Health Psychol. 2012 Sep;31(5):548-51. doi: 10.1037/a0026834. Epub 2012 Jan 9.
Lu Q1, Zheng D, Young L, Kagawa-Singer M, Loh A.
Little attention has been focused on Asian American breast cancer survivor’s psychological needs. No outcome-based psychosocial interventions have been reported to target at this population. Expressive writing interventions have been previously shown to improve health outcomes among non-Hispanic White breast cancer populations. This pilot study aimed to test the cultural sensitivity, feasibility, and potential health benefits of an expressive writing intervention among Chinese-speaking breast cancer survivors.
Participants (N = 19) were asked to write about their deepest thoughts and feelings, their coping efforts, and positive thoughts and feelings regarding their experience with breast cancer each week for 3 weeks. Health outcomes were assessed at baseline, 3, and 6 months after the intervention. A Community-Based Participatory Research Approach (CBPR) is used.
Expressive writing was associated with medium and large effect sizes (η(p)² = 0.066∼0.208) in improving multiple health outcomes (quality of life, fatigue, posttraumatic stress, intrusive thoughts, and positive affect) at follow-ups. Participants perceived the study to be valuable. The study yielded high compliance and completion rates.
Expressive writing is associated with long-term improvement of health outcomes among Chinese breast cancer survivors and has the potential to be utilized as a support strategy for minority cancer survivors. In addition, CBPR is valuable in improving feasibility and cultural sensitivity of the intervention in understudied populations. Future studies employing randomized, controlled trial designs are warranted.
J Soc Clin Psychol. 2010 May 1;26(3):362-384.
Radcliffe AM1, Lumley MA, Kendall J, Stevenson JK, Beltran J.
Studies suggest that written emotional disclosure can improve health. Unknown, however, is whether the presence or absence of an audience for one’s disclosure matters, and whether time management control writing has any effects. Undergraduates (N = 165) with unresolved stress were randomized to 1 of 3 groups that wrote for 4 sessions: shared written disclosure (submitted to researchers), private written disclosure (not submitted), or time management control writing; or to a fourth group (no-writing control). At 3-month follow-up, the two control groups were equivalent on outcomes. Both shared and private disclosure resulted in less cognitive intrusion and avoidance than the combined control groups. Yet, shared disclosure reduced depression and interpersonal sensitivity more than either private disclosure or the control groups, and only shared disclosure reduced physical symptoms. Although truly private writing improves cognitive stress effects, shared writing has broader benefits, suggesting that social disclosure for one’s writing matters.
J Behav Ther Exp Psychiatry. 2008 Dec;39(4):558-66. doi: 10.1016/j.jbtep.2007.11.008. Epub 2008 Feb 6.
Guastella AJ1, Dadds MR.
We report on a controlled trial of three structured writing paradigms that engage the writer with cognitive-behavioural emotion-processes: exposure, devaluation, and benefit-finding. University students (N=198) wrote once a week for three weeks about their most upsetting experience. The long-term effects of these structured writing procedures were compared to an unstructured emotion writing condition and control. Outcomes indicated that exposure writing sped the reduction of intrusive and avoidant symptoms, while benefit-finding writing increased reports of positive growth. Results suggest the use of these paradigms to study emotion-processing mechanisms and, potentially, in practice to enhance coping in process-specific ways.