Efficacy of applet-based acceptance and commitment therapy focused on repetitive negative thinking for adults with comorbid anxiety and depression: A randomized controlled trial with mediation analysis

IF 3.7 2区医学 Q1 PSYCHIATRY

General hospital psychiatry Pub Date : 2025-09-23 DOI:10.1016/j.genhosppsych.2025.09.006

Qizheng Cao , Xiayu Du , Francisco J. Ruiz , Marge A. sierra , Xianglian Yu , Zhihong Ren

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引用次数: 0

Abstract

Objective

This study examines the effects of an applet-based Acceptance and Commitment Therapy focused on Repetitive Negative Thinking (RNT-ACT) for adults with comorbid anxiety and depression, and explores the mediating role of Repetitive Negative Thinking (RNT) in its efficacy.

Methods

In a randomized controlled trial, participants with the co-occurrence of elevated anxiety and depressive symptoms (GAD-7 and PHQ-9 scores ≥10; N = 94) were randomly assigned to either the RNT-ACT intervention group (N = 49) or a wait-list control group (N = 45). The intervention group completed a 14-day online RNT-ACT program, while the wait-list group received no intervention. Assessments of RNT, anxiety, and depression were conducted at baseline, mid-intervention, post-intervention for both groups, with an additional one-month follow-up assessment for the intervention group.

Results

The RNT-ACT intervention led to significant reductions in RNT (F_{(2, 272)} = 45.44, p < 0.001), anxiety (F_{(2, 174)} = 25.43, p < 0.001), and depression (F_{(2, 174)} = 25.43, p < 0.001) symptoms post-intervention compared to the control group, with sustained improvements at follow-up. Longitudinal mediation analysis revealed that reductions in RNT mediated improvements in anxiety and depression.

Conclusions

These findings provide empirical support for transdiagnostic interventions and highlight the potential for optimizing treatment strategies for comorbid anxiety and depression. Future research should explore additional mediators to further elucidate the mechanisms underlying comorbidity.

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基于苹果的接受与承诺疗法对成人焦虑抑郁共病患者重复性消极思维的疗效：一项随机对照试验和中介分析

目的观察基于苹果的重复消极思维接受承诺疗法（RNT- act）对成人焦虑抑郁共病的治疗效果，并探讨重复消极思维在治疗中的中介作用。方法在一项随机对照试验中，同时出现焦虑和抑郁症状升高的受试者（GAD-7和PHQ-9评分≥10，N = 94）被随机分配到RNT-ACT干预组（N = 49）和等候名单对照组（N = 45）。干预组完成了为期14天的在线RNT-ACT计划，而等候名单组没有接受干预。两组分别在基线、干预中期和干预后对RNT、焦虑和抑郁进行评估，并对干预组进行一个月的随访评估。结果与对照组相比，RNT- act干预导致干预后RNT （F(2,272) = 45.44, p < 0.001）、焦虑（F(2,174) = 25.43, p < 0.001）和抑郁（F(2,174) = 25.43, p < 0.001）症状显著降低，随访时持续改善。纵向中介分析显示，RNT的减少介导了焦虑和抑郁的改善。结论本研究结果为跨诊断干预提供了实证支持，并强调了优化焦虑和抑郁共病治疗策略的潜力。未来的研究应探索更多的介质，以进一步阐明合并症的机制。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

General hospital psychiatry 医学-精神病学

CiteScore

9.60

自引率

2.90%

发文量

125

审稿时长

20 days

期刊介绍： General Hospital Psychiatry explores the many linkages among psychiatry, medicine, and primary care. In emphasizing a biopsychosocial approach to illness and health, the journal provides a forum for professionals with clinical, academic, and research interests in psychiatry''s role in the mainstream of medicine.