Click here to download

Women and breast cancer: effects of guided. Written disclosure protocol on post-traumatic stress
Author/s: Maria Luisa Martino, Raffaella Onorato, Veronica D'Oriano, Maria Francesca Freda 
Year:  2013 Issue: Language: Italian 
Pages:  12 Pg. 125-136 FullText PDF:  317 KB
DOI:  10.3280/PDS2013-001007
(DOI is like a bar code for intellectual property: to have more infomation:  clicca qui   and here 

Breast cancer appears as a traumatic event that undermines the sense of continuity and integration of own life story often producing psychopathological outcomes. In the expressive writing paradigm this paper assesses the effect of the Guided Written Disclosure Protocol on symptoms associated with post-traumatic stress disorder among 40 women with breast cancer in post-operative drug treatment - 20 under chemotherapy and 20 under biological therapy - through repeated measurements over time of test IES-R. We have performed a series of Repeated Measures Anova. Among the women who have benefit from writing protocol the results show a significant reduction in the intrusion and irritability subscale scores in comparison between sperimental/control group over time. On the contrary, among the control group the increasing trend of the intrusion and irritability subscale scores would suggest that the flow of time, without a psychological space of support, isn’t a "natural remedy" against psychological distress. In addition, the analysis shows that the experiences related to the different therapeutic phases do not affect the possibility to benefit of writing. Within the present study the protocol of writing is configured, therefore, as a useful support tool during the different phases of therapy, which in synergy with medical care, allows to contain the effects of the trauma and to perform, in this way, a preventive function. To promote health, not only after recovery, but since the beginning of the illness.
Keywords: Breast cancer, trauma, writing technique, post-traumatic stress disorder

  1. Pelusi J. (2006). Sexuality and Body Image: Research on breast cancer survivors documents altered body image and sexuality. Cancer Nursing, 29, 2: 32-38.
  2. Pennebaker J.W. (2004). Scrivi cosa ti dice il cuore [Write what your heart tells you]. Trento: Erickson.
  3. Akechi T., Taniguchi K., Suzuki S., Okamura M., Minami H., Okuyama T., Furukawa T.A. and Uchitomi Y. (2007). Multifaceted psychosocial intervention program for breast cancer patients after first recurrence: feasibility study. Psycho-Oncology, 16, 6: 517-524., DOI: 10.1002/pon.1101
  4. Arden-Close E.J. (2008). The effects of guided written disclosure on perceived stress and quality of life in women with ovarian cancer and their partners. United Kingdom: e- Print Soton
  5. Bellani M., Morasso G., Orrù W., Amadori D., Grassi L., Casali P. e Bruzzi P., a cura di (2002). Psiconcologia [Psychoncology]. Milano: Masson
  6. Bohleber W. (2007). Ricordo, trauma e memoria collettiva. La battaglia per il ricordo in psicoanalisi [Memory, trauma and collective memory. The battle for memory in psychoanalysis]. Rivista di psicoanalisi, LIII, 2: 367-394.
  7. Bonomi C. (2003). Between Symbol and Antisymbol – The Meaning of Trauma Reconsidered. International Forum of Psychoanalysis, 12, 1: 17-22.
  8. Castrogiovanni P. e Traverso S. (2006). Per una definizione della traumaticità dell’evento [For a definition of the traumaticity of the event]. NÓOς-Aggiornamenti in psichiatria, 2: 123-149.
  9. Duncan E. (1997). The salutary effects of written emotional expression: parameters for intervention. British Psychological Society, 6, 2: 98-102
  10. Duncan E. and Gidron Y. (1999). Written emotional expression and health: Evidence for a new Guided disclosure technique. Proceedings of the British Psychological Society, 7, 1: 29.
  11. Duncan E., Gidron Y., Rabin E., Gouchberg L., Moser A. and Kapelushink J. (2007). The Effects of Guided Written Disclosure on Psychological Symptoms Among Parents of Children With Cancer. Journal of Family Nursing, 13 (3): 370-38., DOI: 10.1177/1074840707303843
  12. Fobair P., Stewart S.L., Chang S., D’ Onofrio C., Banks P.J. and Bloom J.R. (2006). Body image and sexual problems in young women with breast cancer. Psycho-Oncology 15: 579-594., DOI: 10.1002/pon.991
  13. Gandubert C., Carrière I., Escot C., Soulier M., Hermès A., Boulet P., Ritchie K. and Chaudieu I. (2009). Onset and relapse of psychiatric disorders following early breast cancer: a case–control study. Psycho-Oncology, 18, 10: 1029-1037., DOI: 10.1002/pon.1469
  14. Giannantonio M. (2003). Psicotraumatologia e Psicologia dell’emergenza [Psychotraumatology and Psychology of emergency]. Ecomind: Salerno.
  15. Gidron Y. and Duncan E. (2000). Effects of Guided Written-Disclousure of traumas on somatization and clinic visits among frequent Israeli clinic visitors. British Psychological Society, 8, 1: 15-20.
  16. Gidron Y., Duncan E., Lazar A., Biderman A., Tandeter H. and Schvartzman P. (2002). Effects of guided written disclosure of stressful experiences on clinic visits and symptoms in frequent clinic attenders. Family Practice, 19, 2: 161-166., DOI: 10.1093/fampra/19.2.161
  17. Greenberg M.A., Wortman C.B. and Stone A.A. (1996). Emotional expression and physical health: revising traumatic memories or fostering self-regulation? Journal of Personality and Social Psychology, 71, 3: 588-602., DOI: 10.1037/0022-3514.71.3.588
  18. Klein K. and Boals A. (2001). Expressive writing care increase working memory capacity. Journal of experimental psychology: general, 130: 520-33.
  19. Koopman C., Butler L.D., Classen C., Giese-Davis J., Morrow G. R., Westendorf J., Banerjee T. and Spiegel D. (2002). Traumatic Stress Symptoms Among Women with Recently Diagnosed Primary Breast Cancer. Journal of Traumatic Stress, 15, 4: 277- 289., DOI: 10.1023/A:1016295610660
  20. Koopman C., Hermanson K., Diamond S., Angell K. and Spiegel D. (2007). Social support, life stress, pain and emotional adjustment to advanced breast cancer. Psycho-Oncology, 7, 2: 101-111., DOI: 10.1002/(SICI)1099-1611(199803/04)7:2<101::AID-PON299>3.0.CO;2-3
  21. Lund-Nielsen B., Müller K. and Adamsen L. (2005). Malignant wounds in women with breast cancer: feminine and sexual perspectives. Journal of Clinical Nursing, 14, 1 : 56- 64., DOI: 10.1111/j.1365-2702.2004.01022.x
  22. Mehnert A. and Koch U. (2007). Prevalence of acute and post-traumatic stress disorder and comorbid mental disorders in breast cancer patients during primary cancer care: a prospective study. Psycho-Oncology, 16, 3: 181-188., DOI: 10.1002/pon.1057
  23. Okuyama T., Akechi T., Kugaya A., Okamura H., Shima Y., Maruguchi M., Hosaka T. and Uchitomi Y. (2000). Development and validation of the cancer fatigue scale: a brief, three-dimensional, self-rating scale for assessment of fatigue in cancer patients. Journal Pain Symptom Manage, 191: 5-14.
  24. Sadler-Gerhardt C.J, Reynolds C.A., Britton P.J. and Kruse S.D. (2010). Women Breast Cancer Survivors: Stories of Change and Meaning. Journal of Mental Health Counseling, 32, 3: 265-282.
  25. Solano L. (2007). Scrivere per pensare [Writing to think]. Milano: FrancoAngeli
  26. Stanton A.L., Danoff-Burg S., Sworowski L.A., Collins C.A., Branstetter A.D., Rodriguez Hanley A., Kirk S.B. and Austenfeld J.L. (2002). Randomized, controlled trial of written emotional expression and benefit finding in breast cancer patients. Journal of Clinical Oncology, 15, 20: 4160-8.
  27. Weiss S. and Marmar R. (1997). The impact of event scale revised. New York: Guildford Press
  28. Wilmoth M.C. and Sanders L.D. (2001). Accept me for myself: African American women’s issues after breast cancer. Oncology Nursing Forum, 28: 875-879.
  29. Zakowski S.G., Ramati A., Morton C., Johnson P. and Flanigan R. (2004). Written Emotional Disclosure Buffers the Effects of Social Constraints on Distress Among Cancer Patients. Health Psychology, 23, 6: 555-563., DOI: 10.1037/0278-6133.23.6.555

Maria Luisa Martino, Raffaella Onorato, Veronica D'Oriano, Maria Francesca Freda, Women and breast cancer: effects of guided. Written disclosure protocol on post-traumatic stress in "PSICOLOGIA DELLA SALUTE" 1/2013, pp. 125-136, DOI:10.3280/PDS2013-001007


FrancoAngeli is a member of Publishers International Linking Association a not for profit orgasnization wich runs the CrossRef service, enabing links to and from online scholarly content