Effectiveness and uptake of a transdiagnostic emotion regulation mobile intervention among university students: Protocol for a randomized controlled trial
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Cited by 3 publications
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Optimization of a Mobile Transdiagnostic Emotion Regulation Intervention for University Students: A Micro‐Randomized Trial
Increasing mental health problems among university students highlight the need for scalable, effective solutions. We have developed a transdiagnostic mobile intervention called ROOM, promoting adaptive emotion regulation (ER) skills among university students. Understanding how the intervention works and optimising content and delivery is essential for creating an effective and adaptive system. Therefore, this study aimed to optimise ROOM through a sequential explanatory mixed‐methods design, combining a Micro‐Randomized Trial (MRT), evaluating within‐person effects using repeated randomisation, with user experience interviews. 161 university students (82% females) participated in a 3‐week MRT to assess the intervention proximal outcomes, that is, participants' positive and negative emotional states after completing intervention exercises. Additionally, we evaluated impact on distal outcomes (i.e., distress symptoms and ER skills), and user experience by combining objective (e.g., exercise completion rates) and subjective (e.g., exercise likability and helpfulness ratings) engagement patterns with insights from the semi‐structured interviews (n = 18). Upon receiving the intervention, positive emotional states increased and negative ones decreased. The effect on positive emotional states gradually decreased over time while the effect on negative emotional states remained stable throughout the 3‐week intervention period. Distress symptoms and ER skills either remained stable or improved over the 3 weeks, which indicated the intervention's safety. Overall, engagement patterns and interview data show that the intervention was well received, students enjoyed this study design and found context‐sensitive content recommendations highly relevant.
Optimization of a Mobile Transdiagnostic Emotion Regulation Intervention for University Students: A Micro‐Randomized Trial
Increasing mental health problems among university students highlight the need for scalable, effective solutions. We have developed a transdiagnostic mobile intervention called ROOM, promoting adaptive emotion regulation (ER) skills among university students. Understanding how the intervention works and optimising content and delivery is essential for creating an effective and adaptive system. Therefore, this study aimed to optimise ROOM through a sequential explanatory mixed‐methods design, combining a Micro‐Randomized Trial (MRT), evaluating within‐person effects using repeated randomisation, with user experience interviews. 161 university students (82% females) participated in a 3‐week MRT to assess the intervention proximal outcomes, that is, participants' positive and negative emotional states after completing intervention exercises. Additionally, we evaluated impact on distal outcomes (i.e., distress symptoms and ER skills), and user experience by combining objective (e.g., exercise completion rates) and subjective (e.g., exercise likability and helpfulness ratings) engagement patterns with insights from the semi‐structured interviews (n = 18). Upon receiving the intervention, positive emotional states increased and negative ones decreased. The effect on positive emotional states gradually decreased over time while the effect on negative emotional states remained stable throughout the 3‐week intervention period. Distress symptoms and ER skills either remained stable or improved over the 3 weeks, which indicated the intervention's safety. Overall, engagement patterns and interview data show that the intervention was well received, students enjoyed this study design and found context‐sensitive content recommendations highly relevant.
Genetic Basis of Emotional Regulation: Integrative Analysis of Behavioral and Neurobiological Data
Emotional regulation (ER) is the process by which people change their physiology, expressions, and emotional experiences to operate in their daily lives. Deficits in emotion control may be connected to physical and mental health consequences. This review aims to identify genetic variants, understand neurobiological mechanisms, and explore behavioral phenotypes associated with ER. In our study, we included English studies from online databases such as Web of Science, Cochrane Library, Google Scholar, PubMed, and Scopus using the following keywords “genetic factors”, “genetic markers”, “Emotional regulation”, “emotional dysregulation”, “neurobiology”, and “behavior” till June 2024. The result of the search utilizing our search strategy was 2107 studies. We screened the articles relevant to our topic by screening these articles. We involved 12 studies that met the inclusion criteria of our narrative review. Our study involved 6114 individuals divided into 4511 females and 1603 males. The mean age of the included participants was 18 years. Out of all the genes studied in relation to ER, SLC6A4 was the most frequently found. The findings show that individuals homozygous for the l allele were less likely to misbehave on the task than those with two or one copy of the s allele of the 5-HTTLPR polymorphism. There are essential therapeutic implications from comprehending the genetic basis of ER. It can help with the creation of individualized interventions for people with emotional dysregulation (ED) linked to psychiatric diseases, such as depression and anxiety disorders. For example, the identification of genetic markers may aid in predicting treatment response to particular therapeutic approaches (such as medicine vs cognitive-behavioral therapy) customized to a person's genetic profile. This review is limited by the small sample size and insufficient studies identifying the genetic variants and behavioral phenotypes associated with ER. In conclusion, the current research presents empirical proof that environmental and genetic factors impact individual variances in ER. Moreover, it's significant to note that shared genetic effects play a role in the relationship between neurobiology, behavior, and ER.
Design Process of ROOM: A Mobile Intervention Supporting University Students’ Well-Being (Preprint)
BACKGROUND University students are experiencing a multitude of challenges and a rise in mental health issues impacting their academic performance and overall well-being. In response, Erasmus University Rotterdam started the Student Wellbeing Programme in 2019, offering comprehensive, tailored support through a stepped-care framework to enhance student success and well-being. One of the tools developed for the students is an anonymous and accessible preventative mental health app, ROOM. OBJECTIVE This paper aims to describe the process of ROOM’s development guided by the Centre for eHealth Research roadmap (CeHRes) roadmap and privacy-by-design principles, highlighting lessons learned throughout this process. METHODS This study describes the first three phases of the CeHRes Roadmap: Contextual Inquiry, Value Specification, and Design. It details the population (i.e., stakeholders) included, methods employed (i.e., literature reviews, expert groups, cognitive walkthroughs, interviews, experimental designs) and the outcomes of each phase. RESULTS The four-year development process resulted in ROOM, an adaptive mental health intervention that uses a transdiagnostic approach. The intervention targets underlying factors of most prevalent mental health problems among this population, namely emotion regulation (ER) skills and self-awareness. ROOM employs various therapeutic approaches, including Acceptance and Commitment Therapy, Cognitive Behavioural Therapy, Positive Psychology, Mindfulness, and Self-Compassion, to suit diverse student needs. To address this demographic’s reported technostress, ROOM integrates tools that support the application of skills in real life. Altogether, the minimal viable product consists of 26 ER exercises, tools stimulating the transfer of learned skills into real-life environments, self-assessments evaluating user states (e.g., stress levels) and traits (e.g., perfectionism), a mood tracker, and an intelligent recommender system that increases the relevance and responsiveness of the tool. CONCLUSIONS We detailed the development of ROOM, including the trade-offs and challenges encountered. The trade-offs needed to be made to balance user needs, resource constraints, and privacy-by-design standards, often compromising ROOM’s interactivity. Other challenges included simplifying complex psychological concepts into brief formats, fostering interdisciplinary collaboration, balancing academic rigor with industry production pace, and operating with fixed resources while committing to an iterative process. This paper may serve as a primer for designing transdiagnostic, adaptive mental health interventions for youth, blending therapeutic approaches and fostering skill transfer.
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