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To see if writing about their trauma lessened PTSD and related symptoms, 57 undergraduates, previously screened for traumatic experiences, wrote for 15 minutes on 4 days across 2 weeks about either their trauma or a trivial topic. They reported PTSD, impact, suicide ideas, dissociation, and depression pre-, post-, and at 6-week follow-up testing. Trauma and trivial writers were not different. Surprisingly, at follow-up everyone reported less severe PTSD symptoms, impact, and dissociation, and fewer health visits, but about the same suicidal ideation and depression. On PTSD symptoms and impact, the pattern of improvement was different: Those writing about trauma got worse at posttesting, but improved to better than their initial state by follow-up. Those writing about a trivial topic got better by posttesting, and held that position at follow-up. In this project, writing seemed to reduce PTSD symptoms regardless of whether it concerned the trauma or what they ate for lunch.
Keywords: trauma; posttraumatic stress disorder; writing
As the number of violent acts that are committed in our society continues to rise, so do the prevalence rates for trauma-related disorders (Keane, 1998). One such disorder is Posttraumatic Stress Disorder (PTSD), a diagnosis that affects 8% of the adult population in the United States (American Psychiatric Association, 2000).
Exposure-based treatment reduces anxiety by repeated real or imaginary exposure to feared stimuli, and is the treatment of choice for PTSD (Jaycox & Foa, 1996). Some techniques used in randomized, controlled, clinical trials include direct therapeutic exposure (i.e., flooding, prolonged exposure), stress-inoculation training (Foa et al., 1994), systematic desensitization, hypnotherapy, psychodynamic therapy (Brom, Kleber, & Defares, 1989), and relaxation (Peniston, 1986). Though results are mixed, exposure alone and exposure combined with other therapeutic elements appear more effective than other treatments for PTSD.
Exposure may occur through a variety of mechanisms, including talking to friends, confiding in a therapist, praying, imagining, or writing. An experimental design allows scientific investigation of exposure through writing (Pennebaker, Colder, & Sharp, 1990). In a meta-analysis of 13 writing paradigm studies, participants did not change their health behavior, but their health improved in four areas: physical, physiological functioning, psychological wellness, and daily-life functioning (Smyth, 1998). Also, participants who wrote about any past or current trauma improved in physiological functioning more than did participants...