Abstract
Cognitive-Behavioural Therapy (CBT) is an evidence-based treatment for Generalized Anxiety Disorder (GAD). Worry postponement (WP), in which a client is asked to postpone worry until a 30-minute “worry time,” is a common component of CBT for GAD; however, the efficacy of WP has never been tested in people with GAD. Further, the mechanisms of change of WP are not known; nor are its effects on cognitive processes and symptoms related to GAD. A better understanding of the efficacy and mechanisms of change of WP could help to optimize CBT for GAD. The goals of the present study were to examine, in a sample of people with GAD, the effects of WP on worry and GAD symptoms, and cognitive processes and symptoms related to GAD. The study also examined the effects of WP on two proposed mediators: stimulus control and metacognitive beliefs. Sixty-seven adults were randomized to one of three conditions: 2- week worry postponement intervention (WP), 2-week worry monitoring intervention (MON), or an assessment only control. Participants completed outcome measures before and after the 2- week intervention period and at a 2-week follow-up. In the WP and MON conditions, participants completed daily worry monitoring using a phone-based application. All participants showed a significant decrease in past-week worry over the course of the study, with no significant differences between the conditions. There were no significant changes in GAD symptoms across conditions. There was no evidence that WP had superior effects to control groups on cognitive processes or symptoms related to GAD. There was no evidence that stimulus control or metacognitive beliefs mediated the reduction in past week worry in WP. This is the first known study to examine the effects of WP in people with GAD. Whereas worry did decrease on some indices over the course of the study, there were no significant differences between WP and two control conditions. Further this study found no evidence that WP has specific effects on two processes that are thought to be mechanisms of action. The findings of this study demonstrate the need to establish the efficacy of the treatment components used in CBT.
Highlights
No significant effects of time or condition were demonstrated on negative problem orientation, problem solving style, cognitive avoidance, or self-reported attentional control
On one behavioural measure of attentional control (RIG), one index showed a significant increase in scores over time, reflecting lower working memory capacity. This RIG trend was more pronounced in the WP condition on one index, and more pronounced in the MON condition on another
Change in worry frequency, operationalized as number of daily worry episodes recorded, was examined as an index of worry coming under stimulus control
Summary
This study is investigating the ways in which learning to recognize and track your worry patterns may affect your experience of worry and anxiety. The study includes you tracking your worry over a two week period using a smartphone application. You will either be given a Motorola Moto G Smartphone with the MovisensXS application installed to borrow for the duration of the study or have the MovisensXS application installed on your personal smartphone. You will be asked to carry the device with you for the duration of the study. We ask that you respond multiple times a day so that we are able to keep track how these things change, remain the same, or interact over time. You will be provided more specific details about the study when data collection is completed
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