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Therapist-guided online metacognitive intervention for excessive worry: a randomized controlled trial with mediation analysis
Cognitive Behaviour Therapy ( IF 3.928 ) Pub Date : 2021-07-20 , DOI: 10.1080/16506073.2021.1937695
Tove Wahlund 1, 2 , Hugo Hesser 3, 4 , Sean Perrin 5 , Sanna Johansson 1 , Vilgot Huhn 1 , Sara Sörhus 1 , Severin Lindskog 1 , Eva Serlachius 1, 2 , Erik Hedman-Lagerlöf 1 , Brjánn Ljótsson 1 , Erik Andersson 1
Affiliation  

ABSTRACT

Previous studies have found an association between excessive worrying and negative beliefs about worry. It is unclear if change in these beliefs mediate worry reduction. This study aimed to examine (1) if a simplified online metacognitive intervention can reduce worry, (2) whether changes in negative beliefs about worry mediate changes in worry severity, and (3) moderated mediation, i.e., if the mediating effect is more pronounced in individuals with a high degree of negative beliefs about worry at baseline. Adult excessive worriers (N = 108) were randomized to 10-weeks of the online metacognitive intervention (MCI) aimed at reducing negative beliefs about worry, or to wait-list (WL). Outcomes, mediation, and moderated mediation were examined via growth curve modelling. Results indicated a significant reduction in the MCI group (d = 1.6). Reductions in negative beliefs about worry and depressive symptoms separately mediated changes in worry severity during the intervention, but in a multivariate test only the former remained significant. Sensitivity analysis indicated that the hypothesized mediation was robust to possible violations of mediator-outcome confounding. The moderated mediation hypothesis was not supported. The results from this randomized trial add to the growing literature suggesting that negative beliefs about worry play a key role in worry-related problems. ClinicalTrials.gov Identifier: NCT03393156



中文翻译:

针对过度担忧的治疗师引导的在线元认知干预:具有中介分析的随机对照试验

摘要

以前的研究发现过度担忧和对担忧的消极信念之间存在关联。目前尚不清楚这些信念的改变是否会降低忧虑。本研究旨在检验 (1) 简化的在线元认知干预是否可以减少忧虑,(2) 对忧虑的消极信念的变化是否会介导忧虑严重程度的变化,以及 (3) 适度的中介,即中介效应是否更明显在对基线担忧有高度消极信念的个体中。成人过度忧虑者(N= 108) 被随机分配到为期 10 周的在线元认知干预 (MCI) 旨在减少对担忧的负面信念,或等待名单 (WL)。结果、调解和适度调解通过增长曲线建模进行了检查。结果表明 MCI 组显着减少 (d = 1.6)。在干预期间,对忧虑和抑郁症状的消极信念的减少分别介导了忧虑严重程度的变化,但在多变量测试中,只有前者仍然显着。敏感性分析表明,假设的调解对可能违反调解结果混杂的情况是稳健的。不支持有调节的中介假设。这项随机试验的结果增加了越来越多的文献,表明对担忧的负面信念在与担忧相关的问题中起着关键作用。ClinicalTrials.gov 标识符:NCT03393156

更新日期:2021-07-20
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