Expressive Writing as a Therapeutic Process for Drug Dependent Women

描述（由申请人提供）：研究指出，在物质使用障碍（SUD）妇女的生活中，人际创伤的发生率非常高。创伤和成瘾共病研究一致表明，这些女性可能比那些没有创伤经历或创伤后应激障碍（PTSD）的女性健康状况更差，临床表现更严重，治疗依从性更差。虽然创伤传统上没有被纳入SUD治疗，但研究表明，在SUD治疗期间解决创伤可能会改善治疗结果。在过去的二十年里，越来越多的证据表明，通过表达性写作来披露创伤或压力经历，对身心健康有着广泛的好处。虽然很多注意力都集中在Pennebaker的表达性写作范式的好处，它还没有被检查与SUD人口。表达性书写的功效、效率和成本效益表明，将其用作披露创伤经历的手段可能是传统SUD治疗的有力辅助手段。拟议的项目将研究：a）Pennebaker的表达性写作范式是否有利于目前在SUD治疗的妇女; B）对直接和长期的痛苦的写作任务的影响; c）语言变量的文章使用语言调查和字数统计（LIWC）。人群将是在Rubicon，Inc.住院治疗的女性。写作范例包括连续四天每天写一个指定的主题，每次20分钟。在基线时，参与者将完成问卷调查，评估创伤后的严重程度，痛苦，渴望，抑郁和健康症状。在写作阶段，参与者将被分配到两个条件中的一个，并被要求写下个人创伤/压力经历或中性主题。在第二至第四节写作课中，参与者将保持与第一节相同的条件写作20分钟。在随访时，将完成撰写前实施的措施。如果结果证明是有希望的，他们将支持表达性写作作为一个简短的，成本效益，辅助目前的SUD治疗。结果还将意味着，它的使用，结合目前的SUD治疗方式，应更广泛地考虑，和潜在的SUD和创伤的问题，可以在治疗过程中同时解决。

DESCRIPTION (provided by applicant): Studies point to overwhelming rates of interpersonal trauma in the lives of women with Substance Use Disorders (SUD). Trauma and addiction comorbidity studies consistently reveal these women are likely to have poorer health, more severe clinical profiles, and worse treatment adherence, than those without traumatic experiences or Posttraumatic Stress Disorder (PTSD) symptomatology. While trauma has traditionally not been incorporated into SUD treatment, studies indicate that addressing trauma during SUD treatment may improve treatment outcomes. Accumulating evidence over the past two decades indicates disclosure of traumatic or stressful experiences through expressive writing has widespread mental and physical health benefits. Although much attention has focused on the benefits of Pennebaker's expressive writing paradigm, it has not been examined with a SUD population. Expressive writings' efficacy, efficiency, and cost-effectiveness suggest its use as a means for disclosing traumatic experiences may be a powerful adjunct to traditional SUD treatment. The proposed project will examine: a) whether Pennebaker's expressive writing paradigm benefits women currently in SUD treatment; b) the influence of the writing task over immediate and long-term distress; c) language variables in essays using a Linguistic Inquiry and Word Count (LIWC). The population will be women enrolled in residential treatment at Rubicon, Inc. The writing paradigm includes writing about an assigned topic daily for 20 minute sessions over four consecutive days. At baseline, participants will complete questionnaires assessing post-traumatic severity, distress, craving, depressive, and health symptoms. At writing session one, participants will be assigned to one of two conditions, and asked to write about either a personal traumatic/stressful experience or a neutral topic. In writing sessions two through four, participants will write for 20 min maintaining the same condition as assigned in session one. At follow-up, measures administered prior to writing will be completed. If results prove promising, they will support expressive writing as a brief, cost effective, adjunct to current SUD treatment. Results will also imply that its use, in conjunction with current SUD treatment modalities, should be more broadly considered, and that problems underlying SUD and trauma could be simultaneously addressed during treatment.