Acculturation Moderates the Effects of Expressive Writing on Post-Traumatic Stress Symptoms Among Chinese American Breast Cancer Survivors

Qiao Chu, Celia Ching Yee Wong, Qian Lu

Research output: Contribution to journalArticle

Abstract

Background: Previous research indicated that the benefits of expressive writing on cancer patients’ physical and psychological well-being may vary across cultures. However, it remains unknown whether the within-ethnicity cultural orientation would also moderate the efficacy of expressive writing. Immigrants are a special population who differ widely in extent of endorsing the home culture and the host culture. We examined the role of acculturation in moderating the effect of expressive writing among Chinese American breast cancer survivors in reducing different post-traumatic stress disorder (PTSD) symptom clusters: re-experiencing, avoidance, and arousal. Method: Ninety-six Chinese American breast cancer survivors were randomly assigned to three groups to write about cancer-related topics: a self-regulation group to write about deepest feelings, stress coping, and finding benefits; an emotional disclosure group to write about deepest feelings; and a cancer-fact group to write about cancer experience objectively. The only examined moderator, acculturation, was assessed at baseline. PTSD symptoms were assessed at baseline and 1-, 3-, and 6-month follow-ups. Results: Acculturation moderated the effect of expressive writing at 3- and 6-month follow-ups. Among participants with low acculturation, PTSD symptoms were less severe in the self-regulation and cancer-fact groups compared with the emotional disclosure group; in contrast, no group differences in PTSD were found among highly acculturated participants. Conclusions: Our findings highlight the important role of sub-ethnic cultural orientation in the efficacy of psychosocial interventions targeting immigrant populations. Trial Registration: ClinicalTrials.gov Identifier: NCT03546673.

Original languageEnglish (US)
Pages (from-to)185-194
Number of pages10
JournalInternational Journal of Behavioral Medicine
Volume26
Issue number2
DOIs
StatePublished - Apr 15 2019

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Acculturation
Asian Americans
Survivors
Post-Traumatic Stress Disorders
Breast Neoplasms
Disclosure
Neoplasms
Emotions
Arousal
Population
Psychology
Research

Keywords

  • Acculturation
  • Asian/Chinese breast cancer survivors
  • Expressive writing
  • PTSD

ASJC Scopus subject areas

  • Applied Psychology

Cite this

Acculturation Moderates the Effects of Expressive Writing on Post-Traumatic Stress Symptoms Among Chinese American Breast Cancer Survivors. / Chu, Qiao; Wong, Celia Ching Yee; Lu, Qian.

In: International Journal of Behavioral Medicine, Vol. 26, No. 2, 15.04.2019, p. 185-194.

Research output: Contribution to journalArticle

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abstract = "Background: Previous research indicated that the benefits of expressive writing on cancer patients’ physical and psychological well-being may vary across cultures. However, it remains unknown whether the within-ethnicity cultural orientation would also moderate the efficacy of expressive writing. Immigrants are a special population who differ widely in extent of endorsing the home culture and the host culture. We examined the role of acculturation in moderating the effect of expressive writing among Chinese American breast cancer survivors in reducing different post-traumatic stress disorder (PTSD) symptom clusters: re-experiencing, avoidance, and arousal. Method: Ninety-six Chinese American breast cancer survivors were randomly assigned to three groups to write about cancer-related topics: a self-regulation group to write about deepest feelings, stress coping, and finding benefits; an emotional disclosure group to write about deepest feelings; and a cancer-fact group to write about cancer experience objectively. The only examined moderator, acculturation, was assessed at baseline. PTSD symptoms were assessed at baseline and 1-, 3-, and 6-month follow-ups. Results: Acculturation moderated the effect of expressive writing at 3- and 6-month follow-ups. Among participants with low acculturation, PTSD symptoms were less severe in the self-regulation and cancer-fact groups compared with the emotional disclosure group; in contrast, no group differences in PTSD were found among highly acculturated participants. Conclusions: Our findings highlight the important role of sub-ethnic cultural orientation in the efficacy of psychosocial interventions targeting immigrant populations. Trial Registration: ClinicalTrials.gov Identifier: NCT03546673.",
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