Many individuals with emotional disorders such as anxiety and depression experience repetitive negative thinking (RNT), defined as recurrent, difficult-to-control negative thoughts. RNT is a transdiagnostic process that occurs across most emotional disorders and contributes to their onset and maintenance. To date, little is known about what specific treatment skills most effectively reduce RNT.
The current study uses single-case experimental design to evaluate the relative effectiveness of two brief cognitive skills at reducing RNT: restructuring and defusion. Restructuring and defusion have been found equally effective at reducing the frequency of certain types of negative thoughts; however, existing group-based research designs potentially obscure important individual differences in their effectiveness. Furthermore, these skills have not been studied as treatments for RNT.
Patients (N = 8) were recruited from a community outpatient clinic waitlist. All met criteria for at least one emotional disorder and reported elevated RNT. They completed four sessions of each treatment skill in a counterbalanced order after a two- or four-week assessment-only period. During the assessment period, they completed ecological momentary assessment (EMA) surveys capturing moment-to-moment changes in RNT, negative affect, and positive affect.
It was hypothesized that restructuring and defusion would both reduce RNT, that they would each be associated with change on a specific corresponding mechanism, and that changes in RNT would precede changes in depression and anxiety symptoms. On average, restructuring and defusion were associated with a similar reduction in RNT, although there were clear differences in skill effectiveness across patients. Furthermore, there were individual differences in whether each skill was associated with change in the corresponding mechanism, suggesting that there may be some overlap in how these skills work. Additionally, although changes in RNT and symptoms were significantly correlated in the majority of the sample, changes in RNT did not temporally precede changes in symptoms for most patients. EMA results highlighted individual differences in associations between RNT, positive affect, and negative affect both within and across time points. Overall, this study points to the importance of idiographic research in extending our understanding of RNT and its treatment.
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/49363 |
| Date | 01 October 2024 |
| Creators | Curreri, Andrew James |
| Contributors | Farchione, Todd |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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