About this trial
This two-armed randomized controlled trial aims to investigate the effectiveness of an emotion regulation intervention in individuals with and without depressive disorders. The study encompasses participants diagnosed with mild to moderate major depression or persistent depressive disorder and healthy controls without a current depressive disorder.
Participants will be randomly assigned to either the intervention group, receiving a valence-specific emotion regulation intervention in daily life, or a monitoring-only control group. The valence-specific intervention supports the implementation of different emotion regulation strategies based on whether a person is experiencing mainly positive or negative emotions. In contrast, participants in the control group will solely monitor their positive and negative emotions and the strategies used to regulate them.
Outcome measures include emotion regulation ability, self-efficacy, and strategy use, depressive symptoms, positive and negative affect, and emotion beliefs (controllability, usefulness).
A second aim of the study is to compare beliefs about positive emotions and strategies to regulate them between individuals with and without current depressive disorders. Furthermore, the investigators aim to examine why individuals might choose unfavorable emotion regulation strategies even when feeling good. Therefore, another research question is, how emotion beliefs might explain emotion regulation strategy choice.
Eligibility criteria
This trial accepts healthy volunteersQualifiers
Online consent for participation
Adequate proficiency in the German language, encompassing both reading and comprehension skills
Ownership of a smartphone, compatible with either Android or iOS operating systems, and access to the Internet
Currently meeting the DSM-5 criteria for a mild or moderate major depressive episode, or persistent depressive disorder
Disqualifiers
Current severe substance use disorder
Acute suicidality
Current severe major depressive episode
Lifetime bipolar disorder
Trial design
Parallel
Treatments tested in this trial
Valence-Specific Ecological Momentary Intervention
BehavioralThe ecological momentary intervention is designed to enhance participants ability to select and effectively implement emotion regulation strategies fitting to the valence of their current emotions. Specifically, the intervention instructs participants to use the strategy of savoring to amplify their positive emotions, fostering an appreciation for the present moment. Conversely, for the attenuation of negative emotions, the intervention advocates to use the strategy of reappraisal, encouraging participants to reinterpret adverse situations in a more positive or neutral way, thus reducing their emotional impact. This targeted approach ensures that the emotion regulation strategies are not only effective but also contextually appropriate.
Treatment groups
Trial outcomes
Primary outcomes
Emotion Regulation Ability (Positive, Negative Emotions)
The Perth Emotion Regulation Competency Inventory (PERCI; Preece al., 2021) consists of 32 items, rated on a 7-point scale (1 = strongly disagree, 4 = neither agree nor disagree, 7 = strongly agree) and measures people's ability to regulate their positive and negative emotions. Two different composite scores can be computed to indicate positive and negative emotion regulation ability (Min = 16, Max = 112 for each score), with higher scores indicating a higher level of difficulty regulating positive or negative emotions.
Emotion Regulation Self-Efficacy for Positive and Negative Emotions
The German version of the Regulatory Emotional Self-Efficacy-Revised (RESE-R) Scale (adapted from Caprara et al., 2008) consists of 10 items, rated on a 5-point scale (1 = not at all well to 5 = very well). The scale assesses self-efficacy in expressing positive emotions (4 items, Min = 1, Max = 5) and in managing negative emotions (despondency/distress: 3 Items, anger/irritation: 3 items, Min = 1, Max = 5), with higher scores indicating higher self-efficacy beliefs.
Secondary outcomes
Emotion Regulation Strategy Use in Positive and Negative Emotional Contexts
Data will be collected using an adaption of the smartphone app EmoTrack (adapted from Pruessner et al., 2023). The app assesses among other factors, the intensity with which participants employ various emotion regulation strategies to manage specific positive and negative emotions, using an 11-point scale (1 = not at all, 11 = very much). Scores for strategy usage will be aggregated across all intensity ratings from the four daily measurements over a continuous seven-day period (Min = 1, Max = 11). Higher scores indicate that a participant engages in a specific strategy more strongly in daily life.
Depressive Symptoms
The Beck Depression Inventory-II (Wang et al., 2013) consists of 21 items, rated on a 4-point scale (0-3) with four statements of increasing severity related to a specific depressive symptom. Higher sum scores (Min = 0, Max = 63) indicate a higher severity of depressive symptoms.
Positive and Negative Affect
Data will be collected using an adaption of the smartphone app EmoTrack (adapted from Pruessner et al., 2023). The app measures among other factors, the intensity of specific positive and negative emotions selected from the Positive and Negative Affect Schedule - Expanded Form (PANAS-X; Watson \& Clark, 1994), using an 11-point scale (1 = not at all, 11 = very much). Scores for positive and negative emotions will be aggregated across all intensity ratings from the four daily measurements over a continuous seven-day period (Min = 1, Max = 11). Higher scores indicate that participants experience a higher level of positive (resp. negative) emotions in daily life.
Emotion Beliefs (Controllability, Usefulness) about Positive and Negative Emotions
The Emotion Beliefs Questionnaire (EBQ, Becerra et al., 2020) consists of 16 items, rated on a 7-point scale (1 = strongly disagree, 4 = neither agree nor disagree, 7 = strongly agree). Sum scores can be computed for different subscales: General-Contollability (8 Items, Min: 8; Max: 56), Positive-Usefulness (4 Items, Min: 4, Max: 28), Negative-Usefulness (4 Items, Min: 4, Max: 28), with higher scores indicating that people believe, that emotions are uncontrollable and useless.
Other outcomes
Well-being
The World Health Organization Well-Being Index (WHO-5; Topp et al., 2015) consists of 5 items, rated on a 6-point scale (0 = at no time, 5 = all of the time). Elevated scores indicate a higher well-being (Min = 0, Max = 25).
Life Satisfaction
The Satisfaction With Life Scale (SWLS; Diener et al., 1985) comprises 5 items, rated on a 7-point scale (1 = strongly disagree to 7 = strongly agree). Higher scores indicate a higher level of life satisfaction (Min = 5, Max = 35).
Emotion Beliefs about Positive Emotions (Delay Happiness, Living in the Moment)
The Delaying Happiness and Living in the Moment Scale (Park et al., 2021) consists of 2 subscales with 10 items each, rated on a 7-point scale (1 = strongly disagree to 7 = strongly agree). Higher values indicate stronger beliefs that happiness is an investment over time (Delay Happiness) or stronger beliefs that one should savor happiness now versus later (Living in the Moment, Min = 1, Max = 7 for each scale).
Emotion Beliefs about Positive Emotions (Fear of Happiness)
The Fear of Happiness Scale (Joshanloo et al., 2014) consists of 5 items. Each item is measured on a 7-point scale (1 = strongly disagree to 7 = strongly agree). Higher scores indicate a greater fear of happiness (Min = 5, Max = 35).
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