The Effect of Expressive Writing on Symptoms of Depression in College Students: Randomized Controlled Trial

Introduction: The first year of college can be particularly difficult for students, as they typically face a number of emotional, developmental, social, and financial challenges. Expressive writing (EW) is a writing intervention that requires participants to write about their thoughts and feelings related to a particular event over several days. Methods: Participants in this study included 90 first-year undergraduate students. Participants were assigned to the EW condition (writing about their thoughts and feelings related to their transition to college) or a control condition (writing about any object or event of their choosing). Participants completed 3 consecutive days of writing, and then completed two follow-up visits that occurred one month and six months post-intervention. Participants were divided into two groups based on their initial depression scores (one group with minimal symptoms, and a second group with mild/moderate/severe symptoms). Results: Among participants in the mild/moderate/severe group, those in the EW condition demonstrated significant decreases in depression symptoms over the six-month study period, while participants in the control condition did not. Among this same subset of participants, those in the EW condition also demonstrated significantly fewer physician visits due to physical illness when compared to the control group. Changes in depression and physical illness visits were not found for participants with minimal symptoms of depression. Discussion: EW is a low-cost procedure that has been empirically demonstrated to alleviate symptoms of depression six months post-intervention. However, this finding only held for participants who were initially categorized in the group of participants with mild/moderate/severe symptoms of depression (as opposed to those participants initially categorized with minimal symptoms of depression). Clinical implications and future directions are discussed.