TAP reading note: Health effects of psychological interventions for worry and rumination: A meta-analysis

What the study found

Across 36 randomized trials (5,098 participants), psychological interventions reduced overall perseverative cognition (g=−0.42), worry (−0.41) and rumination (−0.58); the pooled health-behaviour effect was 0.31. The association between cognition and health-behaviour effect sizes became significant only after removing an influential study; no significant association emerged with physical-health effect sizes. No intervention type clearly outperformed the others for perseverative cognition.

Scope & limitations

36 randomized trials, including three cluster trials, mostly in adults but also schoolchildren, two generalized-anxiety samples and four samples with sleep disturbance. This is not one clinical population.

Most cognition and health outcomes were self-reported; risk of bias was generally unclear or high and effects were heterogeneous. Study-level associations do not establish individual mediation or prevention of chronic disease. For physical health, the accepted manuscript reports g=0.23 with a 95% CI of 0.15–0.31 but calls the effect nonsignificant in its results and discussion. This internal numerical/textual inconsistency remains unresolved; significance is not asserted here.

Population & sample

36 RCTs, 5,098 participants; 31 adult studies and five studies of schoolchildren. Mean female representation was about 70.4%.

Exposure or intervention

Non-pharmacological psychological interventions versus controls, including cognitive behavioural/acceptance and commitment therapies, action planning, mindfulness/relaxation and psychological detachment. The synthesis does not establish a universal ranking.

Outcomes

Overall cognition g=−0.42 (95% CI −0.51 to −0.33); worry −0.41 (−0.51 to −0.30); rumination −0.58 (−0.84 to −0.32); health behaviours 0.31 (0.21–0.42), with sleep-related measures prominent. See the limitation for the physical-health reporting discrepancy.

Time frame

Original search ended 23 November 2019. Cognition, physical-health and health-behaviour measurements occurred at different times, on average about 49, 99 and 143 days after first intervention exposure. These are not universal times to benefit.

Research funding

The lead author’s PhD was funded by the UK Economic and Social Research Council (ESRC). The paper also states that the research received no specific grant from public, commercial or not-for-profit funding agencies; no grant number is given.

Research conflicts of interest

The authors declare no conflict of interest.

Reading scope

Read the 74-page accepted manuscript deposited in White Rose: methods, main results, discussion, disclosures and appended supplementary analyses; compared its bibliographic details and abstract with the published record. This is an accepted manuscript, not the publisher-formatted version. The physical-health reporting discrepancy remains unresolved. Original review registration: CRD42019119381.

• White Rose accepted manuscript and version record ↗
• APA supplementary materials ↗
• PubMed record ↗

References

1. Dane McCarrick, Andrew Prestwich, Arianna Prudenzi, Daryl B. O’Connor (2021). Health effects of psychological interventions for worry and rumination: A meta-analysis. Health Psychology. https://doi.org/10.1037/hea0000985

Publication record

TAP-RDN-0074 · v1.0 · English

Author: TAP Editorial Team ·

The Allostasis Project is founded and supported by Resilio.

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