The Association Between Fear of Emotional Expression and Somatic Symptoms Is Stronger in Metastatic than in Localized or Remitted Cancer

Background: People with cancer often experience strong emotions at the time of diagnosis and when informed that their cancer has metastasized. Whereas the expression of emotions is often healthy, the fear of emotional expression can impede adaptation by undermining motivation and social support and contributing to pain and somatic symptoms. Aim: This study aimed to assess the relevance of fear of emotional expression to cancer-related pain and somatic complaints, particularly as the disease progresses. Design: This cross-sectional secondary analysis examined the association between fear of emotional expression and somatic symptoms. Moderation analysis tested whether the association between fear of emotional expression and somatic symptoms was more pronounced among patients with metastatic cancer than among patients with remitted or localized cancer. Setting/Participants: Data were collected online from 633 participants with remitted, localized, and metastatic cancer diagnoses. Results: Models indicated significantly stronger associations between fear of emotional expression and somatic symptoms among patients with metastatic cancer compared to those with localized or remitted cancer. These results held after adjusting for depression and other putative confounders. Conclusions: Taken together, these findings suggest that difficulties expressing emotions could impede quality of life if physical manifestations of stress layer upon other metastatic cancer-related symptoms and side effects.