Orygen, Melbourne, Australia.
Centre for Youth Mental Health, University of Melbourne, Melbourne, Australia.
Psychol Med. 2023 Jan;53(1):6-16. doi: 10.1017/S0033291722003373. Epub 2022 Nov 14.
Depression and anxiety are prevalent in youth populations and typically emerge during adolescence. Repetitive negative thinking (RNT) is a putative transdiagnostic mechanism with consistent associations with depression and anxiety. Targeting transdiagnostic processes like RNT for youth depression and anxiety may offer more targeted, personalised and effective treatment.
A meta-analysis was conducted to examine the effect of psychological treatments on RNT, depression and anxiety symptoms in young people with depression or anxiety, and a meta-regression to examine relationships between outcomes.
Twenty-eight randomised controlled trials examining 17 different psychological interventions were included. Effect sizes were small to moderate across all outcomes (Hedge's g depression = -0.47, CI -0.77 to -0.17; anxiety = -0.42, CI -0.65 to -0.20; RNT = -0.45, CI -0.67 to -0.23). RNT-focused and non-RNT focused approaches had comparable effects; however, those focusing on modifying the process of RNT had significantly larger effects on RNT than those focusing on modifying negative thought content. Meta-regression revealed a significant relationship between RNT and depression outcomes only across all intervention types and with both depression and anxiety for RNT focused interventions only.
Consistent with findings in adults, this review provides evidence that reducing RNT with psychological treatment is associated with improvements in depression and anxiety in youth. Targeting RNT specifically may not lead to better outcomes compared to general approaches; however, focusing on modifying the process of RNT may be more effective than targeting content. Further research is needed to determine causal pathways.
抑郁和焦虑在青年人群中很普遍，通常在青少年时期出现。重复消极思维（RNT）是一种假定的跨诊断机制，与抑郁和焦虑有一致的关联。针对青少年抑郁和焦虑的 RNT 等跨诊断过程可能提供更有针对性、个性化和有效的治疗方法。
进行了一项荟萃分析，以检查心理治疗对患有抑郁或焦虑的年轻人的 RNT、抑郁和焦虑症状的影响，并进行了元回归分析以检查结果之间的关系。
共纳入了 28 项随机对照试验，研究了 17 种不同的心理干预措施。所有结果的效应大小均为小至中等（抑郁的 Hedge's g = -0.47，CI -0.77 至 -0.17；焦虑 = -0.42，CI -0.65 至 -0.20；RNT = -0.45，CI -0.67 至 -0.23）。RNT 为重点和非 RNT 为重点的方法具有可比的效果；然而，那些专注于修改 RNT 过程的方法对 RNT 的效果明显大于那些专注于修改消极思维内容的方法。元回归显示，仅在所有干预类型中，RNT 与抑郁结果之间存在显著关系，而仅在 RNT 为重点的干预措施中，RNT 与抑郁和焦虑均存在显著关系。
与成人研究结果一致，本综述提供了证据表明，通过心理治疗减少 RNT 与青少年抑郁和焦虑的改善有关。与一般方法相比，专门针对 RNT 可能不会导致更好的结果；然而，专注于修改 RNT 过程可能比针对内容更有效。需要进一步研究以确定因果途径。
