Expressive Writing Intervention Study
- Conditions
- Distress, Emotional
- Interventions
- Other: Expressive writing about events of the dayOther: Expressive writing in response to vignetteOther: Letter of Gratitude
- Registration Number
- NCT05782868
- Lead Sponsor
- University of Wisconsin, Madison
- Brief Summary
This study aims to test to what extent an expressive writing intervention may reduce internalized anti-TNB (trans and nonbinary) stigma and promote well-being over time. Trans and/or nonbinary people may take part in this study, and can expect to participate for 3 months.
- Detailed Description
This study aims to decrease internalized transnegativity and to promote positive and affirming thoughts and emotions related to being transgender/nonbinary through a novel four-day expressive writing intervention. Participants will be trans/nonbinary English-speaking adults (18+) who reside in the US. They will be randomized to one of three study conditions (control, affirming identity, affirming identity + strengthening social connection) and will be enrolled in the study for period of 3 months (baseline, four day intervention, Days 7, 30, and 90 follow up).
Recruitment & Eligibility
- Status
- ACTIVE_NOT_RECRUITING
- Sex
- All
- Target Recruitment
- 117
- 18 years of age or older
- transgender or nonbinary
- access to a phone, computer, and/or device from which they can access the surveys and daily writing session tasks
- ability to read and write English
- cisgender individuals
- self-reported severe levels of psychological distress
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description IA + Strengthening Social Connections (SSC) Condition Letter of Gratitude For participants in the IA+SSC condition, participants will complete the IA intervention on the first three days. On the fourth day, participants will be directed to compose a brief letter. Control Condition Expressive writing about events of the day Expressive writing assignment, without prompts. TNB Identity Affirmation (IA) Condition Expressive writing in response to vignette Participants in the IA only intervention condition will receive the same prompt for all four days of writing, a design used in expressive writing interventions to allow for deeper and continued reflection into specific thoughts and emotions. IA + Strengthening Social Connections (SSC) Condition Expressive writing in response to vignette For participants in the IA+SSC condition, participants will complete the IA intervention on the first three days. On the fourth day, participants will be directed to compose a brief letter.
- Primary Outcome Measures
Name Time Method Effect of missed sessions on Positive and Negative Affect Scale (PANAS) One week post-baseline Participants' total scale scores to the Positive and Negative Affect Scale (PANAS), which can range from 10 to 50, with higher scores indicating greater positive affect (positive affect subscale) and lower scores indicating lower levels of negative affect (negative affect subscale), will be analyzed for their correlations with missed sessions and/or participant attrition, as documented through participant attendance scores, described above.
Assess the feasibility of expressive writing intervention through qualitative data One week post-baseline Collect open-ended text responses to the following question: Considering the logistical and practical side of this study, what was your experience like completing the writing tasks this last week? For example, did you find it easy or challenging to write for the full 20 minutes each session? How was it writing using the device that you did, such as writing in Word and uploading to Qualtrics or writing directly in Qualtrics?
Assess the feasibility of expressive writing intervention by recording the number of attended writing sessions for each participant. One week post-baseline Analyze any differences in number of attended writing sessions for participants by condition, with each participants' attendance score ranging from 0 (none) to 4 (all).
Assess the fidelity of expressive writing intervention One week post-baseline Analyze participants' writing to assess the degree to which intervention condition writing instructions were followed. Two members of the research team will assess participants' writing and code for the presence of emotion/affect-related words (yes=1, no=0), focus on gender identity (yes=1, no=0), and advice or encouragement offered (yes=1, no=0). Interrater agreement will be assessed.
Assess the acceptability of expressive writing intervention through qualitative data One week post-baseline Collect open-ended text responses to the following question:
Emotionally, what was your experience like completing the writing sessions this last week? Did you notice any changes in your emotional experience over the course of the week?Amount of time spent writing One week post-baseline To assess fidelity of intervention, participants will be asked to self-report how much time they spent writing each day. Qualtrics data will also be examined to assess how many minutes participants spent in the survey.
- Secondary Outcome Measures
Name Time Method Change in resilience as determined by scores on the Brief Resilience Scale (BRS) Baseline to 3 months Using the Brief Resilience Scale, participants will indicate the extent to which they agree with several statements on a scale of 1 to 5, where 1 = strongly disagree and 5 = strongly agree. A higher score indicates lower resilience.
Change in psychological well-being Baseline to 3 months Using the Psychological Well-Being Scale (PWB), participants will indicate their level of well-being on an 18 item scale, with a range of 1 to 7, where higher scores indicate greater levels of psychological well-being.
Change in state of depression, anxiety, and stress as determined by their scores on the Depression, Anxiety, and Stress Scale Baseline to 3 months Using the Depression Anxiety Stress Scale (DASS), participants will indicate their negative emotional states of depression, anxiety and stress on a 0-3 scale, with higher scores indicating greater degree of depression, anxiety, or stress.
Change in perception of social support Baseline to 3 months Using TNB Social Support, participants will report number of contacts, as well as degree of closeness with each contact on a scale of 1 to 7, with higher scores indicating greater perception of social support.
Change in Gender Minority Stress and Resilience (GMSR) Baseline to 3 months GMSR: Three subscales with 8 (Pride), 8 (Internalized transphobia), and 5 (community connectedness) items respectively. Rated on a 1-5 scale with higher scores indicating higher levels of pride, internalized transphobia, and community connectedness.
Change in satisfaction with life Baseline to 3 months Participants will indicate agreement with 5 items on a 1 to 7 scale, with higher scores indicating greater satisfaction with life.
Effects of expressive writing intervention on mental health Baseline to 3 months Neuro-QoL short form: Two subscales with 7 (general concerns) and 8 items (fatigue), respectively. Rated on a 1-5 scale, with higher scores indicating lower levels of quality of life in each domain.
Trial Locations
- Locations (1)
University of Wisconsin
🇺🇸Madison, Wisconsin, United States