Does self-affirmation, cognitive processing, or discovery of meaning explain cancerrelated health benefits of expressive writing

physical health. Throughout the past two decades, a large literature has shown that expressive writing improves physical health in a variety of populations (for a review, see Frisina, Borod, & Lepore, 2004; Smyth, 1998). For example, recent studies have shown that expressive writ-ing reduces pain and fatigue and improves well-being in women with fibromyalgia (Broderick, Junghaenel, & Schwartz, 2005), reduces viral load in HIV-infected adults (Petrie, Fontanilla, Thomas, Booth, & Pennebaker, 2004), produces lower evaluations of pain intensity in chronic pain patients (Norman, Lumley, Dooley, & Diamond