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Emotion RegulationNCT05576883

Optimization of a Mobile Transdiagnostic Emotion Regulation Intervention for University Students

A study testing Transdiagnostic emotion regulation intervention in people with Emotion Regulation and Stress, run by Erasmus University Rotterdam at 1 site in Netherlands.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study will explore the functioning of a mobile transdiagnostic emotion regulation intervention designed for university students to optimize the uptake and the effectiveness of the intervention. Read more about this study

Who is it for?
Ages 18 to 27 yearsHealthy volunteers can take part
Conditions the study is for
Emotion Regulation, Stress, Depressive Symptoms
What is being tested?
Transdiagnostic emotion regulation intervention
Could I receive a placebo?
No, everyone receives an active treatment
How many people
161 participants
Where
1 siteNetherlands
Study dates
10 Feb 2023to 13 Jun 2023
Phase
Interventional
Are there results?
None posted in the registry

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 to 27 years
  • All sexes
  • Healthy volunteers accepted
  • Adult

Who may be able to join

  • Willing to provide informed consent
  • Currently enrolled as a student at the Erasmus University Rotterdam
  • Own a smartphone with an active phone number
  • Feel comfortable speaking and writing in the English language
  • Having a score between 5 (mild) and 19 (moderately severe) on the PHQ-9

Who cannot join

  • Participants are not eligible for this study if they:
  • Experience significant suicidal thoughts over the past month
  • Have a medical diagnosis of psychosis or bipolar disorder, severe clinical depression or anxiety disorder
  • Are undergoing psychopharmacological treatment or treatment with experimental drugs

Trial locations and contacts

1 site in 1 country.

Netherlands1 site
  • Erasmus University Rotterdam

    Rotterdam, South Holland, 3062 PA

Other trials in Netherlands

About this study

Official title: Optimizing a Mobile Transdiagnostic Emotion Regulation Intervention for University Students: A Micro Randomized Trial

This study will explore the functioning of a mobile transdiagnostic emotion regulation intervention designed for university students to optimize the uptake and the effectiveness of the intervention.

Read the detailed description

It is estimated that globally between 12 and 50% of all university students are affected by mental health problems, the most common ones being anxiety, depression, and substance abuse. Over the past years online-based interventions have been spotlighted by researchers and clinicians as an avenue for a better outreach and provision of low threshold interventions aimed at primary and secondary prevention of mental health problems among the university students population.

As part of a student wellbeing program at the Erasmus University Rotterdam (EUR), a transdiagnostic mobile intervention consisting of a suite of preventative self-guided tools is being developed. Its' goal is to help students better manage their mental health by teaching them adaptive emotional regulation strategies.

The intervention includes exercises from different therapeutic approaches, and targets transdiagnostic factors such as negative self-referential thoughts, rumination, experiences of prolonged negative emotional states, and mental health literacy. The intervention is delivered via a smartphone and consists of 20 therapeutic exercises teaching students strategies like upregulation of positive affect, staying present in the moment, cognitive defusion, relaxation and breathing techniques, and self compassion skills.

The main goals of the study are to evaluate whether the intervention and its components have the intended effects on student's emotional states as well as get insight into students' engagement patterns and experience with the intervention. This will be done by utilizing an explanatory sequential mixed methods approach combining novel methods of online-intervention assessment, specifically Micro Randomized Trials (MRT) with semi-structured interviews, which will provide information on the lived experiences of the participants with the intervention and provide explanation of the quantitative results. The results of this trial will support the optimization and further development of the mobile application that will later be evaluated for its full-scale effectiveness.

Being tested
Transdiagnostic emotion regulation intervention
Keywords
Transdiagnostic intervention, Micro Randomized Trials, User research, Mental health, University Students
Medical subject headings
Emotional Regulation, Depression, Anxiety Disorders, Psychological Well-Being

What participants receive

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

  • Transdiagnostic emotion regulation interventionBehavioural

    The intervention under study includes 5 therapeutic approaches, namely: Positive psychology [PP], Mindfulness, Acceptance and Commitment Therapy [ACT], Breathing and relaxation, and Self-compassion [SC].

    The intervention consists of 4 core features:

    (i) monitoring through filling in EMAs assessing participants emotional states

    (ii) feedback through visualization of participant emotional states upon every completion of the EMAs

    (iii) exercises targeting different emotion regulation skills [i.e., upregulation of positive affect, mindfulness, cognitive defusion, breathing and relaxation, self-compassion) and health facts (i.e., control intervention) describing health information including nutrition, exercise, sleeping habits.

    (iv) psychoeducative articles describing the 5 therapeutic approaches (PP, ACT, Mindfulness, Breathing and Relaxation, SC)

Study groups in NCT05576883
Study groupRoleWhat they receive
Emotion Regulation Intervention and Control InterventionOtherParticipants will be asked in the morning and in the evening at their self-selected time to evaluate their emotional state through ecological momentary assessment (EMA) and will be prompted to engage in an ER intervention (60% likelihood) or to read health information (40% likelihood). Upon completion they will evaluate the likability and helpfulness of the exercise or the article and re-evaluate their emotional state (post-EMA). The intervention consists of 20 ER exercises and 20 health facts. The ER intervention is based on different therapeutic approaches targeting various underlying transdiagnostic factors such as rumination, self-referential thoughts etc. The 20 health facts will act as a placebo intervention with no effect on emotion regulation and keep participants engaged in the post-EMA evaluation when they are not randomized to an exercise. The interventions and the control intervention materials were developed by the research team for the purposes of this study.
Receives: Behavioral: Transdiagnostic emotion regulation intervention

What is being measured

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

  1. Changes in a momentary emotional state

    Participants will be asked to evaluate seven emotional states before and after engaging in the ER intervention or control intervention by answering the question: "How [affect (e.g., happy)] do you feel at the moment?" Each of 7 emotional states is evaluated on a scale from 1 [Not at all] to 5 [Extremely]. The emotional states are combined into 2 categories of affect: negative (stressed, frustrated, sad, fatigued) and positive (happy, energetic, relaxed).

    Changes in the momentary emotional states (i.e., positive and negative affect) will be evaluated by looking at the responses on the pre and post EMA in the relation to whether a participant received an ER intervention or health information.

    Measured: Day 2 - day 22

  2. Changes in thought believability and discomfort after engaging in CD exercise

    When randomized to CD exercise, participants will be asked to evaluate their self-selected unhelpful thought answering the following questions on a scale from 1 (not at all uncomfortable/believable) to 100 (extremely uncomfortable / believable) before and after the exercise:

    "How uncomfortable is the thought?" "How believable (true) is the thought?"

    The effects of CD exercises will be assessed by comparing the pre and post scores on the two thought parameters.

    Measured: Day 2 - day 22

  3. Objective engagement patterns: Engagement metrics

    Objective engagement patterns with the intervention will be assessed using descriptive statistics of engagement metrics (i.e., exercise completion rates, average time spent, and times of the day where participants completed the exercises) per exercise and exercise category. In addition, a correlational analysis will be used to evaluate whether there is a relationship between time of the day and exercise completion rates.

    Measured: Day 2 - day 22

  4. Objective engagement patterns: Relationship between time of the day and exercise completion

    A correlational analysis will be used to evaluate whether there is a relationship between the time of the day participants engaged in an exercise and exercise completion rates.

    Measured: Day 2 - day 22

  5. Subjective engagement patterns: Exercise likeability and helpfulness

    Subjective engagement patterns will be evaluated by combining exercise likeability and helpfulness ratings with information from the semi-structured interviews.

    Exercise likeability and helpfulness are assessed with items rated on a scale from 1 (not at all) to 5 (very much):

    "How much did you like the exercise?" "How helpful did you find the exercise?"

    Measured: Day 2 - day 22

  6. Subjective engagement patterns: User experience

    Semi-structured interviews will be conducted with a subsample of participants (n=21) within three weeks upon completion of the MRT. University students will be asked to report on their general experience with intervention as well as intervention categories and separate exercises. Example questions are: "What do you think about the intervention?", "What kind of difficulties did you experience while using it?",

    Measured: Up to 3 weeks upon completion of the Micro Randomized Trial

Secondary outcomes (4)
  1. Changes in ER skills

    ER skills will be measured with the Emotion Regulation Skills Questionnaire [ERSQ] that evaluates seven types of ER skills: awareness, sensation, clarity, understanding, acceptance, tolerance, compassionate self-support, readiness to confront distressing situations, and modification of negative emotions. The 27 items are rated on a scale from 0 [ not at all ] to 4 [ almost always ]. Higher scores on the ERSQ subscales and the overall ERSQ score indicate higher ER skills.

    Measured: At the baseline and day 23

  2. Changes in Anxiety symptoms

    Symptoms of anxiety will be measured with the Generalized Anxiety Disorder questionnaire [GAD-7] Participants will indicate how often they have been bothered by different symptoms over the last two weeks on a scale from 0 (not at all) to 3 (nearly every day). The summed scores for GAD-7 range between 0-21, with higher scores indicating higher levels of depression and anxiety symptoms

    Measured: At the baseline and day 23

  3. Changes in Depressive symptoms

    Symptoms of depression will be measured with the Patient Health Questionnaire [PHQ-9]. Participants will indicate how often they have been bothered by different symptoms over the last two weeks on a scale from 0 (not at all) to 3 (nearly every day). The summed scores for PHQ range from 0-27, with higher scores indicating higher levels of depression and anxiety symptoms

    Measured: At the baseline and day 23

  4. Changes in stress levels

    Perceived Stress Scale [PSS-10] will be used to assess stress levels. Participants will be asked to indicate how often they felt or thought a certain way over the last month on a scale from 0 [never] to 5 [very often]. The summed score ranges from 0 - 40, with higher scores indicating higher levels of perceived stress symptoms.

    Measured: At the baseline and day 23

Timeline

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

  1. First posted13 Oct 2022
  2. Study start10 Feb 2023
  3. Primary completion13 Jun 2023
  4. Study completion13 Jun 2023

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
Prevention
Allocation
Not applicable
Intervention model
Single group
Model description
This study utilizes a Micro Randomized Trial \[MRT\] method to evaluate the effects of the intervention. Compared to a multi-arm trial, in which participants are randomized to an intervention or control group, in an MRT individuals are randomized repeatedly to different interventions during the trial which allows for a large number of observations of the targeted proximal outcome(s) per participant (in this case, emotional states). This design also allows us to investigate contextual moderators of proximal effects such as time of intervention delivery and emotional state.
Masking
None (open label)
Enrolment
161 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT05576883
Sponsor's protocol ID
ETH2122-0677
Status last verified
Jan 2024
First submitted
6 Oct 2022
Last updated
17 Jan 2024
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Data \[and code\] produced in the project will be shared in a research data repository \[EUR Data Repository (EDR) and Open Science Framework (OSF)\]. A DCMI \[Dublin Core Metadata Initiative\] standard will be used to document this research. There will be a temporary restriction on re-using of the data (Embargo period of 6 months). Data \[and code\] that will be shared in a research data repository are: Anonymized survey data, Codebook and Blank Questionnaires, Readme text file (general description of the data, including date of collection, selection procedure of participants, tools used to collect the data etc.), and scripts of data analysis.

Publications

  • Laure T, Engels RCME, Remmerswaal D, Spruijt-Metz D, Konigorski S, Boffo M. Optimization of a Transdiagnostic Mobile Emotion Regulation Intervention for University Students: Protocol for a Microrandomized Trial. JMIR Res Protoc. 2023 Oct 27;12:e46603. doi: 10.2196/46603.

    PubMed 37889525
  • Laure T, Villegas Meija C, Remmerswaal D, Dulloo D, Van der Hallen R, Mayer B, Littel M, Dierckx B, Legerstee JS, Engels RCME, Boffo M. ROOM to Grow, a Mobile Well-Being Intervention for University Students: Overview of the Design Process and Outcomes. JMIR Form Res. 2025 Dec 17;9:e63325. doi: 10.2196/63325.

    PubMed 41406474

Questions about this trial

What is this clinical trial studying?

A study testing Transdiagnostic emotion regulation intervention in people with Emotion Regulation and Stress, run by Erasmus University Rotterdam at 1 site in Netherlands.

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 5 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: finished, as of the sponsor's last update on 17 Jan 2024. 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 Netherlands. 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. 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?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Changes in a momentary emotional state (time frame: Day 2 - day 22). The study lists 6 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 NCT05576883, 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 17 Jan 2024.

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