The expressive writing (EW) paradigm developed by Pennebaker (1985) has been found to provide health benefits in populations with medical and psychological conditions. Several theories have been proposed to explain the effectiveness of EW such as: the inhibition theory, increased social connections theory, the cognitive adaptation theory, and the exposure/emotional processing theory. Some studies have suggested that the effects of EW on health outcomes are mediated by varying degrees of depth processing (DP). The present study examines differences in emotional expression (EE) and DP in self-identified gay (GM) and straight men (SM), and assesses changes in levels of depression and PTSD symptoms from pre- to post-intervention. It was hypothesized that GM would display higher levels of EE, and consequently DP, in their written essays. This hypothesis was based on the notion that GM are behaviorally and emotionally more similar to women, who typically display higher levels of EE. Lower levels of depression and PTSD symptoms at follow-ups sessions were expected because theories to explain the effectiveness of EW address several common life experiences of GM. Results showed that GM expressed significantly more negative emotion words and were significantly more involved in the writing process than SM. However, when education was controlled for, the findings were no longer significant. The two groups did not differ from each other in their slope of change in levels of depression and PTSD symptoms from pre- to post-intervention, although the SM group displayed a significant within-group reduction in PTSD symptoms. It appears that EW may actually be more beneficial for HIV-positive SM than GM in alleviating PTSD symptoms. Interpretations and implications for future research are also discussed.

The study attempted to assess whether test anxiety could be successfully managed using an expressive writing or meditation anxiety reduction technique, and whether these results would be maintained one week following the manipulation. Three administrations of the Test Anxiety Inventory were collected one week before, directly after, and one week following the assignment of participants to one of three study test conditions: meditation, expressive writing, and a control (narrative account of the previous day’s events). The students were given a 24-question GRE practice exam to simulate a high-stakes test environment. Repeated measures ANOVA and ANCOVA were performed to test the effectiveness of the intervention. Relationships between GPA, procrastination, test-preparedness, and test anxiety were examined, as were the correlations among depression, worry, and test anxiety. The results of the main and exploratory analyses did not indicate any significant differences across the three conditions. Suggestions for future research include incorporating a more robust version of the treatment, recruiting more participants reporting high anxiety at baseline, and utilizing test conditions in which the participants are more invested. / text

An impressive body of research indicates expressive writing (Pennebaker & Beall, 1986) produces physiological and psychological benefits. One study found that expressive writing decreases depressive symptoms among formerly depressed college students (Gortner, Rude, & Pennebaker, 2006). Gortner et al. (2006) argue that expressive writing may produce changes by reducing negative evaluations of emotional experiences and self-judgment, often associated with depression, through instructions encouraging participants to delve into their “deepest thoughts and feelings.” In other words, the standard writing instructions appear to send an implicit message that individuals be accepting and non-judgmental towards emotions and cognitions. The mindfulness literature suggests that making this message explicit may improve the preventative power of expressive writing in depression-vulnerable populations (Baer, 2003; Kingston, Dooley, Bates, Lawlor, & Malone, 2007; Teasdale et al., 2000; Toneatto & Nguyen, 2007). Therefore, the specific goal of the present study was to examine the effects of a mindfulness-enhanced expressive writing intervention among depression-prone individuals. Depression-vulnerable participants (e.g., dysphoric or formerly depressed) were randomly assigned to one of three groups. Although writing instructions varied for each group, all participants wrote for 20 minutes across a three-day period. The mindfulness condition received writing instructions that encouraged participants to be non-judgmental, accepting, and self-compassionate as they wrote about distressing events. Participants in the traditional writing condition received standard writing instructions, which consisted of writing about their deepest thoughts and feelings related to an emotional incident. Finally, students in the control condition were instructed to write about what they did the previous day. Results showed marginally significant decreases in depressive symptoms among participants in the mindfulness group compared to the control condition. In addition, results indicated that low suppressive depression-vulnerable individuals in the mindfulness condition marginally improved their cognitive processing biases compared to their counterparts in the traditional and control groups. Results failed to support hypotheses that predicted improvements on self-compassion, rumination, and mindfulness skills. Further, self-compassion was not found to mediate the effects of treatment on depressive symptoms and rumination. Obviously more research needs to be conducted, however preliminary results suggest that brief mindfulness interventions may be beneficial for a depression-vulnerable population. / text

Forgiveness is an important characteristic of a healthy relationship. Several factors have been shown to be connected to forgiveness, but other factors may play a significant role in the forgiveness process. Little is known about how humility affects forgiveness in the context of an interpersonal conflict. Expressive writing, when combined with humility, may help counselors and other mental health providers in understanding how to better foster forgiveness among individuals and help them cope with stressful events and relational problems. The primary purpose of this study was to examine whether expressive writing involving humility regarding a minor offense leads to increased forgiveness compared to expressive writing that does not involve humility. The theoretical framework was based on the REACH model of forgiveness and Pennebaker's writing paradigm. The focus of the primary research question was on what role, if any, humility plays in forgiveness-based expressive writing. A randomized experimental design involving 4 groups was used. Each group received slightly different instructions, with 1 group having a humility (self-criticism) aspect. Forgiveness was measured using the TRIM-12 item questionnaire. Planned contrasts within a 1-way ANOVA were conducted along with a t test for analysis. The results of this research study were non-significant regarding the role of humility in increasing forgiveness in expressive writing. Regarding positive social change, this study adds to the literature by providing knowledge concerning what factors do not affect forgiveness in expressive writing and supports the need for future research on humility and forgiveness.

This project examined the imp act of an expressive writing intervention as compared to a general health in formation control on breast cancer patients' postradiation treatment. It further examined the content of the expressive writing narratives. The sample included women who were completing radiation treatment for breast cancer at the Huntsman Cancer Institute and City of Hope hospital. The measures utilized in this study were self-report instruments targeting psychological distress (PANAS, JES) and general functioning (SIP), as well as demographic questionnaires. Results revealed the expressive writing intervention significantly impacted positive affect over time. Furthermore, participants from both the treatment and control groups evidenced improvements in psychological distress and general functioning over time. Linguistic analyses revealed participants' use of positive affect words increased across writing sessions, whereas the use of negative affect words and cognitive words did not change. Additionally, the use of past tense words decreased across writing sessions, whereas the use of present tense words increased and the use of future tense remained constant. The findings revealed from this study indicate that an expressive writing intervention can positively impact breast cancer patients up to 1 year postradiation treatment. Furthermore, the analysis of writing trends suggests that the use of positive affect words, the decrease in use of past tense words, along with the increase of present tense words across writing sessions, may be important linguistic components in positive outcomes.

A growing body of literature supports the relationship between pathological worry and deleterious health consequences, including having a diagnosis of generalized anxiety disorder (GAD; Waters & Craske, 2005). Individuals who suffer from pathological worry tend to live life in the future rather than in the present moment. Mindfulness, a practice grounded in the acceptance of present-moment experience, can therefore be conceptualized as the antithesis of worry. Thus, the current study aimed to better understand the interplay between mindfulness and pathological worry and the potential role of mindfulness practice in reducing pathological worry. This study examined the effect of a brief mindful breathing practice and an expressive writing exercise on psychological health outcomes in a sample of college students with pathological worry. The study aimed to replicate findings that expressive writing is helpful for individuals with pathological worry, and it aimed to test the hypothesis (Brody & Park, 2004) that expressive writing itself is a process conceptually similar to mindfulness. Participants practiced either a mindful breathing exercise or a relaxation exercise prior to engaging in three consecutive sessions of either expressive writing or a control writing exercise. It was expected that individuals who practiced mindfulness and engaged in expressive writing would have lower levels of depression, worry, and GAD symptoms as well as increased levels of self-reported mindfulness when assessed one month after completing the study, but these hypotheses were not supported. It was found, however, that individuals who engaged in expressive writing demonstrated a decrease in negative affect over time compared to those who engaged in control writing. Furthermore, those who engaged in mindfulness practice compared to those who engaged in relaxation practice reported higher levels of mindful awareness directly following the writing sessions. The study has the practical implication of understanding the utility of brief mindfulness practice to alleviate symptoms of worry and GAD in a sample of non-treatment-seeking high worriers. / Psychology

Depression is a condition characterized by sadness and other symptoms, which are implicated in a persistent style of thinking referred to as depressive rumination. The analytical rumination hypothesis argues that depression is an adaptive response to complicated, personal problems, and that rumination involves an analysis of these problems. This analytical rumination has two stages: first, depressive symptoms promote causal analysis (i.e., considering why the problems happened). Causal analysis then leads to problem-solving analysis (i.e., finding ways to deal with problems), which in turn reduces depression. The empirical studies in this dissertation collectively test whether the nature of depressive thinking is consistent with the analytical rumination hypothesis. In Chapter 2, I investigated the temporal order of sadness and the stages of analytical rumination by asking participants to write about their personal problems. This writing paradigm promoted sadness and causal analysis, but not problem-solving analysis, suggesting that depressive symptoms coincide with causal thinking. In Chapter 3, I explored whether emotions during writing were related to analytical thinking by modifying the paradigm to isolate the impact of other factors (i.e., personal experience with the problem and its valence). These factors could not fully account for emotional changes during writing, suggesting that analytical thinking played a role. Analytical rumination is one of several theories of depressive thinking, so in Chapter 4, I conducted a joint factor analysis of four rumination questionnaires and compared the prevalence of the emerging factors. Factors reflecting causal thoughts and problem-solving were most frequently endorsed, even when they were measured in the presence of sadness induced by the writing paradigm in Chapter 5. Furthermore, associations between these factors and depressive symptoms were consistent with the stages of analytical rumination. Overall, my findings suggest that depressive thinking focuses on understanding and solving problems, and it may have functional implications for depression. / Dissertation / Doctor of Philosophy (PhD) / Depression is a mental health condition in part characterized by sadness and changes in thinking. One evolutionary perspective argues that depression is a response to complicated, personal problems, and that symptoms of depression, like sadness, help individuals think through their problems. According to this perspective, depressive thinking is analytical, and it involves causal thinking to identify why the problems happened and problem-solving to find potential solutions. In my dissertation, I examine whether individuals engage in causal thinking and problem-solving when they are sad or depressed. My experiments assess whether writing about personal problems promotes sadness and causal thinking, and they examine the impact of analytical thinking on changes in sadness during writing. Because the evolutionary perspective is one of several theories on depressive thinking, I also use a psychometric method to integrate these theories and to examine how causal thinking and problem-solving are linked with sadness and other depressive symptoms.

Depression is a crippling burden on a great many people, and it is often well hidden. Mental health professionals are able to treat depression, but the general public is not well versed in recognizing depression symptoms or assessing their own mental health. Active Listening Journal Interaction (ALJI) is a computer program that seeks to identify and refer people suffering with depression to mental health support services. It does this through analyzing personal journal entries using machine learning, and then privately responding to the author with proper guidance. In this thesis, we focus on determining the feasibility and usefulness of the machine learning models that drive ALJI. With heavy data limitations, we cautiously report that with a single journal entry, our model detects when a person's symptoms warrant professional intervention with a 61% accuracy. A great amount of discussion on the proposed solution, methods, results, and future directions of ALJI is included. / Master of Science / An incredibly large number of people suffer from depression, and they can rightfully feel trapped or imprisoned by this illness. A very simple way to understand depression is to first imagine looking at the most beautiful sunset you've ever seen, and then imagine feeling absolutely nothing while looking that same sunset, and you can't explain why. When a person is depressed, they are likely to feel like a burden to those around them. This causes them to avoid social gathering and friends, making them isolated away from people that could support them. This worsens their depression and a terrible cycle begins. One of the best ways out of this cycle is to reveal the depression to a doctor or psychologist, and to ask them for guidance. However, many people don't see or realize this excellent option is open to them, and will continue to suffer with depression for far longer than needed. This thesis describes an idea called the Active Listening Journal Interaction, or ALJI. ALJI acts just like someone's personal journal or diary, but it also has some protections from illnesses like depression. First, ALJI searches a journal entry for indicators about the author's health, then ALJI asks the author a few questions to better understand the author, and finally ALJI gives that author information and guidance on improving their health. We are starting to create a computer program of ALJI by first building and testing the detector for the author's health. Instead of making the detector directly, we show the computer some examples of the health indicators from journals we know very well, and then let the computer focus on finding the pattern that would reveal those health indicators from any journal. This is called machine learning, and in our case, ALJI's machine learning is going to be difficult because we have very few example journals where we know all of the health indicators. However, we believe that fixing this issue would solve the first step of ALJI. The end of this thesis also discusses the next steps going forward with ALJI.

Expressive Writing (EW) involves asking participants to write emotionally about stressful life events and has been associated with improvements in psychological and physical health. The purpose of the current study was to extend previous work by examining the moderating and mediating role of emotion regulation within the EW intervention. Sixty participants who had experienced a traumatic event were recruited from the community and were assigned to an EW or control writing condition. Measures assessing emotion regulation and indices of psychological and physical health were administered at baseline and one month follow-up to determine changes in symptomatology. In comparison to control writing, EW led to significant improvements in depression, emotional clarity, and to a lesser degree emotional awareness. Although no other group differences were found, all participants demonstrated significant improvements in their symptoms of posttraumatic stress, reported physical health, overall emotion regulation abilities, their ability to accept their emotions, engage in goal directed behaviour when distressed, and access emotion regulation strategies they perceive as effective. No support was found for our moderation hypothesis. However, a significant moderation was discovered revealing that difficulties engaging in goal directed behaviour when distressed moderated improvements in posttraumatic stress symptoms. Specifically, control participants with this emotion regulation deficit demonstrated significantly poorer outcomes than control participants without this deficit; in comparison to the EW group participants who improved similarly on posttraumatic stress symptoms regardless of their level of difficulties at baseline engaging in goal directed behavour when distressed. Additionally, baseline emotion regulation abilities predicted improvements on psychological health (but not physical health) outcome measures for both groups. No support was found for our mediation hypothesis. Exploratory analyses revealed that the EW group demonstrated greater emotional arousal in response to their writing in sessions 1 and 2, but that by session 3 their arousal had significantly decreased and was equivalent to that of the control group, which showed no changes in arousal across sessions. No support was found for the moderating or mediating influence of arousal on outcome. Results will be discussed within a model of emotional expression and emotion regulation and compared to the existing EW literature.

Expressive Writing (EW) involves asking participants to write emotionally about stressful life events and has been associated with improvements in psychological and physical health. The purpose of the current study was to extend previous work by examining the moderating and mediating role of emotion regulation within the EW intervention. Sixty participants who had experienced a traumatic event were recruited from the community and were assigned to an EW or control writing condition. Measures assessing emotion regulation and indices of psychological and physical health were administered at baseline and one month follow-up to determine changes in symptomatology. In comparison to control writing, EW led to significant improvements in depression, emotional clarity, and to a lesser degree emotional awareness. Although no other group differences were found, all participants demonstrated significant improvements in their symptoms of posttraumatic stress, reported physical health, overall emotion regulation abilities, their ability to accept their emotions, engage in goal directed behaviour when distressed, and access emotion regulation strategies they perceive as effective. No support was found for our moderation hypothesis. However, a significant moderation was discovered revealing that difficulties engaging in goal directed behaviour when distressed moderated improvements in posttraumatic stress symptoms. Specifically, control participants with this emotion regulation deficit demonstrated significantly poorer outcomes than control participants without this deficit; in comparison to the EW group participants who improved similarly on posttraumatic stress symptoms regardless of their level of difficulties at baseline engaging in goal directed behavour when distressed. Additionally, baseline emotion regulation abilities predicted improvements on psychological health (but not physical health) outcome measures for both groups. No support was found for our mediation hypothesis. Exploratory analyses revealed that the EW group demonstrated greater emotional arousal in response to their writing in sessions 1 and 2, but that by session 3 their arousal had significantly decreased and was equivalent to that of the control group, which showed no changes in arousal across sessions. No support was found for the moderating or mediating influence of arousal on outcome. Results will be discussed within a model of emotional expression and emotion regulation and compared to the existing EW literature.