Internet-delivered cognitive behavioral therapy for adolescents with excessive worry: a randomized controlled trial with mediation analysis.
Tove Wahlund, Sean Perrin, Klara Olofsdotter Lauri et al.
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In 30 seconds
This randomized controlled trial tested an 8-week, internet-delivered cognitive behavioral therapy (ICBT) program focused on exposure to uncertainty in 62 adolescents aged 13–17 years with excessive worry. Compared with a waitlist, ICBT produced significantly greater reductions in worry at week 12 (bootstrapped d = 0.59). Worry reductions were associated with improvements in anxiety and depression symptoms. In mediation analyses, changes in depression, but not intolerance of uncertainty, mediated worry outcomes, contrary to the treatment’s proposed mechanism.
Key findings
- ICBT reduced worry more than waitlist at week 12 (bootstrapped d = 0.59).
- Worry reductions mediated improvements in anxiety and depression symptoms.
- Changes in depression, but not intolerance of uncertainty, mediated worry outcomes.
Why it matters
The trial suggests that a brief online intervention may reduce excessive worry in adolescents and that worry improvement can accompany broader symptom gains. Its mediation findings also caution against assuming that targeting uncertainty necessarily changes intolerance of uncertainty or that this mechanism explains treatment outcomes.
What to keep in mind
The trial included 62 adolescents and used self-reported outcomes; the abstract does not report longer-term follow-up beyond the 12-week assessment period.