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Can virtues enhance the benefits of expressive writing among healthy Chinese? A pilot study ab

c

c

a

Yonghong Zhang , Wenjie Duan , Xiaoqing Tang & Zhihan Yang a

School of Culture and Social Development Studies

b

Center of Studies for Psychology and Social Development, Southwest University ChongqingChina c

Department of Applied Social Studies, City University of Hong Kong Hong Kong SARChina Published online: 23 May 2015.

Click for updates To cite this article: Yonghong Zhang, Wenjie Duan, Xiaoqing Tang & Zhihan Yang (2014) Can virtues enhance the benefits of expressive writing among healthy Chinese? A pilot study, Journal of Mental Health, 23:5, 231-235 To link to this article: http://dx.doi.org/10.3109/09638237.2014.924050

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http://informahealthcare.com/jmh ISSN: 0963-8237 (print), 1360-0567 (electronic) J Ment Health, 2014; 23(5): 231–235 ! 2014 Shadowfax Publishing and Informa UK Limited. DOI: 10.3109/09638237.2014.924050

ORIGINAL ARTICLE

Can virtues enhance the benefits of expressive writing among healthy Chinese? A pilot study Yonghong Zhang1,2*, Wenjie Duan3*, Xiaoqing Tang3, and Zhihan Yang1 School of Culture and Social Development Studies and 2Center of Studies for Psychology and Social Development, Southwest University, Chongqing, China, and 3Department of Applied Social Studies, City University of Hong Kong, Hong Kong SAR, China

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1

Abstract

Keywords

Objective: This study aims to explore the relationship between virtues and self-disclosure via a cross-sectional study and an intervention study among Chinese. Methods: In study one, 144 healthy individuals completed the Chinese Virtues Questionnaire (CVQ) and the short version of Jourard Self-Disclosure Questionnaire. In study two, 41 undergraduates voluntarily attended a nine-week intervention. Satisfaction with Life Scale (SWLS) was adopted as the well-being indicator. They were asked to complete the vitality sub-scale of CVQ and SWLS at week one for obtaining the virtue scores and baseline scores of well-being. After an eight-week intervention, SWLS was completed again to examine the intervention efficacy. Results: Among the three virtues, only vitality had the significant and positive relation with self-disclosure. After eight weeks, the high-vitality group obtained the significant growth of satisfaction with life. The change degree of satisfaction among high vitality individuals was significantly higher than the low vitality group. Conclusion: Prescreening of individual vitality may be helpful for identifying the sensitive targets of expressive writing intervention. However, considering that this is a preliminary study, more rigorous randomized controlled trials will be helpful to test this conclusion in future.

Expressive writing, self-disclosure, virtues, vitality, well-being

Introduction Expressive writing is an effective intervention strategy that has usually been used as an important approach in psychological counseling and psychotherapy areas (Sloan, 2010), considering that writing could provide an outlet for individuals to express unpleasant emotions and psychological distress. Furthermore, evidence from clinical areas indicated that expressive writing was beneficial for enhancing both physical and psychological health among different kinds of patients (e.g. Lepore & Smyth, 2002). Nevertheless, the applicability and effectiveness of expressive writing among Chinese have seldom been examined due to cultural obstacles (Lu et al., 2012). Many Chinese are ashamed to express their own negative experiences to strangers. Recently, Lu et al. (2012) successfully administrated an expressive writing intervention among Chinese-speaking breast cancer survivors, which indicated that the feasibility and cultural sensitiveness were extremely important in the Chinese context. In their

History Received 10 January 2014 Revised 21 February 2014 Accepted 10 April 2014 Published online 19 June 2014

design, each step, including study design, intervention operation and data collection should be culturally appropriate and acceptable (Lu et al., 2012). For example, the Community Based Participatory Research model was adopted for increasing involvement from researchers and the participants. Notably, the majority of extant interventions based on expressive writing were used among clinical samples as they suffered trauma, psychological distress and illness. However, whether normal individuals benefit from expressive writing has not been examined. Ordinary individuals did not always experience major stresses, but the majority of them were troubled by daily hassles. Based on the transactional model of stress and the corresponding evidence-based studies, daily hassles are much more important than major stresses in affecting distress among ordinary populations (McIntyre et al., 2008). Therefore, considerable insight can be gained from examining whether ordinary individuals can promote well-being via this private and guided writing exercise.

Individual differences on virtues

*These authors contributed equally to this work. Correspondence: Wenjie Duan, Department of Applied Social Studies, City University of Hong Kong, Hong Kong SAR, China. E-mail: [email protected] or [email protected]

Jones & Pennebaker (2006) stated that individual difference should be carefully considered in implementing expressive writing intervention because it may influence the effect of intervention. Peterson & Seligman (2004) proposed a framework of virtues for guiding the research of positive qualities.

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Y. Zhang et al.

This system included six core virtues and 24 character strengths (Peterson & Seligman, 2004), which can be assessed by the 240-item Value in Action Inventory of Strengths (VIA-IS). Study findings in the recent decade demonstrated that the virtues and strengths were significantly related to health and well-being for different people in different countries (for a review, see Niemiec, 2013). The writing method has been widely adopted in strength-based interventions (Parks & Biswas-Diener, 2013). In a certain study, for example, investigators taught Chinese undergraduates how to use their personal strengths and then asked them to write down their process of using and the subsequent thoughts in short essays (Duan et al., in press). Even after 18 weeks, the participants continued to obtain steady improvement in their satisfaction with life. However, in these studies, the contributing factors were strengths, rather than the expressive writing method. The relationship between these positive qualities and traditional self-disclosure has not been explored as yet. In addition, another issue concerns the classification of virtues and strengths. Kristja´nsson (2010) suggested that the culturally dependent issues should be considered in the process of distinction and selection of these positive qualities, and the differences between the present strengths, as well as the virtues and strengths seemed to be a little bit vague (Duan et al., 2012b; Kristja´nsson, 2010). For example, based on the same 24-character strengths, Kim (2008) obtained a threefactor virtue with a chronic illness and disability American sample, whereas Brdar & Kashdan (2010) found a four-factor virtue with a healthy undergraduate Croatia sample. These inconsistent results, referring to methodological issues, partly result in the relatively few empirical studies at the virtue level. Accordingly, Duan et al. (2012b) adopted the Combined Etic-Emic Approach to reduce the culturally inappropriate items of the VIA-IS by both qualitative and quantitative analysis. After exploratory factor analysis, confirmatory factor analysis and psychometric evaluation, a 96-item Chinese Virtues Questionnaire (CVQ) was developed to measure three virtues among the Chinese: relationship, vitality and conscientiousness (Duan et al., 2012b, 2013). Relationship reflects positive cognitions, emotions and behaviors of interacting with other people; vitality reflects positive qualities to the world; and conscientiousness reflects certain intrapersonal traits of self-improvement.

This study The main purpose of this study was to examine the role of virtues in expressive writing intervention. Furthermore, two studies were conducted. Study 1 (cross-sectional study) aimed to explore the relationship between virtues and self-disclosure among ordinary Chinese sample. Study 2 (intervention study), based on the findings of Study 1, aimed to examine the effectiveness of expressive writing among different significant virtue holders.

Study 1: relationship between virtues and self-disclosure Although no study explored the relationship between virtues and self-disclosure, according to the definitions of virtues, it can be expected that individuals with higher vitality and

J Ment Health, 2014; 23(5): 231–235

relationship would be more likely to conduct self-disclosure, whereas those with conscientiousness would have negative relations with self-disclosure. Methods Participants and procedures Participants involved in study 1 were recruited via the public internet. An Uniform Resources Locator directing to our online survey was distributed through BBS, WeChat and Weibo1, and the receivers were invited to participate voluntarily. A total of 144 samples from 19 provinces in China were obtained in three weeks, including 41 males (28.50%) and 103 females (71.50%). Thirty-seven persons were at the age range from 16 to 20 years, 81 ranging from 21 to 25 years, 23 ranging from 26 to 30 years and 3 individuals were above 31 years old. Measurements Jourard Self-Disclosure Questionnaire The short version of Jourard Self-Disclosure Questionnaire (12 items) developed by Gudykunst (1985) was used to assess the degree of individual self-disclosure. Participants were asked to indicate their disclosure degree (0 ¼ no disclosure, 1 ¼ disclosure in general terms and 2 ¼ full disclosure) to different persons (father, mother, same sex friend and opposite sex friend) on four aspects (attitude, work and study, character and body). For instance, for this item ‘‘My study (work) aspirations and goals’’, respondents should give three scores (0–2) to indicate the degree of self-disclosure for different persons. The higher the sum score of the whole scale reflected the higher degree of self-disclosure. Chinese Virtues Questionnaire CVQ was a simplified Chinese scale that assessed the three mentioned virtues (relationship, conscientiousness and vitality) with 96 items (Duan et al., 2012b, 2013). An example of items is ‘‘I am a true life-long learner’’ (vitality). The respondents were asked to rate to what extent each item describes them on a five-point Likert scale ranging from 1 (very much unlike me) to 5 (very much like me). The scores of the three virtues were obtained by summing the corresponding items of each subscale and then divided by the item numbers of each subscale. A high score reflects a high degree of the virtue within an individual. Results Correlation analysis The correlation analysis found that only vitality had significantly positive relation with self-disclosure (r ¼ 0.23, p50.01; Table 1). The relationship and conscientiousness had no significant relations with self-disclosure. Regression analysis Regression analyses were further conducted to obtain the predictive ability of the three virtues. The results of the 1

Both WeChat and Weibo are very popular public Internet medium in Mainland China, each with hundreds of millions of members.

Virtues and expressive writing

DOI: 10.3109/09638237.2014.924050

Table 1. Correlations and regressions analysis (N ¼ 144). Self-disclosure Regressions Virtues

Correlations (r)

Beta

t

0.14 0.23a 0.13

–0.03 0.22 0.07

–0.23 2.17b 0.70

Relationship Vitality Conscientiousness

Chinese Virtues Questionnaire The sub-scale of CVQ was used to assess the vitality virtue (40 items).

Table 2. Dominance analysis (N ¼ 144). R2 Relationship Vitality Conscientiousness

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attend a nine-week expressive writing experiment (40 min per time once a week). The mean age of the sample was 19.82 years (SD ¼ 1.02; range 18–23), while 23 (46%) were males and 27 (54%) were females. The ethical approval to collect data for this study was obtained from the School of Culture and Social Development Studies, Southwest University, China. Measurements

Dependent variable is self-disclosure. a p50.01 and bp50.05.

Relationship Vitality Conscientiousness Relationship and vitality Relationship and conscientiousness Vitality and conscientiousness Relationship, vitality and conscientiousness Decomposition of R2 % of the predicted variance

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– 0.018 0.053 0.017 0.053

0.018 – 0.000 0.008 –

0.053 0.035 – 0.038 –

0.017 0.007 0.003 – 0.003

0.025



0.031



0.056

0.000





0.056







0.0073 13.04%

0.0402 71.79%

0.0083 14.82%

Dependent variable is self-disclosure.

multiple regression analyses with enter method showed that vitality was the only significant predictor of self-disclosure ( ¼ 0.22, t ¼ 2.17, p50.01; Table 1). Dominance analysis Johnson (2000) suggested that the traditional multiple regression analysis may underestimate the predictive ability of the weaker independent variable. Dominance analysis should be adopted to reveal the relative importance of each predictor (Budescu, 1993). Following the steps recommended by Budescu (1993), the vitality contributed 71.79% of the predicted variances (Table 2).

Study 2: the function of vitality in expressive writing intervention Based on the findings in Study 1, among the three virtues, only vitality had a significantly positive relationship with the self-disclosure. This implies that the person with higher vitality will be more likely to conduct self-disclosure, which in turn gain additional benefits through expressive writing exercise. Therefore, the Study 2 aimed to examine the function of vitality in an intervention study. Methods Participants A total of 50 undergraduates were recruited from different classes in a certain university. They were recommended to

The Satisfaction with Life Scale Satisfaction with Life Scale (SWLS) (Diener et al., 1985) was adopted as outcome indicator of well-being in this intervention study. Participants were required to evaluate the global satisfaction with life with five items using a seven-point Likert scale (1 ¼ strongly disagree, 7 ¼ strongly agree). Intervention procedures During week one, students were given a brief introduction on this experiment. The instructor and students did not know each other. Their responses were kept confidential, and the completion of the survey was voluntary as described in a Non-disclosure Agreement (NDA). This approach can enhance the level of involvement and guarantee privacy (Duan et al., in press; Lu et al., 2012). All students agreed to participate in the study. In this week, they were asked to complete the SWLS to obtain the baseline of life satisfaction (Time 1, T1) and the sub-scale of CVQ to obtain their vitality virtue scores. In the subsequent eight weeks, students were required to write an essay with the following instructions once a week: Life is not calm; you must have experienced certain unfortunate events. These events may be of stressful, emotional, traumatic events or personal views on important issues. Please describe an event to explore your deepest thoughts and feelings. Please write down your thoughts in a short essay without any scruples (limited to 400 Chinese characters). All assignments were required to complete in 40 min and then contained within a sealed envelope before submission to the instructors. As the NDA indicated, no one could assess these essays without the permission of the respective writers. Each student totally wrote eight essays. During week nine, students were asked to complete the SWLS again for examining the efficacy of our intervention program (Time 2; T2). After completing all the experimental procedures, instructor explained the basic theories and knowledge of this intervention and answered questions. Data analysis The median score of vitality virtue (Median ¼ 3.58) of this sample was adopted as a cut-off point to distinguish the highvitality group and low-vitality group. To evaluate the quality of essays, two graduate students who majored in psychology were invited to serve as independent raters. Before evaluation, permission to assess these materials was obtained from the participants. All materials were anonymized. Previous studies

Y. Zhang et al.

J Ment Health, 2014; 23(5): 231–235

demonstrated that these strategies can discriminate invalid participants (Duan et al., in press; Proctor et al., 2011; Seligman et al., 2005). The raters did not know the purpose of this experiment and were required to read and score each essay on a seven-point Likert scale (from 1 ¼ very unserious to 7 ¼ very serious). Notably, ‘‘serious’’ is a translation from Chinese, which indicates the depth and degree of selfdisclosure. The scores did not depend on the handwriting, writing skills or the length, but on the content of the essay. The evaluation consistency coefficients of the two raters were 0.67–0.84 (p50.05). The correlation coefficients of the scores and the word count of the essays were 0.08–0.11 (p40.10). These statistics demonstrated a reliable consistency of their evaluations. Nine students were removed from the final data pool for their irrelevant writing content and short length. Interestingly, all excluded samples came from the low-vitality group. This may imply that the individuals with low vitality would not prefer to conduct self-disclosure via an expressive writing exercise. In addition, the excluded participants indicated no difference with the remaining ones on the baseline of satisfaction with life (t ¼ –0.89, p ¼ 0.36). As a result, 41 samples were retained into the following analysis, including 25 high-vitality individuals (15 males and 10 females) and 16 low-vitality individuals (4 males and 12 females). Results Baseline and post-test analysis T-test were conducted to reveal that there was no significant difference of on pre-test SWLS scores (Time 1) between highvitality and low-vitality groups (Mhigh1 ¼ 16.16, SDhigh1 ¼ 4.72; Mlow1 ¼ 18.75, SDlow1 ¼ 6.63; t1 ¼ –1.46, p1 ¼ 0.15), as well as the post-test SWLS scores (Time 2) between the two groups (Mhigh2 ¼ 23.04, SDhigh2 ¼ 5.60; Mlow2 ¼ 20.88, SDlow2 ¼ 4.79; t2 ¼ 1.28, p2 ¼ 0.21). The change trend may be seen in Figure 1. Paired-test was conducted to examine the efficacy of expressive writing intervention of the whole sample. The results showed that only the individuals with high vitality obtained significant development in terms of satisfaction growth after an eightweek writing exercise (t3 ¼ 5.60, p350.001; Table 3). Analysis of changed levels of satisfaction with life To further reflect the magnitude of the changes in satisfaction with life of the participants more explicitly, the baseline High-vitality Group

Low-vitality Group

24 23.04

23

Satisfaction With Life

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22

19

Discussion Roles of virtues in expressive writing This study found that vitality was a positive moderator in expressive writing intervention. This means that higher vitality would result in added benefits obtained by individuals via expressive writing exercises. A meta-analysis conducted by Frattaroli (2006) found that personality was a critical moderator, which could influence various obtained benefits of participants, including psychological health, physiological functioning and reported health. This pilot study revealed the trait-like quality, vitality, also indicated the function of personality as proposed by Peterson & Seligman (2004). Individuals with high vitality often exhibit much more courage, zest, hope and optimism (Duan et al., 2012b, 2013). This would result in their increased willingness to conduct self-disclosure to others, which in turn provided an outlet for psychological distress and improved well-being. A previous study found that vitality was the only predictor of satisfaction with life among Chinese (Duan et al., 2012a). This study may show a possible mechanism behind this conclusion, that is, individuals with high vitality are more likely to conduct self-disclosure, and which in turn promotes their well-being. On the contrary, the excluded nine participants came from the low-vitality group. Therefore, they were unwilling to expressive negative information to others, reflected by their writing content. Although no differences occurred between the excluded subjects and the remaining ones on the baseline (Study 2, Data Analysis), the excluded nine participants indicated much lower satisfaction with life than the others after intervention (Mexcluded ¼ 15.42, SDexcluded ¼ 2.96). This also demonstrated that low-vitality individuals would gain less in the expressive writing intervention. Notably, however, higher levels of vitality are not necessary. For instance, in a recent study, researchers found that vitality was a risk factor of pathological Internet use among adolescents (Zhang et al., 2014). Therefore, additional studies will be needed to clarify the function and internal mechanism of vitality in future. Logically speaking, effective interpersonal skills can help individuals improve their self-disclosure. However, these results failed to support this idea. This phenomenon can be Table 3. The means, standard deviations and t-test analysis (N ¼ 41).

21 20

SWLS scores were subtracted through the post-test scores. Then, a new variable ‘‘Satisfaction with Life Change’’ was created for further analysis. The results demonstrated that the change between the high-vitality and low-vitality groups was significantly different (Mhigh-c ¼ 6.88, SDhigh-c ¼ 6.14; Mlowc ¼ 2.13, SDlow-c ¼ 6.53; t-c ¼ 2.36, p-c ¼ 0.02; Table 3).

20.88 18.75

Satisfaction with life

18

Time 1

17 16

16.16

15 Time 1

Time 2

Figure 1. Change trend of satisfaction with life before (Time 1) and after (Time 2) intervention.

Time 2

High-vitality 16.16 ± 4.72 23.04 ± 5.60 group Low-vitality 18.75 ± 6.63 20.88 ± 4.79 group t-Test –1.46 1.28 a

p50.001 and bp50.05.

Satisfaction with life t-Test change t-Test 5.60a

6.88 ± 6.14

1.30

2.12 ± 6.53

2.36b

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DOI: 10.3109/09638237.2014.924050

explained by the dual effects of social support (Gleason et al., 2008), which was also found in an ongoing study. The person who emphasized interpersonal strengths might prevent themselves from expressing sensitive or harmful information that may harm the interpersonal relationships, which in turn neutralized the positive effects of self-disclosure. This also reflected a typical collectivist culture characterized by maintaining harmony, and Mainland Chinese tend to be more restrained and introverted in interpersonal communication (Bond, 1993). Individuals with high conscientiousness, emphasized self-cultivation of their own intrapersonal strengths to resolve conflicts instead of seeking external help. However, the self-regulation theory implied that the writing tasks of traumatic experiences elicited a process of self-regulation, which would be beneficial for the participants (Lepore & Smyth, 2002). Hence, conscientiousness may serve a different function in traumatic self-disclosure. Notably, the hypothesized role and the corresponding explanations of relationship and conscientiousness were not examined in the present intervention study. Additional studies are needed as discussed below. This intervention design highlighted the involvement and cultural sensitivity via several approaches, such as signed NDA, materials anonymized and triple-blinds among the instructor, raters and participants. These methods may ease the anxiety of Chinese people brought by self-disclosure.

Limitations and future directions This study has certain limitations. First, the pilot research missed a control group for the recruited small sample. Future studies must involve a bigger sample, and three virtue and control groups should be set, respectively, to verify the conclusion. Second, the sample median of vitality was adopted as a cut-off point to distinguish the high- and lowvitality group, which may reduce the differences between the two groups. More scientific methods should be used to identify the cut-off points of virtues based on large-scale surveys. Finally, various samples are needed to re-examine and refine the virtues-based expressive writing intervention.

Declaration of interest The authors declare that they have no competing interests. The study was supported by the 2013 Central Universities Annual Fundamental Research Project – Character Strengths Training (CST) – the Development of a New Model of Mental Health Education (Funding No. swu1309419) and the Major Project of the Chongqing Key Research Foundation in Humanities and Social Sciences (Funding No. 13SKB005).

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Can virtues enhance the benefits of expressive writing among healthy Chinese? A pilot study.

This study aims to explore the relationship between virtues and self-disclosure via a cross-sectional study and an intervention study among Chinese...
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