Exposure to community violence is related to many adjustment problems in youth, including psychological distress and aggressive behavior. Our preliminary research in Richmond, VA, suggests that expressive writing interventions are effective at reducing aggressive behavior and symptoms of anxiety and depression associated with violence exposure. The primary objective of the proposed research, which is guided by our emotion-regulation model of expressive writing, is to further develop and test the short- and long-term efficacy of an expressive writing intervention for youth exposed to violence. Secondary objectives include identifying mediators and moderators of the effects of the writing intervention and finding ways to maximize efficacy of the intervention. Tertiary objectives include identifying barriers and supports within the school for the effective adoption and implementation of the EW intervention, and developing guidelines for school systems interested in implementing evidence-based expressive-writing interventions. The research will be conducted in two cities with high levels of community violence Richmond, VA, and Philadelphia, PA in order to evaluate whether the interventions are effective in different school settings. Study 1 will use a randomized, three-group (standard expressive writing, standard expressive writing with booster sessions, control writing) repeated measures four-wave design to evaluate the relative efficacy of a novel, school- based expressive-writing intervention with and without booster sessions. Forty-eight 7th -8th grade classrooms will be randomized to one of the three writing conditions. In standard expressive writing with and without the booster, youth privately write about their deepest thoughts and feelings concerning violence or related stressors. Booster sessions are included to determine if the efficacy of the expressive writing intervention can be enhanced. Youth in the control condition will write about non-emotional topics, unrelated to violence. Study 2 is a qualitative focus group study with students, teachers, school counselors and administrators designed to identify the potential barriers and available supports for adopting the expressive writing intervention as part of the school health education curricula. Finally, we will use the intervention findings, as well as data from the focus groups, to design dissemination guidelines for investigators and school systems interesting in implementing expressive writing interventions in school settings.

Public Health Relevance

PARAGRAPH: Witnessing and experiencing community violence negatively affects the psychological and behavioral adjustment of millions of children. Expressive writing interventions, which have proven effective for adults, may be a cost-effective way to reduce the negative consequences associated with community violence exposure, yet little systematic evaluation has been conducted on this intervention strategy. The proposed studies will provide data on the short- and long-term efficacy of a school-based expressive writing intervention, identify who is most likely to benefit from the intervention and why, and identify potential barriers and supports within the school for the effective adoption and implementation of the expressive writing intervention.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Research Project (R01)
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Psychosocial Development, Risk and Prevention Study Section (PDRP)
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Sarampote, Christopher S
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Virginia Commonwealth University
Schools of Arts and Sciences
United States
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Kliewer, Wendy; Lepore, Stephen J (2015) Exposure to violence, social cognitive processing, and sleep problems in urban adolescents. J Youth Adolesc 44:507-17
Lepore, Stephen J; Kliewer, Wendy (2013) Violence exposure, sleep disturbance, and poor academic performance in middle school. J Abnorm Child Psychol 41:1179-89