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Intolerance of uncertainty-focused treatment for adolescents with excessive worry - A pilot feasibility study

Wahlund, Tove ; Andersson, Erik ; Jolstedt, Maral ; Perrin, Sean LU orcid ; Vigerland, Sarah and Serlachius, Eva (2020) In Cognitive and Behavioral Practice 27(2). p.215-230
Abstract
Bouts of excessive worry are common across the lifespan, increasing in frequency and complexity during adolescence and adulthood, and are found in several psychiatric disorders, particularly the anxiety disorders. There are evidence-based treatments for adolescents with anxiety disorders but psychological treatments designed specifically to target excessive worrying in adolescents are rare. Intolerance of uncertainty (IU), a cognitive predisposition described as a fear of the unknown, is highly associated with worry among adolescents. This study investigated the feasibility, acceptability, and preliminary efficacy of IU-focused cognitive behavioral therapy (IU-CBT) for adolescents with excessive worry. Twelve participants (aged 13–17... (More)
Bouts of excessive worry are common across the lifespan, increasing in frequency and complexity during adolescence and adulthood, and are found in several psychiatric disorders, particularly the anxiety disorders. There are evidence-based treatments for adolescents with anxiety disorders but psychological treatments designed specifically to target excessive worrying in adolescents are rare. Intolerance of uncertainty (IU), a cognitive predisposition described as a fear of the unknown, is highly associated with worry among adolescents. This study investigated the feasibility, acceptability, and preliminary efficacy of IU-focused cognitive behavioral therapy (IU-CBT) for adolescents with excessive worry. Twelve participants (aged 13–17 years) with excessive worry, irrespective of psychiatric diagnosis, were provided weekly face-to-face sessions, primarily including therapist and self-guided exposure to situations involving uncertainty. Sessions were supplemented with an internet-delivered educational program for parents, designed to teach parents about worry, IU and helpful parental behaviors. The main outcome measure was the Penn-State Worry Questionnaire for Children (PSWQ-C). The treatment was well tolerated with no dropouts and families reporting being satisfied with the treatment. Participants were able to grasp the notion of IU and its relationship to worry and avoidance. Significant reductions were observed for self-reported worry, anxiety, depression, IU, and parent-reported worry, as were significant increases in global functioning. Based on a clinician rating, 58.3% were categorized as much or very much improved at posttreatment, rising to 66% at 3-month follow-up. Participants with generalized anxiety disorder (GAD) benefitted more from treatment than those with social anxiety disorder. The findings suggest that this IU-focused psychological intervention is acceptable and feasible to adolescents with excessive worry but may be most effective for those with GAD. (Less)
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author
; ; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Intolerance of Uncertainty, Worry, Adolescents, Cognitive behavioral therapy
in
Cognitive and Behavioral Practice
volume
27
issue
2
pages
16 pages
publisher
Elsevier
external identifiers
  • scopus:85065195196
ISSN
1077-7229
DOI
10.1016/j.cbpra.2019.06.002
language
English
LU publication?
yes
id
242cf1cd-4be1-499e-9181-2c67075f2a40
date added to LUP
2019-04-07 13:30:56
date last changed
2022-04-25 22:14:13
@article{242cf1cd-4be1-499e-9181-2c67075f2a40,
  abstract     = {{Bouts of excessive worry are common across the lifespan, increasing in frequency and complexity during adolescence and adulthood, and are found in several psychiatric disorders, particularly the anxiety disorders. There are evidence-based treatments for adolescents with anxiety disorders but psychological treatments designed specifically to target excessive worrying in adolescents are rare. Intolerance of uncertainty (IU), a cognitive predisposition described as a fear of the unknown, is highly associated with worry among adolescents. This study investigated the feasibility, acceptability, and preliminary efficacy of IU-focused cognitive behavioral therapy (IU-CBT) for adolescents with excessive worry. Twelve participants (aged 13–17 years) with excessive worry, irrespective of psychiatric diagnosis, were provided weekly face-to-face sessions, primarily including therapist and self-guided exposure to situations involving uncertainty. Sessions were supplemented with an internet-delivered educational program for parents, designed to teach parents about worry, IU and helpful parental behaviors. The main outcome measure was the Penn-State Worry Questionnaire for Children (PSWQ-C). The treatment was well tolerated with no dropouts and families reporting being satisfied with the treatment. Participants were able to grasp the notion of IU and its relationship to worry and avoidance. Significant reductions were observed for self-reported worry, anxiety, depression, IU, and parent-reported worry, as were significant increases in global functioning. Based on a clinician rating, 58.3% were categorized as much or very much improved at posttreatment, rising to 66% at 3-month follow-up. Participants with generalized anxiety disorder (GAD) benefitted more from treatment than those with social anxiety disorder. The findings suggest that this IU-focused psychological intervention is acceptable and feasible to adolescents with excessive worry but may be most effective for those with GAD.}},
  author       = {{Wahlund, Tove and Andersson, Erik and Jolstedt, Maral and Perrin, Sean and Vigerland, Sarah and Serlachius, Eva}},
  issn         = {{1077-7229}},
  keywords     = {{Intolerance of Uncertainty; Worry; Adolescents; Cognitive behavioral therapy}},
  language     = {{eng}},
  number       = {{2}},
  pages        = {{215--230}},
  publisher    = {{Elsevier}},
  series       = {{Cognitive and Behavioral Practice}},
  title        = {{Intolerance of uncertainty-focused treatment for adolescents with excessive worry - A pilot feasibility study}},
  url          = {{http://dx.doi.org/10.1016/j.cbpra.2019.06.002}},
  doi          = {{10.1016/j.cbpra.2019.06.002}},
  volume       = {{27}},
  year         = {{2020}},
}