Examination of moderators of expressive writing in patients with renal cell carcinoma: the role of depression and social support.

Psycho-oncology

PubMedID: 27145447

Milbury K, Lopez G, Spelman A, Wood C, Matin SF, Tannir NM, Jonasch E, Pisters L, Wei Q, Cohen L. Examination of moderators of expressive writing in patients with renal cell carcinoma: the role of depression and social support. Psychooncology. 2016;.
OBJECTIVE
To identify groups most likely to benefit from an Expressive Writing (EW) intervention, we examined psychosocial variables as intervention moderators. We hypothesized that EW would be particularly effective for participants with high levels of depressive symptoms and social support at study entry.

METHODS
Patients (n?=?277; 60.6% male) with kidney cancer were randomly assigned to either an expressive (EW) or neutral writing (NW) condition. Intervention outcomes included measures of depressive symptoms (CESD), cancer-related symptoms (MDASI), fatigue (BFI), and sleep disturbances (PSQI) assessed at baseline, 1, 4, and 10 months later. Moderators were measured at baseline.

RESULTS
As hypothesized, depressive symptoms and social support moderated intervention efficacy. When examining both moderators simultaneously, EW appeared to be most effective in terms of cancer-related symptoms (p?
CONCLUSIONS
Recognition of baseline depressive symptoms and social support as intervention moderators may lead to improved patient selection for EW interventions, as EW may be particularly beneficial regarding QOL outcomes for patients that have social support available including participants with depressive symptoms. EW may not be beneficial, or potentially even contraindicated, for participants lacking social support. Copyright © 2016 John Wiley & Sons, Ltd.