When it came to dealing with conflicts, about 30 per cent of men said they usually or always kept their feelings to themselves, compared to about 20 per cent of women. But women who “self-silenced” were four times more likely to die during the study than women who always spoke out. Psychologists said men often are silent during conflicts to avoid subjects they would rather not discuss, a pattern called “demand-withdraw”. Women engage in this behavior but less frequently.

“We see this pattern in studies in which the wife pushes her husband to stop drinking or smoking and he withdraws,” Rohrbaugh said.

Dana Crowley Jack, a professor at Western Washington University and author of the 1991 book Silencing the Self, said women’s motivations for avoiding conflict are more complex. They are socialised to keep feelings of conflict with their spouses to themselves, she said, believing that their behavior will protect their marriages or family relationships, she said. “One way of being pleasing is to go along with what the other person wants ,” she said.