Pennebaker&Chung_FriedmanChapter

Pennebaker&Chung_FriedmanChapter - Pennebaker,...

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Pennebaker, J.W., & Chung, C.K. (2007). Expressive writing, emotional upheavals, and health. In H. Friedman and R. Silver (Eds.), Handbook of health psychology (pp. 263-284). New York: Oxford University Press. Expressive Writing, Emotional Upheavals, and Health James W. Pennebaker and Cindy K. Chung The University of Texas at Austin Correspondence should be addressed to James W. Pennebaker, Department of Psychology A8000, University of Texas, Austin, TX 78712 (e-mail: Pennebaker@mail.utexas.edu). Preparation of this paper was aided by a grant from the National Institutes of Health (MH52391).
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2 Expressive Writing, Emotional Upheavals, and Health There is a long history in psychology and medicine linking the occurrence of traumatic experiences with subsequent physical and mental health problems. What is it about a trauma that influences health? Several candidates immediately come to mind. Psychologically, personal upheavals provoke intense and long-lasting emotional changes. The unexpected events are generally associated with cognitive disruption including rumination and attempts to understand what happened and why. Socially, traumas are known to cause wholesale disruptions in people’s social networks. Behaviorally, and perhaps because of the social and psychological changes, traumas are often associated with lifestyle changes such as unhealthy smoking, drinking, exercise, sleeping, and eating patterns. Each of these psychological, social, and behavioral effects is associated with a host of biological changes including elevations in cortisol, immune disruption, cardiovascular changes, and a cascade of neurotransmitter changes. Individuals who are highly reactive to novel stimuli (Vaidya & Garfield, 2003), are highly anxious (Miller, 2003), avoidant, and self-blaming (Sutker, Davis, Uddo, & Ditta, 1995), and high in hypnotic ability (Bower & Sivers, 1998) may be particularly susceptible to traumatic experiences. Similarly, the more extreme the trauma and the longer time over which it lasts are predictors of Post-Traumatic Stress Disorder (PTSD) incidence (e.g., Breslau, Chilcoat, Kessler, & Davis, 1999). It is also generally agreed that people most prone to PTSD have had a history of depression, trauma, and other PTSD episodes in the past even prior to their most recent traumatic experience (cf., Miller, 2003). Perhaps more surprising than the discovery of the trauma-illness link is in realizing that most people don’t become sick after a trauma. There is another group of perhaps 30% who do not evidence PTSD symptoms but are still upset by the experience several weeks and months
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3 after. In a classic article, Wortman and Silver (1989) summarized several studies showing that at least half of people who have faced the death of a spouse or child did not experience intense anxiety, depression, or grief. Numerous studies report that at least 65 percent of male and female soldiers who have lived through horrific battles or war-zone stress never show any evidence of
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Pennebaker&Chung_FriedmanChapter - Pennebaker,...

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