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J Behav Ther Exp Psychiatry. 2018 Dec;61:72-79. doi: 10.1016/j.jbtep.2018.06.009. Epub 2018 Jun 25.

Banning pre-event rumination in social anxiety: A preliminary randomized trial.

Author information

1
Clinical Psychology Unit, School of Psychology, The University of Sydney, 88 Mallet St, Building F, MO2F, NSW, 2050, Australia.
2
Clinical Psychology Unit, School of Psychology, The University of Sydney, 88 Mallet St, Building F, MO2F, NSW, 2050, Australia. Electronic address: maree.abbott@sydney.edu.au.

Abstract

BACKGROUND AND OBJECTIVES:

Pre-event rumination has a clear role in maintaining social anxiety according to cognitive models. However, it is unclear what specific strategies can address pre-event rumination for individuals diagnosed with SAD. The current study aimed to determine the effectiveness of a brief intervention on multiple aspects of pre-event rumination, state anxiety and performance and threat appraisals. Additionally, the trajectory of pre-event rumination was investigated over four days.

METHODS:

Participants with SAD were informed they would be required to complete a speech task in four days' time and were randomised to an intervention (n = 27) or a non-active control group (n = 25). The intervention group were instructed to "ban" pre-event rumination using a metacognitive therapy technique known as detached mindfulness. All participants completed daily measures of pre-evet rumination that assessed frequency, uncontrollability, engagement and distress associated with pre-event rumination. On the day of the speech task, participants also completed state and cognitive measures before delivering the speech task.

RESULTS:

The intervention group reported reduced frequency, uncontrollability and distress associated with pre-event rumination, compared to the control group. There was no difference between groups for performance and threat appraisals as well as state anxiety. Rumination is a stable and robust process, with an increase in frequency and associated distress 24 hours before a feared social situation.

LIMITATIONS:

The lack of an active control group precludes comparisons to more traditional cognitive-behavioural therapy strategies for pre-event rumination.

CONCLUSIONS:

Pre-event rumination is a durable process but banning pre-event rumination using metacognitive therapy techniques shows promise for specifically addressing this maladaptive process.

KEYWORDS:

Pre-event rumination; Social anxiety; State anxiety; Treatment

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