Abstract
Used linguistic analysis of written narratives of caregivers of hospitalized youth with chronic illness to identify emotional and cognitive processes related to physical and psychological health outcomes following writing. Measures were administered at baseline and 4 months. Experimental group (n = 29) wrote about traumas whereas the control group (n = 24) wrote about summer activities for 20 min on three different days. Compared groups on negative emotion- and cognition-related word use. Tested change in negative emotion- and cognition-related word use as predictors of outcomes in experimental group. Consistent with hypotheses, experimental group used more negative emotion words [F(1, 53) = 77.55, p < .001] and cognition-related words than control group [F(1, 53) = 19.09, p < .001] and an increase in cognition words predicted Physical Health Summary Score on SF-36 (standardized β = .37, p < .05). A decrease in negative emotion words was related to Physical Health Summary Score on SF-36 only when entered into regression with change in cognition words (standardized β = −.31, p < .05). A decrease in negative emotion together with an increase in cognitive processing facilitated by written emotional disclosure has beneficial effects on physical health-related quality of life.
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REFERENCES
Barakat, L. P., Kazak, A. E., Meadows, A. T., Casey, R., Meeske, K., & Stuber, M. L. (1997). Families surviving childhood cancer: A comparison of posttraumatic stress symptoms with families of healthy children. Journal of Pediatric Psychology, 22, 843–859.
Berry, D. S., & Pennebaker, J. W. (1998). Nonverbal and verbal emo-tional expression and health. In G. A. Fava & H. Freyberger (Eds.), Handbook of psychosomatic medicine (pp. 69–83). Madison, CT: International Universities Press.
Booth, R. J., Petrie, K. J., & Pennebaker, J. W. (1997). Changes in cir-culating lymphocyte numbers following emotional disclosure: Evidence of buffering? Stress Medicine, 13, 23–29.
Cameron, L. D., & Nicholls, G. (1998). Expression of stress-ful experiences through writing: Effects on a self-regulation manipulation for pessimists and optimists. Health Psychology, 17, 84–92.
Esterling, B. A., L'Abate, L., Murray, E. J., & Pennebaker, J. W. (1999). Empirical foundations for writing in prevention and psychotherapy: Mental health and physical health outcomes. Clinical Psychology Review, 19, 79–96.
Foa, E. B. (1997). Psychological processes related to recovery from a trauma and an effective treatment for PTSD. Annals of the New York Academy of Sciences, 821, 410–424.
Francis, M. E., & Pennebaker, J. W. (1992). Putting stress into words: Writing about personal upheavals and health. American Jour-nal of Health Promotion, 6, 280–287.
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 So-cial Psychology, 63, 75–84.
Greenberg, M. A., Wortman, C. B., & Stone, A. A. (1996). Emo-tional expression and physical health: Revising traumatic memories or fostering self-regulation. Journal of Personality and Social Psychology, 71, 588–602.
King, L. A. (2001). The health benefits of writing about life goals. Personality and Social Psychology Bulletin, 27, 798–807.
King, L. A. (2002). Gain without pain? Expressive writing and self-regulation. In S. J. Lepore & J. M. Smyth (Eds.), The writing cure (pp. 119–134). Washington, DC: APA Press.
King, L. A., & Miner, K. N. (2000). Writing about the per-ceived benefits of traumatic events: Implications for physical health. Personality and Social Psychology Bulletin, 26, 220–230.
Klein, L. (2002). Stress, expressive writing, and working memory. In S. J. Lepore & J. M. Smyth (Eds.), The writing cure (pp. 135–155). Washington, DC: APA Press.
Lepore, S. J., Greenberg, M. A., Bruno, M., & Smyth, J. M. (2002). Expressive writing and health: Self-regulation of emotion-related experience, physiology, and behavior. In S. J. Lepore & J. M. Smyth (Eds.), The writing cure (pp. 99–117). Washington, DC: APA Press.
Lutgendorf, S. K., & Antoni, M. H. (1999). Emotional and cognitive processing in a trauma disclosure paradigm. Cognitive Therapy and Research, 23, 423–440.
McNair, D. H., Lorr, M., & Droppelman, L. F. (1992). Manual for Profile of Mood States, Revised 1992. San Diego, CA: Edits Education and Industrial Testing Service.
Park, C. L., & Blumberg, C. J. (2002). Disclosing trauma through writing: Testing the meaning-making hypothesis. Cognitive Therapy and Research, 26, 597–616.
Pennebaker, J. W. (1982). The psychology of physical symptoms. New York: Springer-Verlag.
Pennebaker, J. W. (1993). Putting stress into words: Health, lin-guistic, and therapeutic implications. Behaviour Research and Therapy, 31, 539–548.
Pennebaker, J. W. (1997). Opening up: The healing power of ex-pressing emotions. New York: Guilford Press.
Pennebaker, J. W., & Beal, S. K. (1986). Confronting a traumatic event: Toward an understanding of inhibition and disease. Journal of Abnormal Psychology, 95, 274–281.
Pennebaker, J. W., Colder, M., & Sharp, L. K. (1990). Accelerating the coping process. Journal of Personality and Social Psychol-ogy, 58, 528–537.
Pennebaker, J. W., & Francis, M. E. (1996). Cognitive, emotional, and language processes in disclosure. Cognition and Emotion, 10, 601–626.
Pennebaker, J. W., Francis, M. E., & Booth, R. J. (2001). Linguistic Inquiry and Word Count (LIWC): LIWC 2001. Mahwah, NJ: Erlbaum.
Pennebaker, J. W., Kielcolt-Glaser, J. K., & Glaser, R. (1988). Dis-closure of traumas and immune function: Health implications for psychotherapy. Journal of Consulting and Clinical Psychol-ogy, 56, 239–245.
Pennebaker, J. W., & King, L. A. (1999). Linguistic Styles: Lan-guage use as an individual difference. Journal of Personality and Social Psychology, 77, 1296–1312.
Pennebaker, J. W., Mayne, T. J., & Francis, M. E. (1997). Linguistic predictors of adaptive bereavement. Journal of Personality and Social Psychology, 72, 863–871.
Pennebaker, J. W., Mehl, M. R., & Niederhoffer, K. G. (2003). Psy-chological aspects of natural language use: Our words, our selves. Annual Review of Psychology, 54, 547–577.
Petrie, K., Booth, R., Pennebaker, J. W., Davison, K. P., & Thomas, M. (1995). Disclosure of trauma and immune re-sponse to hepatitis B vaccination program. Journal of Con-sulting and Clinical Psychology, 63, 787–792.
Schoutrop, M. J. A., Lange, A., Hanewald, G., Davidovich, U., Salomon, H. (2002). Structured writing and processing major stressful events: Acontrolled trial. Psychotherapy and Psycho-somatics, 71, 151–157.
Schwartz, L., & Drotar, D. (2004). Effects of written emotional dis-closure on caregivers of children and adolescents with chronic illness. Journal of Pediatric Psychology, 29, 105–118.
Smyth, J. M. (1998). Written emotional disclosure. Effects on symp-toms, mood, and disease status in patients with asthma or rheumatoid arthritis. Dissertation Abstracts International: Sec-tion B: The Sciences & Engineering, 59, 4543.
Smyth, J. M., Stone, A. A., Hurewitz, A., & Kaell, A. (1999). Ef-fects of writing about stressful experiences in symptom reduc-tion in patients with asthma or rheumatoid arthritis: A ran-domized trial. Journal of the American Medical Association, 281, 1304–1309.
Ullrich, P. M., & Lutgendorf, S. K. (2002). Journaling about stressful events: Effects of cognitive processing and emotional expres-sion. Annals of Behavioral Medicine, 24, 244–250.
Ware, J. E. (1993) SF-36 Health Survey: Manual and interpretation guide. Boston: The Health Institute, New England Medical Center.
Watson, D., Clark, L. A., Weber, K., Assenheimer, J. S., Strauss, M. E., & McCormick, R. A. (1995). Testing a tripar-tite model: II. Exploring the symptom structure of anxiety and depression in student, adult, and patient samples. Journal of Abnormal Psychology, 104, 15–25.
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Schwartz, L., Drotar, D. Linguistic Analysis of Written Narratives of Caregivers of Children and Adolescents with Chronic Illness: Cognitive and Emotional Processes and Physical and Psychological Health Outcomes. Journal of Clinical Psychology in Medical Settings 11, 291–301 (2004). https://doi.org/10.1023/B:JOCS.0000045349.10034.62
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DOI: https://doi.org/10.1023/B:JOCS.0000045349.10034.62