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B. , Poulsen, S. , Gondan, M. , Grafton, B. , Austin, S. F. , Kistrup, M. , Rosenberg, N. G. K. , Howard, H. , & Watkins, E. R. (2019). Group rumination-focused cognitive-behavioural therapy (CBT) v. Group cbt for depression: Phase ii trial. 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Targeting specific risk factors, such as rumination, may improve prevention. Rumination-focused Cognitive Behavioral Therapy (RFCBT) was developed to specifically target depressive rumination.<\/p>\n                <\/sec>\n                                <sec>\n                    <title>OBJECTIVE<\/title>\n                        <p>The primary objective of this study was to test whether guided Web-based RFCBT (i-RFCBT) would prevent the incidence of major depression relative to usual care in UK university students. The secondary objective was to test the feasibility and estimated effect sizes of unguided i-RFCBT.<\/p>\n                <\/sec>\n                                <sec>\n                    <title>METHODS<\/title>\n                        <p>To address the primary objective, a phase III randomized controlled trial was designed and powered to compare high risk university students (N=235), selected with elevated worry\/rumination, recruited via an open access website in response to circulars within universities and internet advertisements, randomized to receive either guided i-RFCBT (interactive Web-based RFCBT, supported by asynchronous written Web-based support from qualified therapists) or usual care control. To address the secondary objective, participants were also randomized to an adjunct arm of unguided (self-administered) i-RFCBT. The primary outcome was the onset of a major depressive episode over 15 months, assessed with structured diagnostic interviews at 3 (postintervention), 6, and 15 months post randomization, conducted by telephone, blind to the condition. Secondary outcomes of symptoms of depression and anxiety and levels of worry and rumination were self-assessed through questionnaires at baseline and the same follow-up intervals.<\/p>\n                <\/sec>\n                                <sec>\n                    <title>RESULTS<\/title>\n                        <p>Participants were randomized to guided i-RFCBT (n=82), unguided i-RFCBT (n=76), or usual care (n=77). Guided i-RFCBT reduced the risk of depression by 34% relative to usual care (hazard ratio [HR] 0.66, 95% CI 0.35 to 1.25; P=.20). Participants with higher levels of baseline stress benefited most from the intervention (HR 0.43, 95% CI 0.21 to 0.87; P=.02). Significant improvements in rumination, worry, and depressive symptoms were found in the short-to-medium term. Of the 6 modules, guided participants completed a mean of 3.46 modules (SD 2.25), with 46% (38\/82) being compliant (completing \u22654 modules). Similar effect sizes and compliance rates were found for unguided i-RFCBT.<\/p>\n                <\/sec>\n                                <sec>\n                    <title>CONCLUSIONS<\/title>\n                        <p>Guided i-RFCBT can reduce the onset of depression in high-risk young people reporting high levels of worry\/rumination and stress. 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