Batista João, Marinai Janine C, Gouveia Melissa, Oliveira João Tiago, Gonçalves Miguel M
Psychotherapy and Psychopathology Unit, School of Psychology, University of Minho, Braga, Portugal.
Front Psychol. 2022 Jul 7;13:874600. doi: 10.3389/fpsyg.2022.874600. eCollection 2022.
There are a plethora of studies on expressive writing and positive writing interventions, but few have addressed the combination of both paradigms. Additionally, research on the role of ambivalence toward change in the context of writing-based interventions is lacking. Ambivalence toward change is a natural movement of approaching and avoiding change that may occur in various situations. In psychotherapy, its resolution is associated with successful outcomes.
This study tested the efficacy of a combination of expressive and positive writing paradigms in an internet-based intervention to improve university students' mental health. Additionally, focusing participants on a current, unresolved problem allowed us to explore the possible role of ambivalence toward change as a mediator of the intervention's results.
We recruited 172 participants who were randomly divided into experimental ( = 85) and control ( = 87) groups. The intervention consisted of the identification of a current problem and four writing tasks on consecutive days. Assessment was conducted at baseline and posttest in both groups and at follow-up in the experimental group. Participants in the experimental condition were also assessed after each task. Measures of anxiety, depression, rumination, ambivalence toward change, distress, and wellbeing (optimism, affect, and satisfaction with life) were collected.
Multivariate analysis of variance (MANOVA) showed that participants in the experimental group had a significant decrease from baseline to posttest in ambivalence toward change and rumination when compared with the control group. These results were maintained at follow-up. No differences were found in the remaining measures. Within the experimental group, ambivalence toward change, rumination, and distress significantly decreased throughout the intervention and the exploratory mediation analysis indicated that ambivalence toward change partially mediated the improvements in rumination and distress.
Considering different perspectives about a current problem and using a combination of expressive and positive writing fostered the reduction of ambivalence toward change and rumination. Ambivalence toward change reduction after the second writing task may have created optimal conditions for the subsequent decrease in rumination and distress. Future studies should replicate this finding and dismantle the components that are more adequate in changing these variables.
关于表达性写作和积极写作干预的研究众多，但很少有研究涉及这两种范式的结合。此外，在基于写作的干预背景下，对改变的矛盾态度所起作用的研究也很缺乏。对改变的矛盾态度是在各种情况下可能出现的接近和回避改变的自然动态过程。在心理治疗中，其解决与成功的治疗结果相关。
本研究测试了表达性写作和积极写作范式相结合的基于网络的干预措施对改善大学生心理健康的效果。此外，让参与者关注当前未解决的问题，使我们能够探讨对改变的矛盾态度作为干预结果中介的可能作用。
我们招募了172名参与者，将他们随机分为实验组（n = 85）和对照组（n = 87）。干预包括识别当前问题和连续四天的四项写作任务。两组在基线和后测时进行评估，实验组在随访时进行评估。实验条件下的参与者在每项任务后也进行评估。收集焦虑、抑郁、沉思、对改变的矛盾态度、痛苦和幸福感（乐观、情感和生活满意度）的测量数据。
多变量方差分析（MANOVA）表明，与对照组相比，实验组参与者从基线到后测时对改变的矛盾态度和沉思显著降低。这些结果在随访时得以维持。其余测量指标未发现差异。在实验组中，整个干预过程中对改变的矛盾态度、沉思和痛苦显著降低，探索性中介分析表明，对改变的矛盾态度部分中介了沉思和痛苦的改善。
考虑当前问题的不同观点并结合使用表达性写作和积极写作有助于减少对改变的矛盾态度和沉思。第二次写作任务后对改变的矛盾态度的减少可能为随后沉思和痛苦的降低创造了最佳条件。未来的研究应重复这一发现，并拆解在改变这些变量方面更合适的组成部分。
