Managing rumination and worry: A pilot study of an internet intervention targeting repetitive negative thinking in Australian adults.


Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
01 11 2021
Historique:
received: 25 02 2021
revised: 15 07 2021
accepted: 16 07 2021
pubmed: 31 7 2021
medline: 30 10 2021
entrez: 30 7 2021
Statut: ppublish

Résumé

Rumination and worry, both forms of repetitive negative thinking (RNT), have been implicated in the onset, maintenance, severity, and relapse risk of depression and anxiety disorders. Despite promising initial findings for internet-delivered interventions targeting both rumination and worry simultaneously, no studies have investigated treatment effects in an adult population or when delivered in a brief, unguided format. We developed a 3-lesson unguided online treatment program targeting both rumination and worry and evaluated the adherence and effectiveness in Australian adults using an open pilot trial. Adult participants (N=26) experiencing elevated levels of RNT completed the online program over 6-weeks. Outcomes were assessed at baseline, post-treatment, and 1-month follow-up. Intention-to-treat linear mixed models were used to examine effects on RNT, anxiety, depression, and general psychological distress. Of the 26 participants who started the program, 18 completed all three lessons (69.2% completion rate). Large within-subject effect sizes were found between pre- and post-treatment for RNT (Hedges' g= 2.26) and symptoms of depression (g = 1.04), generalised anxiety (g = 1.82) and distress (g = 0.93). Treatment effects were maintained at 1-month follow-up. No long-term follow-up, exclusion of severely depressed individuals. This is the first study to evaluate a brief, unguided internet intervention targeting both rumination and worry in adults. The results provide promising preliminary evidence for the feasibility and acceptability of the online program. Randomised controlled trials are needed to evaluate treatment efficacy compared to a control group and to investigate long-term outcomes.

Sections du résumé

BACKGROUND
Rumination and worry, both forms of repetitive negative thinking (RNT), have been implicated in the onset, maintenance, severity, and relapse risk of depression and anxiety disorders. Despite promising initial findings for internet-delivered interventions targeting both rumination and worry simultaneously, no studies have investigated treatment effects in an adult population or when delivered in a brief, unguided format. We developed a 3-lesson unguided online treatment program targeting both rumination and worry and evaluated the adherence and effectiveness in Australian adults using an open pilot trial.
METHODS
Adult participants (N=26) experiencing elevated levels of RNT completed the online program over 6-weeks. Outcomes were assessed at baseline, post-treatment, and 1-month follow-up. Intention-to-treat linear mixed models were used to examine effects on RNT, anxiety, depression, and general psychological distress.
RESULTS
Of the 26 participants who started the program, 18 completed all three lessons (69.2% completion rate). Large within-subject effect sizes were found between pre- and post-treatment for RNT (Hedges' g= 2.26) and symptoms of depression (g = 1.04), generalised anxiety (g = 1.82) and distress (g = 0.93). Treatment effects were maintained at 1-month follow-up.
LIMITATIONS
No long-term follow-up, exclusion of severely depressed individuals.
CONCLUSIONS
This is the first study to evaluate a brief, unguided internet intervention targeting both rumination and worry in adults. The results provide promising preliminary evidence for the feasibility and acceptability of the online program. Randomised controlled trials are needed to evaluate treatment efficacy compared to a control group and to investigate long-term outcomes.

Identifiants

pubmed: 34330043
pii: S0165-0327(21)00755-2
doi: 10.1016/j.jad.2021.07.076
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

483-490

Informations de copyright

Copyright © 2021. Published by Elsevier B.V.

Auteurs

Amy E Joubert (AE)

Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent's Hospital, Level 4 O'Brien Centre, 394- 404 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia; School of Psychology, Faculty of Science, University of New South Wales, Sydney, NSW, 2052, Australia. Electronic address: amy.joubert@unsw.edu.au.

Ashlee B Grierson (AB)

Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent's Hospital, Level 4 O'Brien Centre, 394- 404 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia; School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.

Aileen Z Chen (AZ)

Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent's Hospital, Level 4 O'Brien Centre, 394- 404 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia; School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.

Michelle L Moulds (ML)

School of Psychology, Faculty of Science, University of New South Wales, Sydney, NSW, 2052, Australia.

Aliza Werner-Seidler (A)

Black Dog Institute, The University of New South Wales, Sydney, NSW, 2052, Australia.

Alison E J Mahoney (AEJ)

Clinical Research Unit for Anxiety and Depression (CRUfAD), St. Vincent's Hospital, Level 4 O'Brien Centre, 394- 404 Victoria Street, Darlinghurst, Sydney, NSW, 2010, Australia; School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2052, Australia.

Jill M Newby (JM)

Black Dog Institute, The University of New South Wales, Sydney, NSW, 2052, Australia.

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