Emotional Disclosure Research Articles

Expressive writing in school children: Effects on well-being and working memory

This study examines the benefits of an expressive writing intervention in 5th graders on well-being – anxiety and depression symptoms – and on working memory capacity. A classical paradigm of expressive writing was used in school children during their classroom time: half of the participants had to write about stressful and negative events of their own lives, whereas the other half had to write about a normal school day. Children were asked to write four times in two weeks, resulting in four days of writing. Each group completed questionnaires yielding measures of depression, anxiety, and working memory 3 times: before the intervention, just after the writing sessions and two months after following the intervention. The narratives were analyzed using Emotaix-Tropes software. The results revealed that all the children showed a decrease in depression and anxiety symptoms. By contrast, only children in the expressive writing group showed working memory improvement. The potential benefits of emotional disclosure in school children are discussed. While there are several possible explanations for these findings, the results of this study indicate, first, that expressive writing seems to be both feasible and potentially valuable for school children, and second, that some cognitive changes occur in terms of cognitive functioning.

Expressive writing intervention for posttraumatic stress disorder among Chinese American breast cancer survivors: the moderating role of social constraints.

Posttraumatic stress disorder (PTSD) is a significant condition among breast cancer survivors (BCSs). However, few intervention studies for cancer-related PTSD were conducted among Asian cancer survivors. We evaluated a culturally sensitive expressive writing intervention, which combined cognitive reappraisal and emotional disclosure, in reducing PTSD among Chinese American BCSs. We also tested social constraints (defined as social conditions when individuals feel misunderstood or alienated when they desire to disclose their thoughts and feelings) as a moderator. Chinese American BCSs (n = 136) were randomly assigned to three groups with assigned writing topics for 3weeks: a self-regulation group, which wrote about the deepest feelings related to cancer in week 1, cognitive reappraisal about stress and coping in week 2, and benefit finding in week 3; an enhanced self-regulation group, with the same instructions, except weeks 1 and 2 were reversed; and a cancer-fact group, which wrote about cancer experiences objectively for 3weeks. PTSD symptoms were measured at baseline and 1-, 3-, and 6-month follow-ups. Social constraints were measured at baseline. Both the self-regulation and enhanced self-regulation groups showed reduced PTSD symptoms compared to the cancer-fact group. For reexperiencing and hyperarousal symptoms, expressive writing was more effective for BCSs who experienced high vs. low levels of social constraints; the opposite was found for avoidance symptoms. Findings demonstrated the effectiveness of expressive writing intervention in reducing PTSD for this minority population, and that the moderating role of survivors' social network varies among different PTSD symptom clusters. ClinicalTrials.gov Identifier: NCT02946619.

Is the content of patient’s written emotional disclosure associated with improved health outcomes for asthma patients?

Written emotional disclosure (WED) is a self-directed, writing intervention. Treatment effects post-WED vary between studies, prompting research into which variables promote the largest improvements. Thus far, research has focused on the frequency of certain linguistic properties of the writing, and subjective stress-related ratings. This study tests the feasibility of using an objective coding framework for stress typology to categorise WED extracts and explores whether any characteristics of the stress described were associated with intervention outcomes. WED extracts from a randomised controlled trial of patients with asthma were coded using an objective stress typology framework. The contents of the WED extracts were reviewed to ascertain whether the experience met the DSM-5 definition for trauma, involved abuse, and was experienced directly or vicariously. Also analysed were the degree of upheaval and upset associated with the event described, together with the time of the event, and number of events written about. Correlational analyses indicated that improvements in asthma-related outcomes were associated with writing about experiences that occurred in childhood, constituted abuse, or caused greater upheaval (all ps <. 05). We found some evidence that the treatment effects of WED may be dependent on what types of stressful experiences participants write about. The use of our objective stress coding scheme was only partially successful as it could not be applied consistently to all WED extracts. Findings require replication using a prospective experimental design.

Improving photoprotection in adults with xeroderma pigmentosum: personalisation and tailoring in the ‘XPAND’ intervention

ABSTRACT Background Individualised behaviour change interventions can result in greater effects than one-size-fits-all approaches. Factors linked to success include dynamic (vs. static) tailoring, and tailoring on behaviour, multiple theoretical variables, and participant characteristics. XP is a very rare (∼100 UK patients) genetic disease, involving an inability to repair ultraviolet radiation (UVR)-induced damage, resulting in skin cancers and eye damage from an early age, and mean life expectancy of 32-years. Management involves rigorous UVR photoprotection, which is often inadequate, and no interventions have been published. UK-based care is personalised and delivered by a multidisciplinary team at the National XP Service in London. Following an intensive, mixed-methods formative phase with patients diagnosed with XP (n-of-1, qualitative interviews, objective UVR measurement, cross-sectional survey) and relevant stakeholder consultation (clinical and patient/public teams), the ‘XPAND’ intervention was developed. This paper describes the comprehensive and novel tailoring and personalisation processes used to deliver the intervention. Methods XPAND consists of core and personalised modules targeting cue-based (time of day, weather, symptoms), belief-based (motivation, priority), self-regulatory (effort, barriers, planning), and emotional (stress, self-consciousness, mental exhaustion) factors, social support, disclosure, habit, and willingness, using appropriately-matched BCTs. A-priori, phase I data and a baseline profiling questionnaire (data sources) were used to allocate modules to participants (‘personalisation’) and to adapt module content (‘tailoring’). Iterative decisions about delivery were based on patient response to feedback, identification of additional barriers (e.g. reasons for varying protection across contexts), and emergence of new barriers as improvements in protection were attempted or achieved (e.g. appearance concerns). Conclusions Dynamic multi-level personalisation and tailoring based on mixed-methods in XPAND allowed for insights and decision-making not possible with cross-sectional quantitative or qualitative methods alone. Data collection and allocation/adaptation methods may be of use in other rare conditions where small patient numbers mean that within-participant, individual-level delivery is well-suited and feasible.

Fear and Hope, Bitter and Sweet: Emotion Sharing of Cancer Community on Twitter

Emotions are non-negligible parts of the experience among the cancer-affected population to be reckoned with. With the increasing usage of social media platforms as venues for emotional disclosure, we ask the question, what and how are the emotions of the cancer community being shared there? Using a deep learning model and social network analysis, we investigated emotions expressed in a large collection of cancer-related tweets. The results showed that joy was the most commonly shared emotion, followed by sadness and fear, with anger, hope, and bittersweet being less shared. In addition, both the gatekeepers and influencers were more likely to post content with positive emotions, while gatekeepers refrained themselves from posting negative emotions to a greater extent. Last, cancer-related tweets with joy, sadness, and hope received more likes, whereas tweets with joy and anger were more retweeted. The implications of the findings are discussed in the context of social media health communities.

The benefits of expressive writing among newly diagnosed mainland Chinese breast cancer patients.

The study aimed to evaluate the effects of an expressive writing intervention on quality of life (QoL) among mainland Chinese breast cancer patients. A total of 118 Chinese breast cancer patients were randomly assigned to one of four groups: a cancer-facts writing condition (CTL group), an emotional disclosure writing condition (EMO group), a self-regulation writing condition (SR group), or a neutral control condition with no writing tasks (CON group). QoL was assessed by FACT-B at baseline, 3-, and 6-month follow-ups. A repeated measure analysis of variance revealed significant effects of time (F = 13.9, P < 0.001, η2 = 0.20) and the time × group interaction (F = 3.5, P < 0.01, η2 = 0.08) on QoL. Residualized change models showed that the CTL, EMO and SR groups reported higher levels of QoL than the CON group at the 6-month follow-up. The EMO group had a higher level of QoL than the SR group. The CTL group had higher level of physical well-being compared to the SR group. Mainland Chinese breast cancer patients shortly after diagnosis benefit from expressive writing. They benefited more from cancer-facts and emotional disclosure compared to self-regulation. The study indicated that the impact of expressive writing may differ due to stage of cancer survivorship, social, and cultural context.

Dispositifs thérapeutiques par l’écriture à l’adolescence : une revue systématique de la littérature

ObjectivesThis systematic literature review aims to define the state of the art regarding the use of writing in therapeutic settings with adolescents. We wish to highlight the effects of therapeutic interventions involving writing. We study the different modalities of interventions based on writing, and how they are mobilized by healthcare or counselling professionals. Our study focuses on the plurality of disciplinary fields using therapeutic writing with adolescents. MethodWe used the PRISMA methodology to select the relevant studies with respect to our subject. We carried out a search by keywords on the following databases: “PsycInfo and Psycarticle”, “Web of Science” and “Science Direct”. 70 references were selected for this review. ResultsOur research emphasizes that writing is often mobilized in therapeutic contexts related to psychic and somatic care to encourage adolescents’ engagement in a therapeutic process. In addition, professionals also apply this method to help reduce anxiety, and to promote emotional disclosure, decentering, and distance from one's personal history. DiscussionThe therapeutic effects of writing have been mainly studied in cognitive-behavioral and, to a lesser degree, psychodynamic perspectives. Although the explanatory models are different, the studies produced in these two paradigms show the positive effects of writing practices on adolescents. ConclusionHowever, the literature on the subject is primarily single case studies, which offer little reproducibility. In addition, there is more research on therapeutic writing practices produced in the cognitive-behavioral field than in the psychodynamic field. More research is thus needed to support the effectiveness of these devices, particularly in a psychoanalytical framework.

Emotional Communication in Advanced Pediatric Cancer Conversations

ContextCancer is a life-changing diagnosis accompanied by significant emotional distress, especially for children with advanced disease. However, the content and processes of discussing emotion in advanced pediatric cancer remain unknown. ObjectivesTo describe the initiation, response, and content of emotional communication in advanced pediatric cancer. MethodsWe audiorecorded 35 outpatient consultations between oncologists and families of children whose cancer recently progressed. We coded conversations based on Verona Coding Definitions of Emotional Sequences. ResultsAbout 91% of conversations contained emotional cues, and 40% contained explicit emotional concerns. Parents and clinicians equally initiated cues (parents: 48%, 183 of 385; clinicians: 49%) and concerns (parents: 51%; clinicians: 49%). Children initiated 3% of cues and no explicit concerns. Emotional content was most commonly related to physical aspects of cancer and/or treatment (28% of cues and/or concerns, present in 80% of conversations) and prognosis (27% of cues and/or concerns, present in 60% of conversations). Clinicians mostly responded to emotional cues and concerns implicitly, without specifically naming the emotion (85%). Back channeling (using minimal prompts or words that encourage further disclosure, e.g., uh-huh) was the most common implicit response that provided space for emotional disclosure (32% of all responses). Information advice was the most common implicit response that reduced space for further emotional disclosure (28%). ConclusionEmotional communication in advanced pediatric cancer appears to be a subtle process where parents offer hints and clinicians respond with non-emotion-laden statements. Also, children were seldom engaged in emotional conversations. Clinicians should aim to create an environment that allows families to express emotional distress if and/or when ready.

QOLP-33. ACCEPTABILITY RANDOMIZED CONTROLLED TRIAL A COUPLES-BASED MIND-BODY INTERVENTION FOR PATIENTS WITH HIGH GRADE GLIOMA AND THEIR PARTNERS

Abstract BACKGROUND Given the incurable nature, short survival and high symptom burden of high grade glioma (HGG), patients and their partners are at risk of experiencing psychological and existential/spiritual distress. To address these concerns, we developed a dyadic intervention integrating meditation training with emotional disclosure exercises. The primary aim was to examine feasibility and acceptability of the intervention study procedures. METHODS Dyads completed baseline self-report measures and were randomized to a couple-based mind-body (CBMB) or a waitlist control (WLC) group. Couples in the CBMB groups attended 4 weekly (60 min each) therapist-led sessions that were delivered via FaceTime. The CBMB program focused on cultivating mindfulness, compassion, gratitude and purpose. All groups were reassessed, 1 month and 3 months after baseline. RESULTS We approached 60 eligible patient-partner dyads of which 37 (62%) consented and 18 were randomized to the CBMB and 16 to the WLC group. Of those randomized, 23 dyads (67%) completed all assessments (n= 12 in CBMB; n=11 in WLC). Attrition was due to patients’ death (n=3), symptom burden (n=5) or passive withdrawal (n=3). Patients (57% male; mean age=57 years) and partners’ (59% female; mean age=54 years) attended a mean of 3.17 sessions (SD=1.2) with 83% attending at least 2 sessions. All dyads in the CBMB group reported the intervention as beneficial and useful and would recommend this program to other couples. Of note, 60% of couples would have preferred in-person delivery and 95% of patients but only 33% of partners stated that a dyadic intervention is their preference. CONCLUSION It seems to be feasible, acceptable and possibly efficacious to deliver a dyadic intervention via FaceTime to couples coping with HGG. Although both members of the dyad reported to have benefited, dyadic delivery appears to be less desirable for partners.

Results of a pilot randomized controlled trial: A couple-based meditation intervention for patients with metastatic lung cancer and their partners.

135 Background: Although mindfulness-based interventions have been widely examined in patients with early stage cancer, the feasibility and efficacy of these types of programs are largely unknown in the palliative care setting. We developed a couple-based intervention integrating meditation training with emotional disclosure exercises to target psychological distress in patients with metastatic lung cancer and their partners. Methods: Dyads completed baseline self-report measures and were then randomized to a couple-based meditation (CBM), a supportive-expressive (SE), or a waitlist control (WLC) group. Couples in the CBM and ES groups attended 4 weekly, 60 min. therapist-led sessions that were delivered via FaceTime. All groups were reassessed 1 month and 3 months later. Results: Seventy-five patients (51% female; mean age = 64 years) and their partners’ (52% female; mean age = 64 years) were randomized (63% consent rate) of which 79% completed the first and 65% completed the second follow-up assessments. Attrition was mainly due to patients’ death (44%). Although attendance was high in both groups (means: CBM = 3.12; SE = 3.08), dyads in the CBM group indicated greater benefit (P &lt; .003) and usefulness (P &lt; .05) of the sessions compared to those in the SE group. Compared with the WLC group, patients in the CBM group reported significantly lower depressive symptoms (P = .02; d = .49; CES-D means: CBM = 7.87; SE = 11.51; WLC = 12.76) and cancer specific distress (P = .05; d = .44; IES means: CBM = 12.40; SE = 16.34; WLC = 18.22). Similarly, compared with the WLC group, partners in the CBM group reported significantly lower depressive symptoms (P = .02; d = .58; means: CBM = 7.18; AC = 8.91; WLC = 11.62). For both patients and partners, there were no effects between SE and WLC groups. While small effects (d = .22-.42) in favor of the CBM group relative to the SE group were revealed, these differences were not significant. Conclusions: It seems to be feasible, acceptable and possibly efficacious to deliver dyadic interventions via FaceTime to couples coping with metastatic lung cancer. Mindfulness-based interventions may be of value to manage symptom burden in the palliative care setting. Clinical trial information: NCT02596490.

Connections to neighborhood storytellers and community-oriented emotional disclosure on Twitter during an emergency event

From a communication infrastructure theory perspective, this study examined local residents’ connections to neighborhood storytellers and its association with community-oriented emotional disclosure, a specific form of neighborhood storytelling, during an emergency event. A sample of 1676 local residents and their Twitter activities were obtained from Twitter’s streaming application programming interface (API) during a 2-hour window after the event. A connection was established when the focal user retweeted, commented on, or replied to another user. The results show that scope of connections to residents, community organizations, and mainstream media positively predicted community-oriented disclosure of negative emotions. Scope of connections to residents positively predicted community-oriented disclosure of positive emotions. Scope of connections to local media did not predict community-oriented emotional disclosure.

Secrecy, adaptation, and liminality in early-onset bipolar disorder: reflections from a sample of emerging adults

ABSTRACTEarly-onset bipolar disorder (EOBD) diagnoses have increased, yet much remains to be understood about its impact on developmental considerations that influence the course of illness and treatment. This qualitative study utilized semi-structured interviews to explore the experience of stigma, self-stigma, and identity associated with EOBD during adolescence. Participants described experiencing changes in identity and stigma and self-stigma across seven sub-themes: adaptation and integration, emotional adjustment, secrecy and selective disclosure of illness, change in identity and sense of self, labeling, self-labeling, and challenging and rejecting labeling. Implications of findings for social work practice and directions for future research are discussed.

Integration and differentiation of self through reminiscing and narrative

AbstractHumans construct coherence and meaning in their lives through reminiscing with and about others. The four articles in this Social Development Quartet focus on how reminiscing about emotionally and morally challenging personal experiences is a critical mechanism for integration and differentiation across development, both within the individual and within sociocultural interactions. Examining linguistic forms, emotional disclosure, expressions of perspective, and personal growth, these studies demonstrate that the ways in which we reminisce about our personal past with others matter for developmental outcome. Both the ways in which individuals differentiate between self and other, and between different types of events, and the ways in which individuals integrate perspectives across different types of events is related to emotional well‐being.

Emotional disclosure and cognitive processing in couples coping with head and neck cancer.

Head and neck cancer (HNC) patients and their spouses experience communication problems and high rates of emotional distress. Couple-based interventions that encourage emotional disclosure hold promise for improving cognitive processing and distress in this population, but more research needs to examine when and for whom emotional disclosure is an effective coping strategy. In this observational study, 125 HNC patients (83% male) and their spouses were videotaped discussing a cancer-related concern in the laboratory. Discussions were coded with the specific affect coding system. Actor-partner interdependence models showed that patient expression of negative emotions (i.e., disdain, contentiousness, distress) was not related to his/her own or the spouse's cognitive processing (assessed as reaction times to cancer and noncancer words on a computerized cognitive task administered immediately following the discussion). When spouses expressed support (e.g., interest, validation), they had better cancer- (effect size r = - 0.21) and noncancer-related cognitive processing (r = - 0.17), but patients did not. However, when spouses expressed disdain (e.g., contempt) and contentiousness (e.g., criticism, domineering), patients had poorer cancer- (r = 0.20-0.22) and noncancer-related cognitive processing (r = 0.19-0.26). Findings suggest consideration of the valence of affective expression and which partner is disclosing/listening before unilaterally encouraging HNC couples to openly express emotions as a means of alleviating distress.

Who cares for academics? We need to talk about emotional well-being including what we avoid and intellectualise through macro-discourses

This article explores academics’ well-being through analysing published sensitive disclosures, bringing to journal space the pain, rawness and emotional suffering of individuals’ experiences. We confront the taboos of speaking openly about mental health and emotional well-being in academic institutions, with masculine structures and encroaching neoliberal discourses that create hostile atmospheres unsupportive of vulnerability and uncertainty. We also challenge existing discourses about academics’ well-being, implicitly burdening individuals as responsible for their pain and creating walls of shame, rather than building new healthy structures. By spotlighting the voices of academics’ emotional disclosures, intensified by embodied social inequalities, we plead for openness in formal academic outlets for sharing pre-existing emotional struggles and new wounds created by cruelly competitive, winner-takes-all structures, fortified by neoliberal ideals. Led by individuals’ voices and experiences, we make recommendations for supporting academics as an attempt to extract academia from its current perverse state and commit to repair and transformation.

Emotional disclosure as a therapeutic intervention in palliative care: a scoping review protocol

IntroductionEmotional disclosure (ED) is a term used to describe the therapeutic expression of emotion. ED underlies a variety of therapies aimed at improving well-being for various populations, including people with...

Timing of adolescent emotional disclosures: The role of maternal emotions and adolescent age.

Adolescent disclosure is a positive feature of parent-adolescent relationships, though disclosure to parents typically declines across adolescence. However, little is known about parental emotions that facilitate or inhibit real-time adolescent disclosures about their emotions and how parents respond to such disclosures during parent-adolescent interactions. The present study tested (1) whether maternal emotions were associated with the time to adolescents' spontaneous emotional disclosures and (2) whether these associations varied as a function of adolescent age. Adolescents (N = 49, Mage = 14.84 years) and their mothers participated in a 10-min conflict discussion. Adolescent emotional disclosures and maternal emotions were coded moment-to-moment. Results from survival analysis demonstrated that older adolescents whose mothers expressed high levels of negative affect or high levels of validation were more likely to make emotional disclosures earlier in the discussion than were older adolescents whose mothers expressed low negative affect or low validation. There were no differences in associations between maternal emotions and the timing of emotional disclosures for younger adolescents. Findings suggest that a range of maternal emotions (validation and negative affect) might be features of high-quality mother-adolescent relationships in older adolescence, when parent-adolescent relationships are more egalitarian and negative emotions may be more readily expressed. Implications for applying observational methodologies and dynamic statistical techniques to the adolescent disclosure literature are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Gender Stereotypes and Emotional Self-Disclosure: Predictors of different Emotions in Young Adults

This study investigated the relationship between gender stereotypes and emotional self-disclosurein young adults. It was intended to determine the predictors of different emotions. A self-constructed Demographic Questionnaire; Gender Typicality Measure(Patterson,2012) and Emotional Self Disclosure Scale (Snell,1990) were administered to measure gender stereotyping and the level of emotional self-disclosure,respectively. The sample comprised of 300 young adults;150 men and 150 women (Mage=21.16,SD=1.84) recruited from two different educational institutes of Lahore. Reliability analysis was run to determine the reliability of the scales used in the study.Pearson Product Moment Correlation Coefficient, Multiple hierarchical Regression, independent Samplet Test and Cohen’sd were computed. Results revealed a sign if i cant relationship between gender stereotyping and happiness. Gender, educationan gender stereotyping emerged assign if i cant predictors of happiness and fear. Women man if ested higher emotional disclosure of happiness and fear. The current findings have implications for educational psychologists and for professionals focusing on gender relatedfactors.

Horizons of vulnerability and the problem of human dignity: Ethical and phenomenological assessments

The paper suggests how a phenomenological account of vulnerability, in the context of moral emotions, may address the clarification of the problem of human dignity. In order to present this claim, the paper emphasizes the horizon dynamics involved in the emotional disclosure of the axiological sphere in Husserl’s phenomenology, in regard to some essential aspects of the experience of feeling vulnerable. Afterwards, it is suggested how such consciousness of being vulnerable is connected to the realization of basic values, particularly, the very intrinsic value of human life.

Emotional adjustment among parents of adolescents and young adults with cancer: the influence of social constraints on cognitive processing and fear of recurrence.

Parents of adolescents and young adults (AYAs) with cancer experience distress comparable to other caregiver populations, but remain understudied. This study tested the social cognitive processing model of emotional adjustment to cancer. We hypothesized that social constraints on emotional disclosure would inhibit cognitive processing and be related to greater fear of cancer recurrence (FCR), potentially negativelyinfluencing psychological adjustment. Data were collected through an online cross-sectional survey study of 66 parents of AYAs with cancer (aged 15-39) and analyzed using bootstrapping techniques for ordinary least squares regression. One-third of the parents reported moderate to severe depressive symptoms. Serial mediation analyses indicated that greater social constraints were related topoorer cognitive processing and higher FCR, and, ultimately, greater depressive symptoms. Alternative models were tested and were not significant. Future psychosocial interventions for parents of AYAs with cancer should include improving cancer-related communication between parents and their social network.