title: A randomized controlled trial of emotionally expressive writing for women with metastatic breast cancer.
abstract: OBJECTIVE
  To test the effects of emotionally expressive writing in a randomized controlled trial of metastatic breast cancer patients and to determine whether effects of the intervention varied as a function of perceived social support or time since metastatic diagnosis.
  
  
  METHODS
  Women (N = 62) living with Stage IV breast cancer were randomly assigned to write about cancer-related emotions (EMO; n = 31) or the facts of their diagnosis and treatment (CTL; n = 31). Participants wrote at home for four 20-min sessions within a 3-week interval.
  
  
  METHODS
  Depressive symptoms, cancer-related intrusive thoughts, somatic symptoms, and sleep quality at 3 months postintervention.
  
  
  RESULTS
  No significant main effects of experimental condition were observed. A significant condition x social support interaction emerged on intrusive thoughts; EMO writing was associated with reduced intrusive thoughts for women reporting low emotional support (eta2 = .15). Significant condition x time since metastatic diagnosis interactions were also observed for somatic symptoms and sleep disturbances. Relative to CTL, EMO participants who were more recently diagnosed had fewer somatic symptoms (eta2 = .10), whereas EMO participants with longer diagnosis duration exhibited increases in sleep disturbances (eta2 = .09).
  
  
  CONCLUSIONS
  Although there was no main effect of expressive writing on health among the current metastatic breast cancer sample, expressive writing may be beneficial for a subset of metastatic patients (including women with low levels of emotional support or who have been recently diagnosed) and contraindicated for others (i.e., those who have been living with the diagnosis for years).
authors.affiliation: Department of Psychiatry.
authors.forename: Carissa A
authors.initials: CA
authors.lastname: Low
authors.forename: Annette L
authors.initials: AL
authors.lastname: Stanton
authors.forename: Julienne E
authors.initials: JE
authors.lastname: Bower
authors.forename: Lauren
authors.initials: L
authors.lastname: Gyllenhammer
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology*; D003863:Depression / Q000523:psychology; D019260:Expressed Emotion; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D012893:Sleep Wake Disorders / Q000517:prevention & control; D012944:Social Support; D013850:Thinking; D016896:Treatment Outcome; D014956:Writing