title: Negative affectivity, restriction of emotions, and site of metastases predict mortality in recurrent breast cancer.
abstract: OBJECTIVE
  To assess whether negative affectivity and restriction of emotions predict survival time with recurrent breast cancer.
  
  
  METHODS
  Thirty-two patients with recurrent breast cancer, diagnosed 6-19 months earlier and stabilized using surgical, medical and/or radiation therapies, were enrolled. Cox regression survival analyses, including initial severity of metastases (RR=4.3 [1.3-14.3]; p=0.02), were used to explore the association of psychological variables with survival.
  
  
  RESULTS
  Low chronic anxiety in the context of low emotional constraint predicted low mortality (RR 0.07 [0.01-0.52]; p=0.007). However, patients with low chronic anxiety scores but with high constraint had higher mortality (RR=3.7 [1.2-11.5; p=0.02). High chronic anxiety, with or without high constraint, also predicted earlier death, as did high control of feelings.
  
  
  CONCLUSIONS
  An integrated model of negative affectivity in the context of restriction of emotions appears to strengthen the prediction of survival based on severity of breast cancer metastases.
authors.affiliation: Center for Family Research, Department of Psychiatry and Behavioral Sciences, The George Washington University Medical Center, Ross Hall, Room 612B, 2300 Eye Street, NW, Washington, DC 20037, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Weihs
authors.forename: T M
authors.initials: TM
authors.lastname: Enright
authors.forename: S J
authors.initials: SJ
authors.lastname: Simmens
authors.forename: D
authors.initials: D
authors.lastname: Reiss
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000523:psychology*; D001943:Breast Neoplasms / Q000401:mortality / Q000523:psychology*; D004644:Emotions; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000523:psychology*; D012803:Sick Role; D016019:Survival Analysis