abstract: Multiple studies have found that writing with self-compassion about a difficult event helps promote mental health and improve affect in college students and non-clinical populations (Johnson & O'Brien, 2013; Leary et al, 2007; Shapira & Mongrain, 2010). This study investigated whether a self-compassion writing intervention would lead to increases in self-compassion and proactive coping and reductions in depression and physical symptoms in a sample of individuals with different types of mental illness. This study also looked more broadly at the feasibility of conducting an online randomized trial on individuals with mental illness, including psychotic disorders, on Amazon MTurk. Individuals with schizophrenia, schizoaffective disorder, bipolar disorder and/or depression on Amazon MTurk were recruited and randomly assigned to either a (1) treatment condition in which participants wrote with self-compassion or a (2) neutral condition in which participants wrote about how they spent their time. Participants were asked to write for 20 minutes each day for three consecutive days. Outcome measures were administered at baseline, after the three-day intervention, and one month later. Computerized linguistic analysis (LIWC; Pennebaker et al., 2015) was also used to analyze participants' writing to determine if the intervention had the intended effect. Both the treatment and control groups showed significant improvements in self-compassion, proactive coping, general mental health and physical health following the intervention and both groups showed significant improvements in self-compassion, proactive coping and general mental health between the post-test and 1-month follow-up. In addition, the self-compassion writing group's positive affect improved significantly more than the control group after the wave 1 writing intervention and the control group's negative affect improved significantly more than the self-compassion writing group after the wave 2 writing intervention. Overall, the results suggest both self-compassion writing and writing about how one spends one's time may be beneficial for individuals with mental illness with different needs. Moreover, it was found Amazon MTurk may not be a reliable platform for recruiting individuals with psychotic disorders, and that the prevalence of individuals with any mental illness on MTurk may be equal or greater than the prevalence of any mental illness in the general population. / Dissertation/Thesis / Masters Thesis Social Work 2018

This study analyzed the expressive writing of college students. Twenty-two ADHD students and 22 controls were asked to write a story based on a picture story and a personal challenge. The texts were compared based on several qualitative and quantitative parameters. The results show that students in both groups presented similar text quality. Out of six qualitative parameters only one was statistically different between the two groups: ADHD students performed worse in adequacy, but only in the picture task. Students writings were also investigated using corpus based analysis. This analysis showed that ADHD students used less unusually frequent words in the picture story but more in the challenge task. Taken together the findings indicate no significant difference in expressive writing between ADHD and non ADHD college students. An explanation to this result is that college students with ADHD may have passed the filter of prior education.

The present study sought to build on the large body of past research into written disclosure of traumatic memories. This research has consistently found that participants who write about their traumatic experiences realize long-term physiological and psychological health benefits. More recently, it has been found that those participants who realize the most benefits are those who progressively include more elements of a good narrative, or story, in their writing about a traumatic experience over several sessions. Therefore, research has begun to examine the role of language and the structure of language in the health benefits gained from written disclosure of traumatic memories. A guided written disclosure protocol was designed for the present study, which sought to aid participants in supplying an increasing amount of narrative structure to their written disclosures of a single traumatic experience. Participants (N = 30) completed several measures of psychological and physiological health prior to and one month after completing the guided written disclosure protocol. Analyses revealed that participants who completed all four writing sessions showed statistically significant reductions in symptoms of general psychological distress, obsessive-compulsive symptoms, and intrusive and avoidant symptoms related to the traumatic experience. No significant self-reported physiological health benefits were found. The clinical and research implications of these findings are discussed.

This essay analyses the representation of trauma and gendered violence in Colleen Hoover’s novel It Ends With Us. To do this, trauma theory and the notion of gendered violence are applied in the analysis, as well as Dorrit Cohn’s ideas of diary novels, dissonant narrator and consonant narrator. The findings show that the protagonist, Lily’s, way of coping with her trauma and gendered violence during her teenage years, was to keep a diary, effectively using scriptotherapy. When that was not enough, however, she actively suppressed her problems. The essay also shows that Cohn’s ideas of dissonant and consonant narrator play a part in how Lily’s development is shown throughout the novel.

The mode of expression used by individuals, in written or spoken word, offers insight into one’s cognitive and emotional processes. Over the past 25 years expressive writing has become an interest to researchers, therapists, and the public. Writing provides a symbolic way of expressing thoughts, feelings, and emotions. Analytical programs provide a way to study the structure and content of written communication. There is little research that includes marital relationships and expressive writing and no known research that includes marital relationships and writing analyses. In relationships, meanings are created to help make sense of situations and interactions. Symbols also include the process of evaluating relationships. The present study uses the Linguistic Inquire and Word Count (LIWC) to analyze the writing samples from participants and the Couples Satisfaction Index (CSI) to measure relationship satisfaction. To more fully understand the relationship between writing and couple satisfaction, this study focused on married couples. This study used a dyadic analysis approach so that partner effects could be analyzed. This study had two main goals: (1) to examine the relationship between first person pronoun use (singular and plural) and marital satisfaction, and (2) to examine the relationship between affective language use (positive and negative) and marital satisfaction. Each of these goals also included exploring possible sex and length of marriage differences. The results from this study indicate that individuals who use more first person plural pronouns (e.g., we) are more likely to report higher marital satisfaction. This indicates that individual perceptions of couple togetherness are related to higher marital satisfaction. Results also indicate that individuals who use more positive affective language are more likely to report higher marital satisfaction. Also, individuals whose partners use more positive affective language are more likely to report higher marital satisfaction. This suggests that positive affect in relationships is linked to higher satisfaction for both spouses. Although negative affective language was not related to marital satisfaction, if individuals used anger language it was negatively associated with marital satisfaction. This reveals the need for more research on the specific effects of anger on relationship satisfaction. Examining relationships from this new perspective may have valuable implications for couple therapy, interventions, and future research.

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Non-physical intimate partner violence (NPIPV) is the most pervasive type of abuse, yet literature has predominantly focused on physical IPV victimization. This study employed a mixed-methods design utilizing archival expressive writing data previously collected to identify the presence of NPIPV victimization. Participants wrote about their experience after a relationship dissolution using the expressive writing paradigm. They were asked to share their deepest thoughts and feelings across two sessions. A constructivist grounded theory approach established the theoretical framework for coding the presence of NPIPV acts between romantic partners. Four themes of NPIPV were established (degradation, isolation, control, and jealousy). Disclosure of NPIPV and other themes were also evident in these data. Quantitative analyses assessed changes in participants' psychological distress after completing a brief writing intervention. The intervention increased the likelihood of NPIPV victimization being mentioned from Time 1 to Time 2 writing sessions. This study increases clinical awareness regarding NPIPV by providing insights into this longest-sustained IPV subtype. All participants reported a reduction in avoidance symptoms after completing the writing intervention. Finally, gender continues to complicate this field as researchers must acknowledge both the existence of men's victimization experiences and the greater severity of women's victimization. Clinical implications demonstrate a strength in narrative therapy when processing relationship dissolution particularly when NPIPV victimization is present.

When a romantic relationship ends in dissolution, the ex-partners may experience distress similar to post-traumatic stress or complex grief (i.e., dysphoric mood, feelings of loss, intrusive memories, negative rumination regarding the relationship, and a loss of self-esteem). Interventions designed to reduce post-breakup distress have historically attempted to foster integration of the breakup into the self-narrative through techniques such as expressive writing. Recent research indicates centrality, or heightened integration of an event or concept into an individual’s identity, predicts heightened levels of distress in the case of negative life events, including romantic relationship dissolution. Given the role romantic relationships themselves play in identity formation, exploration is warranted of the potential distress resulting from over-identification with a romantic relationship itself, or relationship centrality, after a breakup has occurred. Furthermore, if an individual has overly-integrated a relationship into their identity, the effectiveness of interventions focusing on further integration of the breakup is called into question. This study explored the centrality of participants’ previous romantic relationships, the distress resulting from the dissolution of those relationships, and the role of expressive writing as a distress reduction tool when centrality is taken into account.

Expressive writing has been linked to positive psychological and health outcomes in general and medical populations, but research examining this intervention in HIV is limited. Higher levels of emotional expression (EE) and depth processing (DP) during writing have been linked to better health status in HIV. Expressive writing has been shown to improve health-related quality of life (HRQoL) in other populations, but has not been examined in HIV. HRQoL is often compromised in HIV+ individuals and therefore improvements in this area are an appropriate goal of psychosocial interventions. This longitudinal study used HLM analyses to examine the relationship between levels of EE and DP during trauma writing and the rate of change in HRQoL over six months in an ethnically diverse sample of 106 HIV+ men and women. Three subscales of the HIV/AIDS-targeted Quality of Life measure were examined: Overall Healthy Functioing (HRQoL-Overall), Without Health Worries (HRQoL-Health), and Life Satisfaction (HRQoL-Life). All longitudinal analyses controlled for demographic (age, gender, race/ethnicity, education), medical (CD4 and VL) and psychological (stressful life events) factors. No significant effects were found for EE/DP to predict changes in HRQoL over time for the full sample. When men and women were examined separately, there was a non-significant tendency for men to decrease in HRQoL over time and for women to increase over time, and a number of EE/DP variables were significant predictors of rate of change in HRQoL. As hypothesized, for women (n = 44) higher level of Experiential Involvement DP predicted greater increase in HRQoL-Overall and HRQoL-Life, and higher negative EE also predicted greater increase in HRQoL-Life over time. Opposite of the direction hypothesized, higher Self Esteem DP predicted a lower level of increase in HRQoL-Life for women. For men (n = 62), findings appeared to be in the opposite direction of women, with greater Self Esteem DP working as a buffer to decreases in HRQoL-Life and HRQoL-Health over time. Furthermore, higher Experiential Involvement and negative EE appeared detrimental for men as both predicted greater decreases in HRQoL-Life over time and Experiential Involvement also predicted greater decreases in HRQoL-Health. Results should be interpreted with caution, as the overall slopes did not show significant change in HRQoL over time. The reasons for observed gender differences are not known. This is the first study to examine the impact of EE and DP in expressive trauma writing on HRQoL in HIV+ individuals. Implications and limitations are discussed.

Il presente programma di ricerca si è proposto di valutare l’utilizzo di un intervento di scrittura su una popolazione di soggetti adolescenti iscritti al primo anno di scuola superiore. Ciò nei termini di risultati (effetti a breve e lungo termine), mediatori e moderatori. Tali questioni sono state esplorate nell’ambito di due diversi progetti. Il primo progetto si è esplicato in uno studio sperimentale sull’efficacia di un intervento di Expressive Writing [EW] standard rispetto ad un compito di scrittura focalizzato sugli aspetti positivi di un evento (Benefit Finding [BF]) e ad un gruppo di controllo che scriveva su temi superficiali (Trivial [TR]). Le analisi quantitative sono state effettuate all’interno di due studi finalizzati a testare gli effetti della modificazione delle consegne di scrittura e gli effetti di mediazione del linguaggio sui risultati dell’intervento (Studio 1), nonché gli effetti di moderazione di ottimismo, supporto familiare e relazioni interpersonali (Studio 2). Questi studi hanno fornito supporto alla letteratura di ricerca che ha messo in luce gli effetti positivi della scrittura tra gli adolescenti, rivelando risultati migliori per il gruppo BF. Il secondo progetto ha implicato uno studio naturalistico condotto in una scuola superiore del Nord Italia due settimane dopo la morte di uno studente, avvenuta durante le lezioni. In particolare è stato esaminato il processo della scrittura, considerando i cambiamenti linguistici in funzione di variabili legate al trattamento (le tre sessioni di scrittura) e ai partecipanti (l’ottimismo e le traiettorie individuali di adattamento). / The current research program aimed to evaluate the use of a writing intervention on an adolescent population transitioning from middle school to high school in terms of outcomes (short and long term effects), mediating mechanisms, and moderators. These issues have been investigated within two different projects. The first project implied a longitudinal, randomized, controlled trial on the efficacy of a standard Expressive Writing [EW] intervention relative to a writing assignment focused on positive aspects of an event (Benefit Finding [BF]) and a control group writing on neutral topics (Trivial [TR]). Quantitative analyses were performed within two studies aimed to test the effects of altering writing assignments and the mediating effects of language on writing outcomes (Study 1), and the moderating effects of optimism, family support, and interpersonal relationships (Study 2). These studies provided support to research literature showing positive effects of writing among adolescents, revealing greater outcomes for the BF group. The second project implied a small, naturalistic study conducted in a high school of Northern Italy two weeks after a student died during classes (Study 3). The process of writing was examined, considering linguistic changes in writing as a function of treatment variables (the three writing sessions) and participant variables (optimism and individuals’ adjustment trajectories).