Stress can occur to any human being. Stress is a normal psychological and physical reaction to the demands of life particularly to traumatic incidences. The process of induced abortion or natural is a stressful time for many women (Adler, N. E., David, H. P., Major, B. N., Roth, S. H., Russo, N. F., & Wyatt, G. E. 1990, p. 41). The stress can occur before and after abortion. In this study we are focusing only on post abortion stress. Women who undergo abortion natural or induced are likely to experience acute stress i.e. Acute stress originates from the demands and pressures of the immediate past and anticipated demands and pressures of the future. Because it is short term, acute stress doesn't usually create the physical and psychological damage associated with long-term stress, but severely affect the day to day functioning of the victim during the acute period. A coping mechanism that is effective and simple can be of great help to the women.
There are a set of therapy called Writing therapy, which is a form of expressive therapy that uses the act of writing and processing the written words as therapy (Classen, C., Butler, L. D., Koopman, C., Miller, E., DiMiceli, S., Giese-Davis., & Spiegel, D., 2001, p. 495). Writing therapy proposes that by writing one's feelings / thoughts, it would help to gradually ease the unhealthy feelings of emotional trauma. Writing therapy can take place individually or in a group setting and it can be administered in the presence of a therapist or remotely through e-mailing or the Internet. Written Disclosure is a variant of writing therapy and it is considered as an effective technique to overcome the stressful situations.
Writing therapy, especially the written disclosure can have salubrious effect on the moods and psyche of the women undergoing post abortion trauma. In order to study the impact of the exercise called “written disclosure” on the degree of stress for the women who have undergone abortion, the following experiment is designed. For long researchers have found the positive values of self-disclosure and established in their studies that it is essential for personal growth (Cozby, P. C., 1973, p.73). The researchers identified that, people who reveal their attitudes, assumptions, thinking and purposes, as well as actions, are likely to receive feedback and help from others. The research has shown that without direct or indirect feedback, coping is difficult, and the emotional energy needed to hide our inner reality to the stress than reduces it. Surprisingly personal strength increases as we disclose to another person or even to a non- sentient entity. Written Disclosure is technique to help the trauma victims to disclose about themselves.
- Post Abortion Women (PAW) (women who have undergone the experience of abortion recently) are likely to have reduction in stress level and apply more effective coping strategies if they practice the procedure of ‘Written Disclosure’ irrespective of their age, socioeconomic status, and level of education.
- Post Abortion Women who are not exposed to “written disclosure” are likely to overcome the stress at a slower pace and use less effective coping strategies.
- Women with higher socio economic status and level of education are also likely to overcome the stress quicker.
- Younger women are likely to be concerned about the social pressures than the older women.
- Older women are likely to be concerned about their health than the social pressures.
For studying the impact of the process of written disclosure, a group of PAW needs to undergo the process. Since the researcher manipulates or intervenes with the participants to create an outcome, this is an experimental study. The researcher is intending to have four groups, two experimental and two control groups.
The dependent variable in this experiment is Stress of the PAW (scores on the standardized test) and the priority on the concern checklist. The independent variables are ‘Written disclosure’, age, socio economic status, and level of education of the PAW.
The experimental procedure proposed for this study is systematic because the sample will be stratified random, there are experimental and control groups to compare the outcomes , the tools used are standardized tests that meet the needed criteria of reliability and validity, the statistical analysis proposed is ANOVA and t tests, and finally the instructions and test administration will be carried out by the assistants in the abortion clinics/ hospitals , who will be blind to the purpose of the study.
There will be four groups two experimental and two control groups. One of the control and the experimental group will have pretest before the intervention is applied. The pretest is to measure the stress level of the PAW. The other two groups will not have pretest. The intervention will be in three stages. The first written disclosure will happen within six hours of abortion, another disclosure will be after three days of abortion and final disclosure will be on the 8th day of the abortion. On 10th day, the standardized scale to measure the stress will be administered.
Internal and External Validity of Research
For increasing the internal validity of the study, the sampling will be done rigorously, the instructors and test administrators will be trained and sensitized about the common pitfalls, the tools used will be standardized, only completed scores will be accepted for the analysis, appropriate analysis will be selected, proper timing of the interventions will be ensured, unbiased approach to interpretations of the results will be maintained and all efforts will be taken to minimize the error variance (Onwuegbuzie, A. J. 2000, p 3). For improving the external validity of the study, proper review of literature will be carried out, a theoretical outlook will be developed to explain the relationship among the variables, and a repeat study at different location will be carried out.
The PAW women shall be put to randomized controlled trial to test whether written disclosure can reduce stress and improve coping. Before the PAW will be subjected to writing disclosure, two groups will receive pretests. Writing will take place alongside prescribed medication and will consist of three 15-minute writing sessions, one with in six hours of abortion, second after three days, and the third after seven days. PAW in the experimental group shall follow a structured procedure of written disclosure. The first written format will be about the onset of their pregnancy and other situations in a chronological manner. Second, written procedure will be about their emotions and to describe the impact of the abortion on them and finally they will write about their coping strategies and psychological growth. PAW in control group will not undergo the writing assignments. In addition to standardized test, a counselor, blind to experimental condition, will assess the PAW regarding their coping attempts.
The Research Flow
- Research Method : Experiment
- Independent variables: Written Disclosure, Age, Socio-economic status, and level of education of PAW
- Dependent variables: Level of stress and coping strategies
- Groups: Experimental and control groups
- Pre-testing and post testing present
- The proposed experimental design
O1 X O2 (Experimental group with pretest)
O1 O2 (Control group with pretest)
X O2 (Experimental group without pretest)
O2 (Control group without pretest)
Adler, N. E., David, H. P., Major, B. N., Roth, S. H., Russo, N. F., & Wyatt, G. E. (1990). Psychological responses after abortion. Science, 248(4951), 41-44.
Classen, C., Butler, L. D., Koopman, C., Miller, E., DiMiceli, S., Giese-Davis, J., & Spiegel, D. (2001). Supportive-expressive group therapy and distress in patients with metastatic breast cancer: a randomized clinical intervention trial. Archives of General Psychiatry, 58(5), 494-501.
Cozby, P. C. (1973). Self-disclosure: a literature review. Psychological bulletin, 79(2), 73.
Onwuegbuzie, A. J. (2000). Expanding the Framework of Internal and External Validity in Quantitative Research.