Objective: Repetitive negative thinking (RNT) e.g., worry in generalized anxiety disorder (GAD) and rumination in depression, is often targeted during psychological treatments. To test the hypothesis that negative interpretation bias contributes to worry and rumination, we assessed the effects of inducing more positive interpretations in reducing RNT. Method: Volunteers diagnosed with GAD (66) or Depression (65) were randomly allocated to one of two versions of Cognitive Bias Modification (CBM-I), either with or without RNT priming prior to training), or a control condition, each involving 10 internet-delivered sessions. Outcome measures of interpretation bias, a behavioral RNT task and self-reported worry, rumination, anxiety and depression were obtained at baseline, after home-based training and at 1-month follow up (self-report questionnaires only). Results: CBM-I training, across diagnostic groups, promoted a more positive interpretation bias and led to reductions in worry, rumination, and depressive symptoms, which were maintained at follow up. Anxiety symptoms were reduced only in the GAD group at follow up. There were no differences between CBM-I versions; brief priming of RNT did not influence CBM-I effectiveness. Level of interpretation bias post training partially mediated the effects of CBM-I on follow-up questionnaire scores. Conclusions: In contrast to some recent failures to demonstrate improvements following internet-delivered CBM, we found that self-reported RNT and negative mood were reduced by CBM-I. This is consistent with a causal role for negative interpretation bias in both worry and rumination, suggesting a useful role for CBM-I within treatments for anxiety and depression.
Repetitive negative thinking (RNT; e.g. worry and rumination) is common across emotional disorders, as is the tendency to generate negative interpretations (interpretation bias).Ameliorating negative interpretations via cognitive bias modification of interpretations (CBM-I) reduces worry/rumination, and improves mood in people diagnosed with GAD or Depression.We investigated whether these findings generalize to high worry or rumination populations, irrespective of diagnosis, and whether effects are increased by enhancing emotional engagement with training with active generation of positive resolutions of ambiguity and imagery. Method: Community volunteers with excessive worry and/or rumination who were above clinical cut-off on anxiety and/or depression measures, were allocated to an active control condition (N=54), interpretation training with prior activation of RNT (CBM_RNT; N=54), or training augmented with positive outcome generation and imagery (CBM_ENH; N=53). Interpretation bias, RNT, and mood were assessed before and following 10 internet-based sessions completed within a one-month period. RNT and mood questionnaires were also completed at 1-month follow-up. Results: After training, both forms of CBM-I (vs. control) facilitated more positive interpretations and reduced negative intrusions during a worry task. At one-month follow-up, anxiety, depression, RNT, and worry in the past week were lower in the CBM-I than control conditions, but not rumination or trait worry. Compared to standard CBM-I, the augmented form facilitated more positive interpretations, reduced negative intrusions after training, and reduced trait rumination at onemonth follow-up, but it did not augment effects on trait worry, anxiety or depression. Conclusions: Interpretation bias maintains transdiagnostic RNT and internet-based CBM-I can reduce longer-term RNT.
Worry and rumination, two forms of repetitive negative thinking (RNT), are prevalent in generalized anxiety disorder (GAD) and depression. Cognitive processing biases, especially the tendency to draw negative conclusions from ambiguous information (interpretation bias), may maintain worry and rumination. Yet the relationship between interpretation bias and both forms of RNT has not been explored in clinical versus nonclinical samples. In this cross-sectional study, participants with GAD ( n = 72), depression ( n = 79), or neither disorder ( n = 71) completed two tasks assessing interpretation bias, measures of worry and rumination, and reported negative thought intrusions during a behavioral task. Interpretation bias was associated with higher levels of worry, rumination, and negative thought intrusions. Both clinical groups generated significantly more negative interpretations than healthy comparison participants. These findings link interpretation bias to worry and rumination and establish the need for research investigating the causal role of interpretation bias in maintaining RNT.
Background: Autistic people have a high likelihood of developing mental health difficulties but a low chance of receiving effective mental health care. Therefore, there is a need to identify and examine strategies to improve mental health care for autistic people. Aims: To identify strategies that have been implemented to improve access, experiences of care and mental health outcomes for autistic adults and examine evidence on their acceptability, feasibility and effectiveness. Method: A co-produced systematic review was conducted. MEDLINE, PsycINFO, CINHAL, medRxiv and PsyArXiv were searched. We included all study designs reporting acceptability or feasibility outcomes and empirical quantitative study designs reporting effectiveness outcomes. Data were synthesised using a narrative approach. Results: A total of 29 articles were identified. These included 16 studies of adapted mental health interventions, seven studies of service improvements and six studies of bespoke mental health interventions developed for autistic people. There was no conclusive evidence on effectiveness. However, most bespoke and adapted approaches appeared to be feasible and acceptable. Identified adaptations appeared to be acceptable and feasible, including increasing knowledge and detection of autism, providing environmental adjustments and communication accommodations, accommodating individual differences, and modifying the structure and content of interventions. Conclusion: Many identified strategies are feasible and acceptable and can be readily implemented in services with the potential to make mental health care more suitable for autistic people, but important research gaps remain. Future research should address these and investigate a co-produced package of service improvement measures.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.