Adverse Childhood ExperiencePREVENT-DERSNCT07921446
Preventive and Personalized Digital Emotion Regulation Skills Intervention to Reduce Depression and Anxiety in Youths With Adverse Childhood Experiences
A study testing Lifestyle psychoeducation intervention and Personalized digital psychoeducation intervention on emotion regulation in people with Adverse Childhood Experience and Depression / Major Depressive Disorder, run by Institute of Mental Health, Singapore.
Trial summary
The present study aims to determine whether a personalized digital psychoeducation intervention (active intervention group) is more effective than self-monitoring of one's mood (control group) in reducing emotion regulation difficulties, depression, anxiety, and stress symptoms in at-risk youths exposed to adverse… Read more about this study
- Who is it for?
- Ages 15 to 35 years
- Conditions the study is for
- Adverse Childhood Experience, Depression / Major Depressive Disorder, Anxiety Depression
- What is being tested?
- Lifestyle psychoeducation intervention and Personalized digital psychoeducation intervention on emotion regulation
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 140 participants
- Where
- No sites listed yet
- Study dates
- Dec 2026to Apr 2030
- 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 15 to 35 years
- All sexes
- No healthy volunteers
- Child, Adult
Who may be able to join
- Exposed to at least one Adverse Childhood Experience (ACE)
- Screened positive for elevated scores on the Difficulty with Emotion Regulation Scale (DERS) OR Ruminative Response Scale (RRS) OR mild to moderate scores on the Depression Anxiety and Stress Scales (DASS)
- Aged 15 years to 35 years
- Singapore citizens or permanent residents
- Able to speak or understand English
- Regular access to a smart phone or tablet with internet connection
Who cannot join
- Self-reported diagnosis of any mental disorder
- Currently seeking mental health support from any mental health professional (i.e., psychiatrist, clinical psychologist, counsellor, etc.) for any mental health difficulties
- Self-reported active suicidal behavior
- Miss 2 consecutive intervention sessions
Trial locations and contacts
No sites are listed yet. Contact the study team or a site near you to ask about taking part.
About this study
Official title: Preventive and Personalized Digital Emotion Regulation Skills Intervention to Reduce Depression and Anxiety in Youths With Adverse Childhood Experiences: The PREVENT-DERS Randomized Controlled Trial
The present study aims to determine whether a personalized digital psychoeducation intervention (active intervention group) is more effective than self-monitoring of one's mood (control group) in reducing emotion regulation difficulties, depression, anxiety, and stress symptoms in at-risk youths exposed to adverse childhood experiences (ACEs).
We hypothesized that the active intervention group will be associated with less severe emotion regulation difficulties, depression, anxiety, and stress symptoms than the control group at post-intervention and 3-month follow-up. This study will recruit a total of N = 140 youths (age 15 to 35 years) with ACEs and randomized into either the active intervention group (n = 70) or the control group (n = 70). Participants will complete study measures at baseline, post-intervention, and at 3-month follow-up. The study team has expertise in youth mental health. This study is feasible and will be completed within 4 years. Our findings will support the development and implementation of an efficacious, cost-effective, personalized and scalable intervention to reduce poor mental health and prevent the onset of mental disorders among at-risk youths. Our intervention has significant potential to improve population health, quality of life, functioning, morbidity, and mortality, as well as alleviate the healthcare burden associated with ACEs.
Read the detailed description
Specific aims:
This study aims to examine the efficacy of personalized digital psychoeducation to self-monitoring control (1) to reduce poor mental health as indexed by self-reported depression, anxiety, and stress symptoms at post-intervention and at 3-month follow-up; and (2) to reduce emotion dysregulation as indexed by momentary emotion regulation ability deficits and rumination severity at post-intervention in youths with elevated hypothesized risk (exposure to adverse childhood experiences (ACEs) and elevated levels of emotion dysregulation, or mild to moderate depression, anxiety or stress symptoms).
Hypotheses:
We hypothesized that (1) the active intervention group will be associated with less depression, anxiety, and stress symptoms than the control group at post-intervention and 3-month follow-up; (2) the active intervention group will be associated with less severe emotion dysregulation than the control group at post-intervention.
Methodology and approach:
This study will involve a two-arm, single-blinded, prospective (i.e., three time-points; baseline, post-intervention, 3-month follow-up), pilot randomized controlled trial. A total of N = 140 youths (age 15 to 35 years) with ACEs will be recruited and randomized into either the active intervention group (Personalized Psychoeducation + Self-Monitoring; n = 70) or the control group (Self-Monitoring; n = 70).
Feasibility:
The study team has clinical and research expertise in youth mental health. This study is supported by a multidisciplinary team of established clinician-scientists and researchers. It is expected that this study will be completed within four years.
Importance to science or medicine:
We aim to develop an efficacious, cost-effective, personalized, scalable, and accessible transdiagnostic intervention to reduce poor mental health and prevent the onset of mental disorders among youths exposed to ACEs. Our intervention has a significant public health impact due to positive downstream effects on improving population health, quality of life, functioning, morbidity, and mortality, as well as alleviating the healthcare burden due to ACEs.
- Conditions
- Adverse Childhood Experience, Depression / Major Depressive Disorder, Anxiety Depression, Anxiety
- Being tested
- Lifestyle psychoeducation intervention, Personalized digital psychoeducation intervention on emotion regulation
- Keywords
- Prevention, Emotion Regulation, Youth Mental Health, Adverse Childhood Experiences, Precision Psychiatry, Digital Interventions, Ecological Momentary Assessment
- Medical subject headings
- Depression, Depressive Disorder, Major, Anxiety Disorders, Emotional Regulation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Lifestyle psychoeducation interventionBehavioural
The Control Intervention is a 4-week (1 hour per session) online psychoeducation intervention focused on learning healthy lifestyle strategies. The first online session (Week 1) involves providing participants with a background of psychoeducation, adverse childhood experiences (ACEs), and mental health. The second online session (Week 2) involves teaching participants the importance of sleep hygiene. The third online session (Week 3) involves teaching participants the importance of a healthy diet. The fourth online session (Week 4) involves teaching participants the importance of exercise and providing an overview of outdoor activities in Singapore. Participants will undergo Ecological Momentary Assessment (EMA) self-monitoring of their emotions between each intervention session.
Personalized digital psychoeducation intervention on emotion regulationBehavioural
The Active Intervention is a 4-week (1 hour per session) online psychoeducation and skills training intervention focused on improving emotion regulation skills. The Active Intervention includes personalized and non-personalized syllabus. The non-personalized intervention syllabus includes the following content: Session 1 (Enhancing emotional awareness and clarity), Session 2 (Accepting emotional responses), Session 3 (Reducing impulsivity and engaging in goal-directed behavior), and Session 4 (Accessing emotion regulation strategies). The personalized syllabus is based on each participant's Ecological Momentary Assessment (EMA)-generated emotion regulation profiles at baseline. In general, for weaker areas, we will reduce the difficulty in the type of skills taught and provide more skills practice. For stronger areas, we will teach more advanced skills for the participant to explore. Participants will undergo EMA self-monitoring of their emotions between each intervention session.
| Study group | Role | What they receive |
|---|---|---|
| Personalized digital psychoeducation intervention on emotion regulation | Experimental | In this active intervention arm, participants will undergo a 4-week (1 hour per session) online psychoeducation and skills training intervention focused on improving emotion regulation skills. We will tailor and personalize the 4-week intervention to each participant based on the Ecological Momentary Assessment-generated emotion regulation profiles at baseline. Emotion regulation profiles are mapped to 6 core areas (poor emotional awareness, poor emotional clarity, non-acceptance of emotional responses, difficulty in engaging in goal-directed behavior, impulsivity, and limited access to adaptive emotion regulation strategies) as outlined by the validated Difficulty in Emotion Regulation Scale (DERS) or DERS model. Receives: Behavioral: Personalized digital psychoeducation intervention on emotion regulation |
| Lifestyle psychoeducation intervention | Active comparator | In this Active Comparator arm, participants will undergo a 4-week (1 hour per session) online psychoeducation intervention focused on learning healthy lifestyle strategies. The purpose of this arm is to support the blinding process, where both arms appear to receive similar interventions. Further, the lifestyle psychoeducation intervention is an evidence-based prevention intervention for depression and anxiety. Receives: Behavioral: Lifestyle psychoeducation intervention |
What is being measured
The primary outcome is the main question the study is designed to answer.
Depression, Anxiety, and Stress as Assessed by DASS-21
The 21-item Depression Anxiety and Stress Scales (DASS; Lovibond \& Lovibond, 1995) will be used to screen for mild to moderate depression, anxiety, and stress symptoms. The DASS will also be administered at post-intervention and at the 3-month follow-up. Each item is rated on a 4-point Likert scale ranging from 0 (Did not apply to me) to 3 (Applied to me very much); higher scores indicate more severe depression, anxiety, and stress symptoms. Each subscale comprises 7 items and the subscale scores will be summed and multiplied by 2 as per scoring guidelines. Hence, each subscale score will range from 0 to 42.
Measured: From enrollment to 3-month (post-intervention) follow-up
Global Emotion Dysregulation as Assessed by the DERS-SF
The 18-item Difficulties with Emotion Regulation Scale Short-Form (DERS-SF; Kaufman et al., 2016) will be used to screen for elevated levels of global emotion dysregulation. Global emotion dysregulation has 6 subscales: poor emotional awareness, poor emotional clarity, non-acceptance of emotional responses, difficulty in engaging in goal-directed behavior, impulsivity, and limited access to adaptive emotion regulation strategies. These subscales correspond to the 6 dimensions of the DERS model. Each item is rated a 5-point Likert scale ranging from 1 (Almost never) to 5 (Almost always); higher scores will indicate more severe global emotion dysregulation (scores range from 18 to 90).
Measured: From enrollment to 3-month (post-intervention) follow-up
Ecological Assessment of Momentary Emotion Dysregulation
Ecological momentary assessment (EMA) of emotion dysregulation in the following two areas: Rumination and emotion regulation abilities. Two EMA items to assess rumination in response to recent stressors since the previous beep (How much were you focusing on the stressors? How much were you focusing on your emotions due to the stressors?). Both items are rated on a 100-point visual slider scale from 0 (not at all) to 100 (extremely). 21 EMA items to assess for emotion regulation abilities. Each item is rated on a 5-point Likert scale ranging from 1 (not at all) to 5 (completely).
Measured: From baseline to the end of intervention at 4 weeks
Rumination as Assessed by the RRS
The 10-item Ruminative Response Scale short-form (RRS; Treynor et al., 2003) will be used to screen for elevated levels of rumination. Each item is rated on a 4-point Likert scale ranging from 1 (Almost never) to 4 (Almost always); higher scores indicate more severe rumination (scores range from 10 to 40).
Measured: From enrollment to 3-month (post-intervention) follow-up
Secondary outcomes (2)
Subjective Well-Being as Assessed by the WEMWBS
The 14-item Warwick Edinburgh Mental Wellbeing Scale (WEMWBS; Tennant et al., 2007) will be used to assess for subjective well-being. Each item is rated on a 5-point Likert scale ranging from 1 (None of the time) to 5 (All of the time); higher scores indicate better positive well-being.
Measured: From enrollment to the 3-month (post-intervention) follow-up
Multi-Dimensional Impulsivity as Assessed by the UPPS-P
The 20-item Urgency-Premeditation-Perseverance-Sensation Seeking-Positive Urgency scale (UPPS-P; Cyders et al., 2014) will be used to assess for multi-dimensional impulsivity and the subdomains include negative and positive urgency, lack of perseverance, lack of premeditation, and sensation-seeking. Each item is rated on a 4-point Likert scale ranging from 1 (Strongly Agree) to 4 (Strongly Disagree).
Measured: From enrollment to three-month (post-intervention) follow-up
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted6 Nov 2026
- Study startDec 2026 (estimated)
- Primary completionApr 2029 (estimated)
- Study completionApr 2030 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for Adverse Childhood ExperienceStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
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
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Outcomes assessor
- Enrolment
- 140 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Institute of Mental Health, Singapore
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Liu Jianlin, Institute of Mental Health, Singapore
- Investigators
- Mythily Subramaniam, Ph.D., Study director, Institute of Mental Health, Singapore
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07921446
- Sponsor's protocol ID
- 2026-0592
- Other IDs
- MOH-TA25jul-0002
- Acronym
- PREVENT-DERS
- Status last verified
- Aug 2026
- First submitted
- 2 Nov 2026
- Last updated
- 6 Nov 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: All de-identified IPD used in the results publication and subjected to formal approval by our governing ethics board.
Publications
Widdershoven RLA, Wichers M, Kuppens P, Hartmann JA, Menne-Lothmann C, Simons CJP, Bastiaansen JA. Effect of self-monitoring through experience sampling on emotion differentiation in depression. J Affect Disord. 2019 Feb 1;244:71-77. doi: 10.1016/j.jad.2018.10.092. Epub 2018 Oct 6.
PubMed 30321767Topper M, Emmelkamp PM, Watkins E, Ehring T. Prevention of anxiety disorders and depression by targeting excessive worry and rumination in adolescents and young adults: A randomized controlled trial. Behav Res Ther. 2017 Mar;90:123-136. doi: 10.1016/j.brat.2016.12.015. Epub 2016 Dec 23.
PubMed 28049069Subramaniam M, Vaingankar JA, Tan B, Abdin E, Chang S, Tan Y, Samari E, Archana S, Chua YC, Lee JK, Tang C, Lee YP, Chong SA, Verma SK. Examining psychological distress among youth in Singapore: Insights from the National Youth Mental Health Study. Asian J Psychiatr. 2025 Mar;105:104405. doi: 10.1016/j.ajp.2025.104405. Epub 2025 Feb 17.
PubMed 39987652Subramaniam M, Abdin E, Seow E, Vaingankar JA, Shafie S, Shahwan S, Lim M, Fung D, James L, Verma S, Chong SA. Prevalence, socio-demographic correlates and associations of adverse childhood experiences with mental illnesses: Results from the Singapore Mental Health Study. Child Abuse Negl. 2020 May;103:104447. doi: 10.1016/j.chiabu.2020.104447. Epub 2020 Mar 12.
PubMed 32171798Saccaro LF, Giff A, De Rossi MM, Piguet C. Interventions targeting emotion regulation: A systematic umbrella review. J Psychiatr Res. 2024 Jun;174:263-274. doi: 10.1016/j.jpsychires.2024.04.025. Epub 2024 Apr 18.
PubMed 38677089Miu AC, Szentagotai-Tatar A, Balazsi R, Nechita D, Bunea I, Pollak SD. Emotion regulation as mediator between childhood adversity and psychopathology: A meta-analysis. Clin Psychol Rev. 2022 Apr;93:102141. doi: 10.1016/j.cpr.2022.102141. Epub 2022 Feb 21.
PubMed 35219929Mink F, Lutz W, Hehlmann MI. Ecological Momentary Assessment in psychotherapy research: A systematic review. Clin Psychol Rev. 2025 Apr;117:102565. doi: 10.1016/j.cpr.2025.102565. Epub 2025 Feb 28.
PubMed 40068346Liu J, Tan BCW, Abdin E, Padmini YS, Oh JY, Chong SA, Subramaniam M. Health care utilization, productivity losses, and burden of adverse childhood experiences in Singapore: Findings from a national survey. Psychol Trauma. 2025 Jan;17(1):1-9. doi: 10.1037/tra0001691. Epub 2024 Jun 20.
PubMed 38900512Bralee E, Mostazir M, Warren FC, Newbold A, Hulme C, Cranston T, Aas B, Bear H, Botella C, Burkhardt F, Ehring T, Fazel M, Fontaine JRJ, Frost M, Garcia-Palacios A, Greimel E, Hossle C, Hovasapian A, Huyghe VEI, Iversen N, Karpouzis K, Lochner J, Molinari G, Pekrun R, Platt B, Rosenkranz T, Scherer KR, Schlegel K, Schuller BW, Schulte-Korne G, Suso-Ribera C, Voigt V, Voss M, Watkins ER. Brief use of behavioral activation features predicts benefits of self-help app on depression symptoms: Secondary analysis of a selective prevention trial in young people. J Consult Clin Psychol. 2025 Apr;93(4):293-306. doi: 10.1037/ccp0000917.
PubMed 40126557Conejo-Ceron S, Bellon JA, Motrico E, Campos-Paino H, Martin-Gomez C, Ebert DD, Buntrock C, Gili M, Moreno-Peral P. Moderators of psychological and psychoeducational interventions for the prevention of depression: A systematic review. Clin Psychol Rev. 2020 Jul;79:101859. doi: 10.1016/j.cpr.2020.101859. Epub 2020 May 11.
PubMed 32505982
Study at a glance
From the registry record, last updated by the sponsor on 6 Nov 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Preventive and Personalized Digital Emotion Regulation Skills Intervention to Reduce Depression and Anxiety in Youths With Adverse Childhood Experiences: The PREVENT-DERS Randomized Controlled Trial
- ClinicalTrials.gov ID
- NCT07921446
- Acronym / sponsor ID
- PREVENT-DERS / 2026-0592
- Conditions
- Adverse Childhood Experience, Depression / Major Depressive Disorder, Anxiety Depression, Anxiety
- Keywords
- Prevention, Emotion Regulation, Youth Mental Health, Adverse Childhood Experiences, Precision Psychiatry, Digital Interventions, Ecological Momentary Assessment
- Study type
- Interventional
- Recruitment status
- Not yet recruiting
- Enrolment
- 140 participants (estimated)
- Lead sponsor
- Institute of Mental Health, SingaporeUniversity, hospital or other
- Study start
- Dec 2026 (estimated)
- Primary completion
- Apr 2029 (estimated)
- Study completion
- Apr 2030 (estimated)
- First posted
- 6 Nov 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
The present study aims to determine whether a personalized digital psychoeducation intervention (active intervention group) is more effective than self-monitoring of one's mood (control group) in reducing emotion regulation difficulties, depression, anxiety, and stress symptoms in at-risk youths exposed to adverse childhood experiences (ACEs).
We hypothesized that the active intervention group will be associated with less severe emotion regulation difficulties, depression, anxiety, and stress symptoms than the control group at post-intervention and 3-month follow-up. This study will recruit a total of N = 140 youths (age 15 to 35 years) with ACEs and randomized into either the active intervention group (n = 70) or the control group (n = 70). Participants will complete study measures at baseline, post-intervention, and at 3-month follow-up. The study team has expertise in youth mental health. This study is feasible and will be completed within 4 years. Our findings will support the development and implementation of an efficacious, cost-effective, personalized and scalable intervention to reduce poor mental health and prevent the onset of mental disorders among at-risk youths. Our intervention has significant potential to improve population health, quality of life, functioning, morbidity, and mortality, as well as alleviate the healthcare burden associated with ACEs.
Detailed description
Specific aims:
This study aims to examine the efficacy of personalized digital psychoeducation to self-monitoring control (1) to reduce poor mental health as indexed by self-reported depression, anxiety, and stress symptoms at post-intervention and at 3-month follow-up; and (2) to reduce emotion dysregulation as indexed by momentary emotion regulation ability deficits and rumination severity at post-intervention in youths with elevated hypothesized risk (exposure to adverse childhood experiences (ACEs) and elevated levels of emotion dysregulation, or mild to moderate depression, anxiety or stress symptoms).
Hypotheses:
We hypothesized that (1) the active intervention group will be associated with less depression, anxiety, and stress symptoms than the control group at post-intervention and 3-month follow-up; (2) the active intervention group will be associated with less severe emotion dysregulation than the control group at post-intervention.
Methodology and approach:
This study will involve a two-arm, single-blinded, prospective (i.e., three time-points; baseline, post-intervention, 3-month follow-up), pilot randomized controlled trial. A total of N = 140 youths (age 15 to 35 years) with ACEs will be recruited and randomized into either the active intervention group (Personalized Psychoeducation + Self-Monitoring; n = 70) or the control group (Self-Monitoring; n = 70).
Feasibility:
The study team has clinical and research expertise in youth mental health. This study is supported by a multidisciplinary team of established clinician-scientists and researchers. It is expected that this study will be completed within four years.
Importance to science or medicine:
We aim to develop an efficacious, cost-effective, personalized, scalable, and accessible transdiagnostic intervention to reduce poor mental health and prevent the onset of mental disorders among youths exposed to ACEs. Our intervention has a significant public health impact due to positive downstream effects on improving population health, quality of life, functioning, morbidity, and mortality, as well as alleviating the healthcare burden due to ACEs.
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, outcomes assessor)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Personalized digital psychoeducation intervention on emotion regulation | Experimental | Behavioral: Personalized digital psychoeducation intervention on emotion regulationIn this active intervention arm, participants will undergo a 4-week (1 hour per session) online psychoeducation and skills training intervention focused on improving emotion regulation skills. We will tailor and personalize the 4-week intervention to each participant based on the Ecological Momentary Assessment-generated emotion regulation profiles at baseline. Emotion regulation profiles are mapped to 6 core areas (poor emotional awareness, poor emotional clarity, non-acceptance of emotional responses, difficulty in engaging in goal-directed behavior, impulsivity, and limited access to adaptive emotion regulation strategies) as outlined by the validated Difficulty in Emotion Regulation Scale (DERS) or DERS model. |
| Lifestyle psychoeducation intervention | Active comparator | Behavioral: Lifestyle psychoeducation interventionIn this Active Comparator arm, participants will undergo a 4-week (1 hour per session) online psychoeducation intervention focused on learning healthy lifestyle strategies. The purpose of this arm is to support the blinding process, where both arms appear to receive similar interventions. Further, the lifestyle psychoeducation intervention is an evidence-based prevention intervention for depression and anxiety. |
Who may qualify
- Ages
- 15 to 35 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Child, Adult
Key inclusion criteria (6 listed)
- Exposed to at least one Adverse Childhood Experience (ACE)
- Screened positive for elevated scores on the Difficulty with Emotion Regulation Scale (DERS) OR Ruminative Response Scale (RRS) OR mild to moderate scores on the Depression Anxiety and Stress Scales (DASS)
- Aged 15 years to 35 years
- Singapore citizens or permanent residents
- Able to speak or understand English
Key exclusion criteria (4 listed)
- Self-reported diagnosis of any mental disorder
- Currently seeking mental health support from any mental health professional (i.e., psychiatrist, clinical psychologist, counsellor, etc.) for any mental health difficulties
- Self-reported active suicidal behavior
- Miss 2 consecutive intervention sessions
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Lifestyle psychoeducation interventionThe Control Intervention is a 4-week (1 hour per session) online psychoeducation intervention focused on learning healthy lifestyle strategies. The first online session (Week 1) involves providing participants with a background of psychoeducation, adverse childhood experiences (ACEs), and mental health. The second online session (Week 2) involves teaching participants the importance of sleep hygiene. The third online session (Week 3) involves teaching participants the importance of a healthy diet. The fourth online session (Week 4) involves teaching participants the importance of exercise and providing an overview of outdoor activities in Singapore. Participants will undergo Ecological Momentary Assessment (EMA) self-monitoring of their emotions between each intervention session. | Behavioural | Lifestyle psychoeducation intervention |
| Personalized digital psychoeducation intervention on emotion regulationThe Active Intervention is a 4-week (1 hour per session) online psychoeducation and skills training intervention focused on improving emotion regulation skills. The Active Intervention includes personalized and non-personalized syllabus. The non-personalized intervention syllabus includes the following content: Session 1 (Enhancing emotional awareness and clarity), Session 2 (Accepting emotional responses), Session 3 (Reducing impulsivity and engaging in goal-directed behavior), and Session 4 (Accessing emotion regulation strategies). The personalized syllabus is based on each participant's Ecological Momentary Assessment (EMA)-generated emotion regulation profiles at baseline. In general, for weaker areas, we will reduce the difficulty in the type of skills taught and provide more skills practice. For stronger areas, we will teach more advanced skills for the participant to explore. Participants will undergo EMA self-monitoring of their emotions between each intervention session. | Behavioural | Personalized digital psychoeducation intervention on emotion regulation |
Primary outcome
Depression, Anxiety, and Stress as Assessed by DASS-21
Time frame: From enrollment to 3-month (post-intervention) follow-up
The 21-item Depression Anxiety and Stress Scales (DASS; Lovibond \& Lovibond, 1995) will be used to screen for mild to moderate depression, anxiety, and stress symptoms. The DASS will also be administered at post-intervention and at the 3-month follow-up. Each item is rated on a 4-point Likert scale ranging from 0 (Did not apply to me) to 3 (Applied to me very much); higher scores indicate more severe depression, anxiety, and stress symptoms. Each subscale comprises 7 items and the subscale scores will be summed and multiplied by 2 as per scoring guidelines. Hence, each subscale score will range from 0 to 42.
Global Emotion Dysregulation as Assessed by the DERS-SF
Time frame: From enrollment to 3-month (post-intervention) follow-up
The 18-item Difficulties with Emotion Regulation Scale Short-Form (DERS-SF; Kaufman et al., 2016) will be used to screen for elevated levels of global emotion dysregulation. Global emotion dysregulation has 6 subscales: poor emotional awareness, poor emotional clarity, non-acceptance of emotional responses, difficulty in engaging in goal-directed behavior, impulsivity, and limited access to adaptive emotion regulation strategies. These subscales correspond to the 6 dimensions of the DERS model. Each item is rated a 5-point Likert scale ranging from 1 (Almost never) to 5 (Almost always); higher scores will indicate more severe global emotion dysregulation (scores range from 18 to 90).
Ecological Assessment of Momentary Emotion Dysregulation
Time frame: From baseline to the end of intervention at 4 weeks
Ecological momentary assessment (EMA) of emotion dysregulation in the following two areas: Rumination and emotion regulation abilities. Two EMA items to assess rumination in response to recent stressors since the previous beep (How much were you focusing on the stressors? How much were you focusing on your emotions due to the stressors?). Both items are rated on a 100-point visual slider scale from 0 (not at all) to 100 (extremely). 21 EMA items to assess for emotion regulation abilities. Each item is rated on a 5-point Likert scale ranging from 1 (not at all) to 5 (completely).
Rumination as Assessed by the RRS
Time frame: From enrollment to 3-month (post-intervention) follow-up
The 10-item Ruminative Response Scale short-form (RRS; Treynor et al., 2003) will be used to screen for elevated levels of rumination. Each item is rated on a 4-point Likert scale ranging from 1 (Almost never) to 4 (Almost always); higher scores indicate more severe rumination (scores range from 10 to 40).
2 secondary outcomes
Subjective Well-Being as Assessed by the WEMWBS
Time frame: From enrollment to the 3-month (post-intervention) follow-up
Multi-Dimensional Impulsivity as Assessed by the UPPS-P
Time frame: From enrollment to three-month (post-intervention) follow-up
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 6 Nov 2026.
- Background: PubMed 30321767Widdershoven RLA, Wichers M, Kuppens P, Hartmann JA, Menne-Lothmann C, Simons CJP, Bastiaansen JA. Effect of self-monitoring through experience sampling on emotion differentiation in depression. J Affect Disord. 2019 Feb 1;244:71-77. doi: 10.1016/j.jad.2018.10.092. Epub 2018 Oct 6.
- Background: PubMed 28049069Topper M, Emmelkamp PM, Watkins E, Ehring T. Prevention of anxiety disorders and depression by targeting excessive worry and rumination in adolescents and young adults: A randomized controlled trial. Behav Res Ther. 2017 Mar;90:123-136. doi: 10.1016/j.brat.2016.12.015. Epub 2016 Dec 23.
- Background: PubMed 39987652Subramaniam M, Vaingankar JA, Tan B, Abdin E, Chang S, Tan Y, Samari E, Archana S, Chua YC, Lee JK, Tang C, Lee YP, Chong SA, Verma SK. Examining psychological distress among youth in Singapore: Insights from the National Youth Mental Health Study. Asian J Psychiatr. 2025 Mar;105:104405. doi: 10.1016/j.ajp.2025.104405. Epub 2025 Feb 17.
- Background: PubMed 32171798Subramaniam M, Abdin E, Seow E, Vaingankar JA, Shafie S, Shahwan S, Lim M, Fung D, James L, Verma S, Chong SA. Prevalence, socio-demographic correlates and associations of adverse childhood experiences with mental illnesses: Results from the Singapore Mental Health Study. Child Abuse Negl. 2020 May;103:104447. doi: 10.1016/j.chiabu.2020.104447. Epub 2020 Mar 12.
- Background: PubMed 38677089Saccaro LF, Giff A, De Rossi MM, Piguet C. Interventions targeting emotion regulation: A systematic umbrella review. J Psychiatr Res. 2024 Jun;174:263-274. doi: 10.1016/j.jpsychires.2024.04.025. Epub 2024 Apr 18.
- Background: PubMed 35219929Miu AC, Szentagotai-Tatar A, Balazsi R, Nechita D, Bunea I, Pollak SD. Emotion regulation as mediator between childhood adversity and psychopathology: A meta-analysis. Clin Psychol Rev. 2022 Apr;93:102141. doi: 10.1016/j.cpr.2022.102141. Epub 2022 Feb 21.
- Background: PubMed 40068346Mink F, Lutz W, Hehlmann MI. Ecological Momentary Assessment in psychotherapy research: A systematic review. Clin Psychol Rev. 2025 Apr;117:102565. doi: 10.1016/j.cpr.2025.102565. Epub 2025 Feb 28.
- Background: PubMed 38900512Liu J, Tan BCW, Abdin E, Padmini YS, Oh JY, Chong SA, Subramaniam M. Health care utilization, productivity losses, and burden of adverse childhood experiences in Singapore: Findings from a national survey. Psychol Trauma. 2025 Jan;17(1):1-9. doi: 10.1037/tra0001691. Epub 2024 Jun 20.
- Background: PubMed 40126557Bralee E, Mostazir M, Warren FC, Newbold A, Hulme C, Cranston T, Aas B, Bear H, Botella C, Burkhardt F, Ehring T, Fazel M, Fontaine JRJ, Frost M, Garcia-Palacios A, Greimel E, Hossle C, Hovasapian A, Huyghe VEI, Iversen N, Karpouzis K, Lochner J, Molinari G, Pekrun R, Platt B, Rosenkranz T, Scherer KR, Schlegel K, Schuller BW, Schulte-Korne G, Suso-Ribera C, Voigt V, Voss M, Watkins ER. Brief use of behavioral activation features predicts benefits of self-help app on depression symptoms: Secondary analysis of a selective prevention trial in young people. J Consult Clin Psychol. 2025 Apr;93(4):293-306. doi: 10.1037/ccp0000917.
- Background: PubMed 32505982Conejo-Ceron S, Bellon JA, Motrico E, Campos-Paino H, Martin-Gomez C, Ebert DD, Buntrock C, Gili M, Moreno-Peral P. Moderators of psychological and psychoeducational interventions for the prevention of depression: A systematic review. Clin Psychol Rev. 2020 Jul;79:101859. doi: 10.1016/j.cpr.2020.101859. Epub 2020 May 11.
- Individual participant dataSharing planned: Yes. All de-identified IPD used in the results publication and subjected to formal approval by our governing ethics board.
Related trials for Adverse Childhood Experience
Recruiting
A Pilot Study to Examine the Efficacy of Internet-Delivered Skills Training in Affective and Interpersonal Regulation (i-STAIR) for Individuals With Adverse Childhood Experiences and Subsyndromal Depression
Subthreshold Depression
Active, not recruiting
Resilient Students Training (ReST) : A Pilot RCT
Psychological Wellness
Not yet recruiting
EMI for Reducing Psychological Distress in Young Adults With Multiple ACEs: A RCT Study
Psychological Distress, Adverse Childhood Experience
Not yet recruiting
EMI for Reducing Psychological Distress in Young Adults With Multiple ACEs: A Feasibility Study
Psychological Distress, Adverse Childhood Experience
Enrolling by invitation
Telephone-Based Care Coordination for Services Addressing Childhood Adversity
Health Services, Mental Health
Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Mythily Subramaniam, Ph.D. study director
Institute of Mental Health, Singapore
Questions about this trial
What is this clinical trial studying?
A study testing Lifestyle psychoeducation intervention and Personalized digital psychoeducation intervention on emotion regulation in people with Adverse Childhood Experience and Depression / Major Depressive Disorder, run by Institute of Mental Health, Singapore.
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: opening soon, as of the sponsor's last update on 6 Nov 2026. Status can change between updates, so confirm with the study contact before making plans.
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?
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 JIANLIN LIU, Ph.D. (63893627, jianlinliu@nhghealth.com.sg), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Depression, Anxiety, and Stress as Assessed by DASS-21 (time frame: From enrollment to 3-month (post-intervention) follow-up). 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 NCT07921446, which also lists 10 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 6 Nov 2026.