The effect of expressive writing intervention on psychological and physical health outcomes in cancer patients: a systematic review and meta-analysis
A null result worth knowing. Pooling 16 randomised trials of expressive writing in cancer patients and survivors, the authors found no statistically significant effect on psychological health, physical health, or quality of life - and the result held regardless of control condition, setting or cancer type.
Sixteen randomised trials, and expressive writing did not significantly beat control on anything measured.
Zachariae and O’Toole screened 223 citations and pooled 16 independent randomised controlled trials published between 1999 and 2014, covering psychological health, physical health and quality of life in cancer patients and survivors.
Every confidence interval crossed zero:
- Psychological outcomes: g = 0.04, 95% CI -0.06 to 0.14
- Physical outcomes: g = 0.08, 95% CI -0.05 to 0.20
- Quality of life: g = 0.09, 95% CI -0.05 to 0.24
The results were unaffected by type of control condition, study setting, cancer type, or overall study quality.
Why this is in the library. A resource collection that only contains supportive findings is a marketing brochure. This is one of the better-conducted reviews in the field and it found nothing, in a population where writing interventions have been heavily promoted.
The authors’ own reading is measured rather than dismissive: a subset of studies hinted that people experiencing low emotional support may be more likely to benefit, and given how inexpensive writing is, small effects in subgroups could still be clinically relevant.
This does not show that writing is useless in general - it tested one specific protocol in one specific population. The authors note a possible moderating effect of social constraints, suggesting people with little emotional support may still benefit, and argue that even small effects could matter clinically given how cheap the intervention is.
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Summarized by Tiago Martins · Last updated: · How we write these
