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Rumination-Focused Cognitive Behavioral Therapy Decreases Anxiety and Increases Behavioral Activation Among Remitted Adolescents

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Abstract

Rumination involves a repetitive, passive focus on one’s thoughts and feelings and has been hypothesized as a mechanism contributing to multiple psychopathologies. The current investigation explores secondary outcomes from a pilot study to examine whether rumination-focused cognitive behavior therapy (RFCBT) alleviates symptoms of anxiety, increases behavioral activation, or increases global functioning among adolescents with a history of Major Depressive Disorder (MDD). Thirty-three adolescents were randomized to receive either RFCBT (n = 17) or assessment only (AO; n = 16) over the course of eight weeks. Mixed effects regression models were used to conduct intent-to-treat (ITT) analyses. The quadratic interaction for group-by-time-by-time was significant for anxiety. Adolescents in the RFCBT group experienced a significant decrease in anxiety across the first six weeks of intervention (F = 7.01, df = 108.49, p = 0.009). The group-by-time interaction was significant for the behavioral activation outcome (F = 4.28, df = 25.60, p = 0.049) with youth randomized to RFCBT demonstrating increasing activation compared to AO. Global functioning did not significantly differ between groups (F = 0.40, df = 1, p > 0.05). Preliminary evidence suggests that RFCBT may hold promise as an intervention that alleviates both depressive and anxiety symptoms when comorbid.

Highlights

  • RFCBT reduces anxiety symptoms among adolescents in remission from depression.

  • SRumination may be a mechanism in both depressive and anxious disorders.

  • Behavioral activation increases among youth randomized to RFCBT.

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Author Contributions

C.G.F. analyzed the data and wrote the paper, R.H.J. designed and executed the study and assisted with writing the paper, E.R.W. collaborated on the design, A.T.P. assisted with data analyses, K.L.B. assisted with writing the paper, S.A.L. collaborated in all aspects of the study.

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Author notes

  1. Claudia G. Feldhaus

    Present address: Xavier University, 3800 Victory Pkwym, Cincinnati, OH, 45207, USA

  2. Rachel H. Jacobs

    Present address: Northwestern University, 710 N. Lake Shore Drive, Chicago, IL, 60611, USA

  3. Amy T. Peters

    Present address: Massachusetts General Hospital & Harvard Medical School, 50 Staniford St, Suite 580, Boston, MA, 02114, USA

  4. Katie L. Bessette & Scott A. Langenecker

    Present address: University of Utah, 501 Chipeta Way, Salt Lake City, UT, 84108, USA

Authors and Affiliations

  1. University of Illinois at Chicago, 1747 W. Roosevelt Rd., Chicago, IL, 60608, USA

    Claudia G. Feldhaus, Rachel H. Jacobs, Amy T. Peters, Katie L. Bessette & Scott A. Langenecker

  2. University of Exeter, Sir Henry Wellcome Building for Mood Disorders Research, Exeter, EX4 4QG, UK

    Edward R. Watkins

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  1. Claudia G. Feldhaus
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Correspondence to Rachel H. Jacobs.

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Research was conducted at University of Illinois at Chicago with approval from the Institutional Review Board and all parents and adolescents signed consent and assent, respectively.

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Research was conducted at University of Illinois at Chicago with approval from the Institutional Review Board and all parents and adolescents signed consent and assent, respectively.

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Feldhaus, C.G., Jacobs, R.H., Watkins, E.R. et al. Rumination-Focused Cognitive Behavioral Therapy Decreases Anxiety and Increases Behavioral Activation Among Remitted Adolescents. J Child Fam Stud 29, 1982–1991 (2020). https://doi.org/10.1007/s10826-020-01711-7

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