Meaning-Directed Writing to Reduce PTSD and Develop Resilience for Future Trauma

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DESCRIPTION (provided by applicant): Trauma exposure in the general population is high, and constitutes a major risk factor for experiencing high levels of distress, including PTSD symptomatology, in subsequent stressful and traumatic encounters. However, prior exposure per se constitutes only one risk factor. Survivors' ongoing appraisals of and coping with trauma are related as strongly, or perhaps even more so, to levels of PTSD symptomatology and distress, as well as to their responses to future potentially traumatic events. Fairly simple interventions involving writing about one's traumatic experiences have been shown to improve physical health and well- being, but few have examined the influence of writing on PTSD symptomatology. Further, there is little understanding of the mechanisms through which writing interventions may affect trauma-related distress. This 14 month longitudinal study of trauma survivors involves a writing intervention and a longer-term follow up that prospectively examines the influence of the intervention on coping with subsequent highly stressful experiences. This study extends the expressive writing intervention paradigm in four ways: (1) by examining a technique of meaning-directed writing designed to more directly influence survivors' appraisal and coping processes to help them achieve a higher degree adaptive appraisal of their trauma and more adaptive coping with it; (2) by focusing explicitly on post-traumatic stress symptomatology as well as other measures of distress and functioning; (3), by testing whether these more adaptive appraisals and coping processes not only reduce current symptomatology, but also serve as a protective factor for individuals when they encounter future traumatic or highly stressful experiences, and (4) by examining the effectiveness of extending focused expressive writing interventions via implementation on the World Wide Web. These results will have important implications for public health in elucidating the pathways through which traumatic exposure may affect subsequent functioning, and pointing the way for enhancing resilience and adaptive coping abilities. If effective, this intervention--short-term, easily adapted and implemented, and low-cost-- could be implemented at a community-wide level to decrease post-traumatic stress symptomatology and distress and build resilience for future stressful encounters. These results will have important implications for public health in elucidating the pathways through which traumatic exposure may affect subsequent functioning, and pointing the way for enhancing resilience and adaptive coping abilities. If effective, this intervention--short-term, easily adapted and implemented, and low-cost--could be implemented at a community-wide level to decrease post-traumatic stress symptomatology and distress and build resilience for future stressful encounters.