Pre-event and post-event rumination have been consistently identified by cognitive models as important maintaining factors in Social Anxiety Disorder (SAD). This systematic review and meta-analysis aimed to investigate the effectiveness of psychological treatment in reducing pre-event and post-event rumination in adults with social anxiety. A comprehensive literature search identified 26 eligible studies, with 1524 total participants. Psychological treatments demonstrated large significant within-group effect sizes (from pre- to post-treatment) in reducing pre-event rumination (g = 0.86) and post-event rumination (g = 0.83). Subgroups analysed showed CBT to have large significant effect sizes in reducing pre-event rumination (g = 0.97) and post-event rumination (g = 0.85). Interventions that specifically addressed rumination were found to be significantly more effective in reducing pre-event rumination than those that did not (p = .006). Both individual and group treatment formats were equally effective in reducing pre-event rumination and post-event rumination. Meta-regressions revealed that pre-event rumination treatment effects were significantly larger in individuals with higher baseline social anxiety, meanwhile post-event rumination treatment effects were larger for those with higher baseline depression. Overall findings show that pre-event and post-event rumination are effectively reduced through psychological treatment, and clinical implications for the enhancement of evidence-based treatment protocols are discussed.

认知模型一致认为事件前和事件后的沉思是社交焦虑症（SAD）的重要维持因素。这项系统评价和荟萃分析旨在调查心理治疗在减少患有社交焦虑的成年人事件前和事件后沉思方面的有效性。全面的文献检索确定了 26 项符合条件的研究，共有 1524 名参与者。心理治疗在减少事件前沉思（g = 0.86）和事件后沉思（g = 0.83）方面表现出显着的组内效应（从治疗前到治疗后）。亚组分析表明，CBT 在减少事件前的沉思（g = 0.97）和事件后的沉思（g = 0.85）方面具有显着的效果。研究发现，专门针对反刍问题的干预措施在减少事件前反刍行为方面比不针对反刍问题的干预措施显着更有效 ( p  = .006)。个人和团体治疗形式在减少事件前的沉思和事件后的沉思方面同样有效。元回归显示，对于基线社交焦虑较高的个体，事件前的沉思治疗效果显着更大，同时对于基线抑郁症较高的个体，事件后的沉思治疗效果更大。总体研究结果表明，通过心理治疗可以有效减少事件前和事件后的沉思，并讨论了增强循证治疗方案的临床意义。