Disclosure of traumas and immune function: Health implications for psychotherapy.

Can psychotherapy reduce the incidence of health problems? A general model of psychosomatics assumes that inhibiting or holding back one's thoughts, feelings, and behaviors is associated with long-term stress and disease. Actively confronting upsetting experiences—through writing or talking—is hypothesized to reduce the negative effects of inhibition. Fifty healthy undergraduates were assigned to write about either traumatic experiences or superficial topics for 4 consecutive days. Two measures of cellular immune-system function and health center visits suggested that confronting traumatic experiences was physically beneficial. The implications for psychotherapy as a preventive treatment for health problems are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Expressive writing for gay-related stress: Psychosocial benefits and mechanisms underlying improvement.

Objective: This study tested the effectiveness of an expressive writing intervention for gay men on outcomes related to psychosocial functioning. Method: Seventy-seven gay male college students (mean age = 20.19 years, SD = 1.99) were randomly assigned to write for 20 min a day for 3 consecutive days about either (a) the most stressful or traumatic gay-related event in their lives or (b) a neutral topic. We tested an exposure-based hypothesis of written emotional expression by asking half of the participants who were assigned to write about gay-related stress to read their previous day’s narrative before writing, whereas the other half did not. Posttest and 3-month follow-up outcomes were assessed with common measures of overall psychological distress, depression, physical health symptoms, and positive and negative affect. Gay-specific social functioning was assessed with measures of gay-related rejection sensitivity, gay-specific self-esteem, and items regarding openness and comfort with one’s sexual orientation. Results: Participants who wrote about gay-related stress, regardless of whether they read their previous day’s writing, reported significantly greater openness with their sexual orientation 3 months following writing than participants who wrote about a neutral topic, F(1, 74) = 6.66, p     

Negative affective consequences of thinking about disease detection behaviors.

It was proposed that thinking about disease-detection behavior would lead to more negative moods than thinking about health-promotion behavior. Detection behaviors produce more negative moods because they can threaten perceptions of good health. In a laboratory study, the initial mood states of 121 participants recruited from undergraduates and the general community were measured using a neutral-words rating procedure. Then participants were randomly assigned to think about performing a disease-detection behavior or a health-promotion behavior. Subsequently, they wrote down their responses to the behavior and evaluated these 35 either positive, negative, or neutral. Finally, the participant's mood was remeasured using both a neutral words-rating procedure and a more traditional bipolar rating measure. Results indicated that thought about disease-detection behavior produced more negative affective responses and more negative mood change than did thought about health-promotion behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Disclosure of trauma and immune response to a hepatitis B vaccination program.

This study investigated whether emotional expression of traumatic experiences influenced the immune response to a hepatitis B vaccination program. Forty medical students who tested negative for hepatitis B antibodies were randomly assigned to write about personal traumatic events or control topics during 4 consecutive daily sessions. The day after completion of the writing, participants were given their first hepatitis B vaccination, with booster injections at 1 and 4 months after the writing. Blood was collected before each vaccination and at a 6-month follow-up. Compared with the control group, participants in the emotional expression group showed significantly higher antibody levels against hepatitis B at the 4 and 6-month follow-up periods. Other immune changes evident immediately after writing were significantly lower numbers of circulating T helper lymphocytes and basophils in the treatment group. The finding that a writing intervention influences immune response provides further support for a link between emotional disclosure and health. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Confronting traumatic experience and immunocompetence: A reply to Neale, Cox, Valdimarsdottir, and Stone.

In their comment, Neale, Cox, Valdimarsdottir, and Stone (1988) argued that one should not conclude, based on our findings, that there is any positive effect of a brief psychotherapeutic writing treatment on immunocompetence. We disagree. Our experimental technique of having subjects write about the most traumatic experiences of their lives has now been shown to reduce health center visits for illness in three studies in two laboratories. In the Pennebaker, Kiecolt-Glaser, and Glaser (1988) study, we found that those subjects who wrote about traumatic experiences showed an improvement in one immunological assay (blastogenesis with the mitogen phytohemagglutinin) relative to control subjects who wrote about trivial topics. Furthermore, theoretically meaningful internal analyses demonstrated similar effects with another mitogen, concanavalin A. Although it is not possible to pinpoint the exact physiological links, consideration of all of the data indicate that confronting traumatic experience is, in all probability, physically beneficial. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Influence of mood on health-relevant cognitions.

Three experiments assessed the effects of mood on symptom appraisal, health behavior self-efficacy, outcome expectations, and perceptions of vulnerability. Ss in Experiments 1 and 2 were acutely ill, whereas Ss in Experiment 3 were healthy. In each experiment, happy, sad, and neutral moods were induced. In Experiment 1, Ss who experienced sadness reported more aches and pains and greater discomfort than happy Ss. Sad Ss were less confident that they could carry out illness-alleviating behaviors. Experiments 2 and 3 demonstrated that mood's influence of vulnerability perceptions is moderated by health status. Although mood had little impact on perceptions of vulnerability among ill Ss, probability estimates of future negative health-relevant events among healthy Ss were mood sensitive. Seeing oneself as invulnerable to future negative events was accentuated among happy Ss and attenuated among sad Ss. Mood may be an important determinant of care seeking, adherence, and recovery from illness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The psychophysiology of confession: Linking inhibitory and psychosomatic processes.

We investigated the short-term autonomic correlates of disclosing personal and traumatic experiences among two samples of healthy undergraduates. In Experiment 1, subjects talked into a tape recorder about extremely stressful events that had occurred in their lives, as well as what they planned to do following the experiment. Skin conductance, blood pressure, and heart rate were continuously measured. Based on judges' ratings of subjects' depth of disclosure, subjects were classified as high or low disclosers. Talking about traumatic events was associated with decreased behavioral inhibition, as measured by lower skin conductance levels among high disclosers. Disclosing traumatic material was also associated with increased cardiovascular activity. In Experiment 2, subjects both talked aloud and thought about a traumatic event and about plans for the day. Half of the subjects were alone in an experimental cubicle and talked into a tape recorder; the remaining subjects talked to a silent "confessor" who sat behind a curtain. Among high disclosers, both talking and thinking about traumatic events produced lower skin conductance levels than did thinking or talking about plans for the day. The presence of a confessor inhibited subjects' talking. Implications for understanding the nature of confession and the development of an inhibitory model for psychosomatic processes are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Short-term effects of occupational stressors on daily mood and health complaints.

Related daily changes in 2 job conditions, workload and social interaction with co-workers and supervisors, to daily mood and health complaints. 52 air-traffic controllers (ATCs) completed measures of subjective well-being and perceived job conditions on 3 consecutive days; objective indicators of daily workload (air traffic volume and visibility at the airport) were also obtained. The results indicate that increases in job stressors are associated with a same-day deterioration in physical and psychological well-being. On days in which workload was perceived to be high, ATCs reported more health complaints and moods that were more negative and less positive. On days in which there was greater air traffic volume (objectively measured), ATCs reported moods that were more negative. On days in which interactions with co-workers and supervisors were described as more distressing, ATCs reported moods that were more negative and less positive. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The costs and benefits of writing, talking, and thinking about life's triumphs and defeats.

Three studies considered the consequences of writing, talking, and thinking about significant events. In Studies 1 and 2, students wrote, talked into a tape recorder, or thought privately about their worst (N = 96) or happiest experience (N = 111) for 15 min each during 3 consecutive days. In Study 3 (N = 112), students wrote or thought about their happiest day; half systematically analyzed, and half repetitively replayed this day. Well-being and health measures were administered before each study's manipulation and 4 weeks after. As predicted, in Study 1, participants who processed a negative experience through writing or talking reported improved life satisfaction and enhanced mental and physical health relative to those who thought about it. The reverse effect for life satisfaction was observed in Study 2, which focused on positive experiences. Study 3 examined possible mechanisms underlying these effects. Students who wrote about their happiest moments--especially when analyzing them--experienced reduced well-being and physical health relative to those who replayed these moments. Results are discussed in light of current understanding of the effects of processing life events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Further Examination of the Exposure Model Underlying the Efficacy of Written Emotional Disclosure.

In the current study, the authors examined the effects of systematically varying the writing instructions for the written emotional disclosure procedure. College undergraduates with a trauma history and at least moderate posttraumatic stress symptoms were asked to write about (a) the same traumatic experience, (b) different traumatic experiences, or (c) nontraumatic everyday events across 3 written disclosure sessions. Results show that participants who wrote about the same traumatic experience reported significant reductions in psychological and physical symptoms at follow-up assessments compared with other participants. These findings suggest that written emotional disclosure may be most effective when individuals are instructed to write about the same traumatic or stressful event at each writing session, a finding consistent with exposure-based treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correction to Sheese et al. (2004).

Reports an error in the original article by B. Sheese et al (Health Psychology, 2004[Sep], Vol 23 [5], 457-464). On page 459, Table 1 contained errors in the reported values. The corrected table is provided. (The following abstract of this article originally appeared in record 2004-18051-003.) 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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mood influences on helping: Direct effects or side effects?

A review of the literature concerning the promotive influence of experimentally generated happiness and sadness on helping suggests that (a) increased helping among saddened Ss is an instrumental response designed to dispel the helper's negative mood state, and (b) increased helping among elated Ss is not an instrumental response to (maintain) the heightened effect but is a concomitant of elevated mood. A derivation from this hypothesis—that enhanced helping is a direct effect of induced sadness but a side effect of induced happiness—was tested in an experiment that placed 86 undergraduates in a happy, neutral, or sad mood. Through a placebo drug manipulation, half of the Ss in each group were led to believe that their induced moods were temporarily fixed, that is, temporarily resistant to change from normal events. The other Ss believed that their moods were labile and, therefore, manageable. As expected, saddened Ss showed enhanced helping only when they believed their moods to be changeable, whereas elated Ss showed comparable increases in helping whether they believed their moods to be labile or fixed. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Does repressive coping promote resilience? Affective-autonomic response discrepancy during bereavement.

Traditional theories of coping emphasize the value of attending to and expressing negative emotion while recovering from traumatic life events. However, recent evidence suggests that the tendency to direct attention away from negative affective experience (i.e., repressive coping) may promote resilience following extremely aversive events (e.g., the death of a spouse). The current study extends this line of investigation by showing that both bereaved and nonbereaved individuals who exhibited repressive coping behavior--as measured by the discrepancy between affective experience and sympathetic nervous system response--had fewer symptoms of psychopathology, experienced fewer health problems and somatic complaints, and were rated as better adjusted by close friends than those who did not exhibit repressive coping. Results are discussed in terms of recent developments in cognitive and neuroimaging research suggesting that repressive coping may serve a protective function. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Response biases and the relation between negative life events and psychological symptoms.

Investigated whether reporting biases can account for the correlation between negative life events and subclinical psychological symptoms. 73 undergraduates each brought a close friend to the experiment. Ss completed the Beck Depression Inventory, the Brief Symptom Inventory, the Marlowe-Crowne Social Desirability Scale, and a college student life events schedule. Friends were asked to report about life events experienced by the Ss. Findings did not support an S reporting bias associated with social desirability, depression, or symptoms. For one of the life events scales, depression was significantly associated with a higher rate of agreement between Ss and friends as to which negative events occurred to Ss. There were significant correlations between symptom and depression measures and life events measures that were free of S-reporting biases (Ss' negative life events reported by both Ss and their significant others, as well as Ss' negative life events as reported by significant others alone). Data suggest that response biases may not be able to account for the relation between negative events and psychological symptoms. It is contended, however, that the hypothesis that negative life events play a significant role in symptom development remains plausible. (18 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Accelerating the coping process.

On the basis of previous work, freshmen should evidence improved health after writing about their thoughts and feelings associated with entering college. One hundred thirty subjects were assigned to write either about coming to college or about superficial topics for 20 min on 3 days. One fourth of the subjects in each group wrote during the 1st, 5th, 9th, or 14th week of classes. Physician visits for illness in the months after writing were lower for the experimental than for the control subjects. Self-reports of homesickness and anxiety were higher in the experimental group 2–3 months after writing. By year's end, experimental subjects were either superior or similar to control subjects in grade average and in positive moods. No effects emerged as a function of when people wrote, suggesting that the coping process can be accelerated. Implications for comparing insight treatments with catharsis and for distinguishing between objective and self-report indicators of distress are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Mood and memory under natural conditions: Evidence for mood incongruent recall.

The effect of mood on memory was studied under natural conditions in 2 field quasi-experiments. In both, Ss in happy moods recalled autobiographical memories that were more negative than were memories recalled by subjects in bad moods, a phenomenon termed mood incongruent recall. Three subsequent laboratory experiments are reported that suggest that mood incongruent recall is a reliable phenomenon, occurring when subjects are unaware that their moods are relevant to the experiment. Mood incongruent recall is hypothesized to be related to mood regulation. The implications of these findings for the relation between mood and memory, for mood congruent recall, for laboratory mood inductions, and for self-regulation of mood and depression are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)