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Funk J, Takano K, Babl M, Goldstein R, Oberwestersberger R, Kopf-Beck J, Rohleder N, Ehring T. Can an intervention designed to reduce repetitive negative thinking alter the response to a psychosocial stressor? A randomized controlled study. Behav Res Ther 2024; 178:104547. [PMID: 38678755 DOI: 10.1016/j.brat.2024.104547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/07/2023] [Accepted: 04/21/2024] [Indexed: 05/01/2024]
Abstract
Prior research suggests that repetitive negative thinking (RNT) negatively impacts mental health by intensifying and prolonging emotional reactivity to stress. This study investigated whether an intervention designed to reduce RNT alters emotional reactivity. Young adults with high trait RNT (N = 79) were randomly allocated to an RNT-focused intervention (smartphone app-based, 10 days) or a waiting list before exposure to a standardized stressor. The pre-registered analysis did not reveal a significant condition * time interaction for negative affect. However, exploratory analyses showed that whilst initial increases in negative affect in response to the stressor did not differ between conditions, participants in the intervention condition reported less negative affect throughout the following recovery phase. Additionally, participants in the intervention condition appraised their ability to cope with the stressor as higher and reported less RNT in the recovery phase. In contrast, the intervention did not affect biological stress responses. The findings indicate that RNT-focused interventions might have positive effects on mental health by breaking the self-reinforcing cycle of RNT, negative affect and maladaptive appraisals in response to stress. However, as findings are partly based on exploratory analyses, further research is needed to confirm whether reduced subjective stress reactivity mediates the effects of RNT-focused interventions on psychopathological symptoms.
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Affiliation(s)
- Julia Funk
- Ludwig-Maximilians-Universität München, Germany, Department of Psychology, Clinical Psychology and Psychological Treatment.
| | - Keisuke Takano
- National Institute of Advanced Industrial Science and Technology, Japan, Human Informatics and Interaction Research Institute
| | - Marina Babl
- Ludwig-Maximilians-Universität München, Germany, Department of Psychology, Clinical Psychology and Psychological Treatment
| | - Rebecca Goldstein
- Ludwig-Maximilians-Universität München, Germany, Department of Psychology, Clinical Psychology and Psychological Treatment
| | - Regina Oberwestersberger
- Ludwig-Maximilians-Universität München, Germany, Department of Psychology, Clinical Psychology and Psychological Treatment
| | - Johannes Kopf-Beck
- Ludwig-Maximilians-Universität München, Germany, Department of Psychology, Clinical Psychology and Psychological Treatment
| | - Nicolas Rohleder
- Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany, Institute of Psychology, Health Psychology
| | - Thomas Ehring
- Ludwig-Maximilians-Universität München, Germany, Department of Psychology, Clinical Psychology and Psychological Treatment
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Booth RW, Mackintosh B, Hasşerbetçi S. Probability, cost, and interpretation biases' relationships with depressive and anxious symptom severity: differential mediation by worry and repetitive negative thinking. Cogn Emot 2024:1-16. [PMID: 38693727 DOI: 10.1080/02699931.2024.2348031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/20/2024] [Indexed: 05/03/2024]
Abstract
People high in depressive or anxious symptom severity show repetitive negative thinking, including worry and rumination. They also show various cognitive phenomena, including probability, cost, and interpretation biases. Since there is conceptual overlap between these cognitive biases and repetitive negative thinking - all involve thinking about potential threats and misfortunes - we wondered whether repetitive negative thinking could account for (mediate) these cognitive biases' associations with depressive and anxious symptom severity. In three studies, conducted in two languages and cultures, cost bias and (in two studies) interpretation bias only predicted symptom severity via worry and repetitive negative thinking; this suggests these biases are actually associated with repetitive negative thinking, rather than with symptoms. In contrast, probability bias showed direct relationships with depressive (all studies) and anxious (two studies) symptom severity, suggesting its relationships with symptoms are partly independent of repetitive negative thinking. These results show the value of studying relationships among the various cognitive features of psychopathology. Furthermore, new interventions which target cognitive biases in depression or anxiety must show that they can improve upon cognitive behavioural therapy, which is already widely available, targets both repetitive negative thinking and probability bias, and is highly effective.
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Affiliation(s)
- Robert W Booth
- Faculty of Arts and Social Sciences, Sabanci University, Istanbul, Turkey
| | | | - Servet Hasşerbetçi
- Faculty of Arts and Social Sciences, Sabanci University, Istanbul, Turkey
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Hu Y, Wu X, Li S, Liu P, Wang D. Imagine before you leap: Episodic future thinking combined with transcranial direct current stimulation training for impulsive choice in repetitive negative thinking. Int J Clin Health Psychol 2024; 24:100455. [PMID: 38577657 PMCID: PMC10992705 DOI: 10.1016/j.ijchp.2024.100455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/25/2024] [Indexed: 04/06/2024] Open
Abstract
Background Immediate reward preference in repetitive negative thinking (RNT) has a high clinical correlation with a variety of maladaptive behaviors, whereas episodic future thinking (EFT) may be conducive to dealing with non-adaptive thinking and decision-making. Objectives This study aimed to evaluate the efficacy of EFT training combined with transcranial direct current stimulation (tDCS) stimulation over the ventromedial PFC (vmPFC) in inhibiting impulsive choice of RNT individuals. Method Study 1 explored the effects of EFT on immediate reward preference of participants with high and low RNT (N = 48). Study 2 conducted a randomized controlled trial (RCT) to examine the treatment effect of the EFT-neural training on impulsive choice of high RNT individuals (N = 103). Results In study 1, individuals with high RNT were more likely to choose smaller and sooner (SS) rewards, however, there were no significant differences between the high-RNT group and the low-RNT group under the positive EFT condition. In study 2, a significant decrease was shown in the proportion of choosing SS rewards under the 8-week EFT-neural training, and the effect was maintained at 1 month follow-up. Conclusion RNT is a vulnerability factor for short-sighted behaviors, and EFT-neural training could be suitable for reducing RNT and improving immediate reward preference.
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Affiliation(s)
| | | | - Shuyi Li
- School of Psychology, Shandong Normal University, China
| | - Peiyao Liu
- School of Psychology, Shandong Normal University, China
| | - Dawei Wang
- School of Psychology, Shandong Normal University, China
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Donohue HE, Modini M, Abbott MJ. Psychological interventions for pre-event and post-event rumination in social anxiety: A systematic review and meta-analysis. J Anxiety Disord 2024; 102:102823. [PMID: 38142483 DOI: 10.1016/j.janxdis.2023.102823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 12/04/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
Pre-event and post-event rumination have been consistently identified by cognitive models as important maintaining factors in Social Anxiety Disorder (SAD). This systematic review and meta-analysis aimed to investigate the effectiveness of psychological treatment in reducing pre-event and post-event rumination in adults with social anxiety. A comprehensive literature search identified 26 eligible studies, with 1524 total participants. Psychological treatments demonstrated large significant within-group effect sizes (from pre- to post-treatment) in reducing pre-event rumination (g = 0.86) and post-event rumination (g = 0.83). Subgroups analysed showed CBT to have large significant effect sizes in reducing pre-event rumination (g = 0.97) and post-event rumination (g = 0.85). Interventions that specifically addressed rumination were found to be significantly more effective in reducing pre-event rumination than those that did not (p = .006). Both individual and group treatment formats were equally effective in reducing pre-event rumination and post-event rumination. Meta-regressions revealed that pre-event rumination treatment effects were significantly larger in individuals with higher baseline social anxiety, meanwhile post-event rumination treatment effects were larger for those with higher baseline depression. Overall findings show that pre-event and post-event rumination are effectively reduced through psychological treatment, and clinical implications for the enhancement of evidence-based treatment protocols are discussed.
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Affiliation(s)
| | - Matthew Modini
- School of Psychology, The University of Sydney, Australia; Concord Centre for Mental Health, Sydney Local Health District, Australia
| | - Maree J Abbott
- School of Psychology, The University of Sydney, Australia.
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Bell I, Arnold C, Gilbertson T, D'Alfonso S, Castagnini E, Chen N, Nicholas J, O'Sullivan S, Valentine L, Alvarez-Jimenez M. A Personalized, Transdiagnostic Smartphone Intervention (Mello) Targeting Repetitive Negative Thinking in Young People With Depression and Anxiety: Pilot Randomized Controlled Trial. J Med Internet Res 2023; 25:e47860. [PMID: 38090786 PMCID: PMC10753417 DOI: 10.2196/47860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/30/2023] [Accepted: 10/04/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Repetitive negative thinking (RNT) is a key transdiagnostic mechanism underpinning depression and anxiety. Using "just-in-time adaptive interventions" via smartphones may disrupt RNT in real time, providing targeted and personalized intervention. OBJECTIVE This pilot randomized controlled trial evaluates the feasibility, acceptability, and preliminary clinical outcomes and mechanisms of Mello-a fully automated, personalized, transdiagnostic, and mechanistic smartphone intervention targeting RNT in young people with depression and anxiety. METHODS Participants with heightened depression, anxiety, and RNT were recruited via social media and randomized to receive Mello or a nonactive control over a 6-week intervention period. Assessments were completed via Zoom sessions at baseline and at 3 and 6 weeks after baseline. RESULTS The findings supported feasibility and acceptability, with high rates of recruitment (N=55), uptake (55/64, 86% of eligible participants), and retention (52/55, 95% at 6 weeks). Engagement was high, with 90% (26/29) and 59% (17/29) of the participants in the Mello condition still using the app during the third and sixth weeks, respectively. Greater reductions in depression (Cohen d=0.50), anxiety (Cohen d=0.61), and RNT (Cohen d=0.87) were observed for Mello users versus controls. Mediation analyses suggested that changes in depression and anxiety were accounted for by changes in RNT. CONCLUSIONS The results indicate that mechanistic, targeted, and real-time technology-based solutions may provide scalable and effective interventions that advance the treatment of youth mental ill health. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry ACTRN12621001701819; http://tinyurl.com/4d3jfj9f.
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Affiliation(s)
- Imogen Bell
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Chelsea Arnold
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Tamsyn Gilbertson
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Simon D'Alfonso
- Orygen, Melbourne, Australia
- School of Computing and Information Systems, University of Melbourne, Melbourne, Australia
| | - Emily Castagnini
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Nicola Chen
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Jennifer Nicholas
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Shaunagh O'Sullivan
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Lee Valentine
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia
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Tichenor SE, Gerwin KL, Walsh B. Repetitive Negative Thinking in Adolescents Who Stutter. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023; 66:3290-3306. [PMID: 37494925 PMCID: PMC10558142 DOI: 10.1044/2023_jslhr-23-00147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 05/08/2023] [Accepted: 05/10/2023] [Indexed: 07/28/2023]
Abstract
PURPOSE Repetitive negative thinking (RNT) is the process of engaging in negatively valenced and habitual thought patterns. RNT is strongly associated with mental health conditions and often affects quality of life. This study explored RNT in older school-age children and adolescents who stutter to quantify the relationship between RNT and self-reported anxiety characteristics. An additional aim was to describe how individual differences in an adolescent's goal when speaking influences the frequency they engage in RNT. METHOD Ninety-nine children and adolescents who stutter aged 9-18 years completed a measurement of the frequency/severity of RNT, a screener of anxiety characteristics, and a measure of adverse impact related to stuttering. Children aged 10 years and above also answered questions about their goal when speaking. RESULTS Individual differences in RNT significantly predicted Overall Assessment of the Speaker's Experience of Stuttering (OASES) Total Scores more so than a child or adolescent's age. Higher generalized or social anxiety scores were significantly correlated with more frequent RNT and higher OASES Total Scores. Individual differences in goal when speaking (i.e., whether or not to stutter openly) were found to predict RNT. Finally, 22 children and adolescents (22.2%) also screened positive for generalized anxiety disorder and 32 (32.3%) screened positive for social anxiety disorder. DISCUSSION These data provide strong evidence that (a) many children and adolescents who stutter engage in RNT; (b) children and adolescents who engage more frequently in RNT or who have higher OASES Total Scores may be at increased risk for more characteristics of generalized or social anxiety; and (c) individual differences in goal when speaking can predict the degree to which an adolescent engages in RNT. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.23713296.
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Abdoli N, Sadeghi-Bahmani D, Salari N, Khodamoradi M, Farnia V, Jahangiri S, Brühl AB, Dürsteler KM, Stanga Z, Brand S. Nomophobia (No Mobile Phone Phobia) and Psychological Health Issues among Young Adult Students. Eur J Investig Health Psychol Educ 2023; 13:1762-1775. [PMID: 37754467 PMCID: PMC10527744 DOI: 10.3390/ejihpe13090128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Smart phone use has become a part of people's everyday life. However, when the lack of using the smart phone to establish and maintain electronic communication is related to psychological distress, such a behavior may be considered a modern-age phobia, or nomophobia (no mobile phone phobia). The aims of the present study were to investigate among a sample of young adults the associations between scores for nomophobia and symptoms of depression, anxiety, stress, insomnia, and obsessive-compulsive disorders. METHODS A total of 537 students (mean age: 25.52 years; 42.3% females) participated in the study. They completed a booklet of self-rating questionnaires covering sociodemographic information and symptoms of nomophobia, depression, anxiety, stress, insomnia, and obsessive-compulsive disorders. RESULTS Higher scores for nomophobia were associated with higher scores for depression, anxiety, and stress, but not with scores for insomnia and obsessive-compulsive disorders. The regression model confirmed that symptoms of anxiety predicted nomophobia. CONCLUSIONS The present results support the assumption that nomophobia appears to be a mood disturbance related to stronger associations with symptoms of anxiety and, to a lesser extent, with symptoms of depression and stress. By contrast, nomophobia appeared to be unrelated to insomnia and symptoms of obsessive-compulsive disorders.
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Affiliation(s)
- Nasrin Abdoli
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran; (N.A.); (M.K.); (V.F.); (S.J.)
| | - Dena Sadeghi-Bahmani
- Department of Psychology, Stanford University, Stanford, CA 94305, USA;
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA 94305, USA
| | - Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran;
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran
| | - Mehdi Khodamoradi
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran; (N.A.); (M.K.); (V.F.); (S.J.)
| | - Vahid Farnia
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran; (N.A.); (M.K.); (V.F.); (S.J.)
| | - Somayeh Jahangiri
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran; (N.A.); (M.K.); (V.F.); (S.J.)
| | - Annette Beatrix Brühl
- Center for Affective, Stress and Sleep Disturbances, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland;
| | - Kenneth M. Dürsteler
- Division of Substance Use Disorders, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland;
- Department for Psychiatry, Psychotherapy and Psychosomatic, Psychiatric Hospital, University of Zurich, 8001 Zurich, Switzerland
| | - Zeno Stanga
- Centre of Competence for Military and Disaster Medicine, Swiss Armed Forces, 3008 Bern, Switzerland;
| | - Serge Brand
- Substance Abuse Prevention Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah 6719851115, Iran; (N.A.); (M.K.); (V.F.); (S.J.)
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA 94305, USA
- Center for Affective, Stress and Sleep Disturbances, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland;
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise, and Health, Faculty of Medicine, University of Basel, 4052 Basel, Switzerland
- School of Medicine, Tehran University of Medical Sciences, Teheran 1417466191, Iran
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland
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