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. 2020;29(7):1982-1991.
doi: 10.1007/s10826-020-01711-7. Epub 2020 Apr 28.

Rumination-focused cognitive behavioral therapy decreases anxiety and increases behavioral activation among remitted adolescents

Claudia G Feldhaus  1 , Rachel H Jacobs  1 , Edward R Watkins  2 , Amy T Peters  1 , Katie Bessette  1 , Scott A Langenecker  1
Affiliations

Rumination-focused cognitive behavioral therapy decreases anxiety and increases behavioral activation among remitted adolescents

Claudia G Feldhaus et al. J Child Fam Stud. 2020.

Abstract

Objectives: Rumination involves a repetitive, passive focus on one's thoughts and feelings and has been hypothesized as a mechanism contributing to multiple psychopathologies. The current investigation explores secondary outcomes from a pilot study to examine whether rumination-focused cognitive behavior therapy (RFCBT) alleviates symptoms of anxiety, increases behavioral activation, or increases global functioning among adolescents with a history of Major Depressive Disorder (MDD).

Methods: Thirty-three adolescents were randomized to receive either RFCBT (n = 17) or assessment only (AO; n = 16) over the course of eight weeks. Mixed effects regression models were used to conduct intent-to-treat (ITT) analyses.

Results: The quadratic interaction for group-by-time-by-time was significant for anxiety. Adolescents in the RFCBT group experienced a significant decrease in anxiety across the first six weeks of intervention (F = 7.01, df = 108.49, p = .009). The group-by-time interaction was significant for the behavioral activation outcome (F = 4.28, df = 25.60, p = .049) with youth randomized to RFCBT demonstrating increasing activation compared to AO. Global functioning did not significantly differ between groups (F = .40, df = 1, p > .05).

Conclusions: Preliminary evidence suggests that RFCBT may hold promise as an intervention that alleviates both depressive and anxiety symptoms when comorbid.

Keywords: adolescence; anxiety; major depressive disorder; rumination; treatment.

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Conflict of interest statement

The authors report no conflicts of interest.

Figures

Figure 1.
Figure 1.
CONSORT.
Figure 2.
Figure 2.
Mixed-Effects Regression Models: Predicted scores for anxiety symptoms among intent-to-treat sample across eight weeks Note. MASC = Multidimensional Anxiety Scale for Children
Figure 3.
Figure 3.
Mixed-Effects Regression Models: Predicted scores for behavioral activation among intent-to-treat sample Note. BADS-A = Behavior Activation Depression Scale – Adolescent
Figure 4.
Figure 4.
Change in global functioning across 8 weeks among completers sample Note. CGAS = Global Assessment Scale for Children
See this image and copyright information in PMC

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