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PubMed2000

Emotional disclosure in school children.

Recent research with adults by Pennebaker and his colleagues has found that emotional disclosure through writing about stressful events appears to have significant benefits in terms of psychological and physical health outcomes. This report describes a controlled trial of emotional disclosure, adapted for school children, with the major hypothesis that the repeated description of negative events will have beneficial effects on measures of mental health, attendance, and school performance. The sample consisted of children aged 8-13 years from four schools, a primary and a secondary school both from a suburban and an inner-city area. Children were randomly assigned to one of three conditions: writing about negative events, writing about nonemotional events, and a non-writing control group. Children in all groups were seen four times during a single week and were then followed up after 2 months with measures of health and school performance. The intervention was well received by both schools and children, and the scripts written by the emotional and nonemotional writing groups differed in content in the predicted ways. Contrary to expectation, there was little evidence of a specific effect of emotional disclosure, and several possible reasons for this are discussed. Nevertheless, there was a general reduction in symptom measures, indicating that children may have benefited from their involvement in the study. Although there are several possible explanations for our findings, they indicate that it is both feasible and potentially valuable to give children opportunities to engage in discussion about sources of stress and their reactions to them.

Affect↗
PubMed2001

Shame and non-disclosure: a study of the emotional isolation of people referred for psychotherapy.

Thirty-four people referred to an NHS psychotherapy department were given a modified form of Oatley and Duncan's (1992) emotion diary which included questions about whether each recorded emotion had been subsequently disclosed to anyone (for example a partner, friend or professional). One week later the diaries were collected and participants interviewed. Interviews focused, among other things, on reasons for nondisclosure of recorded emotional experiences and the relationship between shame and non-disclosure. The results indicated that a majority of the emotional incidents recorded in the diaries were not disclosed (68%). This result contrasts with studies on non-clinical samples in which only approximately 10% of everyday emotions are kept secret. Qualitative analysis of the interview data revealed that participants appeared to be habitual non-disclosers of emotional and personal experiences and that non-disclosure was related to the anticipation of negative interpersonal responses to disclosure (in particular labelling and judging responses) in addition to more self-critical factors including shame. It is suggested that these results add to the existing literature on shame by illustrating the interpersonal effects of shame in a clinical sample.

Adult↗
PubMed1987

Effect of HIV antibody disclosure on subsequent sexual activity in homosexual men.

During a prospective study of the natural history of AIDS, 1001 homosexual or bisexual men were offered the opportunity to learn their HIV antibody status. Six hundred and seventy (67%) of the population who elected to do so were similar to the 331 (33%) people who declined in a number of baseline characteristics. All were counselled to practice safe sex. To determine whether disclosure of HIV serologic status affects subsequent sexual behavior, we examined changes at four time-points in three sexual activities during the previous 6 months: the number of male partners with whom the participant had (1) sexual intercourse, (2) unprotected anal receptive intercourse, and (3) unprotected anal insertive intercourse. All activities decreased strikingly over the 18-month study period. Following disclosure, the mean number of partners dropped to 47% of the baseline number in people remaining unaware of their antibody status, to 45% in people told that they were seropositive, and to 55% in people told that they were seronegative. The mean number of partners for younger seropositives declined less than that for older seropositives. The mean number of partners with whom unprotected anal receptive intercourse was practiced declined to 57% of baseline in unaware people, 42% in aware seropositives, and 62% in aware seronegatives. The mean number of partners with whom unprotected anal insertive intercourse was practiced declined to 52% of baseline in unaware people, 42% in aware seropositives and 59% in aware seronegatives. Disclosure of a negative test result led to a significantly smaller decline in these sexual activities.(ABSTRACT TRUNCATED AT 250 WORDS)

Acquired Immunodeficiency Syndrome↗
PubMed1998

Countertransference disclosure and the conceptualization of analytic technique.

Most discussions of countertransference disclosure have focused on points of impasse. Here, I will discuss countertransference disclosure in which the analyst attempts to make explicit to the patient how the analyst experiences something during an analytic session that differs from the way the patient experiences the same moment. The analyst presents his observation as something for the patient and analyst to work on together, with the aim of arriving at further understanding. In a clinical example, I suggest a way of comparing uses of countertransference that relate to other approaches in analytic technique. Since the analyst's disclosure evokes questions regarding asymmetry and anonymity in the analytic process, I will briefly elaborate these dimensions.

Countertransference↗
PubMedDate not supplied

Abuse disclosure in privately and medicaid-funded pregnant women.

Disclosure of abuse by pregnant women can vary depending on whether the woman is assessed directly by a trained interviewer versus written questionnaires, and if she is asked repeatedly during the course of pregnancy. One thousand pregnant women were enrolled in a randomized clinical trial designed to assess the effects of a nursing case management intervention on the mental and physical well-being of pregnant women experiencing or at risk for abuse. Thirteen percent of the total study participants reported current abuse and/or abuse within the past year, with only 2% of those reporting that the abuse occurred during pregnancy. The incidence of reported abuse was much higher among Medicaid-funded women (28.9%) than privately insured women (8.7%). Regardless of source of payment, women reporting abuse were significantly younger, less educated, nonwhite with lower income, and had significantly higher stress and lower self-esteem than women not reporting abuse. A high incidence of women reporting intimate partner violence described being choked on the Danger Assessment Screen (34%). We strongly urge that choking be added to routine screening questions used during pregnancy and that the Danger Assessment tool is used for further evaluation of women who screen positive. In addition, we believe another barrier to reporting abuse was fear of being reported to child protective services, contributing to the overall low rate of abuse disclosure.

Age Factors↗
PubMed1995

The effects of disclosure and intervention on sexually abused children.

There has been concern that disclosure and intervention might negatively impact victims of sexual abuse. In this retrospective study, 82 children and their families were interviewed about their experiences with disclosure and intervention an average of 3.5 years later. The children and parents completed a measure of distress developed for the study which discriminated between abused and non-abused children. The children reported primarily favorable experiences and provided clinically helpful descriptions of the positive and negative aspects of intervention. More contacts with intervention professionals was associated with increased distress, placement, offender removal and testifying were not. Based on the children's comments, suggestions for improving the intervention process are made.

Age Factors↗
PubMed1997

Ethical issues in genetic research: disclosure and informed consent.

As research to correlate genetic status with predisposition to disease has accelerated, so has the concern that participation in such studies creates the risk of genetic discrimination and emotional distress. There is a need to broaden disclosure during the consent process to ensure that potential subjects understand these risks and other issues and to address them in the consent form. We describe the broad approach that we have taken in regard to disclosure and consent in gene mapping studies.

Adult↗
PubMed1995

The consequences of disclosure: one hospital's response to the presence of an HIV-positive physician.

Health care administrators are having to confront the many and complex problems associated with patient fears about the transmissibility of the HIV virus. Particularly acute are concerns that are raised when the physicians are HIV-positive or have AIDS. This article presents a case history of how one hospital handled the problems created by the announcement by one of its emergency room physicians that he was HIV-positive. The hospital's response--which included disclosure to the community, the full cooperation of the physician, provision of free counseling, and HIV testing--and the aftermath of this AIDS-related event are described. This case is discussed in relationship to the ongoing debate about the ethics and consequences of disclosure of the HIV status of health care workers.

Centers for Disease Control and Prevention, U.S.↗
PubMed1992

The disclosure of the diagnosis of cancer.

In summary, the consensus today is that full disclosure of the diagnosis of cancer to competent individuals (including children) is morally, ethically, legally, and therapeutically the appropriate policy. Unfortunately, this task is one that most physicians still find awkward, in part because of the continued de-emphasis of "soft" clinical skills in the medical education. Thus, doctors have little opportunity to address their own beliefs and emotions. By being cognizant of clinician unease and using well-described communication skills, however, disclosure can be satisfactorily accomplished. As American health care becomes increasingly ambulatory in nature, primary care physicians will have even more need to hone this skill.

Attitude of Health Personnel↗
PubMed1975

Self-disclosure in group therapy with schizophrenics.

Self-disclosure was investigated as a process variable in group psychotherapy with chronic schizophrenic patients. Consistent with previous data obtained from nonpsychotic populations, greater perceived therapist interpersonal facillitativeness was associated with higher levels of patient self-disclosure. In contrast to earlier findings, however, patients who were more self-revealing made less therapeutic progress than their counterparts who divulged less personal material. This failure to replicate was tentatively attributed to the limited ability of psychotic persons to integrate social feedback. The results underscore the delicacy of the psychotherapeutic undertaking with schizophrenics.

Adult↗
PubMed1978

Biofeedback-assisted EMG reduction and subsequent self-disclosure.

A male E and a female E each conducted a single session of EMG biofeedback training with 24 male and 24 female Ss (N =96) under one of three conditions: verbal reinforcement presented contingently on EMG reduction, yoked noncontingent verbal reinforcement, and no verbal reinforcement. After the biofeedback session, all Ss completed a Journard Self-disclosure Scale. Sex of S and verbal reinforcement conditions did not affect EMG biofeedback performance, but Ss treated by the male E decreased EMG mean and standard deviation more than Ss treated by the female E (p less than .01). Ss who received noncontingent verbal reinforcement reported being least willing to disclose to the E (p less than .05). These results are discussed in terms of the interpersonal influences that may affect biofeedback performance and self-disclosure.

Biofeedback, Psychology↗
PubMed1978

Essential hypertension and self-disclosure.

A matched sample of 16 hypertensive and 16 non-hypertensive Air Force male Ss were administered the Journal Self-Disclosure questionnaire and participated in an interview that discussed high and low intimate topics. Questionnaire data, content analysis scores of interview topics, and situational stress measures supported the hypothesis that hypertensives conceal their personal thoughts and feelings from others and deny the emotion-arousing stimuli of a self-disclosure situation. Investigation of the underlying psychodynamics of hypertension in a self-disclosing situation as a potentially fruitful line of research was discussed.

Adult↗
PubMed1983

Hypertension, disclosure of personal concerns, and blood pressure response.

Studied the degree of self-disclosure in borderline and hypertensive individuals (N = 50) using a checklist of personal concerns. Shoppers who sought blood pressure measurements in a health display had blood pressure measured before and after the completion of the checklist. Results showed that individuals with elevated blood pressure did not disclose as many personal concerns as normotensives and were less likely to report feeling stressed after the cognitive task even when blood pressure increases had occurred. These findings indicate the need both for further understanding of the nature of self-disclosure and also concurrent investigations of hypertensive characteristics and blood pressure responsivity.

Adaptation, Psychological↗
PubMed1984

Self-disclosure and its relationship to marital intimacy.

Examined the relationship between marital intimacy and self-disclosure from a multidimensional framework within a sample of 10 clinical and 10 nonclinical married couples. The linear combination of various parameters of self-disclosing behavior was able to account for 71.7% (R = .853) of the variance in intimacy ratings derived from a structured interview. Results are discussed in terms of both the role that self-disclosure plays in the development of marital intimacy and its therapeutic benefits and limitations in marital therapy.

Adult↗
PubMed1989

Counselors' reports of their use of self-disclosure with clients.

Ninety-six counselors indicated the frequency of their use of 11 types of self-disclosure, which varied in intimacy from incidental information (age, race) to personal weaknesses. Positive emotional responses to clients were used most frequently, and opinions/attitudes were used least frequently. A factor analysis showed three factors to describe the data best. Factor 1 was represented by information related to the personal identify and experiences of the therapist. Factor 2 involved the emotional responses of the therapist to the client. Factor 3 was principally the disclosure of professional experiences and identity. Implications are considered.

Adult↗
PubMed2003

Disclosure, confidentiality, and families: experiences and attitudes of those with genetic versus nongenetic medical conditions.

Despite policy attention to medical privacy and patient confidentiality, little empirical work exists documenting and comparing experiences of persons with genetic versus nongenetic medical conditions concerning persons' disclosure to others as well as their views about appropriate confidentiality to and within families. The goal of this cross-sectional interview study with nearly 600 participants was to document and compare the experiences, attitudes, and beliefs of persons with strictly genetic conditions to those of persons with or at risk for other serious medical conditions in terms of the degree to which they have disclosed to others that they have the condition and their views about how others ought to maintain the confidentiality of that information. While almost all participants reported that family members knew about their condition, results suggest participants want to control that disclosure themselves and do not want doctors to disclose information to family members without their knowledge. Similarly, participants do not think family members should be able to get information about them without their knowledge but feel overwhelmingly that it is a person's responsibility to disclose information about hereditary conditions to other family members. Ambivalence about confidentiality was evident: while most participants did not mind doctors sharing information with other doctors when it was for their benefit, the majority also felt that doctors should be punished for releasing information without their permission. The views and experiences reported here generally did not differ by whether participants had genetic versus nongenetic conditions, suggesting that the extensive policy focus on genetic information may be unwarranted.

Adult↗
PubMed1985

Hypertension, perceived clinician empathy, and patient self-disclosure.

The purpose of this study was to compare groups of outpatient hypertensive and diabetic patients to a control group (no known chronic illnesses) on their perceptions of clinician empathy and the importance and difficulty of disclosing information about themselves to health care providers. It was hypothesized that hypertensives would differ from the other groups in perceiving less clinician empathy and in attributing less importance, but greater difficulty, to self-disclosing. The sample was 54 hypertensives, 47 diabetics, and 115 nonchronically ill patients. Each subject completed the Empathy scale of the Barrett-Lennard Relationship Inventory and a patient self-disclosure questionnaire. The empathy hypothesis was supported but the self-disclosure hypotheses were not. Hypertensive patients differed from other patients in perceiving the least clinician empathy and in attributing the greatest importance to discussing their responses to health care.

Adolescent↗