Evaluating a written emotional disclosure homework intervention for lower-limb amputees

Objective: To evaluate the Pennebaker Emotional Disclosure paradigm with lower-limb amputee patients in terms of compliance and efficacy. Design: Repeated measures. Setting: Home based. Participants: Low compliance, both with the initial mailed request (28%) and the subsequent writing task (48%), resulted in 23 lower-limb amputees who had been fitted with a prosthesis participating. Interventions: Patients completed a 15-minute writing task, 6 times, over 2 weeks, with initial baseline and 2-month follow-up assessments. Main Outcome Measures: Cognitive processing, well-being, adjustment to an artificial limb, pain, and prosthetic use. Results: Stronger emotional disclosure was associated with significant reductions in psychologic and physical aspects of amputees' satisfaction with their prosthesis, some of which were mediated by positive changes in affect immediately after the writing tasks. Conclusions: Our results failed to support previous findings with nonclinical samples; in fact, our results contradicted previous findings. We therefore caution that written emotional disclosure may be contraindicated with lower-limb amputee patients.