Off-campus WSU users: To download campus access dissertations, please use the following link to log into our proxy server with your WSU access ID and password, then click the "Off-campus Download" button below.

Non-WSU users: Please talk to your librarian about requesting this dissertation through interlibrary loan.

Access Type

WSU Access

Date of Award


Degree Type


Degree Name




First Advisor

Rita Casey

Second Advisor

Mark Lumley


Written emotional disclosure (ED) benefits some adults with health problems, but its effect on pediatric populations is unknown. Prior research in adults with asthma has demonstrated clinically significant improvements in lung function. The current study sought to extend the adult ED literature to a sample of adolescents with chronic health concerns (pediatric asthma). In a randomized controlled trial of ED in 50 asthmatics aged 12--17 (M = 14.0), participants wrote for 3 days about stressful events (ED; n = 28) or a neutral topic (time management control; n = 22). Adolescents and parents each reported teen health at baseline, 1- and 2-month follow-ups. A subset (n = 32) received lung function testing at baseline and 2 months. Aspects of essay content were also analyzed as potential predictor variables. Group comparisons covaried baseline values of outcomes. Compared to controls, the ED group reported significantly higher positive affect at 1 and 2 months, and fewer internalizing behavior problems at 2 months, both self-rated ( p = .02) and parent-rated (p = .04). The level of illness severity moderated outcome for self-report of asthma symptoms. Teens with elevated levels of baseline asthma symptoms significantly improved on these measures in the ED group, compared to controls. In contrast to expectations, ED had no significant effect on spirometry indices. Various aspects of essay content were factor analyzed and examined as potential predictors of outcome within the ED group. Support was found for the importance of both negative and positive emotion word use, coupled with words denoting higher levels of cognitive processing. The use of cognitive processing words alone did not predict outcomes. There was some evidence that disclosing about more severe stressors may predict poorer outcome, especially if participants do not use high levels of emotion words. This is the first study showing ED benefits in a pediatric population. Written ED improves symptoms and functioning of teens with asthma, especially those with elevated baseline symptoms. Also, disclosure essays incorporating positive and negative emotion and insightful thinking predict better health results.

Off-campus Download