Ecological Momentary Intervention for Reward in Anhedonia

NCT07155941 | Recruiting

• 1 other identifier: EMIRA
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

The present study evaluates a two week ecological momentary intervention (EMI) in reducing anhedonia and psychological distress (i.e. elevated depression, stress and anxiety). Participants in the experimental group complete three daily exercises targeting reward-related processes, including positive mental imagery, savoring, gratitude, taking ownership for positive experience, and silver lining. These components were selected to improve reward anticipation as well as reward consumption and reward learning as the underlying mechanisms of anhedonia. An active control group receives progressive muscle relaxation training, matched in format and frequency. Exercise units are presented using audio recordings via smartphone app.

Conditions

Anhedonia; Anxiety; Stress; Depression

Outcome Measures

Primary Outcomes (2)

• Change in anhedonia/hedonic capacity; measured with the Snaith-Hamilton Pleasure Scale (SHAPS) from baseline to post-intervention and baseline to 3-months follow-up

  The scale consists of 14 items rated on a four-point Likert-scale (1 = "I completely agree", 2 = "I agree", 3 = "I do not agree", 4 = "I completely disagree"). The SHAPS assesses participants' hedonic capacity/ability to feel pleasure. Sum scores range from 14 to 56, with a higher scores indicating more pronounced anhedonia. The scale is a standard survey method for anhedonia and has been validated by a large number of studies.

  Baseline, 2 weeks (completion of intervention) and 3 months

• Change in depression, anxiety and stress; measured with the Depression-Anxiety-Stress-Scale (DASS-21) from baseline to completion and baseline to follow-up

  The questionnaire consists of 21 items rated on a four-point Likert-scale (0 = "Didn't apply to me at all", 1 = "Applied to me to a certain extent or sometimes", 2 = "Applied to me to a considerable extent or quite often", 3 = "Applied very strongly to me, or most of the time"). The questionnaire is used to assess the severity of depressive, and anxiety symptoms as well as symptoms of distress during the last week. Scores range from 0 to 63 with the overall score being an indicator of general psychopathology. Subscales for depression, anxiety and stress exist. The scale is a widely used survey method and has proven to be a valid measure many times.

  Baseline, 2 weeks (completion of intervention) and 3 months

Secondary Outcomes (18)

• Change in anhedonia; measured with the Dimensional Anhedonia Rating Scale (DARS) from baseline to completion and baseline to follow-up

  Baseline, 2 weeks (completion of intervention) and 3 months

• Change in reward sensitivity and procession; measured with the Positive Valence System Scale-21 (PVSS-21) from baseline to completion and baseline to follow-up

  Baseline, 2 weeks (completion of intervention) and 3 months

• Trait-Positive Emotionality (PE) and its change as measured with the NEO-Five-Factor (NEO-FFI) Positive-Emotionality-Subscale from baseline to completion and baseline to follow-up

  Baseline, 2 weeks (completion of intervention) and 3 months

• Positive and negative affect and their changes; measured with the Positive and Negative Affect Schedule (PANAS) from baseline to completion and baseline to follow-up

  Baseline, 2 weeks (completion of intervention) and 3 months

• Change in social anxiety; measured with the Social Phobia Inventory (SPIN) from baseline to completion and baseline to follow-up

  Baseline, 2 weeks (completion of intervention) and 3 months

Study Arms (2)

Reward Training

EXPERIMENTAL

Behavioral: Training of reward processing/sensitivity; Other: Psychoeducation

Relaxation Training

ACTIVE COMPARATOR

Behavioral: Relaxation Training (PMR); Other: Psychoeducation

Interventions

Training of reward processing/sensitivity BEHAVIORAL

Participants in the experimental group complete a two-week ecological momentary intervention (EMI) consisting of three brief training units per day, each delivered via a smartphone. The exercises target different aspects of reward processing and are scheduled at specific times throughout the day. The morning unit (to be completed between 10:00 and 12:00 a.m.) involves a positive mental imagery task guided by audio recording. Participants are guided to vividly imagine a future situation with the most pleasurable and meaningful outcome possible. They are encouraged to mentally activate all senses, thoughts, and emotions associated with this scenario. The afternoon unit (to be completed between 3:00 and 5:00 p.m.) consists of a savoring exercise guided by audio recording. Participants recall a positive experience from the past and are instructed to re-experience and savor it mentally by focusing on its sensory details, emotional quality, and personal significance. The evening unit (to be

Reward Training

Relaxation Training (PMR) BEHAVIORAL

Participants in the control group complete a two-week progressive muscle relaxation (PMR) program designed to match the reward training in both frequency and duration. The intervention consists of three daily units, each delivered via a smartphone app and guided by audio recordings. The first and second units of each day consist of short audio-guided PMR sessions (approximately 5 minutes each). These exercises systematically guide participants through alternating tension and relaxation of different muscle groups to promote physical and mental relaxation. The third unit of the day focuses on reflection. Participants are asked to evaluate their experiences with the relaxation exercises over the course of the day. They reflect on their ability to engage with the exercises, the perceived effects (e.g., feelings of relaxation), any difficulties they encountered, and strategies to enhance the effectiveness of relaxation in their daily life beyond the intervention.

Relaxation Training

Psychoeducation OTHER

All participants receive a psychoeducation session on the day before the respective intervention starts. In this session, a graduate-level study team member introduces the rationale behind the training (PMR or reward-training), and demonstrates each exercise. Participants also practice each task.

Relaxation Training; Reward Training

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• German speaking
• Smartphone available and willingness to participate in repeated training units and questions delivered via app
• Clinically elevated anhedonia (SHAPS \>= 25) and elevated depression (DASS-21-Depression \>= 10), elevated anxiey (DASS-21-Anxiety \>= 6) or elevated stress (DASS-21-Stress \>= 10)

You may not qualify if:

• Psychotropic medication
• Psychotherapy currently ongoing or planned during participation
• Suicidality, lifetime diagnosis of bipolar disorders or psychotic episodes

Sponsors & Collaborators

• Philipps University Marburg: lead

Study Sites (1)

Philipps-University Marburg

Marburg, Hesse, 35037, Germany

RECRUITING

MeSH Terms

Conditions

Anhedonia; Anxiety Disorders; Depression

Interventions

Sensitivity and Specificity; Relaxation Therapy

Condition Hierarchy (Ancestors)

Neurobehavioral Manifestations; Neurologic Manifestations; Nervous System Diseases; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Mental Disorders; Behavioral Symptoms; Behavior

Intervention Hierarchy (Ancestors)

Epidemiologic Research Design; Epidemiologic Methods; Investigative Techniques; Statistics as Topic; Mathematical Concepts; Health Care Evaluation Mechanisms; Quality of Health Care; Health Care Quality, Access, and Evaluation; Public Health; Environment and Public Health; Mind-Body Therapies; Complementary Therapies; Therapeutics; Behavior Therapy; Psychotherapy; Behavioral Disciplines and Activities

Central Study Contacts

Martin J Skopp, M.Sc.

CONTACT

+4964212827106; martin.skopp@uni-marburg.de

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: PARTICIPANT
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator

Study Record Dates

• First Submitted: July 30, 2025
• First Posted: September 4, 2025
• Study Start: June 18, 2025
• Primary Completion: January 1, 2026
• Study Completion: January 1, 2026
• Last Updated: January 9, 2026

Record last verified: 2026-01

Locations

DE (1)