The Effect of COVID-Focused Expressive Writing on Symptoms of Depression, Anxiety, and Distress in College Students: A Randomized Controlled Trial

Objective: The coronavirus disease of 2019 (COVID-19) pandemic has been associated with increased levels of distress for college students. This study aimed to assess the efficacy of a COVID-focused expressive writing intervention in reducing symptoms of depression, anxiety, and distress. Methods: A total of 169 college students were assigned either to a COVID-focused expressive writing intervention or to a nonwriting control group. All participants completed a 1-month follow-up assessment, and all study procedures were completed online due to COVID-19 restrictions. Depression was measured with the Beck Depression Inventory-II, anxiety was measured with the Beck Anxiety Inventory, and distress was measured with a Likert-scale question that measured distress specifically related to the COVID-19 pandemic. Results: Results indicated that participants in the expressive writing group demonstrated a significant decrease (b = -1.35) in anxiety symptoms whereas participants in the control group did not. None of the participants in either group demonstrated a significant decrease in depression symptoms. Ratings of distress in the expressive writing group were significantly lower (d = -0.51) at the 1-month follow-up when compared to the control group. Discussion: COVID-focused expressive writing is a relatively brief and inexpensive intervention that has been associated with lower symptoms of anxiety and distress in college students. Theoretical implications are discussed.