Expressive writing as an exposure based therapy for depression: An investigation of emotion, cognition, and physiology

Abstract

Although we have several therapeutic interventions for depression, we lack an understanding of the mechanisms that underlie these interventions. To gain a better understanding of the mental health conditions we treat, diagnoses we make, and interventions we use, mechanistic understandings are necessary. There is evidence that exposure to depressive emotion and cognitions can yield therapeutic outcome. The current study examines the physiology associated with an intervention, expressive writing (EW), which other research has shown to produce therapeutic outcomes because it increases exposure to negative feelings. The current study tests the hypothesis that EW increases depressive emotion, cognition, and physiology. Depression has been associated with decreased respiratory sinus arrhythmia (RSA) and increased heart rate (HR). RSA and HR were measured while participants did either EW or a control writing (CW) task. Because measures of RSA can be confounded by respiratory rate (RR), RR was also measured and statistically controlled for. Results revealed that EW does not alter RSA or HR. Interestingly, exploratory regression analyses between HR and RR during EW suggest that EW might trigger exposure to a depressive physiological state. Further investigation into the relationship between HR and RR during EW is warranted.