An emotional processing writing intervention and heart rate variability: the role of emotional approach

Expressing and understanding one's own emotional responses to negative events, particularly those that challenge the attainment of important life goals, is thought to confer physiological benefit. Individual preferences and/or abilities in approaching emotions might condition the efficacy of interventions designed to encourage written emotional processing (EP). This study examines the physiological impact (as indexed by heart rate variability (HRV)) of an emotional processing writing (EPW) task as well as the moderating influence of a dispositional preference for coping through emotional approach (EP and emotional expression (EE)), in response to a laboratory stress task designed to challenge an important life goal. Participants (n?=?98) were randomly assigned to either EPW or fact control writing (FCW) following the stress task. Regression analyses revealed a significant dispositional EP by condition interaction, such that high EP participants in the EPW condition demonstrated higher HRV after writing compared to low EP participants. No significant main effects of condition or EE coping were observed. These findings suggest that EPW interventions may be best suited for those with preference or ability to process emotions related to a stressor or might require adaptation for those who less often cope through emotional approach.     

How benefits of expressive writing vary as a function of writing instructions,ethnicity and ambivalence over emotional expression

Written emotional disclosure has been reported to confer a variety of benefits on physical and psychological well-being. However, variable findings suggest that outcomes may vary systematically as a function of specific parameters of the experimental design. This study aims to investigate the unique and combined effects of disclosure instructions focusing on emotional expression and instructions facilitating cognitive reappraisal and to examine how ambivalence over emotional expression and ethnicity moderate the effects of these writing instructions. Seventy-one Asian and 59 Caucasian undergraduates (N = 130) with at least minimal physical or depressive symptoms were randomly assigned to one of the four writing conditions: emotional disclosure (ED), cognitive reappraisal (COG), the combination of ED and COG, or a control condition. Self-reported physical symptoms, positive affect (PA) and negative affect were assessed at baseline and three follow-ups spanning 4 months. Mixed linear models revealed that COG writing reduced physical symptoms, ED buffered a decrease in PA over time, and the combination of ED and COG (i.e. self-regulation; SR) was most effective. Asians and highly ambivalent participants benefited most from expressive writing. Findings contribute to the development of a SR moderator model and carry implications for designing expressive disclosure studies, particularly for ethnic minorities.     

表达性写作应用于社会灾难时期心理救援的理论探讨

疫情等社会灾难时期, 创伤经历者急剧增加, 加之交通阻断, 传统的心理救援很难及时应对大范围的灾民心理危机; 而表达性写作便于心理学工作者大规模实施, 且可通过电话、网络等远程通讯工具进行指导, 治疗PTSD等心理创伤, 改善生理、心理健康。社会灾难时期表达性写作的机制复杂, 涉及暴露脱敏、意义重建、自我抽离—自我调节、工作记忆优化和认知神经机制正常化; 其疗效受到作者特质、干预时间和写作形式等潜在因素的影响。相应地, 未来应结合本土社会文化因素, 重视在线干预研究, 探索表达性写作相关的认知神经机制, 综合不同的生理、心理健康指标评估表达性写作的疗效。     

The durability of beneficial health effects associated with expressive writing

Abstract

This study examined the durability of benefits associated with expressive writing. Sixty-eight college undergraduates completed measures of physical and psychological health at the beginning of their first year and were then randomized to either an expressive writing or a control writing condition. Changes in physical health, psychological health (i.e., depression, stress, and anxiety), and academic performance were assessed two, four, and six months later. Findings indicated that participants assigned to the expressive writing condition reported less depression symptom severity at the two-month follow-up assessment relative to participants assigned to the control condition. However, these symptom reductions were not observed at any of the subsequent follow-up assessments. No significant changes were reported for physical health complaints, stress symptoms, anxiety symptoms, or academic performance. These findings suggest that, among first-year college students, expressive writing may provide some short-term relief for certain symptoms.     

Testing the benefits of expressive writing for workplace embitterment: a randomized control trial

Clinicians working in occupational health services often recognize features of embitterment in organizations; however, research on interventions for embitterment are scarce. The present study aimed to assess the effectiveness of an expressive writing intervention on working adults who experience workplace embitterment. Employing a randomized control trial we sought to test an expressive writing intervention for its effects on reducing embitterment, work-related rumination and sleep quality and assess whether the effect of the intervention was maintained over time by following up participants after one and three months. Findings partially supported our hypothesis as results showed that participants who completed the expressive writing intervention (N = 23) did not show significantly lower levels of embitterment, affective rumination, higher levels of detachment, either improved sleep quality, compared to participants who completed the factual writing (N = 21), when baseline values were controlled for. However, when looking at the mean scores embitterment and affective rumination levels diminished, detachment levels increased and sleep quality improved throughout the course of the intervention for both groups. Given the stability of embitterment and as findings from this study indicate embitterment diminished after a writing exercise irrespective of emotional disclosure taking place or not, further research and investigation are warranted.     

Randomised trial of expressive writing for distressed metastatic breast cancer patients

Women with metastatic breast cancer and significant psychological distress (N?=?87) were assigned randomly to engage in four home-based sessions of expressive writing or neutral writing. Women in the expressive writing group wrote about their deepest thoughts and feelings regarding their cancer, whereas women in the neutral writing group wrote about their daily activities in a factual manner. No statistically significant group differences in existential and psychological well-being, fatigue and sleep quality were found at 8-weeks post-writing. However, the expressive writing group reported significantly greater use of mental health services during the study than the neutral writing group (55% vs. 26%, respectively; p?<?0.05). Findings suggest that expressive writing may improve the uptake of mental health services among distressed cancer patients, but is not broadly effective as a psychotherapeutic intervention.     

A pilot randomised controlled trial of a home-based writing intervention for individuals with seizures

Objective: We investigated the feasibility, acceptability and preliminary effectiveness of a writing intervention for individuals with epilepsy or psychogenic nonepileptic seizures.

Methods: Individuals were randomised to write about potentially ‘therapeutic’ topics (n = 43) or about their daily events (n = 25). Participants were asked to write on four separate occasions for at least 20 min. Repeated-measures analysis of variance was used to investigate change in measures of health-related quality of life (NEWQoL-6D), depression (NDDI-E), anxiety (GAD-7) and illness perception (B-IPQ) from baseline to one and three-month follow-ups. Qualitative and quantitative data taken from a Writing Task Questionnaire was analysed between the two conditions.

Results: Recruitment was acceptable with 52% of those randomised completing the full writing intervention. In both conditions, participants wrote for longer than 20 min suggesting those who completed the study engaged well with the procedure. Greater benefits were observed in the ‘therapeutic’ condition (p < 0.05), which was associated with an improvement in health-related quality of life at one-month follow-up (p = 0.02). No differences were found in the other measures.

Conclusions: A writing intervention is acceptable in this population. Self-reported benefits were modest, suggesting therapeutic writing may be more suitable as a supplement to other therapies rather than a stand-alone therapeutic intervention.     

Examining explanatory mechanisms of positive and expressive writing: Towards a resource-oriented perspective

This study tested the hypothesis that benefits of positive and expressive writing accrue when the intervention matches or activates the participant’s personal resources. Students were randomly assigned to keep a newly developed resource diary (RD, n = 114), which asked the participants to write about positive experiences and personal resources, or an expressive writing diary (ED, n = 114), which asked the participants to engage with negative emotional experiences, at home on three consecutive days per week for four weeks. Participants keeping the RD perceived significantly more social support and reported a significantly better mood at post-test than participants keeping the ED. Compared to a control group (n = 81) treatment effects of both writing interventions were higher for participants with lower pre-test values of well-being and brooding as well as for participants who wrote in an ‘atmosphere of activated resources.’ It is suggested that research should move away from testing deficit-compensating hypotheses towards a stronger resource orientation.     

A randomized controlled trial of expressive writing in breast cancer survivors with lymphedema

Objective: Breast cancer survivors who develop lymphedema report poorer quality of life (QoL) than those without lymphedema. Expressive writing is a potential intervention to address QoL.

Design: Adult women (N = 107) with breast cancer and chronic Stage II lymphedema were randomised to writing about thoughts and feelings specific to lymphedema and its treatment (intervention) or about daily activities (control) for four, 20-min sessions.

Main Outcome Measures: Outcome measures were several indicators of QoL assessed at baseline, one, three, and six months post-intervention (total scores and subscales of Upper Limb Lymphedema 27 and Functional Assessment of Cancer Therapy–Breast). Hypothesised moderators of change in QoL were dispositional optimism, avoidant behaviours, and time since lymphedema diagnosis.

Results: There was no statistically significant intent-to-treat main effects of expressive writing on QoL. Statistically significant moderating effects on change in different indicators of QoL were observed for all three moderators. Expressive writing was more effective for improving QoL in women who were higher on optimism, lower on avoidance and had less time since a lymphedema diagnosis.

Conclusion: These results provide further evidence that there are subsets of individuals for whom expressive writing is more effective. Future research may investigate targeting expressive writing based on identified moderators.     

The journey towards active self-care and empowerment: Insights from a thematic analysis of a women's therapeutic expressive writing group (UK)

There is a strong evidence base that demonstrates the beneficial impact of engaging in therapeutic writing tasks, often with reference to the successful emotional processing of traumatic life events. This paper looks to explore the experiences and impact of a community-based therapeutic expressive writing group, which embraced a direct psychoeducational model to enhance emotional well-being in a group of women. From an experiential qualitative position that embraces a “hermeneutics of empathy”, this study uses a thematic analysis (TA) methodology (informed by the work of Braun & Clarke (2013) to explore the group members' narratives obtained through semistructured interviews. The study reveals the significance of a number of key factors, including the importance of the group setting, the identification of core therapeutic writing activities, the beneficial impact of skilled and supportive therapist facilitation, and the emotional value in “letting go” of unhelpful thoughts and feelings in order to strengthen psychological well-being and resilience. The findings have important implications for service commissioning and the proactive delivery of effective time-limited, low-cost mental health interventions within primary settings across society.     

Self-esteem,body-esteem,emotional intelligence,and social anxiety in a college sample: the moderating role of weight

To examine the relationships between self-esteem, body-esteem, emotional intelligence, and social anxiety, as well as to examine the moderating role of weight between exogenous variables and social anxiety, 520 university students completed the self-report measures. Structural equation modeling revealed that individuals with low self-esteem, body-esteem, and emotional intelligence were more likely to report social anxiety. The findings indicated that obese and overweight individuals with low body-esteem, emotional intelligence, and self-esteem had higher social anxiety than others. Our results highlight the roles of body-esteem, self-esteem, and emotional intelligence as influencing factors for reducing social anxiety.     

Prospective writing: Randomized controlled trial of an intervention for facilitating growth after adversity

Little is known about how posttraumatic growth (PTG) can be fostered and controversy surrounds how it is best measured. We designed and tested an intervention, prospective writing, to facilitate PTG by encouraging people to explore new possibilities after adversity. Adults (N = 188) with recent adverse experiences were randomly assigned to do prospective writing, factual writing, or no writing weekly for one month. PTG was assessed with both retrospective and current-standing measures. Hierarchical linear modeling and response profile analysis were used to assess the intervention’s impact, and latent growth curve modeling was used to test mediation. Prospective writing participants showed the greatest gains in PTG as assessed by the current-standing measure, but did not reliably show greater retrospective PTG than controls. Although large effect sizes for the mediation paths suggested that engagement with new possibilities may be a plausible mechanism, this result fell short of statistical significance. Prospection-based interventions merit further investigation.     

The personality basis of aggression: The mediating role of anger and the moderating role of emotional intelligence

High neuroticism and low agreeableness have been found to predict higher levels of aggression through an increase of negative emotions such as anger. However, previous research has only investigated these indirect associations for physical aggression, whereas evidence for such indirect effects on other types of aggression (i.e., verbal or indirect aggression) is currently lacking. Moreover, no previous work has investigated the moderating role of Ability Emotional Intelligence (AEI), which may buffer against the effects of anger on aggression. The present study (N = 665) directly addresses these gaps in the literature. The results demonstrate that high neuroticism and low agreeableness were indirectly related to higher levels of physical, verbal, and indirect aggression via increased chronic accessibility to anger. Importantly however, the associations with physical aggression were significantly weaker for those higher (vs. lower) on AEI, confirming the buffering role of AEI. We discuss the implications of our findings for theoretical frameworks aiming to understand and reduce aggression and violent behavior.     

Computer-based written emotional disclosure: the effects of advance or real-time guidance and moderation by Big 5 personality traits

Standard written emotional disclosure (WED) about stress, which is private and unguided, yields small health benefits. The effect of providing individualized guidance to writers may enhance WED, but has not been tested. This trial of computer-based WED compared two novel therapist-guided forms of WED – advance guidance (before sessions) and real-time guidance (during sessions, through instant messaging) – to both standard WED and control writing; it also tested Big 5 personality traits as moderators of guided WED. Young adult participants (n = 163) with unresolved stressful experiences were randomized to conditions, had three, 30-min computer-based writing sessions, and were reassessed six weeks later. Contrary to hypotheses, real-time guidance WED had poorer outcomes than the other conditions on several measures, and advance guidance WED also showed some poorer outcomes. Moderator analyses revealed that participants with low baseline agreeableness, low extraversion, or high conscientiousness had relatively poor responses to guidance. We conclude that providing guidance for WED, especially in real-time, may interfere with emotional processing of unresolved stress, particularly for people whose personalities have poor fit with this interactive form of WED.     

Workplace fairness and emotional exhaustion in Nigeria police: The moderating role of gender

Abstract

This study examined the moderating role of gender in the relationship between perceived workplace fairness and reported level of emotional exhaustion among a sample of Nigeria police. A total of 214 participants took part in the cross-sectional survey. Results of the moderated hierarchical regression analysis provided support for gender as a moderating variable in the relationship between perceived workplace fairness and emotional exhaustion, such that perceived workplace fairness was a stronger predictor of emotional exhaustion among male police than for female police. The practical implications for the management of emotional exhaustion in general, and for the Nigeria police in particular, were emphasized.     

Understanding the utility of emotional approach coping: evidence from a laboratory stressor and daily life

Background: Dispositional emotional approach coping (EAC) marks an adaptive tendency to process and express emotions. EAC's association with cognitions, affect, and intra- and interindividual characteristics that may account for its utility was examined in response to an acute stressor and in daily life. Design: This study included a laboratory stress task and ecological momentary assessment. Methods: Healthy undergraduate students (n = 124; mean age: 20; women: 56%) completed a laboratory component (baseline survey, speech stress task, pre- and posttask measures) and five subsequent days of surveys via palm pilot (six surveys/day). Results: Controlling for sex, neuroticism, and social support, greater EAC was associated with more positive cognitive appraisals, personal resources, and positive affect and less-negative affect during the lab stressor, and with more perceived control and positive affect in daily life. Significant EAC × sex interactions were found for poststressor affect: men with high EAC reported more positive affect and women with high EAC reported less negative affect. Conclusions: Findings provide support that EAC's utility may be independent of intra- and interindividual characteristics, and that men and women may benefit from EAC in different ways in regards to affect. The proclivity to use EAC may come with a resiliency that protects against stress and promotes general well-being.     

Anxieties about aging and death and psychological distress: The protective role of emotional complexity

Death and aging anxieties are related to higher psychological distress, but no study has examined whether these relationships are moderated by emotional complexity, an important indicator of adaptive emotional regulation among older adults. Participants (N = 188; mean age = 57; range = 29–100) rated their death and aging anxieties, general psychological distress, and reported their emotions on a daily basis over 14 days. Results showed that emotional complexity moderated the relationship between each of the two anxieties and psychological distress (i.e., the positive relationship between the two anxieties and psychological distress existed only among subjects with low emotional complexity). The findings suggest that emotional complexity buffers against psychological distress, and can be further explored as a facilitating mechanism in protecting against the negative mental health effects of aging and death anxieties.