BACKGROUND
Anxiety disorders are the most common mental disorders worldwide. However, 65% of them do not access services. The high prevalence of anxiety and low intervention uptake indicate a pressing need to develop timely, scalable, and potent interventions suitable for adolescents.
OBJECTIVE
Adapting the existing single-session interventions (SSIs), the study further developed SSI on growth mindset about negative emotion for adolescent mental health. This study aimed to compare the effectiveness of four SSIs: Single-session Intervention of Growth Mindset for Anxiety (SIGMA), SIGMA with boosters, SSI of Growth Mindset of Personality (SSI-GP) and active control (ST, support therapy), in reducing adolescent anxiety.
METHODS
Classes were randomised to one of four intervention conditions: the SIGMA, SIGMA with boosters, SSI-GP, or ST. Each intervention took approximately 45 minutes online. Participants reported anxiety symptoms (primary outcome), depressive symptoms, suicidal/self-hurting thoughts, perceived control, hopelessness, attitude toward help-seeking and psychological well-being (secondary outcomes) at pre-intervention, the 2-week and 8-week follow-up. Participants also filled out the feedback scale at post-intervention. Generalized Estimating Equations (GEE) was used to examine the effectiveness of the SSIs.
RESULTS
731 adolescents from seven secondary schools were randomised. The intent-to-treat analysis found a significant decrease in anxiety symptoms (the mean and 95% confidence interval(CI) at baseline: SIGMA-Booster: 6.8 [6.0, 7.6], SIGMA: 6.5 [5.8, 7.3], SSIGP: 7.0 [6.2, 7.7], ST: 6.9 [6.1, 7.7]) in two-week (the mean and 95%CI at two-week follow-up: SIGMA-Booster: 5.9 [5.1, 6.7], SIGMA: 5.7 [4.9, 6.5], SSIGP: 5.4 [4.6, 6.2], ST: 5.7 [4.9, 6.4]) and eight-week follow-ups (the mean and 95%CI at eight-week follow-up: SIGMA-Booster: 5.9 [5.1, 6.7], SIGMA: 5.3 [4.5, 6.0], SSIGP: 5.6 [4.8, 6.4], ST: 5.8 [5.1, 6.6]) in all four groups. Moderation analysis found participants with higher motivation for change and higher baseline anxiety scores and fixed mindsets had more improvements in anxiety symptoms. More than 70% of participants were positive about the feasibility and acceptability of the SSIs.
CONCLUSIONS
The single-session interventions were effective at reducing anxiety and depression among adolescents over 8 weeks. Our data revealed the potential benefits of brief web-based intervention for adolescents, which may be scalable destigmatized and cost-effective alternative to school-based programs.
CLINICALTRIAL
ClinicalTrials.gov NCT05027880;
https://clinicaltrials.gov/ct2/show/NCT05027880