Optimization of a Mobile Transdiagnostic Emotion Regulation Intervention for University Students
Condition: Emotion Regulation; Stress; Depressive Symptoms; Anxiety
MeSH terms: Depression
Study type: Interventional

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.
    

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.
    

Intervention name(s): Transdiagnostic emotion regulation intervention
Intervention type(s): Behavioral
Intervention description(s): 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)
Intervention model: Single Group Assignment
Intervention 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)
Primary purpose: Prevention
Keywords: Transdiagnostic intervention; Micro Randomized Trials; User research; Mental health; University Students