The effects of emotional disclosure on psychosocial and physiological outcomes in patients with rheumatoid arthritis

Aims: The current study explores the effects of emotional disclosure on a variety of psychosocial and physiological outcomes in rheumatoid arthritis (RA) patients with varying disease severity. Methods: Thirty-five RA patients were recruited and assessed at baseline, 1, 6 and 10 weeks post-intervention. At each session clinical and psychosocial data were collected including, disease activity, CRP and ESR (markers for inflammation) and measures of emotional well-being. Patients were randomly assigned to either the disclosure group or an episodic recall control group . The intervention comprised an established disclosure paradigm adapted specifically for RA patients whereby, in their own homes, patients were asked to write or talk into a recorder for a 20 minute period on 4 consecutive days. Following each disclosure session all patients completed questionnaires regarding how stressful or arousing they found the session. Results: Results from the first 10 patients to undergo the disclosure intervention demonstrated increases in disease activity, CRP and ESR at 1 week post-intervention. Fluctuations in mood were also evident with decreases in positive affect and increases in negative affect. However, at 10 weeks disclosure patients demonstrated improvements in disease activity, CRP, ESR and emotional well-being compared to control patients. Conclusions: The results indicate that the disclosure intervention improves a variety of outcomes in RA patients. Results from all 35 patients will be discussed and potential psychological and physiological mediators of this process will be proposed.