Bogdan Tudor Tulbure, Diana Paula Dudău, Ștefan Marian, Edward Watkins
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引用次数: 0
Abstract
Targeting transdiagnostic psychopathological mechanisms like repetitive negative thinking (RNT; worry, rumination) could improve interventions for depression and anxiety. The goal of the current study was to test whether therapist-supported internet-based RNT-targeting cognitive behavioral therapy reduces RNT, anxiety, and depression in adults with elevated RNT and anxiety and/or depression. To this end, a single-blind, two-arm parallel-group superiority randomized controlled trial (RCT) was conducted with 118 adults across Romania with elevated levels of worry and/or rumination and at least a subclinical/clinical diagnosis of major depressive disorder (MDD), dysthymia, generalized anxiety disorder (GAD), social anxiety disorder (SAD), or panic disorder. Eligible participants were randomized to internet rumination-focused CBT (i-RF-CBT; n = 59) or a waitlist control group (i-RF-CBT delayed 7 weeks; n = 59). Primary outcome was changes in perseverative thinking, anxiety, and depression 7 weeks after randomization. Secondary outcomes included changes on all measures after 6 months in the i-RF-CBT condition only. Participants in the i-RF-CBT arm showed significantly lower levels of perseverative thought [PTQ] (d = 0.44, 95% CI [0.23, 0.64], p<.001), brooding (d = 0.56, 95% CI [0.35, 0.77], p < .001), worry [PSWQ] (d = 0.62; 95% CI [0.40, 0.84], p < .001), anxiety [GAD7] (d = 0.41; 95% CI [0.21, 0.62], p < .001), and depression [PHQ9] (d = 0.38; 95% CI [0.18, 0.58], p < .001) after 7 weeks, relative to waitlist control. Improvements were maintained at the 6-month follow-up. The results showed that i-RF-CBT significantly reduced RNT, worry, rumination, anxiety, and depression in adults with anxiety and/or major depressive disorders, providing proof of principle that this approach can target RNT and that targeting RNT has transdiagnostic benefits on anxiety and depression symptoms.
期刊介绍:
Behavior Therapy is a quarterly international journal devoted to the application of the behavioral and cognitive sciences to the conceptualization, assessment, and treatment of psychopathology and related clinical problems. It is intended for mental health professionals and students from all related disciplines who wish to remain current in these areas and provides a vehicle for scientist-practitioners and clinical scientists to report the results of their original empirical research. Although the major emphasis is placed upon empirical research, methodological and theoretical papers as well as evaluative reviews of the literature will also be published. Controlled single-case designs and clinical replication series are welcome.