JMIR Publications

ABSTRACT

Background:

Intrusive thoughts (ITs) are common yet distressing experiences for many adolescents and young adults. Brief, accessible interventions that provide psychoeducation and coping strategies are needed, yet little is known about how youth perceive such interventions.

Objective:

The present study examined both qualitative and quantitative indicators of acceptability in adolescents and young adults with ITs through a digital single-session intervention (SSI) which gathered intervention feedback from participants and helped determine whether symptom improvement and/or demographic factors predicted acceptability.

Methods:

We conducted a secondary analysis of a randomized controlled trial comparing our SSI to an information-only control group in individuals aged 13-25 (N=196), from a university undergraduate subject pool and the online data collection platform, CloudResearch. The analyses focus on identifying acceptability factors of the SSI condition and their associations with clinical and demographic factors by comparing means and performing regression analyses.

Results:

Thematic analyses revealed that young people with ITs prefer interventions that normalize the experience of ITs, are emotionally validating, accessible and engaging, stimulate self-reflection, and contain evidence-based strategies. Interrater agreement was high (between 88%-99%). Importantly, participants who reported qualitatively accepting the intervention were more likely to experience a reduction in hopelessness symptoms at post-intervention (t(183)=-3.45, P=.001, d=-0.47); however, acceptability was not associated with distress reduction (t(115)=-0.78, P=.44, d=-0.12). Of interest, those who identified as non-Caucasian were less likely to report they had a positive intervention experience compared to Caucasian individuals (B=0.77, SE=0.38, z=2.03, P=.04). Participants reported wanting more diverse examples of ITs to connect more with the psychoeducation, as well as more personalized examples for validation.

Conclusions:

These findings indicate acceptability factors and barriers that young adults with ITs experienced during a brief SSI and provide valuable information for the planning of future IT-related interventions. Future studies, employing more diverse examples of ITs, will be crucial for understanding further effects on acceptability and engagement.