Effect of Short Term Expressive Writing on Stress Reaction

Effect of Short Term Expressive Writing on Stress Reaction
Author(s): CHAI Ming-li, YU Hui-hui, LIU Yuan, LU Qian, PAN Fang, School of Medicine, Shandong University, Department of Psychology, University of Houston
Pages: 1128-1132
Year: 2014 Issue:  6
Journal: Chinese Journal of Clinical Psychology
Keyword:  StressExpressive writingCortisolPosttraumatic growthPsychological intervention;
Abstract: Objective: To examine the effect of short term expression writing on stress response in laboratory condition.Methods: 64 4th grade clinical medical students were randomly divided into intervention group and control group. Stress responses were induced by videoes doctor-patient conflicts. After that, state anxiety, negative emotion(such as anger, anxiety, depression and fear), salivary cortisol and posttraumatic growth were assessed. 15 minutes expressive writings included feeling and ideas, express emotion and search for resources and support about stress event was used as the intervention method in writing group for 3 times. The subjects of control group took uninvolved writing. Results: The conflict video induced obvious stress response of subjects, the levels of state anxiety, anger, anxiety, depression and fear scores after video show were significantly higher than that at the baseline in both groups(P<0.01). Both expressive and uninvolved writing significantly decreased the levels of state anxiety, anger, anxiety and fear(P<0.01), but had no effects on depression scores(P>0.05). Compared with control group, expressive writing group had lower levels of anxiety and anger(P<0.01; P<0.05). Expressive writing had no significant effect on salivary cortisol level and posttraumatic growth(P>0.05). Trait anxiety had positive correlation with state anxiety, anxiety, depression and fear(P<0.001) just after stress-induction, and had positive correlation with state anxiety and depression after intervention(P<0.001). Gender(female) had positive association with state anxiety, depression and fear after stress(P<0.001; P<0.005). Conclusion: Short term expressive writing significantly can decrease stress reactions effciently.

Narrowing the gap: the effects of an expressive writing intervention on perceptions of actual and ideal emotional support in women who have completed treatment for early stage breast cancer.

Psychooncology. 2010 Jan;19(1):77-84. doi: 10.1002/pon.1532.

Gellaitry G1, Peters K, Bloomfield D, Horne R.

To assess the effects of an expressive writing (EW) intervention on perceptions of emotional support in women completing treatment for early stage breast cancer.


Women were recruited to the study during their final week of treatment. Of 260 eligible patients, 104 (40%) agreed to participate, and 93 were randomised. Women in the writing group wrote for 20 min on four consecutive days. The control group received normal care. Women’s perceptions of emotional support, quality of life (QOL), mood, and healthcare utilisation were assessed at baseline, 1 month, 3 months and 6 months. Interviews were conducted to explore women’s experience of writing.


Eighty participants completed all follow-ups. There was a significant effect of group on women’s perceptions of social support with those in the intervention group being more satisfied with the emotional support they received (p<0.05). Satisfaction with emotional support was negatively correlated with depression/dejection (p<0.05) and anger/hostility (p<0.05) and positively correlated with social and family well-being (p<0.001) 6 months post intervention. There were no significant effects of the intervention on mood, QOL or healthcare utilisation. Most participants found writing valuable and did not report any long-term negative effects.


EW was associated with a higher level of satisfaction with emotional support compared with controls. Given the existing evidence supporting the importance of social support in adjustment to breast cancer, it seems feasible to suggest that EW may be a cost effective accessible treatment that could be incorporated into the ongoing care of women.