Online Positive Affect Journaling in the Improvement of Mental Distress and Well-Being in General Medical Patients With Elevated Anxiety Symptoms: A Preliminary Randomized Controlled Trial

Joshua M Smyth, Jillian A Johnson, Brandon J Auer, Erik Lehman, Giampaolo Talamo, Christopher N Sciamanna, Joshua M Smyth, Jillian A Johnson, Brandon J Auer, Erik Lehman, Giampaolo Talamo, Christopher N Sciamanna

Abstract

Background: Positive affect journaling (PAJ), an emotion-focused self-regulation intervention, has been associated with positive outcomes among medical populations. It may be adapted for Web-based dissemination to address a need for scalable, evidence-based psychosocial interventions among distressed patients with medical conditions.

Objective: This study aimed to examine the impact of a 12-week Web-based PAJ intervention on psychological distress and quality of life in general medical patients.

Methods: A total of 70 adults with various medical conditions and elevated anxiety symptoms were recruited from local clinics and randomly assigned to a Web-based PAJ intervention (n=35) or usual care (n=35). The intervention group completed 15-min Web-based PAJ sessions on 3 days each week for 12 weeks. At baseline and the end of months 1 through 3, surveys of psychological, interpersonal, and physical well-being were completed.

Results: Patients evidenced moderate sustained adherence to Web-based intervention. PAJ was associated with decreased mental distress and increased well-being relative to baseline. PAJ was also associated with less depressive symptoms and anxiety after 1 month and greater resilience after the first and second month, relative to usual care.

Conclusions: Web-based PAJ may serve as an effective intervention for mitigating mental distress, increasing well-being, and enhancing physical functioning among medical populations. PAJ may be integrated into routine medical care to improve quality of life.

Trial registration: ClinicalTrials.gov NCT01873599; https://ichgcp.net/clinical-trials-registry/NCT01873599 (Archived by WebCite at http://www.webcitation.org/73ZGFzD2Z).

Keywords: adult; anxiety; depression; emotions; expressed emotion; internet; stress, psychological/physiopathology; surveys and questionnaires; treatment outcome; writing.

Conflict of interest statement

Conflicts of Interest: None declared.

©Joshua M Smyth, Jillian A Johnson, Brandon J Auer, Erik Lehman, Giampaolo Talamo, Christopher N Sciamanna. Originally published in JMIR Mental Health (http://mental.jmir.org), 10.12.2018.

Figures

Figure 1
Figure 1
Participant flowchart.
Figure 2
Figure 2
Average number of journaling sessions completed by participants over the 12-week study period.

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