Strategies for Coping With Negative Thoughts

Study Overview
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Brief Summary
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The primary objective of this study is to assess the impact of two strategies for coping with negative automatic thoughts (positive thinking and cognitive restructuring) on one's belief in negative thoughts and one's affect. Another main objective is to assess whether participating in a positive mood induction (versus no mood induction) prior to using one of the two coping strategies impacts belief in negative thoughts and affect. We will also explore the interaction between strategy condition and mood induction condition. As secondary outcomes, we will evaluate whether there are changes in positive thinking skills and cognitive restructuring skills and depressive symptoms after one week of using the strategy.

Detailed Description
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Participants will be randomized to learn about positive thinking or cognitive restructuring, which will involve watching brief videos, being presented with examples of how one might apply the strategy when experiencing negative thoughts, and practicing with a personal example using a worksheet. Participants will also be randomized to positive mood induction, which is comprised of an autobiographical recall exercise in which participants are asked to recall a pleasant memory before filling out the worksheet. Participants will be asked to use the strategy and complete a worksheet online once per day for six days. Participants will respond to questionnaires at baseline and after 6 days of strategy use.

Official Title
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Strategies for Coping With Negative Thoughts

Conditions
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Anxiety, Depressive Symptoms, Negative Thinking

Intervention / Treatment
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* Other: Positive thinking
* Other: Positive thinking + Mood induction
* Other: Thought reevaluation
* Other: Thought reevaluation + Mood induction


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: 18 years old or older. Exclusion Criteria: A level of visual impairment that would prevent them from being able to answer questions on an electronic screen.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Active Comparator: Positive thinking<br>Videos will describe negative automatic thoughts and then describe positive thinking, its benefits, and how to use it to cope with negative thoughts. A worksheet will then walk participants through applying the strategy to a recent negative thought of their own. Daily surveys will involve a shortened version of this worksheet. | Other: Positive thinking<br>* Participants will be provided with information about how to cope with negative thoughts using positive thinking and asked to complete a worksheet walking them through the steps of positively reevaluating negative thoughts.<br>|
| Active Comparator: Positive thinking plus mood induction<br>The same videos will be used to describe negative automatic thoughts and then describe positive thinking, its benefits, and how to use it to cope with negative thoughts. Participants will then undergo a positive mood induction in which they are asked to recall a pleasant memory and try to re-experience those feelings. A worksheet will then walk participants through applying the strategy to a recent negative thought of their own. Daily surveys will involve the same mood induction and a shortened version of this worksheet. | Other: Positive thinking + Mood induction<br>* Participants will be provided with information about how to cope with negative thoughts using positive thinking and asked to complete a worksheet walking them through the steps of positively reevaluating negative thoughts. They will be assigned to a positive mood induction before completion of the worksheet.<br>|
| Active Comparator: Thought reevaluation<br>Videos will describe negative automatic thoughts and then describe reevaluating thoughts, its benefits, and how to use it to cope with negative thoughts. A worksheet will then walk participants through applying the strategy to a recent negative thought of their own. Daily surveys will involve a shortened version of this worksheet. | Other: Thought reevaluation<br>* Participants will be provided with information about how to cope with negative thoughts using thought reevaluation and asked to complete a worksheet walking them through the steps of reevaluating negative thoughts.<br>|
| Active Comparator: Thought reevaluation plus mood induction<br>The same videos will be used to describe negative automatic thoughts and then describe reevaluating thoughts, its benefits, and how to use it to cope with negative thoughts. Participants will then undergo a positive mood induction in which they are asked to recall a pleasant memory and try to re-experience those feelings. A worksheet will then walk participants through applying the strategy to a recent negative thought of their own. Daily surveys will involve the same mood induction and a shortened version of this worksheet. | Other: Thought reevaluation + Mood induction<br>* Participants will be provided with information about how to cope with negative thoughts using thought reevaluation and asked to complete a worksheet walking them through the steps of reevaluating negative thoughts. They will be assigned to a positive mood induction before completion of the worksheet.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Positive and Negative Affect Schedule | The PANAS is a 20-item self report scale that measures positive affect (10 items) and negative affect (10 items). Each item is rated on a Likert scale from 1 to 5, with higher scores indicating a higher endorsement of each affective descriptor. | Assessed at baseline, each day for 6 days, and one week post-baseline. | 
| Change in belief in negative thought | Participants will be asked how much they believed in a negative thought (0-100%) they recently experienced before completing a worksheet. After using a positive thinking or cognitive restructuring worksheet, participants will rate how much they currently believe their initial negative thought. | Assessed at baseline, each day for 6 days, and one week post-baseline. | 
| Change in mood | Participants will be asked to rate their mood on a scale of 0 (very negative) to 100 (very positive) before and after the positive mood induction. | Assessed at baseline, each day for 6 days, and one week post-baseline. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in positive thinking and cognitive restructuring skills | Cognitive restructuring skills will be assessed by the Competencies of Cognitive Therapy Scale-10, which is a 10-item self-report measure assessing the use of cognitive strategies to cope with negative mood. Positive thinking skills will be measured by the 10-item Positive Thinking Skills Scale, which assesses the use of positive thinking strategies to cope with negative mood. | Assessed at baseline and one week post-baseline. | 
| Change in Quick Inventory of Depressive Symptoms Self-Report | The QIDS-SR is a 16-item self-report measure of depressive symptoms. Scores range from 0 to 27, with higher scores indicating greater depressive symptom severity. | Assessed at baseline and one week post-baseline. |