The overall aim of this application is to extend work on a new psychological phenomenon that may have direct clinical relevance for a variety of somatic diseases. The basic finding of interest relates to observed relationships between a brief writing task that creates emotional expression about past traumas, and salutary effects on some affective, psychophysiological, physiological, and symptom outcome measures. Participants examined in the majority of previous studies were typically healthy. In one previous study, however, the writing task produced reductions in symptoms in patients with asthma or rheumatoid arthritis. The proposed experiment attempts to extend such work as such a demonstration could suggest that treatment procedures based on the writing task be developed and employed in these and other medical conditions. A shift in affect, and presumably cognitive processes as well, apparently occurs in the interval between the written emotional expression and subsequent assessments. Current theorizing about this observation focuses on the idea that the cognitive representation of traumatic memories is altered in this period, resulting in reductions in negative affect and physiological arousal although there is no documentation of any such process. The primary goals of the study are to (1) determine the effect of written emotional expression on subsequent symptomatology, mood, and disease status in patients with asthma or rheumatoid arthritis, and (2) establish what psychological and/or social pathway(s) the manipulation may be operating through. Patients with asthma or rheumatoid arthritis will be assigned randomly to either experimental (writing about the most traumatic or stressful event they remember) or control condition (writing about neutral topics). Affect, cognition, social contacts, and symptoms will be assessed several times a day using palm top computers for one week prior to and two weeks following the manipulation. Disease status will be measured every six months for a period of two years, and quality of life measures will also be taken.
