Expression and ambivalence over expression of negative emotion: Cross-sectional associations with psychosocial factors and health-related quality of life in postmenopausal women

Inhibition of emotional expression has been associated with the incidence and progression of breast cancer and other chronic illnesses. The important health-related factor, however, may be ambivalence about the expression of emotions rather than repression itself. This cross-sectional analysis of baseline data from 159,557 participants in the Women's Health Initiative examined the influence of expression of negative emotion and ambivalence about expression of emotion on psychosocial factors and health-related quality of life measured by the Medical Outcomes Study Short-form 36 (SF-36). Overall, observed correlations were modest but in the expected direction; that is, greater ambivalence about negative emotional expression was associated with worse general health and poorer psychosocial risk profile. Ambivalence about expressing negative emotion was more highly correlated with psychosocial factors and health-related quality of life than emotional expression. In general, our analysis supports prior studies suggesting that ambivalence may be more important to consider in studies of health-related outcomes than expression.