We examined whether instructing participants to write in a narrative fashion about stressful life events would produce superior physical and psychological health benefits relative to standard expressive writing instructions that do not specify the essay's structure. Undergraduates (N = 101) were randomly assigned to engage in two, 20-minute narrative writing, standard expressive writing, or control writing tasks. Follow-up data were obtained one month later. The essays of the narrative writing group evidenced higher levels of narrative structure than did those of the expressive writing group. Greater narrative structure was associated with mental health gains, and self-rated emotionality of the essays was associated with less perceived stress at follow-up. In addition, the narrative and expressive writing groups reported lower levels of perceived stress and depressive symptoms relative to controls but did not differ from each other with regard to these outcomes. Health care utilization at follow-up did not vary by group assignment. Findings suggest that both emotional expression and narrative structure may be key factors underlying expressive writing's mental health benefits. Results also suggest that, among college students, instruction in narrative formation does not increase the positive effects of expressive writing relative to standard expressive writing instructions.Keywords expressive writing; emotional disclosure; narrative; health; stress; psychological adjustment
Does Narrative Writing Instruction Enhance the Benefits of Expressive Writing?Extensive research has documented links between expressive writing and improvement in physical and mental health, when participants writing about personal stressors or traumatic experiences have been compared to control participants assigned to write about more perfunctory topics (see Frattaroli, 2006, for a meta-analytic review). These studies have been conducted with college student samples (see Smyth, 1998, for a meta-analytic review), community-residing adults (Francis & Pennebaker, 1992;Spera, Buhrfeind, & Pennebaker, 1994), survivors of child sexual abuse (Batten, Follette, Hall, & Palm, 2002) and rape (Brown & Heimberg, 2001), and medical patients (e.g., Danoff-Burg, Agee, Romanoff, Kremer, & Strosberg, 2006;Norman, Lumley, Dooley, & Diamond, 2004;O'Cleirigh, Ironson, Fletcher, & Schneiderman, 2008;Petrie, Fontanilla, Thomas, Booth, & Pennebaker, 2004;Smyth, Stone, Hurewitz, & Kaell, 1999;Stanton et al., 2002). Despite the proliferation of expressive writing research, the mechanisms underlying its therapeutic effect are not yet clear (Low, Stanton, & Danoff-Burg, 2006). In attempting to explain mechanisms by which expressive writing produces benefits, researchers have emphasized the importance of creating a narrative (Pennebaker & Seagal, 1999;Ramírez-Esparza & Pennebaker, 2006;Smyth & Pennebaker, 1999). Although numerous theories exist regarding what constitutes a narrative (e.g., Gergen & Gergen, 1997;McAdams, 1996), definitions often emphasize story...
