How Does Insightful and Emotional Disclosure Bring Potential Health Benefits?: Study Based on Online Support Groups for Women with Breast Cancer.

J Commun. 2011 Jun;61(3):432-464.

Shim M1, Cappella JN2, Han JY3.

PMID:25568496PMCID:PMC4283796DOI:10.1111/j.1460-2466.2011.01555.x

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283796/

 

Despite much research on the beneficial effects of written disclosure, relatively little attention has been paid to specifying the mechanism underlying the effects. Building upon the two theoretical models (the cognitive adaptation model and the emotional exposure-habituation model), this research focused on two aspects of disclosure content—insights and emotions—and examined how women with breast cancer benefit from written disclosure in online support groups. Using survey data collected at baseline and after four months and messages posted in bulletin-board-type online groups in between, we analyzed how the content of disclosive messages predicted health outcomes. Disclosure of insights led to greater improvements in health self-efficacy, emotional well-being, and functional well-being, which was mediated by lowered breast cancer concerns. Disclosure of negative emotions did not have main effects on health outcomes; instead, it weakened the unfavorable association between concerns at baseline and functional well-being at follow-up. Our findings support both theoretical models, but in regard to different aspects of disclosure content.

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THE THERAPEUTIC BENEFIT OF EXPRESSIVE WRITING FOR POSTTRAUMATIC SYMPTOMS: A RANDOMIZED CONTROLLED TRIAL OF EMOTIONAL MODERATORS AND WRITING MODALITY

Expressive writing is a therapeutic intervention requiring individuals to write about distressing events and their emotional responses to these experiences (Pennebaker & Beall, 1986). The use of expressive writing has improved behavioural, physiological, and psychological outcomes in many populations, including individuals with posttraumatic stress disorder (PTSD; Baikie & Wilhelm, 2005). Greater self-disclosure on such writing tasks has been associated with higher perceived benefits and helpfulness (Brewin & Lennard, 1999). Researchers have investigated how expressive writing protocols can be utilized online to increase levels of self-disclosure when writing about traumatic experiences and, consequently, improve PTSD symptom outcomes. Researchers have not yet assessed for modality-based differences (e.g., typed vs. hand-written expressive writing) for therapeutic efficacy or emotional engagement. The present investigation examined whether 1) typed and hand-written expressive writing equally reduced PTSD symptoms; and 2) emotional engagement affected the efficacy of expressive writing in reducing PTSD symptoms. A community and student sample (n = 29) with clinically significant PTSD symptoms completed the trial. Participants were randomized to one of four conditions with different writing modalities (i.e., typed or hand-written) and paradigms (i.e., control or expressive writing). In one session, participants were administered three 15-minute writing tasks and self-report questionnaires evaluating aspects of emotion (i.e., recognition, expression, trait negative emotionality) and PTSD symptom severity. An optional 7-day follow-up questionnaire re-evaluating PTSD symptom severity was also administered to participants. Each experimental group had non-significant decreases in PTSD symptoms from pre- to post-intervention, these

changes being dependant on pre-intervention symptom severity; however, alexithymia, i

dissociation (i.e., attentional dissociation and dissociative amnesia), negative affect, emotional approach coping, and the presence of a learning disability did affect symptom changes, and when these factors were considered the experimental conditions significantly differed in their effect on symptom outcomes. In conclusion, findings of the current trial suggest that a day-intensive session of expressive writing neither reduces PTSD symptoms nor differs in efficacy based on its method of completion unless emotional engagement with the task is considered. Further investigation into how learning disabilities and emotional predispositions affect engagement with expressive writing is warranted to clarify its efficacy in clinical PTSD populations.

http://ourspace.uregina.ca/bitstream/handle/10294/7086/D%27Ambrosio_Christina_Ma_Psyc_200338097_Fall2016.pdf

Emotional Distress Following Childbirth: An Intervention to Buffer Depressive and PTSD Symptoms.

Eur J Psychol. 2015 May 29;11(2):214-32. doi: 10.5964/ejop.v11i2.779. eCollection 2015 May.

Di Blasio P1, Miragoli S1, Camisasca E2, Di Vita AM3, Pizzo R4, Pipitone L4.

Childbirth for some women is a negative experience associated with depressive and post-traumatic symptoms. The preventive actions focusing on helping mothers to cope with negative emotions experienced after childbirth are strongly recommended. It is also recommended both to intervene early and on all women to avoid the risk that these symptoms can worsen in the months after childbirth. The intervention described in the current study is focalized on the elaboration of post-partum negative thoughts and emotion through a writing task, with the purpose to help new mothers to reflect, understand, evaluate and, thus, reformulate the stressful situation with new beliefs and emotions. 176 women aged from 19 to 43 years (M = 31.55, SD = 4.58) were assessed for depression and PTSD in the prenatal phase (T1). In about 96 hours after childbirth they were randomly assigned to either “Making Sense condition” (MS: in which they wrote about the thoughts and emotions connected with delivery and childbirth) or “Control-Neutral condition” (NC: in which they wrote about the daily events in behavioural terms) and then reassessed for depression and PTSD (T2). A follow up was conducted 3 months later (T3) to verify depression and posttraumatic symptoms. The results showed that depressive symptoms decreased both at 96 hours and at 3 months as a result of making-sense task. Regarding the posttraumatic symptoms the positive effect emerged at three months and not at 96 hours after birth.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873107/

Effects of mode of writing on emotional narratives.

J Trauma Stress. 1999 Apr;12(2):355-61.

Brewin CR, Lennard H.

The authors hypothesized that writing longhand about a stressful experience, compared to typing, arouses greater negative emotion. Eighty college students were randomly assigned to describe either a neutral or stressful topic by typing or writing longhand, in a 2 x 2 factorial design. Students describing the stressful topic, compared to the neutral topic, wrote for a longer period, used more words, and reported greater negative and less positive affect. Consistent with prediction, writing about a stressful experience longhand induced greater negative affect than typing, and led to more self-rated disclosure. These findings suggest a method whereby therapists can help patients control their levels of negative affect when producing a trauma narrative.

https://www.ncbi.nlm.nih.gov/pubmed/10378172

The benefits of expressive writing after the Madrid terrorist attack: Implications for emotional activation and positive affect.

Br J Health Psychol. 2008 Feb;13(Pt 1):31-4. doi: 10.1348/135910707X251234.

Fernández I1, Páez D.

This study examined the effects of expressive narrative writing in 607 participants. Compared with a control group, the participants randomly assigned to write about their feelings and thoughts after the Madrid train attack on M11 report less negative emotions related to the recall of the collective trauma at a 2-month follow-up after the attacks. However, no effects were found on positive affect, probably because the study had only one writing session of brief duration. Stronger feelings of joy, use of positive words, and low use of negative words in the narratives predicted low emotional activation at follow-up.

https://www.ncbi.nlm.nih.gov/pubmed/18230227

Written emotional expression and emotional well-being: the moderating role of fear of rejection.

Pers Soc Psychol Bull. 2005 Jun;31(6):818-30.

Langens TA1, Schüler J.

Empirical research shows that individuals high in fear of rejection typically report low levels of perceived social support and are more vulnerable to stressful experiences. At the same time, writing about stressful experiences in an emotional way seems to help people adapt to current stressors and not-yet-assimilated stressful experiences. Therefore, the authors suggest that written emotional expression may be a particularly effective strategy to manage negative emotions for individuals high in fear of rejection. Three studies were conducted to test these assumptions. Study 1 found that high fear of rejection is linked to a lack of perceived social support. Longitudinal Studies 2 and 3 supported our main hypothesis, demonstrating that written emotional expression is linked to lower levels of negative mood among individuals high (but not among individuals low) in fear of rejection.

https://www.ncbi.nlm.nih.gov/pubmed/15833908

Expressive Writing Intervention for Teens Whose Parents Have Cancer

https://kuscholarworks.ku.edu/handle/1808/8082?show=full

The role of emotional expression was explored in the writings of adolescent children of parents with cancer. Participants ages 12-18 (n=40) were assigned randomly to write in 3 sessions about their thoughts and feelings regarding their parents’ cancer (experimental condition) or their time management (fact control condition). Physical health (i.e., doctor visits, school absences, physical symptoms) and psychological health variables (i.e., internalizing and externalizing behavior, depression, anxiety, positive emotion, negative emotion, post traumatic growth) were assessed as a function of writing condition and participants’ temporal orientation (i.e., the time period on which a person bases the majority of his or her perceptions of reality). Results from analysis of covariance indicated experimental condition was related to decreases in negative affect, self reported depression symptoms, parent-reported anxiety symptoms, and parent- reported internalizing problems in the adolescent participants and increases in post traumatic growth reported by the adolescent participants. Past temporal orientation was related to increased conduct problems reported by parents, increased physical symptoms, and decreased school absences. Conduct problems scores reported by parent were related to increased positive affect, increased anxiety, and decreased illness-related doctor visits. Adolescent Atypicality scores were related to increased parent-reported anxiety in the child, physical symptoms, and school absences. Problem solving coping was related to decreased anxiety, and behavioral avoidance coping was related to increased depression as reported by parent and increased internalizing problems as reported by parent. Given the significant results for the experimental condition, the findings are discussed in light of future possible research on the use of emotional expressive writing in adolescents as well as use of emotional writing tasks as interventions for adolescent children of cancer patients.

full text: https://kuscholarworks.ku.edu/bitstream/handle/1808/8082/LaubHuizenga_ku_0099D_11305_DATA_1.pdf?sequence=1&isAllowed=y