Mullarkey Michael, Dobias Mallory, Sung Jenna, Ahuvia Isaac, Shumake Jason, Beevers Christopher, Schleider Jessica
Department of Psychology, Stony Brook University, Stony Brook, NY, United States.
JMIR Ment Health. 2022 Apr 12;9(4):e33473. doi: 10.2196/33473.
Anxiety is rising across the United States during the COVID-19 pandemic, and social distancing mandates preclude in-person mental health care. Greater perceived control over anxiety has predicted decreased anxiety pathology, including adaptive responses to uncontrollable stressors. Evidence suggests that no-therapist, single-session interventions can strengthen perceived control over emotions like anxiety; similar programs, if designed for the COVID-19 context, could hold substantial public health value.
Our registered report evaluated a no-therapist, single-session, online intervention targeting perceived control over anxiety in the COVID-19 context against a placebo intervention encouraging handwashing. We tested whether the intervention could (1) decrease generalized anxiety and increase perceived control over anxiety and (2) achieve this without decreasing social-distancing intentions.
We tested these questions using a between-subjects design in a weighted-probability sample of US adults recruited via a closed online platform (ie, Prolific). All outcomes were indexed via online self-report questionnaires.
Of 522 randomized individuals, 500 (95.8%) completed the baseline survey and intervention. Intent-to-treat analyses using all randomized participants (N=522) found no support for therapeutic or iatrogenic effects; effects on generalized anxiety were d=-0.06 (95% CI -0.27 to 0.15; P=.48), effects on perceived control were d=0.04 (95% CI -0.08 to 0.16; P=.48), and effects on social-distancing intentions were d=-0.02 (95% CI -0.23 to 0.19; P=.83).
Strengths of this study included a large, nationally representative sample and adherence to open science practices. Implications for scalable interventions, including the challenge of targeting perceived control over anxiety, are discussed.
ClinicalTrials.gov NCT04459455; https://clinicaltrials.gov/show/NCT04459455.
在新冠疫情期间，美国民众的焦虑情绪不断上升，而社交距离规定使得面对面的心理健康护理无法进行。更高的焦虑感控制感已被证明可以减少焦虑症状，包括对无法控制的压力源的适应性反应。有证据表明，无需治疗师参与的单节干预措施可以增强对焦虑等情绪的控制感；如果针对新冠疫情背景设计类似项目，可能具有重大的公共卫生价值。
我们的预注册报告评估了一种无需治疗师参与的单节在线干预措施，该措施旨在增强新冠疫情背景下对焦虑的控制感，并与鼓励洗手的安慰剂干预措施进行对比。我们测试了该干预措施是否能够（1）降低广泛性焦虑并增强对焦虑的控制感，以及（2）在不降低社交距离意愿的情况下实现这一目标。
我们采用组间设计，在美国成年人的加权概率样本中测试这些问题，这些样本通过封闭的在线平台（即Prolific）招募。所有结果均通过在线自我报告问卷进行评估。
在522名随机分组的个体中，500名（95.8%）完成了基线调查和干预。使用所有随机参与者（N=522）进行的意向性分析未发现对治疗效果或医源性效果的支持；对广泛性焦虑的影响为d=-0.06（95%CI -0.27至0.15；P=0.48），对控制感的影响为d=0.04（95%CI -0.08至0.16；P=0.48），对社交距离意愿的影响为d=-0.02（95%CI -0.23至0.19；P=0.83）。
本研究的优势包括样本量大、具有全国代表性以及遵循开放科学实践。文中讨论了可扩展干预措施的意义，包括针对焦虑控制感的挑战。
ClinicalTrials.gov NCT04459455；https://clinicaltrials.gov/show/NCT04459455
