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Targeting excessive worry with internet-based extinction therapy: a randomised controlled trial with mediation
Erik Andersson1, Brjánn Ljótsson1, Maria Hedman-Lagerlöf1
1Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Stockholm, Sweden.
Psychological Medicine
|April 29, 2020
Summary
Internet-based extinction therapy (IbET) significantly reduced excessive worry compared to an active control. This online intervention shows promise for treating worry and is cost-effective.
Area of Science:
- Psychology
- Clinical Psychology
- Behavioral Science
Background:
- Excessive worry is a prevalent mental health concern.
- Internet-based extinction therapy (IbET) was previously developed for excessive worry.
- This study aimed to compare IbET against an active control (CTRL).
Purpose of the Study:
- To evaluate the efficacy of IbET compared to an active control (CTRL) for excessive worry.
- To assess the cost-effectiveness of IbET.
- To explore mediation and moderation of IbET's effects.
Main Methods:
- A 10-week, parallel-group, participant-blind randomized controlled trial.
- 311 self-referred adults with excessive worry were randomized to IbET, CTRL, or waiting-list.
- Primary outcome was change in worry (Penn State Worry Questionnaire) from baseline to 10 weeks.
Main Results:
- IbET demonstrated significantly greater reductions in worry compared to CTRL (–3.6 points).
- A higher proportion of participants responded to IbET versus CTRL (63% vs. 51%).
- IbET was found to be 99% likely to be cost-effective compared to CTRL.
Conclusions:
- Internet-based extinction therapy (IbET) is more effective than an active comparator for treating excessive worry.
- The observed effects of IbET were mediated by reduced thought suppression.
- Further research in real-world settings is recommended.
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