Does self-affirmation, cognitive processing, or discovery of meaning explain cancer-related health benefits of expressive writing?

Although expressive writing has positive effects on health, little is known about the underlying psychological mechanisms for these effects. The present study assessed self-affirmation, cognitive processing, and discovery of meaning as potential mediators of the effects of expressive writing on physical health in early-stage breast cancer survivors. A content analysis of the essays showed that self-affirmation writing was associated with fewer physical symptoms at a 3-month follow-up assessment, with self-affirmation writing fully mediating the effects of the emotional expression and benefit-finding writing conditions on reduced physical symptoms. Cognitive processing and discovery of meaning writing were not associated with any physical health outcomes. Consistent with evidence showing that self-affirmation plays an important role in buffering stress, the present study provides the first evidence for self-affirmation as a viable mechanism underlying the health benefits of expressive writing.     

Women's theories of menstruation and biases in recall of menstrual symptoms

Previous research is consistent with the proposition that people use implicit theories of personal stability or change in remembering the attributes they possessed in the past. However, there has been little systematic investigation of the relation between these implicit theories and memory biases. In this study, the relation between women's theories of menstrual distress and their recollections of physical and affective symptoms was examined. Ss completed daily questionnaires in which they evaluated themselves on several physical and affective symptoms. Later, some Ss were asked to recall the ratings they had made on a day when they were menstruating; others recalled a day when they were not menstruating. At the time of recall, all Ss were in the intermenstrual phase. Finally, Ss completed a measure designed to assess their theories of how they are typically affected by menstruation. The recollections of Ss who recalled the menstrual state were biased so as to be consistent with their theories of menstrual distress: The more a woman believed in the phenomenon of menstrual distress, the more she exaggerated, in recall, the negativity of her symptoms during her last period. The recollections of women asked to recall the intermenstrual state were unrelated to their theories of menstruation. Furthermore, consistent with previous research, the daily questionnaire ratings revealed that physical symptoms varied with menstrual cycle phase, whereas affective symptoms did not. Finally, comparisons between subjects' theories and daily ratings revealed that, on average, women exaggerate the degree to which they experience changes during menstruation.     

Childhood trauma and parental bonding among Japanese female patients with borderline personality disorder

The present study explored the relationship between borderline personality disorder (BPD) and childhood trauma and perceived parental behaviours among a sample of Japanese female outpatients. Participants were 45 female patients who were diagnosed with BPD and 45 female patients with a diagnosis of other nonorganic psychological disorders (aged 19 to 53). The participants completed surveys that assessed recollection of childhood abuse and neglect, perceived parental-rearing behaviours, and symptoms of BPD. MANOVAs and logistic regression analyses were conducted in order to analyse the data. The results showed that the patients with BPD reported more severe forms of childhood traumas, including emotional, physical, and sexual abuse and emotional and physical neglect, than did the non-BPD patients. This is consistent with previous findings in North America that have reported higher prevalence and greater severity of various childhood traumas in individuals with BPD compared with those with non-BPD disorders or nonclinical samples. This study also found that the patients with BPD recalled both of their parents as more overprotective/controlling and less caring than did the non-BPD patients. Last, logistic regression analyses found significant predictors of BPD diagnosis were reported emotional abuse and neglect as well as perceived paternal overprotection. Overall, these results indicate that whereas psychological risk factors in Japan are similar to those reported elsewhere, the same pathology can emerge from somewhat different causal pathways.     

Girls�� and Boys�� Disclosure about Problems as a Predictor of Changes in Depressive Symptoms Over Time

Gender differences consistently emerge in adolescents?? friendships, with girls disclosing to friends about troubles and concerns more than boys. Although theories regarding possible emotional benefits of catharsis, as well as everyday assumptions, suggest that talking about problems makes people feel better, research regarding the impact of disclosure about problems on depressive symptoms has not been conclusive. In the current study, 79 early adolescent high school students residing in the Southeastern United States (73% European American) were observed talking about problems with a friend. Of primary interest was whether disclosure to friends predicted changes in self-reported depression over 6 months for girls and boys. Although girls disclosed to friends about problems (especially interpersonal problems) more than did boys, disclosure did not buffer girls from the development of depressive symptoms over time. In contrast, boys?? disclosure predicted their experiencing fewer depressive symptoms 6 months later. Results suggest that talking to friends may not be an especially effective method of coping with problems for girls.     

Effects of writing about emotions versus goals on psychological and physical health among third-year medical students

A randomized, controlled trial compared writing about emotional topics (EMO) to writing about goals as the "best possible self" (BPS; after King, 2001) and evaluated emotional approach coping, i.e., efforts to cope through processing and expressing emotion, as a moderator of writing effects on psychological and physical health in 64 third-year medical students. In participants with higher baseline hostility, the EMO condition was associated with less hostility at 3 months compared to the BPS and control conditions. Emotional processing (EP) and emotional expression (EE) moderated the effect of experimental condition on depressive symptoms at 3 months; high EP/EE participants reported fewer depressive symptoms in the EMO condition, whereas low EP/EE individuals reported fewer depressive symptoms in the BPS condition compared to the EMO and control conditions. A moderating effect of EP on physical health was also identified, such that low EP individuals who wrote about goals (BPS) had fewer health care visits at 3 months compared to low EP participants in the EMO and control conditions.     

Telling and the remembered self: linguistic differences in memories for previously disclosed and previously undisclosed events

Prior work suggests that disclosing experiences may provide people with more distance, more positive emotion, greater cognitive elaboration, and greater certainty regarding those experiences. Two studies (n=58 undergraduates and n=123 community-living adults) examined linguistic indicators of such differences between previously disclosed and previously undisclosed memories elicited on subsequent, solitary occasions using the LIWC text analysis program (Pennebaker & Francis, 1999). Disclosure was associated with differences in the linguistic features of subsequent memories. Potential mechanisms and implications of those differences are discussed.     

Motivation-focused thinking: Buffering against stress-related physical symptoms and depressive symptomology

Developmental transitions are experienced throughout the life course and necessitate adapting to consequential and unpredictable changes that can undermine health. Our six-month study (n = 239) explored whether selective secondary control striving (motivation-focused thinking) protects against the elevated levels of stress and depressive symptoms increasingly common to young adults navigating the challenging school-to-university transition. Path analyses supplemented with tests of moderated mediation revealed that, for young adults who face challenging obstacles to goal attainment, selective secondary control indirectly reduced long-term stress-related physical and depressive symptoms through selective primary control and previously unexamined measures of discrete emotions. Results advance the existing literature by demonstrating that (a) selective secondary control has health benefits for vulnerable young adults and (b) these benefits are largely a consequence of the process variables proposed in Heckhausen et al.’s (2010) theory.     

Financial strain,social capital,and perceived health during economic recession: a longitudinal survey in rural Canada

Although the health consequences of financial strain are well documented, less is understood about the health-protective role of social capital. Social capital refers to a sense of community embeddedness, which is in part reflected by group membership, civic participation, and perceptions of trust, cohesion, and engagement. We investigated whether perceptions of social capital moderate the relation between financial strain and health, both mental and physical. This longitudinal study surveyed adults in two communities in rural Ontario where significant job losses recently occurred. Data were collected on financial strain, social capital, perceived stress, symptoms of anxiety and depression, and physical health on three occasions over 18 months (N's = 355, 317, and 300). As expected, financial strain positively related to perceived stress, poor physical health and symptoms of anxiety and depression, whereas social capital related to less stress, better physical health, and fewer symptoms of anxiety and depression. Effects of financial strain on perceived stress and depressive symptoms were moderated by social capital such that financial strain related more closely to perceived stress and depressive symptoms when social capital was lower. The findings underscore the health-protective role of community associations among adults during difficult economic times.     

Writing content predicts benefit from written expressive disclosure: Evidence for repeated exposure and self-affirmation

Expressive disclosure regarding a stressful event improves psychological and physical health, yet predictors of these effects are not well established. The current study assessed exposure, narrative structure, affect word use, self-affirmation and discovery of meaning as predictors of anxiety, depressive and physical symptoms following expressive writing. Participants (N = 50) wrote on four occasions about a stressful event and completed self-report measures before writing and three months later. Essays were coded for stressor exposure (level of detail and whether participants remained on topic), narrative structure, self-affirmation and discovery of meaning. Linguistic Inquiry and Word Count software was used to quantify positive and negative affect word use. Controlling for baseline anxiety, more self-affirmation and detail about the event predicted lower anxiety symptoms, and more negative affect words (very high use) and more discovery of meaning predicted higher anxiety symptoms three months after writing. Findings highlight the importance of self-affirmation and exposure as predictors of benefit from expressive writing.     

Responses to the September 11, 2001, Terrorist Attacks: Experience of an Indirect Traumatic Event and Its Relationship With Perceived Benefits

Little is known about how people might benefit from an indirectly experienced traumatic event. The authors examined the relationship between perception of benefit and trauma symptoms in response to a relatively severe, but indirectly experienced, traumatic event. The authors sampled from 2 colleges located in the southeastern United States (N = 136). Individuals responded to questionnaires that assessed perceived benefits and trauma symptoms 1-2 weeks after the terrorist attacks of September 11, 2001, and again approximately 10 weeks later. Participants did perceive benefits from witnessing this event, although their perception of benefit declined over time. Level of trauma symptoms correlated positively with perception of benefit, and experiencing a previous trauma also correlated positively with perceived benefits. Additional analysis indicated that level of trauma symptoms mediated the relationship between previous trauma and perception of benefit. These findings help to elucidate understanding of the development of perceived benefits in response to indirectly experienced events.     

Responses to the September 11, 2001, terrorist attacks: experience of an indirect traumatic event and its relationship with perceived benefits

Little is known about how people might benefit from an indirectly experienced traumatic event. The authors examined the relationship between perception of benefit and trauma symptoms in response to a relatively severe, but indirectly experienced, traumatic event. The authors sampled from 2 colleges located in the southeastern United States (N = 136). Individuals responded to questionnaires that assessed perceived benefits and trauma symptoms 1-2 weeks after the terrorist attacks of September 11, 2001, and again approximately 10 weeks later. Participants did perceive benefits from witnessing this event, although their perception of benefit declined over time. Level of trauma symptoms correlated positively with perception of benefit, and experiencing a previous trauma also correlated positively with perceived benefits. Additional analysis indicated that level of trauma symptoms mediated the relationship between previous trauma and perception of benefit. These findings help to elucidate understanding of the development of perceived benefits in response to indirectly experienced events.     

Emotional expression in cyberspace: searching for moderators of the Pennebaker disclosure effect via e-mail.

Research has shown that writing about emotional topics can positively influence physical and mental health. The current study tested the efficacy of an e-mail-based writing treatment and shows how such an implementation can aid in the search for moderators. Participants (N = 546) were randomly assigned to either a long- or short-interval traumatic writing condition or to a nonemotional writing control condition. In contrast to previous disclosure research, participants received and submitted their writing responses via e-mail. Health outcomes were assessed weekly for 5 weeks after treatment and were reported at the conclusion of the study. Results supported the effectiveness of an e-mail-based writing treatment in producing positive health outcomes and successfully identified several moderators of the writing treatment effect. The moderators implicated varied depending on the nature of the health outcome assessment.     

The relationship between self-control and health: The mediating effect of avoidant coping

Trait self-control is related to a number of positive outcomes, including mental health, interpersonal success, academic success and health-related behaviours. This study sought to explore the relationships between self-control, reports of mental and physical health symptoms and coping styles. The results revealed that higher self-control was related to fewer mental and physical health symptoms and less avoidance coping. There was not a significant relationship between self-control and problem-focused or emotion-focused coping styles. Further, the relationships between self-control and mental and physical health outcomes were partially mediated by avoidance coping style. Specifically, the data suggest lower self-control is associated with unhealthy coping strategies (avoidance coping), which in turn are associated with worse mental health outcomes and greater reports of physical health symptoms. Thus lower trait self-control can serve as an indicator, suggesting circumstances in which individuals' tendencies to engage in unhealthy coping strategies are increased. These findings add to a growing body of literature underscoring the importance of trait self-control.     

The relationship between self-control and health: The mediating effect of avoidant coping

Trait self-control is related to a number of positive outcomes, including mental health, interpersonal success, academic success and health-related behaviours. This study sought to explore the relationships between self-control, reports of mental and physical health symptoms and coping styles. The results revealed that higher self-control was related to fewer mental and physical health symptoms and less avoidance coping. There was not a significant relationship between self-control and problem-focused or emotion-focused coping styles. Further, the relationships between self-control and mental and physical health outcomes were partially mediated by avoidance coping style. Specifically, the data suggest lower self-control is associated with unhealthy coping strategies (avoidance coping), which in turn are associated with worse mental health outcomes and greater reports of physical health symptoms. Thus lower trait self-control can serve as an indicator, suggesting circumstances in which individuals’ tendencies to engage in unhealthy coping strategies are increased. These findings add to a growing body of literature underscoring the importance of trait self-control.     

A healthy dose of trust: The relationship between interpersonal trust and health

The positive effects of trust are manifold. Recent research has shown that trust levels may even influence physical health. The current work explores this issue and aims to shed light on the mechanisms underlying the relationship between trust and health in a 5‐wave longitudinal data set. Results showed that trust was positively related to physical health: Participants report fewer health problems when they trust their partner more, replicating earlier findings. More importantly, symptoms of anxiety and depression mediate the effect of trust on self‐reported health. Finally, results of residual lagged analyses show that earlier levels of trust predict later symptoms of anxiety and depression symptoms, in turn predicting changes in physical health symptoms over time.     

Illness disclosure and mental health among women with HIV/AIDS

The current study examines two contrasting models of the relationship between illness disclosure and mental health among an ethnically‐diverse group of women with HIV/AIDS. In the first, and commonly accepted model, illness disclosure predicts enhanced mental health status. In the second or alternate model, based on the stigmatization that accompanies HIV/AIDS infection, illness disclosure predicts poorer mental health. We also explore an alternate interpretation for this second model, namely that the mental health status of participants is predictive of their levels of disclosure. A total of 176 women from three major ethnic groups were interviewed and assessed during the baseline visit for a comprehensive longitudinal study. Results showed that these women constituted a highly‐disclosed population; over one‐third of them had disclosed their HIV status to their entire social networks. Contrary to expectation, disclosure was unrelated to mental health among the African‐American (n = 72) and European‐American (n = 47) women. Among the Latina women (n = 57), however, greater disclosure was related to higher levels of depression, psychological distress, and reported pain. Regression analyses controlling for age, education, and illness severity showed that disclosure makes a small but independent contribution to the prediction of mental health status. Thus, among the Latinas, the data were consistent with both the stigma model and the hypothesis that greater distress predicts wider disclosure. General patterns of disclosure are described and possible explanations for the inconsistent relationships found between disclosure and mental health among the three ethnic groups are considered. Copyright © 2000 John Wiley & Sons, Ltd.     

Intimate Partner Violence, Welfare Receipt, and Health Status of Low-Income African American Women: A Lifecourse Analysis

Although the association among intimate partner violence (IPV), welfare receipt, and health status has been well-established, little is known about the temporal sequencing of these events. In a random sample of low-income African American women in an urban Midwestern county, lifecourse data about IPV and welfare receipt were obtained using the Life History Calendar method (D. Freedman, A. Thornton, D. Camburn, D. Alwin, & L. Young-DeMarco, 1988), along with data about mental and physical health status. Controlling for relevant factors, longitudinal analyses found that previous experience of IPV increased women's odds of receiving welfare benefits in a given year, but previous welfare receipt did not. Cumulative IPV, but not cumulative welfare receipt, was associated with current and past-year health problems. These findings are consistent with the hypothesis that IPV leads women to turn to welfare assistance, and that compromised physical and mental health due to past cumulative IPV interferes with women's gainful employment.     

The good, the bad, and the healthy: impacts of emotional disclosure of trauma on resilient self-concept and psychological distress

This study examined the impact of disclosing traumas on resilient self-perceptions and psychological distress. Participants (N = 50) wrote about a traumatic life event or their plans for the next day and completed measures of resilience and distress before disclosing (pretest) and 3 months later (posttest). Results revealed that trauma participants increased in positive self-perceptions (mastery, personal growth, self-acceptance) and decreased in distress (depression, interpersonal sensitivity, anxiety, somatization) from pretest to posttest. Control participants showed no changes except for autonomy, on which they decreased. Results suggest that in addition to reducing psychological distress, disclosing traumas change self-perception, resulting in a more resilient self-concept.     

Pre-existing Perceptions of ADHD Predict Children’s Sociometrics Given to Classmates with ADHD

Considerable research documents that even young children possess stigma about mental illness, which may affect how they evaluate peers with mental health conditions. This study examined children’s pre-existing perceptions of Attention Deficit/Hyperactivity Disorder (ADHD) behaviors as predictors of their subsequent sociometric judgments of classmates with ADHD in a 2-week summer day camp. Participants were previously unacquainted children ages 6.8–9.8 years (113 typically-developing and 24 with ADHD; 48.2% boys; 81% White). Children initially more inclined to interact with a hypothetical classmate with ADHD gave fewer “dislike” nominations to real-life classmates with ADHD at camp. Children who initially believed that ADHD symptoms were uncontrollable gave more “dislike” nominations and lower liking ratings to classmates with ADHD when those classmates displayed severe ADHD symptoms. For children who had ADHD, their attribution of uncontrollability for ADHD symptoms predicted fewer “like” nominations and more “dislike” nominations given to classmates with ADHD. Lastly, children who initially reported they would help a hypothetical classmate with ADHD gave higher liking ratings to classmates with ADHD. These results were found after statistical control of the actual level of ADHD behaviors displayed by the classmates with ADHD. In summary, other children’s pre-existing or stigmatizing perceptions of ADHD behaviors may contribute, in part, to the substantial peer rejection typically experienced by ADHD populations. Findings have implications for understanding peer problems in children with this common mental health condition.