EMOTIONAL BENEFITS OF EXPRESSIVE WRITING IN A SAMPLE OF ROMANIAN FEMALE CANCER PATIENTS

Cogniţie, Creier, Comportament / Cognition, Brain, Behavior
Copyright © 2008 Romanian Association for Cognitive Science. All rights reserved. ISSN: 1224-8398
Volume XII, No.1 (March), 115 – 129

 

The main purpose of the present study was to investigate the possible positive effects of the Expressive Writing paradigm on a sample of Romanian female cancer patients. The major tenet of this paradigm is that if individuals with high levels of distress express in writing, for three or four consecutive writing sessions, their deepest thoughts and emotions regarding the activating event and its consequences, on the follow-up assessment they would experience significantly lower levels of distress, and improved physical and/or psychological functioning. Our study has evinced, that the participants of the sample we investigated has experienced at the follow-up assessment significantly lower levels of distress, and significantly higher levels of positive meaning in life and benefit finding, however, the results may depend on the pre-intervention levels of depression. Nevertheless, the Expressive Writing task has not significantly contributed in our sample to the enhancement of the levels of positive emotions.

http://www.ascred.ro/images/attach/Emotional%20benefits%20of%20expressive%20writing%20in%20a%20sample%20of%20romanian%20female%20cancer%20patients.pdf

 

A pilot study of expressive writing intervention among Chinese-speaking breast cancer survivors.

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.

METHODS:

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.

RESULTS:

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.

CONCLUSION:

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.

https://www.ncbi.nlm.nih.gov/pubmed/22229930

The efficacy of a brief internet-based self-help intervention for the bereaved.

Behav Res Ther. 2010 May;48(5):359-67. doi: 10.1016/j.brat.2009.12.009. Epub 2009 Dec 23

Research so far has shown little evidence that written disclosure facilitates recovery from bereavement. There are good reasons to assume that written disclosure may only benefit those bereaved who are at risk for developing problems or who are experiencing significant psychological problems as a result of their loss, and only when appropriate writing instructions are used. Drawing on previous work in the area of post-traumatic stress, a writing intervention was designed to test these assumptions. Bereaved individuals, who were still significantly distressed by their loss, were randomly assigned to the intervention condition (N = 460) or a waiting-list control condition (N = 297). Both groups filled in questionnaires online at baseline, and 3 and 6 months later. The intervention was administered via e-mail immediately after baseline measurement. Results showed that writing decreased feelings of emotional loneliness and increased positive mood, in part through its effect on rumination. However, writing did not affect grief or depressive symptoms. Contrary to expectations, effects did not depend on participants’ risk profile or baseline distress level. Implications of these findings are discussed.

Writing for Health: Rationale and Protocol for a Randomized Controlled Trial of Internet-Based Benefit-Finding Writing for Adults With Type 1 or Type 2 Diabetes.

JMIR Res Protoc. 2017 Mar 14;6(3):e42. doi: 10.2196/resprot.7151.

Crawford J1,2, Wilhelm K1,2,3, Robins L1,3, Proudfoot J2,4.

Diabetes mellitus is Australia’s fastest growing chronic disease, and has high comorbidity with depression. Both subthreshold depression and diabetes distress are common amongst people with type 1 or type 2 diabetes, and are associated with poorer diabetes self-care. A need exists for low-intensity self-help interventions for large numbers of people with diabetes and diabetes distress or subthreshold depression, as part of a stepped-care approach to meeting the psychological needs of people with diabetes. Benefit-finding writing is a very brief intervention that involves writing about any positive thoughts and feelings about a stressful experience, such as an illness. Benefit-finding writing has been associated with increases in positive affect and positive growth, and has demonstrated promising results in trials amongst other clinical populations. However, benefit-finding writing has not yet been examined in people with diabetes.

OBJECTIVE:

The aim of this randomized controlled trial (RCT) is to evaluate the efficacy of an Internet-based benefit-finding writing (iBFW) intervention for adults with type 1 or type 2 diabetes (compared to a control writing condition) for reducing diabetes distress and increasing benefit-finding in diabetes, and also improving a range of secondary outcomes.

METHODS:

A two-arm RCT will be conducted, using the online program Writing for Health. Adults with type 1 or type 2 diabetes living in Australia will be recruited using diabetes-related publications and websites, and through advertisements in diabetes services and general practitioners’ offices. Potential participants will be referred to the study-specific website for participant information and screening. All data will be collected online. Participants will be randomized to either iBFW about diabetes, or a control writing condition of writing about use-of-time. Both conditions involve three daily sessions (once per day for three consecutive days) of 15-minute online writing exercises. Outcome measures will be administered online at baseline, one-month, and three-month follow-ups.

RESULTS:

This trial is currently underway. The primary outcomes will be diabetes distress and benefit-finding in diabetes. Secondary outcomes will be depression, anxiety, diabetes self-care, perceived health, and health care utilization. We aim to recruit 104 participants. All stages of the study will be conducted online using the Writing for Health program. Group differences will be analyzed on an intention-to-treat basis using mixed models repeated measures. Linguistic analyses of the writing exercise scripts, and examinations of the immediate emotional responses to the writing exercises, will also be undertaken.

CONCLUSIONS:

This RCT will be the first study to examine iBFW for adults with type 1 or type 2 diabetes. If iBFW is found to be efficacious in reducing diabetes distress and improving diabetes self-care and other outcomes, iBFW may offer the potential to be a low-cost, easily accessible self-help intervention to improve the wellbeing of adults with diabetes.

TRIAL REGISTRATION:

Australia and New Zealand Clinical Trials Registry (ACTRN12615000241538).

https://www.ncbi.nlm.nih.gov/pubmed/28292741

 

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

Health effects of written emotional disclosure in adolescents with asthma: a randomized, controlled trial.

J Pediatr Psychol. 2006 Jul;31(6):557-68. Epub 2005 Jul 13.

Warner LJ1, Lumley MA, Casey RJ, Pierantoni W, Salazar R, Zoratti EM, Enberg R, Simon MR.

To test the effects of written emotional disclosure on the health of adolescents with asthma and to examine how language in disclosures predicts outcomes.

METHODS:

We randomized 50 adolescents with asthma to write for 3 days at home about stressful events (disclosure) or control topics. At baseline and 2 months after writing, we assessed symptoms, affect, disability, internalizing behavior problems, and lung function; parents independently rated internalizing behavior and disability.

RESULTS:

Compared with control writing, disclosure writing led to improved positive affect and internalizing problems. Disclosure also decreased asthma symptoms and functional disability among adolescents with baseline elevations of these difficulties. Lung function was not changed. Disclosures with more negative emotion, insight, and causal words–and increased causal or insight words over days–predicted improved health.

CONCLUSIONS:

Written emotional disclosure improves emotional and behavioral functioning among adolescents with asthma, particularly those whose writings suggest emotional processing and cognitive restructuring.

https://www.ncbi.nlm.nih.gov/pubmed/16014820

Effects of an expressive writing intervention on cancer-related distress in Danish breast cancer survivors – results from a nationwide randomized clinical trial.

Psychooncology. 2013 Jul;22(7):1492-500. doi: 10.1002/pon.3193. Epub 2012 Sep 19.

Jensen-Johansen MB1, Christensen S, Valdimarsdottir H, Zakowski S, Jensen AB, Bovbjerg DH, Zachariae R.

To examine the effects of an expressive writing intervention (EWI) on cancer-related distress, depressive symptoms, and mood in women treated for early stage breast cancer.

METHODS:

A nationwide sample of 507 Danish women who had recently completed treatment for primary breast cancer were randomly assigned to three 20-min home-based writing exercises, one week apart, focusing on either emotional disclosure (EWI group) or a non-emotional topic (control group). Cancer-related distress [Impact of Event Scale (IES)], depressive symptoms (Beck Depression Inventory-Short Form), and negative (37-item Profile of Moods State) and positive mood (Passive Positive Mood Scale) were assessed at baseline and at 3 and 9 months post-intervention. Choice of writing topic (cancer versus other), alexithymia (20-item Toronto Alexithymia Scale), and social constraints (Social Constraints Scale) were included as possible moderators.

RESULTS:

Significant (p<0.01) group differences in mood change from before to immediately after each session suggested successful manipulation. Reductions over time in psychological symptoms were seen in both groups (p<0.05), but no time × group interactions were found. Choice of writing topic moderated effects on IES, with women writing about other themes showing greater reductions in cancer-related avoidance than women writing about their cancer. Fewer depressive symptoms and higher levels of positive mood were seen 3 months post-intervention in women writing about their cancer when compared with the control group. Difficulties describing feelings and externally oriented thinking (20-item Toronto Alexithymia Scale) moderated effects on positive mood and IES-total, while no moderating effects were found of social constraints.

CONCLUSIONS:

In concordance with the majority of previous results with cancer patients, no main effects of EWI were found for cancer-related distress, depressive symptoms, and mood. Moderator analyses suggested that choice of writing topic and ability to process emotional experiences should be studied further.

https://www.ncbi.nlm.nih.gov/pubmed/22991162