Short-Term Efficacy and Mechanisms of Change of a Worry Postponement Intervention for Generalized Anxiety Disorder
Condition: Generalized Anxiety Disorder
MeSH terms: Anxiety Disorders
Study type: Interventional

Summary: 
      Worry postponement is a commonly recommended treatment component in cognitive behavioral
      therapy for Generalized Anxiety Disorder in which people are asked to postpone naturally
      occurring instances of worry to a designated 30 minute "worry period" later in the day.
      Despite being commonly recommended, there is little known about the efficacy and mechanisms
      of worry postponement. The purpose of this study is to determine the efficacy and mechanisms
      of change of a two-week worry postponement intervention in people with Generalized Anxiety
      Disorder. Ninety subjects with generalized anxiety disorder will be randomly assigned to two
      weeks of daily worry postponement, two weeks of worry monitoring, or an assessment only
      control condition. Changes in worry or associated features will be examined at post
      intervention and at a 2-week follow up.
    

Detailed description: 
      Generalized Anxiety Disorder (GAD) is a disorder characterized by excessive and
      uncontrollable worry. People with GAD report that worry significantly interferes with their
      ability to enjoy their life and function effectively in their roles. Worry postponement is a
      treatment technique developed by Borkovec and colleagues (1983) to reduce excessive worry. In
      worry postponement, people are instructed to notice naturally occurring episodes of worry and
      to then disengage from their worry and postpone it to a designated 30 minute "worry period"
      later in the day. People are instructed to confine their worry to this 30 minute period and
      to use that period to problem solve concerns they have been having. Worry postponement is a
      widely recommended technique for treating excessive worry in people with GAD and is often
      combined with other cognitive-behavioural interventions. Despite being commonly recommended,
      there are very few studies demonstrating worry postponement's efficacy for reducing worry,
      and no studies have looked at the effect of this intervention in people with GAD. The present
      study aims to extend the literature by comparing a two-week worry postponement intervention
      to worry monitoring alone and to an assessment only control condition. Participants will
      complete baseline self-report measures of worry and associated symptoms and cognitive
      processes. They will complete three computer tasks measuring attention control. They will
      then be randomized to one of three conditions (worry postponement, worry monitoring,
      assessment only control). Participants will follow instructions corresponding to their
      condition daily for two weeks. In the worry postponement and worry monitoring conditions this
      will involve completing brief daily worry questionnaires at home for the two weeks of the
      intervention. In the assessment only condition participants will not complete any measures
      during the two weeks after the first session. Subsequent to this, all participants will
      return to the lab to repeat baseline measures, and will return again two weeks later to
      complete measures. The entire study will require three lab visits, spanning over four weeks.
      This study aims to determine what the effects of worry postponement are, relative to worry
      monitoring and assessment only, on worry, GAD and associated symptoms, and cognitive
      processes related to worry. A secondary aim of this study is to examine which mechanisms
      predict change in worry in a worry postponement study. This will be the first study to our
      knowledge, to examine these questions in a sample of people with GAD. This study will provide
      important information for optimizing the treatment of worry in people with GAD.
    

Intervention name(s): Worry Postponement; Worry Monitoring
Intervention type(s): Behavioral; Behavioral
Intervention description(s): In worry postponement, participants are instructed to learn to notice naturally occurring episodes of worry. When they notice they are worrying they are instructed to disengage from their worry and postpone it to a designated 30 minute "worry period" to be carried out at the same time and place daily during the two week intervention. Participants are to use their worry time to worry about problems that have come up during the day and to problem solve where appropriate.; For two weeks participants are instructed to monitor their worry using a smartphone based application. Participants are instructed to make a record each time they have a worry episode by briefly describing the content of their worry. Participants also complete two brief daily questionnaires about the duration of their worry, the intensity of their worry, their ability to disengage from their worry, and the occurrence of nighttime episodes of worry.
Other intervention name(s): Stimulus Control for Worry
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Participant)
Primary purpose: Treatment
Keywords: Worry Postponement; Stimulus Control