Anger suppression mediates the relationship between optimism and natural killer cell cytotoxicity in men treated for localized prostate cancer.

OBJECTIVE: This study evaluated relations among optimism, depression, anger suppression and natural killer cell cytotoxicity (NKCC) in 61 men treated for localized prostate cancer (PC). METHOD: All participants were assessed at a single time point where demographics, optimism, depression and anger suppression were measured. We also collected peripheral venous blood to assess NKCC. RESULTS: Results showed that greater optimism was associated with greater NKCC (beta=.27, P<.05), less depression (beta=-.63, P<.001) and less anger suppression (beta=-.29, P<.05). Furthermore, less anger suppression (beta=-.35, P<.01) was associated with greater NKCC. In a hierarchical regression model controlling for depression and then anger suppression, the relationship between optimism and NKCC became nonsignificant [beta=.18, t(56)=1.51, P=.14], while anger suppression remained significantly correlated with NKCC [beta=-.29, t(56)=-2.40, P<.05]. CONCLUSIONS: Results suggest that optimism is associated with NKCC and a greater ability to adaptively express anger. Furthermore, it appears that less anger suppression partially mediates the relationship between optimism and NKCC.

Emotional expression and depth processing of trauma and their relation to long-term survival in patients with HIV/AIDS.

OBJECTIVE: This study examined the relationship between emotional expression and depth processing of trauma and long-term survival of patients living with AIDS. A further purpose was to examine the immune, health behavior and psychosocial correlates of emotional disclosure and depth processing. METHOD: Subjects wrote essays describing their reactions to past traumas; these were scored for emotional expression and depth processing (positive cognitive appraisal change, experiential involvement, self-esteem enhancement and adaptive coping strategies). Two HIV-seropositive groups were recruited for this study; long-term survivors (LTS; n=46) patients who had survived at least 4 years past a Category C (AIDS defining) symptom prior to starting protease inhibitors and an equivalent HIV-seropositive comparison group (ECOMP(LTS); n=89) who had CD4+ cells between 150 and 500, and had no history of Category C symptoms. The groups were equivalent on age, gender, ethnicity, education, employment, income, sexual orientation and route of infection. RESULTS: The group LTS were significantly higher than the ECOMP(LTS) group on emotional expression and depth processing. Depth processing mediated the relationship between emotional expression and long-term survival status. Depth processing was positively related to CD4+ cell number for women. Emotional expression was also significantly related to viral load (negatively) and to CD4+ cell number (positively) for women only. Interestingly, only depth processing (and not emotional expression) was related to medication adherence and to psychosocial variables (perceived stress and social support). CONCLUSIONS: Emotional expression and depth processing were related to long-term survival, however, depth processing was the mediator for this relationship and only depth processing was associated with medication adherence, perceived stress and social support. Our results underscore the importance of depth processing (and not just emotional expression) of traumatic experiences for people living with HIV/AIDS.