title: Which symptoms matter? Self-report and observer discrepancies in repressors and high-anxious women with metastatic breast cancer.
abstract: Clinicians working with cancer patients listen to them, observe their behavior, and monitor their physiology. How do we proceed when these indicators do not align? Under self-relevant stress, non-cancer repressors respond with high arousal but report low anxiety; the high-anxious report high anxiety but often have lower arousal. This study extends discrepancy research on repressors and the high-anxious to a metastatic breast cancer sample and examines physician rating of coping. Before and during a Trier Social Stress Test (TSST), we assessed affect, autonomic reactivity, and observers coded emotional expression from TSST videotapes. We compared non-extreme (N = 40), low-anxious (N = 16), high-anxious (N = 19), and repressors (N = 19). Despite reported low anxiety, repressors expressed significantly greater Tension or anxiety cues. Despite reported high anxiety, the high-anxious expressed significantly greater Hostile Affect rather than Tension. Physicians rated both groups as coping significantly better than others. Future research might productively study physician-patient interaction in these groups.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 401 Quarry Road, Stanford, CA, 94305-5718, USA, jgieseda@ucalgary.ca.
authors.forename: Janine
authors.initials: J
authors.lastname: Giese-Davis
authors.forename: Rie
authors.initials: R
authors.lastname: Tamagawa
authors.forename: Maya
authors.initials: M
authors.lastname: Yutsis
authors.forename: Suzanne
authors.initials: S
authors.lastname: Twirbutt
authors.forename: Karen
authors.initials: K
authors.lastname: Piemme
authors.forename: Eric
authors.initials: E
authors.lastname: Neri
authors.forename: C Barr
authors.initials: CB
authors.lastname: Taylor
authors.forename: David
authors.initials: D
authors.lastname: Spiegel
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000339:Affect; D000368:Aged; D001007:Anxiety / Q000150:complications / Q000523:psychology*; D001143:Arousal; D001943:Breast Neoplasms / Q000150:complications / Q000523:psychology*; D005260:Female; D005712:Galvanic Skin Response / Q000502:physiology; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008875:Middle Aged; D012094:Repression, Psychology; D057566:Self Report