Can emotional expressivity and writing content predict beneficial effects of expressive writing among breast cancer patients receiving chemotherapy? A secondary analysis of randomized controlled trial data from China

Wu, Yanni; Yang, Dongliang; Jian, Biao; Li, Chaixiu; Liu, Liping; Li, Wenji; Li, Xiaojin; Zhou, Chunlan

Abstract

Background
To explore whether emotional expressivity and the patterns of language use could predict benefits from expressive writing (EW) of breast cancer (BC) patients in a culture that strongly discourages emotional disclosure.

Methods
Data were obtained from a recent trial in which we compared the health outcomes between a prolonged EW group (12 sessions) and a standard EW group (four sessions) (n = 56 per group) of BC patients receiving chemotherapy. The Chinese texts were tokenized using the THU Lexical Analyser for Chinese. Then, LIWC2015 was used to quantify positive and negative affect word use.

Results
Our first hypothesis that BC patients with higher levels of emotional expressivity tended to use higher levels of positive and negative affect words in texts was not supported (r = 0.067, p = 0.549 and r = 0.065, p = 0.559, respectively). The level of emotional expressivity has a significant effect on the quality of life (QOL), and those who used more positive or fewer negative affective words in texts had a better QOL (all p < 0.05). However, no significant difference was identified in physical and psychological well-being (all p > 0.05). Furthermore, the patterns of affective word use during EW did not mediate the effects of emotional expressivity on health outcomes (all p > 0.05).

Conclusions
Our findings suggest that the level of emotional expressivity and the pattern of affective word use could be factors that may moderate the effects of EW on QOL, which may help clinicians identify the individuals most likely to benefit from such writing exercises in China.

• Journal Article Type: Article
• Acceptance Date: Jun 1, 2021
• Online Publication Date: Aug 24, 2021
• Publication Date: 2023-03
• Deposit Date: Jan 22, 2024
• Journal: Psychological Medicine
• Print ISSN: 0033-2917
• Electronic ISSN: 1469-8978
• Publisher: Cambridge University Press (CUP)
• Peer Reviewed: Peer Reviewed
• Volume: 53
• Issue: 4
• Pages: 1527-1541
• DOI: https://doi.org/10.1017/s0033291721003111
• Keywords: Psychiatry and Mental health; Applied Psychology
• Additional Information: Copyright: Copyright © The Author(s), 2021. Published by Cambridge University Press