Efficacy of expressive writing versus positive writing in different populations: Systematic review and meta-analysis.
Jiawei Lai, Huijuan Song, Ying Wang and 6 others
PMID 37434395WHAT IT FOUND
Positive writing produced more positive mood and less negative mood than expressive writing, mainly in general populations.
In patients, negative mood did not differ clearly, and neither prompt clearly changed depression, anxiety, stress, or health.
Key findings
01Positive writing was associated with higher positive emotions and lower negative emotions than expressive writing across the pooled trials.
02The pooled trials found no significant difference between prompts for depression, anxiety, stress, or health outcomes.
03The mood advantage was mainly seen in the general population; in patients, negative emotions did not differ significantly, and positive emotions showed only a marginal difference.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The included trials had high or unclear risk of bias, especially for reporting and selection, and many had unclear blinding or allocation concealment. The pooled mood findings came from only seven trials, and patient subgroup data were sparse. Outcome tools and follow-up times varied widely, and some missing values were estimated from p-values and sample sizes. Publication-bias testing was underpowered, and Egger tests suggested possible bias for anxiety, positive words, and a tiredness symptom checklist. The analysis did not consider basic emotions, ethnicity, or culture, so results may not transfer across settings.
Declared interests
The authors declared no conflicts of interest. The named funder was Nanfang Hospital.
The easy way to misread this
Do not read the mood difference as proof that positive writing treats depression, anxiety, stress, or health problems in patients. Those specific outcomes were not significantly different, and the clearest mood benefit was in general populations.