Abstract
This study examined the effects a traumatic environmental stressor, Hurricane Andrew, upon the psychological distress response, as well as the neuroendocrine, immune, and health status of 43 patients diagnosed with Chronic Fatigue Syndrome and 114 subjects from a healthy community sample. In addition, this study investigated the relationship between the intervening variables of emotional expression, optimism and coping style to the physiological and psychological impact of the storm. Subjects either wrote an essay or verbally disclosed what it was like for them in the days before, during, and after the storm. Essays and transcripts were rated for total emotional words, percentages of negative and positive emotional words, intensity of emotional words, the degree to which insight was displayed, problem solving behavior, expression of thoughts versus feelings, and the degree of emotional involvement in the task of essay writing or verbal disclosure.Negative emotional expression was related to greater levels of psychological distress and PTSD symptoms in the months following the storm. This relationship was mediated by the use of denial and suppression of thoughts as coping strategies. In contrast, the qualitative expression variable "insight" (cognitive change), and the dispositional variable optimism, both predicted less psychological distress above and beyond storm-related impact variables. Longitudinally, insight and optimism predicted decreased use of avoidance over time which in turn predicted decreased use of denial and suppression of thoughts as coping strategies.Negative emotional expression was related to higher NKCA, greater illness burden and cytokine levels in the CFS patient population. In addition, avoidance coping predicted higher cytokine levels in these patients, an effect which was mediated by negative emotional expression. Insight and optimism were related to lower illness burden after the hurricane. This effect was mediated by less reliance on avoidance coping strategies.These findings have implications for both psychological and physical recovery from traumatic life events. The results suggest that simply expressing negative feelings is not enough for cognitive-affective integration and recovery to occur. Instead the best interventions for the aftermath of trauma may need to facilitate the expression of negative feelings, while decreasing avoidance strategies and improving cognitive change and insight.