Calming Minds Study

Understanding the Mechanisms Driving the Reduction of Repetitive Negative Thought

The goal of this study is to understand why certain treatments help people reduce repetitive negative thinking (RNT), which is common in many mental health problems. We want to:

1. Figure out what actually causes repetitive negative thinking to decrease when people use cognitive-behavioral therapy (CBT).
2. Find out which parts of RNT-focused CBT are the most important - the parts that truly make a difference in reducing RNT.

The main result we will look at is how much a person's repetitive negative thought patterns change from the start of the study to the end of treatment (16 weeks). We will measure this using the Perseverative Thinking Questionnaire at baseline and week 16.

Participants in this study will be randomly assigned to one of 16 different treatment groups. Each group will get a different mix of 1-5 tools or strategies taken from Rumination-Focused Cognitive Behavioral Therapy (RF-CBT).

All participants, regardless of their treatment assignment, will get a basic set of lessons about repetitive negative thinking (RNT) and how CBT can help. This means every participant gets therapeutic support.

Participants will use a digital therapy program through the MyDataHelps app. The CBT lessons are available in English or Spanish, according to the participant's preference. Each participant will also be offered 3-6 meetings with a coach from our team, to review the lessons and tools in the digital therapy program. It is expected that the digital therapy program and coaching sessions will be completed within 4 months on study. Once 4 months have passed since their start on study, participants are asked to complete online questionnaires that will measure their recent symptom experiences. Participants are then asked to complete these questionnaires again 1 year after starting on study. These questionnaires are used to measure changes in symptom experiences from baseline (before starting the digital therapy program).

In addition to the primary goals listed in the brief summary, this study also aims to look at the following:

1. How anxiety and depression symptoms change during their use of the digital therapy program.
2. Whether people's mental health symptoms change over time after using the digital therapy program.

d) Who benefits most from which components, so therapy can be more personalized in the future.

Inclusion Criteria:

• Aged 18+ years
• Able to provide a valid Imperial Valley College email address
• Access to a suitable smartphone/device (iPhone 8+ running iOS 16.4 or higher, or Android version 8 or higher)
• Access to internet
• Elevated repetitive negative thought (RNT) based on scores from Ruminative Response Scale Brood subscale (RSS-brood) and Penn State Worry Questionnaire (PSWQ)

Exclusion Criteria:

• Concurrent psychotherapy
• Self-reported current or past diagnosis or treatment for Psychosis
• Self-reported current or past diagnosis or treatment for Bipolar disorder
• Self-reported current or past diagnosis or currently receiving, or waiting to receive, treatment for substance abuse/dependence
• Self-reported current diagnosis or currently receiving, or waiting to receive, treatment for alcohol abuse/dependence
• Antidepressant/anxiolytic medication that has changed in dose or nature in last 6 weeks
• Current severe PTSD defined as measured by the adapted International Trauma Questionnaire
• Active suicidal thoughts or self-harm