An interventional study of Lifestyle psychoeducation intervention and Personalized digital psychoeducation intervention on emotion regulation in Adverse Childhood Experience, Depression / Major Depressive Disorder and Anxiety Depression, sponsored by Institute of Mental Health, Singapore. Not yet recruiting. Open to participants aged 15 Years to 35 Years. Per ClinicalTrials.gov, last updated 2026-11-06.
Sponsored by Institute of Mental Health, Singapore · Not applicable, Interventional, and Prevention
The present study aims to determine whether a personalized digital psychoeducation intervention (active intervention group) is more effective than self-monitoring of one's mood (control group) in reducing emotion regulation difficulties, depression, anxiety, and stress symptoms in at-risk youths exposed to adverse childhood experiences (ACEs).
We hypothesized that the active intervention group will be associated with less severe emotion regulation difficulties, depression, anxiety, and stress symptoms than the control group at post-intervention and 3-month follow-up. This study will recruit a total of N = 140 youths (age 15 to 35 years) with ACEs and randomized into either the active intervention group (n = 70) or the control group (n = 70). Participants will complete study measures at baseline, post-intervention, and at 3-month follow-up. The study team has expertise in youth mental health. This study is feasible and will be completed within 4 years. Our findings will support the development and implementation of an efficacious, cost-effective, personalized and scalable intervention to reduce poor mental health and prevent the onset of mental disorders among at-risk youths. Our intervention has significant potential to improve population health, quality of life, functioning, morbidity, and mortality, as well as alleviate the healthcare burden associated with ACEs.
Specific aims:
This study aims to examine the efficacy of personalized digital psychoeducation to self-monitoring control (1) to reduce poor mental health as indexed by self-reported depression, anxiety, and stress symptoms at post-intervention and at 3-month follow-up; and (2) to reduce emotion dysregulation as indexed by momentary emotion regulation ability deficits and rumination severity at post-intervention in youths with elevated hypothesized risk (exposure to adverse childhood experiences (ACEs) and elevated levels of emotion dysregulation, or mild to moderate depression, anxiety or stress symptoms).
Hypotheses:
We hypothesized that (1) the active intervention group will be associated with less depression, anxiety, and stress symptoms than the control group at post-intervention and 3-month follow-up; (2) the active intervention group will be associated with less severe emotion dysregulation than the control group at post-intervention.
Methodology and approach:
This study will involve a two-arm, single-blinded, prospective (i.e., three time-points; baseline, post-intervention, 3-month follow-up), pilot randomized controlled trial. A total of N = 140 youths (age 15 to 35 years) with ACEs will be recruited and randomized into either the active intervention group (Personalized Psychoeducation + Self-Monitoring; n = 70) or the control group (Self-Monitoring; n = 70).
Feasibility:
The study team has clinical and research expertise in youth mental health. This study is supported by a multidisciplinary team of established clinician-scientists and researchers. It is expected that this study will be completed within four years.
Importance to science or medicine:
We aim to develop an efficacious, cost-effective, personalized, scalable, and accessible transdiagnostic intervention to reduce poor mental health and prevent the onset of mental disorders among youths exposed to ACEs. Our intervention has a significant public health impact due to positive downstream effects on improving population health, quality of life, functioning, morbidity, and mortality, as well as alleviating the healthcare burden due to ACEs.
8,577 studies on the registry are indexed under Depression; 1,720 are open to participants now.
This study's planned enrollment of 140 is above the median of 81 across 7,063 interventional studies indexed under Depression.
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Exclusion Criteria:
In this active intervention arm, participants will undergo a 4-week (1 hour per session) online psychoeducation and skills training intervention focused on improving emotion regulation skills. We will tailor and personalize the 4-week intervention to each participant based on the Ecological Momentary Assessment-generated emotion regulation profiles at baseline. Emotion regulation profiles are mapped to 6 core areas (poor emotional awareness, poor emotional clarity, non-acceptance of emotional responses, difficulty in engaging in goal-directed behavior, impulsivity, and limited access to adaptive emotion regulation strategies) as outlined by the validated Difficulty in Emotion Regulation Scale (DERS) or DERS model.
Behavioral: Personalized digital psychoeducation intervention on emotion regulation
In this Active Comparator arm, participants will undergo a 4-week (1 hour per session) online psychoeducation intervention focused on learning healthy lifestyle strategies. The purpose of this arm is to support the blinding process, where both arms appear to receive similar interventions. Further, the lifestyle psychoeducation intervention is an evidence-based prevention intervention for depression and anxiety.
Behavioral: Lifestyle psychoeducation intervention
The Control Intervention is a 4-week (1 hour per session) online psychoeducation intervention focused on learning healthy lifestyle strategies. The first online session (Week 1) involves providing participants with a background of psychoeducation, adverse childhood experiences (ACEs), and mental health. The second online session (Week 2) involves teaching participants the importance of sleep hygiene. The third online session (Week 3) involves teaching participants the importance of a healthy diet. The fourth online session (Week 4) involves teaching participants the importance of exercise and providing an overview of outdoor activities in Singapore. Participants will undergo Ecological Momentary Assessment (EMA) self-monitoring of their emotions between each intervention session.
The Active Intervention is a 4-week (1 hour per session) online psychoeducation and skills training intervention focused on improving emotion regulation skills. The Active Intervention includes personalized and non-personalized syllabus. The non-personalized intervention syllabus includes the following content: Session 1 (Enhancing emotional awareness and clarity), Session 2 (Accepting emotional responses), Session 3 (Reducing impulsivity and engaging in goal-directed behavior), and Session 4 (Accessing emotion regulation strategies). The personalized syllabus is based on each participant's Ecological Momentary Assessment (EMA)-generated emotion regulation profiles at baseline. In general, for weaker areas, we will reduce the difficulty in the type of skills taught and provide more skills practice. For stronger areas, we will teach more advanced skills for the participant to explore. Participants will undergo EMA self-monitoring of their emotions between each intervention session.
Depression, Anxiety, and Stress as Assessed by DASS-21
The 21-item Depression Anxiety and Stress Scales (DASS; Lovibond \& Lovibond, 1995) will be used to screen for mild to moderate depression, anxiety, and stress symptoms. The DASS will also be administered at post-intervention and at the 3-month follow-up. Each item is rated on a 4-point Likert scale ranging from 0 (Did not apply to me) to 3 (Applied to me very much); higher scores indicate more severe depression, anxiety, and stress symptoms. Each subscale comprises 7 items and the subscale scores will be summed and multiplied by 2 as per scoring guidelines. Hence, each subscale score will range from 0 to 42.
Time frame: From enrollment to 3-month (post-intervention) follow-up
Global Emotion Dysregulation as Assessed by the DERS-SF
The 18-item Difficulties with Emotion Regulation Scale Short-Form (DERS-SF; Kaufman et al., 2016) will be used to screen for elevated levels of global emotion dysregulation. Global emotion dysregulation has 6 subscales: poor emotional awareness, poor emotional clarity, non-acceptance of emotional responses, difficulty in engaging in goal-directed behavior, impulsivity, and limited access to adaptive emotion regulation strategies. These subscales correspond to the 6 dimensions of the DERS model. Each item is rated a 5-point Likert scale ranging from 1 (Almost never) to 5 (Almost always); higher scores will indicate more severe global emotion dysregulation (scores range from 18 to 90).
Time frame: From enrollment to 3-month (post-intervention) follow-up
Ecological Assessment of Momentary Emotion Dysregulation
Ecological momentary assessment (EMA) of emotion dysregulation in the following two areas: Rumination and emotion regulation abilities. Two EMA items to assess rumination in response to recent stressors since the previous beep (How much were you focusing on the stressors? How much were you focusing on your emotions due to the stressors?). Both items are rated on a 100-point visual slider scale from 0 (not at all) to 100 (extremely). 21 EMA items to assess for emotion regulation abilities. Each item is rated on a 5-point Likert scale ranging from 1 (not at all) to 5 (completely).
Time frame: From baseline to the end of intervention at 4 weeks
Rumination as Assessed by the RRS
The 10-item Ruminative Response Scale short-form (RRS; Treynor et al., 2003) will be used to screen for elevated levels of rumination. Each item is rated on a 4-point Likert scale ranging from 1 (Almost never) to 4 (Almost always); higher scores indicate more severe rumination (scores range from 10 to 40).
Time frame: From enrollment to 3-month (post-intervention) follow-up
Subjective Well-Being as Assessed by the WEMWBS
The 14-item Warwick Edinburgh Mental Wellbeing Scale (WEMWBS; Tennant et al., 2007) will be used to assess for subjective well-being. Each item is rated on a 5-point Likert scale ranging from 1 (None of the time) to 5 (All of the time); higher scores indicate better positive well-being.
Time frame: From enrollment to the 3-month (post-intervention) follow-up
Multi-Dimensional Impulsivity as Assessed by the UPPS-P
The 20-item Urgency-Premeditation-Perseverance-Sensation Seeking-Positive Urgency scale (UPPS-P; Cyders et al., 2014) will be used to assess for multi-dimensional impulsivity and the subdomains include negative and positive urgency, lack of perseverance, lack of premeditation, and sensation-seeking. Each item is rated on a 4-point Likert scale ranging from 1 (Strongly Agree) to 4 (Strongly Disagree).
Time frame: From enrollment to three-month (post-intervention) follow-up
No study locations are listed for this record.
Plan to share: Yes — All de-identified IPD used in the results publication and subjected to formal approval by our governing ethics board.
Supporting information: Study protocol, Statistical analysis plan, Analytic code
Time frame: Beginning 1 year after publication with no end date
Access criteria: Researchers who contact the Principal Investigator and (1) submit a proposal that describes planned analyses (including but not limited to IPD meta-analysis, Intention-to-Treat (ITT) analyses based on pooled RCT data); and (2) sign a data sharing agreement; and (3) receive formal approval from our governing ethics board may be granted access to the de-identified IPD. Access to the de-identified IPD will be provided by the Principal Investigator and/or other methods (e.g., Trust Platform) as approved by our ethics boards and stated in the signed data sharing agreement.
Data sharing details ↗ · www.trustplatform.sg
From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
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Institute of Mental Health, Singapore