Structured writing about stressful events: Exploring potential psychological mediators of positive health effects

In a previous study, the authors found that structured writing about stress ful events improved symptomatology in 112 patients with rheumatoid arthriti s and asthma relative to patients who did not write (J. Smyth, A. Stone, A. Hurewitz, & A. Kaell, 1999). However, little is currently known about the pathways from the intervention to alterations in outcomes. In addition to m easuring symptom outcomes after the intervention in the previous study, the authors monitored perceived stress, quality of sleep, affect, substance us e, and medication use on a momentary basis for the 7 days prior to writing, during the 3 intervention days, and for the 14 days following the interven tion (N = 105). These variables were tested in a secondary data analysis to determine whether they mediated the effects observed in the J. Smyth, A. S tone, et al. study. No evidence was found supporting mediation, and the mec hanism underlying structured writing about stressful events remains unknown .