Effectiveness of written emotional disclosure interventions for eating disorders: a systematic review and meta-analysis

BackgroundEating disorders are illnesses that can seriously impair the health and wellbeing of patients. Written emotional disclosure has been recognized as a therapeutic technique that may be helpful in aiding patients’ emotional and psychological adjustment. However, it is unclear what favorable e...

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Main Authors: Yufei Wang, Tao Xu, Yuexian Tao, Xintong Cai
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-12-01
Series:Frontiers in Nutrition
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Online Access:https://www.frontiersin.org/articles/10.3389/fnut.2024.1476956/full
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author Yufei Wang
Tao Xu
Yuexian Tao
Xintong Cai
author_facet Yufei Wang
Tao Xu
Yuexian Tao
Xintong Cai
author_sort Yufei Wang
collection DOAJ
description BackgroundEating disorders are illnesses that can seriously impair the health and wellbeing of patients. Written emotional disclosure has been recognized as a therapeutic technique that may be helpful in aiding patients’ emotional and psychological adjustment. However, it is unclear what favorable effects eating disorder patients can derive from written emotional disclosure therapy. This study aimed to review the effectiveness of written emotional disclosure in treating eating disorders using a systematic review and meta-analysis.ObjectiveThis study was to examine the validity of written emotional disclosure intervention for eating disorders as well as to provide guidelines for the management of eating disorders in patients.MethodsResearchers independently developed inclusion and exclusion criteria according to the PICOS principle and systematically searched English literature databases such as PubMed, Medline, Web of Science, Cochrane Library, CINAHL, EBSCO, Embase, and so on, from the time of library construction to December 2023. Cochrane Risk of Bias version 2 (RoB 2) was used to evaluate studies included in this review. All the studies included in this study were randomized controlled trials. Accurate information was extracted and then subjected to meta-analysis with Review Manager 5.4 software. The credibility of the evidence of the studies was assessed using GRADEprofiler 3.6 software.ResultsThe final analysis included 13 randomized controlled trials involving 1,444 participants. The written emotional disclosure intervention can decrease eating disorder symptoms scores (SMD = −0.20, 95% CI [−0.34, −0.05], Z = 2.59, p = 0.01), body dissatisfaction scores (SMD = 0.37, 95% CI [0.21, 0.52], Z = 4.59, p < 0.001), and thin ideal internalization score (SMD = 0.42, 95% CI [0.22, 0.62], Z = 4.12, p < 0.001). Anxiety scores (MD = 0.43, 95% CI [−0.77, 1.63], Z = 0.70, p = 0.48), depression scores (MD = −0.66, 95% CI [−1.78, 0.47], Z = 1.14, p = 0.25) and negative affect scores (SMD = 0.51, 95% CI [−0.24, 1.27], Z = 1.33, p = 0.18), with no statistically significant differences.ConclusionIn conclusion, this systematic review analyzed the existing literature and showed that written emotional disclosure intervention is effective in alleviating eating disorder symptoms and patients’ body image problems, but there is insufficient evidence in alleviating depression, anxiety, and negative affect. However, the evidence is limited. Therefore, more research is needed in the future to further enrich the evidence for written emotional disclosure intervention in the field of eating disorders.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/,CRD42023445577.
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spelling doaj-art-dae4534d5a9c4b998050326992f13f3b2025-08-20T02:39:25ZengFrontiers Media S.A.Frontiers in Nutrition2296-861X2024-12-011110.3389/fnut.2024.14769561476956Effectiveness of written emotional disclosure interventions for eating disorders: a systematic review and meta-analysisYufei WangTao XuYuexian TaoXintong CaiBackgroundEating disorders are illnesses that can seriously impair the health and wellbeing of patients. Written emotional disclosure has been recognized as a therapeutic technique that may be helpful in aiding patients’ emotional and psychological adjustment. However, it is unclear what favorable effects eating disorder patients can derive from written emotional disclosure therapy. This study aimed to review the effectiveness of written emotional disclosure in treating eating disorders using a systematic review and meta-analysis.ObjectiveThis study was to examine the validity of written emotional disclosure intervention for eating disorders as well as to provide guidelines for the management of eating disorders in patients.MethodsResearchers independently developed inclusion and exclusion criteria according to the PICOS principle and systematically searched English literature databases such as PubMed, Medline, Web of Science, Cochrane Library, CINAHL, EBSCO, Embase, and so on, from the time of library construction to December 2023. Cochrane Risk of Bias version 2 (RoB 2) was used to evaluate studies included in this review. All the studies included in this study were randomized controlled trials. Accurate information was extracted and then subjected to meta-analysis with Review Manager 5.4 software. The credibility of the evidence of the studies was assessed using GRADEprofiler 3.6 software.ResultsThe final analysis included 13 randomized controlled trials involving 1,444 participants. The written emotional disclosure intervention can decrease eating disorder symptoms scores (SMD = −0.20, 95% CI [−0.34, −0.05], Z = 2.59, p = 0.01), body dissatisfaction scores (SMD = 0.37, 95% CI [0.21, 0.52], Z = 4.59, p < 0.001), and thin ideal internalization score (SMD = 0.42, 95% CI [0.22, 0.62], Z = 4.12, p < 0.001). Anxiety scores (MD = 0.43, 95% CI [−0.77, 1.63], Z = 0.70, p = 0.48), depression scores (MD = −0.66, 95% CI [−1.78, 0.47], Z = 1.14, p = 0.25) and negative affect scores (SMD = 0.51, 95% CI [−0.24, 1.27], Z = 1.33, p = 0.18), with no statistically significant differences.ConclusionIn conclusion, this systematic review analyzed the existing literature and showed that written emotional disclosure intervention is effective in alleviating eating disorder symptoms and patients’ body image problems, but there is insufficient evidence in alleviating depression, anxiety, and negative affect. However, the evidence is limited. Therefore, more research is needed in the future to further enrich the evidence for written emotional disclosure intervention in the field of eating disorders.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/,CRD42023445577.https://www.frontiersin.org/articles/10.3389/fnut.2024.1476956/fullwritten emotional disclosureexpressive writingeating disordersbody imagemeta-analysis
spellingShingle Yufei Wang
Tao Xu
Yuexian Tao
Xintong Cai
Effectiveness of written emotional disclosure interventions for eating disorders: a systematic review and meta-analysis
Frontiers in Nutrition
written emotional disclosure
expressive writing
eating disorders
body image
meta-analysis
title Effectiveness of written emotional disclosure interventions for eating disorders: a systematic review and meta-analysis
title_full Effectiveness of written emotional disclosure interventions for eating disorders: a systematic review and meta-analysis
title_fullStr Effectiveness of written emotional disclosure interventions for eating disorders: a systematic review and meta-analysis
title_full_unstemmed Effectiveness of written emotional disclosure interventions for eating disorders: a systematic review and meta-analysis
title_short Effectiveness of written emotional disclosure interventions for eating disorders: a systematic review and meta-analysis
title_sort effectiveness of written emotional disclosure interventions for eating disorders a systematic review and meta analysis
topic written emotional disclosure
expressive writing
eating disorders
body image
meta-analysis
url https://www.frontiersin.org/articles/10.3389/fnut.2024.1476956/full
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AT yuexiantao effectivenessofwrittenemotionaldisclosureinterventionsforeatingdisordersasystematicreviewandmetaanalysis
AT xintongcai effectivenessofwrittenemotionaldisclosureinterventionsforeatingdisordersasystematicreviewandmetaanalysis