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Tao L, Lv J, Tan X, Hu X, Fu L, Li J. Relationships between Attachment Style, Emotional Self-Disclosure, and Quality of Life among Young Breast Cancer Survivors: A Cross-Sectional Study. Semin Oncol Nurs 2024; 40:151526. [PMID: 37977973 DOI: 10.1016/j.soncn.2023.151526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 07/26/2023] [Accepted: 10/05/2023] [Indexed: 11/19/2023]
Abstract
OBJECTIVES This investigation aims to explore relationships between adult attachment, emotional self-disclosure, and quality of life (QoL). DATA SOURCES The study sample completed the Chinese versions of the Experiences in Close Relationships Inventory, the Functional Assessment of Cancer Therapy-Breast Scale, and the Distress Disclosure Index between October 2021 and March 2022. The relationships between adult attachment, emotional self-disclosure, and QoL were investigated using a multiple mediation effects test and structural equation modeling. CONCLUSION Attachment anxiety and avoidance were risk factors for young Chinese breast cancer survivors' emotional self-disclosure and QoL. Emotional self-disclosure mediates the association between attachment anxiety or avoidance and QoL. Assessing and easing attachment anxiety and avoidance may improve the emotional self-disclosure and QoL of young breast cancer survivors. IMPLICATIONS FOR NURSING PRACTICE This study confirms that adult attachment plays an important role in young breast cancer patients' adaptation to the disease and that high adult anxiety and avoidance levels can significantly reduce emotional self-disclosure and QoL in young breast cancer survivors. Identifying attachment patterns can help caregivers better understand patients' responses, adaptation, and treatment adherence to cancer, thereby helping caregivers develop targeted and personalized cancer care practice programs or psychotherapy interventions to improve patients' physical and mental health outcomes.
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Affiliation(s)
- Lin Tao
- Cancer Day-care Unit, Division of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Jieying Lv
- Cancer Day-care Unit, Division of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Xueling Tan
- School of Basic Medical Sciences, Chengdu University, Chengdu, China
| | - Xiaoxia Hu
- Division of Breast Surgery, Department of General Surgery, West China Hospital, Sichuan University/Breast Center, Sichuan University, Chengdu, China
| | - Lan Fu
- Cancer Day-care Unit, Division of Medical Oncology, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China
| | - Junying Li
- Thoracic Oncology Ward, Cancer Center, West China Hospital, Sichuan University/West China School of Nursing, Sichuan University, Chengdu, China.
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McIntosh R, Hoogerwoerd H, Ahmad SS, Michel C, Dillon K, Kumar M, Ironson G. A 4-session written emotional disclosure intervention lowers 6-month sympathoadrenal urinary output in persons living with HIV. Psychoneuroendocrinology 2024; 159:106403. [PMID: 37839156 DOI: 10.1016/j.psyneuen.2023.106403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 08/22/2023] [Accepted: 09/21/2023] [Indexed: 10/17/2023]
Abstract
OBJECTIVE We previously reported that a brief guided written emotional disclosure (WED) intervention resulted in significant reductions in post-traumatic stress disorder (PTSD) symptomology in women, but not men, living with HIV. Levels of 24-hour urinary output of epinephrine (E) and norepinephrine (NE) are shown to be elevated in persons diagnosed with PTSD. The current study tested whether there was an effect for the 4-week WED intervention on 6-month change in urinary E and NE output amongst persons living with HIV. METHOD Fourteen women and 11 men living with HIV randomized to four 30-min expressive writing sessions of either trauma writing or daily events writing in the parent trial were included based upon collection of urine specimens at baseline, 1-, and 6-months after the intervention. Total volume (µg) and concentration (µg/ml) of urinary E and NE were derived from the specimens as study outcomes. RESULTS Four repeated measures analyses of covariance (ANCOVA) were performed to evaluate study outcomes using trauma- versus daily-writing as the between-subject factors and collection time point as the within-subject factor, controlling for age and sex. A group x time interaction was observed wherein the trauma writing treatment group showed a significantly greater decrease in total urinary output, F(2, 46) = 4.03, p = .03, and concentration, F(2, 46) = 4.74, p = .01 of epinepherine. Post-hoc analyses revealed the interaction effect for the total, F(2, 22) = 4.82, p = .03, and concentration, F(2, 22) = 7.57, p = .005, of urinary E output over 6-months was significant for women. Interactions were not observed in urinary NE output. CONCLUSIONS Significant reductions in the total output and concentration of urinary E were found up to 6-months following initiation of a 4-session guided written emotional disclosure intervention. Profiles of sympathoadrenal activity and response to expressive writing differ between men and women living with HIV. Futher research is need to characterize the putative pathways linking sympathoadrenal response to upstream neurobiological function and downstream inflammatory-immune status in women living with HIV and PTSD.
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Affiliation(s)
- Roger McIntosh
- Department of Psychology, Health Division, University of Miami, Miami, FL, USA; Brain Resilience Embodiment Affect and Translational Health (B.R.E.A.T.H.) Laboratory, University of Miami, Miami, FL, USA.
| | - Hannah Hoogerwoerd
- Department of Psychology, Health Division, University of Miami, Miami, FL, USA; Brain Resilience Embodiment Affect and Translational Health (B.R.E.A.T.H.) Laboratory, University of Miami, Miami, FL, USA
| | - Salman S Ahmad
- Department of Psychology, Health Division, University of Miami, Miami, FL, USA
| | - Cassandra Michel
- Brain Resilience Embodiment Affect and Translational Health (B.R.E.A.T.H.) Laboratory, University of Miami, Miami, FL, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
| | - Kaitlyn Dillon
- Department of Psychology, Health Division, University of Miami, Miami, FL, USA; Brain Resilience Embodiment Affect and Translational Health (B.R.E.A.T.H.) Laboratory, University of Miami, Miami, FL, USA
| | - Mahendra Kumar
- Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Gail Ironson
- Department of Psychology, Health Division, University of Miami, Miami, FL, USA
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Michel-Kröhler A, Wessa M, Berti S. Experimental induction of state rumination: A study evaluating the efficacy of goal-cueing task in different experimental settings. PLoS One 2023; 18:e0288450. [PMID: 37992013 PMCID: PMC10664951 DOI: 10.1371/journal.pone.0288450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 06/27/2023] [Indexed: 11/24/2023] Open
Abstract
Based on previous studies, the present four experiments (total N = 468) aimed at investigating the effectivity of rumination induction in different experimental settings. We were particularly interested in rumination in the context of individual goal achievement and tested whether an instruction that referred to unresolved goals had a direct observable effect on state rumination. For this purpose, participants were asked to identify, evaluate, and focus on a personally relevant goal that was previously unresolved and still bothered them. In Experiment 1a to 1c, we compared three different modifications of the unresolved condition with shortened instructions with the elaborated unresolved condition and an additional control condition that did not refer to goals. In general, the results were mixed, but basically confirmed the effectiveness of the method used. Finally, in Experiment 2, we compared the two most promising versions of the unresolved condition and, by adding a goal-related control condition, we examined which control condition was best suited to maximize effects related to state rumination in future research. Results of various mixed ANOVAs demonstrated that a shortened version (in terms of shortened audio instructions) of the unresolved condition could be used as well as the original unresolved condition to induce reliable state rumination. The significance of the effects obtained with this method for real-life applications as well as approaches for future research are discussed.
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Affiliation(s)
- Alena Michel-Kröhler
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University Mainz, Mainz, Germany
| | - Michèle Wessa
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University Mainz, Mainz, Germany
- Leibniz Institute for Resilience Research (LIR), Mainz, Germany
| | - Stefan Berti
- Department of Clinical Psychology and Neuropsychology, Institute for Psychology, Johannes Gutenberg-University Mainz, Mainz, Germany
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Bradley MM, Sambuco N, Lang PJ. Imagery, emotion, and bioinformational theory: From body to brain. Biol Psychol 2023; 183:108669. [PMID: 37648076 DOI: 10.1016/j.biopsycho.2023.108669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Revised: 08/18/2023] [Accepted: 08/26/2023] [Indexed: 09/01/2023]
Abstract
The bioinformational theory of emotional imagery is a model of the hypothetical mental representations activated when people imagine emotionally engaging events, and was initially proposed to guide research and practice in the use of imaginal exposure as a treatment for fear and anxiety (Lang, 1979). In this 50 year overview, we discuss the development of bioinformational theory and its impact on the study of psychophysiology and psychopathology, most importantly assessing its viability and predictions in light of more recent brain-based studies of neural functional activation. Bioinformational theory proposes that narrative imagery, typically cued by language scripts, activates an associative memory network in the brain that includes stimulus (e.g., agents, contexts), semantic (e.g., facts and beliefs) and, most critically for emotion, response information (e.g., autonomic and somatic) that represents relevant real-world coping actions and reactions. Psychophysiological studies in healthy and clinical samples reliably find measurable response output during aversive and appetitive narrative imagery. Neuroimaging studies confirm that emotional imagery is associated with significant activation in motor regions of the brain, as well as in regions implicated in episodic and semantic memory retrieval, supporting the bioinformational view that narrative imagery prompts mental simulation of events that critically includes the actions and reactions engaged in emotional contexts.
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Affiliation(s)
- Margaret M Bradley
- Center for the Study of Emotion and Attention, University of Florida, USA.
| | - Nicola Sambuco
- Center for the Study of Emotion and Attention, University of Florida, USA
| | - Peter J Lang
- Center for the Study of Emotion and Attention, University of Florida, USA
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Guo L. The delayed, durable effect of expressive writing on depression, anxiety and stress: A meta-analytic review of studies with long-term follow-ups. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2023; 62:272-297. [PMID: 36536513 DOI: 10.1111/bjc.12408] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/17/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022]
Abstract
BACKGROUND Expressive writing is a promising tool to heal the wounds with words. AIMS This meta-analysis evaluated the current state of efficacy of expressive writing on depression, anxiety and stress symptoms among healthy and subclinical samples. MATERIALS AND METHODS Thirty-one experimental studies (N = 4012) with randomized controlled trials and follow-up assessments were analysed. RESULTS Results showed that expressive writing had an overall small but significant effect (Hedges' g = -0.12, 95% CI [-0.21, -0.04]) on reducing symptoms of depression, anxiety and stress. Change score analyses suggested that the intervention effect emerged after a delay, as evidenced by assessments at follow-up periods. Moderator analyses indicated that the effect sizes varied as a function of one intervention feature: interval. Studies that implemented short intervals (1-3 days) between writing sessions yielded stronger effects (Gdiff = -0.18, p = .01) relative to studies that implemented medium intervals (4-7 days) or long intervals (>7 days). The effects of expressive writing remained consistent across other intervention features including focus, instruction, number of sessions, topic repetition and delivery mode. DISCUSSION Together, these findings provide evidence for the delayed, durable effect of expressive writing and underscore the importance of scheduling writing sessions at short intervals. CONCLUSION Implications for incorporating expressive writing into clinical practice and daily life are discussed.
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Affiliation(s)
- Lin Guo
- Languages, Literatures and Linguistics Department, Syracuse University, Syracuse, New York, USA
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Davis PA, Gustafsson H, Callow N, Woodman T. Written Emotional Disclosure Can Promote Athletes' Mental Health and Performance Readiness During the COVID-19 Pandemic. Front Psychol 2020; 11:599925. [PMID: 33329269 PMCID: PMC7728796 DOI: 10.3389/fpsyg.2020.599925] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 11/02/2020] [Indexed: 12/17/2022] Open
Abstract
The widespread effects of the coronavirus disease 2019 (COVID-19) pandemic have negatively impacted upon many athletes’ mental health and increased reports of depression as well as symptoms of anxiety. Disruptions to training and competition schedules can induce athletes’ emotional distress, while concomitant government-imposed restrictions (e.g., social isolation, quarantines) reduce the availability of athletes’ social and emotional support. Written Emotional Disclosure (WED) has been used extensively in a variety of settings with diverse populations as a means to promote emotional processing. The expressive writing protocol has been used to a limited extent in the context of sport and predominantly in support of athletes’ emotional processing during injury rehabilitation. We propose that WED offers an evidence-based treatment that can promote athletes’ mental health and support their return to competition. Research exploring the efficacy of the expressive writing protocol highlights a number of theoretical models underpinning the positive effects of WED; we outline how each of these potential mechanisms can address the multidimensional complexity of the challenging circumstances arising from the COVID-19 pandemic (e.g., loss of earnings, returning to training and competition). Considerations and strategies for using WED to support athletes during the COVID-19 pandemic are presented.
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Affiliation(s)
- Paul A Davis
- Department of Psychology, Umeå University, Umeå, Sweden
| | - Henrik Gustafsson
- Department of Health Sciences, Karlstad University, Karlstad, Sweden.,Norwegian School of Sport Sciences, Oslo, Norway
| | - Nichola Callow
- School of Sport, Health, and Exercise Sciences, Bangor University, Bangor, United Kingdom
| | - Tim Woodman
- School of Sport, Health, and Exercise Sciences, Bangor University, Bangor, United Kingdom
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Jacques T, Alves RA, Fadaei S, Barbosa F. Real-Time Psychophysiological and Writing Correlates of Expressive Writing. Exp Psychol 2020; 67:237-245. [PMID: 33111656 DOI: 10.1027/1618-3169/a000495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Concealing memories and emotions associated with a traumatic event seems to have negative effects on health. Re-enacting those events through writing is an opportunity to disclose such memories and emotions, and especially for emotion regulation. To study this, 57 university students were randomly assigned to one of two groups. They either completed an expressive writing or a neutral writing task. Real-time writing and psychophysiological data were recorded throughout the experiment to examine writing dynamics associated with emotion regulation and its psychophysiological correlates (electrodermal activity and electrocardiography measures). The results showed that the expressive group (EG) paused for longer than the control group (CG) denoting a positive and medium effect size ( η p 2 = .10 ) . Furthermore, during and after writing, the EG showed a higher low frequency/high frequency ratio than the CG, evidencing a positive and large effect size ( η p 2 = .22 ) . These real-time findings are interpreted as signs of emotion regulation happening during writing.
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Affiliation(s)
- Teresa Jacques
- Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - Rui A Alves
- Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - Setareh Fadaei
- Faculty of Psychology and Education Sciences, University of Porto, Portugal
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Portugal
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Vrana SR, Bono RS, Konig A, Scalzo GC. Assessing the coherence of narratives of traumatic events with latent semantic analysis. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2019; 11:521-524. [PMID: 30346207 PMCID: PMC6476707 DOI: 10.1037/tra0000415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Memories of traumatic events are thought to be less coherent than memories for nontraumatic events, and expressive writing about traumatic events may help create more organized, coherent memories. Investigations of traumatic memories have been hampered by limitations in conceptualizing and measuring memory organization and coherence. The objective of this investigation was to compare the coherence of written narratives of trauma and neutral memories and examine changes in coherence of trauma narratives as a function of repeated expressive writing about the trauma using an atheoretical, computational method for assessing the coherence of text. METHOD Participants (N = 246) wrote 3 times about either their daily activities (neutral condition) or the most traumatic event of their lives. Latent semantic analysis, a method of calculating meaning from text based on semantic association between words, was used to assess narrative coherence as the average semantic association between contiguous sentences. RESULTS Neutral narratives were more coherent than trauma narratives overall, but neutral narratives decreased whereas trauma narratives increased in coherence from the first to the final session. CONCLUSIONS These findings provide evidence that memories for trauma experiences are less coherent than neutral memories and suggest that writing helps to create a more coherent representation of a traumatic event, highlighting a potential mechanism for expressive writing's effects. Results demonstrate the utility of latent semantic analysis for examining coherence of memories of traumatic events. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Pavlacic JM, Buchanan EM, Maxwell NP, Hopke TG, Schulenberg SE. A Meta-Analysis of Expressive Writing on Posttraumatic Stress, Posttraumatic Growth, and Quality of Life. REVIEW OF GENERAL PSYCHOLOGY 2019. [DOI: 10.1177/1089268019831645] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Expressive writing is beneficial for promoting both positive psychological and physical health outcomes. Unfortunately, inhibiting emotions is related to impairments in psychological and physical health. James Pennebaker and others have used expressive writing as an experimental manipulation to gauge its efficacy in treating a wide variety of physical and psychological outcomes. While many studies have been conducted that examine the efficacy of expressive writing across such outcomes, a considerable amount of these studies tend to neglect necessary considerations, such as different levels of symptomatology, power, and meaningfulness of respective effect sizes. Six previous meta-analyses have been conducted that examine expressive writing’s effect on psychological outcomes. However, these studies focus on the experimental versus control group effect size. Thus, our meta-analysis sought to examine the efficacy of an expressive writing task on only the experimental conditions in studies measuring posttraumatic stress, posttraumatic growth, and quality of life using random effects models. Results indicated a small overall effect size for posttraumatic stress and negligible to small effect sizes for posttraumatic growth and quality of life. However, those studies requiring a diagnosis of posttraumatic stress disorder (PTSD) exhibited a medium to large effect size. Implications for future research design and interpretation of published research are discussed.
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Sheerin CM, Konig A, Eonta AM, Vrana SR. Effect of expressive and neutral writing on respiratory sinus arrhythmia response over time. J Behav Ther Exp Psychiatry 2018; 59:129-133. [PMID: 29408050 PMCID: PMC5866212 DOI: 10.1016/j.jbtep.2018.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 11/20/2017] [Accepted: 01/10/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Parasympathetic activity, as indexed by respiratory sinus arrhythmia (RSA), underlies key aspects of emotional and cognitive self-regulation. Examining time-varying RSA response during expressive writing about trauma may help inform theory about mechanisms of this intervention. The present study investigated changes in RSA during expressive writing. METHODS Participants (N = 246, Mage = 21.5 years, 72% female) were randomly assigned to expressive or neutral writing conditions and wrote for three 20-min sessions. RSA was measured continuously during the first and third writing session. RESULTS Linear mixed model analyses of RSA changes within and across sessions by writing groups found that neutral writers, but not expressive writers, exhibited change in RSA. The overall RSA changes during expressive and neutral writing are consistent with theory about the relationship between cognitive and emotional processing mechanisms and vagal activation. LIMITATIONS As the present study was not a clinical sample selected on trauma exposure, findings should be considered preliminary. Additionally, engagement of affective and cognitive processes was only hypothesized, as manipulation checks were not performed. CONCLUSIONS The present study illustrates the benefits of examining changes in RSA over time. Future work with clinical samples should include additional measures and tasks to better define these mechanisms and rule out alternative hypotheses.
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Affiliation(s)
- Christina M Sheerin
- Virginia Institute for Psychiatric and Behavioral Genetics, 800 E Leigh Street, Richmond, VA, USA; Virginia Commonwealth University, 821 West Franklin St., Richmond, VA, USA.
| | - Andrea Konig
- St. Mary’s of Bon Secours Virginia Health System; 5801 Bremo Rd. Richmond, VA
| | - Alison M. Eonta
- Virginia Commonwealth University; 821 West Franklin St., Richmond VA
| | - Scott R. Vrana
- Virginia Commonwealth University; 821 West Franklin St., Richmond VA
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Travagin G, Margola D, Revenson TA. How effective are expressive writing interventions for adolescents? A meta-analytic review. Clin Psychol Rev 2015; 36:42-55. [PMID: 25656314 DOI: 10.1016/j.cpr.2015.01.003] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 01/04/2015] [Accepted: 01/08/2015] [Indexed: 10/24/2022]
Abstract
This meta-analysis evaluated the effects of the expressive writing intervention (EW; Pennebaker & Beall, 1986) among adolescents. Twenty-one independent studies that assessed the efficacy of expressive writing on youth samples aged 10-18 ears were collected and analyzed. Results indicated an overall mean g-effect size that was positive in direction but relatively small (0.127), as well as significant g-effect sizes ranging from 0.107 to 0.246 for the outcome domains of Emotional Distress, Problem Behavior, Social Adjustment, and School Participation. Few significant effects were found within specific outcome domains for putative moderator variables that included characteristics of the participants, intervention instructions, or research design. Studies involving adolescents with high levels of emotional problems at baseline reported larger effects on school performance. Studies that implemented a higher dosage intervention (i.e., greater number and, to some extent, greater spacing of sessions) reported larger effects on somatic complaints. Overall, the findings suggest that expressive writing tends to produce small yet significant improvements on adolescents' well-being. The findings highlight the importance of modifying the traditional expressive writing protocol to enhance its efficacy and reduce potential detrimental effects. At this stage of research the evidence on expressive writing as a viable intervention for adolescents is promising but not decisive.
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Emotion processing deficits in alexithymia and response to a depth of processing intervention. Biol Psychol 2014; 103:212-22. [DOI: 10.1016/j.biopsycho.2014.09.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2013] [Revised: 09/17/2014] [Accepted: 09/19/2014] [Indexed: 11/20/2022]
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