Emotional (non)-expression and health: Data, questions, and challenges

The available evidence on the relationship between expression and non-expression of emotions (E/NE) and health is selectively and critically reviewed. It is concluded that research in this field still lacks conceptual lucidity with regard to the many existing E/NE concepts. Despite the fact that few studies adopted appropriate designs for examining causal relationships, some intriguing results have been reported showing promise for the future. These results involve prospective associations between E/NE and chronic disease, such as cardiovascular disease and HIV infection related outcomes. Future studies have to better discriminate between (i) various forms of E/NE, (ii) different (social) contexts of E/NE as well as different cognitive decision processes underlying E/NE, and (iii) individuals for whom different forms of E/NE may be adaptive. We recommend that besides (quasi)experimental studies on the potential mechanisms involved, more prospective studies are conducted in this field in order to allow for causal inferences.