The Dynamic Relationship of Negative Emotional Content in the Context of Trauma-Focused Writing Interventions on Improvements in Cognitive Reappraisal: A Pilot Study

Objective: Writing about traumatic experiences is beneficial for the reduction of posttraumatic stress symptoms, yet little research has examined the linguistic content of trauma-focused writing interventions. The current pilot study had two aims (a) characterize changes in linguistic features in two trauma-focused writing interventions; and (b) examine how changes in linguistic content may be associated with proposed mechanisms of change in trauma treatment (i.e., emotion regulation, cognitive reappraisal, and experiential avoidance). Method: Data were a secondary analysis of a proof-of-concept trial of written exposure therapy (WET) compared to trauma-focused expressive writing. Participants (N = 33, 76% female) completed five virtual sessions and measures of emotion regulation, posttraumatic cognitions, and experiential avoidance. Reliable change was calculated for each mechanism pre/postintervention. Linguistic inquiry and word count (Boyd et al., 2022) was used to analyze linguistic content (i.e., negative emotion words, past tense, cognitive processing, and death-related content). Results: Group differences emerged in slopes of narrative content across time for negative emotion words (b = 0.3, p = .008), past tense (b = -1.45, p < .01), and causal language (b = 0.39, p = .002). Contrary to expectations, only the slope of change in negative emotion words was associated with reliable changes in posttraumatic cognitions (b = -0.59, p = .023). Conclusions: Findings contribute evidence to support the use of negative emotion words early in treatment as a potentially influential target for improving posttraumatic cognitions in WET.