Expressive Writing for Gay-Related Stress: Psychosocial Benefits and Mechanisms Underlying Improvement

Objective: This study tested the effectiveness of an expressive writing intervention for gay men on outcomes related to psychosocial functioning. Method: Seventy-seven gay male college students (mean age = 20.19 years, SD = 1.99) were randomly assigned to write for 20 min a day for 3 consecutive days about either (a) the most stressful or traumatic gay-related event in their lives or (b) a neutral topic. We tested an exposure-based hypothesis of written emotional expression by asking half of the participants who were assigned to write about gay-related stress to read their previous day's narrative before writing, whereas the other half did not. Posttest and 3-month follow-up outcomes were assessed with common measures of overall psychological distress, depression, physical health symptoms, and positive and negative affect. Gay-specific social functioning was assessed with measures of gay-related rejection sensitivity, gay-specific self-esteem, and items regarding openness and comfort with one's sexual orientation. Results: Participants who wrote about gay-related stress, regardless of whether they read their previous day's writing, reported significantly greater openness with their sexual orientation 3 months following writing than participants who wrote about a neutral topic, F(1, 74) = 6.66, p < .05, eta(2) = .08. Additional analyses examined the impact of emotional engagement in the writing, severity of the expressed topic, previous disclosure of writing topic, tendency to conceal, and level of perceived social support on mental health outcomes. Conclusions: The findings suggest that an expressive writing task targeting gay-related stress can improve gay men's psychosocial functioning, especially openness with sexual orientation. The intervention seems to be particularly beneficial for those men who write about more severe topics and for those with lower levels of social support. The findings suggest future tests of expressive writing tasks for different aspects of stigma-related stress.