Randomized Controlled Trial Assessing the Efficacy of Expressive Writing in Reducing Symptoms of Anxiety: Waitlist Control Design

Abstract

Introduction: There are mixed data in the literature regarding the efficacy of expressive writing (EW) interventions. The current study utilized a waitlist control design to assess whether symptom change occurred during a waitlist period and an intervention period. We also assessed the potential relationship between initial anxiety symptom severity and follow-up scores of anxiety. Methods: One hundred forty-one first-year college students were randomly assigned to either (a) initiate an EW protocol immediately or (b) initiate an EW protocol after at least four weeks had elapsed. All participants completed three consecutive days of EW and two follow-up visits. Results: Participants who started their EW protocol immediately demonstrated a significant decrease in anxiety at the one-month follow-up while participants in the waitlist condition did not demonstrate a significant decrease in anxiety during the waiting period. All participants demonstrated a significant decrease in anxiety between the first day of the EW intervention and the six-month follow-up visit. This effect was moderated by initial anxiety symptom level. Discussion: Completing an EW intervention, whether immediately or after a one-month waiting period, was associated with lowered anxiety scores six months post-intervention. College students’ anxiety levels did not naturally improve over the course of a one-month waiting period.