1 Supplementary Materials of Additional Content for Stepping Back to Move Forward: Expressive Writing Promotes Self-Distancing Jiyoung Park1, Ozlem Ayduk2, & Ethan Kross3 1 Department of Psychological and Brain Sciences, University of Massachusetts, Amherst 2 3 Department of Psychology, University of California, Berkeley Department of Psychology, University of Michigan, Ann Arbor 2 In this section, we report results from three additional analyses. First, we present results from additional measures we administered in Studies 1 and 2 to explore issues that were not directly relevant to the questions assessed in the main text. We also report the results for a variable that was inadvertently not included in all follow-up assessments, thus preventing us from performing a full within subjects, repeated measures analysis (Study 2). Second, we present results from a combined analysis using the data across both studies to explore an indirect effect of expressive writing on an exploratory clinical outcome. Finally, we summarize the results from several measures that were administered in both studies to check whether our experimental manipulation was successful. Supplementary Analyses I: Effects of Condition on Emotion, Reconstrual, and Recounting Study 1 In the main text of Study 1, we describe how expressive writing impacts several emotional reactivity measures that have been used in prior work on self-distancing (Ayduk & Kross, 2008, 2010; Kross & Ayduk, 2008). In addition to these measures, we also examined whether expressive writing impacts discrete negative emotions (e.g., sad, upset) in Study 1 using a measure included in Pennebaker & Beall (1986; see also Richards, Beal, Seagal, & Pennebaker, 2000). We did not discuss this measure in the main text for two reasons. First, it was only administered in Study 1. Second, although we observed a significant effect of condition on this measure in the predicted direction, scores on this measure did not correlate with the emotional reactivity items that we administered (α = .33). Thus, collapsing it with the other emotional reactivity items to create a composite index was not justified. Therefore, we elected to report the results of our analysis of this measure here to keep the main text tightly focused on our main variable of interest: emotional reactivity, which we assessed across studies. 3 In this section, we also report how expressive writing impacts people’s tendency to reconstrue versus recount their distressing experiences. Prior research indicates that people who adopt a self-distanced (vs. self-immersed) perspective while reflecting over their negative experience focus more on reconstruing it in ways that promote insight and closure and less on recounting the experience (i.e., What happened to me? What did I feel?) (for review, see Kross & Ayduk, 2011). We did not discuss these measures in the main text because they are not directly relevant to the main focus of the current work: whether expressive writing promotes selfdistancing. Supplementary Materials Negative Emotions After reflecting on their distressing experiences, participants rated on a 5-point scale (1 = not at all, 5 = a great deal) the extent to which they experienced six negative emotions (e.g., sad, guilty) and two positive emotions (happy, contented) using the emotion questionnaire used in Pennebaker & Beall (1986; see also Richards et al., 2000) during the baseline (α = .80, M = 2.50, SD = .68), 1-day follow-up (α = .73, M = 2.25, SD = .57), and 1-month follow-up (α = .71, M = 2.17, SD = .57) sessions. Following previous studies (Pennebaker & Beall, 1986; Richards et al., 2000), the positive emotion ratings were reverse-coded before all items were averaged to create a composite index of negative emotional experience. Thought Content: Reconstrual and Recounting Following prior research (Ayduk & Kross, 2010; Grossmann & Kross, 2010), participants’ agreement with the following three items were averaged to create an index of reconstrual (1 = strongly disagree, 7 = strongly agree): “As I thought about my experience during the study, I had a realization that caused me to think differently about the experience,” 4 “As I thought about my experience during the study, I had a realization that made me experience a sense of closure,” and “Thinking about my experience during the experiment led me to have a clearer and more coherent understanding of this experience” (baseline: α = .84, M = 2.44, SD = 1.36; 1-day follow-up: α = .89, M = 3.31, SD = 1.89; 1-month follow-up: α = .79, M = 3.34, SD = 1.63). Participants rated their agreement with the statement, “My thoughts focused on the specific chain of events—sequence of events, what happened, what was said and done—as I thought about the experience in the study” to operationalize recounting (baseline: M = 4.97, SD = 1.70; 1-day follow-up: M = 4.98, SD = 1.70; 1-month follow-up: M = 4.33, SD = 1.82). Supplementary Results and Discussion We performed repeated measures general linear models (GLMs) with condition (expressive writing vs. control writing) as a between-participants factor, follow-up time (1-day vs. 1-month) as a within-participants factor with the same set of covariates used in the main analysis (i.e., participants’ baseline levels for the dependent measure being analyzed, memory age, and BDI scores). Negative Emotions Expressive writing participants displayed significantly lower levels of negative emotions during the two follow-ups (M = 1.95, SE = .08, 95% CI = [1.78, 2.11]) compared to control writing participants (M = 2.40, SE = .07, 95% CI = [2.25, 2.55]), F(1, 37) = 15.71, p < .001, ηp2 = .30. Neither the effect of follow-up time nor the interaction between follow-up time and condition were significant, Fs < 1.56, ps > .22, ηp2s < .04. Thought Content: Reconstrual and Recounting The effect of condition was significant for reconstrual, F(1, 39) = 26.47, p < .001, ηp2 = .40. Expressive writing participants reconstrued their experience more when they reflected 5 over their distressing experience again during the follow-ups (M = 4.65, SE = .29, 95% CI = [4.07, 5.23]) compared to control writing participants (M = 2.58, SE = .26, 95% CI = [2.06, 3.11]). There was no effect of follow-up time and no interaction between follow-up time and condition, Fs < 1.15, ps > .29, ηp2s < .03. Neither the effect of condition nor the effect of follow-up time were significant for recounting, Fs < 2.19, ps > .15, ηp2s < .05. However, we observed a significant Condition x Follow-up time interaction on this variable, F(1, 39) = 20.14, p < .001, ηp2 = .34. Expressive writing participants displayed a significant decline in their tendency to recount their experience over time (1-day follow-up: M = 5.10, SE = .29, 95% CI = [4.49, 5.71] vs. 1-month follow-up: M = 3.75, SE = .42, 95% CI = [2.87, 4.63]), F(1, 16) = 13.41, p = .002, ηp2 = .46, whereas control writing participants showed the reversed pattern (1-day follow-up: M = 4.24, SE = .28, 95% CI = [3.65, 4.83] vs. 1-month follow-up: M = 4.71, SE = .30, 95% CI = [4.08, 5.33]), F(1, 20) = 5.48, p = .03, ηp2 = .22. The contrasting pattern of changes the two groups displayed across time resulted in an expected group difference during the 1-month follow-up, F(1, 39) = 4.61, p = .04, ηp2 = .11; Expressive writing participants recounted their distressing experience less (M = 3.64, SE = .39, 95% CI = [2.86, 4.42]) than control writing participants (M = 4.80, SE = .35, 95% CI = [4.09, 5.51]). During the 1-day follow-up, the group difference was not significant, F(1, 39) = 2.82, p = .10, ηp2 = .07. This finding indicates that the effects of expressive writing on recounting emerge relatively slowly over time compared to its effects on other outcomes variables such as negative emotions and reconstrual. Study 2 Since the negative emotion measure we administered in Study 1 did not cohere well with the other emotional reactivity items we administered, we assessed participants’ negative 6 emotional experiences in Study 2 with the negative affect (NA) subscale of the Positive Affect and Negative Affect Schedule (PANAS; Watson, Clark, & Tellegen, 1988). Although scores on this measure did correlate significantly with the emotional reactivity index, rs > .21, ps ≤ .05, due to a procedural error, we did not administer it during one of the follow-up assessments. Thus, in the main text, we focused on the emotional reactivity measures that were assessed at each time point, allowing us to run a full within subjects, repeated measures analysis. These measures were the same that we administered in Study 1, allowing us to additionally make direct comparisons across studies and merge the data for additional analyses that we report in the main text. As in Study 1, we again administered the thought content measures (reconstrual and recounting) in this study to replicate the Study 1 results. Supplementary Materials Negative Emotions Participants rated on a 5-point scale (1 = very slightly or not at all, 5 = extremely) the extent to which they felt 10 negative emotions (e.g., nervous, upset) using the NA subscale of PANAS (Watson et al., 1988) after reflecting over their distressing experiences during their baseline (α = .84, M = 1.75, SD = .61), 1-day follow-up (α = .81, M = 1.61, SD = .58), and 1month follow-up (α = .83, M = 1.58, SD = .53) sessions. Thought Content: Reconstrual and Recounting We used the same measures administered in Study 1 to assess participants’ levels of reconstrual and recounting after the memory reflection task during the baseline (reconstrual: α = .82, M = 2.21, SD = 1.19; recounting: M = 4.85, SD = 2.01), 1-day follow-up (reconstrual: α = .82, M = 3.63, SD = 1.61; recounting: M = 4.20, SD = 1.94), 1-month follow-up (reconstrual: α = .84, M = 3.27, SD = 1.60; recounting: M = 3.58, SD = 2.01), and 6-month follow-up 7 (reconstrual: α = .81, M = 3.76, SD = 1.39; recounting: M = 3.83, SD = 1.69) sessions. Supplementary Results and Discussion As in the main analysis in Study 2, we performed repeated measures GLMs with a planned contrast on expressive writing (+2) versus control writing and thinking (both -1) and follow-up time as a within-participants factor with the same set of covariates used in Study 1. As noted earlier, negative emotional experience was not assessed during one of the follow-up sessions (i.e., the 6-month follow-up). We thus conducted a GLM analysis with the two levels of follow-up time (1-day vs. 1-month) for negative emotions and with the three levels of follow-up time (1-day vs. 1-month vs. 6-month) for reconstrual and recounting. Negative Emotions Expressive writing participants displayed a trend towards experiencing lower levels of negative emotions during the two follow-ups (M = 1.46, SE = .20, 95% CI = [1.27, 1.65]) compared to participants in the other two conditions (control writing: M = 1.64, SE = .09, 95% CI = [1.46, 1.82]; thinking: M = 1.66, SE = .09, 95% CI = [1.47, 1.85]), F(1, 61) = 2.75, p = .10, ηp2 = .04. There was a marginal effect of follow-up time, F(1, 61) = 3.45, p = .07, ηp2 = .05, suggesting that participants experienced negative emotions less during the 1-month follow-up (M = 1.58, SE = .06, 95% CI = [1.45, 1.70]) than during the 1-day follow-up (M = 1.59, SE = .06, 95% CI = [1.45, 1.71]). There was no interaction effect between condition and follow-up time, F(2, 61) = .28, p = .76, ηp2 = .01. Thought Content: Reconstrual and Recounting The planned contrast was marginally significant for reconstrual, F(1, 61) = 3.03, p = .09, ηp2 = .05. As predicted, expressive writing participants reconstrued their experience more than the combined control participants. However, follow-up pairwise analyses revealed that this 8 difference was driven by control writing participants. Replicating the Study 1 results, expressive writing participants reconstrued their experience more during the three follow-ups (M = 3.94, SE = .25, 95% CI = [3.45, 4.43]) than control writing participants (M = 2.94, SE = .23, 95% CI = [2.49, 3.40]), F(1, 61) = 8.87, p = .004, ηp2 = .13. Contrary to our prediction, however, thinking participants did not differ from expressive writing participants on their levels of reconstrual (M = 3.86, SE = .16, 95% CI = [3.42, 4.38]), F(1, 61) = .02, p = .90, ηp2 < .001, and displayed significantly higher levels compared to control writing participants, F(1, 61) = 8.32, p = .005, ηp2 = .12. The condition effect tended to be larger during the 1-day follow-up, F(2, 61) = 12.38, p < .001, ηp2 = .29, compared to the 1-month, F(2, 61) = 1.29, p = .28, ηp2 = .04, and 6-month follow-up, F(2, 61) = 2.98, p = .06, ηp2 = .09, which resulted in a significant Condition x Followup time interaction, F(4, 122) = 2.58, p = .04, ηp2 = .08. We also observed a significant Condition x Follow-up time interaction on recounting, F(4, 122) = 4.53, p = .002, ηp2 = .13. Similar to Study 1, expressive writing participants displayed a significant decline in their tendency to recount their experience over time, F(2, 34) = 3.35, p = .05, ηp2 = .16, whereas the other two groups did not show any change in their levels of recounting [control writing: F(2, 40) = 1.55, p = .23, ηp2 = .07; thinking: F(2, 36) = 1.01, p = .38, ηp2 = 05]. There was no effect of condition or follow-up time, Fs < 1.52, ps > .23, ηp2s < .05. Summary. These findings are generally consistent with the Study 1 findings. Compared to both control writing and thinking participants, expressive writing participants tended to experience lower levels of negative emotions and recounted their distressing experience less over time. There was, however, one unexpected finding that emerged from this study on reconstrual— thinking participants reconstrued their distressing experience significantly more than control 9 writing participants. The enhanced reconstrual of thinking participants might reflect their efforts to make sense of their distressing experience during the three-day thinking period. Yet, the fact that such effort did not translate to other benefits associated with expressive writing (i.e., enhanced self-distancing, reduced emotional reactivity, and less recounting over time) suggests that their attempts were not successful (Lyubomirsky, Sousa, & Dickerhoof, 2006; Martin & Tesser, 1989). Supplementary Analysis II: Indirect Effect of Condition on Clinical Measures For exploratory purposes, we administered several clinically-relevant measures (both during the baseline and 1-month follow-up sessions in Study 1, and during the baseline, 1-month follow-up, and 6-month follow-up sessions in Study 2). These measures included: the Beck Depression Inventory (BDI-II; Beck, Steer, & Brown, 1996), (b) the Ruminative Response Scale (RRS; Nolen-Hoeksema & Morrow, 1991), and (c) the Revised Impact of Event Scale, a measure of intrusive ideation and avoidance (IES-R; Weiss & Marmar, 1997).1 Because we were primarily interested in exploring whether expressive writing has broad clinical implications (rather than the effects of expressive writing on any single scale construct), we collapsed data across these scales to create a single mental health index after standardizing scores on each scale (Study 1: Baseline: α = .77, M = .00, SD = .69; 1-month follow-up: α = .75, M = .00, SD = .68; Study 2: Baseline: α = .67, M = .00, SD = .62; 1-month follow-up: α = .73, M = .00, SD = .67; 6-month follow-up: α = .79, M = .00, SD = .71). Higher numbers reflected poorer mental health. In addition, in Study 2 we also administered the Satisfaction with Life Scale (SWLS; Diener, Emmons, Larsen, & Griffin, 1985). When we included this variable in the mental health composite, this did not substantially alter the results. The indirect effect of expressive writing on mental health was still significant both with 1-day follow-up self-distancing and 1-day follow-up emotional reactivity as mediators (95% bias-corrected bootstrapping CI = [-.12, -.02]) and with 1-day follow-up self-distancing and 1-month follow-up emotional reactivity as mediators (95% bias-corrected bootstrapping CI = [-.11, -.02]). 1 10 As with the physical health findings we report in the main text, we did not observe any effect of condition or its interaction with follow-up time on this variable across studies, Fs < .35, ps > .56, ηp2s < .01. Therefore, we next examined whether the same indirect pathway that characterized the relationship between expressive writing and physical health—expressive writing promoted selfdistancing during the1-day follow-up, which led to less emotional reactivity during the 1-day follow-up, which in turn led to enhanced physical health during the 1-month follow-up— explained the relationship between expressive writing and this mental health variable, using the combined data across both studies to increase statistical power.2 As Panel A of Figure S1 illustrates, this was the case. Specifically, condition positively predicted self-distancing during the 1-day follow-up, b = .97, 95% CI [.40, 1.51], t(100) = 3.59, p = .003, d = .72. The enhanced self-distancing caused by expressive writing, in turn, led to less emotional reactivity during the 1-day follow-up, b = -.23, 95% CI [-.30, -.15], t(100) = -6.06, p = .001, d = 1.21, which in turn predicted better mental health during the 1-month follow-up, b = .24, 95% CI [.12, .35], t(100) = 4.40, p = .001, d = .88. A bootstrapping test confirmed that the indirect effect of condition on mental health through the pathway of self-distancing and emotional reactivity was statistically significant (95% bias-corrected bootstrapping CI = [-.12, -.02]).3 In sum, these analyses suggest that expressive writing influences variables relevant to clinical health (i.e., depressive symptoms, ruminative tendencies, and intrusive and avoidant We did not include the 6-month follow-up mental health variable in this analysis because it was only available in Study 2. 3 The indirect effect of condition on mental health was also significant when we tested emotional reactivity during the 1-month follow-up as the second mediator in the path model (i.e., Condition 1-day follow-up self-distancing 1-month follow-up emotional reactivity 1month follow-up mental health; 95% bias-corrected bootstrapping CI = [-.10, -.01]; see Panel B of Figure S1 for statistics). 2 11 ideation) indirectly, in a manner similar to how it influences physical health. They further highlight the role that self-distancing plays as a mediator of these effects. Supplementary Analyses III: Additional Manipulation Check As the main text notes, participants’ essays constituted our manipulation check—i.e., we read participants’ essays to determine whether they followed instructions. If their essays discussed what they were supposed to discuss, then participants were included in the analyses unless they were excluded for another reason documented in the paper. Participants were, however, also asked to complete several self-report questions used in prior research (Pennebaker & Beall, 1986; Richards et al., 2000) after each day of writing (or thinking) to further examine compliance. Specifically, they answered five manipulation check questions (e.g., overall, how personal was the topic you wrote [or thought] today; how much did you focus on your emotions when you wrote [thought] about an assigned topic today), using a 5-point scale (1 = not at all, 5 = a great deal). Because these items were highly correlated both within and across the three experimental manipulation sessions in both studies, they were collapsed to form a composite manipulation check index (Study 1: α = .91, M = 2.33, SD = .82; Study 2: α = .84, M = 2.70, SD = .84). When we examined the effects of condition on this variable, we observed the expected results—i.e., those who processed their distressing experience over the three-day manipulation session period (i.e., expressive writing participants in Study 1 and expressive writing and thinking participants in Study 2) scored higher on this index compared to control writing participants [Study 1: F(1, 42) = 112.89, p < .001, ηp2 = .73; Study 2: F(1, 64) = 89.56, p < .001, ηp2 = .58]. In addition, participants also indicated how many of the last 15 minutes they spent focusing on the assigned task during each experimental manipulation session (1 = 0-5 min, 2 = 5- 12 10 min, 3 = 10-15 min, 4 = all 15 min). In Study 1, expressive writing participants reported spending less time than control writing participants, F(1, 42) = 6.10, p = .02, ηp2 = .13; in Study 2, thinking participants reported spending less time than both expressive writing, F(1, 63) = 12.03, p = .001, ηp2 = .16, and control writing participants, F(1, 63) = 16.89, p < .001, ηp2 = .21. Controlling for this variable did not substantively alter any of the results in either study. 13 Supplementary References Ayduk, Ö., & Kross, E. (2008). Enhancing the pace of recovery: Self-distanced analysis of negative experiences reduces blood pressure reactivity. Psychological Science, 19, 229231. Ayduk, Ö., & Kross, E. (2010). From a distance: Implications of spontaneous self-distancing for adaptive self-reflection. Journal of Personality and Social Psychology, 98(5), 809-829. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck Depression Inventory-II. San Antonio, TX: Psychological Corporation. Diener, E., Emmons, R. A., Larsen, R. J., & Griffin, S. (1985). The Satisfaction with Life Scale. Journal of Personality Assessment, 49, 71-74. Grossmann, I., & Kross, E. (2010). The impact of culture on adaptive versus maladaptive selfreflection. Psychological Science, 21(8), 1150-1157. Kross, E., & Ayduk, Ö. (2008). Facilitating adaptive emotional analysis: Distinguishing distanced-analysis of depressive experiences from immersed-analysis and distraction. Personality and Social Psychology Bulletin, 34(7), 924-938. Kross, E., & Ayduk, Ö. (2011). Making meaning out of negative experiences by self-distancing. Current Directions in Psychological Science, 20(3), 187-191. Lyubomirsky, S., Sousa, L., & Dickerhoof, R. (2006). The costs and benefits of writing, talking, and thinking about life's triumphs and defeats. Journal of Personality and Social Psychology, 90, 692-708. Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61(1), 115-121. 14 Pennebaker, J. W., & Beall, S. K. (1986). Confronting a traumatic event: Toward an understanding of inhibition and disease. Journal of Abnormal Psychology, 95, 274-281. Richards, J. M., Beal, W. E., Seagal, J., & Pennebaker, J. W. (2000). Effects of disclosure of traumatic events on illness behavior among psychiatric prison inmates. Journal of Abnormal Psychology, 109, 156-160. Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: the PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063-1070. Weiss, D. S., & Marmar, C. R. (1997). The impact of event scale-revised. . In J. P. Wilson & T. M. Keane (Eds.), Assessing Psychological Trauma and PTSD: A Handbook for Practitioners (pp. 399-411). New York: Guilford Press. 15 Figure S1. Results of path analyses examining the role of self-distancing 1-day following the intervention and emotional reactivity 1day (Panel A) and 1-month (Panel B) following the intervention in mediating the effect of condition on mental health 1-month following the intervention. The higher number on mental health indicates poorer health. Both path models provided a good fit to the data; Panel A [X2(11, N = 111) = 7.59, CFI = 1.000, NFI = .962, GFI = .980, RMSEA = .000] and Panel B [X2(11, N = 111) = 5.51, CFI = 1.000, NFI = .972, GFI = .985, RMSEA = .000]. Unstandardized coefficients are shown. The values in parentheses show the relationship between condition and mental health after controlling for self-distancing and emotional reactivity. The values in square brackets are 95% bias-corrected confidence intervals from a bootstrap test with 2000 replications; the mediation is significant if the confidence interval does not include zero. Baseline self-distancing, baseline mental health, and memory age are controlled. **p ≤ .01, ***p ≤ .001.