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Writing About Emotional Experiences as a Therapeutic Process
Abstract
For the past decade, an increasing number of studies have demonstrated that when individuals write about emotional experiences, significant physical and mental health improvements follow. The basic paradigm and findings are summarized along with some boundary conditions. Although a reduction in inhibition may contribute to the disclosure phenomenon, changes in basic cognitive and linguistic processes during writing predict better health. Implications for theory and treatment are discussed.
... In recent years, we have become concerned with developing efficient ways to examine a large number of text files of distressed individuals to learn whether the words people use to express themselves can predict long-term psychological and physical health (e.g., Pennebaker, 1997). As suggested by our literature search, most available text analysis programs adopted theoretical stances that were either outmoded or simply inconsistent with our own. ...
... For example, within the emotion category, specific dictionaries for overall negative emotion word use, anger words, positive emotions, and so forth were computed. The selection of words for each category was based on independent ratings by expert judges (see Pennebaker &Francis, 1996, andPennebaker, Mayne, &Francis, 1997, for psychometric information). ...
... That is, the more that people made distinctions in their writing, the better their health or health-related behaviors (less alcohol, fewer cigarettes, and fewer doctor visits). It should be noted that this pattern is consistent with recent reanalyses of our disclosure research, which also indicates that the more people make distinctions over the course of writing, the better their subsequent physical health (Pennebaker, 1997). ...
Can language use reflect personality style? Studies examined the reliability, factor structure, and validity of written language using a word-based, computerized text analysis program. Daily diaries from 15 substance abuse inpatients, daily writing assignments from 35 students, and journal abstracts from 40 social psychologists demonstrated good internal consistency for over 36 language dimensions. Analyses of the best 15 language dimensions from essays by 838 students yielded 4 factors that replicated across written samples from another 381 students. Finally, linguistic profiles from writing samples were compared with Thematic Apperception Test coding, self-reports, and behavioral measures from 79 students and with self-reports of a 5-factor measure and health markers from more than 1,200 students. Despite modest effect sizes, the data suggest that linguistic style is an independent and meaningful way of exploring personality.
... Language provides a window into our inner experiences (Pennebaker et al., 2003) and is an important medium to share emotions with others (Rimé, 2009). Emotion word use can be defined as the negative (e.g., angry, frustrated) and positive (e.g., happy, glad) emotion words individuals use and has attracted considerable interest in affective, clinical, and relationship science (e.g., Karan et al., 2017;Pennebaker, 1997;Torre & Lieberman, 2018;Vine et al., 2020). A potential correlate of emotion word use with particular relevance is cardiovascular reactivity, which is commonly indexed by differences in heart rate or blood pressure between rest and trial periods (Centers for Disease Control and Prevention, 2020). ...
... One prominent view, also commonly shared by laypeople, is that verbally expressing emotions-positive as well as negative-is broadly beneficial and soothing (Greenberg, 2019;Pennebaker, 1997;Torre & Lieberman, 2018). Verbalizing emotions when stressed is thought to help individuals downregulate physiological arousal (Torre & Lieberman, 2018) and emotion word use has consequently been seen as an implicit form of emotion regulation (e.g., Torre & Lieberman, 2018). ...
... In a related vein, expressive writing studies (e.g., Pennebaker, 1997) have shown that putting thoughts and feelings surrounding traumatic events into words goes along with decreases in physiological arousal (e.g., blood pressure; McGuire et al., 2005;Petrie et al., 1995) and improvements in physical health (Pennebaker, 1997) from the first to the last day of writing. Individuals who used a lot of positive emotion words in their writings showed the biggest improvements (e.g., Pennebaker, 1997). ...
Putting feelings into words is often thought to be beneficial. Few studies, however, have examined associations between natural emotion word use and cardiovascular reactivity. This laboratory-based study examined emotion word use (i.e., from computerized text analysis) and cardiovascular reactivity (i.e., interbeat interval changes from baseline) across two interaction contexts (i.e., conflict and positive conversations) in 49 mixed-sex married couples (age: M = 43.11, SD = 9.20) from diverse socioeconomic backgrounds. We focused on both frequency (i.e., relative proportion of emotion words) and diversity (i.e., relative proportion of unique emotion words) of emotion words. Data were collected between 2015 and 2017 and analyzed treating both partners and conversations as repeated measures, resulting in 196 observations overall (four per dyad). Findings showed that (1) when spouses used more negative emotion words (especially anger), they showed higher cardiovascular reactivity. This finding was robust when controlling for covariates; generalized across gender, interaction contexts, and socioeconomic status. Moreover, (2) when spouses used a more diverse negative emotion vocabulary, they showed higher cardiovascular reactivity, but this was not robust when controlling for negative emotion word frequency. Associations between (3) positive emotion word use and cardiovascular reactivity were not statistically significant. Verbalizing negative emotions thus seems to go along with higher cardiovascular reactivity, at least in the short term. Replication is needed across other relationship types, genders, and sexual orientations. These findings highlight emotion word use as an indicator of cardiovascular reactivity, which has implications for the identification of potential health risks that emerge during marital interactions.
... Language provides a window into our inner experiences (Pennebaker et al., 2003) and is an important medium to share emotions with others (Rimé, 2009). Emotion word use can be defined as the negative (e.g., angry, frustrated) and positive (e.g., happy, glad) emotion words individuals use and has attracted considerable interest in affective, clinical, and relationship science (e.g., Karan et al., 2017;Pennebaker, 1997;Torre & Lieberman, 2018;Vine et al., 2020). ...
... One prominent view, also commonly shared by laypeople, is that verbally expressing emotionspositive as well as negativeis broadly beneficial and soothing (Greenberg, 2019;Pennebaker, 1997;Torre & Lieberman, 2018). Verbalizing emotions when stressed is thought to help individuals down-regulate physiological arousal (Torre & Lieberman, 2018) and emotion word use has consequently been seen as an implicit form of emotion regulation (e.g., Torre & Lieberman, 2018). ...
... In a related vein, expressive writing studies (e.g., Pennebaker, 1997) have shown that putting thoughts and feelings surrounding traumatic events into words goes along with decreases in physiological arousal (e.g., blood pressure; McGuire et al., 2005;Petrie et al., 1995) and improvements in physical health (Pennebaker, 1997) from the first to the last day of writing. ...
... Extensive research in psychology has shown that word use and linguistic features can reflect individuals' thoughts, emotions, and experiences and thus can be used to identify their social and psychological states [12,13]. For example, numerous studies have shown that expressive writing (EW) and interviews are effective ways to listen to the patients' voice [10,14]. ...
... Pennebaker's EW mode [13] was adopted to obtain the written text corpus of patients with BC in 3 different stages: newly diagnosed, postoperative, and undergoing chemotherapy. Consistent with the requirement to include maximal variation during purposive sampling for qualitative text analysis, we recruited 50 EW participants undergoing each of the aforementioned 3 phases [66,67]. ...
... The research was conducted in accordance with the Declaration of Helsinki and followed ethical principles and guidelines. Ethical approval for the study was granted by the Medical Ethics Committee of Nanfang Hospital of Southern Medical University (NFEC-2021-124), and a standardized informed consent form was established (V1.0/2021- [4][5][6][7][8][9][10][11][12][13][14]. Eligible participants were informed about the study, and they provided written informed consent for participation prior to the study. ...
Background
The innovative method of sentiment analysis based on an emotional lexicon shows prominent advantages in capturing emotional information, such as individual attitudes, experiences, and needs, which provides a new perspective and method for emotion recognition and management for patients with breast cancer (BC). However, at present, sentiment analysis in the field of BC is limited, and there is no emotional lexicon for this field. Therefore, it is necessary to construct an emotional lexicon that conforms to the characteristics of patients with BC so as to provide a new tool for accurate identification and analysis of the patients’ emotions and a new method for their personalized emotion management.
Objective
This study aimed to construct an emotional lexicon of patients with BC.
Methods
Emotional words were obtained by merging the words in 2 general sentiment lexicons, the Chinese Linguistic Inquiry and Word Count (C-LIWC) and HowNet, and the words in text corpora acquired from patients with BC via Weibo, semistructured interviews, and expressive writing. The lexicon was constructed using manual annotation and classification under the guidance of Russell’s valence-arousal space. Ekman’s basic emotional categories, Lazarus’ cognitive appraisal theory of emotion, and a qualitative text analysis based on the text corpora of patients with BC were combined to determine the fine-grained emotional categories of the lexicon we constructed. Precision, recall, and the F1-score were used to evaluate the lexicon’s performance.
Results
The text corpora collected from patients in different stages of BC included 150 written materials, 17 interviews, and 6689 original posts and comments from Weibo, with a total of 1,923,593 Chinese characters. The emotional lexicon of patients with BC contained 9357 words and covered 8 fine-grained emotional categories: joy, anger, sadness, fear, disgust, surprise, somatic symptoms, and BC terminology. Experimental results showed that precision, recall, and the F1-score of positive emotional words were 98.42%, 99.73%, and 99.07%, respectively, and those of negative emotional words were 99.73%, 98.38%, and 99.05%, respectively, which all significantly outperformed the C-LIWC and HowNet.
Conclusions
The emotional lexicon with fine-grained emotional categories conforms to the characteristics of patients with BC. Its performance related to identifying and classifying domain-specific emotional words in BC is better compared to the C-LIWC and HowNet. This lexicon not only provides a new tool for sentiment analysis in the field of BC but also provides a new perspective for recognizing the specific emotional state and needs of patients with BC and formulating tailored emotional management plans.
... Written exposure therapy (WET; Sloan & Marx, 2019) is a brief intervention for PTSD with an emerging literature on reducing PTSS, with sustained treatment gains (Thompson-Hollands et al., 2018). WET was developed through a series of studies manipulating the instructions and dose of expressive writing (EW; Pennebaker et al., 1997) in individuals with PTSD and/or PTSS (see Sloan & Marx, 2019, for an overview of treatment development). A main finding in the development of WET was that the standard dose of expressive writing (i.e., three sessions, 20-min of writing per session) was not sufficient to reduce PTSS in individuals with PTSD (Sloan et al., 2011). ...
... More research is needed to enhance understanding of the efficacy of WET delivered via telehealth with other populations. Additionally, WET has not been empirically tested against the EW paradigm (Pennebaker, 1997) from which it was developed (Sloan & Marx, 2019). As calls for appropriate control conditions for nonspecific treatment effects have been made (e.g., Budde et al., 2023), comparing WET to EW allows for rigorous control for the alterations made to EW during the development of WET (i.e., psychoeducation, changes in writing instructions, and feedback). ...
The literature demonstrates that posttraumatic stress disorder (PTSD) rates are estimated to be higher on college campuses compared to lifetime estimates in the general population. Written exposure therapy (WET) is a promising brief intervention for posttraumatic stress symptoms (PTSS) with a growing literature of evidence suggesting efficacy, lower drop‐out rates compared to other evidence‐based protocols, and long‐term treatment gains. This proof‐of‐concept study examined the efficacy of WET delivered via telehealth compared to expressive writing (EW), the protocol from which WET was derived. The sample included non–treatment‐seeking trauma‐exposed undergraduate students ( N = 33) with elevated PTSS. The results suggest that both WET, g = 1.26, and EW, g = 0.61, were associated with within‐person decreases in PTSS. However, reliable change indices indicated that a significantly larger proportion of individuals in the WET condition (61.5%) demonstrated reliable symptom improvement compared to those who received EW (20.0%), g = 0.91. Contrary to our hypotheses, the WET and EW groups did not differ on reliable slopes of change; however, between‐group effects were underpowered and should be interpreted with caution. These findings offer preliminary support for WET delivered via telehealth, including for individuals with subthreshold PTSS.
... According to Malle [11], the explanatory language of individuals is usually divided into two types, namely, explained actions (e.g., I bought/chose/threw out the phone because…) and explained reactions (e.g., I hate/love the characters in this fiction because…). Compared with prior studies that focused on whether consumers make explanations [13] and why they want to explain [14], recent studies focus on what consumers explain and how the explanations influence review readers' perceptions of online reviews [9,15]. However, there are still some issues that remain unsolved: Does this kind of explanation content have an impact in real-world contexts? ...
... Reviews that do not contain explanatory language greatly reduce the perceived helpfulness of consumers [22]. In other words, regardless of the degree of explanation, as long as the review text contains explanatory language, it will have an impact on consumers' purchase decisions [13]. The two different types of explanations in online reviews describe the reviewers' more specific product selection actions and attitude reactions. ...
Online review helpfulness has been a hot topic of discussion among academics and practitioners. The purpose of this study is to explore the impact of the two types of explanation content, explained actions and explained reactions, on online review helpfulness, along with the moderating effects of product type and sentiment polarity. We developed and empirically examined the proposed hypotheses with data collected from 57,491 product reviews and 415 experimental participants. The word-of-bag was used for measuring the explanation content (explained actions and explained reactions), and negative binomial regression results showed that both explained actions and explained reactions in the reviews have positive effects on review helpfulness. The main results were further verified by three experiments with strict controls. The current study could help online retailers identify the most helpful review, thereby reducing consumer search costs and helping reviewers contribute more valuable online reviews.
... Participants will be asked to write during 15 to 20 min once started. The Linguistic Inquiry Word Count (LIWC; [102]) will be applied to patient trauma narratives to investigate patient narratives about their central early trauma as well as to their dream diaries [103,104]. ...
Background
Whether and how psychotherapies change brain structure and function is unknown. Its study is of great importance for contemporary psychotherapy, as it may lead to discovery of neurobiological mechanisms that predict and mediate lasting changes in psychotherapy, particularly in severely mentally ill patients, such as those with chronic depression. Previous studies have shown that psychoanalytic psychotherapies produce robust and enduring improvements in not only symptom severity but also personality organization in patients who have chronic depression and early life trauma, especially if therapy is delivered at a high weekly frequency.
Methods/design
Patients with chronic major depression and a history of early life trauma will be recruited, assessed, and treated across 3 international sites: Germany, Switzerland, and the United States. They will be randomized to one of two treatment arms: either (1) once weekly psychoanalytic psychotherapies, or (2) 3–4 times weekly psychoanalytic psychotherapies. They will have full clinical characterization as well as undergo MRI scanning at study baseline prior to randomization and again one year later. A group of matched healthy controls will undergo similar assessments and MRI scanning at the same time points to help discern whether study treatments induce brain changes toward or away from normal values. Primary study outcomes will include anatomical MRI, functional MRI, and Diffusion Tensor Imaging measures. Study hypotheses will be tested using the treatment-by-time interaction assessed in multiple general linear models with repeated measures analyses in an intent-to-treat analysis.
Discussion
MODE may allow the identification of brain-based biomarkers that may be more sensitive than traditional behavioral and clinical measures in discriminating, predicting, and mediating treatment response. These findings could help to personalize care for patients who have chronic depression patients and early life trauma, and they will provide new therapeutic targets for both psychological and biological treatments for major depressive illness.
... Expressive writing is one method that meets these requirements (Pennebaker, 1997). Expressive writing is a stress management method that can be conducted alone in a short time either outdoors or indoors (Burton & King, 2008). ...
Stress management activities that older adults can efficiently perform at home are needed. We therefore created a home-based expressive writing for older adults focusing on habituation and conducted a randomized controlled trial. Participants were randomly assigned to the expressive writing group (n = 42) and the active control group (n = 40). The expressive writing group wrote about stressful events for 15 to 30 minutes 3 times each day at home. The active control group wrote about what they bought the previous day on three different days. Twenty six participants were included in the final analysis. The results showed that rumination, a risk factor for depression, decreased in the active control group compared to the expressive writing group. Our findings suggest that older adults can efficiently perform writing sessions at home. Also, a task such as cognitive training, rather than writing about stressful events, decreased rumination in older adults concerned about their forgetfulness.
... Participants completed a short expressive writing exercise to assess their free-moving thoughts over the week. Participants were asked to explore their thoughts, feelings, and the impact the event would have on their lives and relationships with others (Pennebaker, 1997). The direct prompt for the essay was, Please reflect on your thoughts that have been on your mind within the past seven days. ...
Objectives
Free-moving thoughts can have profound implications on how an individual interacts with the world, as well as their sense of self—sometimes maladaptively so. Previous research has suggested that mindfulness allows one to better detect the contents of the mind and thus prevent rumination on negative thoughts, but the association between mindfulness and free-moving thought dynamics is still unknown. In this study, we examined the relationship between trait mindfulness and free-moving thought dynamics.
Method
One hundred and twenty-three participants between 18 and 50 years old (M = 19.59, SD = 3.34 years) completed the Five Facet Mindfulness Questionnaire (FFMQ) and the free association semantic task (FAST), and rated the valence, arousal, and dominance of each generated word in the FAST. Zero–one inflated beta (ZOIB) regressions were used to analyze the relationship between trait mindfulness and thought transitions.
Results
Several components of the FFMQ predicted affective qualities of participants’ free-moving thoughts. Act-awareness and non-judgment significantly predicted the likelihood of transitioning from a low to high affective valence. Act-awareness, observing, and describing were also significant predictors of transitioning from a high to low affective valence. Finally, act-awareness was a significant predictor of switching from a high to low arousal state, while observing was a significant predictor of switching from high to low dominance.
Conclusions
Our study revealed that the use of the FAST could identify nuances in dynamics of free-moving thoughts and is associated with dimensions of trait mindfulness. Moreover, the use of ZOIB regression modeling demonstrates its feasibility for use with data bounded by values between 0 and 1.
Preregistration
This study is not preregistered.
... People who tend to be secretive about, for instance, their sexual orientation or having had an abortion, report higher levels of depression, anxiety, and/or somatic symptoms (Flentje et al., 2020;Major & Gramzow, 1999;Meyer, 2003). Experimental research suggests that simply writing about non-disclosed traumatic events can alleviate distress and depression, alongside other positive health benefits (Pennebaker, 1997; for meta-analytic evidence, see, e.g., Frattaroli, 2006;Smyth, 1998). ...
Objective This study investigated the reasons why pedohebephilic clients disclose their sexual attraction to children in therapy and the experiences associated with this decision among English-speaking samples. Method: The pre-registered online survey combined (1) quantitative correlational data of self-reported improvement, alliance, therapist reaction to disclosure, and the belief that mandatory reporting laws were in place, and (2) qualitative data about reasons for disclosure or no disclosure as well as perceived consequences. The sample consisted of pedohebephilic people who have been clients in therapy and have disclosed (n = 96) or not disclosed (n = 40). Results: While the disclosure and no disclosure groups did not differ in improvement or beliefs about mandatory reporting, those who had disclosed reported a stronger alliance. Clients who did not perceive the therapist’s reaction as supportive reported less improvement than the no disclosure group. Thematic analysis of qualitative data identified three themes concerning motives for disclosing or not disclosing and a fourth regarding differential impacts of disclosure. Discussion: This study indicates that disclosing pedohebephilia does not in and of itself lead to improvement but is contingent on a therapist’s reaction.
... The distal benefits of this coping strategy, however, may outweigh the initial proximal costs. Similar patterns have been found with catharsis as a coping strategy: emotional expression initially produces an increase in negative affect, but the long-term effect is an increase in adaptive outcomes such as better health and higher levels of positive affect (Pennebaker, 1997;Pennebaker & Beall, 1986). ...
The associations among coping, mood, and health variables were examined prospectively over 2 years in 86 HIV positive (HIV+) and 167 HIV negative (HIV−) gay men undergoing the stress of AIDS-related caregiving. Path models suggested that including both positive and negative mood and the men's associated coping strategies increases understanding of why some people suffer adverse health effects during times of stress. Among the HIV− caregivers, higher levels of social coping predicted increases in positive affect, which in turn resulted in lower levels of physical symptoms. In contrast, higher levels of cognitive avoidance predicted increases in negative affect, which in turn resulted in higher levels of physical symptoms. Self-injurious forms of avoidance coping predicted higher levels of physical symptoms independent of mood among the HIV+ caregivers.
... We then probe not only the mental health impact of the COVID-19 pandemic on university students in the U.S., but also the question of whether ethnographic journaling, either with PJP or in another format, might have therapeutic benefit. While PJP was not created as a therapeutic intervention, the project was deeply informed by evidence that journaling and other forms of expressive writing and creative expression can have therapeutic value (Hirai et al., 2020;Kim-Godwin et al., 2020;Mason et al. 2022;Pennebaker, 1997;Pennebaker & Chung, 2011;Utley & Garza, 2011;Younie, 2009;Younie & Swinglehurst, 2019). The potential therapeutic value of journaling for students is especially worthy of consideration since concerns about student mental health preceded COVID-19, and since the pandemic only exacerbated existing challenges and cast the stakes and urgency of this issue into sharper relief (Amerio et al., 2022;Conrad et al., 2021;Gonzales et al., 2020;Kim et al., 2021;Penner et al., 2021;Prowse et al., 2021;Zolopa et al., 2022;see, e.g., Duffy et al., 2019;Meda et al., 2021;Sani et al., 2020; see also other contributions to this issue). ...
Ethnographic journaling can provide students with powerful opportunities to recognize and value their individual and collective perspectives as both observers and analysts of the world around them, especially in times of crisis. In this Perspectives essay, we share our experiences of using the Pandemic Journaling Project platform as a teaching resource in the first years of the COVID-19 pandemic and beyond. We consider various aspects of online ethnographic journaling, including creative teaching strategies, journaling’s therapeutic potential, and student perspectives on the opportunity to document their own experiences as a forward-looking form of “archival activism.” We also discuss how journaling can create robust ethnographic learning opportunities while at the same time providing a valuable space for connection and social support, especially when classroom dynamics are constrained by crisis conditions. Ethnographic journaling can help students appreciate what it means for ethnographers to bring their whole selves into their qualitative work in ways that can challenge mainstream misconceptions and contribute concrete forms of data and ethnographic insight. Overall, the essay explores how ethnographic journaling can create meaningful and creative opportunities for curricular innovation; generate durable forms of ethnographic insight; and also bring student experiences into the classroom in ways that can help them cultivate their voice, build a sense of solidarity, and potentially ease student distress.
... 2 Initial therapy stage (Maskmaking and Writing Prompt) [30,31] Participants completed mask and wrote (15 min) using the prompt: "Create a title for your mask and describe what your mask conveys about you or your experiences including those related to TBI, PTSD, or other aspects of your military career." ...
Among the disabling post-traumatic stress (PTS) symptoms are irritability, aggressive behavior, distressing memories and general impaired cognition and negative mood. Art therapy interventions, including mask-making, can potentially alleviate these symptoms. We tested the hypothesis that art conveys emotions and predicted that blinded viewers would be able to perceive changes in theoretically derived emotional profiles expressed in art made by military personnel with PTSS from the onset to the end of therapy. Five service members and veterans exhibiting PTSS were enrolled in an 8-session art therapy protocol, during which they artistically transformed papier-mâché masks at the beginning and end of the protocol.
We found that blinded viewers without knowledge of the masks' creation stage (onset or end of therapy) read initial masks as conveying more negative emotions (e.g., angry, upset, and challenged) and later masks as conveying more positive emotions (calm and pleasure). Based on the assessments from the blinded evaluators, we infer the emotional transition experienced by the participants was expressed in the masks. In an exploratory arm of the study, we also found that viewers were better able to empathize with the negative emotions experienced by participants with PTSS when asked to explicitly take their perspective.
... Due to this, the breath deepens, while the body relaxes. The skill of breathing control is also the basis for other relaxation techniques and, as confirmed by research, a change of breathing pattern exerts an effect on the nerve centres engaged in the regulation of emotions [26,27]. ...
... An early study asked a group of college students to spend half an hour a day for 3-5 days writing down their deepest thoughts and feelings about some very upsetting experiences, whereas the control group wrote about nonemotional topics. At the end-of-semester follow-up, students in the experimental group got sick less, drank less alcohol, and received better grades than the control group (Pennebaker, 1997). Very importantly, the good effects of these activities were not merely due to the expression of emotions. ...
Background
Drawing can regulate emotions through venting or distraction. Distraction is more helpful for short‐term emotion recovery; however, the sustainability of this difference is yet to be clarified. This study used functional near‐infrared spectroscopy (fNIRS) to explore potential differences between venting and distraction.
Methods
A total of 44 college students participated in the experiment. After inducing fear by video, they were divided into two groups: The venting group drew their emotional experience, and the distraction group drew a house. Subsequently, the participants were instructed to relax by a brief video.
Results
Although the distraction group had a higher valence than the venting group at the end of the drawing activity, there was no difference between the two groups after a relaxation period. Additionally, the activation pattern of the prefrontal cortex differed between the two groups. Compared to the distraction group, the venting group had fewer channels with elevated prefrontal activity during drawing, suggesting less cognitive control, and had more channels with reduced prefrontal activity during relaxation, suggesting a higher level of relaxation. Drawing coding and fNIRS data were both associated with variations in valence.
Conclusion
The less the cognitive control over emotion and the more free the expression of emotion during drawing, the higher the increase in valence; inversely, the more the cognitive control over emotion and the less free the expression of emotion, the lower the increase in valence.
... Relatedly, group online spaces may play a role similar to that of group psychotherapy in that they allow individuals to not only receive help, but also provide it to peers (Yalom & Leszcz, 2020). Finally, it may simply be the act of writing about one's problems that provides relief (Pennebaker, 1997). ...
Objective:
The primary aim of this study was to investigate the factors affecting individuals' decisions to discuss specific personal issues in psychotherapy vs on social media, either non-anonymously or pseudonymously/anonymously.
Method:
A heterogeneous sample of participants (N = 443) completed an online survey that included assessments of their therapy experience, attachment style, attitudes towards seeking mental healthcare, and the extent of their disclosures about personally distressing topics in therapy and online under different conditions.
Results:
Results suggest that attachment style plays a significant role in determining individuals' likelihood of discussing personally distressing topics online and in determining the extent to which they find disclosures in therapy and in anonymous and non-anonymous online spaces to be helpful.
Conclusion:
Clinicians may find it helpful to monitor the extent to which patients disclose personal issues online, checking as to whether patients, especially younger patients and those with avoidant and ambivalent attachment styles, view psychotherapy as an appropriate domain to disclose specific personally distressful issues.
... According to Barnett, the drive for creativity itself is expressed as a "creative will". "Desire of relief and avoidance" refers to desirable changes in existing conditions because the individual experiences physical or mental discomfort under certain conditions [16]. Some changes are accepted because the existing mechanism is not enough to provide something of value; through this process, an innovative process can occur within a complete cultural framework of society [17]. ...
Artistic research on community empowerment through artistic innovation in the Ceprotan Ceremony in Sekar Village aims to explain how the steps for optimizing performing arts innovations at the Ceprotan ceremony are through village community empowerment strategies. The initial step of this artistic research was carried out by direct observation to obtain data and information regarding the myths and practices of the Ceprotan Ceremony. In addition, to obtain more in-depth data, the researcher used the participant observer strategy and, at the same time, conducted in-depth interviews. The results of this investigation are then used by researchers to develop a community empowerment-based artistic innovation model. The results of this community empowerment-based artistic research are (1) systematic performance management; (2) the creation of social cohesion in the series of Ceprotan performances; (3) the identity of the village of Sekar is formed; (4) the revitalization of the Sekar Taji dance drama; (5) the reduction of bad events or trance (possession). The contribution of this research is an example for other regions that want to use artistic innovation as the formation of village identity and, at the same time, as an effort to complement and advance the cultural potential of Sekar Village
... "Emotional Writing" consists of writing about highly emotional experiences, especially those never disclosed to others (four 30-min sessions; one session per week). It is based on the theory that the suppression of emotions leads to psychological distress, originally proposed by Pennebaker [43]. According to the theory, expressive writing about deeply emotional memories should decrease distress. ...
Background
Placebo effects are a well-established phenomenon in the treatment of depression. However, the mechanism underlying these effects are not fully understood. Treatment expectations are considered one explanation for why placebos work. Treatment expectations are likely to be affected by clinician-patient interactions. This study aims to investigate the role of the communicated treatment rationale in modulating treatment expectations and its effects on the treatment outcomes of a pharmacological and a psychological active placebo intervention for depression. In this study, treatment expectations are modulated by presenting illness models that are either congruent or incongruent with the treatment intervention that follows.
Methods
This 2 × 2 randomized controlled trial will involve patients with major depression. Participants will either receive a biological or a psychological illness model from a clinician. Following this, they are randomly assigned to receive either a pharmacological or a psychological active placebo intervention. The illness model and the treatment are either congruent or incongruent with each other, resulting in four groups. In addition, a natural course control group will be included.
Discussion
This study will provide insights into the mechanism of expectation modulation in active placebo treatments for major depression. The results may provide insights for clinicians to improve their communication with patients by focusing on treatment expectations. By identifying the factors that contribute to placebo effects, this study has the potential to improve the effectiveness of existing depression treatments and reduce the burden of this highly prevalent mental health condition.
Trial registration
This trial has been registered prospectively at ClinicalTrials.gov under the identifier: NCT04719663. Registered on January 22, 2021.
... Expressive writing merupakan sebuah proses terapi dengan menggunakan metode menulis ekspresif untuk mengungkapkan pengalaman emosional dan mengurangi stress yang dirasakan individu sehingga dapat membantu memperbaiki kesehatan fisik, menjernihkan pikiran, memperbaiki perilaku dan menstabilkan emosi (Sindoro, 2016). Secara spesifik, mengekspresikan pikiran dan perasaan tentang kejadian traumatis dapat mengembangkan kondisi kesehatan mental dan fisik seseorang (Frattaroli, 2006;Pennebaker, 1997;Smyth, 1998). ...
The differences in emotional handling between male and female adolescents lead to differences in the way of thinking, feeling, and behaving. This experimental research used the Emotional Experience Writing (EXPRIT) model as an intervention for 15 orphans (8 male adolescents from the Tunas Melati Orphanage and 7 female adolescents from Tunas Harapan Orphanage in Pontianak City aged 12-18 years). There were rapport-building sessions at the start of the study as well as five intervention sessions. Qualitative data were collected by coding techniques on the subject's writing, and The Emotional Handling Scale was used to collect quantitative data. The data analysis is using paired t test. This study revealed differences in emotional handling abilities between the two groups of adolescents based on gender. The t test scores were higher than the t table in both orphanages. This result shows that the EXPRIT model as an intervention, affects the ability to deal with emotions for both genders in the form of different models of emotional control.
... Following previous clinical and nonclinical research on the effects of the expression of negative affective states, it can be supposed that the writing has led to enhanced self-acceptance, fostered self-understanding, and reduced inhibition of negative feelings, which, in turn, goes along with reduced feelings of stress (e.g. 61,62 ). Additionally, we found that writing on giving in has helped people who felt lower levels of BAS after threat to increase their approach-oriented affective state. ...
The present research investigated whether the Italian mafia as a Dark Triad threat increased threat-related affective states and explored how thinking about defense mechanisms may help to reduce these states. For this, we conducted a multi-method experimental study with Italians (N = 253). The quantitative results show that the mafia as a threat manipulation increased threat-related affective states in terms of higher behavioral inhibition (BIS) and lower behavioral activation (BAS). The qualitative results further depict proximal and distal defense mechanisms to reduce this threat, which can be categorized into models of threat and defense. Exploratory analyses indicate that naming distal defenses positively affected the increase of BAS. Additionally, when participants had higher levels of BIS after the threat, naming more defenses and proximal defenses positively affected the decrease of BIS. Further qualitative results provide valuable information on effective personal and societal buffers for the perceived threat of the Italian mafia.
... Active psychological placebo choice: "Emotional Writing" consists of writing about highly emotional experiences, especially those never disclosed to others (four 30-minute sessions; one session per week). It is based on the theory that the suppression of emotions leads to psychological distress, originally proposed by Pennebaker (43). According to the theory, expressive writing about deeply emotional memories should decrease distress. ...
Background
Placebo effects are a well-established phenomenon in the treatment of depression. However, the mechanism underlying these effects are not fully understood. Treatment expectations are considered one explanation for why placebos work. Treatment expectations are likely to be affected by clinician-patient interactions. This study aims to investigate the role of the communicated treatment rationale in modulating treatment expectations and its effects on the treatment outcomes of a pharmacological and a psychological active placebo intervention for depression. In this study, treatment expectations are modulated by presenting illness models that are either congruent or incongruent with the treatment intervention that follows.
Methods
This 2x2 randomized controlled trial will involve patients with major depression. Participants will either receive a biological or a psychological illness model from a clinician. Following this they are randomly assigned to receive either a pharmacological or a psychological active placebo intervention. The illness model and the treatment are either congruent or incongruent with each other, resulting in four groups. In addition, a natural course control group will be included.
Discussion
This study will provide insights into the mechanism of expectation modulation in active placebo treatments for major depression. The results may provide insights for clinicians to improve their communication with patients by focusing on treatment expectations. By identifying the factors that contribute to placebo effects, this study has the potential to improve the effectiveness of existing depression treatments and reduce the burden of this highly prevalent mental health condition.
Trial registration
This trial has been registered prospectively at clinicaltrials.gov under the identifier: NCT04719663.
... Using words to express feelings is an effective way of managing emotions (Kashdan et al., 2015;Pennebaker, 1997;Pennebaker et al., 1997) that engages IFC (Etkin et al., 2006;Hariri et al., 2000;Lieberman et al., 2007;Taylor et al., 2006). While functional neuroimaging studies have detected transient IFC activity during emotion regulation and affect labeling tasks (McRae et al., 2011;Hariri et al., 2000;Ochsner et al., 2004), our results suggest that using words to report emotional experience in a precise and detailed way also relates to more enduring differences in the structural architecture of bilateral IFC. ...
Individuals with high emotional granularity make fine-grained distinctions between their emotional experiences. To have greater emotional granularity, one must acquire rich conceptual knowledge of emotions and use this knowledge in a controlled and nuanced way. In the brain, the neural correlates of emotional granularity are not well understood. While the anterior temporal lobes, angular gyri, and connected systems represent conceptual knowledge of emotions, inhibitory networks with hubs in the inferior frontal cortex (i.e., posterior inferior frontal gyrus, lateral orbitofrontal cortex, and dorsal anterior insula) guide the selection of this knowledge during emotions. We investigated the structural neuroanatomical correlates of emotional granularity in 58 healthy, older adults (ages 62–84 years), who have had a lifetime to accrue and deploy their conceptual knowledge of emotions. Participants reported on their daily experience of 13 emotions for 8 weeks and underwent structural magnetic resonance imaging. We computed intraclass correlation coefficients across daily emotional experience surveys (45 surveys on average per participant) to quantify each participant’s overall emotional granularity. Surface-based morphometry analyses revealed higher overall emotional granularity related to greater cortical thickness in inferior frontal cortex ( p FWE < 0.05) in bilateral clusters in the lateral orbitofrontal cortex and extending into the left dorsal anterior insula. Overall emotional granularity was not associated with cortical thickness in the anterior temporal lobes or angular gyri. These findings suggest individual differences in emotional granularity relate to variability in the structural neuroanatomy of the inferior frontal cortex, an area that supports the controlled selection of conceptual knowledge during emotional experiences.
... This reflects that stress, depression, and frustration often accompany illness [39]. Consistent with the expressive writing paradigm, some experimental work suggests that expressing difficult feelings allows individuals to make sense of these experiences and find solutions [40,41]. In social contexts such as peer-to-peer forums, expressing one's challenges may also lead to receiving more social support [18,42]. ...
Background
Smartphone-based apps are increasingly used to prevent relapse among those with substance use disorders (SUDs). These systems collect a wealth of data from participants, including the content of messages exchanged in peer-to-peer support forums. How individuals self-disclose and exchange social support in these forums may provide insight into their recovery course, but a manual review of a large corpus of text by human coders is inefficient.
Objective
The study sought to evaluate the feasibility of applying supervised machine learning (ML) to perform large-scale content analysis of an online peer-to-peer discussion forum. Machine-coded data were also used to understand how communication styles relate to writers’ substance use and well-being outcomes.
Methods
Data were collected from a smartphone app that connects patients with SUDs to online peer support via a discussion forum. Overall, 268 adult patients with SUD diagnoses were recruited from 3 federally qualified health centers in the United States beginning in 2014. Two waves of survey data were collected to measure demographic characteristics and study outcomes: at baseline (before accessing the app) and after 6 months of using the app. Messages were downloaded from the peer-to-peer forum and subjected to manual content analysis. These data were used to train supervised ML algorithms using features extracted from the Linguistic Inquiry and Word Count (LIWC) system to automatically identify the types of expression relevant to peer-to-peer support. Regression analyses examined how each expression type was associated with recovery outcomes.
ResultsOur manual content analysis identified 7 expression types relevant to the recovery process (emotional support, informational support, negative affect, change talk, insightful disclosure, gratitude, and universality disclosure). Over 6 months of app use, 86.2% (231/268) of participants posted on the app’s support forum. Of these participants, 93.5% (216/231) posted at least 1 message in the content categories of interest, generating 10,503 messages. Supervised ML algorithms were trained on the hand-coded data, achieving F1-scores ranging from 0.57 to 0.85. Regression analyses revealed that a greater proportion of the messages giving emotional support to peers was related to reduced substance use. For self-disclosure, a greater proportion of the messages expressing universality was related to improved quality of life, whereas a greater proportion of the negative affect expressions was negatively related to quality of life and mood.
Conclusions
This study highlights a method of natural language processing with potential to provide real-time insights into peer-to-peer communication dynamics. First, we found that our ML approach allowed for large-scale content coding while retaining moderate-to-high levels of accuracy. Second, individuals’ expression styles were associated with recovery outcomes. The expression types of emotional support, universality disclosure, and negative affect were significantly related to recovery outcomes, and attending to these dynamics may be important for appropriate intervention.
While interactions with social robots are novel and exciting for many people, one concern is the extent to which people’s behavioural and emotional engagement might be sustained across time, since during initial interactions with a robot, its novelty is especially salient. This challenge is particularly noteworthy when considering interactions designed to support people’s well-being, with limited evidence (or empirical exploration) of social robots’ capacity to support people’s emotional health over time. Accordingly, our aim here was to examine how long-term repeated interactions with a social robot affect people’s self-disclosure behaviour toward the robot, their perceptions of the robot, and how such sustained interactions influence factors related to well-being. We conducted a mediated long-term online experiment with participants conversing with the social robot Pepper 10 times over 5 weeks. We found that people self-disclose increasingly more to a social robot over time, and report the robot to be more social and competent over time. Participants’ moods also improved after talking to the robot, and across sessions, they found the robot’s responses increasingly comforting as well as reported feeling less lonely. Finally, our results emphasize that when the discussion frame was supposedly more emotional (in this case, framing questions in the context of the COVID-19 pandemic), participants reported feeling lonelier and more stressed. These results set the stage for situating social robots as conversational partners and provide crucial evidence for their potential inclusion in interventions supporting people’s emotional health through encouraging self-disclosure.
Social media has been an increasingly utilized communication tool, and it has gained popularity among adolescent athletes. Our aim here was to investigate whether a positive and honest self-presentation on social media increased adolescent athletes' self-esteem, and we examined the moderating effect of perceived responsiveness. After receiving informed consent of participants and their parents/legal guardians, we recruited 468 adolescent athletes/participants (244 males, 224 females; Mage = 15.39 years, SD = 1.61) through purposive sampling and engaged them in completing face-to-face or online self-report measures of their: (a) self-presentation on social media, (b) perceived responsiveness of others, and (c) Rosenberg self-esteem scales. Given the continuous nature of our moderating variable (i.e., perceived responsiveness), we conducted regression analysis using Hayes’s PROCESS macro in SPSS software. A positive self-presentation showed no significant relationship with self-esteem, except when the level of perceived responsiveness was high. Conversely, an honest self-presentation was positively related to higher self-esteem, and the relationship between honest self-presentation and self-esteem was moderated by perceived responsiveness. Our findings extend existing psychological theory into the online environment and have practical implications. These data highlight the link between social media self-presentation and self-esteem among adolescent athletes and illustrate the crucial role of perceived responsiveness in the social media context.
In this chapter, a more unfolded analysis is presented, of practices called ‘aesthetic documentation’ at a Copenhagen facility for counselling young drug users. A general introduction places those practices as prototypical for one way to develop ‘post-therapeutic’ approaches in this field, and especially for taking up aesthetics as a way to cultivate meta-motives. The specific activities studied, in close collaboration with participants, are those of a ‘creative writing group’. This requires a contextualization in the current cultural revolution of forms and genres of writing and of self-writing, in art, self-help and beyond, spurred not least by technological developments. Introduced by a sample poem, we then discuss the writing group in dialogue with the writer of the poem, before we dive into a recorded sequence of the writing group activity, to see how the aesthetic dissense of poetic re-/presentation works as a form of externalization and generalization that allows meta-motives to be addressed in a caring way.
This chapter is a critical reflection from three adult survivors of childhood sexual abuse, incest and rape on Boxing with the Boys, a component of the research project entitled Left Write Hook (LWH). The aim of LWH is to test the premise that the combination of writing and boxing in a group setting can help counter some of the long-term effects of childhood sexual abuse. Boxing with the Boys is one session within the LWH workshops series where the participants get in the boxing ring with trained boxers under the agreement that the boxers defend but do not hit back. The aim is to give the participants an experience of agency, strength, and power through writing and boxing. Our research adds to feminist sports scholarship that advocates for lived experience to redress gendered inequities. LWH intersects with research that supports the benefits of writing, with the caveat of adding survivor voices to public discourse, as opposed to remaining private and solely therapeutic. Our aim is to raise awareness around systemic socio-cultural and political problems that enable incest and rape.
This abstract examines strategies for EFL educators to nurture resilience, foster growth mindsets, and create an optimal learning environment, drawing from collaborative research by Fountoulakis and Tangas (Τάγκας & Φουντουλάκης, 2001). The study emphasizes understanding students' perspectives and the importance of a growth mindset environment, including vocabulary expansion, cognitive enhancement, and arousal regulation. Evidence-based strategies such as cognitive restructuring, mindfulness, journaling, and seeking diverse perspectives are explored, highlighting their ability to challenge negative beliefs, cultivate resilience and self-compassion, enhance cognitive flexibility, and foster new thinking patterns. Implementing these strategies in educational settings has demonstrated positive outcomes in student attitudes, engagement, academic performance, and well-being. The study underscores the need for further research on long-term effects, sustainability, and contextual factors that influence strategy effectiveness. By reshaping thinking patterns and promoting personal growth, these strategies empower individuals to embrace a future filled with possibilities, fostering resilience and a positive mindset. LITERATURE REVIEW Effectiveness of Strategies Strategies like cognitive restructuring, mindfulness, journaling, and seeking diverse perspectives reshape thinking patterns and promote personal growth. They challenge negative beliefs, cultivate resilience, enhance cognitive flexibility, and facilitate new thinking patterns. However, more research is needed to explore long-term effects and sustainability. Role of Self-Reflection and Support Self-reflection and seeking support contribute to personal development and well-being by improving self-awareness, emotional regulation, and problem-solving skills. Understanding the underlying mechanisms is crucial. Implementation in Educational Settings Implementing these strategies in educational settings improves student attitudes, engagement, academic performance, and well-being. However, further research is needed to examine
There is overwhelming evidence that social support can be effective in ameliorating the negative impact of stress including that which arises from trauma reactions including secondary traumatization. It is likely that the company of others has had evolutionary survival value, and for this reason it continues to serve as a buffer to trauma-induced stress. When we oppose the biological imperative for social contact, such as when an individual is placed in solitary confinement as a form of punishment, this isolation can be as distressing as physical torture. It is for this reason that solitary confinement serves as an extreme form of punishment. The chapter highlights a case in which group support serves to alleviate the distress of an individual whose spouse suffered from an incurable disease. Another case shows the value of social support among VA personnel. Social support has been used by first responders and emergency medical technicians as a way of coping with work-induced secondary trauma. Barriers to social support exist when organizations such as those representing the uniformed services view the need for support as a form of weakness. In such cases the seeking of social support can be a barrier to professional advancement.
The authors report a meta-analysis of high-quality studies published from 1990–1998 on the efficacy of manualized psychotherapies for depression, panic disorder, and generalized anxiety disorder (GAD) that bear on the clinical utility and external validity of empirically supported therapies. The results suggest that a substantial proportion of patients with panic improve and remain improved; that treatments for depression and GAD produce impressive short-term effects; that most patients in treatment for depression and GAD do not improve and remain improved at clinically meaningful follow-up intervals; and that screening procedures used in many studies raise questions about generalizability, particularly in light of a systematic relation across studies between exclusion rates and outcome. The data suggest the importance of reporting, in both clinical trials and meta-analyses, a range of outcome indices that provide a more comprehensive, multidimensional portrait of treatment effects and their generalizability. These include exclusion rates, percent improved, percent recovered, percent who remained improved or recovered at follow-up, percent seeking additional treatment at follow-up, and data on both completer and intent-to-treat samples.
The main purpose of this study was to examine the effects of anger regulation on emotion regulation strategies applied through writing tasks. In this respect, a scenario that would trigger the anger was created. Levels of anger regulation were then evaluated by examining the effects of expression, problem-solving, and distraction strategies applied through writing tasks. The change in anger regulation was evaluated in terms of positive affect, negative affect, valence, and arousal values of emotion. In addition, the levels of effectiveness of these emotion regulation strategies were compared with each other. The sample of the study consisted of 152 female university students (for age; M =19.71, SD = 1.38). The Positive and Negative Affect Scale, Emotion and Arousal Assessment, and Emotional Valence Assessment Form were used as data collection tools. It was found that all three emotion regulation strategies had significant effects on negative affect and arousal. The most effective strategy for negative affect was distraction (M =14.44, SD = 4.83), while the least effective was expression (M =27.38, SD = 8.01). Finally, the most effective strategies for arousal were distraction and expression with problem-solving, and there was no significant difference between the effectiveness of these two strategies (M =3.40, SD = 0.80; M =3.54, SD = 1.09, respectively), while the least effective strategy was expression (M =4.11, SD = 1.07).
Expressive writing is a form of writing in which a person discloses highly charged emotional episodes, such as the loss of a loved one or a life-threatening episode. Typically, such events are concealed and seem to exert a toll on health. Fortunately, written disclosure is frequently associated with increased well-being (Pennebaker & Smyth, 2016). In this chapter, we report on a writing study conducted with undergraduates in which we manipulated a disclosure topic (expressive writing or daily routine) and pronoun perspective (first person/self-immersed; third person/self-distanced). The linguistic perspective that pronouns convey on discourse is likely not innocuous to a consideration of content and emotions shown in expressive writing. Studies have shown that using third person seems to facilitate self-distancing from the actual emotional experience (Kross and Ayduk, Advances in experimental social psychology. Elsevier Academic Press, 2017). Perhaps leading to increased expressiveness and increased self-regulation. One hundred and ten texts collected in 15 min writing sessions were analysed by automated linguistic analyses (using HandSpy 3.0) and evaluated by independent judges, to study the linguistic features and emotional content of the texts. We found that the trauma groups wrote using a higher number of different function words and higher lexical density and the self-distanced groups showed higher idea density, in comparison to the other groups. In addition, the self-distanced trauma group wrote using a higher number of positive words, in comparison to the self-immersed group. This is a push forward in the field of expressive writing as it might encourage others to start using non-traditional expressive writing prompts and to analyse linguistic and emotional content used during writing. These findings are framed and discussed at the light of the well-known Graham’s Writer(s)-Within-Community model (Educ Psychol 53:258–279, 2018a).
Dışavurumcu yazmanın (DY) psikolojik işlev üzerindeki etkisini inceleyen çalışmalar, duyguların yazı ile açılmasının zihinsel ve fiziksel sağlığa fayda sağlayabileceğini göstermiştir. Araştırmada, dışavurumcu yazma uygulamasında katılımcıların olumlu duygulara yönlendirilmesinin veya yönlendirilmemesinin katılımcıların edindiği fayda ile ilişkili olup olmadığı incelenmiştir. Araştırmaya gönüllü olan katılımcılar, seçkisiz atama yöntemi ile yönlendirilmemiş (duygu odağı belirtilmeyen) ve yönlendirilmiş (olumlu duygu odaklı) iki müdahale grubuna atanmıştır. Katılımcılar, birer hafta aralıklarla üç dışavurumcu yazma uygulamasını tamamlamış, aynı zamanda her bir uygulama seansında yazma deneyimlerini ve psikolojik streslerini ölçen araçları cevaplamıştır. Çalışmaya 86 lisans öğrencisi gönüllü olsa da çoğunluğu kadınlardan oluşan (kadın = 60, erkek = 6) 68 katılımcı (Myaş = 20.38; SS = 1.67) çalışmayı tamamlamıştır. Çalışma hipotezlerinin test edilmesinde büyüme eğrisi modeli (growth curve modelling) kullanılmıştır. Çalışmanın sonuçları, yönlendirilmiş ve yönlendirilmemiş gruplar arasında başlangıçta bir fark olmadığını gösterirken uygulama sonucunda yönlendirilmiş grup katılımcılarının psikolojik stres puanlarında istatistiksel olarak anlamlı derecede azalma olduğu görülmüştür. Ek olarak yazma deneyiminin her iki grupta da psikolojik stres ile ters orantılı olduğu gözlenmiştir: Yazma deneyimi puanlarındaki artışın psikolojik stres puanlarındaki düşüş ile ilişkili olduğu gözlenmiştir. Özellikle, yönlendirilmiş olumlu duygu odaklı dışavurumcu yazma uygulamalarının önemli bir müdahale aracı olabileceği gözlenmektedir.
Patients narratives are being recorded increasingly frequently and spontaneously in short user produced content (UGC) films, which may have an impact on the vlogger’s health as well as the public’s comprehension of the relevant health concerns. This paper addressed three research questions regarding the population characteristics of UGC video publishers, the narrative theme of the videos, and the emotional orientation of the commenters. This study aimed to deepen our understanding of COVID-19 patients’ narrative intentions and emotional needs through the theoretical frameworks of theory of planned behavior (TPB) and negative dominance theory (NDT). We collected 335 videos from 28 COVID-19 patients and 572,052 comments as samples on Douyin platform, the largest short-video website in China. Using Latent Semantic Analysis, we analyzed the descriptive information of the video blogs, the narrative textual information of the videos, and the emotional orientation of the comments. Our findings revealled seven categories of narrative themes, with 52.1% of video comments exhibiting a positive emotional orientation. Within a framework integrating TPB and NDT theories, we analyzed the behavioral intentions of vloggers and viewers during COVID-19 epidemic, and interpreted the persistent posting of videos and the active posting of comments as positive actions that counteracted the multiple effects of negative messages. This study contributes to the understanding of individual narratives in macro-risk communication, both theoretically and empirically, and offers policy recommendations in relevant fields.
Purpose: This study interpreted journaled experiences of registered nurses (RNs) who were working at the bedside early in the pandemic as they were simultaneously enrolled in a baccalaureate (RN-BSN) completion program. Design: This qualitative interpretive descriptive study used purposive sampling. Methods: Eighteen students participated in the journal assignment. Fifteen students consented to participate in journal analyses. Journals were de-identified and a code book was used to document the entirety of journal reflections to identify meaningful text, and, ultimately, assert thematic codes. Thorne's interpretive description guided analysis. Researchers coded four journals together to obtain trustworthiness and rigor. Each doctorally prepared researcher independently coded a subset of the remaining journals. Emerging significant statements and subthemes were discussed and verified as a team. Results: Researchers identified the essence of pandemic footprints as the following themes emerged: Physical Threats to Safety, Emotional Threats to Safety, Workplace Culture, Healing Energies, and Professional Identity. Conclusions: Compared to previously published research conducted at later points of the pandemic this study is unique. Study data captured nurses' expressed voices through journaling at the brink (March 2020) of what became a global reality. Results illuminated dichotomies that existed then, particularly in response to their own and others' safety and security, leaving profound imprints on their identities extending beyond care environments.
When President Trump called COVID-19 the “Chinese virus,” media outlets picked up the term and spread it like wildfire. Many Asian Americans experienced both verbal and physical abuse and an unprecedented rate of discrimination towards them in places that used to be more inclusive. A sixty-seven-year-old Asian woman got brutally attacked in New York City for just being Asian—an incident that revealed to Asian people that the United States (US) no longer welcomed them. These anti-Asian hate crimes combined with postpartum depression (PPD) made me emotionally ill. Desperate for uplift, I took on expressive writing as a therapeutic tool to cope with the childbirth trauma, oppression, and racism I experienced. Through rounds of thematic analysis, I used four different themes to restory the critical events: 1) my earlier racial identity: colourism in Thai and American cultures; 2) (denied) access to spaces: immigrating while Asian; 3) being silenced during labour; and 4) baby love leads to (Asian) self-love.This article examines the role of internalized racism and racial inequity that a Thai mother-scholar experiences while immigrating, settling, and giving birth in the US.
Purpose:
To provide evidence-based recommendations to health care providers on integrative approaches to managing anxiety and depression symptoms in adults living with cancer.
Methods:
The Society for Integrative Oncology and ASCO convened an expert panel of integrative oncology, medical oncology, radiation oncology, surgical oncology, palliative oncology, social sciences, mind-body medicine, nursing, methodology, and patient advocacy representatives. The literature search included systematic reviews, meta-analyses, and randomized controlled trials published from 1990 through 2023. Outcomes of interest included anxiety or depression symptoms as measured by validated psychometric tools, and adverse events. Expert panel members used this evidence and informal consensus with the Guidelines into Decision Support methodology to develop evidence-based guideline recommendations.
Results:
The literature search identified 110 relevant studies (30 systematic reviews and 80 randomized controlled trials) to inform the evidence base for this guideline.
Recommendations:
Recommendations were made for mindfulness-based interventions (MBIs), yoga, relaxation, music therapy, reflexology, and aromatherapy (using inhalation) for treating symptoms of anxiety during active treatment; and MBIs, yoga, acupuncture, tai chi and/or qigong, and reflexology for treating anxiety symptoms after cancer treatment. For depression symptoms, MBIs, yoga, music therapy, relaxation, and reflexology were recommended during treatment, and MBIs, yoga, and tai chi and/or qigong were recommended post-treatment.
Discussion:
Issues of patient-health care provider communication, health disparities, comorbid medical conditions, cost implications, guideline implementation, provider training and credentialing, and quality assurance of natural health products are discussed. While several approaches such as MBIs and yoga appear effective, limitations of the evidence base including assessment of risk of bias, nonstandardization of therapies, lack of diversity in study samples, and lack of active control conditions as well as future research directions are discussed.Additional information is available at www.asco.org/survivorship-guidelines.
Creativity is usually seen as a good thing, but why? The Creativity Advantage first offers an overview of creativity studies with an emphasis on the little-discussed benefits of being creative. These include how creativity can lead to self-insight, help people heal, forge connections with others, inspire drive, and enable people to leave behind a meaningful legacy. Written in an engaging style and illustrated with interesting anecdotal material, this book offers a new perspective on creativity scholarship that can serve as an introduction to the field for newcomers or as a way to encourage new avenues for research.
Drawing on contemporary research on the nature and treatment of trauma in psychology, neuroscience and the emerging field of art therapy, this article adopts a psychosocial approach to examine the role that the arts may play in assisting individuals and societies to recover from the trauma of violent conflict and contribute to the establishment of sustainable peace. Taking a broad understanding of the arts to include a range of creative endeavours, it primarily focuses on non-verbal art forms, including but not restricted to music, painting, sculpture, drawing and dance, as well as traditional arts and crafts. It demonstrates that many art forms have the potential to make specific contributions to the amelioration of conflict-related trauma by addressing pervasive non-verbal memories that typically stand outside the remit of more conventional psychosocial practices, such as truth-telling and storytelling. They do so, it argues, by providing a means of expressing, evoking, regulating and transforming the emotions in ways that allow individuals and societies to confront and acknowledge their violent pasts, develop supportive relationships in the present and draw on their creativity to imagine a better future.
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) 2012 APA, all rights reserved)
The purpose of this study was to compare vocal and written expression of feeling about interpersonal traumatic and trivial events in 20-min sessions over a 4-day period. Similar emotional processing was produced by vocal and written expression of feeling about traumatic events. The painfulness of the topic decreased steadily over the 4 days. At the end, both groups felt better about their topics and themselves and also reported positive cognitive changes. A content analysis of the sessions suggested greater overt expression of emotion and related changes in the vocal condition. Finally, there was an upsurge in negative emotion after each session of either vocal or written expression. These results suggest that previous findings that psychotherapy ameliorated this negative mood upsurge could not be attributed to the vocal character of psychotherapy.
This study sought to replicate previous findings that disclosing traumas improves physical health and to compare the effects of revealing previously disclosed versus undisclosed traumas. According to inhibition theory, reporting about undisclosed traumas should produce greater health benefits. Sixty healthy undergraduates wrote about undisclosed traumas, previously disclosed traumas, or trivial events. Contrary to expectations, there were no significant between-groups differences on longer term health utilization and physical symptom measures. However, Ss who disclosed more severe traumas reported fewer physical symptoms in the months following the study, compared with low-severity trauma Ss, and tended to report fewer symptoms than control Ss. Results suggest that health benefits occur when severe traumas are disclosed, regardless of whether previous disclosure has occurred.
This study examined the incidence of infectious and neoplastic diseases among 222 HIV-seronegative gay men who participated in the Natural History of AIDS Psychosocial Study. Those who concealed the expression of their homosexual identity experienced a significantly higher incidence of cancer (odds ratio = 3.18) and several infectious diseases (pneumonia, bronchitis, sinusitis, and tuberculosis; odds ratio = 2.91) over a 5-year follow-up period. These effects could not be attributed to differences in age, ethnicity, socioeconomic status, repressive coping style, health-relevant behavioral patterns (e.g., drug use, exercise), anxiety, depression, or reporting biases (e.g., negative affectivity, social desirability). Results are interpreted in the context of previous data linking concealed homosexual identity to other physical health outcomes (e.g., HIV progression and psychosomatic symptomatology) and theories linking psychological inhibition to physical illness.
This chapter explores the nature of confession and inhibition. Conversely, not confiding significant experiences is associated with increased disease rates, ruminations, and other difficulties. This pattern of findings has helped in developing a useful theory of active inhibition that shares many of the assumptions of learning theory, psychodynamic models, and more recent cognitive perspectives. The chapter examines the nature of confession per se. The chapter focuses on the physiological and psychological effects of confronting or actively avoiding past traumatic experiences. Based on a number of laboratory and field studies, it is clear that requiring people to write or talk about traumas is associated with both immediate and long-term health benefits. The chapter presents a formal theory of active inhibition. The links among the theory and Freud, animal learning, and cognitive perspectives are discussed in the chapter. The chapter describes the reexamination of catharsis, the development and breakdown of the self, and the role of psychosomatics in social psychology.
In an effort to understand emotional change, brief psychotherapy was compared with written expression about stressful life events as well as with a control condition of writing about trivial events using college students. The written expression condition was quite effective in temporarily arousing negative affect but not in changing feelings about the traumatic events. Some self-generated cognitive changes did occur. In contrast, psychotherapy aroused less negative affect but showed much more cognitive reappraisal and a dramatic shift to positive affect, as well as in a basic change in attitude about the stressful event. The study supports a model of therapeutic change stressing emotional expression followed by cognitive reappraisal rather than a model of simple affective discharge.
In order to assess whether disclosure of emotions through writing about upsetting or traumatic events resulted in changes in blood-associated immune variables over time, healthy volunteers were randomly assigned to write about either emotional issues or trivial topics for 4 consecutive days. Circulating lymphocytes and T lymphocyte subsets (CD4 (helper), CD8 (cytotoxic/suppressor)) as well as a variety of standard hematological markers were measured following the writing intervention and compared with baseline values. In two separate studies (N=40 and N=38), there were reproducible significant differences between the emotional disclosure and control writing groups immediately following the intervention in CD4, CD8 and total circulating lymphocyte numbers but not in CD4/CD8 ratios or any other hematological variables. Circulating lymphocyte numbers in the emotional writing group stayed relatively constant over the time-course of the studies, suggesting that the difference between the groups was due to a transient elevation in postwriting blood lymphocyte numbers in the control group. Self-evaluations immediately before and after each writing session confirmed that the intervention was stressful for subjects in the emotional disclosure group but the effects on circulating lymphocytes were not attributable purely to anxiety-related factors. The results extend our previous observation of changes in immune reactivity following a writing intervention and indicate that the group differences are the result of fluctuations over time in the control group but relative stability in the emotional disclosure group. It is conceivable that such ‘buffering’ of temporal immune variation might be influential in the health-promoting effects of emotional disclosure. © 1997 by John Wiley & Sons, Ltd.
On the basis of a theory of inhibition and psychosomatics, it was predicted that the more individuals disclosed personally traumatic experiences, the better their long-term health following the disclosure. Thirty-three Holocaust survivors talked for 1-2 hours about their personal experiences during World War II while skin conductance level (SCL) and heart rate (HR) were continuously monitored. Each videotaped interview was rated by independent judges once every minute on the degree to which the survivor's experience was traumatic. For each subject, the trauma ratings were correlated with minute-by-minute SCL and HR readings. Based on previous research, negative trauma-SCL correlations are indicative of high personal disclosure, whereas positive trauma-SCL correlations suggest low disclosure, whereas positive trauma-SCL correlations suggest low disclosure. Approximately 14 months after the interview, self-reports of the subjects' health were collected. Controlling for pre-interview health problems, degree of disclosure during the interview was found to be positively correlated with long-term health after the interview. The possible health benefits of disclosure are discussed.
When individuals talk or think about upsetting experiences, different coping and defensive processes are invoked from one minute to the next. Further, some coping strategies are thought to be more effortful and to be associated with greater biological activity than others. The present research sought to identify how the expression of emotions and the use of different psychological defenses were reflected in momentary changes in autonomic nervous system activity while subjects wrote about emotional topics. A new methodology is introduced that links the production of natural written language with autonomic activity on a word-by-word or phrase-by-phrase basis. Using this technique with a sample of 24 subjects who wrote about traumatic experiences, it was found that certain text dimensions are highly related to skin conductance level (SCL) but not heart rate. In general, subjects' SCLs increased when expressing negative emotions and when using denial and the passive voice. SCLs were more likely to drop when subjects used positive emotion words and self-references and at the conclusion of sentences or thought units. Implications for this methodology for understanding psychological defense and physical health are discussed.
Previous research has shown that emotional disclosure of traumatic or stressful events is associated with facilitating insight into the experience, improving mood, and modulating some aspects of the immune system. The current study examined how cognitive changes and experiential involvement during an emotional disclosure induction protocol relate to immune functioning, as measured by IgG antibody titres to the Epstein-Barr virus viral capsid antigen (EBV-VCA). Seventy-six college undergraduates were randomly assigned to either a disclosure induction or an assessment-only control condition. Experimental subjects met with an experimenter for three weekly 20-min individual sessions during which time they were asked to discuss a stressful or traumatic topic which they had previously discussed only minimally with others. Blood was drawn a week prior to the first session and at one week following the third session. Subjects completed the Impact of Event Scale (IES) after session 1 and at followup, and the extent of experiential involvement in disclosure during each session was assessed by means of the Experiencing Scale. Mood was assessed before and after each disclosure using the Nowlis Mood Adjective Checklist. Although the disclosure induction did not directly affect EBV-VCA antibody titres, individual differences in subjects' ability to involve themselves in the disclosure process and abandon their avoidance of the stressful tropic during the course of the 3-wk period were predictive of antibody decrements. These associations were more pronounced for individuals who disclosed older and more troublesome events.
When individuals are asked to write or talk about personally upsetting experiences, significant improvements in physical health are found. Analyses of subjects' writing about traumas indicate that those whose health improves most tend to use a higher proportion of negative emotion words than positive emotion words. Independent of verbal emotion expression, the increasing use of insight, causal, and associated cognitive words over several days of writing is linked to health improvement. That is, the construction of a coherent story together with the expression of negative emotions work together in therapeutic writing. Evidence of these processes are also seen in specific links between word production and immediate autonomic nervous system activity. Implications for therapy and for considering the mind and body as fluid, dynamic systems are discussed.
Health benefits derived from personal trauma disclosure are well established. This study examined whether disclosing emotions generated by imaginative immersion in a novel traumatic event would similarly enhance health and adjustment. College women, preselected for trauma presence, were randomly assigned to write about real traumas, imaginary traumas, or trivial events. Yoked real-trauma and imaginary-trauma participants wrote about real-trauma participants' experiences. Imaginary-trauma participants were significantly less depressed than real-trauma participants at immediate posttest, but they were similarly angry, fearful, and happy. Compared with control group participants, both trauma groups made significantly fewer illness visits at 1-month follow-up; however, real-trauma participants reported more fatigue and avoidance than did the other groups. Imaginary-trauma group effects could reflect catharsis, emotional regulation, or construction of resilient possible selves.
One objective of the present research was to examine the immunological effects of self-disclosing personal information regarding a traumatic or stressful experience. A second objective was to examine the hypothesis that the effect of self-disclosure on immune function is moderated by individual differences in cynical hostility. Forty-three male college undergraduates, classified as high or low on the Cook-Medley Hostility scale were randomly assigned to either a verbal self-disclosure or a nondisclosure discussion condition. Task-induced change in natural killer (NK) cell activity (i.e., cytotoxicity) served as the dependent variable. As predicted, a significant interaction between discussion condition and hostility was obtained. Among subjects in the self-disclosure condition, high hostility subjects exhibited a significantly greater increase in NK cell cytotoxicity than low hostility subjects. The effect of self-disclosure on NK cell activity is moderated by an individual's level of cynical hostility. The greater short term enhancement in NK cell activity observed for hostile persons is a likely correlate of a more pronounced acute arousal response elicited by the self-disclosure task.
A research synthesis was conducted to examine the relationship between a written emotional expression task and subsequent health. This writing task was found to lead to significantly improved health outcomes in healthy participants. Health was enhanced in 4 outcome types--reported physical health, psychological well-being, physiological functioning, and general functioning--but health behaviors were not influenced. Writing also increased immediate (pre- to postwriting) distress, which was unrelated to health outcomes. The relation between written emotional expression and health was moderated by a number of variables, including the use of college students as participants, gender, duration of the manipulation, publication status of the study, and specific writing content instructions.
Inhibiting or holding back one's thoughts, feelings, or behaviors is associated with long-term stress and disease. Actively confronting upsetting experiences can reduce the negative effects of inhibition. The present study describes a unique approach to aid individuals in dealing with psychological and emotional issues that they must often face.
Forty-one of the 81 university employees who were participating in a wellness program agreed to participate in the present study. Subjects were randomly assigned to write about either personal traumatic experiences (n = 23) or non-traumatic topics (n = 18) for 20 minutes once a week for four consecutive weeks.
Results indicate that individuals who wrote about upsetting personal experiences evidenced significant drops in selected blood measures compared to those who wrote about non-traumatic topics (e.g., for SGOT: 4.0% drop among traumatic topic group versus 13.1% increase among non-traumatic topic group, ANOVA p = .029; for SGPT: 24.5% drop versus 7.7% increase, p = .001). During the month of writing, traumatic topic group subjects evidenced a 28.6% reduction in absentee rates from work relative to the eight months before the experiment compared with a 48.5% increase in absentee rates among non-traumatic topic subjects (p = .04). Subjects low in emotional inhibition evidenced the greatest reductions in absentee rates following personal disclosure compared to those high in emotional inhibition (p = .011).
The proposed writing strategy offers a unique tool for health promotion practitioners.(ABSTRACT TRUNCATED AT 250 WORDS)
Unpublished master's thesis
- J A Czajka
Bodily versus written expression of tratumattic experience
- A Krantz
- J W Pennebaker