UCLA

Background: Chronic stress can damage individuals’ mental and physical health. Expressive disclosure about stressful events can decrease psychological distress and physical symptoms for individuals enduring a variety of chronic stressors (Frattaroli, 2006). The use of self-affirming statements about personal values is an active ingredient of expressive writing (e.g., Creswell et al., 2007). Additionally, when individuals face threat, their use of self-affirmation, or focusing on personally relevant values that are unrelated to the threat, can reduce their stress response (Creswell et al., 2005; Sherman, Bunyan, Creswell, & Jaremka, 2009). Few studies have examined the potential benefits of repeated self-affirmation on psychological and physical health beyond single laboratory sessions. This experimental study sought to integrate the existing research on expressive writing and self-affirmation theory by examining the effects of brief expressive writing and self-affirmation writing protocols on psychological and physical health over two months, compared to a control writing condition.

Method: Undergraduate students experiencing chronic financial stress (N=110) were randomized to write about their most important value unrelated to finances (self-affirmation condition), their deepest thoughts and feelings about their financial stress (expressive writing), or how the spent their day (control condition) four times over the course of two laboratory sessions. Measures of mental and physical health were taken two weeks and eight weeks after their final writing session. The present study examined group differences in primary outcomes (negative affect, intrusive thoughts about finances, and physical symptoms) and secondary outcomes (symptoms of anxiety, depressive symptoms, and sleep) over time, as well as potential moderators (reward sensitivity and dispositional avoidance motivation) and mediators (increased positive affect, increased self-kindness, decreased avoidance coping) of self-affirmation and expressive writing.

Results: Multilevel modeling analyses revealed that the linear trajectories of negative affect in the expressive writing and self-affirmation conditions differed significantly from the control condition, accounting for 32% variance of the linear trajectory of negative affect. Specifically, negative affect increased significantly over the study period for the control condition, whereas it decreased slightly but not significantly in the expressive writing condition and significantly decreased in the self-affirmation condition. Experimental condition had no significant effect on the five other outcomes (i.e., intrusive thoughts about finances, physical symptoms, symptoms of anxiety, depressive symptoms, and sleep). Dispositional reward sensitivity significantly moderated the effect of expressive writing, but not self-affirmation, on negative affect and physical symptoms. Individuals in the expressive writing condition who were lower in dispositional reward sensitivity evidenced significantly greater decreases in negative affect and physical symptoms over time compared to their counterparts in the control condition. The expressive writing and control conditions did not differ significantly on change in negative affect or physical symptoms for individuals who were high in dispositional reward sensitivity. Dispositional avoidance motivation did not moderate the effect of expressive writing or self-affirmation, and no significant mediated effects were found for either condition.

Conclusions: Both expressive writing and self-affirmation may benefit undergraduates with chronic financial strain, particularly by buffering against increases in negative affect. Results also suggest that expressive writing might be especially beneficial for individuals who are low in reward sensitivity. However, because the present study was unable to identify mediators, continued research is needed to understand the other potential underlying mechanisms of self-affirmation (e.g., increased coping self-efficacy, sense of belonging, and reward processing). Emotional expression and reflection on personally-important values may be important components of, or combined to create, future interventions for individuals facing chronic stress.