{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,25]],"date-time":"2026-07-25T00:21:49Z","timestamp":1784938909653,"version":"3.55.0"},"reference-count":45,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T00:00:00Z","timestamp":1671753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychol."],"abstract":"<jats:p>Intimate partner violence (IPV) is a serious social, physical and mental health issue. Women victims of IPV can develop short- and long-term consequences such as depression and post-traumatic stress disorder (PTSD). Where trauma has been incurred, standard psychotherapies may usefully be complemented by interventions based on expressive writing (EW). Numerous studies have explored the mechanisms underpinning improvement after writing, focusing on the cognitive and emotional processing of traumatic experiences. The aims of this study were to evaluate changes in PTSD and depression symptoms following EW and to examine the mediating effect of emotional and cognitive processing on symptom reduction in subjects who engaged in EW. Seventy-seven abused women (mean age\u2009=\u200941.43, SD\u2009=\u200910.75) were randomly assigned to a three-session expressive writing condition (<jats:italic>n<\/jats:italic>\u2009=\u200943) or a neutral writing condition (<jats:italic>n<\/jats:italic>\u2009=\u200934). Psychological distress (PTSD and depression) was assessed both before and after the writing sessions. Linguistic inquiry word count software was used to analyze the women\u2019s narratives in relation to emotional processing (positive and negative emotions) and cognitive processing (insight and causal attributions). The mediation model indicated that the reduction in depression was fully mediated by negative emotion processing and partially mediated by cognitive processing, while the reduction in PTSD was partially mediated by negative emotion processing and fully mediated by cognitive processing. No effect of positive emotion processing was found. The clinical implications are discussed.<\/jats:p>","DOI":"10.3389\/fpsyg.2022.1071477","type":"journal-article","created":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T14:42:40Z","timestamp":1671806560000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":9,"title":["The mediating effect of cognitive and emotional processing on PTSD and depression symptoms reduction in women victims of IPV"],"prefix":"10.3389","volume":"13","author":[{"given":"Rossella","family":"Procaccia","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Castiglioni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,12,23]]},"reference":[{"key":"ref90","volume-title":"The Italian LIWC dictionary. LIWC.App","author":"Agosti","year":"2007"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"361","DOI":"10.1016\/j.chb.2004.02.008","article-title":"Evaluation of automatic text analysis in an internet support group","volume":"21","author":"Alpers","year":"2005","journal-title":"Comput. Hum. Behav."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1173","DOI":"10.1037\/0022-3514.51.6.1173","article-title":"The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations","volume":"51","author":"Baron","year":"1986","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref4","volume-title":"Beck depression inventory (BDI-II)","author":"Beck","year":"1996"},{"key":"ref5","volume-title":"Che genere di violenza. Conoscere e affrontare la violenza contro le donne","author":"Bondura","year":"2016"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"781","DOI":"10.1023\/A:1013098307063","article-title":"Effects of writing about rape: evaluating Pennebaker's paradigm with a severe trauma","volume":"14","author":"Brown","year":"2001","journal-title":"J. Trauma. Stress."},{"key":"ref70","article-title":"The development\u00dand psychometric properties of LIWC-22","volume-title":"Austin, TX: University of Texas at Austin","author":"Boyd","year":"2022"},{"key":"ref7","first-page":"567419","article-title":"Fostering the reconstruction of meaning among the general population during the COVID-19 pandemic","volume-title":"Front. 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Ther."},{"key":"ref11","doi-asserted-by":"publisher","first-page":"1165","DOI":"10.1016\/S0140-6736(08)60522-X","article-title":"Intimate partner violence and women\u2019s physical and mental health in the WHO multi-country study on women\u2019s health and domestic violence: an observational study","volume":"371","author":"Ellsberg","year":"2008","journal-title":"Lancet"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1177\/1529100612468841","article-title":"Challenges and successes in dissemination of evidence-based treatments for posttraumatic stress: lessons learned from prolonged exposure therapy for PTSD","volume":"14","author":"Fo\u00e0","year":"2013","journal-title":"Psychol. Sci. Public Interest"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1002\/jts.2490080409","article-title":"Change in rape narratives during exposure therapy for posttraumatic stress disorder","volume":"8","author":"Fo\u00e0","year":"1995","journal-title":"J. Trauma. Stress."},{"key":"ref14","volume-title":"Beck depression inventory-second edition. Adattamento italiano: Manuale","author":"Ghisi","year":"2006"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"505","DOI":"10.1097\/00005053-199608000-00009","article-title":"Written disclosure in posttraumatic stress disorder: is it beneficial for the patient?","volume":"184","author":"Gidron","year":"1996","journal-title":"J. Nerv. Ment. Dis."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"1192","DOI":"10.1177\/1077801207307801","article-title":"Cognitive and emotional processing in narratives of women abused by intimate partners","volume":"13","author":"Holmes","year":"2007","journal-title":"Violence Against Women"},{"key":"ref50","doi-asserted-by":"publisher","first-page":"54","DOI":"10.1521\/jscp.2011.30.6.549","article-title":"The effects of negative emotion and expressive writing on posttraumatic stress symptoms","volume":"30","author":"Hoyt","year":"2011","journal-title":"Journal of Social and Clinical Psychology"},{"key":"ref60","volume-title":"Dipartimento Per Le Pari Opportunit\u00e0: La Violenza Contro Le Donne. Rome: ISTAT.","year":"2015"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1080\/15299730903502979","article-title":"Disclosure of sexual victimization: the effects of Pennebaker's emotional disclosure paradigm on physical and psychological distress","volume":"11","author":"Kearns","year":"2010","journal-title":"J. Trauma Dissociation"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1177\/1073191195002001001","article-title":"The Los Angeles symptom checklist: a self report measure of posttraumatic stress disorder","volume":"2","author":"King","year":"1995","journal-title":"Assessment"},{"key":"ref20","first-page":"160","article-title":"Workbook-journal significantly reduces posttraumatic stress disorder symptoms among rural women with primary breast cancer","volume":"8","author":"Koopman","year":"1999","journal-title":"Psycho-Oncology"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1177\/1359105305049769","article-title":"The effects of expressive writing on pain, depression and posttraumatic stress disorder symptoms in survivors of intimate partner violence","volume":"10","author":"Koopman","year":"2005","journal-title":"J. Health Psychol."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"215","DOI":"10.5498\/wjp.v11.i6.215","article-title":"Intimate partner violence: a loop of abuse, depression and victimization. World","volume":"11","author":"Mazza","year":"2021","journal-title":"J. Psychiatry"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2177","DOI":"10.1111\/jsm.12247","article-title":"Effects of expressive writing on sexual dysfunction, depression, and PTSD in women with a history of childhood sexual abuse: results from a randomized clinical trial","volume":"10","author":"Meston","year":"2013","journal-title":"J. Sex. Med."},{"key":"ref24","doi-asserted-by":"publisher","first-page":"568281","DOI":"10.3389\/fpsyg.2020.56828","article-title":"Linguistic markers of the emotion elaboration surrounding the confinement period in the Italian Epicenter of COVID-19 outbreak","volume":"11","author":"Negri","year":"2020","journal-title":"Front. Psychol."},{"key":"ref25","doi-asserted-by":"publisher","first-page":"162","DOI":"10.1111\/j.1467-9280.1997.tb00403.x","article-title":"Writing about emotional experiences as a therapeutic process","volume":"8","author":"Pennebaker","year":"1997","journal-title":"Psychol. Sci."},{"key":"ref26","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1353\/lm.2000.0011","article-title":"Telling stories: the health benefits of narrative","volume":"19","author":"Pennebaker","year":"2000","journal-title":"Lit. Med."},{"key":"ref27","doi-asserted-by":"publisher","first-page":"577","DOI":"10.1097\/00006842-198909000-00009","article-title":"Disclosure of traumas and health among holocaust survivors","volume":"51","author":"Pennebaker","year":"1989","journal-title":"Psychosom. Med."},{"key":"ref28","doi-asserted-by":"publisher","first-page":"601","DOI":"10.1080\/026999396380079","article-title":"Cognitive, emotional, and language processes in disclosure","volume":"10","author":"Pennebaker","year":"1996","journal-title":"Cogn. Emot."},{"key":"ref29","volume-title":"LIWC2001; linguistic inquiry and word count (software and manual)","author":"Pennebaker","year":"2001"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"863","DOI":"10.1037\/0022-3514.72.4.863","article-title":"Linguistic predictors of adaptive bereavement","volume":"72","author":"Pennebaker","year":"1997","journal-title":"J. Pers. Soc. Psychol."},{"key":"ref31","doi-asserted-by":"publisher","first-page":"1243","DOI":"10.1002\/(SICI)1097-4679(199910)55:10<1243::AID-JCLP6>3.0.CO;2-N","article-title":"Forming a story: the health benefits of a narrative","volume":"55","author":"Pennebaker","year":"1999","journal-title":"J. Clin. Psychol."},{"key":"ref32","doi-asserted-by":"publisher","first-page":"599","DOI":"10.1089\/jwh.2006.15.599","article-title":"The impact of physical, psychological, and sexual intimate male partner violence on women\u2019s mental health: depressive symptoms, post-traumatic stress disorder, state anxiety, and suicide","volume":"15","author":"Pico-Alfonso","year":"2006","journal-title":"J. Women's Health"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"624176","DOI":"10.3389\/fpsyg.2021.624176","article-title":"Benefits of expressive writing on healthcare Workers' psychological adjustment during the COVID-19 pandemic","volume":"12","author":"Procaccia","year":"2021","journal-title":"Front Psychol."},{"key":"ref34","doi-asserted-by":"publisher","first-page":"452","DOI":"10.4081\/ripppo.2020.452","article-title":"Giving words to emotions: the use of linguistic analysis to explore the role of alexithymia in an expressive writing intervention","volume":"23","author":"Renzi","year":"2020","journal-title":"Res. Psychother."},{"key":"ref35","doi-asserted-by":"publisher","first-page":"718","DOI":"10.1080\/08870446.2019.1667500","article-title":"The effects of an expressive writing intervention on pregnancy rates, alexithymia and psychophysical health during an assisted reproductive treatment","volume":"35","author":"Renzi","year":"2019","journal-title":"Psychol. 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Psychol."},{"key":"ref39","volume-title":"Use of Expressive Writing to Mediate the Effects of Ptsd Symptomology on Female Domestic Violence Victims","author":"Southern","year":"2013"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"1282","DOI":"10.3389\/fpsyg.2018.01282","article-title":"Measuring intimate partner violence and traumatic affect: development of VITA, an Italian scale","volume":"9","author":"Troisi","year":"2018","journal-title":"Front. Psychol."},{"key":"ref41","doi-asserted-by":"publisher","first-page":"651","DOI":"10.1093\/bjsw\/bcs005","article-title":"Can sense of coherence moderate traumatic reactions? A cross-sectional study of palestinian helpers operating in war contexts","volume":"43","author":"Veronese","year":"2013","journal-title":"Br. J. Soc. Work."},{"key":"ref42","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1093\/jpepsy\/jsj048","article-title":"Health effects of written emotional disclosure in adolescents with asthma: a randomized, controlled trial","volume":"31","author":"Warner","year":"2005","journal-title":"J. Pediatr. Psychol. Adv. 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