Cognitive behavioural therapy for worry in young individuals with at-risk mental states: a preliminary investigation

Cognitive behavioural therapy (CBT) is a first-line strategy in reducing or delaying risk of transition topsychosis among young individuals with at-risk mental states (ARMS). However, there is little knowledgeabout its effects on other outcomes associated with ARMS. No study on CBT for ARMS has assessed worry,an important process associated with this condition. The present study investigated changes in worry atimmediate post-treatment and 14-month follow-up after CBT for young individuals with ARMS seekingpsychiatric care in mental health services. Thirty-seven young individuals (mean age=26 years,SD=6.07;22.20% female) seeking psychiatric care in mental health services and classified as reporting ARMSthrough the Comprehensive Assessment of At-Risk Mental States were included. The Positive AndNegative Syndrome Scales (PANSS) and Penn State Worry Questionnaire (PSWQ) were administeredat baseline, post-treatment, and follow-up. CBT consisted of 30 weekly individual 1-hour sessions basedon a validated CBT for ARMS manual enriched with components targeting worry [psychoeducation,problem-solving, (meta)cognitive restructuring, behavioural experiments]. Seven participants (18.91%)at follow-up had cumulatively made transition to psychosis. Repeated measures ANOVA withpost-hocpairwise comparisons showed significant changes in PSWQ scores from baseline topost-treatment and from baseline to follow-up; PSWQ scores remained stable from post-treatment tofollow-up. This is the first study investigating changes in worry after CBT for ARMS, which appearsto be a promising strategy also for this outcome. Future research with a larger sample size and controlgroup may determine whether changes in worry are also associated with reduced transition risk.