Direct mapping of intervention to thought features: A Bayesian proof-of-concept study.
Nur Hani Zainal, Christian A Webb, Lauren S Hallion
Behaviour research and therapy April 1, 2025 DOI: 10.1016/j.brat.2025.104717 via PubMed
Summary
A proof-of-concept study with 40 high-worry adults (80% with an anxiety disorder) tested whether features of worry predict which cognitive strategy works best to regulate it. Participants rated their worries on five dimensions and tried mindful acceptance, focused attention meditation, or thought suppression during brain scanning. The preregistered hypotheses were not supported, but exploratory analyses showed that mindfulness-based strategies were more effective than thought suppression for worries rated as more uncontrollable. The authors call for larger studies with more varied perseverative thoughts.
Study at a glance
| Characteristics | Proof-of-concept study, within-subjects design Preregistered Peer reviewed |
|---|---|
| Sample size | 40 |
| Population | Adults selected for high trait worry, 80% meeting DSM-5 anxiety-related diagnoses |
| Key finding | Mindfulness-based strategies were more effective than thought suppression for worries rated higher in uncontrollability, though preregistered hypotheses were not supported. |
Abstract
Although uncontrollability is the core feature of perseverative thought that best accounts for its relationship to psychopathology, other features - for example, valence and content - have also been identified as potentially clinically relevant in their own right. We describe results from a proof-of-concept study that examined the extent to which major underlying features of worry could be used to predict which of three common cognitive regulatory strategies (mindful acceptance; focused attention meditation; and thought suppression) would help regulate that worry. N = 40 adults selected for high trait worry (80% also met criteria for one or more DSM-5 anxiety-related diagnoses) generated and provided feature ratings for three idiographic thought topics. Participants then attempted to control each worry using each of the three strategies during functional magnetic resonance imaging (fMRI) in a within-subjects design with a total of 468 observations. We used Bayesian multilevel modeling to test preregistered hypotheses regarding the extent to which each of five empirically-derived underlying dimensions of a worry (uncontrollability; negative valence; self-focus; apprehension; and social-memory content) could be used to predict which strategy would be most efficacious for regulating that worry. We did not find support for our preregistered hypotheses; however, in exploratory analyses, we found that mindfulness-based strategies were particularly effective compared to thought suppression for thoughts rated as higher (versus lower) in uncontrollability. Future research should test these principles in larger samples, using more diverse expressions of perseverative thought.