Clinical trial NCT05352243: Bereaved Young Adults Study
Official title: Combined Expressive Disclosure and Prosocial Writing to Promote Well-Being and Decrease Psychological Distress Among Bereaved Emerging Adults: Examining The Roles of Psychological Distancing, Universality, and Generativity
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Bereavement
Keywords: Expressive Disclosure
Prosocial
Expressive Writing
Peer Helping
Young Adults
Lead sponsor: University of California, Los Angeles
Sponsor class: OTHER
First posted: 2022-04-28
Enrollment: 178
Sex: ALL
Minimum age (years): 18
Maximum age (years): 26
Standard ages: ADULT
Accepts healthy volunteers: yes
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: SUPPORTIVE_CARE

Brief summary: Bereaved adolescents and emerging adults are at risk for developing psychological disorders and complicated grief. Clinical grief interventions and conventional wisdom reflect an implicit assumption that sharing and expressing one's feelings surrounding a loss (i.e., emotional disclosure) facilitates psychological adjustment. However, studies of emotional disclosure have yielded null results in bereaved samples. Individuals who have encountered stressful life events, including interpersonal loss, often report a desire to "give back" to others in similar situations. Empirical evidence suggests that providing support to others can be equally, if not more, beneficial than receiving support. The opportunity to support others experiencing stressful circumstances may address common feelings of powerlessness and engender a sense of meaning, enhancing positive affect and reducing distress. Interventions that leverage prosocial behaviors are associated with positive effects, including increases in wellbeing in non-bereaved populations. To date, no research has examined the utility of prosocial interventions for bereaved individuals.

The present study tests a novel expressive helping intervention that combines elements of expressive disclosure and prosocial writing. Expressive helping will be compared to traditional expressive disclosure and a neutral writing control condition in a sample of bereaved young adults. Participants (N=156) will be randomized to one of three conditions-expressive disclosure, expressive helping, or a neutral writing control-and complete three weekly 20-minute writing sessions. Measures of psychological distress, well-being, and hypothesized mediators will be administered before, immediately following (within 48 hours of the final writing session), one month, and two months after the writing sessions. It is hypothesized that the participants in the expressive helping condition will evidence greater increases in well-being and decreases in grief-related distress at the one and two-month follow-ups, as compared to the other two groups.


Eligibility criteria: Inclusion Criteria:

1. Experienced the death of a loved one within the last 5 years, but more than 6 months ago.
2. Endorse having close relationship with loved one at time of their death (i.e., 5 or above on 1-10 likert scale with 1 being not at all close, and 10 being extremely close).
3. Endorse moderate to severe distress about the loss (i.e., 5 or above on 1-10 likert scale with 1 being not at all distressed, and 10 being extremely distressed).
4. Feel comfortable writing in English (due to the linguistic nature of the writing sessions).
5. Have access to the Internet and a computer to complete the assessments and writing sessions.

Exclusion Criteria:

1. Express active psychosis or suicidal ideation, or any other circumstances that, in the opinion of the investigators, compromise participant safety.

Primary outcomes:
measure: Change in Wellbeing
timeFrame: Baseline (≤2 weeks of starting the intervention), post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.
measure: Change in Grief Reactions
timeFrame: Baseline (≤2 weeks of starting the intervention), post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.
Secondary outcomes:
measure: Change in Physical Symptoms
timeFrame: Baseline (≤2 weeks of starting the intervention), post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.
measure: Change in Anxiety
timeFrame: Baseline (≤2 weeks of starting the intervention), post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.
measure: Change in Depressive Symptoms
timeFrame: Baseline (≤2 weeks of starting the intervention), post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.
Other outcomes:
measure: Change in Universality
timeFrame: Baseline (≤2 weeks of starting the intervention), directly after each writing session, post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.
measure: Change in Psychological Distance
timeFrame: Baseline (≤2 weeks of starting the intervention), directly after each writing session, post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.
measure: Change in Generativity
timeFrame: Baseline (≤2 weeks of starting the intervention), directly after each writing session, post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.
measure: Change in Coping Tendency
timeFrame: Baseline (≤2 weeks of starting the intervention), post-intervention survey (≤1 week after the final writing assignment), the 1-month follow-up, and 2-month follow up.
Locations:
city: Los Angeles
country: United States
facility: University of California, Los Angeles
state: California
Study officials:
References:
citation: Ayduk O, Kross E. From a distance: implications of spontaneous self-distancing for adaptive self-reflection. J Pers Soc Psychol. 2010 May;98(5):809-29. doi: 10.1037/a0019205.
citation: Boelen PA, Djelantik AAAMJ, de Keijser J, Lenferink LIM, Smid GE. Further validation of the Traumatic Grief Inventory-Self Report (TGI-SR): A measure of persistent complex bereavement disorder and prolonged grief disorder. Death Stud. 2019;43(6):351-364. doi: 10.1080/07481187.2018.1480546. Epub 2018 Jul 17.
citation: Carver CS, Scheier MF, Weintraub JK. Assessing coping strategies: a theoretically based approach. J Pers Soc Psychol. 1989 Feb;56(2):267-83. doi: 10.1037//0022-3514.56.2.267.
citation: Eisenberg SA, Shen BJ, Schwarz ER, Mallon S. Avoidant coping moderates the association between anxiety and patient-rated physical functioning in heart failure patients. J Behav Med. 2012 Jun;35(3):253-61. doi: 10.1007/s10865-011-9358-0. Epub 2011 Jun 10.
citation: Gruenewald TL, Tanner EK, Fried LP, Carlson MC, Xue QL, Parisi JM, Rebok GW, Yarnell LM, Seeman TE. The Baltimore Experience Corps Trial: Enhancing Generativity via Intergenerational Activity Engagement in Later Life. J Gerontol B Psychol Sci Soc Sci. 2016 Jul;71(4):661-70. doi: 10.1093/geronb/gbv005. Epub 2015 Feb 25.
citation: Keyes, C. L. M. (2009). Atlanta: Brief description of the mental health continuum short form (MHC-SF).
citation: Libby LK, Eibach RP. Looking back in time: self-concept change affects visual perspective in autobiographical memory. J Pers Soc Psychol. 2002 Feb;82(2):167-79.
citation: Pennebaker JW, Gonder-Frederick L, Stewart H, Elfman L, Skelton JA. Physical symptoms associated with blood pressure. Psychophysiology. 1982 Mar;19(2):201-10. doi: 10.1111/j.1469-8986.1982.tb02547.x. No abstract available.
citation: Pilkonis PA, Choi SW, Reise SP, Stover AM, Riley WT, Cella D; PROMIS Cooperative Group. Item banks for measuring emotional distress from the Patient-Reported Outcomes Measurement Information System (PROMIS(R)): depression, anxiety, and anger. Assessment. 2011 Sep;18(3):263-83. doi: 10.1177/1073191111411667. Epub 2011 Jun 21.
citation: Radloff, L. S. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied psychological measurement, 1(3), 385-401.
citation: Ross M, Wilson AE. It feels like yesterday: self-esteem, valence of personal past experiences, and judgments of subjective distance. J Pers Soc Psychol. 2002 May;82(5):792-803.
citation: Stanton AL, Kirk SB, Cameron CL, Danoff-Burg S. Coping through emotional approach: scale construction and validation. J Pers Soc Psychol. 2000 Jun;78(6):1150-69. doi: 10.1037//0022-3514.78.6.1150.
citation: Weinberg, N., Uken, J. S., Schmale, J., & Adamek, M. (1995). Therapeutic factors: Their presence in a computer-mediated support group. Social Work with Groups, 18, 57-69.
citation: Yalom, I. D. (1995). The theory and practice of group psychotherapy. Basic Books.