The Effects of Expressive Writing and Compassionate Letter Writing on Emotional Distress Intolerance

NCT05284578 | Completed

• 1 other identifier: 42863
• Study Type: interventional
• Target: 424
• Locations: 1 country
• Sites: 1

Brief Summary

Perceived emotional distress intolerance is a transdiagnostic marker of psychopathology associated with psychological and interpersonal dysfunction, and the development of interventions for perceived emotional distress intolerance is of prime importance. One potential intervention is a behavioural experiment, i.e. a cognitive behaviour therapy technique where clients undergo an exercise designed to test a maladaptive belief, e.g., that negative emotions are unbearable, and adjust their belief to accommodate any disconfirmatory information that arises through the exercise. This study examines the effects of a one-session self-compassion writing behavioural experiment compared to a one-session expressive writing behavioural experiment on low perceived distress tolerance. Participants were recruited from the University of Waterloo and Prolific, and were randomly assigned to the self-compassion condition, expressive writing condition, or a control condition.

Conditions

Distress Intolerance

Outcome Measures

Primary Outcomes (5)

• Distress Tolerance Scale

  Self-report questionnaire with 15 questions on a 5-point Likert scale (scored 1-5, with 4 subscales). Mean scores range from 1-5, with higher increase in score indicative of increased perceived distress tolerance.

  Change from baseline to one week post-intervention

• Distress Tolerance Scale (short form)

  Self-report questionnaire with 4 questions on a 5-point Likert scale (scored 1-5). Mean scores range from 1-5, with higher score indicative of greater perceived distress tolerance.

  Immediately post-intervention

• Endorsement and Discomfort Scale (adapted)

  Self-report questionnaire with 10 questions on a 9-point Likert scale (scored 1-9). Total scores range from 10-90, with higher score indicative of greater acceptability of intervention.

  Immediately post-intervention

• Endorsement and Discomfort Scale (adapted)

  Self-report questionnaire with 10 questions on a 9-point Likert scale (scored 1-9). Total scores range from 10-90, with higher score indicative of greater acceptability of intervention.

  One week post-intervention

• Compassionate Engagement and Action Scale

  Self-report questionnaire with 13 questions on a 10-point Likert scale (scored 1-10). Three questions are reverse-scored and not included in scoring. Total scores range from 10-100, with higher increase in score indicative of increased emotional engagement

  Change from baseline to one week post-intervention

Secondary Outcomes (1)

• Soothing affect measures (researcher-generated) - Adapted from the Serenity Subscale of the PANAS-X and the Safe/Warmth Positive Affect Subscale of the Types of Positive Affect Scale (TPAS)

  Immediately post-intervention (assessed as a mediator)

Study Arms (3)

Self-compassionate writing intervention

EXPERIMENTAL

Participants assigned to this intervention were asked to engage in one brief online self-compassionate writing session, where they were asked to write about and experience their feelings from the perspective of an inner compassionate observer.

Other: Self-compassionate writing intervention

Expressive writing intervention

EXPERIMENTAL

Participants assigned to this intervention were asked to engage in one brief online expressive writing session, where they were asked to explore their deepest thoughts and emotions surrounding an upsetting situation through writing.

Other: Expressive writing intervention

Control writing task

ACTIVE COMPARATOR

Participants assigned to this condition were asked to engage in a neutral time management writing task.

Other: Control writing task

Interventions

Self-compassionate writing intervention OTHER

Participants assigned to this intervention were asked to engage in one brief online self-compassionate writing session, where they were asked to write about and experience their feelings from the perspective of an inner compassionate observer.

Self-compassionate writing intervention

Expressive writing intervention OTHER

Participants assigned to this intervention were asked to engage in one brief online expressive writing session, where they were asked to explore their deepest thoughts and emotions surrounding an upsetting situation through writing.

Expressive writing intervention

Control writing task OTHER

Participants assigned to this condition were asked to engage in a neutral time management writing task.

Control writing task

Eligibility Criteria

• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17), Adult (18-64), Older Adult (65+)

You may qualify if:

• Undergraduate students with a SONA account who are high in emotional distress intolerance (i.e. a lower-than-average score on the Distress Tolerance Scale; mean based on SONA student sample)
• Adults with a Prolific account who are high in emotional distress intolerance (i.e. a lower-than-average score on the Distress Tolerance Scale; mean based on Prolific sample)
• First language English speakers

You may not qualify if:

• None

Sponsors & Collaborators

• University of Waterloo: lead

Study Sites (1)

University of Waterloo

Waterloo, Ontario, N2L3G1, Canada

Location

Study Officials

• Allison Kelly, PhD

  Associate professor

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Masking Details: The participant did not know prior to their study participation that there are three different study conditions, and they did not find out which condition they were randomized to until the end of their study participation.
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Associate Professor

Model Details: 1/3 of the study participants (43 from UWaterloo, 98 from Prolific) were placed into the self-compassionate writing intervention group, 1/3 of the study participants (42 from UWaterloo, 100 from Prolific) were placed into the expressive writing intervention group, and 1/3 of the study participants (41 from UWaterloo, 100 from Prolific) were placed into the control group.

Study Record Dates

• First Submitted: March 8, 2022
• First Posted: March 17, 2022
• Study Start: July 4, 2021
• Primary Completion: July 21, 2022
• Study Completion: July 21, 2022
• Last Updated: June 4, 2025

Record last verified: 2025-05

Locations

CA (1)