Targeting Components of Distress Tolerance

ConditionDistress, Emotional

Trial statusRecruiting

Trial phaseNot applicable

Trial typeInterventional

Biological sexAll

Age18+

SponsorUniversity of Arkansas, Fayetteville

About this trial

The goal of this clinical trial is to learn which aspects of distress intolerance (i.e., difficulties withstanding upsetting emotional states) are the most important for improving effective emotion regulation and associated mental health symptoms.

The main questions it aims to answer are:

How are willingness to feel upset and self-efficacy for withstanding distress associated with different emotion regulation strategies used in daily life?

Does targeting willingness to feel upset and/or self-efficacy for withstanding distress help people use more effective emotion regulation strategies in daily life when they feel upset?

Are improvements in emotion regulation strategies in daily life associated with fewer symptoms of mental health problems over time?

Participants will:

Answer questions about their moods, willingness to feel upset, self-efficacy for withstanding distress and emotion regulation strategies for three weeks using a cell phone app

Undergo a willingness, self-efficacy, combined or psychoeducational control intervention in the lab

Be prompted to use the intervention skill via the cell phone app during the second week, after the intervention

Complete weekly reports of mental health symptoms

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

Fluent in English

Uses Android or iPhone smartphone

Depression Anxiety and Stress Scale (DASS-21) scores of 42 and higher

Distress Intolerance Index (DII) scores of 3 or higher

Disqualifiers

Work or School that does not allow consistent access to phone (or is unsafe)

No internet access for completing follow-up surveys

Trial design

Design model

Parallel

Treatments tested in this trial

Self-Efficacy
Behavioral
Brief skills based psychotherapy session to increase perceived self-efficacy for withstanding distress, giving participants increased beliefs that they \*can\* do it.
Willingness
Behavioral
Brief skills based psychotherapy session to increase perceived willingness to engage with distress for withstanding distress, giving participants increased motivation to try.
Psychoeducation
Behavioral
Psychoeducation about the components and functions of emotion.

Treatment groups

240 Participants

are divided into 4 treatment groups

Group A: Psychoeducational ControlPlacebo comparator 1 intervention

Group B: Self-Efficacy (Only)Experimental treatment 2 interventions

Group C: Willingness (Only)Experimental treatment 2 interventions

Group D: Combined Willingness and Self-EfficacyExperimental treatment 3 interventions

Trial outcomes

Primary outcomes

Engagement behaviors

Emotion regulation strategies reflective of engagement; these are new items developed for this study and are not from an established scale. All items will be rated from 0 (not at all) to 6 (extremely). There will be 7 items assessing labeling ("I'm using emotion words to describe how I feel right now"), processing ("I'm reflecting on or writing about my feelings"), sharing ("I'm sharing how I feel with another person"), physical feeling ("I'm intentionally feeling my feelings in my body"), curiously considering ("I'm curiously considering how my feelings came about"), defusion ("I'm observing my feelings without getting 'stuck' in them"), and importance ("I'm trying to think about how this current situation maps on to what matters.")

Time frame

Assessed 5x/day via ecological momentary assessment

Disengagement behaviors

Emotion regulation strategies reflective of disengagement, some of which were modified from a momentary experiential avoidance measure (Hershenberg et al., 2017). All items will be rated from 0 (not at all) to 6 (extremely).Items will assess distraction ("Trying to distract myself from my feelings'), thought suppression ("Trying to push unwanted thoughts out of my mind."), discounting ("I'm telling myself I shouldn't be feeling the way I'm feeling"), expressive suppression ("I'm trying to control my feelings by not expressing them"), procrastination ("I'm intentionally putting of an unpleasant task until later"), denial ("I'm trying to 'turn off' the feelings that I don't want to feel"), and reduce importance ("Trying to think about the current situation as unimportant to me.")

Time frame

Assessed 5x/day via ecological momentary assessment

GAD-7

Symptoms of anxiety

Time frame