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Generalized Anxiety DisorderNCT04846777

Brief Smartphone Treatment Study

A study testing Mindfulness ecological momentary intervention in people with Generalized Anxiety Disorder, run by Penn State University at 1 site in United States.

Recruiting

Looking for participants now. Contact the study team or a site below to ask about taking part.

Sites and contacts
Official record
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Trial summary

Little is known about whether and how brief mindfulness therapies yield clinically beneficial effects. This gap exists despite the rapid growth of smartphone mindfulness applications and presence of mental health treatment gap. Read more about this study

Who is it for?
Ages 18 years and older
Conditions the study is for
Generalized Anxiety Disorder
What is being tested?
Mindfulness ecological momentary intervention
Type of treatment
Medical device
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
300 participants
Where
1 siteUnited States
Study dates
14 Nov 2018to 31 Jul 2023
Phase
Interventional
Are there results?
Not yet: the study is under way

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Presence of Generalized Anxiety Disorder based on the Generalized Anxiety Disorder Questionnaire-IV self-report and Mini International Neuropsychiatric Interview
  • Current student at the Pennsylvania State University or a community-dwelling adult who expressed interest to participate through the PSU StudyFinder portal
  • Expressed interest to seek treatment
  • Currently not receiving treatment from a mental health professional
  • Able to provide consent
  • Proficient in English

Who cannot join

  • Below age 18
  • Failure to meet any of above inclusion criteria
  • Participant currently undergoing
  • Presence of suicidality, mania, psychosis, or substance use disorders

Trial locations and contacts

1 site in 1 country. Contact the study team or a site near you to ask about taking part.

Nur Hani Zainal, M.S. contact

917-767-7088

nvz5057@psu.edu

Michelle G. Newman, Ph.D. contact

814-883-4572

mgn1@psu.edu

United States1 site, 1 recruiting
  • The Pennsylvania State University

    University Park, Pennsylvania, 16802

    Nur Hani Zainal, M.S., 917-767-7088, nvz5057@psu.edu

    Michelle G. Newman, Ph.D., 814-883-4572, mgn1@psu.edu

    Recruiting

Other trials in United States

About this study

Official title: Brief Smartphone Treatment Study for Anxiety and Depression

Little is known about whether and how brief mindfulness therapies yield clinically beneficial effects. This gap exists despite the rapid growth of smartphone mindfulness applications and presence of mental health treatment gap. Specifically, no prior brief, smartphone mindfulness ecological momentary intervention (MEMI) has targeted generalized anxiety disorder (GAD). Moreover, although theories propose that mindfulness intervention can boost attentional control (AC), executive functioning (EF), perspective-taking, and social cognition skills they have largely gone untested. Thus, this randomized controlled trial (RCT) aims to address these gaps by assessing the efficacy of a 14-day smartphone mindfulness EMI (vs. placebo). Participants with GAD will be randomly assigned to either MEMI or self-monitoring placebo (SMP). Those in treatment will exercise multiple core mindfulness strategies (open monitoring, acceptance, attending to small moments, slowed rhythmic diaphragmatic breathing). Also, those in MEMI will be reminded before bedtime that mindfulness is a lifelong practice. Comparatively, participants assigned to SMP will only be prompted to practice self-monitoring. They will notice their thoughts, rate any distress associated with them, and will not be taught any mindfulness strategies. All prompts will occur 5 times a day, for 14 consecutive days. They will complete self-reports and neuropsychological assessments at pre-, post-, and 1-month follow-up. Multilevel modeling analyses will determine if treatment (vs. self-monitoring placebo (SMP)) produces substantially larger reductions in trait worry and negative perseverative cognitions as well as steeper increases in AC and EF (inhibition, set-shifting, working memory updating). In addition, the investigators hypothesized that MEMI (vs. SMP) would lead to greater increases in performance-based and self-reported trait mindfulness, empathy, and perspective taking. Findings will advance understanding of the efficacy of unguided, technology-assisted, brief mindfulness in a clinical sample.

Being tested
Mindfulness ecological momentary intervention, Self-monitoring placebo
Keywords
Ecological momentary intervention, Mindfulness, Self-help, Digital health, Mobile app
Medical subject headings
Generalized Anxiety Disorder

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Mindfulness ecological momentary interventionDevice

    Access to a smartphone-delivered mindfulness ecological momentary intervention with the Personal Analytics Companion (PACO) app that regularly prompts participants to practice various mindfulness skills at 5 preset times each day.

  • Self-monitoring placeboDevice

    Access to a smartphone-delivered self-monitoring placebo with the PACO app that regularly prompts participants to practice self-monitoring at 5 preset times each day.

Study groups in NCT04846777
Study groupRoleWhat they receive
Mindfulness ecological momentary interventionExperimentalThe SMP condition was developed to parallel the treatment while eliminating its theorized active therapeutic elements - open monitoring, acceptance, attending to small moments, breathing retraining, continual practice of mindfulness. Therefore, it did not mention anything about mindfulness at all. Instead, SMP participants were instructed to notice their cognitions and emotions and how distress they might be. No instruction on accepting their thoughts and feelings as they are were given.
Receives: Device: Mindfulness ecological momentary intervention
Self-monitoring placeboPlacebo comparatorThe SMP condition was developed to parallel the treatment while eliminating its theorized active therapeutic elements - open monitoring, acceptance, attending to small moments, breathing retraining, continual practice of mindfulness. Therefore, it did not mention anything about mindfulness at all. Instead, SMP participants were instructed to notice their cognitions and emotions and how distress they might be. No instruction on accepting their thoughts and feelings as they are were given.
Receives: Device: Self-monitoring placebo

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Change from Baseline Generalized Anxiety Disorder Symptoms at 14-Day Post-Treatment

    Generalized Anxiety Disorder Questionnaire-IV (GAD-Q-IV) with categorical ('Yes' for presence and 'No' for absence) and continuous response formats (0 = not at all to 8 = very severely) (Newman et al., 2002) (Item 1 to Item 14 self-report; possible range = 0-12). Generalized Anxiety Disorder Questionnaire-Dimensional (Item 15 to Item 30) with consistent continuous 8-point Likert scale response formats that measures the frequency, intensity, uncontrollability, and degree of excessive worry (e.g., 0 = Always in control to 8 = Never in control) (Newman et al.) (possible range = 0-128). Larger reduction in score denote better outcome.

    Measured: Baseline to 14-Day Post-Treatment

  2. Change from Baseline Generalized Anxiety Disorder Symptoms at 6-Week Post-Randomization

    Generalized Anxiety Disorder Questionnaire-IV (GAD-Q-IV) with categorical ('Yes' for presence and 'No' for absence) and continuous response formats (0 = not at all to 8 = very severely) (Newman et al., 2002) (Item 1 to Item 14 self-report; possible range = 0-12). Generalized Anxiety Disorder Questionnaire-Dimensional (Item 15 to Item 30) with consistent continuous 8-point Likert scale response formats that measures the frequency, intensity, uncontrollability, and degree of excessive worry (e.g., 0 = Always in control to 8 = Never in control) (Newman et al.) (possible range = 0-128). Larger reduction in score denote better outcome.

    Measured: Baseline to 6-Week Post-Randomization

  3. Change from Baseline Perseverative Cognitions at 14-Day Post-Treatment

    The 45-item PCQ assessed perseverative cognitive traits linked to anxiety, depressive, and obsessive-compulsive symptoms. Respondents endorsed on a 6-point Likert scale (0 = strongly disagree to 5 = strongly agree). Further, the PCQ-45 comprised six factors: dwelling on the past; expecting the worst; lack of controllability; thoughts discrepant with ideal self; preparing for the future; searching for causes and meanings. Additionally, the PCQ had strong two-week retest reliability, discriminant validity, and convergent validity (Szkodny \& Newman, 2019). A total score for PCQ was computed by summing the mean scores from each subscale (total possible score = 0-30). Larger reduction in score denote better outcome.

    Measured: Baseline to 14-Day Post-Treatment

  4. Change from Baseline Perseverative Cognitions at 6-Week Post-Randomization

    The 45-item PCQ assessed perseverative cognitive traits linked to anxiety, depressive, and obsessive-compulsive symptoms. Respondents endorsed on a 6-point Likert scale (0 = strongly disagree to 5 = strongly agree). Further, the PCQ-45 comprised six factors: dwelling on the past; expecting the worst; lack of controllability; thoughts discrepant with ideal self; preparing for the future; searching for causes and meanings. Additionally, the PCQ had strong two-week retest reliability, discriminant validity, and convergent validity (Szkodny \& Newman, 2019). A total score for PCQ was computed by summing the mean scores from each subscale (total possible score = 0-30). Larger reduction in score denote better outcome.

    Measured: Baseline to 6-Week Post-Randomization

Secondary outcomes (18)
  1. Change from Baseline Depression Symptom Severity at 14-Day Post-Treatment

    Beck Depression Inventory (Beck, Steer, \& Brown, 1996) (21 of 21 items; self-report; possible range = 0-63). Larger reduction in score denote better outcome.

    Measured: Baseline to 14-Day Post-Treatment

  2. Change from Baseline Depression Symptom Severity at 6-Week Post-Randomization

    Beck Depression Inventory (Beck, Steer, \& Brown, 1996) (21 of 21 items; self-report; possible range = 0-63). Larger reduction in score denote better outcome.

    Measured: Baseline to 6-Week Post-Randomization

  3. Change from Baseline Attentional Control at 14-Day Post-Treatment

    Attentional Control Questionnaire (Derryberry \& Reed, 2002) (21 of 21 items; self-report; possible range = 0-60). Larger reduction in score denote better outcome.

    Measured: Baseline to 14-Day Post-Treatment

  4. Change from Baseline Attentional Control at 6-Week Post-Randomization

    Attentional Control Questionnaire (Derryberry \& Reed, 2002) (21 of 21 items; self-report; possible range = 0-60). Larger reduction in score denote better outcome.

    Measured: Baseline to 6-Week Post-Randomization

  5. Change from Baseline Working Memory at 14-Day Post-Treatment

    Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV; Wechsler, 2008) (21 of 21 items; self-report; possible range = 0-78). Larger increase in score denote better outcome.

    Measured: Baseline to 14-Day Post-Treatment

  6. Change from Baseline Working Memory at 6-Week Post-Randomization

    Wechsler Adult Intelligence Scale - Fourth Edition (WAIS-IV; Wechsler, 2008) (21 of 21 items; self-report; possible range = 0-78). Larger increase in score denote better outcome.

    Measured: Baseline to 6-Week Post-Randomization

  7. Change from Baseline Set-Shifting at 14-Day Post-Treatment

    Trail Making Test Part A and Part B (TMT-A and B; Strauss, Sherman, \& Spreen, 2006) (2 of 2 items; self-report; possible range = 0-480). Larger reduction in score denote better outcome.

    Measured: Baseline to 14-Day Post-Treatment

  8. Change from Baseline Set-Shifting at 6-Week Post-Randomization

    Trail Making Test Part A and Part B (TMT-A and B; Strauss, Sherman, \& Spreen, 2006) (2 of 2 items; self-report; possible range = 0-480). Larger reduction in score denote better outcome.

    Measured: Baseline to 6-Week Post-Randomization

  9. Change from Baseline Inhibitory Control at 14-Day Post-Treatment

    Color-Word Interference Test response time (Delis, Kaplan, \& Kramer, 2001) (1 of 4 items; self-report; possible range = 0-960). Larger reduction in score denote better outcome.

    Measured: Baseline to 14-Day Post-Treatment

  10. Change from Baseline Inhibitory Control at 6-Week Post-Randomization

    Color-Word Interference Test response time (Delis, Kaplan, \& Kramer, 2001) (1 of 4 items; self-report; possible range = 0-960). Larger reduction in score denote better outcome.

    Measured: Baseline to 6-Week Post-Randomization

  11. Change from Baseline Verbal Fluency at 14-Day Post-Treatment

    Phonemic cue; category fluency; switching fluency (Delis, Kaplan, \& Kramer, 2001) (3 of 3 items; self-report; possible range = 0-240). Larger increase in score denote better outcome.

    Measured: Baseline to 14-Day Post-Treatment

  12. Change from Baseline Verbal Fluency at 6-Week Post-Randomization

    Phonemic cue; category fluency; switching fluency (Delis, Kaplan, \& Kramer, 2001) (3 of 3 items; self-report; possible range = 0-240). Larger increase in score denote better outcome.

    Measured: Baseline to 6-Week Post-Randomization

  13. Change from Baseline Empathy at 14-Day Post-Treatment

    Bell-Lysaker Emotion Recognition Test (BLERT; Bryson, Bell, \& Lysaker, 1997) (21 of 21 items; self-report; possible range = 0-21). Larger increase in score denote better outcome.

    Measured: Baseline to 14-Day Post-Treatment

  14. Change from Baseline Empathy at 6-Week Post-Randomization

    Bell-Lysaker Emotion Recognition Test (BLERT; Bryson, Bell, \& Lysaker, 1997) (21 of 21 items; self-report; possible range = 0-21). Larger increase in score denote better outcome.

    Measured: Baseline to 6-Week Post-Randomization

  15. Change from Baseline Interpersonal Reactivity Traits at 14-Day Post-Treatment

    Interpersonal Reactivity Index (IRI; Davis, 1980) (28 of 28 items; self-report; possible range = 0-140). Larger increase in score denote better outcome.

    Measured: Baseline to 14-Day Post-Treatment

  16. Change from Baseline Interpersonal Reactivity Traits at 6-Week Post-Randomization

    Interpersonal Reactivity Index (IRI; Davis, 1980) (28 of 28 items; self-report; possible range = 0-140). Larger increase in score denote better outcome.

    Measured: Baseline to 6-Week Post-Randomization

  17. Change from Baseline Trait Mindfulness at 14-Day Post-Treatment

    Five Facet Mindfulness Questionnaire (FFMQ; Baer et al., 2008) (28 of 28 items; self-report; possible range = 0-395). Larger increase in score denote better outcome.

    Measured: Baseline to 14-Day Post-Treatment

  18. Change from Baseline Trait Mindfulness at 6-Week Post-Randomization

    Five Facet Mindfulness Questionnaire (FFMQ; Baer et al., 2008) (28 of 28 items; self-report; possible range = 0-395). Larger increase in score denote better outcome.

    Measured: Baseline to 6-Week Post-Randomization

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted15 Apr 2021
  2. Study start14 Nov 2018
  3. Primary completion31 Jul 2023 (estimated)
  4. Study completion31 Jul 2023 (estimated)

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Single blind
Who is masked
Outcomes assessor
Enrolment
300 participants (estimated)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04846777
Sponsor's protocol ID
STUDY00010664
Status last verified
Apr 2022
First submitted
9 Apr 2021
Last updated
26 Apr 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
Individual data sharing
No

Publications

  • Zainal NH, Newman MG. Who engages? Machine learning insights into digital mindfulness-based intervention for generalized anxiety disorder. J Affect Disord. 2026 Apr 15;399:120963. doi: 10.1016/j.jad.2025.120963. Epub 2025 Dec 19.

    PubMed 41422949
  • Zainal NH, Newman MG. Examining the Effects of a Brief, Fully Self-Guided Mindfulness Ecological Momentary Intervention on Empathy and Theory-of-Mind for Generalized Anxiety Disorder: Randomized Controlled Trial. JMIR Ment Health. 2024 May 24;11:e54412. doi: 10.2196/54412.

    PubMed 38787613

Questions about this trial

What is this clinical trial studying?

A study testing Mindfulness ecological momentary intervention in people with Generalized Anxiety Disorder, run by Penn State University at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 6 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: looking for participants now, as of the sponsor's last update on 26 Apr 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

This study is still under way. Results are not available in the source record yet.

How can a doctor refer a patient or contact the research team?

Contact Nur Hani Zainal, M.S. (917-767-7088, nvz5057@psu.edu), or a site near the patient. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Change from Baseline Generalized Anxiety Disorder Symptoms at 14-Day Post-Treatment (time frame: Baseline to 14-Day Post-Treatment). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04846777, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 Apr 2022.

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