title: Holding back sharing concerns, dispositional emotional expressivity, perceived unsupportive responses and distress among women newly diagnosed with gynecological cancers.
abstract: OBJECTIVE
  Little attention has been paid to the role of holding back sharing concerns in the psychological adaptation of women newly diagnosed with gynecological cancers. The goal of the present study was to evaluate the role of holding back concerns in psychosocial adjustment and quality of life, as well as a possible moderating role for emotional expressivity and perceived unsupportive responses from family and friends.
  
  
  METHODS
  Two hundred forty-four women diagnosed with gynecological cancer in the past 8 months completed measures of holding back, dispositional emotional expressivity, perceived unsupportive responses from family and friends, cancer-specific distress, depressive symptoms and quality of life.
  
  
  RESULTS
  Emotional expressivity moderated the association between holding back and cancer-specific distress and quality of life, but not depressive symptoms. Greater holding back was more strongly associated with higher levels of cancer-related distress among women who were more emotionally expressive than among women who were less expressive. Perceived unsupportive responses did not moderate the associations between holding back and psychosocial outcomes.
  
  
  CONCLUSIONS
  Holding back sharing concerns was more common in this patient population than other cancer populations. Dispositional expressivity played a role in how harmful holding back concerns was for women, while unsupportive responses from family and friends did not.
authors.affiliation: Cancer Institute of New Jersey. Electronic address: sharon.manne@rutgers.edu.
authors.forename: Sharon
authors.initials: S
authors.lastname: Manne
authors.affiliation: Cancer Institute of New Jersey.
authors.forename: Shannon
authors.initials: S
authors.lastname: Myers
authors.affiliation: Memorial Sloan Kettering Cancer Center.
authors.forename: Melissa
authors.initials: M
authors.lastname: Ozga
authors.affiliation: Memorial Sloan Kettering Cancer Center.
authors.forename: David
authors.initials: D
authors.lastname: Kissane
authors.affiliation: Michigan State University.
authors.forename: Debby
authors.initials: D
authors.lastname: Kashy
authors.affiliation: University of Pennsylvania School of Medicine.
authors.forename: Stephen
authors.initials: S
authors.lastname: Rubin
authors.affiliation: Fox Chase Cancer Center.
authors.forename: Carolyn
authors.initials: C
authors.lastname: Heckman
authors.affiliation: Jefferson Medical College of Thomas Jefferson University.
authors.forename: Norm
authors.initials: N
authors.lastname: Rosenblum
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D003863:Depression / Q000523:psychology*; D030881:Disclosure; D005260:Female; D005833:Genital Neoplasms, Female / Q000523:psychology*; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology; D012944:Social Support; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Coping; Depressive symptoms; Gynecological cancer; Trajectories of change