(PS1-40) Digital Safety Behavior Treatment for Pathological Worry: Findings from a Pilot Study

Abstract Text: Pathological worry is a central feature of generalized anxiety disorder (GAD) and has also demonstrated significant relationships with other anxiety disorders and major depressive disorder (MDD). Theoretical models of GAD posit that worry is composed of both cognitive and behavioral avoidance strategies, suggesting that worry-related safety behaviors play a significant role in the maintenance of this disorder. Contemporary treatment protocols have been shown to effectively reduce worry and anxiety, but these interventions are typically time-intensive, expensive, and require consultation with a licensed professional. To enhance the accessibility of treatments for worry, alternative protocols can be developed that lower the burden associated with treatment-seeking. In this vein, smartphone-based interventions represent potentially efficacious treatment strategies that increase treatment accessibility and have been shown to result in significant reductions in problematic safety behaviors and associated psychological distress. To that end, we developed a smartphone-based safety behavior treatment utilizing the Worry Behavior Inventory (WBI; Mahoney et al., 2016) as a measure of daily worry-related safety behaviors. The objective of the current study will be to examine pilot data (N = 10) from a preliminary study of the effectiveness of this intervention to examine whether it significantly reduces levels of self-reported worry and anxiety. We will investigate the efficacy of this treatment within a community sample of adults who meet criteria for excessive levels of worry as assessed by Penn State Worry Questionnaire (PSWQ) scores of at least 60. After completing an initial questionnaire assessing levels of worry, anxiety, and depression, participants will receive instructions to decrease or eliminate worry-related safety behaviors. In addition, they will receive daily reminders via text message to decrease these behaviors, along with a behavior monitoring checklist in which they indicate the frequency with which they engaged in each safety behavior over the previous day. Participants will complete these daily checklists for 28 days, followed by assessments at post and one-month follow-up. Once data collection is complete, we will run a series of mixed model ANOVAs to investigate the effects of the treatment on worry behaviors, overall worry, generalized anxiety symptoms, and depression. Significant findings may indicate the need for further research investigating this treatment protocol in a randomized controlled trial.