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Therapist-guided online metacognitive intervention for excessive worry : a randomized controlled trial with mediation analysis

Wahlund, Tove ; Hesser, Hugo ; Perrin, Sean LU orcid ; Johansson, Sanna ; Huhn, Vilgot ; Sörhus, Sara ; Lindskog, Severin ; Serlachius, Eva ; Hedman-Lagerlöf, Erik and Ljótsson, Brjánn , et al. (2022) In Cognitive Behaviour Therapy 51(1). p.21-41
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... (More)

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.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
metacognitive therapy, randomized controlled trial, Mediation analysis, worry, anxiety, depression, Negative beliefs about worry, internet, metacognitions, mediations
in
Cognitive Behaviour Therapy
volume
51
issue
1
pages
21 pages
publisher
Taylor & Francis
external identifiers
  • pmid:34283004
  • scopus:85111353622
ISSN
1651-2316
DOI
10.1080/16506073.2021.1937695
language
English
LU publication?
yes
id
c4d0c8d8-faa1-4da8-8a6b-d2f0337e4d51
date added to LUP
2021-07-30 08:48:24
date last changed
2024-06-15 14:10:33
@article{c4d0c8d8-faa1-4da8-8a6b-d2f0337e4d51,
  abstract     = {{<p>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.</p>}},
  author       = {{Wahlund, Tove and Hesser, Hugo and Perrin, Sean and Johansson, Sanna and Huhn, Vilgot and Sörhus, Sara and Lindskog, Severin and Serlachius, Eva and Hedman-Lagerlöf, Erik and Ljótsson, Brjánn and Andersson, Erik}},
  issn         = {{1651-2316}},
  keywords     = {{metacognitive therapy; randomized controlled trial; Mediation analysis; worry; anxiety; depression; Negative beliefs about worry; internet; metacognitions; mediations}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{21--41}},
  publisher    = {{Taylor & Francis}},
  series       = {{Cognitive Behaviour Therapy}},
  title        = {{Therapist-guided online metacognitive intervention for excessive worry : a randomized controlled trial with mediation analysis}},
  url          = {{https://lup.lub.lu.se/search/files/100828508/Wahlund_et_al_2021_Therapist_guided_online_metacognitive_intervention_for_excessive_worry_RCT_with_mediation.pdf}},
  doi          = {{10.1080/16506073.2021.1937695}},
  volume       = {{51}},
  year         = {{2022}},
}