Psychological interventions for pre-event and post-event rumination in social anxiety: A systematic review and meta-analysis

IF 4.8 2区医学 Q1 PSYCHIATRY

Journal of Anxiety Disorders Pub Date : 2023-12-21 DOI:10.1016/j.janxdis.2023.102823

Hayley E. Donohue , Matthew Modini , Maree J. Abbott

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Abstract

Pre-event and post-event rumination have been consistently identified by cognitive models as important maintaining factors in Social Anxiety Disorder (SAD). This systematic review and meta-analysis aimed to investigate the effectiveness of psychological treatment in reducing pre-event and post-event rumination in adults with social anxiety. A comprehensive literature search identified 26 eligible studies, with 1524 total participants. Psychological treatments demonstrated large significant within-group effect sizes (from pre- to post-treatment) in reducing pre-event rumination (g = 0.86) and post-event rumination (g = 0.83). Subgroups analysed showed CBT to have large significant effect sizes in reducing pre-event rumination (g = 0.97) and post-event rumination (g = 0.85). Interventions that specifically addressed rumination were found to be significantly more effective in reducing pre-event rumination than those that did not (p = .006). Both individual and group treatment formats were equally effective in reducing pre-event rumination and post-event rumination. Meta-regressions revealed that pre-event rumination treatment effects were significantly larger in individuals with higher baseline social anxiety, meanwhile post-event rumination treatment effects were larger for those with higher baseline depression. Overall findings show that pre-event and post-event rumination are effectively reduced through psychological treatment, and clinical implications for the enhancement of evidence-based treatment protocols are discussed.

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社交焦虑事件前和事件后反刍的心理干预：系统回顾和元分析

认知模型一直认为，事件前和事件后的反刍是社交焦虑症（SAD）的重要维持因素。本系统综述和荟萃分析旨在研究心理治疗对减少成人社交焦虑症患者事前和事后反刍的有效性。通过全面的文献检索发现了 26 项符合条件的研究，共有 1524 名参与者。心理治疗在减少事件发生前的反刍（g = 0.86）和事件发生后的反刍（g = 0.83）方面显示出巨大的组内效应大小（从治疗前到治疗后）。分组分析显示，CBT 在减少事件发生前的反刍（g = 0.97）和事件发生后的反刍（g = 0.85）方面具有较大的显著效果。研究发现，专门针对反刍的干预在减少事件前反刍方面的效果明显优于非专门针对反刍的干预（p = .006）。个人和小组治疗形式对减少事件前和事件后的反刍同样有效。元回归显示，事件前反刍的治疗效果在基线社交焦虑较高的个体中明显更大，而事件后反刍的治疗效果在基线抑郁较高的个体中更大。总体研究结果表明，通过心理治疗可以有效减少事件前和事件后的反刍，并探讨了加强循证治疗方案的临床意义。

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来源期刊

Journal of Anxiety Disorders Multiple-

CiteScore

16.60

自引率

2.90%

发文量

期刊介绍： The Journal of Anxiety Disorders is an interdisciplinary journal that publishes research papers on all aspects of anxiety disorders for individuals of all age groups, including children, adolescents, adults, and the elderly. Manuscripts that focus on disorders previously classified as anxiety disorders such as obsessive-compulsive disorder and posttraumatic stress disorder, as well as the new category of illness anxiety disorder, are also within the scope of the journal. The research areas of focus include traditional, behavioral, cognitive, and biological assessment; diagnosis and classification; psychosocial and psychopharmacological treatment; genetics; epidemiology; and prevention. The journal welcomes theoretical and review articles that significantly contribute to current knowledge in the field. It is abstracted and indexed in various databases such as Elsevier, BIOBASE, PubMed/Medline, PsycINFO, BIOSIS Citation Index, BRS Data, Current Contents - Social & Behavioral Sciences, Pascal Francis, Scopus, and Google Scholar.