Examining the Role of Expressive Writing (EW) to Improve Resilience Among Those Experiencing an Emotional Upheaval or a Physical Health Challenge
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Duke University
- Enrollment
- 39
- Locations
- 2
- Primary Endpoint
- Connor-Davidson Resilience Scale (CD-RISC)
Study Overview
Brief Summary
The purpose of this study is to determine whether a 6-week writing to heal seminar/workshop/class, Transform Your Life: Write to Heal, raises resilience scores as measured by the Connor-Davidson Resilience Scale for people who have recently experienced an emotional or physical trauma.
Eligible subjects will be adults who self-identify as having had a recent emotional upheaval or physical health challenge. Potential subjects will be recruited through the use of flyers, advertisements, and emails to the Duke Integrative Medicine email list. Subjects will complete pen and paper measures at baseline and immediately post-treatment, including: the Connor-Davidson Resilience Scale, the 10-item Perceived Stress Scale, The 20-item Center for Epidemiological Studies Depression Scale, the 22-item Rumination Response Scale, and a baseline questionnaire.
The investigators aim to target a sample of 30 completers by enrolling 37 participants. The risks of participation in this study are minimal, and include temporary sadness after the initial writing experience.
Detailed Description
Background The literature of several health care professions suggests that for many people, writing to heal is beneficial and useful for obtaining and sustaining emotional, physical, and spiritual health. Since the 1980s, a growing body of research shows that the heart rate lowers and people are more equipped to fight off infections when they release their worries in writing. In addition to demonstrating better coping with stressful situations, this research shows that writing can have a positive impact on self-esteem and result in helping people overcome their own obstacles.
Much of the research about writing and healing was pioneered by James Pennebaker, Ph.D., and is now sustained by others who work in the disciplines of writing, psychology, medicine, counseling, nursing, coaching, hospice and education. The biological underpinnings of writing for health are currently found in overlapping scientific areas such as: applied psychoneuorimmunology, psychobiology, applied psychophysiology and recent findings in epigenetics. Research about writing to heal, the kind of writing that is deeply personal and is written for one's own eyes only, demonstrates that such expressive writing:
- Boosts thinking ability
- Increases working memory
- Reduces pain, tension, and fatigue
- Enhances mood and sleep quality
- Positively influences immune system function
Rationale A recent study suggests that writing to heal as part of a larger program may be useful in raising resilience for critical care nurses who have been shown to have lower than average resilience scores on the Connor-Davidson Resilience Scale (2014 Mealer, et.al). In Mealer's multi-modal study, subjects participated in a four hour writing to heal workshop and then wrote according to prescribed prompts once a week for the next twelve weeks. Subjects also participated in Mindfulness-Based Stress Reduction (MBSR) and an exercise program. Post-treatment scores on the CD Resilience Scale were higher for nearly all subjects in this study. However, the potential effect of the writing treatment alone is unclear. Therefore, the aim of this study is to isolate the effect of expressive writing on resilience among those who have experienced an emotional upheaval or a physical health challenge.
Objective: Obtain preliminary data that can be used for grant application addressing the following research question:
Study Design
- Study Type
- Interventional
- Allocation
- Na
- Intervention Model
- Single Group
- Primary Purpose
- Treatment
- Masking
- None
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- Yes
Inclusion Criteria
- •They are at least 18 years of age.
- •They self-identify as having had a recent emotional upheaval or physical health challenge (within the past 12 months, but not within the past month).
- •a. Potential challenges include, but are not limited to: i. Death of spouse ii. Divorce iii. Marital separation iv. Death of a parent v. Job loss vi. Personal injury or critical illness vii. Death of a close personal friend viii. Retirement ix. Marriage x. Significant change in financial security
- •They are able to read and write in English.
- •They are able to attend 6 weekly sessions of the Transform Your Health: Write to Heal course held at Duke Integrative Medicine.
- •They are able and willing to provide informed consent.
Exclusion Criteria
- •They are NOT at least 18 years of age.
- •They do NOT self-identify as having had a recent emotional upheaval or physical health challenge (within the past 12 months, but not within the past month).
- •They are NOT able to read and write in English.
- •They are NOT able to attend 6 weekly sessions of the Transform Your Health: Write to Heal course held at Duke Integrative Medicine.
- •They are NOT able and willing to provide informed consent.
Outcomes
Primary Outcomes
Connor-Davidson Resilience Scale (CD-RISC)
Time Frame: 6 weeks
Secondary Outcomes
- 10-Item Perceived Stress Scale (PSS-10)(6 weeks)
- 20-item Center for Epidemiological Studies Depression Scale (CES-D)(6 weeks)
- 22-item Rumination Response Scale (RRS)(6 weeks)