The effects of expressive writing following first myocardial infarction: a randomized controlled trial.

Health Psychol. 2011 Sep;30(5):642-50. doi: 10.1037/a0023519.

Willmott L1, Harris P, Gellaitry G, Cooper V, Horne R.

To assess the effects of expressive writing on health care utilization, clinical variables and subjective quality of life following first myocardial infarction (MI).


One-hundred and seventy-nine first MI patients were randomized to Intervention (N = 88) or Control (N = 91) groups. The intervention group wrote about their thoughts and feelings in relation to having had an MI. Controls wrote in a neutral way about daily activities. The main outcome measures were health care utilization, physical status and subjective quality of life (QOL), assessed after one, two, and five months.


One-hundred and fifty-six (87%) completed the study. Five months post-intervention, the intervention group had significantly fewer recorded medical appointments compared to controls. The number of prescribed medicines decreased over time within the intervention group but increased within the control group. The intervention group attended significantly more rehabilitation sessions, reported fewer cardiac related symptoms and had lower diastolic blood pressure five months post-intervention. There was no significant group by time interaction on reported physical health. The group by time interaction on reported mental health approached significance, those in the intervention group reporting greater improvement.


Expressive writing may be a beneficial strategy which could be incorporated into rehabilitation interventions to help individuals adjust after first MI.

Changes in language use mediate expressive writing’s benefits on health-related quality of life following myocardial infarction.

Health Psychol Behav Med. 2014 Jan 1;2(1):1053-1066. Epub 2014 Oct 29.

Hevey D1, Wilczkiewicz E2.

The present study assessed linguistic mediators on the effects of expressive writing on health-related quality of life (HRQOL), depression and anxiety following myocardial infarction (MI). One hundred and twenty-one cardiac patients were randomised (expressive writing = 61; control = 60), 98 (expressive writing = 47; control = 51) provided pre- and post-data, with 89 (expressive writing = 43; control = 46) completing the three-month follow-up. The expressive writing group wrote (20 mins/day for three consecutive days) about their thoughts and feelings regarding their MI, and the control group wrote (20 mins/day for three consecutive days) about daily events that occurred during the year prior to the MI. The outcome measures of depression, anxiety and HRQOL were completed pre-randomisation, post-intervention and three months post-intervention; the mediating variables assessed were changes in (a) positive emotion words, (b) negative emotion words and (c) cognitive-processing words. Three months post-intervention, the expressive writing group had significantly higher HRQOL. The positive effects of expressive writing were significantly associated with increases in both positive emotion words and cognitive-processing words across the three days of expressive writing. Expressive writing is a beneficial intervention that may enhance HRQOL among cardiac patients.