An Internet-Delivered Rumination-Focused CBT Intervention for Adults With Depression and Anxiety: A Randomized Controlled Trial

IF 3.8 2区 心理学 Q2 PSYCHIATRY
Bogdan Tudor Tulbure, Diana Paula Dudău, Ștefan Marian, Edward Watkins
{"title":"An Internet-Delivered Rumination-Focused CBT Intervention for Adults With Depression and Anxiety: A Randomized Controlled Trial","authors":"Bogdan Tudor Tulbure,&nbsp;Diana Paula Dudău,&nbsp;Ștefan Marian,&nbsp;Edward Watkins","doi":"10.1016/j.beth.2024.12.004","DOIUrl":null,"url":null,"abstract":"<div><div>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; <em>n</em> = 59) or a waitlist control group (i-RF-CBT delayed 7 weeks; <em>n</em> = 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] (<em>d</em> = 0.44, 95% CI [0.23, 0.64], <em>p</em>&lt;.001), brooding (<em>d</em> = 0.56, 95% CI [0.35, 0.77], <em>p</em> &lt; .001), worry [PSWQ] (<em>d</em> = 0.62; 95% CI [0.40, 0.84], <em>p</em> &lt; .001), anxiety [GAD7] (<em>d</em> = 0.41; 95% CI [0.21, 0.62], <em>p</em> &lt; .001), and depression [PHQ9] (<em>d</em> = 0.38; 95% CI [0.18, 0.58], <em>p</em> &lt; .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.</div></div>","PeriodicalId":48359,"journal":{"name":"Behavior Therapy","volume":"56 4","pages":"Pages 785-798"},"PeriodicalIF":3.8000,"publicationDate":"2025-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Behavior Therapy","FirstCategoryId":"102","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0005789424001746","RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
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.
网络传递的以反刍为中心的CBT干预成人抑郁和焦虑:一项随机对照试验
针对重复消极思维(RNT)等跨诊断精神病理机制;忧虑(沉思)可以改善对抑郁和焦虑的干预。当前研究的目的是测试治疗师支持的基于网络的RNT靶向认知行为疗法是否能降低RNT升高、焦虑和/或抑郁的成人的RNT、焦虑和抑郁。为此,一项单盲、双平行组优势随机对照试验(RCT)对罗马尼亚118名焦虑和/或反刍水平升高、至少有亚临床/临床诊断为重度抑郁症(MDD)、心境不良、广泛性焦虑症(GAD)、社交焦虑症(SAD)或恐慌症的成年人进行了研究。符合条件的参与者被随机分配到以互联网反思为中心的CBT (i-RF-CBT;n = 59)或等候名单对照组(i-RF-CBT延迟7周;n = 59)。主要结局是随机分组后7周持续性思维、焦虑和抑郁的变化。次要结局包括仅在i-RF-CBT条件下6个月后所有测量值的变化。i-RF-CBT组的参与者表现出较低的持续性思维[PTQ] (d = 0.44,95% CI [0.23, 0.64], p<.001)、沉思(d = 0.56,95% CI [0.35, 0.77], p <; .001)、担忧[PSWQ] (d = 0.62;95%可信区间[0.40,0.84],p & lt; 措施)、焦虑(GAD7) (d = 0.41;95%可信区间[0.21,0.62],p & lt; 措施),和抑郁[PHQ9] (d = 0.38;7周后,95% CI [0.18, 0.58], p <; .001)。在6个月的随访中仍保持改善。结果显示,i-RF-CBT可显著减少成人焦虑和/或重度抑郁症患者的RNT、担忧、反刍、焦虑和抑郁,这为该方法可以靶向RNT以及靶向RNT对焦虑和抑郁症状具有跨诊断益处提供了原理证明。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Behavior Therapy
Behavior Therapy Multiple-
CiteScore
7.40
自引率
2.70%
发文量
113
审稿时长
121 days
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.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:604180095
Book学术官方微信