Effects of Emotional Disclosure in Caregivers: Moderating Role of Alexithymia

Abstract

Caregivers have been found to experience high levels of depression and anxiety. This study explored the efficacy of two writing interventions aimed at reducing psychological distress in informal caregivers and examined the moderating effects of alexithymia. Caregivers (N = 150) were randomly assigned to (1) write about the stress related to being a caregiver, (2) write about positive life experiences or (3) write about a control topic for 20 min on 3 days at home. Depression and anxiety symptoms were assessed at baseline, 2 weeks, 2 months and 6 months post‐intervention. Analysis of variance for a mixed design revealed no main effects of writing condition on the follow‐up measures. However, among caregivers with lower scores on alexithymia, those who wrote about positive experiences reported less anxiety and/or depression on follow‐ups at 2 weeks, at 2 months and at 6 months. Moreover, in the control condition, less anxiety was reported by caregivers with lower scores on alexithymia at 2 weeks and at 6 months. No effects of stress disclosure were observed; therefore, writing about caregiver stress should not be encouraged in this vulnerable group. These findings highlight the importance of examining moderating factors, such as individual differences variables as well as exploring the efficacy of alternative writing interventions. Copyright © 2011 John Wiley & Sons, Ltd.

Optimizing the Perceived Benefits and Health Outcomes of Writing about Traumatic Life Events

“…Also, they contribute to a long‐established tradition of research that identifies personality‐based and intervention‐based moderators of expressive writing and well‐being outcomes (e.g. Ashley, O'Connor, & Jones, ; Frattaroli, ; Smyth & Pennebaker, ).…”

Feasibility and Participant Experiences of a Written Emotional Disclosure Intervention for Parental Caregivers of People with Psychosis

“…One could challenge why we are designing a trial of therapeutic writing in this care group when there are already four trials of emotional disclosure that have shown little benefit on the wellbeing of caregivers (Schwartz & Drotar, 2004;Mackenzie, Wiprzycka, Hasher, & Goldstein, 2007;Barton & Jackson, 2008;Ashley et al, 2011). These existing studies all have methodological weaknesses (including small samples, inadequately powered and inappropriate controls) and more importantly, they have recruited from a broad range of caregivers with diversity of the type, intensity and duration of care provided.…”

Does written emotional disclosure improve the psychological and physical health of caregivers? A systematic review and meta-analysis

“…Eight studies measured seven outcomes and supplied data suitable for meta-analysis (Ashley, O'Connor, & Jones, 2011;Barry & Singer, 2001; Barton & Jackson, 2008;Duncan et al, 2007;Jones et al, 2015;Mackenzie, Wiprzycka, Hasher, & Goldstein, 2007;Martino, Freda, & Camera, 2013;Schwartz & Drotar, 2004). There were five studies which measured four outcomes that could not be pooled due to insufficient detail or only a single study reported on that outcome (Schwartz & Drotar, 2004;Whitney & Smith, 2014;Zauszniewski, Musil, Burant, & Au, 2014;Martino, Freda, & Camera, 2013;Jones et al, 2015).…”

“…one in Canada (Mackenzie et al, 2007), Israel (Duncan et al, 2007) and Italy (Martino et al, 2013). Six studies had one intervention group and one control group (Barry & Singer, 2001; Barton & Jackson, 2008;Jones et al, 2015;Martino et al, 2013;Schwartz & Drotar, 2004;Whitney & Smith, 2014), two studies had two intervention groups and one control group (Ashley et al, 2011;Mackenzie et al, 2007), and one study had four intervention groups and one control group (Zauszniewski et al, 2014). In one study the same group acted as both control and intervention (Duncan et al, 2007) (Table 1).…”

“…Four studies trialled WED in caregivers of adults (Ashley et al, 2011;Barton & Jackson, 2008;Jones et al, 2015;Mackenzie et al, 2007) and the other six were conducted in caregivers of babies or children (Barry & Singer, 2001;Duncan et al, 2007;Martino et al, 2013;Schwartz & Drotar, 2004;Whitney & Smith, 2014;Zauszniewski et al, 2014). Caregivers of adults were parents, spouses, children or sisters, and they were caring for individuals with a range of mental and physical problems, such as dementia, cognitive impairment, physical disability, cancer (Ashley et al, 2011;Mackenzie et al, 2007), and psychosis (Barton & Jackson, 2008;Jones et al, 2015). Caregivers of children were predominantly biological parents (in particular mothers) as well as adopted mothers, aunts and grandmothers.…”