Expressive Writing Decreases PTSD Symptoms in Women with HIV

A large number of people with HIV have experienced numerous stressful or traumatic events in their lifetimes. These factors have been shown to lead to negative treatment outcomes for HIV, both psychologically and physically. In fact, many people with HIV have a history of sexual assault and physical abuse. All of these events elevate the rates of post-traumatic stress (PTSD) in people with HIV, especially women. Depression, avoidance, and denial are all forces that minimize treatment adherence and increase disease progression. Therefore, novel approaches have been designed to address the psychological issues that decrease treatment participation in individuals living with HIV. One such method is expressive writing.

In a recent study, Gail Ironson of the University of Miami’s Department of Psychology tested how an expressive writing (EW) exercise, designed to address traumatic events, would affect health outcomes in a sample of 244 men and women with HIV when compared to a daily writing control experiment. The participants were evaluated for PTSD and physical health symptoms at baseline, one month, 6 months, and 12 months after they completed 4 writing exercises. Ironson found that the women who completed the EW had greater PTSD, stress, and depression symptom reductions than the men or any participants in the control experiment. This finding was even more evident in the women who exhibited PTSD at baseline.

“For men, an unexpected result was that they had a greater decrease in depression in the daily-events writing control condition than in the trauma-writing condition,” said Ironson. There was no difference in PTSD symptom severity for men in either group. This finding suggests that women are more receptive to the positive effects of EW than men. Ironson believes future research should explore the mechanisms that cause this effect in order to better understand how and why this occurs. However, the men did benefit from the daily writing exercise despite the fact that it did not focus on traumatic events specifically. Ironson noted that even though writing exercises show promise for those with PTSD and HIV, individual therapy can perhaps provide further benefits. A therapist can help clients overcome mental blocks that may stall expressive writing. Also, therapists can guide men and women with PTSD and HIV through the process of looking at traumatic events and help them learn how to cope with the feelings that cause the stress, depression and trauma in adaptive ways that will contribute to positive health outcomes and better disease management.

Ironson, G., O’Cleirigh, C., Leserman, J., Stuetzle, R., Fordiani, J., Fletcher, M., and Schneiderman, N. (2012). Gender-specific effects of an augmented written emotional disclosure intervention on posttraumatic, depressive, and HIV-disease-related outcomes: A randomized, controlled trial. Journal of Consulting and Clinical Psychology. Advance online publication. doi: 10.1037/a0030814

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  • Colby


    January 4th, 2013 at 2:11 AM

    I like how the author suggests that therapy may help with the writing process. Just writing isn’t often enough. Men and women both may need one-on-one help with figuring out what kind of writing will be beneficial to them. Otherwise, as this study found, they could be putting in the time and effort of writing without seeing the benefit.

  • rachel


    January 4th, 2013 at 2:15 AM

    writing for therapy is a good idea my therapist told me to do that and it helped.

    i dont’ have hiv or anything but bad stuff in my past i was trying to work thru.

    maybe this will help some people with hiv i sure hope so!

  • Hannah


    January 4th, 2013 at 2:17 AM

    I guess I had a totally different experience. Writing didn’t help me at all when I was going through therapy. Maybe this is because I write for a living. But, I really didn’t see any results.

  • Katelynn


    January 4th, 2013 at 2:20 AM

    Decreasing depression in men is nothing to sneeze at. If you can get men writing (a big “if” by the way) and it works, I say go for it! I have tried over and over again in my practice to get men to journal and have had little success. They always say they will in my office but never follow through. Has anyone ever tried something that works?

  • brandi


    January 4th, 2013 at 4:01 AM

    Having not ever been through something like this I am surprised to learn that you would even stand a cahnce of developing PTSD after a diagnosis of HIV. I know that this is a scary disease, but I guess that I was under the misunderstanding that youhaveto experience violence against you or be a witness to that in order to show signs of PTSD. So this is a real eye opener for me in that respect, because I am not sure that if I had not read that here that I would have believed that you could have symptoms of this from a diagnosis of a disease, veen a terminal one like HIV and AIDS.

  • adam


    January 5th, 2013 at 10:26 PM

    there is so much benefit to be had just by expressing your feeling and thoughts.many of these people as has been pointed out could have been victims of abuse.such victims often have no confidante that they can speak to and hence their feelings are suppressed.writing offers a good outlet for them to pout down their thoughts and feelings.

    as with regard to women having more benefits maybe its because they are better able to express themselves when they write.on the whole I am happy to know that this is helping people out there,people who are in need.

  • Lori Snyder

    Lori Snyder

    January 7th, 2013 at 12:55 PM

    I have always believed that writing about your thoughts and feelings is a great way to help yourself recover from any number of things. Sometimes it helps just to pour all your feelings out on paper and get it out of your system. There is a book called Writing for Wellness that can be a guide for anyone who wants to give it a try.

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