title: Randomised controlled trial of expressive writing and quality of life in men and women treated for colon or rectal cancer.
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.
  
  
  METHODS
  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.
  
  
  METHODS
  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.
authors.affiliation: a Department of Public Health , Temple University , Philadelphia , PA , USA.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Lepore
authors.forename: Tracey A
authors.initials: TA
authors.lastname: Revenson
authors.forename: Katherine J
authors.initials: KJ
authors.lastname: Roberts
authors.forename: Julie R
authors.initials: JR
authors.lastname: Pranikoff
authors.forename: Adam
authors.initials: A
authors.lastname: Davey
mesh_terms: D000368:Aged; D003110:Colonic Neoplasms / Q000523:psychology* / Q000628:therapy; D003863:Depression; D019260:Expressed Emotion; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011613:Psychotherapy / Q000379:methods*; D011788:Quality of Life; D012004:Rectal Neoplasms / Q000523:psychology* / Q000628:therapy; D012893:Sleep Wake Disorders; D016896:Treatment Outcome; D014956:Writing
keywords: cancer; colorectal; expressive writing; psychological distress; quality of life; social constraints