Studies point to overwhelming rates of interpersonal trauma in the lives of women with Substance Use Disorders (SUD). Trauma and addiction comorbidity studies consistently reveal these women are likely to have poorer health, more severe clinical profiles, and worse treatment adherence, than those without traumatic experiences or Posttraumatic Stress Disorder (PTSD) symptomatology. While trauma has traditionally not been incorporated into SUD treatment, studies indicate that addressing trauma during SUD treatment may improve treatment outcomes. Accumulating evidence over the past two decades indicates disclosure of traumatic or stressful experiences through expressive writing has widespread mental and physical health benefits. Although much attention has focused on the benefits of Pennebaker's expressive writing paradigm, it has not been examined with a SUD population. Expressive writings' efficacy, efficiency, and cost-effectiveness suggest its use as a means for disclosing traumatic experiences may be a powerful adjunct to traditional SUD treatment. The proposed project will examine: a) whether Pennebaker's expressive writing paradigm benefits women currently in SUD treatment; b) the influence of the writing task over immediate and long-term distress; c) language variables in essays using a Linguistic Inquiry and Word Count (LIWC). The population will be women enrolled in residential treatment at Rubicon, Inc. The writing paradigm includes writing about an assigned topic daily for 20 minute sessions over four consecutive days. At baseline, participants will complete questionnaires assessing post-traumatic severity, distress, craving, depressive, and health symptoms. At writing session one, participants will be assigned to one of two conditions, and asked to write about either a personal traumatic/stressful experience or a neutral topic. In writing sessions two through four, participants will write for 20 min maintaining the same condition as assigned in session one. At follow-up, measures administered prior to writing will be completed. If results prove promising, they will support expressive writing as a brief, cost effective, adjunct to current SUD treatment. Results will also imply that its use, in conjunction with current SUD treatment modalities, should be more broadly considered, and that problems underlying SUD and trauma could be simultaneously addressed during treatment. ? ? ?

National Institute of Health (NIH)
National Institute on Drug Abuse (NIDA)
Dissertation Award (R36)
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Human Development Research Subcommittee (NIDA)
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Kahana, Shoshana Y
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Virginia Commonwealth University
Schools of Arts and Sciences
United States
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Meshberg-Cohen, Sarah; Presseau, Candice; Thacker, Leroy R et al. (2016) Posttraumatic Stress Disorder, Health Problems, and Depression Among African American Women in Residential Substance Use Treatment. J Womens Health (Larchmt) 25:729-37
Meshberg-Cohen, Sarah; Svikis, Dace; McMahon, Thomas J (2014) Expressive writing as a therapeutic process for drug-dependent women. Subst Abus 35:80-8