Writing Intervention for Cognitive Health in Older Adults

Overseen By Naomi Eisenberger, Ph.D.

Age: 65+

Sex: Any

Trial Phase: Phase 1

Sponsor: University of California, Los Angeles

Must not be taking: Steroids, Opioids

Disqualifiers: Smokers, Uncontrolled disorders, Infections, Psychiatric, BMI>35, others

Compensation: Varies

Number of Visits: 2

Duration: 6 weeks

200 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

UCLA researchers looking for healthy older adults (aged 65+) to participate in a study investigating how writing about experiences can affect your brain and body. Once a week for 6 weeks, participants will write about their experiences and fill out online questionnaires. Participants will also come to the UCLA campus to complete a neuroimaging session (fMRI), provide a blood spot sample, and fill out questionnaires 2 times: once prior to the 6-week writing period and once immediately after the 6-week writing period.

Do I need to stop taking my current medications for the trial?

The trial excludes participants using certain medications like steroids and opioids. If you are taking these, you may need to stop, but the protocol does not specify a washout period.

Is writing therapy safe for humans?

Research on writing therapy, including expressive writing and therapeutic writing, suggests it is generally safe for humans. Studies have explored its use in various conditions, such as trauma and PTSD, without significant safety concerns. ^{1 2 3 4 5}

How is the Writing Intervention treatment different from other treatments for cognitive health in older adults?

Writing Intervention, such as Expressive Writing Therapy, is unique because it uses writing as a form of emotional expression to improve cognitive and emotional health, unlike traditional treatments that may not focus on personal storytelling and emotional disclosure. This approach can be done individually or in groups, providing flexibility and a non-pharmacological option for enhancing mental well-being. ^{2 6 7 8 9}

What data supports the effectiveness of the treatment Writing Intervention, Expressive Writing Therapy, Narrative Exposure Therapy, Therapeutic Writing for cognitive health in older adults?

Research shows that writing therapy, including expressive writing, can help improve mood and reduce symptoms of depression and distress. It has been used effectively in various therapies to promote psychological well-being and personal growth, suggesting potential benefits for cognitive health in older adults. ^{3 4 8 9 10}

Are You a Good Fit for This Trial?

Healthy adults aged 65 and older can join this UCLA study. It's not for those with chronic infections like Hepatitis C or HIV, a BMI over 35, claustrophobia, current smokers, uncontrolled medical issues, major psychiatric conditions, left-handedness, body metal implants or on steroids/opioids.

Inclusion Criteria

I am 65 years old or older and in good health.

Exclusion Criteria

Claustrophobic

I have a long-term infection like Hepatitis C or HIV.

Psychiatric disorders (e.g., current major depression, bipolar disorder)

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants write about their experiences and fill out online questionnaires once a week for 6 weeks. They also complete a neuroimaging session (fMRI), provide a blood spot sample, and fill out questionnaires at the start and end of the 6-week period.

6 weeks

2 visits (in-person) for neuroimaging and sample collection

Follow-up

Participants are monitored for changes in inflammatory gene expression, social support, social participation, and psychological distress.

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Writing Intervention

Trial Overview The study tests if writing about personal experiences once a week for six weeks impacts brain and body health in older adults. Participants will also have two neuroimaging sessions (fMRI), provide blood samples and complete questionnaires before and after the writing period at UCLA.

How Is the Trial Designed?

Group I: Writing about Experiences Experimental Treatment 1 Intervention

Participants will be asked to write about experiences with familiar individuals in their lives.

Group II: Writing about Places Placebo Group 1 Intervention

Participants will be asked to write about experiences with familiar places in their lives.

Who Is Running the Clinical Trial?

University of California, Los Angeles

Lead Sponsor

Trials

1,594

Recruited

10,430,000+

Published Research Related to This Trial

The study involving 25 individuals with PTSD found that expressive writing about traumatic experiences was safe and acceptable, leading to significant improvements in mood and post-traumatic growth, even though it did not reduce PTSD symptoms.

Expressive writing also significantly reduced cortisol responses to trauma-related memories, suggesting that while it may not change PTSD diagnosis, it helps improve emotional regulation and recovery from trauma.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Expressive writing and post-traumatic stress disorder: effects on trauma symptoms, mood states, and cortisol reactivity. Smyth, JM., Hockemeyer, JR., Tulloch, H.[2015]

Writing Therapy (WT) is an effective tool for promoting self-healing and psychological well-being, showing therapeutic effects on symptoms of mental disorders like PTSD and depression, as well as enhancing positive emotions such as forgiveness and gratitude.

WT can be used as a standalone treatment or integrated into various psychotherapeutic approaches, making it a versatile option for clinicians to help clients achieve personal growth and insight.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Writing Technique Across Psychotherapies-From Traditional Expressive Writing to New Positive Psychology Interventions: A Narrative Review. Ruini, C., Mortara, CC.[2022]

A study analyzing therapeutic texts from 51 PTSD patients revealed that writing about trauma exposure led to a significant increase in the use of negative emotional words like fear and depression compared to writing about biographical experiences.

Cognitive restructuring texts showed the highest emotional intensity, containing both negative and positive affective words, indicating that this component of writing therapy may be particularly effective in addressing a range of emotions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Courses of affects in an internet-based writing therapy for elderly war trauma survivors. A content analytic approach]. Böttche, M., Berth, H., Knaevelsrud, C., et al.[2021]

Participation in an 8-week writing group in nursing homes significantly reduced depression, especially among residents with higher cognitive abilities and greater initial depression levels, based on assessments of 62 participants compared to 54 control subjects.

Writing group participants reported a greater ability to express feelings and ideas, with notable improvements observed even in those typically deemed inappropriate for such activities, including individuals with no prior writing experience and those with cognitive impairments.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effectiveness of writing groups in nursing homes. Supiano, KP., Ozminkowski, RJ., Campbell, R., et al.[2017]

In a systematic review of 24 randomized controlled trials involving 1558 participants, positive writing (PW) was found to improve mood more effectively than expressive writing (EW) in the general population.

For patients, while PW was better at generating positive emotions, EW was more effective in stimulating cognitive changes, suggesting that both writing techniques can be beneficial depending on the population's needs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of expressive writing versus positive writing in different populations: Systematic review and meta-analysis. Lai, J., Song, H., Wang, Y., et al.[2023]

The 6-week expressive writing program, 'Transform Your Life: Write to Heal,' was found to be feasible and well-received by participants, with no adverse events reported, indicating it is a safe intervention for individuals with a history of trauma.

Participants showed significant improvements in resilience, with scores increasing from 64.3 to 74.2, and reductions in perceived stress, depression symptoms, and rumination, suggesting the program is effective in enhancing mental health outcomes for trauma survivors.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Expressive writing to improve resilience to trauma: A clinical feasibility trial. Glass, O., Dreusicke, M., Evans, J., et al.[2019]

A systematic review of 64 studies, including 59 randomized controlled trials, found little evidence supporting the effectiveness of unfacilitated expressive writing for improving health outcomes in long-term conditions, with no significant benefits observed for conditions like HIV, breast cancer, and mental health issues.

Facilitated writing interventions showed some potential benefits for individual long-term conditions, but the studies were heterogeneous and had unclear biases, indicating that more focused research on facilitated therapeutic writing is needed to understand its effectiveness.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic considerations. Nyssen, OP., Taylor, SJ., Wong, G., et al.[2022]

Expressive writing, which involves disclosing thoughts and emotions about significant topics, has been shown to positively impact well-being and psychological health, particularly after stressful or traumatic events.

The effectiveness of expressive writing as a therapeutic intervention for posttraumatic stress disorder (PTSD) varies based on the structure and content of the writing, with mechanisms like emotion regulation and narrative construction playing key roles in its efficacy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Writing therapy after traumatic events: therapeutic approaches and mechanisms of change]. Knaevelsrud, C., Böttche, M.[2013]

The study aims to evaluate the effectiveness of a 24-week Creative Expressive Arts-based Storytelling (CrEAS) program on improving cognitive function and health-related outcomes in 111 older adults with mild cognitive impairment (MCI).

The CrEAS program combines visual arts therapy and storytelling to engage participants in activities that may enhance cognitive abilities, with assessments including cognitive function, anxiety, depression, and quality of life, alongside neuroimaging to explore underlying mechanisms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of Creative Expressive Arts-based Storytelling (CrEAS) programme on older adults with mild cognitive impairment: protocol for a randomised, controlled three-arm trial. Lin, R., Yan, YJ., Zhou, Y., et al.[2021]

A pilot project showed that incorporating narrative writing into support groups for caregivers of older adults significantly improved their physical and mental health, providing an additional coping strategy for stress.

Therapeutic writing can be an effective tool for emotional expression, and nurses can play a key role in developing interventions that utilize this method to support caregivers.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A different kind of caregiving support group. Dellasega, C., Haagen, B.[2022]

Citations

1. England pubmed.ncbi.nlm.nih.gov

Expressive writing and post-traumatic stress disorder: effects on trauma symptoms, mood states, and cortisol reactivity. [2015]

2. United States pubmed.ncbi.nlm.nih.gov

Writing Technique Across Psychotherapies-From Traditional Expressive Writing to New Positive Psychology Interventions: A Narrative Review. [2022]

3. Germany pubmed.ncbi.nlm.nih.gov

[Courses of affects in an internet-based writing therapy for elderly war trauma survivors. A content analytic approach]. [2021]

4. United States pubmed.ncbi.nlm.nih.gov

Effectiveness of writing groups in nursing homes. [2017]

5. United States pubmed.ncbi.nlm.nih.gov

Efficacy of expressive writing versus positive writing in different populations: Systematic review and meta-analysis. [2023]

6. England pubmed.ncbi.nlm.nih.gov

Expressive writing to improve resilience to trauma: A clinical feasibility trial. [2019]

7. England pubmed.ncbi.nlm.nih.gov

Does therapeutic writing help people with long-term conditions? Systematic review, realist synthesis and economic considerations. [2022]

8. Germany pubmed.ncbi.nlm.nih.gov

[Writing therapy after traumatic events: therapeutic approaches and mechanisms of change]. [2013]

9. England pubmed.ncbi.nlm.nih.gov

Effects of Creative Expressive Arts-based Storytelling (CrEAS) programme on older adults with mild cognitive impairment: protocol for a randomised, controlled three-arm trial. [2021]

10. United States pubmed.ncbi.nlm.nih.gov

A different kind of caregiving support group. [2022]