Emotion Regulation Training Eases Anxious Thought Patterns in Teenage Girls, but Not Meta-Worry

A group-based emotion regulation program reduced mind wandering and repetitive negative thinking among adolescent girls with anxiety symptoms, according to a quasi-experimental study published in BMC Psychology, though the training did not significantly lower meta-worry, the tendency to worry about one’s own worrying. The findings suggest that teaching adolescents to modify how they respond to emotions can dampen some of the attentional and cognitive patterns that accompany anxiety, while other worry-related processes may require more targeted approaches.

The research team, led by Arezoo Paydar Tali with Marzieh Pahlevan and Ameneh Sadat Kazemi, worked at the Saba Technical and Vocational High School in Bouin Zahra, Iran. Using a multi-stage cluster random sampling procedure, the researchers first randomly selected the school from among 12 public schools and then randomly chose one class from each grade. Students were screened with the Beck Anxiety Inventory, and girls who scored 8 or higher, a self-report threshold indicating elevated anxiety symptoms, were eligible. From the screened pool, 30 adolescent girls were randomly assigned to either an intervention group or a control group of 15 participants each. The intervention group completed an eight-session emotion regulation training protocol grounded in the process model of emotion regulation developed by Gross and Thompson in 2007.

The researchers measured three interrelated cognitive phenomena. Meta-worry was assessed with the Meta-Worry Questionnaire, capturing worry about worry itself. Mind wandering was measured with the Mind Wandering Scale, reflecting the tendency for attention to drift away from the task at hand. Repetitive negative thinking, the recurrent, unproductive return to negative thoughts and concerns, was assessed with the Repetitive Negative Thinking Questionnaire. All three instruments were administered before the intervention, immediately after it, and at a three-month follow-up, allowing the team to evaluate both immediate effects and the durability of any changes.

Statistical analysis proceeded in two stages. Multivariate analysis of covariance, applied at posttest and controlling for pre-intervention scores, revealed a significant overall effect with a large effect size on the combined set of outcomes, with an eta squared of 0.476, a 95 percent confidence interval spanning 0.214 to 0.678, and a p value of 0.002. At the univariate level, mind wandering showed a significant and sustained reduction, with a partial eta squared of 0.447 and a p value below 0.001, and repetitive negative thinking also declined significantly, with a partial eta squared of 0.193 and a p value of 0.022, both large effects. Repeated-measures analysis of variance was used to assess the stability of these effects over the three-month follow-up period.

Meta-worry, by contrast, did not change significantly, with a p value of 0.078, just above the conventional threshold for statistical significance. The authors interpret this pattern as evidence that emotion regulation training is effective at reducing what they describe as the attentional and cognitive manifestations of anxiety in adolescent girls, namely the drift of attention and the recycling of negative thoughts, but that it may be insufficient for altering deeper, more entrenched metacognitive beliefs. In their conclusion, they suggest that such beliefs may warrant more specialized therapeutic approaches.

The study’s design carries important constraints on interpretation. As a quasi-experimental study with a small sample of 30 participants drawn from a single school, the findings cannot establish causation with the confidence of a large randomized trial, and the self-report screening and outcome measures leave open the possibility of expectancy or reporting effects. The restriction to adolescent girls at one institution also limits generalizability to other ages, sexes, and settings.

Nevertheless, the large effect sizes, the inclusion of a control group, and the indication that benefits persisted at three months support the authors’ conclusion that structured emotion regulation training can meaningfully reduce the attentional and ruminative dimensions of anxiety symptoms in this population. The dissociation between the outcomes that responded and the one that did not also gives researchers a clearer signal about where standard skills-based training may reach its limits, pointing toward the need for interventions that engage metacognitive beliefs more directly.

For now, the results stand as a measured contribution to a growing literature on school-delivered psychological programs: an eight-session protocol, tested against a control group, produced large and durable reductions in mind wandering and repetitive negative thinking among adolescent girls with elevated anxiety symptoms, while leaving meta-worry statistically unchanged.

Subject of Research: Effectiveness of group-based emotion regulation training on meta-worry, mind wandering, and repetitive negative thinking in adolescent girls with anxiety symptoms

Article Title: The effectiveness of emotion regulation training on meta-worry, mind wandering, and repetitive negative thinking in adolescent girls with anxiety symptoms

Article References: Tali, A. P., Pahlevan, M., & Kazemi, A. S. (2026). The effectiveness of emotion regulation training on meta-worry, mind wandering, and repetitive negative thinking in adolescent girls with anxiety symptoms. BMC Psychology. https://doi.org/10.1186/s40359-026-05854-y

Image Credits: AI Generated

DOI: 10.1186/s40359-026-05854-y

Keywords: emotion regulation, anxiety, adolescents, mind wandering, repetitive negative thinking, meta-worry, quasi-experimental study, BMC Psychology, school-based intervention, Iran, effectiveness, emotion