Online written emotional disclosure: Effects on psychological well-being in individuals with infertility.

The negative psychological impact of infertility and resultant stress inherent in the treatment of fertility problems is well documented in the research literature (Greil, 1997). Disclosing emotional reactions to stressful and traumatic experiences through writing has been shown to have beneficial effects on psychological well-being in healthy students and clinical populations (Frattaroli, 2006; Smyth, 1998). The principal aim of this thesis was to examine the efficacy of a written emotional disclosure intervention for individuals with infertility. However, initially the potential moderating effects of delivering the intervention via a computer and within the context of the home was examined. This showed that the adaptation of the traditional laboratory based, handwritten intervention developed by Pennebaker and Beall (1986) did not impact on the short-term or longer-term effects of written emotional disclosure. Subsequently, following a study which failed to recruit participants from an assisted conception unit, a written emotional disclosure intervention for individuals with infertility was examined using an internet-mediated delivery. Results showed that the effectiveness of writing about the experience of infertility and infertility treatment in producing changes in psychological well-being at 4-week follow-up was related to changes in the content of the disclosure narratives across the writing sessions. Analysis revealed that for those individuals in the disclosure group who showed an increase in their use of negative emotion words and cognitive words in their writing over the three disclosure sessions was associated with a reduction in symptoms of psychological distress. The findings of this study are discussed in relation to the heterogeneity of the sample and possible impact of the recruitment methods used. The contribution of this thesis has been to directly test the potential moderating effects of methodological variation in intervention delivery and examine the utility of a written emotional disclosure intervention for individuals with infertility, in doing so the findings of this thesis contribute to the expanding literature. Recommendations are made for more systematic examination of the utility of disclosure writing and investigation of the process by which positive changes occurs in individuals with infertility and other clinical populations.