Hirsch Colette R, Krahé Charlotte, Whyte Jessica, Krzyzanowski Hannah, Meeten Frances, Norton Sam, Mathews Andrew
Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London.
J Consult Clin Psychol. 2021 Jul;89(7):575-589. doi: 10.1037/ccp0000660.
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. 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 ( = 115) or control ( = 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. The per-protocol analyses included = 186 participants (CBM = 94; control = 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 self-reported symptoms at T2 were all significantly lower in the CBM versus control condition. All but one effect (trait RNT) were sustained at T3. 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. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
广泛性焦虑障碍（GAD）是一种使人衰弱的病症，其特征是对模糊情境存在消极解读。本研究测试了完全通过网络进行的解读训练[认知偏差修正（CBM）]与对照组相比，是否能促进积极解读，并减轻患有或未患有抑郁症的广泛性焦虑障碍患者的担忧和焦虑。这是一项双臂（CBM；对照组）平行组随机对照实验。评估时间为干预前（T0）、干预后（T1）、干预后1个月（T2）和干预后3个月（T3）。患有广泛性焦虑障碍（伴有或不伴有共病性抑郁症）的参与者被随机分配到CBM组（n = 115）或对照组（n = 115）。参与者对分配的组别不知情，但研究人员知晓。参与者在1个月内完成多达10次在线CBM或对照训练。在T0和T1测量解读偏差[共同主要结局：乱序句子测试（SST）、识别测试（RT）]以及呼吸聚焦任务期间消极思维侵入的次数。在T0 - T3评估自我报告的担忧水平[宾夕法尼亚州立大学担忧问卷 - 特质版（PSWQ特质版）；宾夕法尼亚州立大学担忧问卷 - 过去一周版（PSWQ周版）]、焦虑[广泛性焦虑障碍量表（GAD - 7）]、抑郁[患者健康问卷（PHQ - 9）]、沉思[沉思反应量表（RRS）]和重复性消极思维[RNT；重复性思维问卷 - 特质版（RTQ - 特质版）]。符合方案分析纳入了186名参与者（CBM组n = 94；对照组n = 92）。如预期的那样，我们发现T1时对解读偏差这一主要结局有中度到较大的训练效果。CBM组与对照组相比，T1时消极思维侵入的次要结局以及T2时自我报告的症状均显著更低。除一项效应（特质RNT）外，所有效应在T3时均持续存在。在这项随机对照研究中，我们发现完全在线的解读训练在训练后长达3个月的时间里改善了患有或未患有共病性抑郁症的广泛性焦虑障碍患者的核心症状。（PsycInfo数据库记录（c）2021美国心理学会，保留所有权利）
