Efficacy of cognitive behavioral therapy in treating repetitive negative thinking, rumination, and worry - a transdiagnostic meta-analysis.

IF 5.9 2区 医学 Q1 PSYCHIATRY
Kilian Leander Stenzel, Joshua Keller, Lukas Kirchner, Winfried Rief, Max Berg
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引用次数: 0

Abstract

Repetitive negative thinking (RNT) is a transdiagnostic process associated with the onset, maintenance, and risk of relapse of various mental disorders. However, previous research syntheses addressing the effect of cognitive behavioral therapy (CBT) on RNT are limited to specific diagnoses, treatments, or RNT constructs (transdiagnostic RNT, worry, rumination). In the present meta-analysis, we integrate findings from randomized controlled trials (RCTs) of CBT on RNT across diagnoses, intervention types, and RNT constructs. We investigate the following questions: What is the overall transdiagnostic efficacy of CBT interventions on all post-treatment RNT outcomes? Which RNT construct is addressed most effectively? Are RNT-specific treatments superior in reducing RNT than less specific approaches? Inclusion criteria were met by 55 studies with a total of 4,970 participants. The overall post-treatment effect of CBT interventions on RNT compared to respective control groups was moderate in favor of CBT (g = -0.67). Treatment efficacy did not differ significantly by RNT construct. RNT-specific interventions (g = -0.99) were significantly more efficacious in reducing RNT than less specific approaches (g = -0.56). Treatment efficacy was not significantly enhanced by individual or in-person settings. Our results advocate a dissemination of RNT-specific treatments in research and practice and a general improvement of CBT treatments by focusing on relevant transdiagnostic processes such as RNT.

重复性消极思维(RNT)是一种与各种精神障碍的发病、维持和复发风险相关的跨诊断过程。然而,先前关于认知行为疗法(CBT)对RNT影响的综合研究仅限于特定的诊断、治疗或RNT结构(跨诊断RNT、担忧、反刍)。在本荟萃分析中,我们整合了CBT对RNT诊断、干预类型和RNT结构的随机对照试验(rct)的研究结果。我们调查了以下问题:CBT干预对所有治疗后RNT结果的总体跨诊断效果是什么?哪一个RNT结构是最有效的?RNT特异性治疗在减少RNT方面是否优于非特异性治疗?55项研究共纳入4,970名受试者,符合纳入标准。与相应的对照组相比,CBT干预对RNT的总体治疗后效果中等(g = -0.67)。不同RNT结构的治疗效果无显著差异。RNT特异性干预(g = -0.99)在减少RNT方面明显比非特异性干预(g = -0.56)更有效。治疗效果不显著提高个人或个人设置。我们的研究结果提倡在研究和实践中推广RNT特异性治疗,并通过关注相关的转诊断过程(如RNT)来全面改进CBT治疗。
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来源期刊
Psychological Medicine
Psychological Medicine 医学-精神病学
CiteScore
11.30
自引率
4.30%
发文量
711
审稿时长
3-6 weeks
期刊介绍: Now in its fifth decade of publication, Psychological Medicine is a leading international journal in the fields of psychiatry, related aspects of psychology and basic sciences. From 2014, there are 16 issues a year, each featuring original articles reporting key research being undertaken worldwide, together with shorter editorials by distinguished scholars and an important book review section. The journal''s success is clearly demonstrated by a consistently high impact factor.
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