Pennebaker’s expressive writing intervention (EWI) may reduce the negative effects of a cancer diagnosis on a patient’s mental health, according to a study published in Supportive Care in Cancer

Being diagnosed with cancer is a traumatic experience and may lead to negative physical and psychological outcomes such as alexithymia, an inability to identify and describe emotions. Previous studies have shown that EWIs — interventions aimed to allow patients to express their worries and pains through writing — improve the quality of life (QOL) among both healthy individuals and patients with disease, but how they modify outcomes among patients with cancer is unclear. 

For this prospective study, researchers randomly assigned 71 first-time patients with cancer to a EWI or control group. Patients completed questionnaires assessing alexithymia, psychiatric symptoms, and health-related quality of life at baseline, and completed the same measures 6 months later. Thirty-two patients were available for analysis at follow-up. 

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Results showed that the Pennebaker’s EWI reduced patients’ global psychopathology, which included domains such as anxiety, depression, hostility, paranoid ideation, and interpersonal sensitivity, compared with patients in the control group. 

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Patients in the EWI group also had marginal, but significant improvements in alexithymia. The mental QOL was reduced in both groups, but patients assigned to the EWI had a lower decrease in psychological well-being; a negligible negative effect on patient physical QOL was observed. 

The authors concluded that “if the promising findings of our clinical trial are confirmed in future studies, the Pennebaker’s EWI could be applied as an effective intervention method for the psychological support of cancer patients and essentially at no cost to the National Health Services.”


La Marca L, Maniscalco E, Fabbiano F, Verderame F, Schimmenti A. Efficacy of Pennebaker’s expressive writing intervention in reducing psychiatric symptoms among patients with first-time cancer diagnosis: a randomized clinical trial[published o