About this trial
This study aims to evaluate the effectiveness of a group-based Positive Affect (PA) intervention compared to an active control condition, Social Skills Training (SST), in reducing loneliness among young adults in Hong Kong and mainland China. It further examines the psychological mechanisms underlying intervention effects, specifically the roles of positive affect and perceived social support as mediators, and rejection sensitivity as a moderator influencing both treatment responsiveness and outcome translation.
Eligibility criteria
This trial does not accept healthy volunteersQualifiers
aged 18 to 30 years
proficiency in Chinese (Cantonese or Mandarin)
experiencing loneliness (defined as a score of ≥ 6 on the 3-item UCLA Loneliness Scale)
Disqualifiers
cognitive impairments
psychiatric disorders, learning disabilities, or active suicidal ideation
currently participating in other psychotherapy or psychosocial interventions aimed at enhancing well-being
Trial design
Parallel
Treatments tested in this trial
Group-based Positive Affect Intervention
BehavioralThis 4-week intervention consists of eight skills aimed at enhancing positive affect, delivered via group-based psychoeducation by trained facilitators. Participants will learn skills such as gratitude, mindfulness, and positive reappraisal, with sessions held once a week to test the effects of the intervention in reducing loneliness among young adults.
Group-based Social Skills Training
BehavioralThe SST intervention serves as an active control and focuses on improving interpersonal competence. It includes training in social behavior styles (assertive, shy, and aggressive), initiating and maintaining social interactions, setting boundaries, giving and receiving feedback, and conflict resolution. Improvements in interpersonal competence are expected to enhance perceived social support, which in turn reduces loneliness. The intervention will be delivered over a 4-week period.
Treatment groups
Trial outcomes
Primary outcomes
Loneliness measured by the University of California, Los Angeles (UCLA) Loneliness Scale
The UCLA Loneliness Scale is a reliable self-assessment tool designed to evaluate subjective feelings of loneliness. Total scores are calculated based on individual item ratings ranging from 1 (never) to 4 (always). Higher scores indicate a greater degree of loneliness (worse outcome).
Secondary outcomes
Perceived Stress on the Perceived Stress Scale (PSS-10)
The Chinese version of the Perceived Stress Scale is a validated self-report tool used to measure the degree to which situations in one's life are appraised as stressful. Individual items are rated on a scale from 0 (never) to 4 (very often). Higher scores indicate higher levels of perceived stress (worse outcome).
Symptoms of Depression on the Patient Health Questionnaire-9 (PHQ-9)
The Patient Health Questionnaire-9 is a reliable self-report measure designed to evaluate the severity of depressive symptoms over the past two weeks. Possible scores for each item range from 0 (not at all) to 3 (nearly every day). Higher scores indicate more severe symptoms of depression (worse outcome).
Symptoms of Anxiety on the Generalized Anxiety Disorder-7 (GAD-7) Scale
The Chinese version of the Generalized Anxiety Disorder-7 Scale is a validated, self-reported instrument assessing the severity of anxiety symptoms. Possible scores for each item range from 0 (not feeling at all) to 3 (most of the time).Higher scores indicate more severe symptoms of anxiety (worse outcome).
Perceived Social Support on the Multidimensional Scale of Perceived Social Support (MSPSS)
The Multidimensional Scale of Perceived Social Support evaluates the social support derived from three key sources: family, friends, and significant others. Respondents rate each item on a 7-point Likert scale, where 1 represents "very strongly disagree" and 7 indicates "very strongly agree." Higher scores indicate a higher level of perceived social support (better outcome).
Other outcomes
Affective Experience over the Past Week on the 30-item Affect Valuation Index (AVI)
The Affect Valuation Index (AVI) is a validated, self-reported instrument assessing affective experiences over the past week. It evaluates the frequency of actual emotions experienced. Possible scores for each emotion item range from 1 (very slightly or not at all) to 5 (extremely or all the time). Higher scores indicate a greater frequency of that specific affective state. (Note: High scores in positive affect represent a better outcome, while high scores in negative affect represent a worse outcome).
Meaning of Life on 7-point Meaning in Life Questionnaire (MLQ)
The Meaning in Life Questionnaire (MLQ) is a reliable self-assessment tool that evaluates an individual's sense of meaning in life across two subscales: Presence of Meaning and Search for Meaning. Each subscale (5 items each) has a minimum score of 5 and a maximum score of 35. Higher scores on the Presence subscale indicate a stronger sense that life is meaningful. Higher scores on the Search subscale indicate a greater drive to find meaning.
Gratitude on 7-point Gratitude Scale Questionnaire-Six Item Form (GQ-6)
The Gratitude Questionnaire-Six Item Form (GQ-6) is a validated self-report measure that evaluates the inclination to recognize and respond to life events with gratitude. Total scores range from 6 (strongly disagree across all items) to 42 (strongly agree across all items). Higher scores indicate a higher level of dispositional gratitude (better outcome).
Mindfulness on the 5-point Five Facet Mindfulness Questionnaire (FFMQ)
The Five Facet Mindfulness Questionnaire (FFMQ) is a validated measure assessing five different elements of mindfulness in daily life. Responses are scored on a scale from 1 (never or very rarely true) to 5 (very often or always true). Higher scores indicate higher levels of mindfulness (better outcome).
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