Expressive disclosure to improve well-being in patients with amyotrophic lateral sclerosis: a randomised, controlled trial.

Psychol Health. 2013;28(6):701-13. doi: 10.1080/08870446.2012.754891. Epub 2013 Jan 7.

Averill AJ1, Kasarskis EJ, Segerstrom SC.

Amyotrophic lateral sclerosis (ALS) is a terminal neurological disease associated with progressive paralysis, loss of communicative ability and functional decline. Expressive disclosure may help people with ALS, particularly those who are emotionally or socially inhibited, meet psychological challenges associated with the disease. People with ALS (N = 48) were randomised to expressive disclosure about their disease or no disclosure. Psychological well-being (affect, depression and quality of life) was assessed pre-intervention and also three and six months later. Results of multi-level models indicated that the group that disclosed thoughts and feelings about ALS had higher well-being than the control group at three months post-intervention, but not six months. Ambivalence over emotional expression (AEE) moderated three-month post-intervention well-being. Those low in AEE had higher well-being than those high in AEE regardless of condition. Those high in AEE, who disclosed, had increased well-being from pre-intervention, whereas controls had decreased well-being from pre-intervention. Expressive disclosure may be helpful for people with ALS, but only those who have difficulty expressing emotions. In addition, the intervention had only temporary effects; the dynamic challenges of ALS progression may mean that the effect of processing thoughts and feelings about the disease in one stage may not generalise to later stages.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4302768/

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The moderating role of autonomy and control on the benefits of written emotion expression.

Pers Soc Psychol Bull. 2009 Mar;35(3):351-64. doi: 10.1177/0146167208328165.

Weinstein N1, Hodgins HS.

Two studies examined the hypothesis that relative to control motivation, autonomy motivation is associated with effective written expression and regulation, leading to positive emotional, physical, and cognitive outcomes over time. Participants viewed a Hiroshima-Nagasaki documentary in each of two sessions. Study 1 showed that dispositionally autonomous participants, particularly those who expressed, had positive well-being, energy, and memory after the second viewing. Study 2 explored benefits of situational motivation by priming autonomy and control. Results showed that dispositionally controlled individuals received the same benefits as autonomous individuals only when primed with autonomy and encouraged to express. Coding of writing content revealed that the benefits of autonomy were mediated by nondefensive and effective emotional processing, as reflected in greater use of self-referencing and cognitive mechanism words and lower use of concrete words. Results support the expectation that autonomy relates to effective expression and emotion regulation, leading to positive functioning over time.

https://www.ncbi.nlm.nih.gov/pubmed/19223457

Targeting Interventions: Moderators of the Effects of Expressive Writing and Assertiveness Training on the Adjustment of International University Students.

Int J Adv Couns. 2011 Jun 1;33(2):101-112.

Hijazi AM1, Tavakoli S, Slavin-Spenny OM, Lumley MA.

Acculturative stress is a common experience for international students and is associated with psychological and physical problems. In a previous study, the authors reported that two stress reduction interventions-expressive writing (EW) and assertiveness training (AT)-had limited overall benefits among international students at an American University. The current analyses of data from that study investigated whether individual differences moderated the effects of EW and AT. Results indicate that greater acculturative stress at baseline predicted greater improvement from both interventions, compared with control. Women benefited more from AT than EW, except that EW improved women’s physical symptoms. Men benefited more from EW than AT. Students with limited emotional awareness and expression tended to benefit from both interventions, relative to control. Finally, nation of origin cultural differences generally did not predict outcomes. It is concluded that the benefits of EW and AT and can be enhanced by targeting these interventions to specific subgroups of international students.

https://www.ncbi.nlm.nih.gov/pubmed/21660220

For whom does it work? Moderators of the effects of written emotional disclosure in a randomized trial among women with chronic pelvic pain.

Psychosom Med. 2004 Mar-Apr;66(2):174-83.

Norman SA1, Lumley MA, Dooley JA, Diamond MP.

Although written emotional disclosure has potential as a stress management intervention for people with health problems, the main (group) effects of disclosure in medical populations are limited. This study sought to identify individual difference moderators of the effects of written disclosure among women with chronic pelvic pain.

METHODS:

In a prospective, randomized trial, 48 women with chronic pelvic pain completed 3 individual difference measures and then wrote for 3 days about stressful consequences of their pain (disclosure) or positive events (control). Health status was assessed at baseline and 2 months after writing.

RESULTS:

Main effect group comparisons indicated that disclosure writing resulted in significantly lower evaluative pain intensity ratings than control writing at follow-up, but there were no main effects on other outcome variables (sensory or affective pain, disability, affect). Three baseline individual difference measures, however, significantly moderated group effects. Compared with control writing, disclosure led to less disability among women with higher baseline ambivalence over emotional expression or higher catastrophizing, and to increased positive affect among women with higher baseline negative affect. Ambivalence, but not catastrophizing, was independent of negative affect in its moderation effect.

CONCLUSION:

Although the main effects of writing about the stress of pelvic pain are limited, women with higher baseline ambivalence about emotional expression or negative affect appear to respond more positively to this intervention.

https://www.ncbi.nlm.nih.gov/pubmed/15039501

An emotional processing writing intervention and heart rate variability: the role of emotional approach

 Journal

Cognition and Emotion

Volume 31, 2017 – Issue 5

Pages 988-994

https://doi.org/10.1080/02699931.2016.1170667

Expressing and understanding one’s own emotional responses to negative events, particularly those that challenge the attainment of important life goals, is thought to confer physiological benefit. Individual preferences and/or abilities in approaching emotions might condition the efficacy of interventions designed to encourage written emotional processing (EP). This study examines the physiological impact (as indexed by heart rate variability (HRV)) of an emotional processing writing (EPW) task as well as the moderating influence of a dispositional preference for coping through emotional approach (EP and emotional expression (EE)), in response to a laboratory stress task designed to challenge an important life goal. Participants (n = 98) were randomly assigned to either EPW or fact control writing (FCW) following the stress task. Regression analyses revealed a significant dispositional EP by condition interaction, such that high EP participants in the EPW condition demonstrated higher HRV after writing compared to low EP participants. No significant main effects of condition or EE coping were observed. These findings suggest that EPW interventions may be best suited for those with preference or ability to process emotions related to a stressor or might require adaptation for those who less often cope through emotional approach.

http://www.tandfonline.com/doi/full/10.1080/02699931.2016.1170667?src=recsys

Insights from an expressive writing intervention on Facebook to help alleviate depressive symptoms

Sang WonLeeab1InyeopKimc1JaehyunYooa1SungkyuParkdBumseokJeongaeMeeyoungChad

Computers in Human Behavior

Volume 62, September 2016, Pages 613-619
Depression is one of the most common mental disorders. Studies have shown that various online social network (OSN) activities can be used as a marker for people’s moods as well as symptoms of subsyndromal depression, suggesting possibilities for online-based interventions. This study investigates one such potential by developing an expressive writing application within Facebook and by investigating how the designed intervention as well as various online social network activities contribute to improving one’s emotional state. Experimental data show that negative emotional words and cognitive words in online expressive writing are the two most important factors in alleviating depressive symptoms. Furthermore, participants who have had previous experience expressing emotions in OSNs reported the greatest reduction in depressive symptoms. Our findings have implications that can assist in designing personalized online intervention platforms and for sophisticated writing therapy to maximize the effect of expressive writing.

 

Insights from an expressive writing intervention on Facebook to help alleviate depressive symptoms

Sang WonLeeab1InyeopKimc1JaehyunYooa1SungkyuParkdBumseokJeongaeMeeyoungChad

Computers in Human Behavior

Volume 62, September 2016, Pages 613-619
Depression is one of the most common mental disorders. Studies have shown that various online social network (OSN) activities can be used as a marker for people’s moods as well as symptoms of subsyndromal depression, suggesting possibilities for online-based interventions. This study investigates one such potential by developing an expressive writing application within Facebook and by investigating how the designed intervention as well as various online social network activities contribute to improving one’s emotional state. Experimental data show that negative emotional words and cognitive words in online expressive writing are the two most important factors in alleviating depressive symptoms. Furthermore, participants who have had previous experience expressing emotions in OSNs reported the greatest reduction in depressive symptoms. Our findings have implications that can assist in designing personalized online intervention platforms and for sophisticated writing therapy to maximize the effect of expressive writing.