Structured writing about current stressors: The benefits of developing plans

To investigate the health outcomes of structured writing about everyday stressors, 64 undergraduates selected a stressful event with which they were currently dealing, and wrote about it at home on three occasions in 1 week. Two forms of writing were manipulated: expressive writing?–?exploring one's thoughts and feelings about the stressor; and planful writing?–?developing plans to deal with the problem. Appraisals of control and efficacy were investigated as mediators. Expressive writing yielded no health benefits and did not affect appraisals, but planful writing did. Whereas non-planners' levels of negative affect (NA) remained stable across writing days, planners initially experienced higher NA, but their NA decreased significantly across writing days. Planful writers, relative to non-planners, felt less control over their emotions and less confidence in resolving their problem, but it was non-planners who experienced an increase in stress-related symptoms following writing. Appraisals did not mediate the physical health outcomes.     

Improving Health Care Utilization, Improving Chronic Disease Utilization, Health Status, and Adjustment in Adolescents and Young Adults with Cystic Fibrosis: A Preliminary Report

We conducted a randomized clinical trial of a 3-session written self-disclosure intervention for patients with cystic fibrosis (CF). Patients (n = 39) who were at least 15 years of age and diagnosed with CF participated in the intervention. Participants in the intervention arm were asked to write in the health care setting about an important emotionally distressing issue of personal significance for a 20-min period of time and two additional 20-min writing episodes at the patient's home, which were prompted by telephone calls. Patients in the control condition received standard care alone. Findings revealed that the intervention resulted in a reduction of the number of days patients spent in the hospital over a 3-month period. The intervention did not have an impact on physiological (Forced Expiratory Volume and Body Mass Index or subjective markers of health status. These findings extend those of Pennebaker's (cf., J. Smyth, 1998) demonstrating an effect of the written-self-disclosure intervention on health care utilization. These preliminary findings are promising and justify further investigation of the modified intervention in other chronic illness populations.     

Stress-buffering factors related to adolescent coping: a path analysis

To uncover those factors that buffer the impact of stressful negative experiences on adolescent adjustment, a theoretical model of adolescent stress and coping, with social support and social problem solving proposed as moderators, was investigated using path analysis. The study was conducted with 122 ninth-and tenth-grade nonreferred high school students. Using the LISREL statistical package (J?reskog & S?rbom, 1986), it was found that a recursive loop leading from stress outcomes back to negative stressors did not allow for a successful solution to the model. However, the effects of stressful events on adjustment were mediated by coping resources, which included a combination of problem-solving abilities and social support. Overall, the findings replicated previous investigations that have demonstrated direct relationships among stressful life events, social support, problem solving, and adolescent adjustment. While a successful fit to the theoretical model was not attained, it was concluded that a refined model may provide a more acceptable solution.     

A Brief Gratitude Writing Intervention Decreased Stress and Negative Affect During the COVID-19 Pandemic

Exploring ways to mitigate the stress of the COVID-19 pandemic is important for long-term health. Expressive and gratitude-focused writing are effective methods to help individuals process traumatic or stressful events. Gratitude-focused writing may yield additional benefits because it helps individuals appraise events positively. We hypothesized that an online gratitude writing intervention would yield greater benefits than an expressive writing intervention or control group. Participants were randomized to one of three groups and completed assessments one-week and one-month post-intervention. The gratitude writing group maintained gratitude levels and decreased stress and negative affect at one-month post-intervention. The expressive writing group decreased in gratitude and showed no changes in stress or negative affect at one-month post-intervention. The control group decreased in gratitude and negative affect and showed no changes in stress at one-month post-intervention. Gratitude writing may be a better resource for dealing with stress and negative affect than traditional expressive writing methods under extremely stressful situations with uncertain trajectories.

     

Randomized controlled trial of expressive writing for psychological and physical health: the moderating role of emotional expressivity

The current study assessed main effects and moderators (including emotional expressiveness, emotional processing, and ambivalence over emotional expression) of the effects of expressive writing in a sample of healthy adults. Young adult participants (N=116) were randomly assigned to write for 20 minutes on four occasions about deepest thoughts and feelings regarding their most stressful/traumatic event in the past five years (expressive writing) or about a control topic (control). Dependent variables were indicators of anxiety, depression, and physical symptoms. No significant effects of writing condition were evident on anxiety, depressive symptoms, or physical symptoms. Emotional expressiveness emerged as a significant moderator of anxiety outcomes, however. Within the expressive writing group, participants high in expressiveness evidenced a significant reduction in anxiety at three-month follow-up, and participants low in expressiveness showed a significant increase in anxiety. Expressiveness did not predict change in anxiety in the control group. These findings on anxiety are consistent with the matching hypothesis, which suggests that matching a person's naturally elected coping approach with an assigned intervention is beneficial. These findings also suggest that expressive writing about a stressful event may be contraindicated for individuals who do not typically express emotions.     

压力性生活事件对工读生毒品使用影响：有中介的调节效应

考察家庭功能对压力性生活事件与工读生毒品使用之间关系的调节效应以及领悟社会支持对此调节效应是否具有中介效应。采用压力性生活事件量表、家庭功能评定问卷、领悟社会支持问卷、毒品使用问卷对514名工读生进行研究。结果表明：（1）家庭功能对压力性生活事件与工读生毒品使用之间关系具有调节效应;（2）这种调节效应以领悟社会支持为中介变量。压力性生活事件对工读生毒品使用的影响是有中介的调节效应。     

Children's narratives and well-being

Research with adults indicates that writing causal-explanatory and emotionally disclosing narratives of stressful experiences is related to psychological well-being. Limited research with children has shown mixed results, but developmental theory suggests that simple extrapolation from adult findings might be problematic. In this study, 9- to 13-year-old children engaged in three days of writing under emotional and non-emotional instructions, and completed measures of depression, anxiety, strengths and difficulties, and somatic symptoms both at baseline and 2 months following intervention. Narratives were coded using a developmentally appropriate, exhaustive coding system. Children in the emotional writing group wrote more about negative evaluations, problems, emotions, explanations and coping than children in the non-emotional writing group. However, those children who wrote more about negative evaluations, problems and explanations subsequently showed higher levels of anxiety, depression and difficulties. Due to limited narrative and emotional regulation skills, expressive writing may not benefit, and may even be detrimental for, some children.     

God Give Me Strength: Exploring Prayer as Self-Disclosure

The current project was designed to examine the contention that written prayers about difficult life events function as self-disclosure to God and are structurally and effectively the same as other forms of written self-disclosure, at least in the short term. Over four writing sessions, 155 participants either wrote about mundane experiences (the control group) or wrote narratives about traumatic or stressful life events that were targeted at no one, targeted at a person of their choice, or construed as prayers to God. The results indicate that written prayers are lexically similar to the other two types of written narratives and distinct from the control group. Furthermore, the immediate effects of trauma writing on mood and physical well-being were similar as well. These findings have potentially important implications for understanding the relationship between personal prayer and a variety of health outcomes.     

Autobiographical memory processes and the course of depression.

The authors report a 6-month follow-up study of clinically depressed patients. At baseline, 2 indexes of autobiographical memory functioning were assessed: the presence of spontaneous intrusive memories of stressful life events and performance on the Autobiographical Memory Test (J. M. G. Williams & K. Broadbent, 1986), which measures overgeneral memory. The index of overgeneral memory was associated with greater levels of spontaneous intrusion of stressful memories. Overgeneral memory did not predict outcome, but depression at follow-up was predicted by the amount of intrusion and avoidance of stressful memories, even after controlling for initial severity of psychiatric symptoms.     

Effects of written emotional expression: the role of positive expectancies.

OBJECTIVE: Writing in an emotional way about stressful or traumatic experiences has beneficial effects on emotional well-being and physical health. Yet the mechanisms that underlie these effects still need to be explored. Integrating research on the effects of positive expectancies, the authors suggest that positive effects of written emotional expression may, in part, depend on expectancies induced by writing about emotional experiences. DESIGN: Two studies were conducted to test this hypothesis. In both studies, participants wrote about either an upsetting event or trivial issues. After the writing period, participants rated their expectancies that the writing intervention would improve (or impair) their emotional well-being over time. MAIN OUTCOME MEASURES: Study 1 assessed the emotional impact of an upsetting event, whereas Study 2 assessed subjective reports of physical symptoms. In both studies, outcome variables were collected both before and 6 weeks after the writing intervention. RESULTS: The results showed that (a) writing about upsetting experiences induced higher positive expectancies than writing about trivial issues and (b) expectancies associated with written emotional expression were related to a reduction in the emotional impact of an upsetting event (Study 1) and to a reduction in physical symptoms (Study 2). CONCLUSIONS: There may be 2 alternative ways to render written emotional expression effective in reducing negative emotions: (a) by rendering an emotional experience more meaningful and (b) by inducing positive affect regulation expectancies.     

Traumatic stress, perceived global stress, and life events: prospectively predicting quality of life in breast cancer patients.

The authors investigated the relationship between stress at initial cancer diagnosis and treatment and subsequent quality of life (QoL). Women (n = 112) randomized to the assessment-only arm of a clinical trial were initially assessed after breast cancer diagnosis and surgery and then reassessed at 4 months (during adjuvant treatment) and 12 months (postadjuvant treatment). There were 3 types of stress measured: number of stressful life events (K. A. Matthews et al., 1997), cancer-related traumatic stress symptoms (M. J. Horowitz, N. Wilner, & W. Alvarez, 1979), and perceived global stress (S. Cohen, T. Kamarck, & R. Mermelstein, 1983). Using hierarchical multiple regressions, the authors found that stress predicted both psychological and physical QoL (J. E. Ware, K. K. Snow, & M. Kosinski, 2000) at the follow-ups (all ps < .03). These findings substantiate the relationship between initial stress and later QoL and underscore the need for timely psychological intervention.     

Cognitive,Emotional, and Language Processes in Disclosure

Previous studies have found that writing about upsetting experiences can improve physical health. In an attempt to explain this phenomenon, 72 first-year college students were randomly assigned to write about either their thoughts and feelings about coming to college or about superficial topics for three consecutive days. Measures of language use within the writing samples and cognitive measures of accessibility and schematic organisation were collected in the weeks before and after writing. As in previous studies, writing about college was found to reduce health centre visits for illness and to improve subjects' grade point average. Text analyses indicated that the use of positive emotion words and changes in words suggestive of causal and insightful thinking were linked to health change. Improved grades, although not linked to these language dimensions, were found to correlate with measures of schematic organisation of college-relevant themes. Implications for using written language to understand cognitive and health processes are discussed.     

Personal and situational variables that describe coping with acute stress in competitive sport

The authors examined the degree to which competitive basketball players in Australia were consistent in their cognitive appraisals and coping strategies in response to 4 types of stressful situations that they had experienced during previous basketball games as functions of perceived stress intensity. The authors predicted that both approach and avoidance coping strategies would be dependent on the type of stressful event, in accord with the transactional model. The results supported that prediction: Approach strategies were more prevalent than avoidance strategies following 3 of the 4 events. Cognitive appraisals and perceived stress intensity also strongly influenced the participants' use of coping strategies, accounting for 34% of the variance.     

Embodied Self-Care: Enhancing Awareness and Acceptance Through Mindfulness-Oriented Expressive Writing Self-Disclosure

Self-care is fundamental to mental health practitioner training and professional efficacy. Expressive writing about stressful events has been researched and shown to have positive physical and psychological effects. Mindfulness, an embodied approach to clinical practice and education, has also been studied and documented as an effective self-care approach. Embodied education integrates experiential history with current learning, which may influence future practitioner performance and client outcomes. This self-care exercise is designed to promote awareness and acceptance among counselors and counselors-in-training, as well as among clients, through use of a mindfulness-oriented written self-disclosure task that may facilitate meaning-making and may enhance psychological well-being and therapeutic efficacy. It aligns with Council for Accreditation of Counseling and Related Educational Programs and American Counseling Association Code of Ethics standards addressing counselor self-care as a necessary facet of ethical practice.     

Effects of disclosure of traumatic events on illness behavior among psychiatric prison inmates

To assess the health effects of writing about traumatic events in a clinical population, 98 psychiatric prison inmates were randomly assigned to 1 of 3 conditions in which they were asked to write about their deepest thoughts and feelings surrounding upsetting experiences (trauma writing condition), write about trivial topics (trivial writing control), or go about their daily routine without writing (no-writing control). Both writing groups wrote for 20 min per day for 3 consecutive days. Participants in the trauma condition reported experiencing more physical symptoms subsequent to the intervention relative to those in the other conditions. Despite this, controlling for prewriting infirmary visits, sex offenders in the trauma writing condition decreased their postwriting infirmary visits. These results are congruent with predictions based on stigmatization and inhibition.     

Chronic job stressors and job control: Effects on event‐related coping success and well‐being

The present study investigates how chronic work characteristics relate to situational work characteristics, and their effect on outcomes such as well‐being, problem solving, and calming down. It also examines how the relationship between situational work characteristics and coping strategies affect these outcomes. Based on an event‐sampling approach, 23 employees of a counselling agency reported 120 stressful events over 7 days, yielding 92 work‐related and 28 private events. Multi‐level analyses revealed that with regard to chronic conditions, job control was positively associated with successful calming down and problem solving in stressful situations, whereas job stressors were negatively related to immediate well‐being. Chronic stressors and job control can be seen as ‘background’ variables that influence the response to stressful events. For situational factors, stressfulness was negatively associated and controllability was positively associated with immediate well‐being and problem solving. In addition, problem‐focused coping predicted positively situation‐related success in calming down and problem solving. An effect on well‐being was found when situational controllability was high, confirming the active coping rule of Perrez and Reicherts (1992) . Palliative coping was positively related to successful calming down.     

An Investigation of the Efficacy of Online Expressive Writing for Trauma-Related Psychological Distress in Hispanic Individuals

This study compared the efficacy of 2 online expressive writing protocols for a traumatic/stressful life event in a Hispanic student sample. Participants who had reported a traumatic event were randomly assigned to either the emotion-focused group or the fact-focused group. The emotion-focused group focused their written accounts on emotions and feelings as well as facts about a stressful/traumatic experience, whereas the fact-focused group focused on facts of a stressful/traumatic event. Both groups completed 3 online writing sessions scheduled for 3 consecutive days, a 1-week online follow-up assessment, and a 5-week online follow-up assessment. Both groups statistically significantly reduced trauma symptoms over time with the emotion-focused group demonstrating statistically significantly greater trauma symptom reductions than the fact-focused group at the 5-week follow-up assessment.     

A pilot study of a family‐focused intervention for children and families affected by maternal depression

A non‐experimental pilot study examined child, mother and family outcomes of a 10‐session multi‐family group intervention designed to reduce risk and promote resilience for mothers with depression and their families. Positive changes following the Keeping Families Strong intervention included mother‐reported decreases in child behaviour and emotional problems, improvements in the quality of family interactions and routines and improvements in their own well‐being and support from others. Children (9–16 years) reported decreased internalizing symptoms, improved coping, increased maternal warmth and acceptance and decreased stressful family events. Attendance and mother‐reported satisfaction were high, indicating the perceived value of the intervention.