Minority stressors and dual identities: an analysis of lesbians’ expressive writing journals.

J Lesbian Stud. 2008;12(4):501-17. doi: 10.1080/10894160802278663.

The purpose of the current study was to examine the content of the expressive writing journals of female sexual minorities. In addition, the relationship between the content of expressive writing journals and mood and perceived stress measured two months later was examined. Journal content was also examined as a function of demographic characteristics. Thirty-nine participants each wrote a total of six journal entries about significant stressful or traumatic events or recurring problems they have experienced as lesbians. Topics that participants wrote about were differentness, leading a double life, coming out, discrimination, rejection, fears of rejection and safety, self-acceptance, and same- and opposite-sex intimate experiences. Themes of feeling different, negative coming out experiences, and negative same-sex intimate experiences were associated with more psychological distress two months after the expressive writing exercise. Occupational level was associated with themes related to leading a double life and negative same-sex and coming out experiences. These results are considered in light of the unique minority stressors experienced by lesbians as well as the difficulties inherent in lesbians having ties to both lesbian and heterosexual cultures.

A pilot study of the effects of expressive writing on psychological and behavioral adjustment in patients enrolled in a Phase II trial of vaccine therapy for metastatic renal cell carcinoma.

Health Psychol. 2002 Nov;21(6):615-9.

de Moor C1, Sterner J, Hall M, Warneke C, Gilani Z, Amato R, Cohen L.

Forty-two patients with metastatic renal cell carcinoma who were participating in a Phase II clinical trial were randomly assigned to an expressive writing (EW) or neutral writing (NW) group. Patients in the EW group wrote about their cancer, and patients in the NW group wrote about health behaviors. No statistically significant group differences were found in symptoms of distress, perceived stress, or mood disturbance, except for the Vigor subscale of the Profile of Mood States. However, patients in the EW group reported significantly less sleep disturbance, better sleep quality and sleep duration, and less daytime dysfunction compared with patients in the NW group. The results suggest that EW may have sleep-related health benefits in terminally ill cancer patients.


Expressive writing as a presurgical stress management intervention for breast cancer patients.

J Soc Integr Oncol. 2008 Spring;6(2):59-66.

de Moor JS1, Moyé L, Low MD, Rivera E, Singletary SE, Fouladi RT, Cohen L.

This study evaluated whether expressive writing (EW) was an effective stress management intervention for breast cancer patients. Women were recruited at the end of neoadjuvant chemotherapy and assigned to write about their cancer experience (EW group; n = 24) or neutral topics (neutral writing [NW] group; n = 25). Women were asked to write for 20 minutes a day for a total of four writing sessions that were completed over a 7-day period. Participants were reassessed approximately 3 days before and 2 weeks after surgery. The intervention did not significantly decrease women’s distress, perceived stress, sleep disturbance, or pain. There was some evidence that the EW group used more sleep medication at the presurgical assessment than the NW group. Social constraints moderated the effect of the intervention. Among women with high social constraints, the EW group reported lower average daily pain than the NW group. Among women with low social constraints, the EW group reported higher average daily pain than the NW group. EW was not broadly effective as a stress management intervention for women with breast cancer. These data do not support the use of EW as a presurgical mind-body complementary medicine program for this population.


A pilot study on the effects and feasibility of compassion-focused expressive writing in Day Hospice patients.

Palliat Support Care. 2012 Jun;10(2):115-22. doi: 10.1017/S1478951512000181.

Imrie S1, Troop NA1.

Research has found that writing about stress can confer physical and psychological health benefits on participants and that adopting a self-compassionate stance may have additional benefits. This pilot study evaluated a self-compassionate expressive writing intervention in a Day Hospice setting.


Thirteen patients with life-limiting illnesses wrote on two occasions about recent stressful experiences. Half also received a self-compassion instruction for their writing. Outcome measures were taken at baseline and one week after the second writing session, and text analysis was used to identify changes in the types of words used, reflecting changes in psychological processes.


Patients given the self-compassion instruction increased in their self-soothing and self-esteem in contrast to patients in the stress-only condition. Happiness broadly increased in both groups although reported levels of stress generally increased in patients given the self-compassion instruction but decreased in patients in the stress-only condition. Those given the self-compassion instruction also increased in their use of causal reasoning words across the two writing sessions compared with those in the stress-only condition.


Expressive writing appears to be beneficial in patients at a hospice and was viewed as valuable by participants. The inclusion of a self-compassion instruction may have additional benefits and a discussion of the feasibility of implementing expressive writing sessions in a Day Hospice is offered.

Expressive writing for trauma: initial results



The DCIHR research team recently completed a study on expressive writing for trauma. This study examined the impact of a 6-week expressive writing course led by John Evans, EdD, on measures of resilience, perceived stress, rumination, and depression in a population of 39 individuals who self-identified as having experienced a traumatic event within the past year. Initial data analysis suggests that the writing intervention had a positive, clinically significant effect on all outcome measures; further data analysis is ongoing.