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Original article

Original article

Efficacy of emotional writing among college students those have primary psychological disorders

Jai Singh Yadav1 Samiksha kaur2, Ritwiz Oodun3

1Assistant Professor, Dept. of Psychiatry, 2Psychologist SRLN Hospital, 3Junior Resident Dept Psychiatry IMS, BHU

Abstract

Background

Emotional writing helps in organizing of cognitive memory in patients those having emotional disorders. Outcome of many cognitive therapies based on organization of memory in patient. Emotional writing is self motivated methods which can benefited in certain group of patients those are more prone to develop stress.

Aim

To assess the efficacy of emotion writing in college students those have primary psychological disorder.

Methodology

Hundred examinations going students screened on CQA scale, from college of nursing S.S. hospital Varanasi. Their socio-demographic data were recorded and they were applied DASS scale , to evaluate the spectrum of emotional disorder. These students were given task to write emotional writing up to 3 months. The mean scores were measured after 1st, 2ndand 3rd months of emotional writing.

Result

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, another scale DASS was also applied on same students, on subsequent rating after 1 st,2nd,and 3rd months, of emotional writing , the mean score of responses decreased on both scales.

Conclusion

Emotional writing is helpful in reduction of stress spectrum disorder in college students, during examination. It is simple and convenient method that can apply on home setup.


Key Words-Emotional Writing, psychological disorder

Introduction 

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.

 

Aim

To assess the efficacy of emotion writing in college students those have primary psychological disorder.

 

Method           

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.

 

Tools

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.

Procedure

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.

 

Result

Table-1 :- Age/Gender

Age group

Female

Male

20-25

50 (52.63)

1(20)

26 -30

30 (31.57)

2(40)

31-35

12 (12.63)

1(20)

>35

2 (2.10)

1(20)

 

Table-2 :- Marital status

Marital status

Female

Male

Unmarried

88 (92.63)

02 (44.40)

 Married

07 (7.36)

03 (63.60)

Total

95

05

                                

 

Table-3 :- Socio-economic Status       

Age group

Low

middle

High

20-25

21

25

04

26 -30

10

18

02

31-35

9

2

01

>35

1

1

0

 

Table-4 :- Stress level CQA Scale

Student given

Response

mean score- on o day

Mean score –after 90 day

99

2.1

1.1

96

1.51

1.4

98

1.2

0.8

99

2.1

1.1

97

2.11

1.9

96

2.18

1.4

98

2.2

0.6

96

2.4

1.0

96

2.02

1.18

97

2.32

1.26

99

2.1

1.6

99

2.5

1.6

96

1.1

0.67

98

2.28

2.4

97

1.9

0.4

100

1.6

1.2

100

1.8

1.3

99

2.8

1.9

98

1.1

1.24

97

2.6

1.82

98

1.6

1.5

96

1.9

1.47

98

2.3

1.56

100

2.9

2.6

99

2.41

1.6

98

1.8

1.2

100

1.9

1.2

97

1.23

1.3

`98

1.1

0.9

97

1.5

1.3

98

1.2

0.8

Min=0, Max=3

Table-5 :- Depression Anxiety stress Scale

Student given response

mean score- on 0 day

Mean score –after 90 day

100

3.4

2.1

99

2.5

1.4

99

3.2

2.8

100

3.1

2.8

97

3.4

2.9

96

2.4

1.6

100

3.4

2.6

99

3.6

3.0

100

3.2

2.18

99

2.2

2.26

99

2.1

2.4

99

3.31

2.6

98

2.4

2.1

98

2.8

1.9

97

2.9

1.4

100

2.6

1.8

99

2.1

1.9

100

2.4

1.8

Min=1, Max=4


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 responses decreased.

Discussion

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 writing about traumatic memories 11-12

References

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