Date of Award

Summer 2009

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD)

Department

Psychology and Behavioral Sciences

First Advisor

Tony R. Young

Abstract

Expressive writing as a form of emotional disclosure produces many physical and psychological benefits (Pennebaker, 2004). Central to the present study are findings that expressive writing decreases symptoms of depression, anxiety, and PTSD (Koopman, Ismailji, Holmes, Classen, Palesh, & Wales, 2005; Opre, Coman, Kallay, Rotaru, & Manier, 2005; Russ, 1992). Reversal Theory (RT) suggests that individuals experience the world from eight different psychological states including serious, playful, conforming, rebellious, mastery, sympathy, self, and other (Apter, 2007). Teaching individuals to be aware of and elicit these states also decreases depression and anxiety (Charat, 2006). The present study sought to determine if the clinical benefit in reducing subclinical symptoms of depression, anxiety, and PTSD in college students could be enhanced by the addition of RT concepts. Theoretically, this addition may increase the benefit derived from expressive writing by augmenting those processes believed to underlie the changes associated with expressive writing. These processes include reduction of inhibition through disclosure, emotional engagement and habituation, and cognitive changes including improved structure for understanding and increased insight (Lepore & Smyth, 2002).

The study involved three groups, each participating in a modified version of the traditional expressive writing paradigm. The control group wrote about trivial topics with instructions to be objective; the expressive writing group wrote about a previous traumatic event with instructions to explore deepest thoughts and feelings; the Reversal Theory group wrote about a previous traumatic event with instructions to elicit and write from the perspective of the eight RT states. Participants were measured at the beginning and end of the study for symptoms of depression, anxiety, stress, and event-related stress. Though it was hypothesized that the RT group would show more clinical gain than the expressive writing group and that both experimental groups would fare better than the controls, the results indicated no significant differences among the groups on any of the measures. The author believes the nonsignificant findings most likely resulted from methodological issues including the relatively early collection of post-test data, the wide range of distress scores among participants, and group administration. Other factors may include the limited time for exposure in each RT state and the limited time for participants to develop a narrative of their trauma. Standardization of procedures and future research in this area, especially with regard to the clinical usefulness of Reversal Theory, is recommended.

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