Randomised Controlled Trial of Expressive Writing and Quality of Life in Men and Women Treated for Colon or Rectal Cancer

Overview

Journal Psychol Health

Publisher Routledge

Specialty Psychology

Date 2014 Oct 2

PMID 25271396

Citations 15

Authors

Stephen J Lepore

Tracey A Revenson

Katherine J Roberts

Julie R Pranikoff

Adam Davey

Affiliations

Soon will be listed here.

Abstract

Objective: This randomised trial tested (i) whether a home-based expressive writing (EW) intervention improves quality of life in patients with colorectal cancer (CRC) and (ii) whether the intervention is more beneficial for men or for people who feel constrained in disclosing cancer-related concerns and feelings.

Design: Patients treated for CRC were randomised to an EW (n = 101) or control writing (CW; n = 92) group. Assessments were completed at 1 month pre- and post-intervention. Sex and perceived social constraints on disclosure were evaluated as moderators.

Main Outcome Measures: Primary outcomes were depressive symptoms, sleep problems and quality of life indicators.

Results: Eighty-one per cent of participants completed all writing assignments. Consistent with hypotheses, relative to the CW group, participants in the EW group expressed more negative emotion in writing and rated their writings as more meaningful, personal and emotionally revealing. There were no significant main effects of EW or moderating effects of sex or social constraints on outcomes.

Conclusions: Although EW is feasible to use with persons who have CRC, it was not effective as a stand-alone psychotherapeutic intervention. Neither was it more effective for men nor for people who felt they could not freely disclose cancer-related concerns and feelings.

Citing Articles

[Effect of psychological interventions on psychosocial variables in patients with colorectal cancer: a narrative review of the literature].

Hernandez-Marin J, Galindo-Vazquez O, Calderillo-Ruiz G, Montero-Pardo X, Costas-Muniz R, Ortega-Andeane P Psicooncologia (Pozuelo de Alarcon). 2024; 19(2):299-318.

PMID: 38756183 PMC: 11097673. DOI: 10.5209/psic.84042.

Systematic review and meta-analysis of the effectiveness of expressive writing disclosure on cancer and palliative care patients' health-related outcomes.

Abu-Odah H, Su J, Wang M, Sheffield D, Molassiotis A Support Care Cancer. 2023; 32(1):70.

PMID: 38157056 DOI: 10.1007/s00520-023-08255-8.

Cancer and aging: Reflections for elders- Expressive writing intervention: A pilot study.

Tutino R, Saracino R, Kelman J, Schofield E, Roth A, Nelson C J Geriatr Oncol. 2022; 13(5):706-714.

PMID: 35246404 PMC: 10108097. DOI: 10.1016/j.jgo.2022.02.009.

Better Together: Long-term Behaviors and Perspectives after a Practitioner-Family Writing Intervention in Clinical Practice.

Schaufel M, Moss D, Donovan R, Li Y, Thoele D Perm J. 2021; 25.

PMID: 33970079 PMC: 8817932. DOI: 10.7812/TPP/20.250.

Impact of non-pharmacological interventions on quality of life, anxiety, and depression scores in patients with colorectal cancer: a systematic review and meta-analysis of randomized controlled trials.

Meng X, Wang X, Dong Z Support Care Cancer. 2021; 29(10):5635-5652.

PMID: 33786669 DOI: 10.1007/s00520-021-06185-x.

References

Chambers S, Meng X, Youl P, Aitken J, Dunn J, Baade P . A five-year prospective study of quality of life after colorectal cancer. Qual Life Res. 2011; 21(9):1551-64. DOI: 10.1007/s11136-011-0067-5. View

Faller H, Schuler M, Richard M, Heckl U, Weis J, Kuffner R . Effects of psycho-oncologic interventions on emotional distress and quality of life in adult patients with cancer: systematic review and meta-analysis. J Clin Oncol. 2013; 31(6):782-93. DOI: 10.1200/JCO.2011.40.8922. View

Buysse D, Reynolds 3rd C, Monk T, BERMAN S, Kupfer D . The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28(2):193-213. DOI: 10.1016/0165-1781(89)90047-4. View

Porter L, Keefe F, Hurwitz H, Faber M . Disclosure between patients with gastrointestinal cancer and their spouses. Psychooncology. 2005; 14(12):1030-42. DOI: 10.1002/pon.915. View

Hoyt M . Gender role conflict and emotional approach coping in men with cancer. Psychol Health. 2010; 24(8):981-96. DOI: 10.1080/08870440802311330. View

de Moor C, Sterner J, Hall M, Warneke C, Gilani Z, Amato R . 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; 21(6):615-9. DOI: 10.1037//0278-6133.21.6.615. View

Aaronson N, Ahmedzai S, Bergman B, Bullinger M, Cull A, Duez N . The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology. J Natl Cancer Inst. 1993; 85(5):365-76. DOI: 10.1093/jnci/85.5.365. View

Carmack C, Basen-Engquist K, Yuan Y, Greisinger A, Rodriguez-Bigas M, Wolff R . Feasibility of an expressive-disclosure group intervention for post-treatment colorectal cancer patients: results of the Healthy Expressions study. Cancer. 2011; 117(21):4993-5002. DOI: 10.1002/cncr.26110. View

Dunn J, Ng S, Breitbart W, Aitken J, Youl P, Baade P . Health-related quality of life and life satisfaction in colorectal cancer survivors: trajectories of adjustment. Health Qual Life Outcomes. 2013; 11:46. PMC: 3648454. DOI: 10.1186/1477-7525-11-46. View

10.

Dunn J, Lynch B, Aitken J, Leggett B, Pakenham K, Newman B . Quality of life and colorectal cancer: a review. Aust N Z J Public Health. 2004; 27(1):41-53. DOI: 10.1111/j.1467-842x.2003.tb00378.x. View

11.

Frattaroli J . Experimental disclosure and its moderators: a meta-analysis. Psychol Bull. 2006; 132(6):823-65. DOI: 10.1037/0033-2909.132.6.823. View

12.

Sloan D, Marx B, Epstein E, Lexington J . Does altering the writing instructions influence outcome associated with written disclosure?. Behav Ther. 2007; 38(2):155-68. PMC: 3898039. DOI: 10.1016/j.beth.2006.06.005. View

13.

Cohen J . A power primer. Psychol Bull. 2009; 112(1):155-9. DOI: 10.1037//0033-2909.112.1.155. View

14.

Zakowski S, Harris C, Krueger N, Laubmeier K, Garrett S, Flanigan R . Social barriers to emotional expression and their relations to distress in male and female cancer patients. Br J Health Psychol. 2003; 8(Pt 3):271-86. DOI: 10.1348/135910703322370851. View

15.

Mosher C, Lepore S, Wu L, Austin J, Valdimarsdottir H, Rowley S . Social correlates of distress following hematopoietic stem cell transplantation: exploring the role of loneliness and cognitive processing. J Health Psychol. 2012; 17(7):1022-32. PMC: 3760721. DOI: 10.1177/1359105311432490. View

16.

Stanton A, Danoff-Burg S, Cameron C, Bishop M, Collins C, Kirk S . Emotionally expressive coping predicts psychological and physical adjustment to breast cancer. J Consult Clin Psychol. 2000; 68(5):875-82. View

17.

Henry E, Schlegel R, Talley A, Molix L, Bettencourt B . The feasibility and effectiveness of expressive writing for rural and urban breast cancer survivors. Oncol Nurs Forum. 2010; 37(6):749-57. DOI: 10.1188/10.ONF.749-757. View

18.

Merz E, Fox R, Malcarne V . Expressive writing interventions in cancer patients: a systematic review. Health Psychol Rev. 2014; 8(3):339-61. DOI: 10.1080/17437199.2014.882007. View

19.

Buda B . Stephen J. Lepore & Joshua M. Smyth (Eds.) (2002). The Writing Cure: How Expressive Writing Promotes Health and Emotional Well-Being. By Béla Buda. Crisis. 2015; 23(3):139. DOI: 10.1027//0227-5910.23.3.139a. View

20.

Schuster T, Kessler R, Aseltine Jr R . Supportive interactions, negative interactions, and depressed mood. Am J Community Psychol. 1990; 18(3):423-38. DOI: 10.1007/BF00938116. View