Gillis Mazy E, Lumley Mark A, Mosley-Williams Angelia, Leisen James C C, Roehrs Timothy
Department of Psychoogy, Wayne State University, Detroit, MI 48202, USA.
Ann Behav Med. 2006 Oct;32(2):135-46. doi: 10.1207/s15324796abm3202_11.
The presence and severity of the chronic pain syndrome fibromyalgia (FM) is associated with unresolved stress and emotional regulation difficulties. Written emotional disclosure is intended to reduce stress and may improve health of people with FM.
This study tests the effects of at-home, written emotional disclosure about stressful experiences on the health of people with FM and uses multiple follow-ups to track the time course of effects of disclosure.
Adults with FM (intention-to-treat, n=83; completers, n=72) were randomized to write for 4 days at home about either stressful experiences (disclosure group) or neutral time management (control group). Group differences in immediate mood effects and changes in health from baseline to 1-month and 3-month follow-ups were examined.
Written disclosure led to an immediate increase in negative mood, which did not attenuate across the 4 writing days. Repeated-measures analyses from baseline to each follow-up point were conducted on both intention-to-treat and completer samples, which showed similar outcomes. At 1 month, disclosure led to few health benefits, but control writing led to less negative affect and more perceived support than did disclosure. At 3-month follow-up, these negative affect and social support effects disappeared, and written disclosure led to a greater reduction in global impact, poor sleep, health care utilization, and (marginally) physical disability than did control writing. Interpretation of these apparent benefits needs to be made cautiously, however, because the disclosure group had somewhat poorer health than controls at baseline and the control group showed some minor worsening over time.
Written emotional disclosure can be conducted at home, and there is tentative evidence that disclosure benefits the health of people with FM. The benefits, however, may be delayed for several months after writing and may be of limited clinical significance.
慢性疼痛综合征纤维肌痛（FM）的存在及严重程度与未解决的压力和情绪调节困难有关。书面情绪表露旨在减轻压力，并可能改善纤维肌痛患者的健康状况。
本研究测试在家中就压力经历进行书面情绪表露对纤维肌痛患者健康的影响，并通过多次随访来追踪表露效果的时间进程。
患有纤维肌痛的成年人（意向性治疗，n = 83；完成者，n = 72）被随机分配，在家中连续4天写下关于压力经历（表露组）或中性的时间管理（对照组）。研究了即时情绪效应的组间差异以及从基线到1个月和3个月随访时健康状况的变化。
书面表露导致负面情绪立即增加，且在4天的写作过程中并未减弱。在意向性治疗样本和完成者样本中，都对从基线到每个随访点进行了重复测量分析，结果相似。在1个月时，表露对健康益处不大，但对照写作比表露导致更少的负面影响和更多的感知支持。在3个月随访时，这些负面影响和社会支持效应消失，书面表露比对照写作在整体影响、睡眠不佳、医疗保健利用和（勉强算）身体残疾方面有更大程度的减轻。然而，对这些明显益处的解读需要谨慎，因为表露组在基线时的健康状况比对照组略差，且对照组随着时间推移出现了一些轻微恶化。
书面情绪表露可以在家中进行，并且有初步证据表明表露对纤维肌痛患者的健康有益。然而，这些益处可能在写作后的几个月才显现，且临床意义可能有限。
