People sometimes privately express in a diary thoughts that they don’t feel comfortable sharing with others.
But does this process actually contribute to healing?
A recent study led by Gail Ironson, MD, PhD, from the University of Miami, investigated whether a written trauma disclosure intervention would be effective with populations of HIV infected individuals.
Dr. Ironson and her colleagues suspected that writing about trauma could reduce PTSD symptoms and depression.
To test this hypothesis, they screened HIV positive individuals, recruiting 244 participants between the ages of 18 and 70.
At the baseline visit, all participants received a questionnaire and interview. For the first study visit, participants were randomly assigned to either the augmented trauma-writing intervention or the daily-event-writing control. They then returned on four occasions during a 2 to 4 week period to write privately in an office for 30 minutes.
After the writing intervention, researchers administered questionnaires, interviews and blood draws at 1, 6 and 12 months.
In the experimental condition, participants were given directions to write about their most traumatic or upsetting experience, and to continue writing about this experience each time they came to visit.
Meanwhile, the control participants were asked to write in detail about what they did on a particular day or their plans for a future day.
The results were not what the researchers expected.
Rather than affirming their hypothesis, the researchers found a gender-moderated effect.
The results showed that women in the trauma-writing condition had a greater reduction in the severity of PTSD symptoms, depression, and HIV-related physical symptoms in comparison to the women in the control. They also found that the effect was even stronger for women with elevated PTSD symptoms at baseline.
Meanwhile, for men, the only significant results seen were that depression decreased in the daily-writing control group, and PTSD decreased in both the experimental and control group. In other words, the intervention did not have a unique effect on the men as it did for the women.
These results lead us to some interesting questions.
Do only people with certain characteristics benefit from expressive writing? Could gender be one of these differences? One theory is that women may benefit more from emotional disclosure writing because in general, they are often better at accessing and expressing their emotions, while men are socialized to inhibit emotional expression.
Future research to see if HIV-positive women with PTSD would benefit from this writing intervention would be useful, as well as whether this treatment can be used with other clinical populations who have PTSD.
To learn more about this study, it was published in the Journal of Consulting and Clinical Psychology, Volume 81, No. 2.
Have you used writing with your patients to help them express their emotions? Do you believe particular treatments elicit different responses depending on gender? Please leave a comment below.