Sayer Nina A, Noorbaloochi Siamak, Frazier Patricia A, Pennebaker James W, Orazem Robert J, Schnurr Paula P, Murdoch Maureen, Carlson Kathleen F, Gravely Amy, Litz Brett T
Center for Chronic Disease Outcomes Research, Minneapolis VA Healthcare System, Minneapolis, Minnesota, USA.
Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
J Trauma Stress. 2015 Oct;28(5):381-90. doi: 10.1002/jts.22047.
We examined the efficacy of a brief, accessible, nonstigmatizing online intervention-writing expressively about transitioning to civilian life. U.S. Afghanistan and Iraq war veterans with self-reported reintegration difficulty (N = 1,292, 39.3% female, M = 36.87, SD = 9.78 years) were randomly assigned to expressive writing (n = 508), factual control writing (n = 507), or no writing (n = 277). Using intention to treat, generalized linear mixed models demonstrated that 6-months postintervention, veterans who wrote expressively experienced greater reductions in physical complaints, anger, and distress compared with veterans who wrote factually (ds = 0.13 to 0.20; ps < .05) and greater reductions in PTSD symptoms, distress, anger, physical complaints, and reintegration difficulty compared with veterans who did not write at all (ds = 0.22 to 0.35; ps ≤ .001). Veterans who wrote expressively also experienced greater improvement in social support compared to those who did not write (d = 0.17). Relative to both control conditions, expressive writing did not lead to improved life satisfaction. Secondary analyses also found beneficial effects of expressive writing on clinically significant distress, PTSD screening, and employment status. Online expressive writing holds promise for improving health and functioning among veterans experiencing reintegration difficulty, albeit with small effect sizes.
我们研究了一种简短、易获取且无污名化的在线干预措施——通过富有表现力地写作来描述向平民生活过渡的效果。自我报告存在重新融入困难的美国阿富汗和伊拉克战争退伍军人（N = 1292，39.3%为女性，M = 36.87，SD = 9.78岁）被随机分配到表达性写作组（n = 508）、事实性对照写作组（n = 507）或无写作组（n = 277）。采用意向性分析，广义线性混合模型表明，干预6个月后，与进行事实性写作的退伍军人相比，进行表达性写作的退伍军人在身体不适、愤怒和痛苦方面的减少更为显著（d值 = 0.13至0.20；p值 < 0.05），与完全不写作的退伍军人相比，在创伤后应激障碍症状、痛苦、愤怒、身体不适和重新融入困难方面的减少更为显著（d值 = 0.22至0.35；p值 ≤ 0.001）。与不写作的退伍军人相比，进行表达性写作的退伍军人在社会支持方面也有更大改善（d = 0.17）。相对于两种对照条件，表达性写作并未带来生活满意度的提高。二次分析还发现表达性写作对具有临床意义的痛苦、创伤后应激障碍筛查和就业状况有有益影响。在线表达性写作有望改善存在重新融入困难的退伍军人的健康和功能，尽管效应量较小。
