The Efficacy of Life-Review as Online-Guided Self-help for Adults: A Randomized Trial

Objectives. The study used a randomized controlled trial to investigate the short-term and long-term effects of life-review as online-guided self-help in adults (40+) with moderate depressive symptomatology. We evaluated ego-integrity and rumination as mediators and assessed whether the effects of the intervention did not differ across middle-aged and older adults. Method. Effects of life-review (n = 58) were compared with a waiting list group (n = 58) and an expressive writing intervention (n = 58) on depressive symptoms (primary outcome), anxiety, and well-being (secondary outcomes). Mediator and moderator analyses were also applied. Results. Compared with the waiting list, life-review reduced depressive symptoms (d = 0.35) and enhanced emotional (d = 0.16) and psychological well-being (d = 0.27). Life-review was not more effective than expressive writing. The effects on depressive symptoms were partly related with increases in ego-integrity and decreases in rumination. The intervention is applicable for middle-aged and older adults. Conclusion. Life-review is effective as self-help for middle-aged and older adults with moderate depressive symptomatology compared with a waiting list group. Future research should investigate whether stimulating ego-integrity and reducing rumination enhance the effects of the intervention.