Gender-specific effects of an augmented written emotional disclosure intervention on posttraumatic, depressive, and HIV-disease-related outcomes: A randomized, controlled trial.

Abstract

Objective Trauma histories and symptoms of PTSD occur at very high rates in people with HIV and are associated with poor disease management and accelerated disease progression. The authors of this study examined the efficacy of a brief written trauma disclosure intervention on posttraumatic stress, depression, HIV-related physical symptoms, and biological markers of HIV disease progression. Method HIV-infected men and women were randomized to four 30-min expressive writing sessions in either a treatment (trauma writing) or an attention control (daily events writing) condition. The disclosure intervention augmented the traditional emotional disclosure paradigm with probes to increase processing by focusing on trauma appraisals, self-worth, and problem solving. Outcomes were assessed at baseline, 1-, 6-, and 12-month follow-up. Results Hierarchical linear modeling (N = 244, intent-to-treat analyses) revealed no significant treatment effects for the group as a whole. Gender by treatment group interactions were significant such that women in the trauma-writing group had significantly reduced posttraumatic stress disorder (PTSD) symptoms (p = .017), depression (p = .009), and HIV-related symptoms (p = .022) compared with their controls. In contrast, men in the trauma-treatment condition did not improve more than controls on any outcome variables. Unexpectedly, men in the daily-event-writing control group had significantly greater reductions in depression then men in the trauma-writing group. Treatment effects were magnified in women when the analysis was restricted to those with elevated PTSD symptoms at baseline. Conclusions A brief (4-session) guided written emotional disclosure intervention resulted in significant and meaningful reductions in PTSD, depression, and physical symptoms for women with HIV, but not for men.

Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic considerations

“…Of the 64 included studies, 9,51-58,66-119 59 9,51,[54][55][56][57][58][66][67][68][71][72][73][74][75][76][77][79][80][81][82][83][84][85][86]88,89,91, were RCTs, and four 52,78,87,92 were non-randomised studies. The remaining study 53 was a matched case-control study.…”

“…All participants were diagnosed with HIV and were receiving active treatment at the time of the study. Some participants in Ironson et al 71 also had PTSD (n = 85 men, n = 47 women).…”

“…There were six studies 50,55,56,[71][72][73] evaluating unfacilitated EW in patients with HIV. A summary of main characteristics is presented in Table 8.…”

“…Four studies were conducted in the USA, 50,[71][72][73] with Kraaij et al 55 and Petrie et al 56 conducted in the Netherlands and New Zealand, respectively. All studies 50,56,[71][72][73] except Kraaij et al 55 had two groups and evaluated one EW intervention compared with one control.…”

“…All studies 50,56,[71][72][73] except Kraaij et al 55 had two groups and evaluated one EW intervention compared with one control. Kraaij et al 55 also compared EW with a cognitive-behavioural self-help programme but this is not considered further here.…”