Efficacy of Pennebaker’s expressive writing intervention in reducing psychiatric symptoms among patients with first-time cancer diagnosis: a randomized clinical trial
- 144 Downloads
The aim of this randomized clinical trial was to examine the efficacy of Pennebaker’s expressive writing intervention (EWI) in improving the perceived quality of life (QoL) and in reducing psychiatric symptoms among patients who received a cancer diagnosis.
Seventy-one consecutively recruited patients who received a cancer diagnosis for the first time in their life were randomized into two groups: an EWI group (EWG: n = 35) and a control group (CG n = 36). At the baseline, anamnestic information was collected for all patients, and the patients completed a series of self-reported measures assessing psychiatric symptoms, alexithymia, and health-related QoL. A modified Pennebaker’s EWI adapted to cancer diagnosis was also administered to the EWG. Six months later, 32 patients (EWG: n = 17, CG: n = 15) participated in the follow-up and filled out the same questionnaires.
The Pennebaker’s EWI was effective in decreasing global psychopathology (d = -.55). Small but significant effects were also observed for alexithymia levels and health-related QoL, with the EWG showing a reduction in alexithymia levels (d = -.31) and an increase in the mental component of QoL (d = .31) compared to the CG.
Our findings indicate that the Pennebaker’s EWI is effective in reducing the negative impact of cancer diagnosis on patients’ mental health.
KeywordsRandomized clinical trial Cancer Expressive writing intervention Alexithymia Psychopathology Quality of life
- 2.Hermelink K, Bühner M, Sckopke P, Neufeld F, Kaste J, Voigt V, Münzel K, Wuerstlein R, Ditsch N, Hellerhoff K, Rjosk-Dendorfer D, Braun M, Von Koch FE, Härtl K, Hasmüller S, Bauerfeind I, Debus G, Herschbach P, Mahner S, Harbeck N (2017) Chemotherapy and post-traumatic stress in the causation of cognitive dysfunction in breast cancer patients. J Natl Cancer Inst 109(10). https://doi.org/10.1093/jnci/djx057
- 5.Bottomley A, Gaafa R, Manegold C, Burgers S, Coens C, Legrand C, Vincent M, Giaccone G, Van Meerbeeck J (2006) Short-term treatment-related symptoms and quality of life: results from an international randomized phase III study of cisplatin with or without raltitrexed in patients with malignant pleural mesothelioma: an EORTC lung-cancer group and National Cancer Institute, Canada, intergroup study. J Clin Oncol 24(9):1435–1442. https://doi.org/10.1200/JCO.2005.03.3027 CrossRefGoogle Scholar
- 13.Messina A, Beadle JN, Paradiso S (2014) Towards a classification of alexithymia: primary, secondary and organic. J Psychopathol 20:38–49Google Scholar
- 14.Holland JC, Breitbart WS, Butow PN, Jacobsen PB, Loscalzo MJ, McCorkle R (2015) Psycho-oncology, Third edn. Oxford Medicine, OxfordGoogle Scholar
- 17.Frisina PG, Borod JC, Lepore SJ (2004) A meta-analysis of the effects of written emotional disclosure on the health outcomes of clinical populations. J Nerv Ment Dis 192(9):629–634. https://doi.org/10.1097/01.nmd.0000138317.30764.63 CrossRefGoogle Scholar
- 20.Jensen-Johansen MB, Christensen S, Valdimarsdottir H, Zakowski S, Jensen AB, Bovbjerg DH, Zachariae R (2013) Effects of an expressive writing intervention on cancer-related distress in Danish breast cancer survivors. Results from a nationwide randomized clinical trial. Psychooncology 22(7):1492–1500. https://doi.org/10.1002/pon.3193 CrossRefGoogle Scholar
- 25.Jensen-Johansen MB, O'Toole MS, Christensen S, Valdimarsdottir H, Zakowski S, Bovbjerg DH, Jensen AB, Zachariae R (2018) Expressive writing intervention and self-reported physical health out-comes–results from a nationwide randomized controlled trial with breast cancer patients. PLoS One 13(2):1–17. https://doi.org/10.1371/journal.pone.0192729 CrossRefGoogle Scholar
- 26.Solano L, Donati V, Pecci F, Persichetti S, Colaci A (2003) Postoperative course after papilloma resection: effects of written disclosure of the experience in subjects with different alexithymia levels. Psychosom Med 65(3):477–484. https://doi.org/10.1097/01.PSY.0000035781.74170.F1 CrossRefGoogle Scholar
- 29.Pennebaker JW (1997) Opening up: the healing power of expressing emotions. Guilford Press, New YorkGoogle Scholar
- 32.Pennebaker JW (2010) Expressive writing in a clinical setting. Indep Pract 30:23–25Google Scholar
- 33.Derogatis LR (1994) SCL-90-R symptom Checklist-90-R administration, scoring and procedures manual. Pearson, MinneapolisGoogle Scholar
- 40.Cohen J (1988) Statistical power analysis for the behavioral sciences, Second edn. Lawrence Earlbaum, HillsdaleGoogle Scholar
- 42.Pennebaker JW, Smyth JM (2016) Opening up by writing it down: how expressive writing improves health and eases emotional pain. Guilford Press, New YorkGoogle Scholar
- 43.Bucci W (1997) Psychoanalysis and cognitive science. A multiple code theory. Guilford Press, New YorkGoogle Scholar
- 44.Schimmenti A (2017) The trauma factor: examining the relationships among different types of trauma, dissociation, and psychopathology. J Trauma Dissociation. https://doi.org/10.1080/15299732.2017.1402400