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Effectiveness of transcranial direct current stimulation with and without positive mood induction on worry and transdiagnostic cognitive-emotional processes: A randomized controlled trial.

Fateme Shahsavari·Farzad Nasiri·Mehdi Zemestani
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Abstract

The present study investigated the effectiveness of transcranial direct current stimulation (tDCS), with and without positive mood induction, on worry and key transdiagnostic cognitive-emotional processes, including attentional bias, working memory, problem solving, and emotion regulation, in individuals with high levels of worry. This single-blind randomized controlled trial included 45 individuals with high levels of worry. After a structured clinical interview, participants were randomly assigned, with gender balancing, to one of three groups: (1) tDCS alone, (2) tDCS combined with positive mood induction, or (3) a sham control group. Outcome measures were administered at three time points (pretest, posttest, and one-month follow-up) and assessed attentional bias (Dot Probe Task), working memory (1-back task), problem solving (Tower of London task), emotion regulation (Gross's Emotion Regulation Questionnaire), and worry severity (Penn State Worry Questionnaire; PSWQ). Repeated-measures ANOVA showed that both active groups (tDCS alone and tDCS + positive mood induction) significantly improved attentional bias, worry, working memory, problem solving, and emotion regulation compared to controls (p < 0.05). The combined intervention produced significantly greater gains than tDCS alone in working memory, problem solving, emotion regulation (p < 0.05), and reductions in attentional bias and worry (p < 0.001). All effects persisted at one-month follow-up (p < 0.05). tDCS reduces worry and attentional bias and enhances cognition and emotion regulation in individuals with high levels of worry. The combined intervention produced larger and more sustained improvements than tDCS alone across the assessed behavioral outcomes. These findings support further investigation of combining tDCS with structured positive mood induction while the mechanisms underlying the additional benefits remain to be established.

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HumansTranscranial Direct Current StimulationFemaleMaleAffectSingle-Blind MethodMemory, Short-TermAnxietyEmotional RegulationAdultProblem SolvingAttentional BiasYoung AdultNeuropsychological TestsCognitionEmotionsCognitive EnhancementTreatment OutcomeAttentional biasEmotion regulationPositive mood inductionWorrytDCSJournal ArticleRandomized Controlled Trial

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Fateme Shahsavari, Farzad Nasiri, Mehdi Zemestani. 2026-08-04. Effectiveness of transcranial direct current stimulation with and without positive mood induction on worry and transdiagnostic cognitive-emotional processes: A randomized controlled trial.. https://doi.org/10.1016/j.physbeh.2026.115461

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Journal Article; Randomized Controlled Trial resourceAdult subjectAffect subjectAnxiety subjectCognition subjectCognitive Enhancement subjectEmotions subjectFemale subjectHumans subjectJournal Article subjectMale subjectNeuropsychological Tests subjectRandomized controlled trials study

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