For whom does it work? Moderators of the effects of written emotional disclosure in a randomized trial among women with chronic pelvic pain.
OBJECTIVE
Although written emotional disclosure has potential as a stress management intervention for people with health problems, the main (group) effects of disclosure in medical populations are limited. This study sought to identify individual difference moderators of the effects of written disclosure among women with chronic pelvic pain.


METHODS
In a prospective, randomized trial, 48 women with chronic pelvic pain completed 3 individual difference measures and then wrote for 3 days about stressful consequences of their pain (disclosure) or positive events (control). Health status was assessed at baseline and 2 months after writing.


RESULTS
Main effect group comparisons indicated that disclosure writing resulted in significantly lower evaluative pain intensity ratings than control writing at follow-up, but there were no main effects on other outcome variables (sensory or affective pain, disability, affect). Three baseline individual difference measures, however, significantly moderated group effects. Compared with control writing, disclosure led to less disability among women with higher baseline ambivalence over emotional expression or higher catastrophizing, and to increased positive affect among women with higher baseline negative affect. Ambivalence, but not catastrophizing, was independent of negative affect in its moderation effect.


CONCLUSIONS
Although the main effects of writing about the stress of pelvic pain are limited, women with higher baseline ambivalence about emotional expression or negative affect appear to respond more positively to this intervention.
Norman
Sally A
SA
Department of Psychology, Wayne State University, Detroit, MI, USA.
Lumley
Mark A
MA
Dooley
John A
JA
Diamond
Michael P
MP
D000223:Adaptation, Psychological; D000293:Adolescent; D000328:Adult; D001294:Attitude to Health; D002908:Chronic Disease; D019260:Expressed Emotion; D005260:Female; D005500:Follow-Up Studies; D006304:Health Status; D006801:Humans; D007206:Individuality; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010147:Pain Measurement; D017699:Pelvic Pain / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy; D010555:Personality Inventory / Q000706:statistics & numerical data; D011446:Prospective Studies; D012650:Self Disclosure; D018434:Sickness Impact Profile; D013315:Stress, Psychological / Q000175:diagnosis*; D011795:Surveys and Questionnaires; D014956:Writing