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.     

The hazards of writing or disclosing information in psychiatry

The health care professional must be aware of the potential hazards in writing or disclosing information about a patient or a non-patient. Two important interests are pitted against each other: dissemination of scientific information versus confidentiality. Presented is a discussion of the legal and ethical issues involved in (1) writing an article or book about a patient, (2) writing about a research subject, (3) writing about a subject of a forensic examination on behalf of the court or attorney, and (4) writing in a medical record.     

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.     

Athletes' experiences of expressive writing about sports stressors

ObjectivesThis study explored athletes' experiences of expressive writing about competitive sport stressors using standard expressive writing and reversal theory framed writing (Apter, 2001).DesignThe study employed a qualitative approach including narrative analysis of expressive writing and semi-structured interviews with athletes.MethodSixteen athletes were randomly allocated to a standard expressive writing or a reversal theory framed writing group. Both groups completed expressive writing about a stressor using standardised instructions. The reversal theory writing group were instructed on reversal theory states and imagery use to recreate them which they employed to write from different state perspectives in four subsequent sessions. Standard writing group participants completed four sessions following usual expressive writing instructions. Both groups completed a final session following these instructions and were interviewed about expressive writing and their perceptions of the stressor.ResultsKey outcomes were: re-evaluation and perspective changes, self development, stressor confrontation, problem solving, emotion management and, future uses of expressive writing.ConclusionsExpressive writing may be a technique that is useful for some athletes and recommendations for its application are made.     

AN EXPRESSIVE WRITING INTERVENTION TO COPE WITH LESBIAN-RELATED STRESS: THE MODERATING EFFECTS OF OPENNESS ABOUT SEXUAL ORIENTATION

Over the past two decades, expressive writing interventions have been used successfully to reduce distress and improve well-being for those dealing with traumatic events, stressors, and illnesses. The purpose of this study was to investigate an expressive writing intervention for lesbian-related stressors. As expected, writing about traumatic events related to sexual orientation reduced self-reported confusion and perceived stress over a 2-month period for those lesbians who were less open about their sexual orientation. Interestingly, writing about such traumatic experiences was associated with increases in confusion and perceived stress for those who were more open about their sexual orientation. Applying this paradigm to assist individuals in coping with stressors related to their sexual orientation represents an important addition to the expressive writing literature. Furthermore, it offers a promising, cost-effective method to assist closeted lesbians in coping with stressors related to their sexual orientation.     

The health benefits of writing about positive experiences: The role of broadened cognition

This study tested the potential to elicit a broadened attentional focus through writing about a positive life experience and to derive health benefits from such writing. Participants (n = 38) wrote for 20 min each day for 3 consecutive days about either a positive life experience or a control topic. Writing about positive experiences led to improved physical health (measured 4–6 weeks after writing) compared to control and higher levels of global cognitive focus after writing mediated this effect. Notably, while the positive writing condition was more broadened than control, positive affect was not responsible for this difference. Implications for disclosive writing and the broaden and build model are discussed.     

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.     

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?相似文献   

The secret life of pronouns: flexibility in writing style and physical health

Numerous disclosure studies have demonstrated that individuals randomly assigned to write about emotional topics evidence improved physical health compared with those who write about superficial topics. The writing samples from three previously published studies of 74 first-year students, 50 upper-division students, and 59 maximum-security prisoners were reanalyzed using Latent Semantic Analysis (LSA) to explore possible relationships of writing content and style to changes in frequency of physician visits following the disclosure intervention. LSA revealed that flexibility in the use of common words—particularly personal pronouns—when writing about traumatic memories was related to positive health outcomes. The findings point to the importance of the role of discussing the self and social relationships in writing and, at the same time, to the remarkable potential of techniques such as LSA.     

Benefits of expressive writing and expressive talking about life goals

This study employed a 2 (writing vs. talking) × 2 (life goals vs. daily schedule) fully crossed, factorial design to examine whether health benefits might accrue for talking and/or writing about life goals. Participants assigned the life goals topic had fewer illness-related health center visits, regardless of mode of expression, compared to participants assigned the non-emotional topic. Counter to expectation, optimism did not moderate the effect of topic on illness-related health center visits. Participants in talking groups rated post-intervention mood as less negative than those in writing groups and participants rated talking about life goals as more difficult than writing about life goals.     

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.     

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.     

How do I love thee? Let me count the words: the social effects of expressive writing

Writing about emotional experiences is associated with a host of positive outcomes. This study extended the expressive-writing paradigm to the realm of romantic relationships to examine the social effects of writing. For 3 consecutive days, one person from each of 86 dating couples either wrote about his or her deepest thoughts and feelings about the relationship or wrote about his or her daily activities. In the days before and after writing, instant messages were collected from the couples. Participants who wrote about their relationship were significantly more likely to still be dating their romantic partners 3 months later. Linguistic analyses of the instant messages revealed that participants and their partners used significantly more positive and negative emotion words in the days following the expressive-writing manipulation if the participants had written about their relationship than if they had written about their daily activities. Increases in positive emotion words partially mediated the relation between expressive writing and relationship stability.     

Writing About Clients: Developing Composite Case Material and Its Rationale

Ethical guidelines of the 4 major professional associations representing counselors and psychotherapists are reviewed. To help clarify thinking about writing up clinical cases, 3 kinds of cases are described. The author concludes that the current guidelines for clinician‐authors in writing about clients for publication or presentation are contradictory and conflicting. The use of composite clinical case material is discussed as having a number of advantages over disguise or consent when writing about clients. Presented are guidelines for developing composite clinical cases and an example of how to use them effectively.     

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.     

Is writing affected by spelling performance and beliefs about spelling?

This study examined relations between self-efficacy and outcome expectancy beliefs and spelling and writing performance. Perceptions about spelling and writing were assessed in 258 collegeage participants. Spelling performance was measured through a 50-item spelling test and writing performance by a holistically scored writing sample. The most highly correlated variables included spelling outcome expectancy and writing outcome expectancy, spelling selfefficacy and writing self-efficacy, spelling performance and spelling self-efficacy, and spelling and writing performance. A causal model relating perceptions, spelling performance, and writing performance was proposed and its appropriateness estimated. Direct effects on spelling were found for spelling self-efficacy, while spelling self-efficacy had indirect effects on writing performance and spelling had a direct effect on writing performance. The causal model was discussed in terms of changing conceptions of writing instruction and traditional views of the role of spelling as a necessary component of good writing.     

Dyslexia,authorial identity,and approaches to learning and writing: A mixed methods study

Background. Dyslexia may lead to difficulties with academic writing as well as reading. The authorial identity approach aims to help students improve their academic writing and avoid unintentional plagiarism, and could help to understand dyslexic students’ approaches to writing. Aims. (1) To compare dyslexic and non‐dyslexic students’ authorial identity and approaches to learning and writing; (2) to compare correlations between approaches to writing and approaches to learning among dyslexic and non‐dyslexic students; (3) to explore dyslexic students’ understandings of authorship and beliefs about dyslexia, writing and plagiarism. Sample. Dyslexic (n= 31) and non‐dyslexic (n= 31) university students. Method. Questionnaire measures of self‐rated confidence in writing, understanding of authorship, knowledge to avoid plagiarism, and top‐down, bottom‐up and pragmatic approaches to writing (Student Authorship Questionnaire; SAQ), and deep, surface and strategic approaches to learning (Approaches and Study Skills Inventory for Students; ASSIST), plus qualitative interviews with dyslexic students with high and low SAQ scores. Results. Dyslexic students scored lower for confidence in writing, understanding authorship, and strategic approaches to learning, and higher for surface approaches to learning. Correlations among SAQ and ASSIST scores were larger and more frequently significant among non‐dyslexic students. Self‐rated knowledge to avoid plagiarism was associated with a top‐down approach to writing among dyslexic students and with a bottom‐up approach to writing among non‐dyslexic students. All the dyslexic students interviewed described how dyslexia made writing more difficult and reduced their confidence in academic writing, but they had varying views about whether dyslexia increased the risk of plagiarism. Conclusions. Dyslexic students have less strong authorial identities, and less congruent approaches to learning and writing. Knowledge to avoid plagiarism may be more salient for dyslexic students, who may benefit from specific interventions to increase confidence in writing and understanding of authorship. Further research could investigate how dyslexic students develop approaches to academic writing, and how that could be affected by perceived knowledge to avoid plagiarism.     

书写表达及其对身心健康的作用

作为心理干预方法, 书写表达是通过书写披露和表达与个人重要经历有关的感受和想法, 由此促进身心健康。书写表达操作简便, 对身心健康均具有显著的促进作用, 但其干预效果会受干预对象的心理特征、卷入水平和书写主题等因素的影响。书写表达的作用机制主要是暴露、适应、注意转向和认知重构。     

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.