Salutary effects of writing about trauma on health are well documented, but little research has directly examined the underlying mechanisms by which these effects occur. The principal study in this article assessed the potential underlying mechanism of meaning-making, defined as changing situational meaning (appraisals of the traumatic experience) and global meaning (world views, personality, and coping styles) in order to reduce the discrepancy between global and situational meaning. Forty-one trauma-writing participants and 21 nontrauma-writing control participants completed 4 days of writing and a 4 month follow-up. Decrements in health were noted for the control group but not for the trauma-writing group. Over time, the trauma-writing group's appraisals changed to reflect less aversive situational meaning (e.g., less stressful, less threatening), and their cognitive processing, reflected by intrusions and avoidance, decreased. Less stressful appraisals and reduced cognitive processing were related to improved health outcomes. Results indicate that writing about trauma facilitates the making of meaning. A second study examined whether scores on several measures used in the first study changed across 4 months without a writing intervention. It was found that these measures did not change across time.
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Bootzin, R. R. (1997). Examining the theory and clinical utility of writing about emotional experiences. Psychological Science, 8, 167–169.
Bower, J. E., Kemeny, M. E., Taylor, S. E., & Fahey, J. L. (1998). Cognitive processing, discovery of meaning, CD4 decline, and AIDS-related mortality among bereaved HIV-seropositive men. Journal of Consulting and Clinical Psychology, 66, 979–986.
Carver, C. S. (1997). You want to measure coping but your protocol's too long: Consider the Brief COPE. International Journal of Behavioral Medicine, 4, 92–100.
Carver, C. S., Scheier, M. G., & eintraub, J. G. (1989). Assessing coping strategies:Atheoretically-based approach. Journal of Personality and Social Psychology, 56, 267–283.
Costa, P. T., Jr., & McCrae, R. R. (1991). The NEO-Personality Inventory manual. Odessa, FL: Psychological Assessment Resources.
Creamer, M., Burgess, P., & Pattison, P. (1992). Reaction to trauma:Acognitive processing model. Journal of Abnormal Psychology, 101, 452–459.
Epstein, S. (1993). Bereavement from the perspective of cognitive-experiential self-theory. In M. S. Stroebe, W. Stroebe, & R. O. Hansson (Eds.), Handbook of bereavement: Theory, research, and intervention (pp. 112–125). New York: Cambridge University Press.
Esterling, B. A., Antoni, M. H., Kumar, M., & Schneiderman, N. (1990). Emotional repression, stress disclosure responses, and Epstein-Barr viral capsid antigen titers. Psychosomatic Medicine, 52, 397–410.
Foa, E. B. (1997). Psychobiology of post-traumatic stress disorder. Annals of the New York Academy of Sciences, 821, 410–424.
Foa, E. B., Molnar, C., & Cashman, L. (1995). Change in rape narratives during exposure therapy for posttraumatic stress disorder. Journal of Traumatic Stress, 8, (Special Issue), 675–690.
Gorsuch, R. L., & McPherson, S. E. (1989). Intrinsic/Extrinsic measurement: I/E-Revised and single item scales. Journal for the Scientific Study of Religion, 28, 348–354.
Greenberg, M. A. (1995). Cognitive processing of traumas: The role of intrusive thoughts and reappraisals. Journal of Applied Social Psychology, 25, 1262–1296.
Greenberg, M. A., & Stone, A. A. (1992). Emotional disclosure about traumas and its relation to health: Effects of previous disclosure and trauma severity. Journal of Personality and Social Psychology, 63, 74–85.
Greenberg, M. A., Wortman, C. B., & Stone, A. A. (1996). Emotional expression and physical health: Revising traumatic memories or fostering self-regulation? Journal of Personality and Social Psychology, 71, 588–602.
Horowitz, M. J. (1991). Person schemas. In M. Horowitz (Ed.), Person schemas and maladaptive interpersonal patterns (pp. 13–31). Chicago: University of Chicago Press.
Horowitz, M. J. (1997). Cognitive psychodynamics:The clinical use of states, person schemas, and defensive control process theories. In D. J. Stein (Ed.), Cognitive science and the unconscious (pp. 189–205). Washington, DC: American Psychiatric Press.
Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: A measure of subjective distress. Psychosomatic Medicine, 41, 209–218.
Janoff-Bulman, R. (1989). Assumptive worlds and the stress of traumatic events: Applications of the schema construct. Social Cognition, 7, 113–136.
Janoff-Bulman, R. (1992). Shattered Assumptions: Towards a new psychology of trauma. New York: Free Press.
Klein, K., & Boals, A. (2001). Expressive writing can increase working memory capacity. Journal of Experimental Psychology: General, 130, 520–533.
King, L. A. (2001). The health benefits of writing about life goals. Personality and Social Psychology Bulletin, 27, 798–807.
Lazarus, R. S. (1999). The cognition-emotion debate:Abit of history. In T. Dalgleish & M. J. Power (Eds.), Handbook of cognition and emotion (pp. 3–19). Chichester, England: Wiley.
Lepore, S. J., & Greenberg, M. (in press). Mending broken hearts: Effects of expressive writing on mood, cognitive processing, social adjustment, and health following a relationship breakup. Psychology and Health.
Lepore, S. J., & Helgeson, V. S. (1998). Social constraints, intrusive thoughts, and mental health after prostate cancer. Journal of Social & Clinical Psychology, 17, 89–106.
Lepore, S. J., Ragan, J.D., & Jones, S. (2000). Talking facilitates cognitive-emotional processes of adaptation to an acute stressor. Journal of Personality & Social Psychology, 78, 499–508.
Lutgendorf, S. K., & Antoni, M. H. (1999). Emotional and cognitive processing in a trauma disclosure paradigm. Cognitive Therapy and Research, 23, 423–440.
McCann, I. L., Sakheim, D. K., & Abrahamson, D. J. (1988). Trauma and victimization: A model of psychological adaptation. Counseling Psychologist, 16, 531–594.
McIntosh,D.N., Silver, R., & Wortman, C. B. (1993). Religion's role in adjustment to a negative life event: Coping with the loss of a child. Journal of Personality and Social Psychology, 65, 812–821.
Murray, E., Lamnin, A., & Carver, C. S. (1989). Emotional expression in written essays and psychotherapy. Journal of Social and Clinical Psychology, 8, 414–419.
Murray, E., & Segal, D. (1994). Emotional processing in vocal and written expression of feelings about traumatic experiences. Journal of Traumatic Stress, 7, 391–405.
Pargament, K. I. (1997). The psychology of religion and coping. New York: Guilford.
Park, C. L., Cohen, L. H., & Murch, R. (1996). Assessment and prediction of stress related growth. Journal of Personality, 64, 71–105.
Park, C. L., & Folkman, S. (1997). Meaning in the context of stress and coping. General Review of Psychology, 1, 115–144.
Peacock, E., & Wong, P. (1990). The stress appraisal measure (SAM): A multidimensional approach to cognitive appraisal. Stress Medicine, 6, 227–236.
Pearlin, L. I., & Schooler, C. (1978). The structure of coping. Journal of Health and Social Behavior, 19, 2–21.
Pennebaker, J. W. (1993). Putting stress into words: Health, linguistics, and therapeutic implications. Behavior Research and Therapy, 31, 539–548.
Pennebaker, J. W. (1997). Writing about emotional experiences as a therapeutic process. Psychological Science, 8, 162–166.
Pennebaker, J. W., Colder, M., & Sharp, L. K. (1990). Accelerating the coping process. Journal of Personality and Social Psychology, 58, 528–537.
Pennebaker, J. W., & Francis, M. E. (1996). Cognitive, emotional, and language processes in disclosure. Cognition & Emotion, 10, 601–626
Pennebaker, J.W., Kiecolt-Glaser, J. K., & Glaser, R. (1988). Disclosure of traumas and immune function: Health implications for psychotherapy. Journal of Consulting and Clinical Psychology, 56, 239–245.
Pennebaker, J. W., Mayne, T. J., & Francis, M. E. (1997). Linguistic predictors of adaptive bereavement. Journal of Personality & Social Psychology, 72, 863–871.
Sansone, R. A., Sansone L. A., & Wiederman, M. W. (1997). Increased health care utilization as a function of participation in trauma research. American Journal of Psychiatry, 154, 1025–1027.
Schwartzberg, S. S., & Janoff-Bulman, R. (1991). Grief and the search for meaning: Exploring the assumptive worlds of bereaved college students. Journal of Social and Clinical Psychology, 10, 270–288.
Scheier, M. F., Carver, C. S., & Bridges, M. W. (1994). Distinguishing optimism from neuroticism (and trait anxiety, self-mastery, and self-esteem): A reevaluation of the Life Orientation Test. Journal of Personality and Social Psychology, 67, 1063–1078.
Segal, D., & Murray, E. J. (1994). Emotional processing in cognitive therapy and vocal expression of feeling. Journal of Social & Clinical Psychology, 3, 189–206.
Smyth, J. M. (1998). Written emotional expression: Effect sizes, outcome types, and moderating variables. Journal of Consulting and Clinical Psychology, 66, 174–184.
Tennen, H., & Affleck, G. (1998). Personality and transformation in the face of adversity. In R. G. Tedeschi, C. L. Park, & L. G. Calhoun (Eds.), Posttraumatic growth: Positive changes in the aftermath of crisis (pp. 65–98). Mahwah, NJ: Erlbaum.
Vitaliano, P. P., Maiuro, R.D., Mitchell, E., & Russo, J. (1989). Perceived stress in medical school: Persistors, adaptors, and maladaptors. Social Science and Medicine, 28, 1321–1329.
Ware, J. E. (1993). SF-36 Health Survey Manual and Interpretation Guide. Boston: The Health Institute, New England Medical Center.
Zilberg, N. J., Weiss, D. S., & Horowitz, M. J. (1982). Impact of Event Scale: A cross-validation study and some empirical evidence supporting a conceptual model of stress response syndromes. Journal of Consulting and Clinical Psychology, 50, 407–414.
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Park, C.L., Blumberg, C.J. Disclosing Trauma Through Writing: Testing the Meaning-Making Hypothesis. Cognitive Therapy and Research 26, 597–616 (2002). https://doi.org/10.1023/A:1020353109229
- cognitive processing
- emotional processing