de Moor, C., Sterner, J., Hall, M., Warneke, C., Gilani, Z., Amato, R., . . . Cohen, L. (2002). A pilot study of the effects of expressive writing on psychological and behavioral adjustment in patients enrolled in a Phase II trial of vaccine therapy for metastatic renal cell carcinoma. Health Psychology, 21, 615–619.

The study included four weekly sessions of expressive writing associated with the first four cancer vaccines; patients were randomly assigned to neutral health issues writing or expressive writing of the group’s deepest thoughts and feelings.

Outcomes were psychological and behavioral adjustment, symptoms of distress, perceived stress, mood, and sleep.

• The sample was comprised of 42 patients (85% male) with newly diagnosed stage IV metastatic renal cell carcinoma who were four to six weeks postoperative.
• Mean age was 56.4 years.

• Outpatient
• Southwestern United States

Patients were undergoing the active treatment phase of care.

This was a pilot, randomized, controlled trial.

Pittsburgh Sleep Quality Index (PSQI)

Statistically significant improvements in the expressive writing group were found for four of the sleep disturbance measures on the PSQI (total score and subscales of Sleep Quality, Sleep Duration, and Daytime Dysfunction).

• The study had a small sample size.
• Generalizability was questionable because of the nature of the illness.
• Space is needed for the writing to occur, prior to the injection.