Efficacy of a brief online intervention in reducing excessive worry and improving daily functioning: A randomized trial with mediation analysis

Excessive worry is common among treatment-seeking individuals in primary care and has a negative impact on daily functioning, which may also lead to other mental health problems. The current study tested whether a worry-focused online intervention – provided in both a guided and an unguided format –...

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Main Authors: Tove Wahlund, Fredrik Spångberg, Viktor Vadenmark, Erik Andersson
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Internet Interventions
Online Access:http://www.sciencedirect.com/science/article/pii/S2214782925000430
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author Tove Wahlund
Fredrik Spångberg
Viktor Vadenmark
Erik Andersson
author_facet Tove Wahlund
Fredrik Spångberg
Viktor Vadenmark
Erik Andersson
author_sort Tove Wahlund
collection DOAJ
description Excessive worry is common among treatment-seeking individuals in primary care and has a negative impact on daily functioning, which may also lead to other mental health problems. The current study tested whether a worry-focused online intervention – provided in both a guided and an unguided format – was efficacious in reducing worry-related symptoms and if these effects were specifically linked to improvements in daily functioning. A total of 82 participants were randomized to intervention with therapist support (guided; n = 28), intervention without therapist support (unguided; n = 27) or to waiting list (n = 27). Results showed that the online intervention was more effective than waiting list in reducing worry at week 5 (between-group d = 0.96). The intervention was effective against waiting list irrespective of whether it was provided in a guided (between-group d = 0.90) or unguided format (between-group d = 1.07) with sustained results at the 7-week follow-up. Reduction in worry mediated improvement in daily functioning (between-group d = 0.58; indirect effect estimate = −1.06 [95 % CI: −1.76 to −0.51], 66 % mediated effect). The mediation effects were fairly robust to mediator-outcome confounding, with residual correlation values set to r = 0.3 in a sensitivity analysis. The results provide further evidence that it is beneficial to provide a low-threshold, easy access intervention to patients with excessive worry, irrespective of primary diagnosis. Clinical implications are discussed.
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spelling doaj-art-85d0cf4680d341e08f42d3d5390a318f2025-08-26T04:14:17ZengElsevierInternet Interventions2214-78292025-09-014110084210.1016/j.invent.2025.100842Efficacy of a brief online intervention in reducing excessive worry and improving daily functioning: A randomized trial with mediation analysisTove Wahlund0Fredrik Spångberg1Viktor Vadenmark2Erik Andersson3Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenDivision of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenDivision of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenCorresponding author at: Department of Clinical Neuroscience, Division of Psychology, Karolinska Institutet, Nobels väg 9, 171 65 Solna, Sweden.; Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, SwedenExcessive worry is common among treatment-seeking individuals in primary care and has a negative impact on daily functioning, which may also lead to other mental health problems. The current study tested whether a worry-focused online intervention – provided in both a guided and an unguided format – was efficacious in reducing worry-related symptoms and if these effects were specifically linked to improvements in daily functioning. A total of 82 participants were randomized to intervention with therapist support (guided; n = 28), intervention without therapist support (unguided; n = 27) or to waiting list (n = 27). Results showed that the online intervention was more effective than waiting list in reducing worry at week 5 (between-group d = 0.96). The intervention was effective against waiting list irrespective of whether it was provided in a guided (between-group d = 0.90) or unguided format (between-group d = 1.07) with sustained results at the 7-week follow-up. Reduction in worry mediated improvement in daily functioning (between-group d = 0.58; indirect effect estimate = −1.06 [95 % CI: −1.76 to −0.51], 66 % mediated effect). The mediation effects were fairly robust to mediator-outcome confounding, with residual correlation values set to r = 0.3 in a sensitivity analysis. The results provide further evidence that it is beneficial to provide a low-threshold, easy access intervention to patients with excessive worry, irrespective of primary diagnosis. Clinical implications are discussed.http://www.sciencedirect.com/science/article/pii/S2214782925000430
spellingShingle Tove Wahlund
Fredrik Spångberg
Viktor Vadenmark
Erik Andersson
Efficacy of a brief online intervention in reducing excessive worry and improving daily functioning: A randomized trial with mediation analysis
Internet Interventions
title Efficacy of a brief online intervention in reducing excessive worry and improving daily functioning: A randomized trial with mediation analysis
title_full Efficacy of a brief online intervention in reducing excessive worry and improving daily functioning: A randomized trial with mediation analysis
title_fullStr Efficacy of a brief online intervention in reducing excessive worry and improving daily functioning: A randomized trial with mediation analysis
title_full_unstemmed Efficacy of a brief online intervention in reducing excessive worry and improving daily functioning: A randomized trial with mediation analysis
title_short Efficacy of a brief online intervention in reducing excessive worry and improving daily functioning: A randomized trial with mediation analysis
title_sort efficacy of a brief online intervention in reducing excessive worry and improving daily functioning a randomized trial with mediation analysis
url http://www.sciencedirect.com/science/article/pii/S2214782925000430
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