Emotion focused coping and emotional expression have been identified as potential mediators of long-term adjustment to a cancer diagnosis. Tools for measuring emotional expression in text have not been well-validated, although there is an abundance of textual data that is available to help explore emotional expression and the relationship between emotional expression and outcome measures. The purpose of this dissertation was to develop a manual coding system of emotional expression that could be compared with current programs that have been used to evaluate emotional expression. Inter-rater reliability was found to be good with the use of the manually coded system of emotional expression between both trained and blinded coders. Sensitivity and specificity statistics compared the ability of a currently used text analysis program to predict both presence and absence of emotional expression. While excellent specificity and negative predictive value were found, the program demonstrated relatively good sensitivity and poor positive predictive value. There were not many notable differences found between manual coding and computerized coding in predicting change over time in regards to outcome measures. Replicating these findings on another sample is one area of future direction. Assessing the possibility of supplementing current content analysis programs to include the capability of attending to context is another important area of future direction.

LLU Discipline

Clinical Psychology


Clinical Psychology


School of Science and Technology

First Advisor

Jason E. Owen

Second Advisor

Kendal C. Boyd

Third Advisor

Michael E. Galbraith

Fourth Advisor

Mark G. Haviland

Fifth Advisor

Patricia K.T. Pothier

Degree Name

Doctor of Philosophy (Medical Science)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Neoplasms -- psychology; Emotions; Expressed Emotion; Neoplasms -- diagnosis



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives

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