Randomized controlled trial of expressive writing for psychological and physical health: the moderating role of emotional expressivity

Abstract

The current study assessed main effects and moderators (including emotional expressiveness, emotional processing, and ambivalence over emotional expression) of the effects of expressive writing in a sample of healthy adults. Young adult participants (N=116) were randomly assigned to write for 20 minutes on four occasions about deepest thoughts and feelings regarding their most stressful/traumatic event in the past five years (expressive writing) or about a control topic (control). Dependent variables were indicators of anxiety, depression, and physical symptoms. No significant effects of writing condition were evident on anxiety, depressive symptoms, or physical symptoms. Emotional expressiveness emerged as a significant moderator of anxiety outcomes, however. Within the expressive writing group, participants high in expressiveness evidenced a significant reduction in anxiety at three-month follow-up, and participants low in expressiveness showed a significant increase in anxiety. Expressiveness did not predict change in anxiety in the control group. These findings on anxiety are consistent with the matching hypothesis, which suggests that matching a person's naturally elected coping approach with an assigned intervention is beneficial. These findings also suggest that expressive writing about a stressful event may be contraindicated for individuals who do not typically express emotions.

Keywords:

• expressive writing
• anxiety
• emotional approach coping
• coping processes
• moderators of expressive writing

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Corrigendum

Acknowledgement

This project was funded by grant R01MH084116 (Lieberman and Stanton) from the National Institutes of Health, Bethesda, MD.

Notes

1. The scan was included to test relations of neural parameters to the outcomes of expressive writing and to other variables. These results will be published in a separate manuscript.

2. Emotional processing was a significant moderator (p = .043) when analyses were conducted on non-Winsorized data; however, this p value did not reach the Bonferroni-corrected level of .006, and therefore, simple effects were not analyzed.