Online Positive Affect Journaling in the Improvement of Mental Distress and Well-Being in General Medical Patients With Elevated Anxiety Symptoms: A Preliminary Randomized Controlled Trial (Preprint)

Abstract

Background: Positive affect journaling (PAJ), an emotion-focused self-regulation intervention, has been associated with positive outcomes among medical populations. It may be adapted for online dissemination to address a need for scalable, evidence-based psychosocial interventions among distressed patients with medical conditions.Objective: This study examined the impact of a 12-week online PAJ intervention on psychological distress and quality of life in general medical patients.Methods: Seventy adults with various medical conditions were recruited from local clinics and randomly assigned to an online PAJ intervention (n=35) or usual care (n=35). The intervention group completed 15-minute online PAJ sessions on three days each week for 12 weeks. At baseline and the end of months 1 through 3, surveys of psychological, interpersonal, and physical well-being were completed. Results:Patients evidenced moderate sustained adherence to online intervention. PAJ was associated with decreased mental distress (p's≤.045) and increased well-being (p's ≤.046) relative to baseline. PAJ was also associated with less depressive symptoms (p=.047) and anxiety (p=.01) after one month, and greater resilience after the first (p=.044) and second month (p=.01), relative to usual care. Conclusions:Online PAJ may serve as an effective intervention for mitigating mental distress, increasing well-being, and enhancing physical functioning among medical populations. PAJ may be integrated into routine medical care to improve quality of life.Trial Registration: ClinicalTrials.gov NCT01873599