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Internet-Delivered Interpretation Training Reduces Worry and Anxiety in Individuals With Generalized Anxiety Disorder: A Randomized Controlled Experiment

Hirsch, CR, Krahé, C, Whyte, J, Krzyzanowski, H, Meeten, F, Norton, S and Mathews, A (2021) Internet-Delivered Interpretation Training Reduces Worry and Anxiety in Individuals With Generalized Anxiety Disorder: A Randomized Controlled Experiment. Journal of Consulting and Clinical Psychology, 89 (7). pp. 575-589. ISSN 0022-006X

Internet_Delivered_Interpretation_Training_HIRSCH_Acc12May2021_GREEN_AAM.pdf - Accepted Version

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Objective: Generalized anxiety disorder (GAD) is a debilitating condition, characterized by negative interpretations about ambiguous situations. This study tested whether entirely internet-delivered interpretation training [cognitive bias modification (CBM)] versus control promotes positive interpretations and reduces worry and anxiety in individuals with GAD, with or without depression. Method: A two-arm (CBM; control) parallel-group randomized controlled experiment. Assessments were preintervention (T0), postintervention (T1), 1-month (T2) postintervention, and 3-month (T3) postintervention. Participants with GAD (with or without comorbid depression) were randomly allocated to either CBM (n = 115) or control (n = 115). Participants, but not researchers, were blind to allocated condition. Participants completed up to 10 online CBM or control sessions across 1 month. Interpretation bias [coprimary outcomes: scrambled sentence test (SST), recognition test (RT)], and number of negative thought intrusions during a breathing focus task were measured at T0 and T1. Self-reported levels of worry [Penn State Worry Questionnaire-trait (PSWQ trait); Penn State Worry Questionnaire-past week (PSWQ weekly)], anxiety [Generalized Anxiety Disorder scale (GAD-7)], depression [Patient Health Questionnaire (PHQ-9)], rumination [Ruminative Response Scale (RRS)], and repetitive negative thinking [RNT; Repetitive Thinking Questionnaire-trait (RTQ-trait)] were assessed at T0–T3. Results: The per-protocol analyses included N = 186 participants (CBM n = 94; control n = 92). As predicted, we found moderate-to-large training effects on the primary outcome of interpretation bias at T1. Secondary outcomes of negative thought intrusions at T1 and selfreported symptoms at T2 were all significantly lower in the CBM versus control condition. All but one effect (trait RNT) were sustained at T3. Conclusions: In this randomized controlled study, we found that fully online interpretation training ameliorated core features of GAD in individuals with or without comorbid depression up to 3 months posttraining.

Item Type: Article
Additional Information: ©American Psychological Association, 2021. This paper is not the copy of record and may not exactly replicate the authoritative document published in the APA journal. The final article is available, upon publication, at: https://psycnet.apa.org/doi/10.1037/ccp0000660
Uncontrolled Keywords: Humans; Treatment Outcome; Anxiety Disorders; Adult; Female; Male; Cognitive Behavioral Therapy; Internet-Based Intervention; Imagery, Psychotherapy; Adult; Anxiety Disorders; Cognitive Behavioral Therapy; Female; Humans; Imagery, Psychotherapy; Internet-Based Intervention; Male; Treatment Outcome; Clinical Psychology; 1701 Psychology
Subjects: B Philosophy. Psychology. Religion > BF Psychology
Divisions: Psychology (from Sep 2019)
Publisher: American Psychological Association (APA)
SWORD Depositor: A Symplectic
Date Deposited: 05 Sep 2022 12:25
Last Modified: 05 Sep 2022 12:30
DOI or ID number: 10.1037/ccp0000660
URI: https://researchonline.ljmu.ac.uk/id/eprint/17494
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