Feasibility, acceptability, and potential effectiveness of an online expressive writing intervention for COVID-19 resilience

Elizabeth Bechard, John Evans, Eunji Cho, Yufen Lin, Arthi Kozhumam, Jill Jones, Sydney Grob, Oliver Glass, Elizabeth Bechard, John Evans, Eunji Cho, Yufen Lin, Arthi Kozhumam, Jill Jones, Sydney Grob, Oliver Glass

Abstract

Background & purpose: The COVID-19 pandemic has negatively impacted mental health in the general population. In this trial, our objective was to assess whether a 6-week expressive writing intervention improves resilience in a sample from the general population in the midst of the COVID-19 pandemic.

Materials & methods: This 6-week trial was conducted online. Eligible participants (n=63) were a sample of adults who self-identified as having been significantly affected by the COVID-19 pandemic.

Primary outcome: Connor-Davidson Resilience Scale (CD-RISC).

Secondary outcomes: Perceived Stress Scale - 10-Item (PSS-10); Center for Epidemiologic Studies Depression Scale - Revised (CESD-R); Post-Traumatic Growth Inventory (PTGI).

Results: Resilience measures (CD-RISC) increased from baseline (66.6 ± 14.9) to immediately post-intervention (73.0 ± 12.4; p=0.014; Cohen's d =0.31), and at a 1- month follow-up (72.9 ± 13.6; p=0.024; Cohen's d =0.28). Across the same timepoints, perceived stress scores (PSS-10) decreased from baseline (21.8 ± 6.6) to immediately post-intervention (18.3 ± 7.0; p=0.008; Cohen's d =0.41), and at the 1- month follow-up to (16.8 ± 6.7; p=0.0002; Cohen's d =0.56). Depression symptoms (CESD-R) decreased from baseline (23.3 ± 15.3) at 6 weeks (17.8 ± 15.4; p=0.058; Cohen's d =0.22), and 10 weeks (15.5 ± 12.7; p=0.004; Cohen's d =0.38). Posttraumatic growth (PTGI) increased from baseline (41.7 ± 23.4) at 6 weeks (55.8 ± 26.4; p=0.004; Cohen's d =0.44), and at the 1-month follow-up (55.9 ± 29.3; p=0.008; Cohen's d =0.49).

Conclusion: An online expressive writing intervention was effective at improving resilience in the midst of the COVID-19 pandemic. NCT#: NCT04589104.

Keywords: COVID-19; Expressive writing; Integrative Medicine; Narrative medicine; Resilience.

Conflict of interest statement

None.

Copyright © 2021 Elsevier Ltd. All rights reserved.

Figures

Fig. 1
Fig. 1
CONSORT 2010 flow diagram.

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