Hostname: page-component-76fb5796d-22dnz Total loading time: 0 Render date: 2024-04-27T10:40:57.030Z Has data issue: false hasContentIssue false
  • English
  • Français

Treatment of adult post-traumatic stress disorder using a future-oriented writing therapy approach

Published online by Cambridge University Press:  22 October 2009

Reginald D. V. Nixon  and
Leonard W. Kling
Reginald D. V. Nixon*
Affiliation:
School of Psychology, Flinders University, Adelaide, SA, Australia
Leonard W. Kling
Affiliation:
School of Psychology, Flinders University, Adelaide, SA, Australia
*
*Address for correspondence: Dr R. D. V. Nixon, School of Psychology, Flinders University, GPO Box 2100, Adelaide, SA 5001, Australia. (email: reg.nixon@flinders.edu.au)
Get access Rights & Permissions [Opens in a new window]

Abstract

The aim of this pilot study was to test whether a future-oriented expressive writing intervention is able to reduce post-traumatic stress disorder (PTSD) severity and associated symptoms such as depression and unhelpful trauma-related beliefs. In an uncontrolled pre-/ post-design participants attended 8 weeks of manualized therapy. Assessment was undertaken pre- and post-treatment, and participants also completed a 3-month follow-up assessment. Of the 17 participants who began therapy, 13 were treatment completers. Results indicated a significant decrease in PTSD severity, depression and unhelpful trauma-related cognitions from pre- to post-treatment and at 3-month follow-up. Clinically meaningful change was more modest; however, three participants reported PTSD remission at 3-month follow-up. It is concluded that expressive writing with a focus on achieving future goals and personal change may have some utility in reducing post-traumatic stress but future research will need to investigate this with greater methodological rigour before firm conclusions can be made.

Keywords

Anxietydepressionexpressive writingPTSDtraumatreatment
Type
Practice article
Information
the Cognitive Behaviour Therapist , Volume 2 , Issue 4 , December 2009 , pp. 243 - 255
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Recommended follow-up reading

King, LA (2001). The health benefits of writing about life goals. Personality and Social Psychology Bulletin 27, 798–807.CrossRefGoogle Scholar
Lepore, SJ, Greenberg, MA, Bruno, M, Smyth, JM (2002). Expressive writing and health: self-regulation of emotion-related experience, physiology, and behaviour. In: The Writing Cure: How Expressive Writing Promotes Health and Emotional Well-being (ed. Lepore, S. J. and Smyth, J. M.), pp. 119–134. Washington, DC: American Psychological Association.Google Scholar

References

Antony, MM, Bieling, PJ, Cox, BJ, Enns, MW, Swinson, RP (1998). Psychometric properties of the 2-item and 2-item versions of the depression anxiety stress scales in clinical groups and a community sample. Psychological Assessment 10, 176–181.Google Scholar
Batten, SV, Follette, VM, Palm, KM (2002). Physical and psychological effects of written disclosure among sexual abuse survivors. Behavior Therapy 33, 107–122.CrossRefGoogle Scholar
Becker, CB, Zayfert, C, Anderson, E (2004). A survey of psychologists'attitudes towards and utilization of exposure therapy for PTSD. Behaviour Research and Therapy 42, 277–292.CrossRefGoogle ScholarPubMed
Brewin, CR, Dalgleish, T, Joseph, S (1996). A dual representation theory of posttraumatic stress disorder. Psychological Review 103, 670–686.CrossRefGoogle ScholarPubMed
Brown, EJ, Heimberg, RG (2001). Effects of writing about rape: evaluating Pennebaker's paradigm with a severe trauma. Journal of Traumatic Stress 14, 781–790.CrossRefGoogle ScholarPubMed
Bugg, A, Turpin, G, Mason, S, Scholes, C (2009). A randomised controlled trial of the effectiveness of writing as a self-help intervention for traumatic injury patients at risk of developing post-traumatic stress disorder. Behaviour Research and Therapy 47, 6–12.CrossRefGoogle ScholarPubMed
Chard, KM (2005). An evaluation of cognitive processing therapy for the treatment of posttraumatic stress disorder related to childhood sexual abuse. Journal of Consulting and Clinical Psychology 73, 965–971.CrossRefGoogle ScholarPubMed
Conway, MA, Pleydell-Pearce, CW (2000). The construction of autobiographical memories in the self-memory system. Psychological Review 107, 261–288.Google Scholar
Ehlers, A, Clark, DM (2000). A cognitive model of posttraumatic stress disorder. Behaviour Research and Therapy 38, 319–345.Google Scholar
First, M, Spitzer, RL, Bibbon, M, Williams, JBW (2002). Structured Clinical Interview for DSM-IV-TR Axis I Disorders – Patient Edition (SCID-I/P, 11/2002 revision). New York: Biometric Research Department, New York State Psychiatric Institute.Google Scholar
Foa, EB (1995). Posttraumatic Diagnostic Scale: Manual. Minneapolis: National Computer Systems.Google Scholar
Foa, EB, Ehlers, A, Clark, DM, Tolin, DF, Orsillos, SM (1999). The Posttraumatic Cognitions Inventory (PTCI): development and validation. Psychological Assessment 11, 303–314.CrossRefGoogle Scholar
Foa, EB, Hembree, EA, Cahill, SP, Rauch, SA, Riggs, DS, Feeny, NC, Yadin, E (2005). Randomized trial of prolonged exposure for posttraumatic stress disorder with and without cognitive restructuring: outcome at academic and community clinics. Journal of Consulting and Clinical Psychology 73, 953–964.Google Scholar
Foa, EH, Keane, TM, Friedman, MJ (2000). Guidelines for treatment of PTSD. Journal of Traumatic Stress 13, 539–588.CrossRefGoogle Scholar
Foa, EB, Rauch, SAM (2004). Cognitive changes during prolonged exposure versus prolonged exposure plus cognitive restructuring in female assault survivors with posttraumatic stress disorder. Journal of Consulting & Clinical Psychology 72, 879–884.Google Scholar
Foa, EB, Zinbarg, R, Rothbaum, BO (1992). Uncontrollability and unpredictability in post-traumatic stress disorder: an animal model. Psychological Bulletin 112, 218–238.CrossRefGoogle ScholarPubMed
Frayne, A, Wade, TD (2006). A comparison of written emotional expression and planning with respect to bulimic symptoms and associated psychopathology. European Eating Disorders Review 14, 329–340.CrossRefGoogle Scholar
Gidron, Y, Peri, T, Connolly, JF, Shalev, AY (1996). Written disclosure in posttraumatic stress disorder: is it beneficial for the patient? Journal of Nervous and Mental Disease 184, 505–507.CrossRefGoogle ScholarPubMed
Greenberg, MA, Wortman, CB, Stone, AA (1996). Emotional expression and physical benefits: revisiting traumatic memories or fostering self-regulation? Journal of Personality and Social Psychology 71, 588–602.Google Scholar
Hopko, DR, Lejuez, CW, Ruggieroc, KJ, Eiferta, GH (2003). Contemporary behavioral activation treatments for depression: procedures, principles and progress. Clinical Psychology Review 23, 699–717.CrossRefGoogle Scholar
Jacobson, NS, Dobson, KS, Truax, PA, Addis, ME, Koerner, K, Gollan, JK, Gortner, E, Prince, S (1996). A component analysis of cognitive-behavioral treatment for depression. Journal of Consulting & Clinical Psychology 64, 295–304.CrossRefGoogle ScholarPubMed
Jacobson, NS, Gortner, ET (1998). Can depression be de-medicalized in the 21st century: scientific revolutions, counter-revolutions and the magnetic field of normal science. Behaviour Research and Therapy 38, 103–117.CrossRefGoogle Scholar
Jacobson, NS, Truax, P (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology 59, 12–19.Google Scholar
Kessler, RC, Sonnega, A, Bromet, E, Hughes, M, Nelson, C(1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry 52, 1048–1060.Google Scholar
King, LA (2001). The health benefits of writing about life goals. Personality and Social Psychology Bulletin 27, 798–807.Google Scholar
King, LA, Miner, KN (2000). Writing about the perceived benefits of traumatic events: implications for physical health. Personality and Social Psychology Bulletin 26, 22–230.Google Scholar
Koopman, C, Ismailji, T, Holmes, D, Classen, C, Palesh, O, Wales, T (2005). The effects of expressive writing on pain, depression and posttraumatic stress disorder symptoms in survivors of intimate partner violence. Journal of Health Psychology 10, 211–221.Google Scholar
Lepore, SJ, Greenberg, MA, Bruno, M, Smyth, JM (2002). Expressive writing and health: self-regulation of emotion-related experience, physiology, and behaviour. In: The Writing Cure: How Expressive Writing Promotes Health and Emotional Well-being (ed. Lepore, S. J. and Smyth, J. M.), pp. 119–134. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
Lovibond, SH, Lovibond, PF (1995). Manual for the Depression Anxiety Stress Scales, 2nd edn. Sydney: Psychology Foundation.Google Scholar
Pennebaker, JW (1989). Confession, inhibition and disease. In: Advances in Experimental Psychology, vol. 22 (ed. Berkowitz, L.), pp. 211–244. New York: Springer-Verlag.Google Scholar
Resick, PA, Galovski, TE, Uhlmansiek, MO, Scher, CD, Clum, GA, Young-Xu, Y (2008). A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence. Journal of Consulting and Clinical Psychology 76, 243–258.Google Scholar
Resick, PA, Nishith, P, Weaver, TL, Astin, MC, Feur, CA(2002). A comparison of cognitive-processing therapy with prolonged exposure and a waiting condition for the treatment of chronic posttraumatic stress disorder in female rape victims. Journal of Consulting and Clinical Psychology 70, 867–879.Google Scholar
Schnurr, PP, Friedman, MJ, Engel, CC, Foa, EB, Shea, MT, Chow, BK, Resick, PA, Thurston, VM, Orsillo, SM, Haug, R, Turner, C, Bernardy, N (2007). Cognitive behavioral therapy for posttraumatic stress disorder in women: a randomized controlled trial. Journal of the American Medical Association 297, 820–830.Google Scholar
Sheeran, T, Zimmerman, M (2002). Screening for posttraumatic stress disorder in a general psychiatric outpatient setting. Journal of Consulting and Clinical Psychology 70, 961–966.Google Scholar
Sloan, DM, Marx, BP (2004 a). A closer examination of the written disclosure paradigm. Journal of Consulting and Clinical Psychology 72, 165–175.Google Scholar
Sloan, DM, Marx, BP (2004 b). Taking pen to hand: evaluating theories underlying the written disclosure paradigm. Clinical Psychology: Science and Practice 11, 121–137.Google Scholar
Sloan, DM, Marx, BP, Epstein, EM (2005). Further examination of the exposure model underlying the efficacy of written emotional disclosure. Journal of Consulting and Clinical Psychology 73, 549–554.CrossRefGoogle ScholarPubMed
Smyth, JM (1998). Written emotional expression: effect sizes, outcome types and moderating variables. Journal of Consulting and Clinical Psychology 66, 174–184.Google Scholar
Smyth, JM, Hockemeyer, JR, Tulloch, H (2008). Expressive writing and post-traumatic stress disorder: effects on trauma symptoms, mood states, and cortisol reactivity. British Journal of Health Psychology 13, 85–93.Google Scholar
Stanton, AL, Danoff-Burg, S, Sworowski, LA, Collins, CA, Branstetter, AD, Rodrigues-Hanley, A, Kirk, SB, Austenfeld, JA(2002). Randomised, controlled trial of written emotional expression and benefit finding in breast cancer patients. Journal of Clinical Oncology 20, 4160–4168.CrossRefGoogle ScholarPubMed
Weathers, FW (2004). Clinician-Administered PTSD Scale (CAPS): Technical Manual. Los Angeles, CA: Western Psychological Services.Google Scholar
Weathers, FW, Newman, E, Blake, DD, Nagy, LM, Schnurr, PP, Kaloupek, DG, Charney, DS, Keane, TM (2004). Clinician-Administered PTSD Scale (CAPS): Interviewer's Guide. Los Angeles, CA: Western Psychological Services.Google Scholar
Submit a response

Comments

No Comments have been published for this article.