Krzikalla Clara, Buhlmann Ulrike, Schug Janina, Kopei Ina, Gerlach Alexander L, Doebler Philipp, Morina Nexhmedin, Andor Tanja
Institute of Psychology, University of Münster, Münster, Germany.
Department of Psychology, Institute of Clinical Psychology and Psychotherapy, University of Cologne, Cologne, Germany.
Clin Psychol Eur. 2024 Jun 28;6(2):e12741. doi: 10.32872/cpe.12741. eCollection 2024 Jun.
Pathological worry is associated with appraisals of worrying as uncontrollable. Worry postponement (WP) with a stimulus control rationale appears to be effective in non-clinical samples. However, preliminary research in participants with generalized anxiety disorder (GAD) does not support its efficacy in reducing negative metacognitions or worry. The aim of this study was to investigate the efficacy of WP with a metacognitive rationale.
Participants with GAD (n = 47) or hypochondriasis (HYP; n = 35) were randomly assigned to either an intervention group (IG) or waitlist (WL). The IG received a two-session long WP intervention aiming at mainly reducing negative metacognitions concerning uncontrollability of worrying. Participants were instructed to postpone their worry process to a predetermined later time during the six days between the two sessions. Participants completed questionnaires of negative metacognitions and worry at pre-assessment, post-assessment, and follow-up.
We observed a significant Time*Group interaction for negative metacognitions and worry. Post-hoc analyses on the total sample and separately for GAD and HYP revealed significantly lower worry scores in the treated GAD sample compared to the WL, representing the only significant effect. In the GAD group, pre-post-effect sizes were small for negative metacognitions and large for worry. Effects persisted to a four-week follow-up.
WP with a metacognitive rationale seems to be effective in reducing worry in participants with GAD. The effectiveness for HYP seems limited, possibly due to the small sample size.
病理性担忧与将担忧评价为无法控制有关。基于刺激控制原理的担忧推迟（WP）在非临床样本中似乎是有效的。然而，对广泛性焦虑症（GAD）患者的初步研究并不支持其在减少消极元认知或担忧方面的疗效。本研究的目的是探讨基于元认知原理的WP的疗效。
将GAD患者（n = 47）或疑病症（HYP；n = 35）随机分为干预组（IG）或等待名单组（WL）。IG接受为期两阶段的WP干预，主要目的是减少关于担忧无法控制的消极元认知。在两个阶段之间的六天里，参与者被指示将他们的担忧过程推迟到预先确定的稍后时间。参与者在预评估、后评估和随访时完成消极元认知和担忧的问卷调查。
我们观察到消极元认知和担忧存在显著的时间*组交互作用。对总样本以及分别对GAD和HYP进行的事后分析显示，与WL相比，接受治疗的GAD样本中的担忧得分显著更低，这是唯一的显著效应。在GAD组中，消极元认知的前后效应量较小，而担忧的效应量较大。效应持续到四周的随访。
基于元认知原理的WP似乎对减少GAD患者的担忧有效。对HYP的有效性似乎有限，可能是由于样本量较小。
