A preliminary investigation into whether attentional bias influences mood outcomes following emotional disclosure.

BACKGROUND: There is considerable interest in factors which may influence the efficacy of emotional disclosure. To date, a range of demographic and psychological variables have been considered. However, consideration has not yet been given to cognitive factors known to influence emotional processing such as attentional bias (AB). PURPOSE: We present the results from an exploratory study examining the role of AB in influencing mood outcomes following emotional disclosure. METHOD: Individuals with negative and avoidant ABs (i.e., individuals vigilant for and individuals avoidant of negative emotional material, respectively) were identified by asking 105 individuals to complete a standardized AB task. Individuals in the bottom quartile of AB scores were categorized as having a negative AB and individuals in the top quartile were categorized as having an avoidant AB. These participants (n = 38) completed the emotional disclosure intervention and mood was assessed at 1, 4, and 8 weeks post-intervention. RESULTS: Negative AB individuals showed greater improvements in depression, anger, fatigue, and total mood disturbance. These results were unrelated to alexithymia. CONCLUSION: These results provide preliminary support for the proposal that AB may influence the effects of emotional disclosure on mood.

Word use in the poetry of suicidal and nonsuicidal poets.

OBJECTIVE: The purpose of this study was to determine whether distinctive features of language could be discerned in the poems of poets who committed suicide and to test two suicide models by use of a text-analysis program. METHOD: Approximately 300 poems from the early, middle, and late periods of nine suicidal poets and nine nonsuicidal poets were compared by use of the computer text analysis program, Linguistic Inquiry and Word Count (LIWC). Language use within the poems was analyzed within the context of two suicide models. RESULTS: In line with a model of social integration, writings of suicidal poets contained more words pertaining to the individual self and fewer words pertaining to the collective than did those of nonsuicidal poets. In addition, the direction of effects for words pertaining to communication was consistent with the social integration model of suicide. CONCLUSIONS: The study found support for a model that suggests that suicidal individuals are detached from others and are preoccupied with self. Furthermore, the findings suggest that linguistic predictors of suicide can be discerned through text analysis.

The Electronically Activated Recorder (EAR): a device for sampling naturalistic daily activities and conversations.

A recording device called the Electronically Activated Recorder (EAR) is described. The EAR taperecords for 30 sec once every 12 min for 2-4 days. It is lightweight and portable, and it can be worn comfortably by participants in their natural environment. The acoustic data samples provide a nonobtrusive record of the language used and settings entered by the participant. Preliminary psychometric findings suggest that the EAR data accurately reflect individuals' natural social, linguistic, and psychological lives. The data presented in this article were collected with a first-generation EAR system based on analog tape recording technology, but a second generation digital EAR is now available.

Stalking the perfect measure of implicit self-esteem: the blind men and the elephant revisited?

Recent interest in the implicit self-esteem construct has led to the creation and use of several new assessment tools whose psychometric properties have not been fully explored. In this article, the authors investigated the reliability and validity of seven implicit self-esteem measures. The different implicit measures did not correlate with each other, and they correlated only weakly with measures of explicit self-esteem. Only some of the implicit measures demonstrated good test-retest reliabilities, and overall, the implicit measures were limited in their ability to predict our criterion variables. Finally, there was some evidence that implicit self-esteem measures are sensitive to context. The implications of these findings for the future of implicit self-esteem research are discussed.

Effects of disclosure of traumatic events on illness behavior among psychiatric prison inmates.

To assess the health effects of writing about traumatic events in a clinical population, 98 psychiatric prison inmates were randomly assigned to 1 of 3 conditions in which they were asked to write about their deepest thoughts and feelings surrounding upsetting experiences (trauma writing condition), write about trivial topics (trivial writing control), or go about their daily routine without writing (no-writing control). Both writing groups wrote for 20 min per day for 3 consecutive days. Participants in the trauma condition reported experiencing more physical symptoms subsequent to the intervention relative to those in the other conditions. Despite this, controlling for prewriting infirmary visits, sex offenders in the trauma writing condition decreased their postwriting infirmary visits. These results are congruent with predictions based on stigmatization and inhibition.

Who talks? The social psychology of illness support groups.

More Americans try to change their health behaviors through self-help than through all other forms of professionally designed programs. Mutual support groups, involving little or no cost to participants, have a powerful effect on mental and physical health, yet little is known about patterns of support group participation in health care. What kinds of illness experiences prompt patients to seek each other's company? In an effort to observe social comparison processes with real-world relevance, support group participation was measured for 20 disease categories in 4 metropolitan areas (New York, Chicago, Los Angeles, and Dallas) and on 2 on-line forums. Support seeking was highest for diseases viewed as stigmatizing (e.g., AIDS, alcoholism, breast and prostate cancer) and was lowest for less embarrassing but equally devastating disorders, such as heart disease. The authors discuss implications for social comparison theory and its applications in health care.

Empirical foundations for writing in prevention and psychotherapy: mental and physical health outcomes.

The use of writing, alone or in conjunction with traditional psychotherapy, has increased substantially in recent years. The most widespread use of writing has been for single-shot ad hoc purposes or to log behavior. The purpose of this review is to summarize a decade of research demonstrating the efficacy of writing about past traumatic experiences on mental and physical health outcomes. It is widely acknowledged in our culture that putting upsetting experiences into words can be healthy. Research from several domains indicates that talking with friends, confiding to a therapist, praying, and even writing about one's thoughts and feelings can be physically and mentally beneficial. This review highlights advances in written disclosure that determine some therapeutic outcomes. In addition, we attempt to explore the mechanisms that predict improved psychological and physical health. Finally, limitations of previous studies are highlighted, and suggestions for future research and application are made.

The effects of traumatic disclosure on physical and mental health: the values of writing and talking about upsetting events.

Directly and indirectly, sudden life transitions can profoundly influence people's social, family, physical, and psychological lives. One traditional goal within psychology has been to understand and develop ways by which to reduce the adverse impact of individual and collective traumas. Four major issues surrounding coping with emotional upheavals are discussed in the current paper. The first concerns the natural sequence of coping that occurs in most disasters. The second focuses on the advantages of talking about upsetting experiences and, conversely, the dangers of not talking about emotional upheavals. The third section, which has been central to our lab's approach, deals with evidence that writing about upsetting experiences is beneficial to health and well-being. The final part of the paper discusses these findings within the context of Critical Incident Stress Management (CISM) debriefing strategies.

Forming a story: the health benefits of narrative.

Writing about important personal experiences in an emotional way for as little as 15 minutes over the course of three days brings about improvements in mental and physical health. This finding has been replicated across age, gender, culture, social class, and personality type. Using a text-analysis computer program, it was discovered that those who benefit maximally from writing tend to use a high number of positive-emotion words, a moderate amount of negative-emotion words, and increase their use of cognitive words over the days of writing. These findings suggest that the formation of a narrative is critical and is an indicator of good mental and physical health. Ongoing studies suggest that writing serves the function of organizing complex emotional experiences. Implications for these findings for psychotherapy are briefly discussed.

Linguistic styles: language use as an individual difference.

Can language use reflect personality style? Studies examined the reliability, factor structure, and validity of written language using a word-based, computerized text analysis program. Daily diaries from 15 substance abuse inpatients, daily writing assignments from 35 students, and journal abstracts from 40 social psychologists demonstrated good internal consistency for over 36 language dimensions. Analyses of the best 15 language dimensions from essays by 838 students yielded 4 factors that replicated across written samples from another 381 students. Finally, linguistic profiles from writing samples were compared with Thematic Apperception Test coding, self-reports, and behavioral measures from 79 students and with self-reports of a 5-factor measure and health markers from more than 1,200 students. Despite modest effect sizes, the data suggest that linguistic style is an independent and meaningful way of exploring personality.

The immunological effects of thought suppression.

Individuals often suppress emotional thoughts, particularly thoughts that arouse negative emotions, as a way of regulating mood and reducing distress. However, recent work has highlighted the complexities and unexpected cognitive and physiological effects of thought suppression. In a study designed to examine the short-term immunological effects of thought suppression, participants wrote about either emotional or nonemotional topics with or without thought suppression. Blood was drawn before and after each experimental session on 3 consecutive days. Results showed a significant increase in circulating total lymphocytes and CD4 (helper) T lymphocyte levels in the emotional writing groups. Thought suppression resulted in a significant decrease in CD3 T lymphocyte levels. The implications of the results for the role of the expression and suppression of emotion in health are discussed.

Linguistic predictors of adaptive bereavement.

The words people use in disclosing a trauma were hypothesized to predict improvements in mental and physical health in 2 studies. The first study reanalyzed data from 6 previous experiments in which language variables served as predictors of health. Results from 177 participants in previous writing studies showed that increased use of words associated with insightful and causal thinking was linked to improved physical but not mental health. Higher use of positive relative to negative emotion words was also associated with better health. An empirical measure that was derived from these data correlated with subsequent distress ratings. The second study tested these models on interview transcripts of 30 men who had lost their partners to AIDS. Cognitive change and empirical models predicted postbereavement distress at 1 year. Implications of using computer-based text analyses in the study of narratives are discussed.

Health outcomes and cognitive aspects of recalled negative life events.

OBJECTIVE: Integrative complexity reflects the level of intellectual resources allocated to coping with a particular situation or problem. This study explored whether the recall of very unpleasant memories would occur at a different level of complexity from that of neutral memories, and whether differences in complexity would be related to health outcomes. METHODS: A series of essays, some dealing with negative life experiences and others with trivial events, had been written by undergraduates for a previous study. Complexity scores of these two types of essays were compared, and were correlated with a composite measure of well-being (immunological assays, visits to the Student Health Center, and self-reported distress and substance abuse). RESULTS: Essays about negative experiences were significantly higher in complexity, implying the allocation of more cognitive effort to the narrative. Subjects who wrote about negative events showed a significant relationship between complexity and improvement in wellness: Complexity scores closer to the median were associated with the most improvement (p < 0.05). CONCLUSIONS: Recalling negative life experiences engages increased cognitive effort, just as coping with negative experiences does. However, both low and high cognitive involvement are associated with lower levels of well-being than is a moderate level. The findings have implications for the relation between cognitive and emotional processes and between cognitive processes and health, as well as for the specific issue of how emotionally negative events are reconstructed in memory.

Recovered memories in context: thoughts and elaborations on Bowers and Farvolden (1996)

The recovered memory debate exposes several traditional and recent contradictions within psychology. Building on K. Bowers and P. Farvolden (1996), the nature of recovered memories has profoundly different meanings for therapeutic versus legal settings. Whereas memory can be distorted during the process of retrieval, certain techniques--such as nondirective writing--may be helpful in reducing suggestive influences in recall. Ironically, methods that have been found to produce the most accurate recollections of the past appear only subtly different from those that yield the greatest distortions. The recovered memory debate must ultimately be viewed within a cultural context, both in terms of the phenomenon and its treatment. The authors discuss parallels to other explanatory and therapeutic fads related to states of nonspecific distress.

Stereotypes of emotional expressiveness of northerners and southerners: a cross-cultural test of Montesquieu's hypotheses.

Montesquieu argued that residents of warmer climates are more emotionally expressive than those living in cooler ones. More than 2,900 college students from 26 countries completed a brief questionnaire assessing the degree to which they considered Northerners and Southerners within their own countries to be emotionally expressive. In addition, individuals rated themselves on their own degree of expressiveness. In partial confirmation of Montesquieu's hypothesis, it was found that large within-country North-South stereotypes exist. Especially in Old World countries, Northerners are viewed as less emotionally expressive than Southerners. Regression and other analyses revealed that self-ratings of expressiveness were, in fact, related to being from the South and to warmer mean temperatures. Several possible explanations for these effects are discussed.

Disclosure of trauma and immune response to a hepatitis B vaccination program.

This study investigated whether emotional expression of traumatic experiences influenced the immune response to a hepatitis B vaccination program. Forty medical students who tested negative for hepatitis B antibodies were randomly assigned to write about personal traumatic events or control topics during 4 consecutive daily sessions. The day after completion of the writing, participants were given their first hepatitis B vaccination, with booster injections at 1 and 4 months after the writing. Blood was collected before each vaccination and at a 6-month follow-up. Compared with the control group, participants in the emotional expression group showed significantly higher antibody levels against hepatitis B at the 4 and 6-month follow-up periods. Other immune changes evident immediately after writing were significantly lower numbers of circulating T helper lymphocytes and basophils in the treatment group. The finding that a writing intervention influences immune response provides further support for a link between emotional disclosure and health.

The body's response to processing emotional trauma: linking verbal text with autonomic activity.

When individuals talk or think about upsetting experiences, different coping and defensive processes are invoked from one minute to the next. Further, some coping strategies are thought to be more effortful and to be associated with greater biological activity than others. The present research sought to identify how the expression of emotions and the use of different psychological defenses were reflected in momentary changes in autonomic nervous system activity while subjects wrote about emotional topics. A new methodology is introduced that links the production of natural written language with autonomic activity on a word-by-word or phrase-by-phrase basis. Using this technique with a sample of 24 subjects who wrote about traumatic experiences, it was found that certain text dimensions are highly related to skin conductance level (SCL) but not heart rate. In general, subjects' SCLs increased when expressing negative emotions and when using denial and the passive voice. SCLs were more likely to drop when subjects used positive emotion words and self-references and at the conclusion of sentences or thought units. Implications for this methodology for understanding psychological defense and physical health are discussed.