Recalling and Anticipating Specific Positive Events to Boost Resilience in Adolescents

NCT05757180 | Completed DMC

• 1 other identifier: G049019N
• Study Type: interventional
• Target: 191
• Locations: 1 country
• Sites: 5

Brief Summary

Many young people are experiencing stress-related mental health problems, with some recent studies suggesting this number is increasing. Especially now, in the context of the COVID-19 pandemic, there is a significant increase in depression and anxiety in adolescents. An important way to help address this challenge is not so much to focus on trying to repair what makes young people vulnerable but to focus on building resilience. Resilience refers to the ability to successfully deal with stressful experiences. Recent research shows that being able to vividly remember and imagine positive events can buffer the negative consequences of stress, and makes a convincing case that training adolescents in recalling and anticipating positive events would promote resilience and thereby improve their mental wellbeing. And this is exactly what the current project sets out to do for the very first time. Adolescents will receive a playful group-training in school to make them better at recalling and anticipating positive events, which is expected to help them to bounce back more swiftly from challenging or otherwise stressful life events. The investigators predict that youngsters who follow our Positive Event Training will experience more positive emotions, will show improved resilience and report better mental wellbeing. The investigators will also develop a free online training protocol for teachers so that schools can provide this resilience program on their own, without the need of external professional trainers.

Conditions

Specific Positive Memories; Specific Positive Future Events; Resilience; Mental Wellbeing

Keywords

adolescents; anhedonia; dampening; episodic future thinking; memory specificity; positive emotions; resilience; savoring; wellbeing

Outcome Measures

Primary Outcomes (2)

• Change in Resilience

  Connor-Davidson Resilience Scale (CD-RISC, short version) to assess resilience - This scale consists of 10 items (e.g., "Dealing with stress makes me stronger.") that are rated on a 5-point Likert scale going from 1 (not at all) to 5 (very often), with higher scores indicating higher resilience.

  1 week before the intervention, 1 week after the intervention and 2 months after the intervention.

• Change in Mental wellbeing

  Short Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS; Stewart-Brown et al., 2009) to assess mental wellbeing - The SWEMWBS consists of seven statements (e.g., "I felt relaxed.") about thoughts and feelings that are scored on a 5-point Likert scale ranging from 1 (never) to 5 (always). Higher scores reflect higher mental wellbeing.

  One week before the intervention, one week after the intervention and two months after the intervention; The SWEMWBS consists of seven statements (e.g., "I felt relaxed.") about thoughts and feelings that are scored on a 5-point Likert scale ranging from

Secondary Outcomes (6)

• Change in Positive affect

  One week before the intervention, one week after the intervention and two months after the intervention

• Change in Positive affect regulation

  One week before the intervention, one week after the intervention and two months after the intervention

• Change in Anhedonia

  One week before the intervention, one week after the intervention and two months after the intervention

• Change in Dampening

  One week before the intervention, one week after the intervention and two months after the intervention

• Change in Savoring

  One week before the intervention, one week after the intervention and two months after the intervention

Other Outcomes (6)

• Change in episodic future thinking specificity (manipulation check)

  One week before the intervention, one week after the intervention and two months after the intervention

• Change in positive memory specificity (manipulation check)

  One week before the intervention, one week after the intervention and two months after the intervention

• Change in Pleasure

  One week before the intervention, one week after the intervention and two months after the intervention

Study Arms (2)

Intervention group

EXPERIMENTAL

Classes that will follow Positive Events Training.

Behavioral: Positive Events Training (PET)

Control group

ACTIVE COMPARATOR

Classes that will follow Bogus Control Training.

Behavioral: CREAtive writing Training (CREAT)

Interventions

Positive Events Training (PET) BEHAVIORAL

PET is a group-based training program combining Memory Specificity Training (MEST; Raes, 2007) and Future Event Specificity Training (FEST; Dutch version of Hallford et al. (2020): Changing the Future: An initial test of Future Specificity Training). It comprises four sessions of 50 minutes each. The training is delivered in a standardized manner, using the Positive Event Training Manual developed for this study (content adapted from our MEST and FEST manuals). Following brief psychoeducation on the rationale, participants practice generating detailed specific memories and future events using neutral and positive cue-words. Participants are maximally supported and challenged by the trainer and by the other group-members to generate very specific and highly detailed memories and future events using mental imagery and drawing upon visual, olfactory, auditory and emotional elements of the events, including both contextual and sensory-perceptual details.

Intervention group

CREAtive writing Training (CREAT) BEHAVIORAL

CREAT follows the exact same format and length as the PET training (i.e., delivered by a trainer in group over 4 x 50-minute sessions, including homework exercises). Following brief psychoeducation on the (bogus\*) rationale behind PET, participants complete a series of creative writing exercises using funny and thought-provoking writing prompts. Just as in PET, participants are maximally supported and challenged by the trainer and by the other group-members, in this case to generate completions that are as creative and funny as possible. The investigators used CREAT successfully before in an online format as a bogus control training for a memory specificity training. (\*) The investigators tell participants that these creative writing exercises have been found to be beneficial for mental wellbeing, as creative writing exercises cultivate creativity and stimulate participants' imagination skills.

Control group

Eligibility Criteria

• Age: 12 Years - 16 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Child (0-17)

You may qualify if:

• All adolescents of the selected classes of the participating schools (12-16 years; 1st and 2nd grade of secondary school) who want to take part in the study and give informed consent (own informed consent and active parental informed consent) will be allowed to take part in the study.
• To minimize the risk of too much heterogeneity in our final sample, for instance due to context factors related to the type of education, the investigators will first recruit classes of adolescents that follow general secondary education. Future studies (after PET has been properly evaluated in this study) should also be conducted in samples of adolescents following other types of secondary education.

Sponsors & Collaborators

• Prof. dr. Filip Raes: lead
• Research Foundation Flanders: collaborator

Study Sites (5)

Sint Lambertuscollege

Bilzen, Limburg, 3740, Belgium

Location

GO! Next sportschool Hasselt

Hasselt, Limburg, 3500, Belgium

Location

Scholen Kindsheid Jesu

Hasselt, Limburg, 3500, Belgium

Location

KOBOS Secundaire Scholen

Kapelle-op-den-Bos, Vlaams-Brabant, 1880, Belgium

Location

Pius X - instituut

Antwerp, 2020, Belgium

Location

Related Publications (35)

• Mojtabai R, Olfson M, Han B. National Trends in the Prevalence and Treatment of Depression in Adolescents and Young Adults. Pediatrics. 2016 Dec;138(6):e20161878. doi: 10.1542/peds.2016-1878. Epub 2016 Nov 14.

  PMID: 27940701 BACKGROUND

• Nearchou F, Flinn C, Niland R, Subramaniam SS, Hennessy E. Exploring the Impact of COVID-19 on Mental Health Outcomes in Children and Adolescents: A Systematic Review. Int J Environ Res Public Health. 2020 Nov 16;17(22):8479. doi: 10.3390/ijerph17228479.

  PMID: 33207689 BACKGROUND

• Jorm AF, Patten SB, Brugha TS, Mojtabai R. Has increased provision of treatment reduced the prevalence of common mental disorders? Review of the evidence from four countries. World Psychiatry. 2017 Feb;16(1):90-99. doi: 10.1002/wps.20388.

  PMID: 28127925 BACKGROUND

• Skrove M, Romundstad P, Indredavik MS. Resilience, lifestyle and symptoms of anxiety and depression in adolescence: the Young-HUNT study. Soc Psychiatry Psychiatr Epidemiol. 2013 Mar;48(3):407-16. doi: 10.1007/s00127-012-0561-2. Epub 2012 Aug 8.

  PMID: 22872359 BACKGROUND

• Simon-Saiz MJ, Fuentes-Chacon RM, Garrido-Abejar M, Serrano-Parra MD, Larranaga-Rubio E, Yubero-Jimenez S. Influence of resilience on health-related quality of life in adolescents. Enferm Clin (Engl Ed). 2018 Sep-Oct;28(5):283-291. doi: 10.1016/j.enfcli.2018.06.003. Epub 2018 Jul 20. English, Spanish.

  PMID: 30037487 BACKGROUND

• Askelund AD, Schweizer S, Goodyer IM, van Harmelen AL. Positive memory specificity is associated with reduced vulnerability to depression. Nat Hum Behav. 2019 Mar;3(3):265-273. doi: 10.1038/s41562-018-0504-3. Epub 2019 Jan 14.

  PMID: 30953005 BACKGROUND

• Speer ME, Delgado MR. Reminiscing about positive memories buffers acute stress responses. Nat Hum Behav. 2017 May;1(5):0093. doi: 10.1038/s41562-017-0093. Epub 2017 Apr 24.

  PMID: 31482135 BACKGROUND

• Arditte Hall KA, De Raedt R, Timpano KR, Joormann J. Positive memory enhancement training for individuals with major depressive disorder. Cogn Behav Ther. 2018 Mar;47(2):155-168. doi: 10.1080/16506073.2017.1364291. Epub 2017 Aug 22.

  PMID: 28826327 BACKGROUND

• Hallford DJ, Yeow JJE, Fountas G, Herrick CA, Raes F, D'Argembeau A. Changing the future: An initial test of Future Specificity Training (FeST). Behav Res Ther. 2020 Aug;131:103638. doi: 10.1016/j.brat.2020.103638. Epub 2020 May 7.

  PMID: 32416495 BACKGROUND

• Tugade MM, Fredrickson BL. Resilient individuals use positive emotions to bounce back from negative emotional experiences. J Pers Soc Psychol. 2004 Feb;86(2):320-33. doi: 10.1037/0022-3514.86.2.320.

  PMID: 14769087 BACKGROUND

• Fredrickson BL. The role of positive emotions in positive psychology. The broaden-and-build theory of positive emotions. Am Psychol. 2001 Mar;56(3):218-26. doi: 10.1037//0003-066x.56.3.218.

  PMID: 11315248 BACKGROUND

• Nelis S, Holmes EA, Raes F. Response Styles to Positive Affect and Depression: Concurrent and Prospective Associations in a Community Sample. Cognit Ther Res. 2015;39(4):480-491. doi: 10.1007/s10608-015-9671-y.

  PMID: 26229213 BACKGROUND

• Nelis S, Bastin M, Raes F, Bijttebier P. When Do Good Things Lift You Up? Dampening, Enhancing, and Uplifts in Relation To Depressive and Anhedonic Symptoms in Early Adolescence. J Youth Adolesc. 2018 Aug;47(8):1712-1730. doi: 10.1007/s10964-018-0880-z. Epub 2018 Jun 20.

  PMID: 29926335 BACKGROUND

• Vinckier F, Gourion D, Mouchabac S. Anhedonia predicts poor psychosocial functioning: Results from a large cohort of patients treated for major depressive disorder by general practitioners. Eur Psychiatry. 2017 Jul;44:1-8. doi: 10.1016/j.eurpsy.2017.02.485. Epub 2017 Mar 8.

  PMID: 28535406 BACKGROUND

• Hallford DJ, Sharma MK. Anticipatory pleasure for future experiences in schizophrenia spectrum disorders and major depression: A systematic review and meta-analysis. Br J Clin Psychol. 2019 Nov;58(4):357-383. doi: 10.1111/bjc.12218. Epub 2019 Mar 10.

  PMID: 30854671 BACKGROUND

• Ducasse D, Loas G, Dassa D, Gramaglia C, Zeppegno P, Guillaume S, Olie E, Courtet P. Anhedonia is associated with suicidal ideation independently of depression: A meta-analysis. Depress Anxiety. 2018 May;35(5):382-392. doi: 10.1002/da.22709. Epub 2017 Dec 12.

  PMID: 29232491 BACKGROUND

• Hallford DJ, Carmichael AM, Austin DW, Takano K, Raes F, Fuller-Tyszkiewicz M. A study protocol for a randomised trial of adjunct computerised memory specificity training (c-MeST) for major depression in youth: targeting cognitive mechanisms to enhance usual care outcomes in mental health settings. Trials. 2020 Jan 14;21(1):85. doi: 10.1186/s13063-019-4036-6.

  PMID: 31937350 BACKGROUND

• Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007 May;39(2):175-91. doi: 10.3758/bf03193146.

  PMID: 17695343 BACKGROUND

• Raes F, Williams JM, Hermans D. Reducing cognitive vulnerability to depression: a preliminary investigation of MEmory Specificity Training (MEST) in inpatients with depressive symptomatology. J Behav Ther Exp Psychiatry. 2009 Mar;40(1):24-38. doi: 10.1016/j.jbtep.2008.03.001. Epub 2008 Mar 12.

  PMID: 18407245 BACKGROUND

• Soer R, Six Dijkstra MWMC, Bieleman HJ, Stewart RE, Reneman MF, Oosterveld FGJ, Schreurs KMG. Measurement properties and implications of the Brief Resilience Scale in healthy workers. J Occup Health. 2019 May;61(3):242-250. doi: 10.1002/1348-9585.12041. Epub 2019 Mar 22.

  PMID: 30903648 BACKGROUND

• Smith BW, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J. The brief resilience scale: assessing the ability to bounce back. Int J Behav Med. 2008;15(3):194-200. doi: 10.1080/10705500802222972.

  PMID: 18696313 BACKGROUND

• Stewart-Brown S, Tennant A, Tennant R, Platt S, Parkinson J, Weich S. Internal construct validity of the Warwick-Edinburgh Mental Well-being Scale (WEMWBS): a Rasch analysis using data from the Scottish Health Education Population Survey. Health Qual Life Outcomes. 2009 Feb 19;7:15. doi: 10.1186/1477-7525-7-15.

  PMID: 19228398 BACKGROUND

• Watson D, Clark LA, Tellegen A. Development and validation of brief measures of positive and negative affect: the PANAS scales. J Pers Soc Psychol. 1988 Jun;54(6):1063-70. doi: 10.1037//0022-3514.54.6.1063.

  PMID: 3397865 BACKGROUND

• Feldman GC, Joormann J, Johnson SL. Responses to Positive Affect: A Self-Report Measure of Rumination and Dampening. Cognit Ther Res. 2008 Aug 1;32(4):507-525. doi: 10.1007/s10608-006-9083-0.

  PMID: 20360998 BACKGROUND

• Bastin M, Nelis S, Raes F, Vasey MW, Bijttebier P. Party Pooper or Life of the Party: Dampening and Enhancing of Positive Affect in a Peer Context. J Abnorm Child Psychol. 2018 Feb;46(2):399-414. doi: 10.1007/s10802-017-0296-3.

  PMID: 28391490 BACKGROUND

• Reijntjes A, Dekovic M, Vermande M, Telch MJ. Role of depressive symptoms in early adolescents' online emotional responding to a peer evaluation challenge. Depress Anxiety. 2009;26(2):135-46. doi: 10.1002/da.20446.

  PMID: 19031485 BACKGROUND

• Hallford DJ, Austin DW, Takano K, Fuller-Tyszkiewicz M, Raes F. Computerized Memory Specificity Training (c-MeST) for major depression: A randomised controlled trial. Behav Res Ther. 2021 Jan;136:103783. doi: 10.1016/j.brat.2020.103783. Epub 2020 Nov 27.

  PMID: 33291054 BACKGROUND

• Clarke A, Friede T, Putz R, Ashdown J, Martin S, Blake A, Adi Y, Parkinson J, Flynn P, Platt S, Stewart-Brown S. Warwick-Edinburgh Mental Well-being Scale (WEMWBS): validated for teenage school students in England and Scotland. A mixed methods assessment. BMC Public Health. 2011 Jun 21;11:487. doi: 10.1186/1471-2458-11-487.

  PMID: 21693055 BACKGROUND

• Hallford DJ, Barry TJ, Austin DW, Raes F, Takano K, Klein B. Impairments in episodic future thinking for positive events and anticipatory pleasure in major depression. J Affect Disord. 2020 Jan 1;260:536-543. doi: 10.1016/j.jad.2019.09.039. Epub 2019 Sep 9.

  PMID: 31539690 BACKGROUND

• Williams JM, Barnhofer T, Crane C, Herman D, Raes F, Watkins E, Dalgleish T. Autobiographical memory specificity and emotional disorder. Psychol Bull. 2007 Jan;133(1):122-48. doi: 10.1037/0033-2909.133.1.122.

  PMID: 17201573 BACKGROUND

• Raes F, Hermans D, Williams JM, Demyttenaere K, Sabbe B, Pieters G, Eelen P. Reduced specificity of autobiographical memory: a mediator between rumination and ineffective social problem-solving in major depression? J Affect Disord. 2005 Aug;87(2-3):331-5. doi: 10.1016/j.jad.2005.05.004.

  PMID: 15979154 BACKGROUND

• Bromberg U, Wiehler A, Peters J. Episodic Future Thinking Is Related to Impulsive Decision Making in Healthy Adolescents. Child Dev. 2015 Sep-Oct;86(5):1458-68. doi: 10.1111/cdev.12390. Epub 2015 Jun 25.

  PMID: 26110500 BACKGROUND

• Bromberg U, Lobatcheva M, Peters J. Episodic future thinking reduces temporal discounting in healthy adolescents. PLoS One. 2017 Nov 22;12(11):e0188079. doi: 10.1371/journal.pone.0188079. eCollection 2017.

  PMID: 29166658 BACKGROUND

• Sherdell L, Waugh CE, Gotlib IH. Anticipatory pleasure predicts motivation for reward in major depression. J Abnorm Psychol. 2012 Feb;121(1):51-60. doi: 10.1037/a0024945. Epub 2011 Aug 15.

  PMID: 21842963 BACKGROUND

• Loyen E, Bogaert L, Hallford DJ, D'Argembeau A, Raes F. Study protocol for a randomized controlled trial of the RASPERA project: recalling and anticipating specific positive events to boost resilience in adolescents. Front Public Health. 2023 Nov 24;11:1216988. doi: 10.3389/fpubh.2023.1216988. eCollection 2023.

  PMID: 38074707 DERIVED

MeSH Terms

Conditions

Anhedonia

Condition Hierarchy (Ancestors)

Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms

Study Officials

• Filip Raes, Prof. dr.

  KU Leuven

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Professor

Model Details: A cluster randomized-controlled trial design will be used with a two (condition: PET vs. active control) x three (time-point: baseline, post-training and FU) factorial-design.

Study Record Dates

• First Submitted: February 14, 2023
• First Posted: March 7, 2023
• Study Start: October 21, 2022
• Primary Completion: May 13, 2023
• Study Completion: May 13, 2023
• Last Updated: July 7, 2023

Record last verified: 2023-07

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, ICF
• Time Frame: The coded, pseudonomized dataset will be uploaded in a csv format to OSF (in a restricted access repository) upon publication of the research results.
• Access Criteria: Coded, pseudonomized data can be shared with regulatory authorities, ethical committees, other parties that collaborate with the research team. Other researchers will only have access to the coded, pseudonomized data, and only if they agree with the confidentiality rules agreed upon within this study.

Locations

BE (5)