Krahé Charlotte, Mathews Andrew, Whyte Jessica, Hirsch Colette R
Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
Department of Psychology, University of California, Davis, California, USA.
BMJ Open. 2016 Dec 16;6(12):e013404. doi: 10.1136/bmjopen-2016-013404.
Worry and rumination are two forms of repetitive thinking characterised by their negative content and apparently uncontrollable nature. Although worry and rumination share common features and have been conceptualised as part of a transdiagnostic repetitive negative thinking (RNT) process, it remains unclear whether they share the same underlying cognitive mechanisms. This multisession experimental study investigates the tendency to make negative interpretations regarding ambiguous information as a cognitive mechanism underlying RNT. We compare multisession cognitive bias modification for interpretations (CBM-I) with an active control condition to examine whether repeatedly training positive interpretations reduces worry and rumination in individuals with generalised anxiety disorder or depression, respectively. Further, we examine the potential modulatory effects of engaging in RNT immediately prior to CBM-I.
DESIGN, METHODS AND ANALYSIS: A community sample of individuals meeting diagnostic criteria for either generalised anxiety disorder (n=60) or current major depressive episode (n=60) will be randomly allocated to CBM-I with prior RNT, CBM-I without prior RNT (ie, standard CBM-I), or an active control (no resolution of ambiguity) condition. All conditions receive a 3-week internet-based intervention consisting of one initial session at the first study visit and nine home-based sessions of CBM-I training (or active control). We will assess and compare the effects of CBM-I with and without prior RNT on 'near-transfer' measures of interpretation bias closely related to the training as well as 'far-transfer' outcomes related to RNT and emotional distress. Impact on questionnaire measures will additionally be assessed at 1-month follow-up. Multigroup analyses will be conducted to assess the impact of CBM-I on near-transfer and far-transfer outcome measures.
担忧和沉思是重复思维的两种形式，其特点是内容消极且明显具有无法控制的性质。尽管担忧和沉思有共同特征，并且已被概念化为跨诊断重复消极思维（RNT）过程的一部分，但它们是否具有相同的潜在认知机制仍不清楚。这项多阶段实验研究调查了对模糊信息做出消极解释的倾向，将其作为RNT的一种潜在认知机制。我们将对解释的多阶段认知偏差修正（CBM-I）与积极对照条件进行比较，以检验反复训练积极解释是否分别减少广泛性焦虑症或抑郁症患者的担忧和沉思。此外，我们还将研究在进行CBM-I之前立即进行RNT的潜在调节作用。
设计、方法与分析：一个符合广泛性焦虑症诊断标准（n = 60）或当前重度抑郁发作诊断标准（n = 60）的社区样本将被随机分配到先进行RNT的CBM-I组、不进行先验RNT 的CBM-I组（即标准CBM-I组）或积极对照（不解决模糊性）组。所有组都接受为期3周的基于互联网的干预，包括在首次研究访问时的一次初始会话和九次基于家庭的CBM-I训练会话（或积极对照）。我们将评估并比较有无先验RNT的CBM-I对与训练密切相关的解释偏差的“近迁移”测量指标以及与RNT和情绪困扰相关的“远迁移”结果的影响。在1个月的随访中还将评估对问卷测量指标的影响。将进行多组分析以评估CBM-I对近迁移和远迁移结果测量指标的影响。
