PURPOSE Posttraumatic stress disorder (PTSD) is a significant condition among breast cancer survivors (BCSs). However, few intervention studies for cancer-related PTSD were conducted among Asian cancer survivors. We evaluated a culturally sensitive expressive writing intervention, which combined cognitive reappraisal and emotional disclosure, in reducing PTSD among Chinese American BCSs. We also tested social constraints (defined as social conditions when individuals feel misunderstood or alienated when they desire to disclose their thoughts and feelings) as a moderator. METHODS Chinese American BCSs (n = 136) were randomly assigned to three groups with assigned writing topics for 3 weeks: a self-regulation group, which wrote about the deepest feelings related to cancer in week 1, cognitive reappraisal about stress and coping in week 2, and benefit finding in week 3; an enhanced self-regulation group, with the same instructions, except weeks 1 and 2 were reversed; and a cancer-fact group, which wrote about cancer experiences objectively for 3 weeks. PTSD symptoms were measured at baseline and 1-, 3-, and 6-month follow-ups. Social constraints were measured at baseline. RESULTS Both the self-regulation and enhanced self-regulation groups showed reduced PTSD symptoms compared to the cancer-fact group. For reexperiencing and hyperarousal symptoms, expressive writing was more effective for BCSs who experienced high vs. low levels of social constraints; the opposite was found for avoidance symptoms. CONCLUSION Findings demonstrated the effectiveness of expressive writing intervention in reducing PTSD for this minority population, and that the moderating role of survivors' social network varies among different PTSD symptom clusters. ClinicalTrials.gov Identifier: NCT02946619.

中文翻译：

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华裔美国乳腺癌幸存者中创伤后应激障碍疾病的表达写作干预：社会约束的调节作用。

目的创伤后应激障碍（PTSD）是乳腺癌幸存者（BCS）中的重要疾病。然而，在亚洲癌症幸存者中很少进行针对癌症相关创伤后应激障碍的干预研究。我们评估了一种文化敏感性的表达写作干预措施，将认知再评估和情感披露相结合，以减少华裔美国人BCS之间的PTSD。我们还测试了作为主持人的社会约束条件（定义为当个人希望表达自己的想法和感受时感到误解或疏远的社会条件）。方法将华裔美国人BCS（n = 136）随机分为三组，每组写作主题，为期3周：一个自我调节组，记录第一周与癌症有关的最深层次的感受，对一周内压力和应对的认知进行重新评估2，并在第3周发现收益；加强自我调节组，除第一和第二周相反外，按相同的说明进行；还有一个癌症事实小组，客观地记录了3周的癌症经历。在基线以及1、3、6个月的随访中测量了PTSD症状。社会限制是在基线时测得的。结果与癌症事实组相比，自我调节和自我调节组均表现出PTSD症状减轻。对于重新体验和情绪亢进的症状，表达写作对于经历过高或低社会约束的BCS更为有效。发现相反的规避症状。结论研究结果证明了表达写作干预对于减少这一少数民族人口的PTSD的有效性，以及幸存者的调节作用 社交网络在不同的PTSD症状群之间有所不同。ClinicalTrials.gov标识符：NCT02946619。