Emotional expression and psychological wellbeing in cancer survivors

Objective: This review aims to systematically evaluate empirical literature relating to the efficacy of emotional expression interventions in those with cancer. Method: A systematic review of the published literature was conducted. Databases searched included Web of Science, PubMed, PsycInfo, and Embase. Only randomised controlled trials examining expressive writing interventions in cancer patients were included. A total of 17 studies consisting of a total of 1755 heterogenous cancer patients were included in this review. Results: The majority of included studies in this review suggest that expressive writing interventions hold no psychological benefits for people with cancer. Physical health benefits were found however and these included lower pain ratings, fewer cancer-related doctor’s visits and better sleep quality. Results suggest that expressive writing interventions may not be feasible to conduct with palliative care patients. Despite the absence of evidence that expressive writing interventions reduced psychological distress for people with cancer, the authors of these trials continue to argue that expressive writing interventions are ‘feasible’ and well received by participants. Discussion: There are several possible reasons that could account for these null findings: 1.) insufficient power, 2.) low rates of depression and anxiety, and high levels of quality of life in study participants, 3.) insufficient differences between expressive writing and neutral writing interventions, 4.) asking participants to write about cancer-related trauma only