102 COPING RESOURCES
There is also evidence suggesting that benefit finding is related to improved immune
functioning (see Bower and Segerstrom, 2004) and a range of objective indicators of
health in HIV and cancer patients (for a review see Bower, Moskowitz and Epel, 2009).
Benefit finding is linked to optimism and positive affect, i.e. those with higher
optimism scores and positive affect are more likely to find benefit in adversity (Hart,
Vella and Mohr, 2008). It is also linked to positive reappraisal, though these are all
distinct constructs (Sears, Stanton and Danoff-Burg, 2003). The mechanism whereby
benefit finding affects health is not yet known. However, Bower et al. (2009), suggest
a model whereby benefit finding is linked to changes in appraisal and coping processes,
social relationships and/or priorities and goals. Changes in these factors in turn leads
to more adaptive responses to future stressors thus minimising the stress experienced
and the harmful physiological effects of stress hormones. They further suggest that
effects on health may also be mediated by positive affect.
Benefit finding is sometimes examined within the context of emotional writing
interventions (see Focus 5.3).
Written emotional disclosure interventionsIn 1986, James Pennebaker developed the ‘emotional writing paradigm’ in which
he explored the effects of writing for 15–20 minutes on three consecutive days
about stressful or traumatic events on a range of health outcomes. Typically,
individuals in the experimental group are asked to write about their deepest
emotions and thoughts about the most upsetting experience(s) in their life. They
are encouraged to really let go and to link their writing to other aspects of their life
such as relationships, their childhood, their careers and who they would like to
become, who they were in the past and who they are now. In the control group,
individuals are asked to write about what they have done the previous day and to
describe their plans for the following day.
Research has found that emotional disclosure through expressive writing can
produce clinically significant changes on a number of physiological and
psychological health outcomes such as enhanced responses to hepatitis B
vaccination in healthy adults, improvement in lung function in asthmatic patients
and increased lymphocyte counts in HIV patients (Petrie et al., 1995; Smyth et al.,
1999; Petrie et al., 2004). Emotional disclosure through writing has also been found
to reduce physician visits at follow-up, increase exam performance, reduce
psychological distress and increase re-employment following job loss (see
Pennebaker, 1997).
Support for the benefits of emotional writing has also been found in meta-
analyses (Smyth, 1998; Frisina, Borod and Lepore, 2004). However, two more
recent reviews have shown that the effects of emotional disclosure are likely to be
smaller than previously hoped and its impact is moderated by individual differencesFOCUS 5.3