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Cognitive Adaptability as a Moderator of Expressive Writing Effects in an HIV Sample

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Abstract

This study explored the effects of expressive writing on positive and negative outcomes related to perceived psychosocial and health status among persons with HIV. This was the first study to examine the moderating effects of cognitive adaptability—consisting of dispositional optimism coupled with perceived competence—on outcomes of expressive writing. Thirty-seven participants wrote about either traumatic experiences or trivial topics in four 20-min sessions. Dependent measures obtained at baseline were repeated 1 month later. Although no main effects for group were found, baseline levels of cognitive adaptability were differentially associated with changes in a positive outcomes index, and a pain and physical functioning index in those assigned to the two groups. No moderating effects of cognitive adaptability were found for changes in a negative outcomes index. Findings underscore the importance of identification of moderating variables in understanding the impact of expressive writing interventions among individuals with HIV or other conditions.

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References

  • Antonovsky, A. (1993). The structure and properties of the sense of coherence scale. Social Science & Medicine, 36, 725–733. doi:10.1016/0277-9536(93)90033-Z.

    Article  CAS  Google Scholar 

  • Broderick, J. E., Junghaenel, D. U., & Schwartz, J. E. (2005). Written emotional expression produces health benefits in fibromyalgia patients. Psychosomatic Medicine, 67, 326–334. doi:10.1097/01.psy.0000156933.04566.bd.

    Article  PubMed  Google Scholar 

  • Burack, J. H., Barrett, D. C., Stall, R. D., Chesney, M. A., Ekstrand, M. L., & Coates, T. J. (1993). Depressive symptoms and CD4 lymphocyte decline among HIV-infected men. Journal of the American Medical Association, 270, 2568–2573. doi:10.1001/jama.270.21.2568.

    Article  CAS  PubMed  Google Scholar 

  • Byrnes, D. M., Antoni, M. H., Goodkin, K., Efantis-Potter, J., Asthana, D., Simon, T., et al. (1998). Stressful events, pessimism, natural killer cytotoxicity, and cytotoxic/suppressor T cell in HIV+ black women at risk for cervical cancer. Psychosomatic Medicine, 60, 714–722.

    CAS  PubMed  Google Scholar 

  • Cameron, L. D., & Nicholls, G. (1998). Expression of stressful experiences through writing: Effects of a self-regulation manipulation for pessimists and optimists. Health Psychology, 17, 84–92. doi:10.1037/0278-6133.17.1.84.

    Article  CAS  PubMed  Google Scholar 

  • Carver, C. S., Scheier, M. F., & Weintraub, J. K. (1989). Assessing coping strategies: A theoretically based approach. Journal of Personality and Social Psychology, 56, 267–283. doi:10.1037/0022-3514.56.2.267.

    Article  CAS  PubMed  Google Scholar 

  • Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24, 385–396. doi:10.2307/2136404.

    Article  CAS  PubMed  Google Scholar 

  • Cole, S. W., Kemeny, M. E., Taylor, S. E., Visscher, B. R., & Fahey, J. L. (1996). Accelerated course of human immunodeficiency virus infection in gay men who conceal their homosexual identity. Psychosomatic Medicine, 58, 219–231.

    CAS  PubMed  Google Scholar 

  • Eriksson, M., & Lindström, B. (2006). Antonovsky’s sense of coherence scale and the relation with health: A systematic review. Journal of Epidemiology and Community Health, 60, 376–381. doi:10.1136/jech.2005.041616.

    Article  PubMed  Google Scholar 

  • Frattaroli, J. (2006). Experimental disclosure and its moderators: A meta-analysis. Psychological Bulletin, 132, 823–865. doi:10.1037/0033-2909.132.6.823.

    Article  PubMed  Google Scholar 

  • Gillis, M. E., Lumley, M. A., Mosley-Williams, A., Leisen, J. C., & Roehrs, T. (2006). The health effects of at-home written emotional disclosure in fibromylagia: A randomized trial. Annals of Behavioral Medicine, 32, 135–146. doi:10.1207/s15324796abm3202_11.

    Article  PubMed  Google Scholar 

  • Greenberg, M. A., & Stone, A. A. (1992). Emotional disclosure about traumas and its relation to health: Effects of previous disclosure and trauma severity. Journal of Personality and Social Psychology, 63, 75–84. doi:10.1037/0022-3514.63.1.75.

    Article  CAS  PubMed  Google Scholar 

  • Greenberg, M. A., Wortman, C. B., & Stone, A. A. (1996). Emotional expression and physical health: Revising traumatic memories or fostering self-regulation? Journal of Personality and Social Psychology, 71, 588–602. doi:10.1037/0022-3514.71.3.588.

    Article  CAS  PubMed  Google Scholar 

  • Harris, A. H. S., Thoresen, C. E., Humphreys, K., & Faul, J. (2005). Does writing affect asthma? A randomized trial. Psychosomatic Medicine, 67, 130–136. doi:10.1097/01.psy.0000146345.73510.d5.

    Article  PubMed  Google Scholar 

  • Helgeson, V. S. (2003). Cognitive adaptation, psychological adjustment, and disease progression among angioplasty patients: 4 years later. Health Psychology, 22, 30–38. doi:10.1037/0278-6133.22.1.30.

    Article  PubMed  Google Scholar 

  • Helgeson, V. S., & Fritz, H. L. (1999). Cognitive adaptation as a predictor of new coronary events after percutaneous transluminal coronary angioplasty. Psychosomatic Medicine, 61, 488–495.

    CAS  PubMed  Google Scholar 

  • Ickovics, J. R., Milan, S., Boland, R., Schoenbaum, E., Schuman, P., & Vlahov, D. (2006). Psychological resources protect health: 5-year survival and immune function among HIV-infected women from four US cities. AIDS (London, England), 20, 1851–1860. doi:10.1097/01.aids.0000244204.95758.15.

    Google Scholar 

  • Klein, K., & Boals, A. (2001). Expressive writing can increase working memory capacity. Journal of Experimental Psychology. General, 130, 520–533. doi:10.1037/0096-3445.130.3.520.

    Article  CAS  PubMed  Google Scholar 

  • Lepore, S. J. (1997). Expressive writing moderates the relation between intrusive thoughts and depressive symptoms. Journal of Personality and Social Psychology, 73, 1030–1037. doi:10.1037/0022-3514.73.5.1030.

    Article  CAS  PubMed  Google Scholar 

  • Leserman, J., Jackson, E. D., Petitto, J. M., Golden, R. N., Silva, S. G., Perkins, D. O., et al. (1999). Progression to AIDS: The effects of stress, depressive symptoms, and social support. Psychosomatic Medicine, 61, 397–406.

    CAS  PubMed  Google Scholar 

  • Lumley, M. A. (2004). Alexithymia, emotional disclosure, and health: A program of research. Journal of Personality, 72, 1271–1300. doi:10.1111/j.1467-6494.2004.00297.x.

    Article  PubMed  Google Scholar 

  • Lumley, M. A., & Provenzano, K. M. (2003). Stress management through written emotional disclosure improves academic performance among college students with physical symptoms. Journal of Educational Psychology, 95, 641–649. doi:10.1037/0022-0663.95.3.641.

    Article  Google Scholar 

  • Mann, T. (2001). Effects of future writing and optimism on health behaviors in HIV-infected women. Annals of Behavioral Medicine, 23, 26–33. doi:10.1207/S15324796ABM2301_5.

    Article  CAS  PubMed  Google Scholar 

  • Marston, C. B. (2003). Written emotional expression, and its relation to psychological and physical health variables among people with HIV disease. Dissertation Abstracts International: Section B: The Sciences and Engineering, 64(2-B), 969.

    Google Scholar 

  • Norman, S. A., Lumley, M. A., Dooley, J. A., & Diamond, M. P. (2004). For whom does it work? Moderators of the effects of written emotional disclosure in a randomized trial among women with chronic pelvic pain. Psychosomatic Medicine, 66, 174–183. doi:10.1097/01.psy.0000116979.77753.74.

    Article  PubMed  Google Scholar 

  • Paez, D., Velasco, C., & Gonzalez, J. L. (1999). Expressive writing and the role of alexithymia as a dispositional deficit in self-disclosure and psychological health. Journal of Personality and Social Psychology, 77, 630–641. doi:10.1037/0022-3514.77.3.630.

    Article  CAS  PubMed  Google Scholar 

  • Pennebaker, J. W. (2004). Theories, therapies, and taxpayers: On the complexities of the expressive writing paradigm. Clinical Psychology: Science and Practice, 11, 138–142. doi:10.1093/clipsy/bph063.

    Article  Google Scholar 

  • Pennebaker, J. W., & Beall, S. K. (1986). Confronting a traumatic event: Toward understanding of inhibition and disease. Journal of Abnormal Psychology, 95, 274–281. doi:10.1037/0021-843X.95.3.274.

    Article  CAS  PubMed  Google Scholar 

  • Pennebaker, J. W., Colder, M., & Sharp, L. K. (1990). Accelerating the coping process. Journal of Personality and Social Psychology, 58, 528–537. doi:10.1037/0022-3514.58.3.528.

    Article  CAS  PubMed  Google Scholar 

  • Pennebaker, J. W., Hughes, C. F., & O’Heeron, R. C. (1987). The psychophysiology of confession: Linking inhibitory and psychosomatic processes. Journal of Personality and Social Psychology, 52, 781–793. doi:10.1037/0022-3514.52.4.781.

    Article  CAS  PubMed  Google Scholar 

  • Petrie, K. J., Fontanilla, I., Thomas, M. G., Booth, R. J., & Pennebaker, J. W. (2004). Effects of written emotional expression on immune function in patients with human immunodeficiency virus infection: A randomized trial. Psychosomatic Medicine, 66, 272–275. doi:10.1097/01.psy.0000116782.49850.d3.

    Article  PubMed  Google Scholar 

  • Reed, G. M., Kemeny, M. E., Taylor, S. E., & Visscher, B. R. (1999). Negative HIV-specific expectancies and AIDS-related bereavement as predictors of symptom onset in asymptomatic HIV-positive gay men. Health Psychology, 18, 354–363. doi:10.1037/0278-6133.18.4.354.

    Article  CAS  PubMed  Google Scholar 

  • Reed, G. M., Kemeny, M. E., Taylor, S. E., Wang, H. Y., & Visscher, B. R. (1994). Realistic acceptance as a predictor of decreased survival time in gay men with AIDS. Health Psychology, 13, 299–307. doi:10.1037/0278-6133.13.4.299.

    Article  CAS  PubMed  Google Scholar 

  • Revicki, D. A., Sorensen, S., & Wu, A. W. (1998). Reliability and validity of physical and mental health summary scores from the Medical Outcomes Study HIV Health Survey. Medical Care, 2, 126–137. doi:10.1097/00005650-199802000-00003.

    Article  Google Scholar 

  • Rivkin, I. D., Gustafson, J., Weingarten, I., & Chin, D. (2006). The effects of expressive writing on adjustment to HIV. AIDS and Behavior, 10, 13–26. doi:10.1007/s10461-005-9051-9.

    Article  PubMed  Google Scholar 

  • Scheier, M. F., & Carver, C. S. (1985). Optimism, coping, and health: Assessment and implications of generalized outcome expectancies. Health Psychology, 4, 219–247. doi:10.1037/0278-6133.4.3.219.

    Article  CAS  PubMed  Google Scholar 

  • Sirois, F. M., Davis, C. G., & Morgan, M. S. (2006). “Learning to live with what you can’t rise above”: Control beliefs, symptom control, and adjustment to tinnitus. Health Psychology, 25, 119–123. doi:10.1037/0278-6133.25.1.119.

    Article  PubMed  Google Scholar 

  • Sloan, D. M., & Marx, B. P. (2004). Taking pen to hand: Evaluating theories underlying the written disclosure paradigm. Clinical Psychology: Science and Practice, 11, 121–137. doi:10.1093/clipsy/bph062.

    Article  Google Scholar 

  • Smith, C. A., Dobbins, C. J., & Wallston, K. A. (1991). The mediational role of perceived competence in psychological adjustment to rheumatoid arthritis. Journal of Applied Social Psychology, 21, 1218–1247. doi:10.1111/j.1559-1816.1991.tb00467.x.

    Article  Google Scholar 

  • Smyth, J. M. (1998). Written emotional expression: Effect sizes, outcome types, and moderating variables. Journal of Consulting and Clinical Psychology, 66, 174–184. doi:10.1037/0022-006X.66.1.174.

    Article  CAS  PubMed  Google Scholar 

  • Smyth, J. M., Stone, A. A., Hurewitz, A., & Kaell, A. (1999). Effects of writing about stressful experiences on symptom reduction in patients with asthma or rheumatoid arthritis. Journal of the American Medical Association, 281, 1304–1309. doi:10.1001/jama.281.14.1304.

    Article  CAS  PubMed  Google Scholar 

  • Spera, S. P., Buhrfeind, E. D., & Pennebaker, J. W. (1994). Expressive writing and coping with job loss. Academy of Management Journal, 37, 722–733. doi:10.2307/256708.

    Article  Google Scholar 

  • Stanton, A. L., Danoff-Burg, S., Sworowski, L. A., Collins, C. A., Branstetter, A. D., Rodriguez-Hanley, A., et al. (2002). Randomized control trial of written emotional expression and benefit finding in breast cancer patients. Journal of Clinical Oncology, 20, 4160–4168. doi:10.1200/JCO.2002.08.521.

    Article  PubMed  Google Scholar 

  • Stiegelis, H. E., Hagedoorn, M., Sanderman, R., van der Zee, K. I., Buunk, B. P., & van den Bergh, A. C. (2003). Cognitive adaptation: A comparison of cancer patients. British Journal of Health Psychology, 8, 303–318. doi:10.1348/135910703322370879.

    Article  PubMed  Google Scholar 

  • Stroebe, M., Schut, H., & Stroebe, W. (2005). Who benefits from disclosure? Exploration of attachment style differences in the effects of expressing emotions. Clinical Psychology Review, 26, 66–85. doi:10.1016/j.cpr.2005.06.009.

    Article  PubMed  Google Scholar 

  • Taylor, S. E. (1983). Adjustment to threatening events: A theory of cognitive adaptation. The American Psychologist, 38, 1161–1173. doi:10.1037/0003-066X.38.11.1161.

    Article  Google Scholar 

  • Taylor, S. E., Kemeny, M. E., Bower, J. E., Gruenewald, T. L., & Reed, G. M. (2000). Psychological resources, positive illusions, and health. The American Psychologist, 55, 99–109. doi:10.1037/0003-066X.55.1.99.

    Article  CAS  PubMed  Google Scholar 

  • Tennen, H., Affleck, G., Urrows, S., Higgins, P., & Mendola, R. (1992). Perceiving control, construing benefits, and daily processes in rheumatoid arthritis. Canadian Journal of Behavioural Science, 24, 186–203. doi:10.1037/h0078709.

    Google Scholar 

  • Thompson, S. C., Collins, M. A., Newcomb, M. D., & Hunt, W. (1996). On fighting versus accepting stressful circumstances: Primary and secondary control among HIV-positive men in prison. Journal of Personality and Social Psychology, 70, 1307–1317. doi:10.1037/0022-3514.70.6.1307.

    Article  CAS  PubMed  Google Scholar 

  • Walker, B. L., Nail, L. M., & Croyle, R. T. (1999). Does emotional expression make a difference in reactions to breast cancer? Oncology Nursing Forum, 26, 1025–1032.

    CAS  PubMed  Google Scholar 

  • Warner, L. J., Lumley, M. A., Casey, R. J., Pierantoni, W., Salazar, R., Zoratti, E. M., et al. (2006). Health effects of written emotional disclosure in adolescents with asthma: A randomized, controlled trial. Journal of Pediatric Psychology, 31, 557–568. doi:10.1093/jpepsy/jsj048.

    Article  PubMed  Google Scholar 

  • Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070. doi:10.1037/0022-3514.54.6.1063.

    Article  CAS  PubMed  Google Scholar 

  • Wu, A. W., Revicki, D. A., Jacobson, D., & Malitz, F. E. (1997). Evidence for reliability, validity, and usefulness of the Medical Outcomes Study HIV Health Survey (MOS-HIV). Quality of Life Research, 6, 481–493. doi:10.1023/A:1018451930750.

    Article  CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. School of Nursing, Godchaux Hall, Vanderbilt University, Nashville, TN, 37240, USA

    Lois J. Wagner, Kellie A. Hilker & Kenneth A. Wallston

  2. University of Arizona College of Nursing, Tucson, AZ, USA

    Joseph T. Hepworth

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  1. Lois J. Wagner
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  2. Kellie A. Hilker
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  3. Joseph T. Hepworth
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  4. Kenneth A. Wallston
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Correspondence to Kenneth A. Wallston.

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Wagner, L.J., Hilker, K.A., Hepworth, J.T. et al. Cognitive Adaptability as a Moderator of Expressive Writing Effects in an HIV Sample. AIDS Behav 14, 410–420 (2010). https://doi.org/10.1007/s10461-008-9427-8

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  • DOI: https://doi.org/10.1007/s10461-008-9427-8

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