Citation

Rice SM, Kealy D, Ogrodniczuk JS, Seidler ZE, Denehy L, Oliffe JL. Cancer Manag. Res. 2020; 12: 1039-1046.

Affiliation

Department of Nursing, The University of Melbourne, Melbourne, VIC, Australia.

Copyright

(Copyright © 2020, Dove Medical Press)

DOI

10.2147/CMAR.S237770

PMID

32104085

PMCID

PMC7023872

Abstract

BACKGROUND: Prostate cancer is a risk factor for major depressive disorder. Recent psycho-oncology research suggests a potential role for male-specific mood-related symptoms in this relationship. Gender socialisation experiences may reinforce men's anger and emotion suppression responses in times of distress, and anger and emotion suppression may be implicated in pathways to, and maintenance of depression in prostate cancer.

PATIENTS AND METHODS: Data were collected online from men with a self-reported diagnosis of prostate cancer (N=100; mean age 64.8 years). Respondents provided information regarding diagnosis and treatment, in addition to current experience of major depression and male-specific externalising symptoms.

RESULTS: Prostate cancer diagnosis in the last 12 months occurred for 35.4% of the sample. Elevated major depression symptoms were observed for 49% of respondents, with 14% endorsing past 2-week suicide ideation. Parallel mediation analysis (99% CIs) controlling for prostatectomy and active surveillance indicated men's emotion suppression mediated the relationship between anger and depression symptoms (R²=0.580). Trichotimised emotion suppression scores with control variables yielded a large multivariate effect (p<0.001, partial η²=0.199). Univariate moderate-sized effects were observed for emotion suppression comparisons for symptoms of depressed mood and sleep disturbance, and a large effect observed for guilt-proneness.

CONCLUSION: Findings highlight the salience of anger in the experience of depression symptoms for men with prostate cancer. The mediating role of emotion suppression, which in turn was strongly linked to men's feelings of guilt, suggests potential assessment and intervention targets. Future work should examine the role of androgen deprivation therapy and other treatments including active surveillance on the relationship between anger and depression in men with prostate cancer. Consideration of interventions focused on emotion processing skills in psycho-oncology settings may help reduce men's reliance on emotion suppression as a strategy for coping with feelings of anger or guilt in the context of prostate cancer.

© 2020 Rice et al.

Language: en

Keywords

anger; depression; emotion suppression; prostate