The feasibility and effectiveness of an expressive writing intervention for rheumatoid arthritis via home-based videotaped instructions
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Background: Expressive emotional writing has demonstrated efficacy for improving health status in a wide variety of healthy persons and recently in patients with chronic disease.Purpose: This study was a randomized, controlled effectiveness trial with 4 arms: 2 active treatment writing groups, 1 inactive writing group, and 1 attention control group. It represents the first attempt to translate the expressive writing intervention into a low-cost, community-based intervention in the form of a videotaped program.Methods: Feasibility of the approach and patient adherence were examined in a community rheumatology practice with rheumatoid arthritis patients (N = 373).Results: The videotape format was able to convey the intervention instructions accurately and produced the expected and differential ratings of stressfulness and emotional provocation across the 3 writing programs. Seventy-nine percent of eligible patients agreed to take the program home; 49% of these patients reported that they followed the protocol. Physician Disease Activity Rating and the Physical Component Summary of the SF36v2 Health Survey were assessed pre and post program.Conclusions: Intent-to-treat analyses found no effect of the treatment. Pretreatment differences among the protocol-adherent patients complicated treatment outcome interpretation. The standard writing instructions did not yield an effect; a modified set of instructions to extract meaning from the traumatic event yielded equivocal results. Contrasts between efficacy and effectiveness trials and the challenge of achieving significant outcomes in effectiveness trials are discussed.
- Hoffman C, Rice D, Sung HY: Persons with chronic conditions: Their prevalence and costs.Journal of the American Medical Association. 1996,276:1473–1479. CrossRef
- Friedman R, Sobel D, Myers P, Caudill M, Benson H: Behavioral medicine, clinical health psychology, and cost offset.Health Psychology. 1995,14:509–518. CrossRef
- Sobel D: Rethinking medicine: Improving health outcomes with cost-effective psychosocial interventions.Psychosomatic Medicine. 1997,57:234–244.
- Sobel DS: Mind matters, money matters: The cost-effectiveness of mind/body medicine.Journal of the American Medical Association. 2000,284:1705. CrossRef
- Devine E: Effects of psychoeducational care for adult surgical patients: A meta-analysis of 191 studies.Patient Education and Counseling. 1992,19:129–142. CrossRef
- Smyth J, L’Abaté L: Using workbooks to promote health: Examining their efficacy. In L’Abaté L, Torem M (eds),Distance Writing and Computer Assisted Intervention in Psychiatry and Mental Health. Westport, CT: Ablex, 2000, 77–92.
- Lorig K, Holman H: Arthritis self-management studies: A twelve-year review.Health Education Quarterly. 1993,20:17–28.
- Lepore SJ, Smyth JM (eds):The Writing Cure: How Expressive Writing Promotes Health and Emotional Well-being. Washington, DC: American Psychological Association, 2002.
- Smyth J, Stone A, Hurewitz A, Kaell A: Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis.Journal of the American Medical Association. 1999,281:1304–1309. CrossRef
- Kelley J, Lumley M, Leisen J: Health effects of emotional disclosure in rheumatoid arthritis patients.Health Psychology. 1997,16:331–340. CrossRef
- Christensen AJ, Edwards D, Wiebe J, et al.: Effect of verbal self-disclosure on natural killer cell activity: Moderating influences of cynical hostility.Psychosomatic Medicine. 1996,58:150–155.
- Petrie K, Booth R, Pennebaker J: Disclosure of trauma and immune response to a hepatitis B vaccination program.Journal of Consulting and Clinical Psychology. 1995,63:787–792. CrossRef
- Richards J, Pennebaker J, Beall W: The effects of criminal offense and disclosure of trauma on anxiety and illness behavior in prison inmates.Journal of Abnormal Psychology. 2000,109:156–160. CrossRef
- Pennebaker JW, Beall SK: Confronting a traumatic event: Toward an understanding of inhibition and disease.Journal of Abnormal Psychology. 1986,95:274–281. CrossRef
- Pennebaker J, Kiecolt-Glaser J, Glaser R: Disclosure of traumas and immune function: Health implications for psychotherapy.Journal of Consulting and Clinical Psychology. 1988,56:239–245. CrossRef
- Esterling B, Antoni M, Fletcher M, Marguiles S, Schneiderman N: Emotional disclosure through writing or speaking modulates Epstein-Barr virus antibody titers.Journal of Consulting and Clinical Psychology. 1994,10:334–350.
- American Psychological Association Task Force on Psychological Intervention Guidelines:Template for Developing Guidelines: Interventions for Mental Disorders and Psychological Aspects of Physical Disorders. Washington, DC: American Psychological Association, 1995.
- Chambless D, Hollon S: Defining empirically supported therapies.Journal of Consulting and Clinical Psychology. 1998,66:7–18. CrossRef
- Oldenburg B, Hardcastle D, Kok G: Diffusion of health education and health promotion innovations. In Glanz K, Lewis F, Rimer B (eds),Health Behavior and Health Education: Theory, Research, and Practice (2nd Ed.). San Francisco: Jossey-Bass, 1997, 270–286.
- Flay B: Efficacy and effectiveness trials (and other phases of research) in the development of health promotion programs.Preventive Medicine. 1986,15:451–474. CrossRef
- Glasgow R, Vogt T, Boles S: Evaluating the public health impact of health promotion interventions: The RE-AIM framework.American Journal of Public Health. 1999,89:1322–1327.
- Center for the Advancement of Health:Integration of Health Behavior Counseling in Routine Medical Care. Washington, DC: Center for the Advancement of Health, 2001.
- Goldfried MR, Wolfe BE: Toward a more clinically valid approach to therapy research.Journal of Consulting and Clinical Psychology. 1998,66:143–150. CrossRef
- Starfield B: Quality-of-care research: Internal elegance and external relevance.Journal of the American Medical Association. 1998,280:1006–1008. CrossRef
- Wilson DB, Lipsey MW: The role of method in treatment effectiveness research: Evidence from meta-analysis.Psychological Methods. 2001,6:413–429. CrossRef
- Zimmerman M, Mattia JI, Posternak MA: Are subjects in pharmacological treatment trials of depression representative of patients in routine clinical practice?American Journal of Psychiatry. 2002,159:469–473. CrossRef
- Seligman M: The effectiveness of psychotherapy: TheConsumer Reports study.American Psychologist. 1995,50:965–974. CrossRef
- Mondloch MV, Cole DC, Frank JW: Does how you do depend on how you think you’ll do? A systematic review of the evidence for a relation between patients’ recovery expectations and health outcomes.Canadian Medical Association Journal. 2001,165:174–179.
- Sorensen G, Emmons K, Dobson A: The implications of the results of community intervention trials.Annual Review of Public Health. 1998,19:379–416. CrossRef
- Baranowski T, Lin L, Wetter D, Resnicow K, Hearn M: Theory as mediating variables: Why aren’t community interventions working as desired ?Annals of Epidemiology. 1997,S7:S89-S95. CrossRef
- Weisz JR, Weiss B, Donenberg GR: The lab versus the clinic: Effects of child and adolescent psychotherapy.American Psychologist. 1992,47:1578–1585. CrossRef
- Clarke G: Improving the transition from basic efficacy research to effectiveness studies: Methodological issues and procedures.Journal of Consulting and Clinical Psychology. 1995,63:718–725. CrossRef
- Rybarczyk B, DeMarco G, DeLaCruz M, Lapidos S: Comparing mind-body wellness interventions for older adults with chronic illness: Classroom versus home instruction.Behavioral Medicine. 1999,24:181–190.
- Lutgendorf SK, Ulrich PM: Cognitive processing, disclosure, and health: Psychological and physiological mechanisms. In Lepore S, Smythe J (eds),The Writing Cure: How Expressive Writing Promotes Health and Emotional Well-Being. Washington, DC: American Psychological Association, 2002.
- Lutgendorf SK, Antoni MH: Emotional and cognitive processing in a disclosure paradigm.Cognitive Therapy and Research. 1999,23:423–440. CrossRef
- Paulus H, Bulpitt K: Rheumatoid arthritis: Outcome measures.Rheumatic Disease Clinics. 1995,21::605–618.
- Felson DT, Anderson JJ, Boers M, et al.: The American College of Rheumatology preliminary core set of disease activity measures for rheumatoid arthritis clinical trials.Arthritis & Rheumatism. 1993,36:729–740. CrossRef
- Tugwell P, Boers M: OMERACT conference on outcome measures in rheumatoid arthritis clinical trials: Introduction.Journal of Rheumatology. 1993,20:528–530.
- Ware JE, Kosinski M, Dewey JE:How to Score Version 2 of the SF-36 Health Survey. Lincoln, RI: QualityMetric, 2000.
- Ware JE:SF-36 Health Survey: Manual & Interpretive Guide. Boston: The Health Institute, New England Medical Center, 1993.
- The Arthritis Society:Understanding Rheumatoid Arthritis. Vancouver, British Columbia, Canada: James Brodie Productions, 1993.
- Campbell D, Kenny D:A Primer on Regression Artifacts. New York: Guilford, 1999.
- Westen D, Morrison K: A multidimensional meta-analysis of treatments for depression, panic, and generalized anxiety disorder: An empirical examination of the status of empirically supported therapies.Journal of Consulting and Clinical Psychology. 2001,69:875–899. CrossRef
- Stone A, Shiffman S, Schwartz J, Broderick J, Hufford M: Patient non-compliance with paper diaries.British Medical Journal. 2002,324:1193–1194. CrossRef
- Spector SL, Kinsman R, Mawhinney H, et al.: Compliance of patients with asthma with an experimental aerosolized medication: Implications for controlled clinical trials.Journal of Allergy & Clinical Immunology. 1986,77(1, Pt. 1):65–70. CrossRef
- Shiffman S: Real-time self-report of momentary states in the natural environment: Computerized ecological momentary assessment. In Stone A, Turkkan J, Bachrach C, et al. (eds),The Science of Self-Report: Implications for Research and Practice. Mahwah, NJ: Lawrence Erlbaum Associates, Inc., 2000, 277–296.
- Pullar T, Kumar S, Feely M: Compliance in clinical trials.Annals of the Rheumatic Diseases. 1989,48:871–875.
- The feasibility and effectiveness of an expressive writing intervention for rheumatoid arthritis via home-based videotaped instructions
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Volume 27, Issue 1 , pp 50-59
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