The costs of repression: a meta-analysis on the relation between repressive coping and somatic diseases

Health Psychol. 2012 Sep;31(5):640-9. doi: 10.1037/a0026257. Epub 2011 Nov 14.


Objective: When Freud introduced the term repression, he stated its pathogenic potential. Since then, this notion was adapted and continued to date. Surprisingly, there is no attempt to synthesize research on the effect of repressive coping on somatic diseases quantitatively. The current study closes this gap and examines the association between repressive coping as operationalized by Weinberger, Schwartz, and Davidson (1979) and the incidence of cancer, cardiovascular diseases, asthma, and diabetes by applying meta-analytic techniques.

Method: An extensive literature search identified 22 studies that met all inclusion criteria and assessed a total of 6,775 participants. The study set was analyzed both as a whole sample (k = 22 studies) and disease-specific (k = 2-10 studies; no study found for diabetes).

Results: The results of the meta-analysis indicate a higher risk for repressive copers to suffer from one of the investigated diseases, especially cancer (logOdds after diagnosis: 0.41; 95% confidence interval, 0.09-0.73, p = .012) and hypertension (logOdds: 0.59; 95% confidence interval, 0.32-0.86, p < .0001). After application of a continuity correction due to a missing control group the results for coronary heart disease imply an increased risk for nonrepressors to be affected. Results for cardiovascular diseases in general, heart attack, and asthma did not reach significance.

Conclusions: The current meta-analysis revealed significant associations between repressive coping, cancer, and cardiovascular diseases, especially hypertension. These results add to the notion of repressive coping as a consequence of cancer as well as to its important role for the issue of hypertension.

Publication types

  • Meta-Analysis

MeSH terms

  • Adaptation, Psychological*
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / psychology*
  • Chronic Disease / epidemiology
  • Chronic Disease / psychology
  • Female
  • Humans
  • Hypertension
  • Incidence
  • Male
  • Myocardial Infarction
  • Neoplasms / epidemiology
  • Neoplasms / psychology*
  • Repression, Psychology*
  • Research Design
  • Risk