In plain language
Medical screening can save lives, but waiting for results — especially cancer results — can be emotionally hard. This study asked what protects people psychologically during that process. Two candidate strengths were examined: the ability to identify and describe one’s feelings (the opposite of alexithymia) and psychological flexibility — the capacity to stay present and act on one’s values even when difficult thoughts and feelings show up.
The researchers followed HIV-positive men who have sex with men as they went through anal cancer screening in Sydney, completing questionnaires at two time points over roughly 14 weeks. They measured difficulty identifying and describing feelings (DIDF), psychological flexibility, depression, anxiety, stress, and quality of life. Strikingly, the actual medical results — whether men received low-threat, reassuring, or high-threat findings — did not predict changes in general mental health. What mattered was the psychological skills men brought to the process.
Men who had more difficulty identifying and describing their feelings at baseline became more depressed, anxious, and stressed over time, and reported lower mental and physical quality of life — regardless of their screening results. Psychological flexibility also predicted better mental health, but its benefits operated entirely through the emotion-identification skills: being flexible seems to help people get to know and name their emotions, which in turn protects mental health. The practical implication is that brief interventions building emotional awareness and flexibility could help people cope with health screening and other threatening health information.
Key findings
- Among 201 HIV-infected men undergoing anal cancer screening over 14 weeks, both difficulty identifying and describing feelings (DIDF) and psychological flexibility reliably predicted mental health.
- Controlling for baseline mental health, greater DIDF predicted increases in depression (7% of residual variance), anxiety (6%), and stress (10%), and decreases in mental and physical quality of life (3% each) at follow-up.
- The medical results themselves did not predict changes in general mental health: neither the “situation effect” model nor the interaction model was supported, while the resilience model was consistently supported.
- Bootstrapped mediation analyses showed that the link between psychological flexibility and mental health was entirely mediated by DIDF; the reverse model (flexibility mediating DIDF) received no support.
- DIDF and psychological flexibility were strongly related (r = −.69), consistent with the idea that flexibility promotes the ability to identify and differentiate emotions, which in turn enhances mental health.
- The authors suggest screening programmes could use measures of emotional identification and flexibility to triage patients who may need extra support, with brief ACT-style interventions a promising option.
How to cite
APA
Landstra, J. M. B., Ciarrochi, J., Deane, F. P., & Hillman, R. J. (2013). Identifying and describing feelings and psychological flexibility predict mental health in men with HIV. British Journal of Health Psychology, 18(4), 844–857. https://doi.org/10.1111/bjhp.12026
BibTeX
@article{landstra2013identifying,
title = {Identifying and describing feelings and psychological flexibility predict mental health in men with HIV},
author = {Landstra, Jodie M. B. and Ciarrochi, Joseph and Deane, Frank P. and Hillman, Richard J.},
journal = {British Journal of Health Psychology},
year = {2013},
volume = {18},
number = {4},
pages = {844--857},
doi = {10.1111/bjhp.12026}
}
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- All publications by Joseph Ciarrochi (searchable, with free PDFs)
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Author: Joseph Ciarrochi (ORCID 0000-0003-0471-8100). Free copy hosted with permission for scholarly use. Please cite the published version via the DOI above.