The effects of an expressive writing intervention on pregnancy rates, alexithymia and psychophysical health during an assisted reproductive treatment

Giving words to emotions: the use of linguistic analysis to explore the role of alexithymia in an expressive writing intervention

“…Expressive Writing Interventions (EWI) are methods focusing on written emotional expression that originally required people to write about past traumatic experiences, with the objective of promoting an elaboration of these events (Pennebaker, 1997 ; Solano, 2013 ). In subsequent studies, the writing topics were expanded to other specific difficult experiences, obtaining beneficial effects in different healthy and clinical populations (Di Trani, Renzi, & Solano, 2014; Renzi et al, 2019 ). There remain no standard instructions for EWI.…”

“…Both infertility and its treatments are considered a stressful experience, with serious implications for individuals’ mental, physical and social well-being (Ben Shlomo, Skvirsky, Taubman-Ben-Ari, Azuri, & Horowitz, 2016 ; Galhardo, Cunha, & Pinto- Gouveia, 2011 ). Accordingly, the provision of psychosocial interventions for people facing these experiences has been recommended by regulatory bodies in several countries, by various associations involved in the care of infertile people and by several mental health professionals working with infertile couples (Boivin, 2003 ; Renzi et al, 2019 ).…”

“…The effects of EWI in infertility subjects undergoing an ART have been examined in previous studies but have yielded contrasting results. For instance, Matthiesen et al ( 2012 ) found EWI effective in reducing infertility-related stress, Frederiksen et al ( 2017 ) found EWI effective in reducing depressive symptoms but not in promoting pregnancy, Renzi et al ( 2019 ) found EWI effective in promoting pregnancy and in reducing alexithymia and psychophysical symptoms, while Panagopoulou, Montgomery and Tarlatzis ( 2009 ) obtained no significant results in terms of stress and pregnancy rates. In fact, despite the large number of promising studies, the overall effect size of writing interventions is modest in this field.…”

“…As regards the only study concerning the effectiveness of EWI in reducing alexithymia levels and psychophysical symptoms as well as in promoting pregnancy, no significant effects were found in terms of psychological dimensions: indeed, the only significant result was related to the promotion of positive outcomes in ART treatments (Renzi et al, 2019 ). Furthermore, the median value of the total alexithymia scores of both experimental and control groups was used to create four subgroups of women (experimental low/high alexithymia and control low/high alexithymia) in order to jointly evaluate the effects of treatment and alexithymia on pregnancy rates (Renzi et al, 2019 ). Statistically significant differences between the four subgroups did not emerge (p=.09), although it was qualitatively interesting to note that in the experimental group, the ART rate of success increased from 22.7% in the high-alexithymia subgroup to 33.3% in the low-alexithymia subgroup (Renzi et al, 2019 ).…”

“…Furthermore, the median value of the total alexithymia scores of both experimental and control groups was used to create four subgroups of women (experimental low/high alexithymia and control low/high alexithymia) in order to jointly evaluate the effects of treatment and alexithymia on pregnancy rates (Renzi et al, 2019 ). Statistically significant differences between the four subgroups did not emerge (p=.09), although it was qualitatively interesting to note that in the experimental group, the ART rate of success increased from 22.7% in the high-alexithymia subgroup to 33.3% in the low-alexithymia subgroup (Renzi et al, 2019 ). This finding, although not statistically significant, may support the hypothesis of a different activation of the elaborative process promoted by the EWI according to different alexithymia levels.…”