Internet-Based Intervention for Rumination and Worry in Adults

Rumination, a pattern of repetitive and intrusive thoughts, is closely linked to anxiety and depression. Rumination can intensify these mental health disorders by amplifying negative emotions, eroding problem-solving abilities, and perpetuating a cycle of distress. Repetitive negative thinking (RNT) in the form of rumination and worry plays a significant role in the development and persistence of depression and anxiety disorders. It keeps individuals stuck in a loop of self-criticism and overthinking, making it challenging to break free from the grip of anxiety and depression. Effective interventions often target rumination to interrupt this cycle and promote healthier thought patterns, improving mental well-being.

Clinical Trial

A randomized controlled clinical trial assessed the effectiveness of an internet-based intervention designed to target rumination and worry in adults. The study also examined whether the intervention yielded better results when delivered with or without guidance from a clinician.

A total of 137 adults with elevated levels of RNT were included in the trial. They were divided into three groups: a clinician-guided online program (with three lessons), a self-help online program (also with three lessons), and a treatment-as-usual (TAU) control group. The online programs were completed over six weeks, while the TAU group had to wait 18 weeks before receiving the program. In the clinician-guided group, participants received semi-structured phone support after each lesson. All participants continued their pre-trial treatment as usual. The study measured RNT, anxiety, depression, and psychological distress at three points: baseline, post-treatment (week 7), and a 3-month follow-up.

Results

Both the self-help and clinician-guided groups demonstrated significant reductions in RNT, anxiety, depression, and distress compared to the TAU group at both the post-treatment and 3-month follow-up assessments. However, the effect size was notably more significant in the clinician-guided group, suggesting that having clinician guidance enhanced the effectiveness of the intervention.

Interestingly, there were no significant differences in program completion or participant satisfaction between the clinician-guided and self-help groups. Both groups showed high rates of program completion (76% and 79%, respectively) and similar levels of treatment satisfaction.

The time spent on clinician guidance was moderate, with an average of approximately 48.64 minutes.

Conclusion

This study highlights the effectiveness of a brief online intervention for RNT in reducing symptoms of anxiety, depression, and distress. Both clinician-guided and self-help formats proved beneficial, but the guided approach yielded more significant treatment effects. Further research through more extensive definitive trials comparing guided and self-guided programs is warranted to understand these interventions' potential better. This study provides valuable insights into addressing RNT and its impact on mental health, offering hope for individuals seeking relief from anxiety and depression.
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