Clinical Trial Details
— Status: Completed
Administrative data
| NCT number |
NCT04816032 |
| Other study ID # |
URomLS_3 |
| Secondary ID |
|
| Status |
Completed |
| Phase |
N/A
|
| First received |
|
| Last updated |
|
| Start date |
November 2, 2017 |
| Est. completion date |
July 30, 2018 |
Study information
| Verified date |
March 2021 |
| Source |
University of Roma La Sapienza |
| Contact |
n/a |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Interventional
|
Clinical Trial Summary
Migration is a global phenomenon that produces several psychological impacts on the migrant
causing psychological changes and difficulties such as the development of psychological
diseases, the decrease of the life expectancy, insecurity, isolation, and poorness. These
diseases create a situation of emergency that has prompted the need to intervene with
specific psychological treatments. This study proposed to verify the effectiveness of
expressive writing on the elaborative processes of the migratory journey's trauma.
Participants were twenty-eight migrants of a reception center. A blinded randomized
controlled trial was performed to divide them into three groups: an experimental sample that
performed the expressive writing treatment, a neutral sample that performed the neutral
description writing, and a control sample. The samples were assessed in three times through
self-report measures. The administration of expressive writing is expected to improve the
psychological health condition of migrants
Description:
Emigration is a global phenomenon with a significant impact in both, host countries and
especially on people who decide to migrate. Italy seems to be a chosen destination for
migrants, mainly due to its geographical position, as one of the European Union's border
countries. Italy is mentioned as the fifth European country in Europe about the number of
migrants. Currently, there are 5 million immigrants in Italy. Recent migratory flows in Italy
have changed the cultural background of the main communities residing in the country.
However, several studies have pointed out that the migration phenomenon is not a comfortable
linear process, on the contrary, there are difficulties related to migratory traveling and
the way it is carried out. Among others, the traveling experience could leave relevant marks
on a psychological level. Recent studies underlie the effect of migration on the development
of psychological diseases, on the loss of hope for the future that it affected the life
expectancy causing insecurity, isolation, and poorness, and producing modification on the
possible existing symptomatology. Moreover, the discrimination and disorientation that
migrants experience while traveling and in host countries seem to have a relationship with
anxiety symptoms.
Therefore, many investigations applied psychological intervention to treat the described
symptomatology. The literature highlights the importance of the treatments such as
cognitive-behavioral therapy, narrative exposure therapy, dynamic therapy, combined
psychological treatments, and combined psychological with pharmacological treatments. Of the
mentioned treatments, the narrative exposure treatment seems to be the less applied
intervention, a meta-analysis suggested a fairly effective application of NET on populations
with trauma, however, this result must be taken with caution. The NET is a trauma-focused
therapy, based on trauma expositions in an autobiographical context. This treatment provides
both verbal and non-verbal application, as the expressive writing-EW. Additionally,
Pennebaker considered that expressive writing referring to the own traumatic events with
emotional descriptions could be of help in the resolution of the own life narrations and the
insert of own memories in life history. The expressive writing technique applies to the own
serious traumatic events, from 3 to 5 consecutive days, for 15 minutes daily. This technique
is more structured compare to NET which can be both written and oral and doesn't necessarily
provide a brief exposition. The expressive writing is applied in a more extended context of
trauma, violence, war, natural catastrophe, cancer, and torture. Currently in literature,
there not seem to be any authoritative studies that have applied the expressive writing
technique to the trauma of the migratory journey. The present investigation allows extending
the acknowledgment of this treatment applied to a population of adult migrants submitted to
forced migration.
The aim of this study was to provide evidence of the effectiveness of expressive writing on
mental and physical health in migrants considering the mediation role of the hope for the
future. The hypothesis was that migrants who performed an expressive writing treatment will
show a decrease in symptomatology in association with a greater sense of hope for the future.
The study involved three different samples: experimental, neutral, and control group. The
three samples were composed through a randomized controlled trial placing 22 participants for
each sample. The random allocation of participants within the three samples was blindly
performed.
The non-profit association "Medihospes" located in Rome provided the migrant participants.
Each participant was invited to read and accept the study by completing and signing the
informed consent form. The inclusion criteria were age >18 years and the refugees' or asylum
seekers' status. The exclusion criteria were psychiatric or neurologic diagnosis and drug
abuse.
The study was settled in three different times. At T0 time were administered a self-report
questionnaires' battery composed of four measures: Beck Hopelessness Scale, BHS, Toronto
Alexithymia Scale 20, TAS-20, Symptom Check-List Revised, SCL-90-R, Impact of Event
Scale-Revised, IES-R.
After this first assessment, the participants of the experimental sample received the
expressive writing Pennebaker's treatment, the participants of the neutral sample received
instructions of writing on a general topic of their choice and the participants of the
control sample received no treatment or instructions.
After one week to the treatment phase (T1) and after one month from T1 time (T2) the same
self-report questionnaire's battery was administered to all the participants.
Treatment Pennebaker's expressive writing was applied for three consecutive days for 20
minutes daily. The participants of the experimental sample were asked to write about the
traumatic traveling experience, focalizing the attention on the deeper emotions, thoughts,
and feelings.
The participants of the neutral sample were asked to write about different topics of their
knowledge for three consecutive days for 20 minutes daily; the topics could relate the
description of the city, their room, their place where they live, or easy procedure like, how
to make a coffee (or something else), or to describe their population, trying to remain free
from deep emotions, thoughts or feelings.
