Written Emotional Disclosure: Testing Whether Social Disclosure Matters.

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.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2932452/

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Does expressive writing reduce stress and improve health for family caregivers of older adults?

Gerontologist. 2007 Jun;47(3):296-306.

Mackenzie CS1, Wiprzycka UJ, Hasher L, Goldstein D.

We examined whether written emotional disclosure reduces stress and improves health outcomes for family caregivers of physically frail and cognitively impaired older adults, as it has been shown to do for certain student and clinical populations.

DESIGN AND METHODS:

Primary caregivers of older adults attending a day program were randomly assigned to expressive-writing (n = 14), time-management (n = 13), or history-writing (n = 13) conditions. Participants wrote for 20 minutes on four occasions over a 2-week period, and they completed self-report measures of caregiver burden and health prior to the intervention, immediately afterward, and at 1-month follow-up.

RESULTS:

Contrary to expectations, expressive-writing and history-writing participants performed similarly across outcomes. Only caregiver participants in the time-management condition experienced significant mental and physical health improvements after writing.

IMPLICATIONS:

The results of this study add to a growing body of research demonstrating equivocal effects of expressive writing with clinical samples, and they suggest the potential benefit of written time management for stressed caregivers.

https://www.ncbi.nlm.nih.gov/pubmed/17565094

Expressive writing and post-traumatic stress disorder: effects on trauma symptoms, mood states, and cortisol reactivity.

Br J Health Psychol. 2008 Feb;13(Pt 1):85-93. doi: 10.1348/135910707X250866.

Smyth JM1, Hockemeyer JR, Tulloch H.

This study investigates the boundary conditions (feasibility, safety, and efficacy) of an expressive writing intervention for individuals with post-traumatic stress disorder [PTSD].

DESIGN:

Randomized trial with baseline and 3-month follow-up measures of PTSD severity and symptoms, mood states, post-traumatic growth, and (post-only) cortisol reactivity to trauma-related stress.

METHODS:

Volunteers with a verified diagnosis of PTSD (N=25) were randomly assigned to an experimental group (writing about their traumatic experience) or control group (writing about time management).

RESULTS:

Expressive writing was acceptable to patients with PTSD and appeared safe to utilize. No changes in PTSD diagnosis or symptoms were observed, but significant improvements in mood and post-traumatic growth were observed in the expressive writing group. Finally, expressive writing greatly attenuated neuroendocrine (cortisol) responses to trauma-related memories.

CONCLUSIONS:

The present study provides insight into several boundary conditions of expressive writing. Writing did not decrease PTSD-related symptom severity. Although patients continue to exhibit the core features of PTSD, their capacity to regulate those responses appears improved following expressive writing. Dysphoric mood decreased after writing and when exposed to traumatic memories, participants’ physiological response is reduced and their recovery enhanced.

https://www.ncbi.nlm.nih.gov/pubmed/18230238

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

Expressive writing and positive writing for participants with mood disorders: An online randomized controlled trial

Karen A.BaikieaLiesbethGeerligsabKayWilhelmab

 

Journal of Affective Disorders

Volume 136, Issue 3, February 2012, Pages 310-319
he following questionnaires were completed online: Centre for Epidemiological Studies—Depression Scale (CES-D), Depression Anxiety Stress Scales (DASS), Pennebaker Inventory of Limbic Languidness (PILL), overall health questions, Temperament and Personality Questionnaire (TPQ) and COPE Inventory (COPE). Participants then wrote for 20 min on 4 occasions, and then completed follow-up questionnaires.
The expressive writing, positive writing and time management control writing groups all reported significantly fewer mental and physical symptoms for at least 4 months post-writing. When expressive and positive writing groups were combined, the resulting `emotional writing group’ showed significantly lower scores on the DASS stress subscale than the control writing group at all time-points. Potential reasons are discussed and areas of further study identified.