Syntax Literate: Jurnal Ilmiah
Indonesia �p�ISSN: 2541-0849 e-ISSN:
2548-1398
Vol. 8, No. 2, Februari
2023
IMMEDIATE EFFECT OF EXPRESSIVE-GRATITUDE
WRITING: EMOTION CRAFT THROUGH WRITING DURING THE COVID-19 PANDEMIC
Setiawati Intan Savitri
Fakultas Psikologi Universitas Mercu Buana, Indonesia
Email: [email protected]
����
Abstract
The world is gradually recovering from the coronavirus outbreak, which was first declared in early 2020 and the pandemic is slowly shifting into an endemic. This transition has brought a profound effect on individuals� mental states. Grief over the loss of loved ones and general suffering appear simultaneously with gratitude because of receiving social support and surviving among many other things. One of the effective and inexpensive interventions to deal with depression is expressive writing. To date, this intervention is still popular. There are two types of expressive writing, the first is writing down negative events, and the second is writing positive things or gratitude writing. These two writing techniques are generally not combined and alone rarely result in immediate effect (Baikie & Wilhelm, 2005). The purpose of this research is to find out the immediate effect of expressing negative events as well as gratitude writing, combining the two writing techniques with the perspective of cathartic-insight theory and gratitude. In the course of this research, expressive-gratitude writing was carried out for three consecutive days. The participants wrote about negative events on the first day, the impact of negative events from the perspective of others on the second, and on the last day, they wrote a letter of gratitude and learning. Immediately after completing the tasks, the depression level of the research participants (N=50, M-age= 33.69; n-woman= 40, n-man= 10) was measured using the BDI-II (21 items) and the Gratitude Questionnaire (6 items). The statistical test using the paired t-test revealed a significant decrease in the BDI-II average score and a significant increase in the gratitude average score. In contrast to previous studies which found that the immediate effect of expressive writing was either enhancing distress or showing no effect whatsoever, this research suggested that the immediate effect of expressive-gratitude writing could significantly reduce negative emotions and increase gratitude.
Keywords: expressive writing; gratitude writing; depression; gratitude; the Covid-19 pandemic
Introduction
The world is slowly
recovering from the ongoing global pandemic Covid-19 which first struck in
early 2020. The Covid-19 crisis has brought a significant effect on the lives
of millions of people around the world. The transition status from pandemic to
endemic has certainly affected the mental state of many individuals.
Depression, grief over the loss of loved ones, general suffering, and social
isolation may appear simultaneously with gratitude because of receiving social
support and surviving among many other things to be thankful for. In a survey
on anxiety, depression, and trauma, conducted by The Indonesian Psychiatric
Association (PDSKJI, 2020) during the Covid-19 pandemic
on 1.552 participants, 63% of participants experienced anxiety and 66% suffered
from depression due to the pandemic. Anxiety symptoms include over-worrying,
irritability, and struggling to relax. Meanwhile, symptoms of depression
include sleep disorder, lack of confidence, fatigue, lack of energy, and loss
of interest (Beck, 1996). The findings of the survey showed that external circumstances
such as the pandemic played a significant role in disrupting an individual�s
mental health.
To date, depression has
been frequently found to have a negative correlation with gratitude (Lin 2015;
Lambert et al., 2012; Wood et al., 2010; Wood et al., 2008b; Savitri, Takwin, Ariyanto, Noviyanti, 2018). Emmons & Mc, Cullough (2004) stated
�Gratitude is an emotion, the core of which is pleasant feelings about the
benefit received�, which means those who are generally positive are less likely
to suffer from depression. Some researchers suggested that treatment for
depression should emphasize the importance of positive emotions such as
gratitude (Lin 2015; Watkins 2014). Gratitude
is a unique positive emotion. This uniqueness is related to the pattern of
attribution that distinguishes it from other positive emotions such as
happiness and satisfaction, which tend to be attributed internally. Gratitude,
on the other hand, is an emotional expression that is attributed externally,
such as responses to other people, the environment, and even God (Watkins, 2014).
�Gratitude
implies that an individual recognizes the role of others or positively
perceives external factors such as God, fate, the universe, and the environment.
An individual can easily express gratitude when he or she experiences a
positive event. However, when a negative event strikes, it is challenging to
perceive the positive side of such an event. Therefore, gratitude is
frequently associated with an individual�s ability to see the positive from a
negative-perceived event. Gratitude also indicates an individual�s maturity in
dealing with negative events. The Covid-19 pandemic as an external circumstance
challenges individual maturity to remain grateful (Jans-Beken, 2021).��
The Covid-19 pandemic
greatly impacted the mental health of many. People were required to implement
social distancing that led to interaction and social support limitations. A
possible psychological intervention during this unprecedented time was a remote
intervention. Some researchers and psychologists suggested that online
expressive writing has the potential to help with the solution (Gao,
2022).� Another reason to adopt
expressive writing intervention is its inexpensiveness and its effectiveness,
even though it is performed online (Markovic et al., 2020, Mickoka-Walus, 2020;
Proccacia et al., 2021; Bechard et al., 2021, Fekete et al., 2022).
A study involving
expressive writing intervention was first held by Pannebaker & Bealss (1986).
This study assigned individuals to write their deepest thoughts and feelings
about a negative event for three consecutive days for 15 to 30 minutes. Past
studies proved that the positive effects of expressive writing on mental health
were shown eventually through follow-up measurements (Pennebaker & Beall,
1986; Pennebaker et al., 1988; Pennebaker & Francis, 1996; King &
Miner, 2000). However, expressive writing creates less beneficial immediate
effects, it increases anxiety and depressive tendencies (Baikie & Wilhelm,
2005). Likewise, expressive writing intervention that assigns participants to
write positive things such as addressing three things they are grateful for,
for several days in a row, did not show any significant immediate effect in
increasing gratitude. The increase in gratitude could, however, be seen in
follow-up measurements (Bono et al., 2012; G. Bono et al., 2015).
A study that applied a standard expressive writing intervention on general participants who signed up through a social media platform during the Covid-19 pandemic (Markovic et al., 2020) delivered a less constructive result. The participants suffered an increase in depression and distress which was shown in immediate measurement after the intervention. The study noted that within the experimental groups, psychological distress and stress symptoms developed after controlling the baseline. There were no significant differences between groups in depression, anxiety, well-being, and subjective quality of life after the intervention. Similarly, no distinctive intervention outcomes between groups or any recorded follow-up measurement were found. On the other hand, in a study conducted on healthcare workers, a contrasting result was revealed. Expressive writing intervention was shown to have a positive impact in decreasing PTSD symptoms, depression, and global psychopathological symptoms. This positive impact varied in age, sex, marital status, and baseline. Younger healthcare workers, males, and married participants as well as those with higher baseline scores in psychopathology, displayed a greater decline in psychological distress symptoms. Meanwhile females, singles, and those with lower baseline scores displayed an increase in social support and resilience. Thus, expressive writing intervention provided diverse positive effects on the psychological health of healthcare workers (Procaccia, et al., 2021).�� Likewise, the positive effects of online expressive writing intervention on participants affected by the pandemic (N=163 participants) were shown. The participants demonstrated an increase in resilience, as reported in the research of Benchard et al. (2022). It can be said that a strong conclusion has not yet been reached regarding the effectiveness of expressive writing intervention assigned to participants with different backgrounds during the Covid-19 pandemic. Therefore, further research needs to be done.
Developing writing instruction as psychological therapy is a necessity, after 40 years of writing therapy for health draws psychologists� and researchers� attention (Gao, 2022). During the pandemic, two articles comparing the effects of standard expressive writing (expressing negative events, 15 minutes a day for three consecutive days) and another on expressing gratitude (writing positive things) were published (Mari�n et.al., 2022; Fekete et.al., 2022). Both studies were performed online. The study conducted by Marien et al. (2022) on Flemish (Belgian ethnicity) youths aged 18-24 years proved that participants in the positive writing group (gratitude) showed a significant increase in positive emotions when dealing with the pandemic compared to the traditional expressive writing group which was assigned to write negative thoughts and emotions. The study conducted by Fekete et al. (2022) applied expressive writing intervention to compare negative writing and gratitude writing groups. The participants in the gratitude group were more able to maintain their level of gratitude as well as lower their stress levels and negative feelings due to the pandemic shown through a follow-up measurement, performed a month after the intervention. Meanwhile, the participants in the expressive group displayed a decline in gratitude levels and stagnant stress levels as well as negative feelings in the follow-up measurement a month after the intervention. The control group displayed similar results to the expressive writing group, with a decline in gratitude and no difference in stress levels or negative feelings a month after the intervention.
The difference between the two studies is that the first study (Marien, et al., 2022) did not conduct a follow-up measurement as is generally performed by researchers in expressive writing studies. Meanwhile, the second study (Fekete et al., 2022) completed a follow-up measurement. According to Fekete et al. (2022), the immediate effect on the control group, expressive writing group, and gratitude group showed no significant differences. On the other hand, Marien, et al. (2022) revealed a significant difference in the immediate effect between the group that wrote positive responses towards Covid-19 and the standard expressive writing group which emphasized writing down their deepest thoughts and feelings regarding negative events.
Contrasting results are found in studies that adopted expressive writing, both with standard instructions as well as developed instructions such as directing thoughts and feelings to focus on positive matters and encouraging gratitude during adversity. The divergent results include the effect of the writing itself and the point when the beneficial effects can be noticed, immediately after writing or after a follow-up measurement. Therefore, this research aimed to answer the question, �Will standard expressive writing when combined with gratitude writing, (the intervention is not given to separate groups) produce an immediate effect in reducing depression and increasing gratitude?�
Expressive writing is
releasing the deepest thoughts and emotions about negative events through
writing for 15 to 30 minutes per day for three consecutive days (Pennebaker
& Smith, 2016). Expressive writing is for self-interest, not to be
published or read by others. It is free writing, where participants are not
required to follow writing or grammar rules (Chung & Pennebaker, in-press).� In the context of psychological and physical
health, expressive writing was first applied to college students by assigning
them to write down traumatic events for three consecutive days, 15 minutes a
day. This study resulted in a reduced rate of hospital visits, but an increase
in negative mood and blood pressure (Pennebaker & Beal, 1986). This
research was then developed on non-students with health problems, such as
patients with lymph cancer (Morgan, Graves, Poggi & Cheson, 2008) and
breast cancer survivors, and the results revealed that the participants
improved their perception of their disease, as well as physical and
psychological functions (Lu, Galagher & Young, 2018). Expressive writing
was also applied in hepatitis B patients (Petrie, Booth, Pennebaker, Davidson
& Thomas, 1995) and the results suggest that expressive writing helped to
boost the patients� antibodies in the follow-up period of four and six months.
For interpersonal problems, this method can help regulate the emotions and
cognition of those who are broken-hearted (Lepore & Greenberg, 2002) and
help the process of dealing with emotional stress (Pennebaker, Colder &
Carras, 1990).
One of the earliest theories suggesting expressive writing as a means of reducing psychological problems is the psychoanalytic approach of catharsis theory. Catharsis, in the perspective of psychoanalysis, is expressing and releasing suppressed emotions. Writing interventions encourage an individual to re-experience his or her emotions when dealing with past negative events, but in a safe environment (Scheff et al., 1984). A safe environment means expressive writing is performed in private and secure circumstances (with a counselor or alone). Information on how to create catharsis can be read in expressive writing instructions:
�For the next three days, I would like you to write about your very deepest thoughts and feeling about the most traumatic experience of your entire life.� In your writing, I'd like you to really let go and explore your very deepest emotions and thoughts. You might tie this trauma to your childhood, your relationships with others, including parents, lovers, friends, or relatives.� You may also link this event to your past, your present, or your future, or to who you have been, who you would like to be, or who you are now. You may write about the same general issues or experiences on all days of writing or on different topics each day.� Not everyone has had a single trauma but all of us have had major conflicts or stressors � and you can write about these as well.� All of your writing will be completely confidential.� Don't worry about spelling, sentence structure, or grammar.� The only rule is that once you begin writing, continue to do so until your time is up�.
Catharsis is sometimes considered synonymous with abreaction, defined as re-experiencing painful emotional events in psychotherapy, usually involving awareness of previously repressed material (Qonitatin, 2011). Psychotherapists believe in two psychotherapy practices applying different approaches. First, the catharsis approach assumes that emotional problems are generated by conflicts between emotions and self-defense, thus, the catharsis approach encourages an individual to express his or her emotions to overcome self-defense. For this approach, therapists often ask their clients to accept and express their emotions instead of holding them back, suppressing, rejecting, or avoiding them. In expressive writing, the instruction for creating catharsis is in the following message, �In your writing, I'd like you to really let go and explore your very deepest emotions and thoughts�. Releasing and exploring the deepest thoughts and emotions will allow clients or participants to experience catharsis. However, the risk of catharsis is the emergence of rumination. Rumination is a model of responding to distress that involves repetitively and passively focusing on symptoms of distress and on the possible causes and consequences of these symptoms. Rumination does not lead to active problem-solving to change the circumstances surrounding these symptoms. Instead, people who are ruminating remain fixated on the problems and on their feelings about them, without taking action (Hoeksema, et al., 2008). The potential to get stuck in rumination is stated in the standard expressive writing instruction, �You may write about the same general issues or experiences on all days of writing or on different topics each day.� Not everyone has had a single trauma but all of us have had major conflicts or stressors � and you can write about these as well�.
The second approach is the cognitive approach which believes that emotional problems lie in certain non-beneficial false beliefs. The cognitive approach is generally less emotional, likely to be rational, and takes time to accept new beliefs. B. Guinagh (1987) stated that the two approaches are difficult to integrate, but may replace each other depending on the client�s circumstances. B. Guinagh (1987) also criticized positive psychology, which requires an individual to focus on positive things in life, repeatedly thinking and expressing them will be of little help because the individual will consider this action fake and self-deceptive.
However, in the last decade, there has been a shift in instructions for expressive writing. Beginning with only writing negative emotional experiences (known as expressive writing), studies started to examine the benefits of writing positive emotional experiences on psychological conditions. Toepfer (2015) conducted a study that compared the effectiveness of positive writing and expressive writing (writing negative events). One of the intervention designs inspired by expressive writing but with a positive writing approach was developed by King (2001) who examined the effect of writing about one�s best possible self. King (2001) revealed that participants significantly developed psychological well-being on a follow-up measure, three weeks after participating in the study compared to the participants who wrote about traumatic life events or the control topic. These results indicate the benefits of positive writing over expressive writing which encourages expressing negative emotional responses towards negative events. Previous studies also suggested that the immediate effect of expressive writing has consistently been shown to substantially increase emotional distress (Smyth, 1998, Baikie, 2005). Therefore, one of the advantages of positive writing compared to expressive writing, which tends to be negative is gaining a positive effect without emotional cost, which King (2002) refers to as 'gain without pain� (page 119).
Many researchers have developed and examined positive writing interventions, such as spending a week writing down three things that went well each day and their reasons (Seligman, Rashid, & Parks, 2006; Seligman, Steen, Park, & Peterson, 2005), reflecting on past events and writing a list of things to be grateful for (Emmons & McCullough, 2003), and reporting well-being episodes (Fava, 1999). Various studies reported that expressive writing provided a positive impact on follow-up measurements, but it also carries a risk of negative emotions right after writing. Nevertheless, the mechanism of positive writing is still unknown (Toepfer, 2015).
According to Mc Cullough et al.
(2001), gratitude consists of four facets namely: intensity, frequency,
density, and span. In the GQ-6 measurement scale (Grimmaldy & Haryanta, 2011), intensity is defined as how deep
gratitude is perceived (e.g., I have so much in life to be thankful for).
Frequency refers to how often an individual acknowledges the role of external
factors and other people for her or his positive experiences (e.g., long
amounts of time can go before I feel grateful to something or someone). Density
can be defined as the extension of gratitude, a grateful individual will have a
long list of names/external factors that contributed to his or her positive
experiences (e.g., I am grateful for everyone around me). Span is an
individual�s perception where feelings of gratitude predominate over feelings
of misfortune throughout their lives (e.g., I frequently feel grateful even for
small things in my life). In gratitude writing practice, a study of adults in
psychotherapy found that participants in a gratitude writing condition showed
greater mental health benefits up to three months post-intervention when
compared to participants in an expressive writing or control condition.
Participants in the gratitude writing condition also used more positive and
fewer negative words than the expressive writing condition (Wong et al.,
2018). Thus, gratitude writing interventions may yield more health benefits
than expressive writing because gratitude writing generates positive emotions
that attenuate negative emotional states, including psychological distress
(Wood et al., 2010).[I1]
�The Covid-19 pandemic is attributed to
external forces, which have been challenging to control. This is certainly
interesting to study, to find out whether people can feel gratitude by writing
down things they are grateful for during a global outbreak. Thus far, gratitude
is frequently associated with a positive stimulus. How could an individual find
gratitude during the Covid-19 crisis helping to minimize sadness and levels of
depression immediately?
The aim of this study was to examine the immediate effect of online writing
instructions by combining expressive writing which encourages participants to
explore negative emotions and gratitude writing which encourages positive
emotion exploration. Specifically for gratitude writing, by examining
participants� depression and gratitude scores. The hypothesis of this study was
the immediate effect of the intervention is a decline in the depression score
and an increase in the gratitude score after writing for three consecutive days
for 15-30 minutes.
Research Method
����������������������� Participants (average age =33.5, male =10,
female =40) of the study were recruited online and given gratitude writing
training on 20th May 2020, about a month after the Indonesian government
imposed large-scale social restrictions known as PSBB. The main requirement to
participate in this study was the willingness to engage in the gratitude
writing sessions for three consecutive days and fill out the requested
self-assessment. Initially, 109 people applied for the training, but 55 people
could not take part in the next stage because they did not fill out the
baseline measurement. On the last day, five people did not complete the
self-assessment or the writing tasks (for three consecutive days), thus, only
50 people, or 45% of the initial participants were possible to assess.
Participants were invited to join a WhatsApp group and a research assistant
sent instructions for the writing activities via the group chat and provided
links to Beck Depression Inventory-II (BDI-II) self-assessment and The
Gratitude Questionaire (GQ-6) as a baseline. After filling out the baseline
questionnaire, participants were requested to write for three days in a row
with different instructions each day, and finally to fill out the BDI-II and
GQ-6 questionnaires immediately after completing the third day�s writing.
Expressive-Gratitude Writing Instructions
The aim of this study
was to design expressive-gratitude writing instructions and some changes were
made as follows:
Table 1
|
Standard
EW Instructions |
Instruction Day 1 |
Instruction Day 2 |
Instruction Day 3 |
|
For the next
three days, I would like you to write about your very deepest thoughts and
feeling about the most traumatic experience of your entire life.� In your writing, I'd like you to really let
go and explore your very deepest emotions and thoughts.� You might tie this trauma to your
childhood, your relationships with others, including parents, lovers,
friends, or relatives.� You may also
link this event to your past, your present, or your future, or to who you have
been, who you would like to be, or who you are now.� You may write about the same general issues
or experiences on all days of writing or on different topics each day.� Not everyone has had a single trauma but
all of us have had major conflicts or stressors � and you can write about
these as well.� All of your writing
will be completely confidential.� Don't
worry about spelling, sentence structure, or grammar.� The only rule is that once you begin
writing, continue to do so until your time is up. |
Same as Standard EW Instructions |
This is your second of three days of writing.
Today you may write about the same traumatic experience or a different one,
whichever you choose. As with day one, explore your very deepest emotions and
thoughts, but you may start to think of why it happened, what it meant, and
how to see it from another perspective. For example: Did it happen to teach
you a particular lesson? Did a part of you gain in a positive way from the
experience? Deeply explore these possibilities in depth and write in detail. |
This is your last day of writing. Today,
write a letter to yourself. You may call yourself by your name or use the
personal pronoun �You�. Tell yourself about an experience that has affected
your life, write down the impact it brought, and tell �yourself� how you
should have handled the situation. Tell �the recipient� of the letter the
meaning and lesson that can be taken from this experience. You may advise
her/him on good things to do. Be kind and say nice things to her/him, cheer
her/him up, and show her/him affection and encouragement with all of your
heart. |
The
table above shows that the first-day writing instruction is standard expressive
writing to give the opportunity for participants to achieve catharsis. On the
second day, writing instructions were added. Participants were required to take
positive meaning from negative experience/s. The last day�s focus was writing a
letter to her/himself as if advising another wisely and providing consolation
by giving positive encouragement.
Result and Discussions
Participants
Demographic
Based on demographic data, the average age of participants was 33,5 years and 109 people applied to participate in the gratitude writing training. First-day participants were 60 people, which decreased to 55 people on the second day, and finally, only 50 participants (10 males and 40 females) completed the gratitude writing study as well as all questionnaires on the third day. The dynamics of the number of participants in gratitude writing can be seen in figure 1. below.
Fig.1 The Dynamics of the Number of Writing Participants
To understand the dynamics of the participants� emotions as well as to do a manipulation check, participants were given four questions that had to be answered immediately after the day�s writing task. The answers to these questions applied a rating scale from 1 to 10, with 1 being the lowest, and 10 being the highest. The questions were as follows: 1) When you wrote, you have outpoured your deepest emotions and thoughts, 2) At this time, you feel very sad, hurt, angry, and disappointed, 3) At this time, you feel glad, happy, satisfied, and calm, 4) I think the writing activity I just did is valuable and meaningful.
The dynamics of participants� emotions after
writing can be seen in figure 2 below.�
For the first question, the manipulation check could be maintained properly with a relatively stable average score, at 8,3 on day 1, 8,6 on day 2, and 8,7 on day 3. Negative emotions such as sadness, anger, and hurt decreased greatly, the average score being 6,8 on day 1, 5,6 on day 2, and 3,9 on the last day. Positive emotions such as happiness and satisfaction increased with an average score of 6,6 on day 1, 6,8 on day 2, and remained at 6,8 on day 3. For the last question, finding out how participants perceived the writing activity, the average score tended to be stable from 8,3 on the first day, 8,5 on the second, and 8,7 on the third day.
Depression
Categorization
The depression measurement scale adopted was Beck Depression Inventory-II (BDI-II) which classifies the results into four categories: 1. Minimum Depression (score 0-13), 2. Mild Depression (score 14-19), 3. Moderate Depression (score 20-28), 4. Severe Depression (score: 29-63) (Beck, 1996). The percentage of each category in the pre-test and post-test of this study can be seen in the following table:
Table
2
Pre-Test
and Post-Test Depression Categorization
|
Pre-Test |
Post-Test |
|
|
Category |
Total/Percentage |
Total/Percentage |
|
Minimum |
27 people 54% |
44 people 88% |
|
Mild |
� 7 people 14% |
4 people 8% |
|
Moderate |
11 people 22% |
1 person 2% |
|
Severe |
� 3 people |
1 person 2% |
From the table above, it can be seen that the percentage of participants with low depression scores increased, but in the mild, moderate, and severe categories, the percentages decreased.
Gratitude Categorization
Gratitude variables were measured using the GQ-6 or Gratitude Questionnaire-6, developed by McCullough, M. E., Emmons, R. A., & Tsang, J. (2002), consisting of six items (e.g., I have so much in life to be thankful for; I am grateful to a wide variety of people), using scale 1 to 7, 1 indicating lack of gratitude and 7 indicating strong gratitude. Reversed items are item 3 (When I see my life, I do not see much to be grateful for) and item 6 (Long amounts of time can go by before I feel grateful to something or someone).
The gratitude categories in the pre-test and post-test are shown in the following table:
Table
3
Pre-Test
and Post-Test Categories of Gratitude
|
Category |
Pre-Test |
Post-Test |
|
Total/Percentage |
Total/Percentage |
|
|
Low |
� 0 people 0% |
�0 people�� 0% |
|
Moderate |
11 people 22% |
�6 people 12% |
|
High |
39 people 78% |
44 people 88% |
Table.2 shows that in the pre-test period, 22% of participants had a moderate score of gratitude, and 78% showed a high score of gratitude. In the post-test period, the medium category decreased to 12% while the high category increased to 88%.
The Results of the
Scale Reliability Test and Assumption Test
The reliability test of the BDI-II achieved a Cronbach�s alpha of 0,88, in the pre-test and 0,87, in the post-test, thus, the BDI-II was confirmed to be reliable. Likewise, the GQ-6 was confirmed to be reliable with a Cronbach�s alpha of 0,76, in the pre-test and 0.62, in the post-test. The assumption of homogeneity tested using Levene�s Test with the pre-test and post-test groups revealed that the depression variable did not meet the homogeneity assumption (p<0.05), therefore, the hypothesis test was carried out using a non-parametric test, the Wilcoxon Rank Test.� The assumption of the homogeneity test using Levene�s Test with the pre-test and post-test groups for the gratitude variable met the homogeneity assumption (p> 0.05), therefore, the hypothesis test was carried out using a parametric test, the paired sample t-test. Even though there were two independent variables, the MANOVA test was unable to be completed in this study because the depression variable did not meet the homogeneity requirements.
The Results of the
Hypothesis Test
This study came up with two hypotheses that need to be proven. First, whether the immediate effect of expressive-gratitude writing would significantly reduce depression levels, and second, whether the immediate effect of expressive-gratitude writing would significantly increase gratitude.
The Wilcoxon Rank Test was conducted to compare depression levels before and after writing gratitude. The results showed a significant decline in depression scores, from M-Pretest=13.3 to M-posttest=7.34.�� Based on the Wilcoxon Rank Test, the Z value obtained was -4.456 with a p-value (Asymp. Sig 2 tailed) of 0,000 which was less than the research critical limit of 0,05, therefore, it was decided to accept the alternative hypothesis that it was proven that expressive-gratitude writing can significantly reduce depression score after three consecutive days of writing.
Paired sample t-test was conducted on the gratitude variable to compare gratitude levels before (M-pretest=34.0) and after writing (M-posttest= 36.0), the results of the paired sample t-test showed a score t (1,49) = -2,83, p = 0.007.� These findings confirmed that the alternative hypothesis could be accepted, establishing that expressive-gratitude writing significantly increases gratitude.
Discussion
The results of this research are consistent with the findings of previous studies, which suggested that when interventions focus on gratitude, they help reduce depression and improve appreciation (Fekete, et al., Wood et al., 2008a, 2008b). Demographic data on baseline measurements showed that participants gratitude scores ranged from moderate to high, it can be said that the participants developed brighter personalities. Apart from the possibility of social desirability bias from participants, gratitude helps individuals identify positive qualities in themselves.
�The most valuable finding in this study that differentiates it from the previous studies is that expressive-gratitude writing produces immediate effects in reducing depression and increasing gratitude. Previous studies (Baikie, 2025, Reinhold, 2017) revealed that the immediate effect of standard expressive writing generally includes increased distress, negative mood, physical symptoms, and decline in positive mood compared to the control group. This study verified that expressive writing when modified with gratitude writing yields immediate effects of reducing depression and increasing gratitude.
The composition of writing instructions which combined the classic writing instructions on day 1, requesting participants to write their deepest thoughts and emotions of negative experience/s (Covid-19 related/non-related), gave an opportunity for participants to create catharsis, thus, the aim of purifying negative emotions by writing was achieved at this stage (Scheff, 1984). This could be observed by the declining pattern of negative emotions such as sadness, anger, and pain from day 1 to day 3.
On day 2, participants were once again instructed to write negative experience/s to stimulate catharsis as done on day 1, followed by requesting them to focus on searching for meaning and learning from the negative experience/s. These instructions helped lower the rumination potential when recalling negative events. Instead of focusing on negative events and negative responses, participants were given the opportunity to focus on the meaning and learning. Hoeksema et al. (2008) suggested that meaning and learning can only be obtained by an individual after encountering negative events such as grief or loss, or other negative experiences (Savitri et al., 2019) which can also lead to wisdom (Brady M, 2019). Learning and making meaning are positive emotions that are different from joy, they are more similar to peace, acceptance, and serenity. These were backed by the high average score for the question, �Do you feel peaceful after writing?�. Writing negative experience/s followed by searching for meaning and learning encourages understanding (individuals are able to understand how the experience fits into larger narratives about themselves, relationships, and the wider world), helps individuals to appreciate life by finding meaning from unwanted experiences, such as the Covid-19 pandemic and other difficult periods (Vohs, et al., 2019)
On day 3, when participants were asked to write a letter to themselves, they had to pretend that the recipient of that letter was someone else. They needed to write that they understood what they had been through, give advice, and praise her/him for surviving through difficult times. Providing support and encouragement is a self-reflecting and self-motivating process that helps change an individual�s cognition to be more positive when dealing with adversity. Writing a letter to thank someone who makes a big contribution to the writer�s life is one of the gratitude writing techniques developed in positive psychology (Huffman, et.al., 2014 din Kaczmarek, et al., 2015). This study approached a different method, instead of writing to someone else, the participants of this study addressed the letters to themselves and it was suggested to call the addressee using the second personal pronoun �you� or their names. Using the second or third personal pronoun is believed to distance a personal problem from themselves, this way, participants can view problems more objectively. Modification of writing instructions using self-distancing theory was also adopted in research by Park et al., (2016).
Conclusions
A limitation of this study was there was no control group
to compare with the experimental group. A control group is needed to obtain
better internal validity; thus, future research needs to include a control
group as a comparison. Another obstacle found in this study was the high
attrition rate from participants. On the last day of the three-day study, more
than 50% of participants did not complete the writing tasks. An effort must be
made to reduce the attrition rate for future research. An issue that also needs
to be addressed is demographic data. The composition between male and female
participants in this study was not balanced, considering several studies
(Chung, Cindy & Pannebaker, J., 2007) revealed that men benefit more from
expressive writing than women. This study was conducted in the context of the
Covid-19 pandemic, but data on virus exposure from participants were not
collected, even though those data were not very substantive as Fekete et al.
(2022) study did not specify that negative events need to be related to the
Covid-19 pandemic. The demographic data did not present participants� income
either, given that the pandemic disrupted several economic sectors and brought
an impact on income at the time, further research should enrich demographic
data and adjust to the context of the participants and conditions that might
influence phenomenon or dependent variables.
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