title: Attachment and couple satisfaction as predictors of expressed emotion in women facing breast cancer and their partners in the immediate post-surgery period.
abstract: OBJECTIVE
  To investigate expressed emotion (EE) in couples facing breast cancer in the immediate post-surgery period. EE may be predictive of psychological disturbances that hinder both partners' capacities to cope with the stress of the disease. Severity of the disease, attachment tendencies, and couple satisfaction were tested as predictors of EE.
  
  
  METHODS
  The design was cross-sectional. Couples (N = 61) were interviewed 2 weeks after the women's breast surgery.
  
  
  METHODS
  Expressed emotion was assessed in women and in partners with the Five-Minute Speech Sample, with a focus on overt and covert criticisms. Self-reported EE, attachment tendencies, and couple satisfaction were assessed with questionnaires. Hierarchical regression analyses were performed to test the predictors and possible interactions between them.
  
  
  RESULTS
  Both partners expressed overt and covert criticisms; women expressed more overt criticisms than did their partners. Cancer stage was inversely related to the number of overt criticisms in women and to the number of covert criticisms in partners. Regression analyses showed that in women, higher attachment anxiety and lower couple satisfaction were positive predictors of overt criticisms; in partners, a higher cancer stage was a negative predictor of overt and covert criticisms.
  
  
  CONCLUSIONS
  Practitioners should pay attention to the couple relationship in breast cancer. EE is most likely to appear when the cancer stage is low, showing that even when the medical prognosis is optimal, relational and emotional disturbances may occur. Statement of contribution What is already known on this subject? The couple relationship is of paramount importance in breast cancer. Expressed emotion (EE) is related to negative individual and relational psychological outcomes in psychiatric and somatic diseases. Expressed emotion has not yet been studied in the context of breast cancer. What does this study add? Expressed emotion is present in breast cancer situations, especially when the cancer stage is low. There was more EE in women than in their partners. Cancer stage, attachment tendencies, and couple satisfaction are predictors of EE.
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Favez
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.
authors.forename: Sarah
authors.initials: S
authors.lastname: Cairo Notari
authors.affiliation: Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.
authors.forename: Tania
authors.initials: T
authors.lastname: Antonini
authors.affiliation: Social Work, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.
authors.forename: Linda
authors.initials: L
authors.lastname: Charvoz
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery; D003430:Cross-Sectional Studies; D019260:Expressed Emotion; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008197:Lymph Node Excision; D008297:Male; D008408:Mastectomy; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009769:Object Attachment; D010549:Personal Satisfaction; D011184:Postoperative Period; D018454:Spouses / Q000523:psychology*; D011795:Surveys and Questionnaires
keywords: attachment; breast cancer in women; couple satisfaction; expressed emotion; partners