Effects of replay and rehearsal expressive writing on mental health: a randomized controlled trial

Abstract

Background

Expressive writing about previous interactions has been found to improve mental health, but the effect of expressive writing about future imagined interactions has not been explored.

Methods

To examine the effects of rehearsal expressive writing on mental health, we recruited 132 people, and 100 (76%) completed writing tasks (31 control, 34 replay, and 35 rehearsal). Each group was measured at baseline, after the 4th consecutive day of 15-minute-per-day writing, and at 1-month follow-up. Measures included psychological adjustment (Mental Health Inventory-18, MHI), self-perceived stress, PROMIS depression and anxiety, work and social adjustment, loneliness, coping (Brief COPE), and daily writing expressiveness. Repeated measures ANOVA examined time and time-by-group effects.

Results

Significant time effects were found for MHI, self-perceived stress, depression and anxiety symptoms, and self-blame. Marginally significant group-by-time effects on behavioural disengagement and venting, subscales of the coping measure, were found, with rehearsal associated with decreased disengagement and increased venting compared to the replay group. The rehearsal group consistently reported significantly higher perceived writing expressiveness than the other groups over time. Rehearsal and replay expressive writing showed different effects on writing expressiveness and coping via behavioural disengagement and venting.

Conclusion

This study established rehearsal as a promising extension to the affordable therapeutic expressive writing paradigm.

Keywords:

• Expressive writing
• mental health
• imagined interaction
• rehearsal
• replay

Acknowledgements

The authors wish to acknowledge the Health Communication Center for offering and managing our research office, and Dr. Jasper Smits, faculty sponsor for the study. We also thank the participants who contributed their time and efforts to the study. We also acknowledge Dr. John Bellquist for editing the manuscript.

Author contributions

All authors conceptualized the study, conducted data collection, analyzed the data, and drafted the paper. All authors are responsible for the integrity of the work. All authors participated in writing and revising the paper. All aspects of the study (design; management, analysis, and interpretation of data; writing of the report; and decision to publish) were led by the authors. All authors read and approved the final manuscript.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was supported by the University of Texas at Austin under the Health Communication Scholars Program grant (M. R. Greenwell, PI; J. Jhang and W. Zhang, Co-Is), and Emory University Nell Hodgson Woodruff School of Nursing’s postdoctoral developmental fund for Dr. W. Zhang.