Differential health effects of written processing of the experience of a surgical operation in high‐ and low‐risk conditions

Abstract

The aim of this study was to assess the effects of the writing technique on postoperative course in interaction with different levels of risk. Participants were 40 urologic inpatients waiting to undergo transurethral resection of the prostate, with different levels of surgical risk as assessed with the Goldman Preoperative Risk Index (L. Goldman et al., 1978). Only 20 participants wrote for 3 days about the experience of being in the hospital. Measures were days of stay in the hospital after the operation, the Symptom Check List (SCL-90; L. R. Derogatis, 1977; Italian version: G. Magni, C. Messina, D. De Leo, A. Mosconi, & M. Carli, 1983) scores, and a medical evaluation of postoperative course. A significant positive effect of writing on all three dependent variables emerged only in low-risk participants. High-risk writing participants showed a nonsignificantly worse postoperative course on all parameters than did high-risk nonwriting participants. In highly stressful conditions, writing therefore should be employed only with caution.

Who Benefits from Pennebaker’s Expressive Writing Paradigm? Research Recommendations from Three Gender Theories

“…A few projects found writing harmful. Among 40 inpatient men undergoing transurethral prostate resection, those at low risk benefited, but those at high risk declined slightly (Solano et al 2007). Among 14 Israeli adults (8 women, 6 men) with posttraumatic stress disorder (PTSD), trauma writers had more health clinic visits (Gidron et al 1996).…”

“…Physical benefits include shorter hospital stays (Solano et al 2007); fewer health visits (Baikie 2008;Range and Kovac 2002;Richards et al 2000;Rosenberg et al 2002), physical complaints (Rosenberg et al 2002), or upper respiratory problems (Greenberg et al 1996); less fatigue (Danoff-Burg et al 2006); and, improved immunity (Pennebaker et al 1988), wound healing (Weinman et al 2008), smoking resistance (Ames et al 2007), and therapy progress (Graf et al 2008). Psychological or general benefits include reduced work absence (Francis and Pennebaker 1992); improved college grades (Pennebaker and Francis 1996); faster reemployment (Spera et al 1994); less affective dysfunction (Smyth et al 1999); and, less unique grief , anxiety, and depression (Graf et al 2008).…”

“…Note, although Pennebaker's research began in the U.S., some has occurred in other countries, including Scotland (Duncan et al 2007), Spain, (Fernández and Páez 2008), The Netherlands (Stroebe et al 2002), Italy (Solano et al 2007), and Australia (Frayne and Wade 2006). Kim (2008) asked 89 bilingual Korean-American and SpanishAmerican students (66 women) to write in one language, switch languages, and or complete a non-writing task.…”

Expecting to heal through self-expression: a perceived control theory of writing and health

“…Accordingly, we propose a curvilinear relationship between pre-interventional perceived control and health outcomes, such that extremely helpless (e.g., PTSD-prone) and extremely resilient or ''in control'' individuals typically do not profit from writing, whereas individuals with moderate control deficits enjoy restorative gains in both perceived control and health (see also Solano et al, 2008). In support of a curvilinear model of efficacy, apparently low-control participants, such as high-risk surgery patients (Solano et al, 2007), sufferers of severe traumas (e.g., Batten, Follette, Hall, & Palm, 2002), and patients with a history of psychopathology (Bird, 1992) or suicidality (Kovac & Range, 2002), have demonstrated negative outcomes in response to expressive writing. On the other end of the spectrum, participants with initially coherent and rich narratives do not demonstrate health improvements as a result of writing (Pennebaker & Seagal, 1999), likely because they have already constructed meaningful trauma narratives and thereby regained a sense of control.…”

A more global approach to musculoskeletal pain: Expressive writing as an effective adjunct to physiotherapy

“…Other research revealed reduced post-surgery hospital stay (Solano, Donati, Pecci, Persichetti, & Colaci, 2003;Solano et al, 2007), better control of glycaemia in diabetes (Pastena, Tabasso, Pepe, Maida, & Solano, 2007), less pain at delivery and lower post-natal depression (Bucci, Solano, Donati, & San Martini, 2005).…”