Written emotional expression as an intervention for asthma

Abstract

This investigation employed a multiple baseline design across five participants to examine written emotional expression as an intervention to improve lung function in high school-aged students, college students, and adults with asthma. The predicted forced expiratory volume in 1 second (FEV 1 measure of large airway functioning) and forced expiratory flow (FEF 25-75 measure of small airway functioning) were evaluated using spirometry. In addition, anxiety was measured using state and trait anxiety self-report scales. Generally, results were effective. Individuals with asthma are at higher risk for increased hospitalization and death. For the schoolaged population, asthma is associated with increased absenteeism, restriction of various class activities such as physical education, and poor relationships with peers. Therefore, adults and children with asthma are in need of services and school psychologists appear uniquely qualified to intervene. More recently, the role of the school psychologist is diversifying with corresponding training (e.g., wellness, consultation, prevention, assessment and treatment of health issues) in the areas of health-related disorders that involve a psychological component.

Written Emotional Expression as an Intervention for Asthma

“…Positive effects have been noted with respect to decreased medical visits, strengthening of the immune system, subjective wellness (Smyth, 1998;Smyth et al, 1999), academic achievement (Pennebaker, Colder, & Sharp, 1990;Pennebaker & Francis, 1996), and securing a new job (Spera, Buhrfeind, & Pennebaker, 1994). With regard to asthma, there have been two experimental studies conducted by Smyth et al (1999) and Bray et al (2003) that examined written emotional expression as an intervention for asthma. Results suggested that lung functioning of the individuals with asthma improved, anxiety was reduced, and an overall improvement in quality of life was realized.…”

“…The purpose of this study was to replicate the findings of Bray et al (2003) and extend the scope of the investigation. This was done by incorporating a longer follow-up period, including only school-aged children, adding a more specific measure of happiness and life satisfaction, and examining the written passages for verification of emotionally-laden content.…”

“…Students were instructed to write for 20 minutes about stressful and traumatic experiences in the school psychologist's office. In accord with Smyth et al (1999) and Bray et al (2003), materials were provided including pen, paper, and verbal and written directions that required them to write continually about stressful and traumatic experiences. The students were informed that punctuation and spelling would not be evaluated.…”

“…The experimenter completed the protocol at the close of each intervention session. In accord with Bray et al (2003), it was comprised of: "(a) individual was seated in a comfortable private location, (b) pen and tablet were provided, (c) writing prompt was distributed with tablet, and was written consistent with Smyth et al (1999), stating, 'Please write about your most stressful life experience(s) that you have ever undergone. Write continuously for 20 minutes without regard for spelling or stylistic concerns.…”

“…A five-point Likert-type scale based on Bray and Kehle's index (1996) and Bray et al (2003) was administered during follow-up. In accord with Bray et al (2003), it was comprised of: "(a) effect of the treatment on their asthma, (b) provision of personal and medical history relative to their asthma, (c) writing about stressful experiences, (d) frequency and duration of the writing exercise, (e) completion of daily asthma diary, (f) completion of the State/Trait Anxiety Inventories, (g) completion of the Asthma Quality of Life Questionnaire, (h) being evaluated using spirometry" (p. 198), and (i) completion of the Piers Harris Self-Concept Scale.…”