Impact of Narrative Expressive Writing on Heart Rate, Heart Rate Variability, and Blood Pressure After Marital Separation

Abstract

Objective Divorce is a common stressor that is associated with increased risk for poor long-term physical and mental health. Using an experimental design, the current study examined the impact of expressive writing (EW) on average heart rate (HR), heart rate variability (HRV), and blood pressure (BP) 7.5 months later. Methods Participants from a community sample of recently separated adults (N=109) were assigned to one of three conditions, traditional EW, narrative EW, or a control writing condition, and assessed three times over an average of 7.5 months. Each study visit included 27 minutes of physiological assessment; the primary outcomes at each assessment were mean-level HR, HRV, BP scores averaged across six different tasks. Results Participants in the traditional EW condition did not significantly differ from control participants in their later HR, HRV, or BP. However, relative to control participants,those in the narrative EW condition had significantly lower HR, B = -3.38, 95% CI [-5.48, -1.23], p = .002, and higher HRV 7.5 months later, B = 0.34, 95% CI [0.15, 0.53], p < .001. These effects were moderately sized, Cohen’s ds = -0.61 and 0.60, respectively, and durable across all task conditions when analyzed in independent models.The writing condition groups did not differ in their later BP. Conclusions Narrative EW decreased HR and increased HRV following marital separation, but did not affect BP. We discuss the possible disconnect between psychology and physiology in response to EW, as well as possible future clinical applications following marital separation.

Real-Time Psychophysiological and Writing Correlates of Expressive Writing

“…The expressive writing paradigm promotes disclosure of emotional content, likely initiating a meaning making process surrounding the stressful life event (Bourassa, Allen, Mehl, & Sbarra, 2017). This emotional disclosure typically leads to psychophysiological arousal, associated with short-term distress and negative mood (McGuire, Greenberg & Gevirtz, 2005;Pennebaker, Kiecolt-Glaser, & Glaser, 1988).…”

A meta-analytical review of the responses in the MMPI-2/MMPI-2-RF clinical and restructured scales of parents in child custody dispute

“…Thus, the effect sizes were less than small (δ < .20) in Hypochondriasis and Depression, with a probability of being classified as a clinical case (U2) of .013 and .012 in Hypochondriasis and Depression, rates below the general population (between .05 and .07 [Somatic Symptom Disorder]; and between .013 and .10 [Illness Anxiety Disorder] in Hypochondriasis, and around .07 in non-persistent depression) (APA, 2013). Second, self-reports close to normality in Depression and Hypochondriasis are indicators of denial of symptoms as couple break-down is strongly related to negative outcomes in Depression and Hypochondriasis (Afifi et al, 2006;Amato, 2010;APA, 2013;Blanco et al, 2017;Bourassa et al, 2017;Seijo et al, 2016;Zella, 2017). Succinctly, on these two dimensions, parents in child custody litigation concealed (feigned) clinical symptomatology depressive and somatic symptoms, and anxiety owing to illness (hypochondriasis passed to be renamed in DSM-5 as Somatic Symptom Disorder and Illness Anxiety Disorder).…”

“…Both separation and divorce entail injury in the psychological adjustment of both parents and their offspring, in particular in terms of high levels of anxiety and depressive symptoms, and in the diagnosis of anxiety and depression (Afifi, Cox, & Enns, 2006;Amato, 2010;APA, 2013;Blanco, Otero, López, Torres, & Vázquez, 2017;Bourassa, Allen, Mehl, & Sbarra, 2017;Seijo, Fariña, Corras, Novo, & Arce, 2016;Zella, 2017). However, evaluations in forensic setting have found that, in general, subjects under evaluation reported normality.…”

Breaking the spell: Narrative Medicine applications for Psychogenic Nonepileptic Seizures (PNES)

“…Narrative writing exercises have provided help for patients with heart problems, cancer, traumatic experiences, asthma, and rheumatoid arthritis [14][15][16][17][18]. These studies reported benefits "including decreased pain, improved health status or well-being, increased vigor, better sleep quality, and decreased doctor-visit rates.…”