Disclosure, psychophysiology, and major depression

A recent line of research has provided consistent evidence that confiding traumatic or stressful experiences not only provides psychological benefits, but also improves physical health among populations without significant psychopathology. This study attempted to replicate and extend the work of Pennebaker and colleagues using a clinical population (i.e. Major Depressive Disorder) and a different method of disclosure (i.e. a structured clinical interview). Thirty-nine out of 61 subjects, who were interviewed to determine eligibility for a depression treatment study, met entrance criteria and completed the study. Heart rate (HR), skin conductance level (SCL), and respiratory sinus arrhythmia (RSA) were recorded before, during and after administering the Hamilton Rating Scale for Depression at baseline. In contrast to expectation and to previous research, disclosure level during the interview did not predict long-term improvements in mental or physical health amongst individuals with Major Depression who completed treatment. Disclosure during a clinical interview about depression may not be as beneficial as open-ended disclosure about traumatic or stressful experiences. Another possible explanation for why disclosure did not result in improved mental or physical health may be that the treatment effect was sufficiently strong to overshadow any subtle effects of disclosure. Increased physiological arousal from before to after the interview predicted less depression and anxiety at the end of the study, but did not predict decreased health utilization or improved health as found in previous research. Increased arousal following disclosure may indicate that cognitive change has occurred. Cognitive change may lead to insights that facilitate long-term improvements in mental health. The present study suggests the utility of further examining the association between physiological arousal during disclosure and its long-term impact on mental and physical health in clinical populations.