Effect of Expressive Writing on Promotion of Body Image in Women with Multiple Sclerosis: A Randomized Controlled Trial

 Background and purpose: Multiple sclerosis (MS) affects own physical function and body image. The aim of this study was to determine the effect of expressive writing on body image in women with MS. Materials and methods: In this randomized trial, the Solomon four-group design was employed. The study was carried out in 116 women attending an MS clinic in Tehran, Iran 2019. The participants were randomly assigned to two subgroups of control (A1 and A2) and two subgroups of intervention (B2 and B1). Pretest and posttest were done in A2 and B2 while for A1 and B1only posttest was performed. Expressive writing including morning pages, meeting the inner child, and creative assignments were carried out for six weeks. The control group received routine care. Fisher Body Focus Questionnaire was completed at pretest in A2 and B2 and at posttest in all groups (immediately after the intervention, and at weeks four and eight). Data analysis was done in SPSS V26. Results: The mean scores for body image in B2 were 145.65±19.89 at pretest, 156.89±9.54 immediately after the intervention, 158.16±8.92 at week four, and 153.96±8.27 at week eight. In A2, the mean score at these times were 144.96±7.17, 145.55±5.10, 145.28±7.84, 145.00±9.15, respectively. Expressive writing significantly improved body image in B2 at immediately and four weeks after the intervention compared to pretest (P˂0.001). There were significant differences between the control group and intervention group at immediately after (P=0.002) and four weeks (P=0.03) after the intervention. Conclusion: Expressive writing could be effective in improving body image in women with MS.   (Clinical Trials Registry Number: IRCT20110629006917N4)