Randomized clinical trial investigating the efficacy of self-administered interventions for reducing pathological academic worry

Abstract

Despite the ostensible prevalence of academic worry at the college and university level, there is a paucity of research in this area. In addition, there is an even greater dearth of research investigating treatments for excessive and uncontrollable academic worry. Further, the research on non-pharmacological treatment strategies for reducing pathological worry (as seen in its most severe form in generalized anxiety disorder; GAD) is limited. The primary goal of this study was to investigate the potential benefits of two self-administered interventions for reducing pathological academic worry. Participants experiencing pathological academic worry (N = 113) were randomized to one of four conditions: (a) worry exposure (WE), (b) expressive writing (EW), (c) a credible placebo control, consisting of pulsed audio-photic stimulation (APS), and (d) wait-list control (WLC). Participants were instructed to practice their interventions three times per week for one month. Participants in all three of the intervention conditions showed significant improvement on self-report measures, while no such changes were observed for the control group. Findings were mixed on the objective measures. In general, neither the WE nor EW conditions consistently outperformed placebo, and in some cases, EW failed to outperform the waitlist control group at post-treatment. Overall, those assigned to WE showed greater improvement than those assigned to EW at posttreatment, but few significant differences between the three intervention groups emerged at follow-up. These mixed findings suggest that either the efficacy of each of the treatments does not go beyond the that which would be expected of non-specific treatment effects, or that the pulsed audio-photic stimulation did in fact exert more of an effect than a typical placebo, suggesting there may have been an unanticipated active treatment component. Despite this, several participants in WE and EW showed marked improvement, and even continued improvement by follow-up, suggesting that, while perhaps not highly potent treatments when delivered in isolation, these may be easy, costeffective interventions for pathological worry. Further research is needed with clinical GAD samples, and research is also needed on the placebo response rate in GAD.