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- Wahlund, Tove, et al.
(författare)
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Therapist-guided online metacognitive intervention for excessive worry : a randomized controlled trial with mediation analysis
- 2022
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Ingår i: Cognitive Behaviour Therapy. - : Informa UK Limited. - 1651-2316 .- 1650-6073. ; 51:1, s. 21-41
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Tidskriftsartikel (refereegranskat)abstract
- Previous studies have found an association between excessive worrying and negative beliefs about worry. It is unclear if change in these beliefs mediate worry reduction. This study aimed to examine (1) if a simplified online metacognitive intervention can reduce worry, (2) whether changes in negative beliefs about worry mediate changes in worry severity, and (3) moderated mediation, i.e., if the mediating effect is more pronounced in individuals with a high degree of negative beliefs about worry at baseline. Adult excessive worriers (N = 108) were randomized to 10-weeks of the online metacognitive intervention (MCI) aimed at reducing negative beliefs about worry, or to wait-list (WL). Outcomes, mediation, and moderated mediation were examined via growth curve modelling. Results indicated a significant reduction in the MCI group (d = 1.6). Reductions in negative beliefs about worry and depressive symptoms separately mediated changes in worry severity during the intervention, but in a multivariate test only the former remained significant. Sensitivity analysis indicated that the hypothesized mediation was robust to possible violations of mediator-outcome confounding. The moderated mediation hypothesis was not supported. The results from this randomized trial add to the growing literature suggesting that negative beliefs about worry play a key role in worry-related problems. ClinicalTrials.gov Identifier: NCT03393156.
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| 2. |
- Lalouni, Maria, et al.
(författare)
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Parental responses and catastrophizing in online cognitive behavioral therapy for pediatric functional abdominal pain : A mediation analysis of a randomized controlled trial
- 2022
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Ingår i: Frontiers in Pain Research. - : Frontiers Media SA. - 2673-561X. ; 3
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To test if decreased parental protective behaviors, monitoring behaviors, and parental catastrophizing mediate relief of gastrointestinal symptoms in children 8–12 years with functional abdominal pain disorders(FAPDs). The study uses secondary data analyses of a randomized controlled trial in which exposure-based online cognitive behavioral therapy (ICBT) was found superior to treatment as usual in decreasing gastrointestinal symptoms.Methods: The ICBT included 10 weekly modules for children and 10 weekly modules for parents. Treatment as usual consisted of any medication, dietary adjustments, and healthcare visits that the participants engaged in during 10 weeks. All measures were self-assessed online by parents. Biweekly assessments of the Adult Responses to Children’s Symptoms (ARCS), Protectand Monitor subscales, and the Pain Catastrophizing Scale, parental version (PCS-P) were included in univariate and multivariate growth models to test their mediating effect on the child’s gastrointestinal symptoms assessed withthe Pediatric Quality of Life Gastrointestinal Symptoms Scale (PedsQL).Results: A total of 90 dyads of children with FAPDs and their parents were includedin the study, of which 46 were randomized to ICBT and 44 to treatment as usual. The PCS-P was found to mediate change in the PedsQL ab = 0.639 (95% CI0.020–2.331), while the ARCS Monitor ab = 0.472 (95% CI −1.002 to 2.547), and Protect ab= −0.151 (95% CI −1.455 to 0.674) were not mediators of change.Conclusions: To target parental catastrophizing in ICBT for pediatric FAPDs is potentially important to reduce abdominal symptoms in children.
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