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.

中文翻译：

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管理沉思和担忧：针对澳大利亚成年人重复消极思维的互联网干预试点研究

背景

沉思和担忧这两种形式的重复性消极思维 (RNT) 都与抑郁症和焦虑症的发作、维持、严重程度和复发风险有关。尽管针对同时针对反刍和担忧的互联网提供的干预措施的初步发现很有希望，但没有研究调查在成年人群中或以简短、无指导的形式提供的治疗效果。我们开发了一个 3 节课的无指导在线治疗计划，同时针对反刍和担忧，并使用开放式试点试验评估了澳大利亚成年人的依从性和有效性。

方法

RNT 水平升高的成年参与者 (N=26) 完成了为期 6 周的在线课程。在基线、治疗后和 1 个月的随访时评估结果。意向治疗线性混合模型用于检查对 RNT、焦虑、抑郁和一般心理困扰的影响。

结果

在开始该计划的 26 名参与者中，18 人完成了所有三节课（69.2% 的完成率）。在 RNT (Hedges' g = 2.26) 和抑郁症状 ( g  = 1.04)、广泛性焦虑 ( g  = 1.82) 和痛苦 ( g  = 0.93)的治疗前和治疗后之间发现了较大的受试者内效应量。治疗效果在 1 个月的随访中得以维持。

限制

无长期随访，排除严重抑郁的个体。

结论

这是第一项评估针对成年人的沉思和担忧的简短、无指导的互联网干预的研究。结果为在线程序的可行性和可接受性提供了有希望的初步证据。需要随机对照试验来评估与对照组相比的治疗效果并调查长期结果。