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Acceptance-Enhanced Expressive Writing Prevents Symptoms in Participants with Low Initial Depression

Abstract

Traditional expressive writing (EW) and EW augmented by emotion-acceptance instructions (EWEA) were compared to non-emotional control writing for their ability to forestall depression symptoms in undergraduates with high or low initial levels of depression symptomatology. EWEA instructions encouraged participants to take a more accepting, “emotion friendly” approach toward expressive writing, stressing the importance of “staying present” with difficult emotional experiences non-judgmentally and with openness. Writing condition interacted significantly with initial depression such that at the 5-week posttest, EWEA was more beneficial than control writing for participants with low to mild initial depression symptoms (CESD <17) and EW was more beneficial than control writing for participants with very low initial depression symptoms (CESD <8). But for the EW condition, this effect was reversed such that participants in this condition with high initial depression (CESD >26) fared worse at posttest than those in the control group.

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References

  1. Baum, E. S. (2010). The benefits of mindfulness-enhanced expressive writing among depression-vulnerable individuals. Unpublished doctoral dissertation, The University of Texas, Austin, Texas.

  2. Beck, A. T. (1967). Depression. New York: Harper and Row.

    Google Scholar 

  3. Bhullar, N., Schutte, N. S., & Malouff, J. M. (2011). Writing about satisfaction processes increases well-being. Individual Differences Research, 9(1), 22–32.

    Google Scholar 

  4. Frattaroli, J. (2006). Experimental disclosure and its moderators: A meta-analysis. Psychological Bulletin, 132(6), 823–865.

    PubMed  Article  Google Scholar 

  5. Frisina, P. G., Borod, J. C., & Lepore, S. J. (2004). A meta-analysis of the effects of written emotional disclosure on the health outcomes of clinical populations. The Journal of Nervous and Mental Disease, 192(9), 629–634.

    PubMed  Article  Google Scholar 

  6. Gidron, Y., Peri, T., Connolly, J. F., & Shalev, A. Y. (1996). Written disclosure in posttraumatic stress disorder: Is it beneficial for the patient? Journal of Nervous and Mental Disease, 184(8), 505–507.

    PubMed  Article  CAS  Google Scholar 

  7. Gilbert, P., & Procter, S. (2006). Compassionate mind training for people with high shame and self-criticism: Overview and pilot study of a group therapy approach. Clinical Psychology and Psychotherapy, 13, 353–379.

    Article  Google Scholar 

  8. Gortner, E. M., Rude, S. S., & Pennebaker, J. W. (2006). Benefits of expressive writing in lowering rumination and depressive symptoms. Behavior Therapy, 37(3), 292–303.

    PubMed  Article  Google Scholar 

  9. Hamilton, E. W., & Abramson, L. Y. (1983). Cognitive patterns and major depressive disorder: A longitudinal study in hospital setting. Journal of Abnormal Psychology, 92(2), 173–184.

    PubMed  Article  CAS  Google Scholar 

  10. Hollon, S. D., Kendall, P. C., & Lumry, A. (1986). Specificity of depressotypic cognitions in clinical depression. Journal of Abnormal Psychology, 95, 52–59.

    PubMed  Article  CAS  Google Scholar 

  11. Kabat-Zinn, J. (1994). Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperion.

    Google Scholar 

  12. Kallay, E., Vaida, S., Borla, S., & Opre, A. (2008). The benefits of classic and enhanced tasks of expressive writing for the emotional life of female freshman students. Cognitie Creier Comportament, 12(3), 251–264.

    Google Scholar 

  13. Kingston, T., Dooley, B., Bates, A., Lawlor, E., & Malone, K. (2007). Mindfulness-based cognitive therapy for residual depressive symptoms. Psychology and Psychotherapy: Theory, Research, and Practice, 80, 193–203.

    Article  Google Scholar 

  14. Koopman, C., Ismailji, T., Holmes, D., Classen, C., Palesh, O., & Wales, T. (2005). The effects of expressive writing on pain, depression, and posttraumatic stress symptoms in partners of intimate violence. Journal of Health Psychology, 10(2), 211–221.

    PubMed  Article  Google Scholar 

  15. Krantz, S. E., & Rude, S. S. (1984). Depressive attributions: Selection of different causes or assignment of dimensional meanings? Journal of Personality and Social Psychology, 47, 193–203.

    PubMed  Article  CAS  Google Scholar 

  16. Langens, T. A., & Schuler, J. (2005). Written emotional expression and emotional well-being: The moderating role of fear of rejection. Personality and Social Psychology Bulletin, 31(6), 818–830.

    PubMed  Article  Google Scholar 

  17. Leary, M. R., Tate, E. B., Adams, C. E., Allen, A. B., & Hancock, J. (2007). Self-compassion and reactions to unpleasant self-relevant events: The implications of treating oneself kindly. Journal of Personality and Social Psychology, 92(5), 887–904.

    PubMed  Article  Google Scholar 

  18. Lepore, S. J. (1997). Expressive writing moderates the relation between intrusive thoughts and depressive symptoms. Journal of Personality and Social Psychology, 73(5), 1030–1037.

    PubMed  Article  CAS  Google Scholar 

  19. Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72(1), 31–40.

    PubMed  Article  Google Scholar 

  20. Neff, K. D. (2004). Self-compassion and psychological well-being. Constructivism in the Human Sciences, 9(2), 27–37.

    Google Scholar 

  21. Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61, 115–121.

    PubMed  Article  CAS  Google Scholar 

  22. Pennebaker, J. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8(3), 162–166.

    Article  Google Scholar 

  23. Pennebaker, J. W. (2004). Theories, therapies, and taxpayers: On the complexities of the expressive writing paradigm. Clinical Psychology: Science and Practice, 11(2), 138–142.

    Article  Google Scholar 

  24. Pennebaker, J. W., Colder, M., & Sharp, L. K. (1990). Accelerating the coping process. Journal of Personality and Social Psychology, 58, 528–537.

    PubMed  Article  CAS  Google Scholar 

  25. Pennebaker, J. W., & Francis, M. E. (1996). Cognitive, emotional, and language processes in disclosure. Cognition and Emotion, 10(6), 601–626.

    Article  Google Scholar 

  26. Pennebaker, J. W., Mayne, T. J., & Francis, M. E. (1997). Linguistic predictors of adaptive bereavement. Journal of Personality and Social Psychology, 72(4), 863–871.

    PubMed  Article  CAS  Google Scholar 

  27. Preacher, K. J., Curran, P. J., & Bauer, D. J. (2006). Computational tools for probing interaction effects in multiple linear regression, multilevel modeling, and latent curve analysis. Journal of Educational and Behavioral Statistics, 31, 437–448.

    Article  Google Scholar 

  28. Radloff, L. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1(3), 385–401.

    Article  Google Scholar 

  29. Ramel, W., Goldin, P. R., Carmona, P. E., & McQuaid, J. R. (2004). The effects of mindfulness meditation on cognitive processes and affect in patients with past depression. Cognitive Therapy and Research, 28(4), 433–455.

    Article  Google Scholar 

  30. Range, L. M., & Kovac, S. H. (2002). Can writing autobiographical essays lessen suicidal thinking? Archives of Suicide Research, 6, 373–382.

    Article  Google Scholar 

  31. Richards, J. M., Beal, W. E., Seagal, J. D., & Pennebaker, J. W. (2000). Effects of disclosure of traumatic events on illness behavior among psychiatric prison inmates. Journal of Abnormal Psychology, 109(1), 156–160.

    PubMed  Article  CAS  Google Scholar 

  32. Rude, S. S., Krantz, S. E., & Rosenhan, D. L. (1988). Distinguishing the dimensions of valence and belief consistency in depressive and nondepressive information processing. Cognitive Therapy and Research, 12, 391–407.

    Article  Google Scholar 

  33. Rude, S. S., Maestas, K. L., & Neff, K. (2007). Paying attention to distress: What’s wrong with rumination? Cognition and Emotion, 21(4), 843–864.

    Article  Google Scholar 

  34. Rude, S. S., Mazzetti, F. A., Pal, H., & Stauble, M. R. (2011). Social rejection: How best to think about it? Cognitive Therapy and Research, 35(3), 209–216.

    Google Scholar 

  35. Schoutrop, M. J., Lange, A., Hanewald, G., Davidovich, U., & Salomon, H. (2002). Structured writing and processing major stressful events: A controlled trial. Psychotherapy and Psychosomatics, 71, 151–157.

    PubMed  Article  Google Scholar 

  36. Segal, Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). Mindfulness-based cognitive therapy for depression. New York: Guilford Press.

    Google Scholar 

  37. Shean, G., & Baldwin, G. (2008). Sensitivity and specificity of depression questionnaires in a college-aged sample. The Journal of Genetic Psychology, 169(3), 281–288.

    PubMed  Article  Google Scholar 

  38. Sloan, D. M., Marx, B. P., Epstein, E. M., & Dobbs, J. L. (2008). Expressive writing buffers against maladaptive rumination. Emotion, 8(2), 302–306.

    PubMed  Article  Google Scholar 

  39. Smyth, J. M., Hockemeyer, J. R., & Tulloch, H. (2008). Expressive writing and post-traumatic stress disorder: Effects on trauma symptoms, mood states, and cortisol reactivity. British Journal of Health Psychology, 13, 85–93.

    PubMed  Article  Google Scholar 

  40. Soliday, E., Garofalo, J. P., & Rogers, D. (2004). Expressive writing intervention for adolescents’ somatic symptoms and mood. Journal of Clinical Child and Adolescent Psychology, 33(4), 792–801.

    PubMed  Google Scholar 

  41. Teasdale, J. D., Segal, Z., Williams, M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4), 615–623.

    PubMed  Article  CAS  Google Scholar 

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Correspondence to Stephanie S. Rude.

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This article is based on the dissertation of the first author.

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Baum, E.S., Rude, S.S. Acceptance-Enhanced Expressive Writing Prevents Symptoms in Participants with Low Initial Depression. Cogn Ther Res 37, 35–42 (2013). https://doi.org/10.1007/s10608-012-9435-x

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Keywords

  • Expressive writing
  • Emotional acceptance
  • Acceptance
  • Emotion regulation
  • Depression
  • Mindfulness
  • Contextual thinking
  • Self compassion