Examining Written Disclosure As An Intervention For PTSD
Denise M Sloan, Associate Professor
Psychiatryboston University Medical Campus
Grant 1R34MH077658-01A2 from National Institute Of Mental Health, IRG: ITMA
Abstract: Motor vehicle accidents (MVAs) are extremely common in the United States, with approximately 3 million MVA´s occurring every year. MVA´s are also the single leading cause of posttraumatic stress disorder (PTSD) in the general population. Given the substantial associated financial costs of PTSD, it is imperative to develop effective, brief, and easily implemented treatments for MVA survivors with PTSD. Several treatments have been developed, however, many MVA survivors do not present for treatment for several reasons, including financial barriers and difficulty accessing treatment. There is also a shortage of available clinicians who are trained in evidence-based treatments for PTSD. The identification and development of a relatively inexpensive (and portable) treatment that can be implemented by a wide range of health care providers would represent a substantial public health advance. One potential intervention is the written disclosure intervention that has shown promise as an efficacious intervention in recent years. Building on a line of research conducted by the PI and funded by NIMH (R03MH068223-1A1), the goal of this project is to investigate whether written disclosure is an efficacious intervention for MVA-related PTSD. Men and women with MVA-related PTSD will be randomly assigned to either a clinic-based written disclosure intervention condition, a home-based written disclosure condition, or a supportive counseling intervention condition (standard care). Follow-up assessments will take place immediately post-treatment and at 3, 6, and 12 months following treatment. In addition to the main goal of examining the efficacy of written disclosure for PTSD, we will also examine the portability of the intervention with the inclusion on a home-based written disclosure treatment arm. In order to make additional refinement to the intervention we will investigate underlying mechanisms (e.g., physiological arousal that occurs during the writing session, narrative structure) and moderators of outcome (e.g., gender). Moreover, information gathered from patient feedback and focus groups of potential implementers will be used to make further refinements to the intervention
Project start date: 2008-08-01
Project end date: 2010-07-31
Sponsored Links Lab Supply Mall http://www.labsupplymall.com
Grants awarded to Denise M Sloan
Efficacy Of Written Disclosure For Trauma Survivors
Denise M Sloan
Temple University 1601 N. Broad Street Philadelphia, Pa 19122
Grant 1R03MH068223-01A1 from National Institute Of Mental Health, IRG: ZMH1
Abstract: There is a long line of work demonstrating that, relative to writing about neutral topics, writing about traumatic experiences produces improvements in physical health. Out of enthusiasm for this line of work, some have suggested that the written disclosure paradigm developed by Dr. James Pennebaker might be used as a therapeutic tool. Although the writing paradigm has been linked to improvements in physical health, relatively little is known about the effects of the paradigm on psychological health. There has also been speculation that males experience greater benefits from the paradigm than females, though no study has directly examined sex differences. Another important issue related to the paradigm relates to the underlying mechanism. While many investigators have studied the paradigm, few studies have examined the mechanism of action. The purpose of the proposed project is to investigate whether written disclosure is associated with improvements in psychological health, in addition to physical health, examine whether sex affects outcome, and if exposure underlies the efficacy of the paradigm. Participants with a history of traumatic experiences will be assigned to either a written emotional disclosure condition or a trivial writing, control condition, For both conditions writing sessions will take place on three consecutive days, for twenty minutes each day. Follow-up visits will take place one month and three months following the writing sessions. Outcome will be evaluated using a both psychological measures and a physical health measure completed at baseline and at the follow-up visits. In addition, both statisticai and clinical significance testing will be conducted. The hypothesis that exposure underlies the effectiveness of the written disclosure paradigm will be examined using self-reported emotion and physiological reactivity to each session. It is expected that the participants assigned to the disclosure condition will show improvement at follow-up compared to participants assigned to the control condition, and that males in the disclosure condition will show greater improvements at follow-up compared females in the same condition. Consistent with an exposure hypothesis, it is expected that disclosure participants will display habituation of emotion (both subjective and physiological) from the first to the last writing session. Further, initial emotional engagement and habituation of emotion is anticipated to be significantly related to symptom improvements at follow-up for the disclosure participants.
Keywords: human therapy evaluation, personal log /diary, psychological shock, psychotherapy, sex differentiation, emotion, gender difference, outcomes research, psychophysiology, sign /symptom, behavioral /social science research tag, clinical research, human subject, interview, patient oriented research, psychological test, psychometrics, questionnaire, university student
Project start date: 2004-06-01
Project end date: 2006-05-31
1R03MH068223-01A1 (2004): $75250
Examining Written Disclosure As An Intervention For PTSD
Denise M Sloan, Associate Professor
Psychiatryboston University Medical Campus
Grant 1R34MH077658-01A2 from National Institute Of Mental Health, IRG: ITMA
Abstract: Motor vehicle accidents (MVAs) are extremely common in the United States, with approximately 3 million MVA´s occurring every year. MVA´s are also the single leading cause of posttraumatic stress disorder (PTSD) in the general population. Given the substantial associated financial costs of PTSD, it is imperative to develop effective, brief, and easily implemented treatments for MVA survivors with PTSD. Several treatments have been developed, however, many MVA survivors do not present for treatment for several reasons, including financial barriers and difficulty accessing treatment. There is also a shortage of available clinicians who are trained in evidence-based treatments for PTSD. The identification and development of a relatively inexpensive (and portable) treatment that can be implemented by a wide range of health care providers would represent a substantial public health advance. One potential intervention is the written disclosure intervention that has shown promise as an efficacious intervention in recent years. Building on a line of research conducted by the PI and funded by NIMH (R03MH068223-1A1), the goal of this project is to investigate whether written disclosure is an efficacious intervention for MVA-related PTSD. Men and women with MVA-related PTSD will be randomly assigned to either a clinic-based written disclosure intervention condition, a home-based written disclosure condition, or a supportive counseling intervention condition (standard care). Follow-up assessments will take place immediately post-treatment and at 3, 6, and 12 months following treatment. In addition to the main goal of examining the efficacy of written disclosure for PTSD, we will also examine the portability of the intervention with the inclusion on a home-based written disclosure treatment arm. In order to make additional refinement to the intervention we will investigate underlying mechanisms (e.g., physiological arousal that occurs during the writing session, narrative structure) and moderators of outcome (e.g., gender). Moreover, information gathered from patient feedback and focus groups of potential implementers will be used to make further refinements to the intervention
Project start date: 2008-08-01
Project end date: 2010-07-31
Related Publications
Development and initial validation of a statistical prediction instrument for assessing combat-related posttraumatic stress disorder. J Nerv Ment Dis. 2008 Aug; 196( 8): 605-11. PMID: 18974672 
Re: "Psychiatric diagnoses in historic and contemporary military cohorts: combat deployment and the healthy warrior effect". Am J Epidemiol. 2008 Nov 1; 168( 9): 1093-4; author reply 1096-8. Epub 2008 Sep 5. No abstract available. PMID: 18775921 Tonic immobility mediates the influence of peritraumatic fear and perceived inescapability on posttraumatic stress symptom severity among sexual assault survivors. J Trauma Stress. 2008 Aug; 21( 4): 402-9. PMID: 18720396 Expressive writing buffers against maladaptive rumination. Emotion. 2008 Apr; 8( 2): 302-6. PMID: 18410204 Military-related PTSD, current disability policies, and malingering. Am J Public Health. 2008 May; 98( 5): 773-4; author reply 774-5. Epub 2008 Apr 1. No abstract available. PMID: 18381982 The Facial Expression Coding System (FACES): development, validation, and utility. Psychol Assess. 2007 Jun; 19( 2): 210-24. PMID: 17563202 Does altering the writing instructions influence outcome associated with written disclosure? Behav Ther. 2007 Jun; 38( 2): 155-68. Epub 2007 Jan 18. PMID: 17499082 
Respiratory sinus arrhythmia predicts written disclosure outcome. Psychophysiology. 2005 Sep; 42( 5): 611-5. PMID: 16176384 Further examination of the exposure model underlying the efficacy of written emotional disclosure. J Consult Clin Psychol. 2005 Jun; 73( 3): 549-54. PMID: 15982152 Is life stress more traumatic than traumatic stress? J Anxiety Disord. 2005; 19( 6): 687-98. PMID: 15927781 Getting to the heart of the matter: written disclosure, gender, and heart rate. Psychosom Med. 2005 May-Jun; 67( 3): 413-9. PMID: 15911904 Peritraumatic dissociation and experiential avoidance as predictors of posttraumatic stress symptomatology. Behav Res Ther. 2005 May; 43( 5): 569-83. PMID: 15865913 The psychophysiological correlates of risk recognition among victims and non-victims of sexual assault. Behav Res Ther. 2005 Feb; 43( 2): 169-81. PMID: 15629748 Empirical classification of eating disorders. Eat Behav. 2005 Jan; 6( 1): 53-62. PMID: 15567111 Emotion regulation in action: emotional reactivity in experiential avoidance. Behav Res Ther. 2004 Nov; 42( 11): 1257-70. PMID: 15381437 Efficacy of sertraline for bulimia nervosa. Int J Eat Disord. 2004 Jul; 36( 1): 48-54. PMID: 15185271 A closer examination of the structured written disclosure procedure. J Consult Clin Psychol. 2004 Apr; 72( 2): 165-75. PMID: 15065952 The effects of trauma history, gender, and race on alcohol use and posttraumatic stress symptoms in a college student sample. Addict Behav. 2003 Dec; 28( 9): 1631-47. PMID: 14656550 Looking at facial expressions: dysphoria and facial EMG. Biol Psychol. 2002 Sep; 60( 2-3): 79-90. PMID: 12270585 Does warm weather climate affect eating disorder pathology? Int J Eat Disord. 2002 Sep; 32( 2): 240-4. PMID: 12224532