 875882.CrossRefGoogle ScholarPubMed
Stanton, A. L., Danoff-Burg, S., & Huggins, M. E. (2002). The first year after breast cancer diagnosis: Hope and coping strategies as predictors of adjustment. Psycho-Oncology, 11, 93102.CrossRefGoogle ScholarPubMed
Stefanek, M. E., Shaw, A., DeGeorge, D., & Tsottles, N. (1989). Illness-related worry among cancer patients: Prevalence, severity, and content. Cancer Investigation, 7, 365371.CrossRefGoogle ScholarPubMed
Temoshok, L. (1987). Personality, coping style, emotion and cancer. Towards and integrative model. Cancer Surveys, 6, 545567.Google ScholarPubMed
Temoshok, L., & Fox, B. H. (1984). Coping styles and other psychosocial factors related to medical status and to prognosis in patients with cutaneous malignant melanoma. In Fox, B. H., & Newberry, B. H. (Eds.), Impact of psychoendocrine systems in cancer and immunity (pp. 258287). Toronto: C. J. Hogrefe.Google Scholar
Temoshok, L., & Heller, B. (1984). On comparing apples, oranges and fruit salad: A methodological overview of medical outcome studies in psychosocial oncology. In Cooper, C. M. (Ed.), Psychosocial stress and cancer (pp. 231260). New York: John Wiley & Sons Ltd.Google Scholar
Watson, M., & Greer, S. (1983). Development of a questionnaire measure of emotional control. Journal of Psychosomatic Research, 27, 299305.CrossRefGoogle ScholarPubMed
Watson, M., Greer, S., Rowden, L., Gorman, C., Robertson, B., Bliss, J. M., & Tunmore, R. (1991). Relationships between emotional control, adjustment to cancer and depression and anxiety in breast cancer patients. Psychological Medicine, 21, 5157.CrossRefGoogle ScholarPubMed
Zabora, J. (1998). Screening procedures for psychosocial distress. In Holland, J. C. (Ed.), The handbook of psycho-oncology (pp. 653661). New York: Oxford University Press.Google Scholar