Estudios primarios relacionados a este tópico

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Estudio primario

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Written emotional disclosure for adults with Type 2 diabetes: a primary care feasibility study.

Autores Dennick K , Bridle C , Sturt J
Revista Primary health care research & development
Año 2015
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AIM: To test the feasibility of written emotional disclosure (WED) for UK primary care patients with Type 2 diabetes. BACKGROUND: WED holds potential to address depressive symptoms in diabetes, yet its feasibility, and potential benefit, for primary care patients has not been established. METHOD: Forty-one adults with Type 2 diabetes were randomised to WED (n=23) or neutral writing (n=18). Principal outcomes were feasibility of recruitment, compliance, acceptability and intervention fidelity. Potential benefit was assessed on between-group differences in depressive symptoms (Centre for Epidemiological Studies Depression scale), diabetes distress (Problem Areas in Diabetes scale), diabetes self-management behaviours (Summary of Diabetes Self-care Activities questionnaire) and perceived health status (EQ-5D) at three-month follow-up. FINDINGS: Recruitment was modest (6%), yet an unmet treatment need was identified. Fourteen intervention (61%) and 13(72%) control participants returned their writing, while 12 in each group (89%) then completed all sessions. Intervention fidelity was confirmed. Acceptability to patients was mixed. Exploratory effectiveness analyses suggested that relative to improvement in controls, WED is associated with a potentially clinically important worsening in depressive symptoms (P=0.006) and a non-significant trend for a reduction in healthy dietary behaviour (P=0.057). There was no significant effect on other outcomes. The exploratory nature of the study, however, necessitates that the observed effects are interpreted with caution, and both the feasibility and effectiveness findings may be an artefact of the sample obtained. The evidence for the feasibility of WED in primary care diabetes was hence mixed, and in an unevaluated environment it may cause iatrogenic harm. On balance, WED is apparently not appropriate for use in this context in its current format. At most, further research with a more appropriate sample is required. The feasibility that was demonstrated and the unmet need identified suggest that this may be a worthy endeavour.

Estudio primario

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The effects of written emotional disclosure and coping skills training in rheumatoid arthritis: A randomized clinical trial.

Revista Journal of consulting and clinical psychology
Año 2014
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OBJECTIVE: Two psychological interventions for rheumatoid arthritis (RA) are cognitive-behavioral coping skills training (CST) and written emotional disclosure (WED). These approaches have developed independently, and their combination may be more effective than either one alone. Furthermore, most studies of each intervention have methodological limitations, and each needs further testing. METHOD: We randomized 264 adults with RA in a 2 × 2 factorial design to 1 of 2 writing conditions (WED vs. control writing) followed by 1 of 2 training conditions (CST vs. arthritis education control training). Patient-reported pain and functioning, blinded evaluations of disease activity and walking speed, and an inflammatory marker (C-reactive protein) were assessed at baseline and 1-, 4-, and 12-month follow-ups. RESULTS: Completion of each intervention was high (>90% of patients), and attrition was low (10.2% at 12-month follow-up). Hierarchical linear modeling of treatment effects over the follow-up period, and analyses of covariance at each assessment point, revealed no interactions between writing and training; however, both interventions had main effects on outcomes, with small effect sizes. Compared with control training, CST decreased pain and psychological symptoms through 12 months. The effects of WED were mixed: Compared with control writing, WED reduced disease activity and physical disability at 1 month only, but WED had more pain than control writing on 1 of 2 measures at 4 and 12 months. CONCLUSIONS: The combination of WED and CST does not improve outcomes, perhaps because each intervention has unique effects at different time points. CST improves health status in RA and is recommended for patients, whereas WED has limited benefits and needs strengthening or better targeting to appropriate patients. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

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Randomized controlled trial of expressive writing for patients with renal cell carcinoma.

Revista Journal of clinical oncology : official journal of the American Society of Clinical Oncology
Año 2014
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<b>PURPOSE: </b>This randomized controlled trial examined the quality-of-life benefits of an expressive writing (EW) intervention for patients with renal cell carcinoma (RCC) and identified a potential underlying mechanism of intervention efficacy.<b>Patients and METHODS: </b>Patients (N = 277) with stage I to IV RCC were randomly assigned to write about their deepest thoughts and feelings regarding their cancer (EW) or about neutral topics (neutral writing [NW]) on four separate occasions. Patients completed the Center for Epidemiologic Studies Depression Scale (CES-D), MD Anderson Symptom Inventory (MDASI), Brief Fatigue Inventory (BFI), Pittsburgh Sleep Quality Index (PSQI), Medical Outcomes Study Short Form-36 (SF-36), and Impact of Event Scale (IES) at baseline and 1, 4, and 10 months after the intervention.<b>RESULTS: </b>The mean age of participants (28% stage IV; 41% female) was 58 years. Multilevel modeling analyses, using a Bonferroni-corrected α = .021 for six outcomes adjusted for the correlation among outcomes, revealed that, relative to the NW group, patients in the EW group reported significantly lower MDASI scores (P = .003) and higher physical component summary scores on the SF-36 (P = .019) at 10 months after the intervention. Mediation analyses revealed that significant group differences for MDASI scores at 10 months were mediated by lower IES scores at 1 month after the intervention in the EW group (P = .042). No significant group differences were observed in the BFI, CES-D, PSQI, and mental component summary of the SF-36.<b>CONCLUSION: </b>EW may reduce cancer-related symptoms and improve physical functioning in patients with RCC. Evidence suggests that this effect may occur through short-term improvements in cognitive processing.

Estudio primario

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Expressive writing as a therapeutic process for drug-dependent women

Revista Substance abuse
Año 2014
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Background: Although women with substance use disorders (SUDs) have high rates of trauma and posttraumatic stress, many addiction programs do not offer trauma-specific treatments. One promising intervention is Pennebaker's expressive writing, which involves daily, 20-minute writing sessions to facilitate disclosure of stressful experiences. Methods: Women (N = 149) in residential treatment completed a randomized clinical trial comparing expressive writing with control writing. Repeated-measures analysis of variance was used to document change in psychological and physical distress from baseline to 2-week and 1-month follow-ups. Analyses also examined immediate levels of negative affect following expressive writing. Results: Expressive writing participants showed greater reductions in posttraumatic symptom severity, depression, and anxiety scores, when compared with control writing participants at the 2-week follow-up. No group differences were found at the 1-month follow-up. Safety data were encouraging: although expressive writing participants showed increased negative affect immediately after each writing session, there were no differences in pre-writing negative affect scores between conditions the following day. By the final writing session, participants were able to write about traumatic/stressful events without having a spike in negative affect. Conclusions: Results suggest that expressive writing may be a brief, safe, low-cost, adjunct to SUD treatment that warrants further study as a strategy for addressing posttraumatic distress in substance-abusing women. © 2014 Copyright Taylor & Francis Group, LLC.

Estudio primario

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Harnessing benefits of helping others: A randomized controlled trial testing expressive helping to address survivorship problems after hematopoietic stem cell transplant.

Revista Health psychology : official journal of the Division of Health Psychology, American Psychological Association
Año 2014
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OBJECTIVE: Prior research supports the hypothesis that cancer survivors who help others face treatment experience a range of psychosocial and health-related benefits as a result of peer helping. This study investigates an expressive helping (EH) intervention designed to harness those benefits by targeting survivorship problems among cancer survivors treated with hematopoietic stem cell transplant. EH includes two components: (a) emotionally expressive writing (EW; writing one’s deepest thoughts and feelings about the transplant experience in a series of brief, structured writing sessions) followed by (b) peer helping (PH; helping other people prepare for transplant by sharing one’s own transplant experiences along with advice and encouragement through a written narrative). METHOD: EH was compared with neutral writing (NW), EW (without PH), and PH (without EW) in a 4-arm randomized controlled trial in which survivors completed baseline measures, 4 structured writing exercises (with instructions depending on randomization), and postintervention measures including validated measures of general psychological distress, physical symptoms, and health-related quality of life (HRQOL). RESULTS: Among survivors with moderate–severe survivorship problems, EH reduced distress (compared with NW and PH; ps &lt; .05) and improved physical symptoms (compared with NW, PH, and EW; ps &lt; .002) and HRQOL (compared with NW; p = .02). CONCLUSIONS: Peer helping through writing benefits transplant survivors with moderate–severe survivorship problems, but only if they have first completed expressive writing. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

Estudio primario

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Efectos de una intervención escritura expresiva en la angustia relacionada con el cáncer en daneses sobrevivientes de cáncer de mama - resultados de un ensayo clínico aleatorizado en todo el país.

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Revista Psycho-oncology
Año 2013
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OBJETIVO: Examinar los efectos de una intervención escritura expresiva (EWI) en la angustia relacionada con el cáncer, los síntomas depresivos, y el estado de ánimo en las mujeres tratadas por cáncer de mama en estadio temprano. MÉTODOS: Una muestra nacional de 507 mujeres danesas que habían completado recientemente el tratamiento para el cáncer de mama primario fueron asignados aleatoriamente a tres ejercicios de escritura de 20 minutos en el hogar, una semana de diferencia, centrándose en cualquiera de divulgación emocional (grupo EWI) o un no-emocional tema (grupo de control). Angustia relacionada con el cáncer [Impacto de Event Scale (IES)], los síntomas depresivos (Form-Inventario de Depresión de Beck Corto) y negativo (37 ítems Perfil de Estados de ánimo del Estado) y el estado de ánimo positivo (Pasivo Positivo Mood Scale) se evaluaron al inicio del estudio y a los 3 y 9 meses después de la intervención. Elección de escribir tema (cáncer versus otra), la alexitimia (20 ítems de alexitimia de Toronto Scale), y las limitaciones sociales (Limitaciones Sociales escala) se incluyeron como posibles moderadores. Resultados significativos (p <0,01) las diferencias de grupo en el cambio de estado de ánimo antes de que inmediatamente después de cada sesión sugirió manipulación exitosa. Las reducciones en el tiempo de los síntomas psicológicos se observaron en ambos grupos (p <0,05), pero no se encontraron ningún momento × interacciones de grupo. Elección de escribir tema moderado efectos en IES, con las mujeres que escriben sobre otros temas que muestran una mayor reducción en la evasión relacionada con el cáncer que las mujeres que escriben sobre su cáncer. Síntomas depresivos Menos y mayores niveles de estado de ánimo positivo se observaron 3 meses después de la intervención en las mujeres que escriben sobre su cáncer, en comparación con el grupo control. Las dificultades que describen sentimientos y el pensamiento orientado hacia el exterior (20 ítems de alexitimia de Toronto Escala) efectos moderados sobre el estado de ánimo positivo y IES-total, mientras que no se encontraron efectos moderadores de las restricciones sociales. CONCLUSIONES: En concordancia con la mayoría de los resultados anteriores con los pacientes de cáncer, no se encontraron efectos principales de EWI por angustia relacionada con el cáncer, los síntomas depresivos, y estado de ánimo. Los análisis de moderadores indicaron que la elección del tema de escritura y capacidad de procesar las experiencias emocionales debería estudiarse más a fondo.

Estudio primario

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Expressive disclosure to improve well-being in patients with amyotrophic lateral sclerosis: A randomised, controlled trial.

Revista Psychology & health
Año 2013
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Amyotrophic lateral sclerosis (ALS) is a terminal neurological disease associated with progressive paralysis, loss of communicative ability and functional decline. Expressive disclosure may help people with ALS, particularly those who are emotionally or socially inhibited, meet psychological challenges associated with the disease. People with ALS (<i>N</i> = 48) were randomised to expressive disclosure about their disease or no disclosure. Psychological well-being (affect, depression and quality of life) was assessed pre-intervention and also three and six months later. Results of multi-level models indicated that the group that disclosed thoughts and feelings about ALS had higher well-being than the control group at three months post-intervention, but not six months. Ambivalence over emotional expression (AEE) moderated three-month post-intervention well-being. Those low in AEE had higher well-being than those high in AEE regardless of condition. Those high in AEE, who disclosed, had increased well-being from pre-intervention, whereas controls had decreased well-being from pre-intervention. Expressive disclosure may be helpful for people with ALS, but only those who have difficulty expressing emotions. In addition, the intervention had only temporary effects; the dynamic challenges of ALS progression may mean that the effect of processing thoughts and feelings about the disease in one stage may not generalise to later stages. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Estudio primario

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Trauma-focused treatment for posttraumatic stress disorder combined with CBT for severe substance use disorder: A randomized controlled trial.

Revista BMC psychiatry
Año 2013
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BACKGROUND: This randomized controlled trial (RCT) investigated the effectiveness of a combined treatment for comorbid Posttraumatic Stress Disorder (PTSD) and severe Substance Use Disorder (SUD). METHODS: Structured Writing Therapy for PTSD (SWT), an evidence-based trauma-focused intervention, was added on to Treatment As Usual (TAU), consisting of an intensive cognitive behavioral inpatient or day group treatment for SUD. The outcomes of the combined treatment (TAU + SWT) were compared to TAU alone in a sample of 34 patients. RESULTS: Results showed a general reduction of SUD symptoms for both TAU + SWT and TAU. Treatment superiority of TAU + SWT was neither confirmed by interaction effects (time x condition) for SUD or PTSD symptoms, nor by a group difference for SUD diagnostic status at post-treatment. However, planned contrasts revealed that improvements for PTSD severity over time were only significant within the TAU + SWT group. In addition, within the TAU + SWT group the remission of PTSD diagnoses after treatment was significant, which was not the case for TAU. Finally, at post-treatment a trend was noticed for between group differences for the number of PTSD diagnoses favoring TAU + SWT above TAU. CONCLUSIONS: In sum, the current study provides preliminary evidence that adding a trauma-focused treatment on to standard SUD treatment may be beneficial. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

Estudio primario

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La escritura expresiva en los primeros sobrevivientes de cáncer de mama.

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Autores Craft MA , Davis GC , Paulson RM
Revista Journal of advanced nursing
Año 2013
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OBJETIVOS: Este artículo es el informe de un estudio destinado a determinar si es o no la escritura expresiva mejora la calidad de vida de los primeros sobrevivientes de cáncer de mama. Un objetivo adicional es la investigación de si o no el tipo de escritura rápida hace una diferencia en los resultados. ANTECEDENTES: El riesgo de crisis puede extenderse más allá del momento de un diagnóstico de cáncer de mama. La expresión emocional puede ayudar a lidiar con esto. Diseño: estudio controlado aleatorio. MÉTODOS: Los participantes (n = 120) fueron asignados al azar a uno de cuatro grupos: un grupo de control (sin escritura) o uno de los tres grupos de la escritura expresiva: el trauma del cáncer de mama, cualquier trauma y hechos relacionados con el cáncer de mama auto-seleccionados. Los participantes escribieron 20 minutos al día durante 4 días consecutivos. Se midió su calidad de vida, a través del "Evaluación Funcional de Cáncer de Mama Terapia-Version ', al inicio y en 1 mes y 6 meses después de escribir. Pruebas t pareadas, análisis multivariado de varianza y de regresión múltiple se utilizaron para analizar los datos de los 97 participantes que completaron la asignación de diario y por lo menos la primera evaluación, recogido en 2006. Se utilizó un análisis por intención de tratar. RESULTADOS / CONCLUSIONES: La escritura expresiva sobre uno de cáncer de mama, cáncer de mama y de trauma hechos relacionados con el cáncer de mama, mejoraron significativamente el resultado de calidad de vida. CONCLUSIÓN: La escritura expresiva, centrándose las instrucciones sobre cómo escribir acerca de la propia vida y hacer frente a un diagnóstico de cáncer de mama, se recomienda para los primeros sobrevivientes de cáncer de mama como un enfoque de tratamiento viable y fácil de implementar para mejorar la calidad de vida.

Estudio primario

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Written emotional disclosure for women with ovarian cancer and their partners: Randomised controlled trial.

Revista Psycho-oncology
Año 2013
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OBJECTIVE: Written emotional disclosure for 15–20 min a day over 3 to 4 days improves physical and psychological health and may benefit cancer patients. However, no studies have tested the effectiveness of guided writing in cancer patients and their partners. A randomised controlled trial tested whether writing about the patient’s diagnosis and treatment of ovarian cancer using the Guided Disclosure Protocol (GDP) is effective in reducing perceived stress and improving quality of life (QoL) in ovarian cancer couples. The study also tested two theories that may account for beneficial effects of written emotional disclosure, the cognitive processing hypothesis and the social interaction hypothesis. METHODS: Patients and their partners (<i>N</i> = 102 couples) were randomised to write at home for 15 min a day over 3 days about the patient’s diagnosis and treatment using the GDP or what the patient did the previous day (control). Couples were assessed at baseline, 3- and 6-month follow-ups on the primary outcomes of perceived stress and QoL and secondary outcomes of intrusive thoughts (testing the cognitive processing hypothesis) and illness-related couple communication (testing the social interaction hypothesis). RESULTS: There were no main effects for any outcomes. However, in patients, the GDP improved QoL if illness-related couple communication improved and buffered the effect of intrusive thoughts on perceived stress. CONCLUSIONS: The GDP might benefit patients in certain circumstances, through changes in communication (in line with the social interaction hypothesis). Further research is needed to determine whether patients benefit from interventions to improve illness-related couple communication and under which conditions. (PsycInfo Database Record (c) 2021 APA, all rights reserved)