A brief ecological momentary intervention for generalized anxiety disorder: A randomized controlled trial of the worry outcome monitoring app

AbstractBackgroundInvestigating specific component interventions for generalized anxiety disorder (GAD) has produced encouraging, yet understudied findings. In a prior study worry outcome monitoring strategies led to declines in worry in individuals diagnosed with GAD (LaFreniere & Newman, 2016). The current study extended these findings tracking additional information and by examining additional outcomes within a larger clinical sample.MethodWe compared the efficacy of a smartphone worry outcome monitoring app (WOM) against a thought recording (TR) active control. Participants were prompted 4x/day as well as at the end of each day for 10-days to engage with their respective tasks. As opposed to WOM, TR individuals were only prompted to record their thoughts without observing the outcomes or challenging the maladaptive nature of their worries. A total of 117 participants with GAD were randomly assigned to either WOM or TR. Participants completed self-report questionnaires at pre-treatment, mid-treatment, post-treatment, and 20-day follow-up. Multilevel modeling analyses were used.ResultsThere was no difference between WOM (vs. TR) on expectancy, credibility, or treatment satisfaction. WOM (vs. TR control) produced substantially larger reductions in worry, positive beliefs about worry, and contrast avoidance. Moreover, 89.14% of feared worry outcomes did not come true and in the 10.86% of time when feared outcomes came true, WOM participants coped better than expected 84.35% of the time.ConclusionFindings advance understanding of the efficacy of technology-delivered, worry outcome monitoring in a clinical sample.