A randomized controlled trial of expressive writing in breast cancer survivors with lymphedema.

Psychol Health. 2017 Jul;32(7):826-842. doi: 10.1080/08870446.2017.1307372. Epub 2017 Mar 30.

Sohl SJ1, Dietrich MS2, Wallston KA2, Ridner SH2.

Breast cancer survivors who develop lymphedema report poorer quality of life (QoL) than those without lymphedema. Expressive writing is a potential intervention to address QoL.

DESIGN:

Adult women (N = 107) with breast cancer and chronic Stage II lymphedema were randomised to writing about thoughts and feelings specific to lymphedema and its treatment (intervention) or about daily activities (control) for four, 20-min sessions.

MAIN OUTCOME MEASURES:

Outcome measures were several indicators of QoL assessed at baseline, one, three, and six months post-intervention (total scores and subscales of Upper Limb Lymphedema 27 and Functional Assessment of Cancer Therapy-Breast). Hypothesised moderators of change in QoL were dispositional optimism, avoidant behaviours, and time since lymphedema diagnosis.

RESULTS:

There was no statistically significant intent-to-treat main effects of expressive writing on QoL. Statistically significant moderating effects on change in different indicators of QoL were observed for all three moderators. Expressive writing was more effective for improving QoL in women who were higher on optimism, lower on avoidance and had less time since a lymphedema diagnosis.

CONCLUSION:

These results provide further evidence that there are subsets of individuals for whom expressive writing is more effective. Future research may investigate targeting expressive writing based on identified moderators.

https://www.ncbi.nlm.nih.gov/pubmed/28355890

Advertisements

Seeing the glass half full: optimistic expressive writing improves mental health among chronically stressed caregivers.

Br J Health Psychol. 2008 Feb;13(Pt 1):73-6.

Mackenzie CS1, Wiprzycka UJ, Hasher L, Goldstein D.

This study explored treatment mediators among caregivers of older adults who did not benefit from expressive writing in a recently published randomized clinical trial.

METHODS:

Twenty-seven expressive writing and time management participants completed questionnaires prior to writing, following their fourth writing session, and 1 month later. We examined the effect of group differences in linguistic markers on health improvements.

RESULTS AND CONCLUSIONS:

Our hypothesis concerning narrative development received no support, and expected links between function words and health were partially confirmed. Results most strongly supported the hypothesis that expressive writing benefited caregivers who used increasingly positive, optimistic, and future-focused language.

https://www.ncbi.nlm.nih.gov/pubmed/17958930