Can an app designed to reduce repetitive negative thinking decrease depression and anxiety in young people? Results from a randomized controlled prevention trial

IF 1.7 4区 医学 Q3 PSYCHIATRY Journal of Behavior Therapy and Experimental Psychiatry Pub Date : 2025-01-15 DOI:10.1016/j.jbtep.2024.102014
Julia Funk , Johannes Kopf-Beck , Keisuke Takano , Edward Watkins , Thomas Ehring
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Abstract

Background and objectives

Rates of mental health disorders are rising among adolescents and young adults. Therefore, scalable methods for preventing psychopathology in these age groups are needed. As repetitive negative thinking (RNT) is a risk factor for depression and anxiety disorders, targeting RNT via smartphone app promises to be an effective, scalable strategy. The current three-arm, parallel group, randomized controlled trial tested whether a self-help app designed to reduce RNT decreased psychopathological symptoms and RNT in adolescents and young adults at risk for mental disorders.

Method

A sample of 16–22-year-olds with elevated levels of RNT (N = 365) were randomly allocated to either use a one of two self-help apps designed to reduce RNT for 6 weeks or to a waitlist. The full RNT-focused intervention app encompassed a variety of RNT-reducing strategies, whereas the concreteness training app focused on one of these strategies, namely, concrete thinking.

Results

The apps did not decrease depressive symptoms, anxiety symptoms and RNT relative to the waitlist. However, exploratory analyses using a minimum dose criterion showed that participants who used the full-RNT-focused intervention app more often, reported greater baseline to follow-up decreases in depressive symptoms compared to waitlist.

Limitations

Include decreased power due to slightly more dropout than expected and limited generalizability due to the mostly female and highly educated sample.

Conclusions

RNT-focused prevention via a self-help app did not decrease depression and anxiety, presumably due to too little engagement with the app content provided.
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一款旨在减少重复消极思维的应用程序能减少年轻人的抑郁和焦虑吗?结果来自一项随机对照预防试验。
背景和目的:青少年和青壮年中精神健康障碍的发病率正在上升。因此,需要可扩展的方法来预防这些年龄组的精神病理。由于重复性消极思维(RNT)是抑郁症和焦虑症的一个风险因素,通过智能手机应用程序瞄准RNT有望成为一种有效的、可扩展的策略。目前的三组平行随机对照试验测试了旨在减少RNT的自助应用程序是否可以减少精神障碍风险的青少年和年轻人的精神病理症状和RNT。方法:一组16-22岁的RNT水平升高的年轻人(N = 365)被随机分配使用两款旨在减少RNT的自助应用程序中的一款,持续6周,或者进入等待名单。完整的以rnt为重点的干预应用程序包含各种减少rnt的策略,而具体训练应用程序侧重于其中一种策略,即具体思维。结果:相对于等待列表,应用程序没有减少抑郁症状、焦虑症状和RNT。然而,使用最小剂量标准的探索性分析显示,与等候名单相比,更经常使用全rnt干预应用程序的参与者报告的抑郁症状基线到随访的减少幅度更大。局限性:由于退学人数略高于预期而导致的能力下降,以及由于大多数是女性和受过高等教育的样本而导致的泛化性有限。结论:通过自助应用程序以rnt为重点的预防并没有减少抑郁和焦虑,可能是由于对应用程序提供的内容的参与太少。
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来源期刊
CiteScore
3.60
自引率
5.60%
发文量
48
期刊介绍: The publication of the book Psychotherapy by Reciprocal Inhibition (1958) by the co-founding editor of this Journal, Joseph Wolpe, marked a major change in the understanding and treatment of mental disorders. The book used principles from empirical behavioral science to explain psychopathological phenomena and the resulting explanations were critically tested and used to derive effective treatments. The second half of the 20th century saw this rigorous scientific approach come to fruition. Experimental approaches to psychopathology, in particular those used to test conditioning theories and cognitive theories, have steadily expanded, and experimental analysis of processes characterising and maintaining mental disorders have become an established research area.
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