title: Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients.
abstract: OBJECTIVE
  Expressing emotions and finding benefits regarding stressful experiences have been associated in correlational research with positive adjustment. A randomized trial was performed to compare effects of experimentally induced written emotional disclosure and benefit finding with a control condition on physical and psychological adjustment to breast cancer and to test whether outcomes varied as a function of participants' cancer-related avoidance.
  
  
  METHODS
  Early-stage breast cancer patients completing medical treatment were assigned randomly to write over four sessions about (1) their deepest thoughts and feelings regarding breast cancer (EMO group; n = 21), (2) positive thoughts and feelings regarding their experience with breast cancer (POS group; n = 21), or (3) facts of their breast cancer experience (CTL group; n = 18). Psychological (eg, distress) and physical (perceived somatic symptoms and medical appointments for cancer-related morbidities) outcomes were assessed at 1- and 3-month follow-ups.
  
  
  RESULTS
  A significant condition x cancer-related avoidance interaction emerged on psychological outcomes; EMO writing was relatively effective for women low in avoidance, and induced POS writing was more useful for women high in avoidance. Significant effects of experimental condition emerged on self-reported somatic symptoms (P =.0183) and medical appointments for cancer-related morbidities (P =.0069). Compared with CTL participants at 3 months, the EMO group reported significantly decreased physical symptoms, and EMO and POS participants had significantly fewer medical appointments for cancer-related morbidities.
  
  
  CONCLUSIONS
  Experimentally induced emotional expression and benefit finding regarding early-stage breast cancer reduced medical visits for cancer-related morbidities. Effects on psychological outcomes varied as a function of cancer-related avoidance.
authors.affiliation: Department of Psychology, University of Kansas, Lawrence, KS 66045, USA. astanton@ukans.edu
authors.forename: Annette L
authors.initials: AL
authors.lastname: Stanton
authors.forename: Sharon
authors.initials: S
authors.lastname: Danoff-Burg
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Sworowski
authors.forename: Charlotte A
authors.initials: CA
authors.lastname: Collins
authors.forename: Ann D
authors.initials: AD
authors.lastname: Branstetter
authors.forename: Alicia
authors.initials: A
authors.lastname: Rodriguez-Hanley
authors.forename: Sarah B
authors.initials: SB
authors.lastname: Kirk
authors.forename: Jennifer L
authors.initials: JL
authors.lastname: Austenfeld
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology*; D004644:Emotions; D006801:Humans; D008875:Middle Aged; D009017:Morbidity; D011594:Psychometrics; D014956:Writing