Emotional disclosure for alleviating depression, anxiety, and stress in women after spontaneous abortion: a randomized controlled trial

Abstract Background Abortion is a common outcome of pregnancy and may result in significant psychological challenges. Emotional expression has demonstrated positive effects on mental health in various populations. However, few studies have examined its effectiveness specifically among women who have undergone abortion. The present study therefore aimed to investigate the efficacy of emotional disclosure on reducing depression, anxiety, and stress in women after spontaneous abortion. Methods A randomized controlled clinical trial was conducted on 65 eligible women hospitalized due to spontaneous abortion at Valiasr and Shahid Rahimi hospitals in Birjand in 2021–2022. The women were randomly allocated to the intervention group or the control group. Both groups received routine hospital care and education. Additionally, the intervention group underwent an emotional disclosure intervention, which consisted of one individual training session followed by four at-home writing sessions (15–20 min each, twice a week). They also participated in two weekly phone sessions with the researcher (15–20 min each) for verbal emotional expression. The Persian version of the 21-item Depression, Anxiety, and Stress Scale (DASS-21) was administered to both groups at baseline, post-intervention, and at a one-month follow-up. Data were analyzed using SPSS version 22 and R software, employing independent-samples t-test, the Mann-Whitney U test, the Chi-square test, the Friedman test, and repeated-measures ANOVA. P-values were adjusted using the false discovery rate (FDR) correction, with a significance threshold of P < 0.05. Results The two groups were homogeneous in terms of demographic and obstetric characteristics ( P > 0.05). The results indicated that emotional disclosure led to a significant reduction in stress levels in the intervention group compared to the control group ( P = 0.02). However, the reductions in depression ( P = 0.45) and anxiety ( P = 0.27) in the intervention group were not statistically significant compared to the control group. Conclusion The findings suggest that emotional disclosure can effectively alleviate stress in women following spontaneous abortion. Thus, it is recommended as a simple and cost-effective intervention to support these patients in stress management. Trial registration This study was registered at the Iranian Registry of Clinical Trials (identifier: IRCT20210528051421N1; date of registration: 29 June 2021).