Emotion is a state which changes by physiological response to events, it
can maintain or abolished with causative event. Student studying in
competitive environment feel much pressure need of success, and meeting
expectation of family society, peers groups, and college. If they fail to cope
on daily basis they developed psychological disorders in forms of drug abuse,
somatic symptoms, acute stress disorder, affective psychosis or neurotic
condition like depression suicidal feeling, anxiety, phobia and obsessive
compulsive disorders. Many studies have demonstrated the beneficial
effects of emotional writing in stressful events. Physical and emotional health
changes the way that participants interacting with others. In a study1
on expressive writing among college students those wrote for 15
minutes on 4 consecutive days about the most traumatic or upsetting experiences
of their entire lives, while controls wrote about superficial topics.
Participants who wrote about their deepest thoughts and feelings reported
significant benefits in both objectively assessed and self-reported physical
health 4 months later. In addition, writing about emotional topics change an
impact on objectively assessed social and linguistic behavior 2. Some
studies have also found longer-term benefits of expressive writing for emotional
health outcomes, including mood 3,,4, psychological well-being 5,
depressive symptoms before examinations 6 and post-traumatic
intrusion and avoidance symptoms 7. Each culture has different
types of stressors, in Indian students such study has not done so far. Our study
mainly focused on college students those have high risk to develop various
psychological problems during examination.
To assess the efficacy of emotion writing in college students those have
primary psychological disorder.
Sample selection:-In this prospective study clustered
sample of two hundred twenty five B.sc. nursing students were selected from
college of nursing institute of medical science BHU. All were going to appear in
examination after 3 month.
Selection criteria; Students not have physical illness; they were agree
to give consent for participation and write of emotional thought content, Score
on coping questionnaire for adolescent (CQA) scale more than 1.
Coping questionnaire for adolescent (CQA) scale for initial screening,
ii-Depression Anxiety Stress Scale (DASS)-for emotional state of depression,
anxiety and stress. Coping questionnaire for adolescent (CQA) scale applied for
assessment of thinking and means used in measures of respondents to cope with
stressful situations. The scale consist 4 subscales which indicates problem
solving, psychological self care , internalizing
thoughts, behaviors, and social support strategies in adolescent . Each
response was based on four point s, 0=I did not used,1= I used some of the
time,2=I used quit a bit of time , 3= I used all of the time. Depression anxiety
stress scale (DASS) is a four point scale ranging from 1to 4. 1=Not at all,2=No
more than usual,3= More than usual 4=Much more than usual.
Two hundred twenty five students were given coping questionnaire for
adolescent (CQA) scale, among these hundred patients fulfilled the selection
criteria, and they were diagnosed by consultant psychiatry on basis of ICD-10
DCR Criteria. The socio demographic data were recorded. Screened students were
applied, depression anxiety stress scale (DASS) and initial scores was noted.
These students were instructed to write about emotionally upsetting experiences
for 15 to 20 minutes a day for 4 consecutive days/week, don’t worry about
spelling, grammar or sentence structure. They also instructed that once you
begin to write, you continue until the time is up. The above scales were applied
on one month interval, for three consecutive months.
A total of 100 subjects were enrolled in the study. They were divided
into age groups; maximum students were in age group 20 to 25 years while less
numbers were more than 35 years. Female were 95%, majorities were unmarried
students. Seventy percentage female and eighty percentage male student were
stayed in hostel in share with single room of two students. 61% students were
from low socioeconomic status. The parents of two student s were died in early
age, while 5% students have single parents. 76% students have joint family setup
and head of family were it heir their father or other/uncle. Among the 100
students 96 to 100 % students given response on CQA scale questionnaires, and
their mean scores were between 1.0 to 2.5, on subsequent rating after 1
month2 month and 3months after emotional writing , minimum mean score reduction
were between 0.4 to 2.4. Similarly on DASS scale the mean score of
It is well established that emotional writing help in organizing of
cognitive schema in patients those have emotional problems. Efficacy of many
therapies based on cognitive processes of patient, therefore before application
of these therapies different methods like abreaction , narcolysis, hypnosis
applied to explore and organize schema, but these processes needs more time and
expenses . Emotional writing is self motivated method which patient can easily
apply on home setup. Indian students have limited money and time to visit
specialized clinic, most of them resides away from their home and not aware on
their emotional problems. In this research we find that this simple method of
emotional writing more helpful during stress in students mainly those who
have more e prone to developed problems during examination. There are limited
trial to date have evaluated the effects of expressive writing in student with
psychological problem. Because many studies on the physiological effects of
expressive writing have found significant and beneficial in many value of the
autonomic nervous system such as skin conductance, heart rate, heart rate
variability and blood pressure, in recent clinical trial on
potential physiological, emotional and cognitive mechanisms underlying the
positive health effects produced by disease-related expressive writing in a
sample of women with early stage breast cancers 8. Hypothesis
supported that autonomic activity (heart rate) mediates the effect of the
expressive writing condition on self-reported physical symptoms. Findings
suggested that the prolonged and repeated exposure and concomitant cognitive
processing might contribute to improved regulation of physiological responses,
presumably leading to less stress on bodily systems and ultimately enhanced
physical health 8. Our findings were also supporting that the
emotional writing is in college students those were going to appears in
examination is beneficial in reduction of emotional problems.
This effective non-pharmacological treatments for this population, is a
low-cost and easily administered psychological intervention was shown to be
effective, it could be widely applied in clinical use. Our result showed that,
one month after writing, the participants who were allocated in the expressive
writing condition exhibited lower mean score on CQA and DASS scale than before
writing and that, after three months after writing, scores on both scales
remained lower than zero days. 9 suggested that the cognitive
processing as a potential mechanism involves in writing help the writer to
organize and structure of the traumatic memory, therefore it resulting in
more adaptive, integrating about self, others and the world . Effects of
prolonged exposure .The effectiveness of prolonged exposure as a treatment for
post-traumatic stress10 led to the suggestion that the writing
paradigm may produce extinction of negative emotional responses through repeated
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