Predicting Burnout Among HIV/AIDS and Oncology Health Care Workers

Abstract

This study examined the relationship between repressive coping, controllability, self-esteem and comparative optimism for health-related events. Repressors (low trait anxiety-high defensiveness) compared with both (a) specific control groups on anxiety and defensiveness (e.g., low-anxious, high-anxious and defensive high anxious) and (b) total nonrepressors were significantly more comparatively optimistic for health-related events. Repressors remained significantly more comparatively optimistic than total nonrepressors when self-esteem was partialled out.

For individual events, repressors differed in comparative optimism for events which were rated as high controllability. It is concluded that repressors are exhibiting comparative optimism over and above nonrepressor groups for events which are rated as controllable. These results suggest that comparative optimism findings may be exaggerated by not controlling for the disproportionate influence of repressors in skewing sample means. Suggestions for future studies are discussed.     

Identifying repressors: A methodological issue for health psychology

Abstract

The majority of studies in health psychology use self-report measures. However, there is a growing body of evidence indicating that this methodology may be problematic for a significant minority of the population: individuals who possess a repressive coping style (repressors). Repressors, who fail to report negative affect, answer many self-report measures in a positive fashion. Research has identified an association between repressors, who are identified by low trait anxiety scores and high defensiveness scores, and adverse health outcomes. Therefore, repressors are an important group for health psychologists to investigate. Health psychology research should use more than one method of data collection in an attempt to unravel this difficult methodological problem.     

Cancer, acute stress disorder, and repressive coping

Pedersen, A. F. & Zachariae, R. (2010). Cancer, acute stress disorder, and repressive coping. Scandinavian Journal of Psychology, 51 , 84–91.
The purpose of this study was to investigate the association between repressive coping style and Acute Stress Disorder (ASD) in a sample of cancer patients. A total of 112 cancer patients recently diagnosed with cancer participated in the study. ASD was assessed by the Stanford Acute Stress Reaction Questionnaire, and repressive coping was assessed by a combination of scores from the Marlowe-Crowne Social Desirability Scale, and the Bendig version of the Taylor Manifest Anxiety Scale. Significantly fewer patients classified as "repressors" were diagnosed with ASD compared to patients classified as "non-repressors". However, further investigations revealed that the lower incidence of ASD in repressors apparently was caused by a low score on anxiety and not by an interaction effect between anxiety and defensiveness. Future studies have to investigate whether different psychological mechanisms are responsible for the lower incidence of ASD in repressors and true low-anxious patients.     

Emotional information processing in repressors: The vigilance–avoidance theory

A vigilance–avoidance theory of the repressive coping style (low trait anxiety and high defensiveness) is presented. The new theory attempts to account for several key findings, including the discrepancy between low self-reported anxiety and high behavioural and physiological indicators of anxiety shown by individuals with a repressive coping style. According to the theory, repressors have an initial rapid vigilant response triggering behavioural and physiological responses and involving attentional and interpretive biases to self-relevant threat stimuli. These biases may be based on negative self-relevant schematic information. This initial vigilant stage is followed by an avoidance stage involving avoidant cognitive biases (attentional, interpretive, and memory) that inhibit the conscious experience of anxiety. Future research should examine systematically the time course of repressors’ reactions to threatening and non-threatening stimuli.     

Cognitive and affective consequences of repressive coping

This investigation examined whether repressors, individuals who seem especially reactive to emotional stimuli, would attempt to control their emotional reactions to unpleasant events, and whether such attempts would impair repressors’ recall for those stimuli. Participants viewed either an unpleasant or an emotionally neutral film and then reported their mood following the film and their recall memory for details in the film. Repressors reported a more pleasant mood than nonrepressors after the unpleasant film. Repressors did not, however, differ from non-repressors in their memory for details in the film. The results suggest that while repressors are efficient regulators of emotion, the cognitive effects of the repressive coping style are less clear. This research was supported by a University of Plymouth QR grant to the first author.     

Cognitive and affective consequences of repressive coping

This investigation examined whether repressors, individuals who seem especially reactive to emotional stimuli, would attempt to control their emotional reactions to unpleasant events, and whether such attempts would impair repressors’ recall for those stimuli. Participants viewed either an unpleasant or an emotionally neutral film and then reported their mood following the film and their recall memory for details in the film. Repressors reported a more pleasant mood than nonrepressors after the unpleasant film. Repressors did not, however, differ from non-repressors in their memory for details in the film. The results suggest that while repressors are efficient regulators of emotion, the cognitive effects of the repressive coping style are less clear. This research was supported by a University of Plymouth QR grant to the first author.     

Children's self-reported coping strategies: the role of defensiveness and repressive adaptation

This study examined differences in self-reported coping strategies across children classified according to Weinberger et al.'s (1979) adaptive style paradigm. Consistent with the larger literature, it was hypothesized that repressors (i.e. characterized by high self-reported defensiveness and low self-reported distress) would endorse fewer behaviorally and cognitively avoidant coping strategies than other adaptive style groups. Participants included 134 children, ranging in age from 10 to 13 (M=11.26, sd=.59), who completed measures of defensiveness, trait anxiety, and coping. Consistent with the hypotheses, results indicated significantly lower endorsement of avoidant coping strategies, and significantly higher endorsement of approach-oriented strategies among repressors, but no significant differences across adaptive style groups for other forms of coping. Results indicate that, consistent with other indicators of psychological functioning, the measurement of coping strategies is subject to the effects of socially desirable responding. Further, results provide evidence that measures of coping may be contaminated by items reflecting adjustment problems.     

Children's self-reported coping strategies: The role of defensiveness and repressive adaptation

Abstract

This study examined differences in self-reported coping strategies across children classified according to Weinberger et al.'s (1979) adaptive style paradigm. Consistent with the larger literature, it was hypothesized that repressors (i.e. characterized by high self-reported defensiveness and low self-reported distress) would endorse fewer behaviorally and cognitively avoidant coping strategies than other adaptive style groups. Participants included 134 children, ranging in age from 10 to 13 (M=11.26, sd=.59), who completed measures of defensiveness, trait anxiety, and coping. Consistent with the hypotheses, results indicated significantly lower endorsement of avoidant coping strategies, and significantly higher endorsement of approach-oriented strategies among repressors, but no significant differences across adaptive style groups for other forms of coping. Results indicate that, consistent with other indicators of psychological functioning, the measurement of coping strategies is subject to the effects of socially desirable responding. Further, results provide evidence that measures of coping may be contaminated by items reflecting adjustment problems.     

Repressors report fewer intrusions following a laboratory stressor: the role of reduced stressor-relevant concept activation and inhibitory functioning

This study investigated whether a repressive coping style is associated with fewer intrusions following an experimentally controlled stressor. Furthermore, we examined whether lower activation of stressor-relevant concepts in long-term memory and better inhibitory functioning may contribute to this association. Extreme-scoring participants on a trait anxiety and a social desirability scale were selected to form repressor (n=35), low anxious (n=15), high anxious (n=30), and defensive (n=21) groups. In line with predictions, repressors reported fewer intrusions following a failure manipulation compared to non-repressors. Furthermore, pre-stressor inhibitory functioning was negatively associated with color-naming interference of stressor-related words. This suggests that overall, higher inhibitory control is related to lower activation of failure-related concepts. However, there was no evidence that concept activation and inhibitory control were responsible for repressors' lower number of self-reported intrusions.     

The relationship between dispositional optimism, dispositional pessimism, repressive coping and trait anxiety

The purpose of this study was to investigate the relationship between dispositional optimism, dispositional pessimism, repressive coping and trait anxiety. The Marlowe-Crowne scale (MC) and the Bendig version of the Taylor Manifest Anxiety Scale (MAS) were used to select repressor and control groups (N=143, aged between 18 and 47 years), who subsequently completed a measure of dispositional optimism, the Life Orientation Test (LOT), which consists of two sets of items: optimism and pessimism. Repressors (high MC, low MAS) reported significantly lower pessimism than all other participants. When the pessimism scale was divided into high and low categories, there were significantly more repressors in the low pessimism group than the other low trait anxiety group, low anxious (low MC, low MAS). However, for the optimism scale the opposite pattern of results was found, with significantly more low anxious in the high optimism group than repressors. These results support the assertion that the pessimism and optimism scales of the LOT are not the same construct and should be measured separately.     

Suppressing thoughts of past events: Are repressive copers good suppressors?

We investigated the ability of individuals with a “repressive coping style” to strategically control thoughts of events from their past, which made them feel either proud or embarrassed, within the thought suppression paradigm. We examined whether (low) anxiety and (high) defensiveness interacts to influence suppression success over and above anxiety and defensiveness alone using low anxious, repressor, high anxious, and defensive high anxious groups. For the emotionally positive “proud event”, all groups avoided event‐related thoughts when instructed to suppress. For the emotionally negative “embarrassed event”, repressors reported fewer event‐related thoughts than all other groups, even when not instructed to suppress. Repressors also reported the lowest level of suppression effort and showed no “rebound”. We discuss repressors' memory performance in terms of their natural tendency to avoid negative self‐referent material, and thought and memory control in everyday life.     

Ropressive Coping Style and the Experience and Recall of Emotion: A Naturalistic Study of Daily Affect

ABSTRACT Research shows that people characterized as repressors display inhibited recall for unpleasant memories. In this study, the relationship between repressive coping style and the recall of affect near the time of the experience was compared to delayed recall. An experience sampling technique was used to collect affect data twice daily for 4 weeks. Repressive coping style was found to be related to low levels of average daily unpleasant affect and lowered delayed recall of unpleasant affect. Unlike repressors, high anxious individuals overestimated unpleasant affect during delayed recall. Repressors did not exhibit isolation of the dominant unpleasant affect from nondominant unpleasant affect in daily reporting. The overall pattern of results suggests that the effect of repressive coping style is to diminish the encoding of all unpleasant affect, whereas trait anxiety appears to promote overestimation in the recall of unpleasant affect.     

Interpretive bias,repressive coping,and trait anxiety

Objectives: According to vigilance–avoidance theory, repressors have an avoidant interpretive bias, i.e., they interpret ambiguous self-relevant situations in a nonthreatening fashion. This study sought to demarcate the range of situations associated with avoidant interpretive bias in repressors. Design: Four groups of participants, representing the four combinations of low- and high-trait anxiety and defensiveness, were identified. Those low in trait anxiety and high in defensiveness were categorized as repressors. Methods: Participants (N = 163) rated their likelihood of making both threatening and nonthreatening interpretations of 32 ambiguous scenarios over four domains: social, intellectual, physical, and health. Half the scenarios were self-relevant and half were other relevant. Brief measures of state anxiety were taken after each likelihood rating. Results: Repressors displayed an avoidant interpretive bias for ambiguous threats in the social and intellectual domains but not the health or physical domains. This was due to repressors' low level of trait anxiety rather than their high defensiveness. Conclusions: Individuals high in trait anxiety are especially sensitive to situations involving social evaluation but not those characterized by danger to their health or physical well-being.     

Repression and effective coping styles

This study investigated the relationship between repressive coping style as defined by Weinberger (1990)—low reported anxiety and high reported defensiveness—and several individual difference measures related to general coping styles. Twenty‐nine studies looking at cognitive, behavioural, and individual difference factors associated with repressive coping were tabulated and reviewed. In the current study 116 women and 32 men were administered a questionnaire including measures of personality, ways of coping, self‐monitoring, interpersonal influence, and locus of control to further explore the repressor coping style. Two measures, as opposed to the usual one, were used to categorize repressors: the use of anxiety and social desirability measures of Weinberger, Schwartz and Davidson (1979) and the Gudjonsson (1981) method using Neuroticism and Lie scales from the EPQ(R). Analysis of variance showed that repressors reported using more positive/healthy and less negative/unhealthy coping styles. The results did not change substantially when more extreme scoring groups were used. Factor analysis of the scales revealed six clear factors relating to ways of coping; again, repressors scored highly on the factor denoting positive coping. It was also found that the Lie and Neuroticism scales of the revised EPQ personality questionnaire of Eysenck, Eysenck and Barrett (1985) could be used as a substitute for anxiety and defensiveness to predict repression with considerable success. However results from both one‐ and two‐way analysis of variance indicated that the two different ways of classifying repressors was not totally inter‐changeable as the overlap in results occurred only with highly significant effects. The results are discussed in the light of previous investigations into repression which suggested that repressors report an overly optimistic way of coping in order to avoid negative affect. Copyright © 1999 John Wiley & Sons, Ltd.     

Self-reported emotional disturbance and its relation to electrodermal reactivity,defensiveness and trait anxiety

The discordance between an electrodermal and a subjective measure of disturbance was studied in 36 males. Electrodermal responses to emotionally loaded questions were recorded and subjects were requested to rate on visual analogue scales how disturbing they found the questions. The subjects were divided into three groups according to their ‘accuracy’ of self-perception and it was hypothesised that those who reported low subjective disturbance but reacted relatively strongly electrodermally (‘repressors’), would have a high defensiveness score but low trait anxiety. Conversely, subjects who amplify their disturbance (‘sensitisers’) were expected to have a low defensiveness score and high trait anxiety. The hypotheses were confirmed suggesting that both under and over reporting of subjective disturbance are related to defensiveness and trait anxiety. Another finding was that ‘sensitisers’ were significantly younger than ‘repressors’.     

Anxiety symptom interpretation in high-anxious, defensive high-anxious, low-anxious and repressor sport performers

For the first time in a sport setting this study examined the intensity and direction of the competitive state anxiety response in collegiate athletes as a function of four different coping styles: high-anxious, defensive high-anxious, low-anxious and repressors. Specifically, the study predicted that repressors would interpret competitive state anxiety symptoms as more facilitative compared to high-anxious, defensive high-anxious, and low-anxious performers. Separate Multivariate Analyses of Variance (MANOVA) were performed on the intensity and direction subscales of the modified Competitive State Anxiety Inventory-2 (CSAI-2). A significant main effect was identified for trait worry revealing that low trait anxious athletes reported lower intensities of cognitive and somatic anxiety and higher self-confidence and interpreted these as more facilitative than high trait anxious athletes. The prediction that performers with a repressive coping style would interpret state anxiety symptoms as more facilitative than performers with non-repressive coping styles was not supported.     

Anxiety symptom interpretation in high-anxious,defensive high-anxious,low-anxious and repressor sport performers

Abstract

For the first time in a sport setting this study examined the intensity and direction of the competitive state anxiety response in collegiate athletes as a function of four different coping styles: high-anxious, defensive high-anxious, low-anxious and repressors. Specifically, the study predicted that repressors would interpret competitive state anxiety symptoms as more facilitative compared to high-anxious, defensive high-anxious, and low-anxious performers. Separate Multivariate Analyses of Variance (MANOVA) were performed on the intensity and direction subscales of the modified Competitive State Anxiety Inventory-2 (CSAI-2). A significant main effect was identified for trait worry revealing that low trait anxious athletes reported lower intensities of cognitive and somatic anxiety and higher self-confidence and interpreted these as more facilitative than high trait anxious athletes. The prediction that performers with a repressive coping style would interpret state anxiety symptoms as more facilitative than performers with non-repressive coping styles was not supported.     

Repressors report fewer intrusions following a laboratory stressor: The role of reduced stressor-relevant concept activation and inhibitory functioning

Abstract

This study investigated whether a repressive coping style is associated with fewer intrusions following an experimentally controlled stressor. Furthermore, we examined whether lower activation of stressor-relevant concepts in long-term memory and better inhibitory functioning may contribute to this association. Extreme-scoring participants on a trait anxiety and a social desirability scale were selected to form repressor (n=35), low anxious (n=15), high anxious (n=30), and defensive (n=21) groups. In line with predictions, repressors reported fewer intrusions following a failure manipulation compared to non-repressors. Furthermore, pre-stressor inhibitory functioning was negatively associated with color-naming interference of stressor-related words. This suggests that overall, higher inhibitory control is related to lower activation of failure-related concepts. However, there was no evidence that concept activation and inhibitory control were responsible for repressors’ lower number of self-reported intrusions.     

Repression and Coping Styles in Asthmatic Patients

The objectives of this study were to (a) determine prevalence of the dispositional repressive coping style as well as other situational coping styles in a sample of asthmatic patients and (b) to analyze the capacity of these styles to predict subsequent morbidity (emergency room visits or hospitalizations due to asthma) during a 12-month follow-up. A sample of 75 adult asthmatic patients was selected and information about sociodemographics, asthma severity, and patient’s perception of illness severity was collected. Repressive coping style was defined by a combination of scores obtained on the Trait Anxiety Inventory and the Marlowe-Crowne Social Desirability Scale. Coping styles were assessed with the dispositional version of the Coping Orientation to Problems Experienced Inventory. Eighteen patients (24%) were classified as repressors. Repressor asthmatics obtained scores significantly lower on Emotion-Focused Coping compared to non-repressors (F _(1,72) = 5.15, p = .026). Patients who perceived their asthma as severe reported to use Emotion-Focused Coping more than those who judged it as mild or moderate (F _(2,71) = 4.83, p = .011). A higher use of Denial (an Emotion-Focused strategy of coping) explained 8% of variance of the frequency of emergency room visits during the 12-month follow-up. The prevalence of repressive coping style in the asthmatic population is similar to that registered in other populations of chronic patients, and it is also associated with the tendency to report a lower use of strategies traditionally considered as maladaptive. The use of Emotion-Focused Coping strategies seems to be related to a worse perception of the physical status, and among this group of strategies, Denial also could favor a poor clinical course in bronchial asthma.