Internet-delivered cognitive-behavior therapy for adolescents with excessive worry : a randomized controlled trial with mediation analysis
(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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https://lup.lub.lu.se/record/9d439830-306a-461c-8bdb-fcaa7b4c14e4
- author
- organization
- publishing date
- 2025-06-06
- 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}}, }