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Internet-delivered cognitive-behavior therapy for adolescents with excessive worry : a randomized controlled trial with mediation analysis

Wahlund, Tove ; Perrin, Sean LU orcid ; Lauri, Klara Olofsdotter ; Burman, Malin ; Dagerborn, Simone ; Meregalli, Micaela ; Västhagen, Maja ; Jolstedt, Maral ; Nordh, Martina and Serlachius, Eva LU , et al. (2025) In Cognitive Behaviour Therapy 54. p.1-23
Abstract
Excessive worry is common during adolescence and across psychiatric disorders. This study investigates whether: 1) internet-delivered cognitive behavioral therapy (ICBT) focused on exposure to uncertainty is effective in reducing excessive worry; 2) improvements in worry are associated with reductions in other psychiatric symptoms; and 3) changes in intolerance of uncertainty (IU) mediates worry outcomes. Adolescents (N= 62; aged 13-17 years) with excessive worry (>30 total score on Penn State Worry Questionnaire for Children) were randomly allocated to eight weeks of ICBT (n=31) or a waitlist for ICBT (Waitlist, n=31). Self-reported worry (primary outcome) was measured weekly for 12 weeks and controlled effects assessed at week 12... (More)
Excessive worry is common during adolescence and across psychiatric disorders. This study investigates whether: 1) internet-delivered cognitive behavioral therapy (ICBT) focused on exposure to uncertainty is effective in reducing excessive worry; 2) improvements in worry are associated with reductions in other psychiatric symptoms; and 3) changes in intolerance of uncertainty (IU) mediates worry outcomes. Adolescents (N= 62; aged 13-17 years) with excessive worry (>30 total score on Penn State Worry Questionnaire for Children) were randomly allocated to eight weeks of ICBT (n=31) or a waitlist for ICBT (Waitlist, n=31). Self-reported worry (primary outcome) was measured weekly for 12 weeks and controlled effects assessed at week 12 post-baseline. IU and a comparator mediator (depression) were measured every other week for 12 weeks during the treatment/waitlist phase. ICBT yielded significantly large reductions in worry compared to Waitlist (bootstrapped d=0.59). Worry reductions mediated improvements in anxiety and depression symptoms. Changes in depression, but not IU, mediated worry outcomes. A brief course of worry-focused ICBT yielded moderate reductions in worry that was associated with improvements in anxiety and depression. Contrary to expectation, changes in IU did not explain worry reductions in this uncertainty- focused treatment. Further studies are needed to identify potential change mechanisms. (Less)
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organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
Excessive worry, adolescents, Internet-delivered treatment, e-health, mediation analysis
in
Cognitive Behaviour Therapy
volume
54
pages
1 - 23
publisher
Taylor & Francis
ISSN
1651-2316
DOI
10.1080/16506073.2025.2515196
project
Targeting excessive worry in adolescents using an online scalable intervention: A randomized controlled trial (Dnr 2020-03612)
language
English
LU publication?
yes
id
9d439830-306a-461c-8bdb-fcaa7b4c14e4
date added to LUP
2025-06-05 06:45:19
date last changed
2025-06-18 14:07:25
@article{9d439830-306a-461c-8bdb-fcaa7b4c14e4,
  abstract     = {{Excessive worry is common during adolescence and across psychiatric disorders. This study investigates whether: 1) internet-delivered cognitive behavioral therapy (ICBT) focused on exposure to uncertainty is effective in reducing excessive worry; 2) improvements in worry are associated with reductions in other psychiatric symptoms; and 3) changes in intolerance of uncertainty (IU) mediates worry outcomes. Adolescents (N= 62; aged 13-17 years) with excessive worry (>30 total score on Penn State Worry Questionnaire for Children) were randomly allocated to eight weeks of ICBT (n=31) or a waitlist for ICBT (Waitlist, n=31). Self-reported worry (primary outcome) was measured weekly for 12 weeks and controlled effects assessed at week 12 post-baseline. IU and a comparator mediator (depression) were measured every other week for 12 weeks during the treatment/waitlist phase. ICBT yielded significantly large reductions in worry compared to Waitlist (bootstrapped d=0.59). Worry reductions mediated improvements in anxiety and depression symptoms. Changes in depression, but not IU, mediated worry outcomes. A brief course of worry-focused ICBT yielded moderate reductions in worry that was associated with improvements in anxiety and depression. Contrary to expectation, changes in IU did not explain worry reductions in this uncertainty- focused treatment. Further studies are needed to identify potential change mechanisms.}},
  author       = {{Wahlund, Tove and Perrin, Sean and Lauri, Klara Olofsdotter and Burman, Malin and Dagerborn, Simone and Meregalli, Micaela and Västhagen, Maja and Jolstedt, Maral and Nordh, Martina and Serlachius, Eva and Vigerland, Sarah and Andersson, Erik}},
  issn         = {{1651-2316}},
  keywords     = {{Excessive worry; adolescents; Internet-delivered treatment; e-health; mediation analysis}},
  language     = {{eng}},
  month        = {{06}},
  pages        = {{1--23}},
  publisher    = {{Taylor & Francis}},
  series       = {{Cognitive Behaviour Therapy}},
  title        = {{Internet-delivered cognitive-behavior therapy for adolescents with excessive worry : a randomized controlled trial with mediation analysis}},
  url          = {{http://dx.doi.org/10.1080/16506073.2025.2515196}},
  doi          = {{10.1080/16506073.2025.2515196}},
  volume       = {{54}},
  year         = {{2025}},
}