(PS3-A2) The Effects of Covid-focused Expressive Writing and Benefit Focused Writing on Symptoms of Depression in College Students: Randomized Controlled Trial

The Effects of COVID-Focused Expressive Writing and Benefit Focused Writing on Symptoms of Depression in College Students: Randomized Controlled Trial

Expressive Writing (EW) is the process of writing about one's thoughts and feelings related to a stressful experience (Gortner, Rude & Pennebaker, 2006).  Given the stress of the COVID-19 pandemic that people have been contending with, the current study aimed to assess the effects of a COVID-Focused EW protocol and a benefit focused writing protocol on symptoms of depression over time.  Prior work has suggested that writing protocols are differentially beneficial for participants with varying levels of symptoms (Robertson et al., 2019), and this variable was examined in the context of the current study.

One hundred twenty-five participants were randomly assigned to either the (a) EW condition, (b) benefit focused writing condition or (c) control condition.  All participants were required to complete a writing task for 20 minutes on three consecutive days. In the EW condition, participants described their thoughts and feelings about the COVID-19 pandemic.  In the benefit focused writing condition, participants were required to describe any perceived benefits associated with COVID-19 pandemic (e.g., more time with family, increased resilience).  Participants in the control condition were required to write about a non-emotional object of their choosing.  All participants completed the Beck Depression Inventory (BDI-II) at five timepoints (the day of enrollment, the three consecutive days of writing, and the one-month follow visit). 

A repeated measures analysis of variance assessed the impact of experimental assignment (EW vs. benefit focused vs. control) and initial symptom severity (minimal, mild, moderate, and severe) on depression scores over time.  Results indicated a significant time X initial symptom severity interaction, such that participants with initially moderate symptoms of depression benefitted the most from the writing interventions.  There was not a significant effect of experimental assignment.  Additional data from this project is currently being collected in the Spring 2022 semester and we will soon be able to re-run this analysis with approximately 100 more participants.

Participants initially rated as having moderate depression symptoms on the BDI-II demonstrated the most improvement in depression symptoms.  This finding is consistent with other work in the field of EW that has demonstrated that participants with severe levels of depression might require a more intensive treatment to reduce their depression symptoms (Robertson et al., 2019).  Clinical implications and future directions are discussed.

Gortner, E., Rude, S. S., & Pennebaker, J. W. (2006). Benefits of Expressive Writing in Lowering Rumination and Depressive Symptoms. Behavior
          Therapy, 37(3), 292-303. https://doi.org/10.1016/j.beth.2006.01.004

Robertson, S. M. C., Short, S. D., Asper, A., Venezia, K., Yetman, C., Connelly, M., & Trumbull, J. (2019). The effect of expressive writing on
          symptoms of depression in college students: Randomized controlled trial. Journal of Social and Clinical Psychology, 38(5), 427–450.     
          https://doi.org/10.1521/jscp.2019.38.5.427