Real-Time and Retrospective Emotion Awareness With Cognitive Reappraisal Training

NCT07607834 | Completed

• 1 other identifier: CRREC-112-036
• Study Type: interventional
• Target: 42
• Locations: 1 country
• Sites: 1

Brief Summary

This pilot randomized active-comparison study examined two formats of emotional awareness and cognitive reappraisal training for adults with co-occurring anxiety and depressive symptoms. Participants were assigned to either a real-time awareness group or a retrospective awareness group. The real-time awareness group used a smartwatch-based heart-rate prompting system to identify emotions in daily life and later complete cognitive reappraisal exercises. The retrospective awareness group completed daily evening reflection and cognitive reappraisal exercises based on emotional events from that day. The study lasted six weeks and included assessments at baseline, mid-intervention, and post-intervention. Outcomes included anxiety symptoms, depressive symptoms, emotional clarity, mood repair, cognitive reappraisal, expressive suppression, and psychological well-being. The purpose of the study was to examine preliminary patterns of change and compare how the two formats may support emotion regulation processes.

Conditions

Depressive Symptoms; Anxiety Symptoms; Emotion Regulation

Outcome Measures

Primary Outcomes (2)

• Change in Anxiety Symptoms

  Anxiety symptoms were assessed using the Chinese version of the Beck Anxiety Inventory (BAI). The BAI consists of 21 items rated on a 4-point scale from 0 to 3, with total scores ranging from 0 to 63. Higher scores indicate greater anxiety symptom severity.

  Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.

• Change in Depressive Symptoms

  Depressive symptoms were assessed using the Chinese version of the Beck Depression Inventory-II (BDI-II). The BDI-II consists of 21 items rated on a 4-point scale from 0 to 3, with total scores ranging from 0 to 63. Higher scores indicate greater depressive symptom severity.

  Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.

Secondary Outcomes (5)

• Change in Emotional Clarity

  Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.

• Change in Mood Repair

  Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.

• Change in Cognitive Reappraisal

  Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.

• Change in Expressive Suppression

  Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.

• Change in Psychological Well-Being

  Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.

Study Arms (2)

Real-Time Awareness With Cognitive Reappraisal

EXPERIMENTAL

Participants in this arm wore a smartwatch to establish an individualized heart-rate baseline and subsequently received vibration prompts when heart rate exceeded the individualized threshold. During the emotional awareness phase, participants identified their current emotional state following physiological prompts. During the cognitive reappraisal phase, participants completed a third-person perspective-taking reappraisal exercise immediately after physiological prompts.

Behavioral: Wearable-Based Real-Time Emotional Awareness and Cognitive Reappraisal Training

Retrospective Awareness With Cognitive Reappraisal

ACTIVE COMPARATOR

Participants in this arm received no active intervention during the initial awareness phase. During the cognitive reappraisal phase, participants completed a daily evening reappraisal exercise based on an emotionally salient event from that day. They recorded the emotion category, emotional intensity, and thoughts experienced at the time of the event, then completed the same third-person perspective-taking reappraisal exercise as the real-time awareness group.

Behavioral: Retrospective Emotion Journaling and Cognitive Reappraisal Training

Interventions

Wearable-Based Real-Time Emotional Awareness and Cognitive Reappraisal Training BEHAVIORAL

This behavioral intervention combined wearable-based physiological prompting, real-time emotion identification, and third-person cognitive reappraisal. Participants wore a smartwatch that monitored heart rate continuously. When heart rate exceeded 20% above the individualized baseline, the device delivered a vibration prompt. Participants identified their current emotion from six basic emotion categories. During the reappraisal phase, they recorded the triggering event, emotion category, emotional intensity, and thoughts, and then completed a third-person perspective-taking reappraisal exercise.

Real-Time Awareness With Cognitive Reappraisal

Retrospective Emotion Journaling and Cognitive Reappraisal Training BEHAVIORAL

This behavioral intervention combined daily end-of-day emotional reflection with third-person cognitive reappraisal. Participants recalled an emotionally salient event from that day, recorded the emotion category, emotional intensity, and thoughts experienced at the time of the event, and then reinterpreted the event from the perspective of a personally significant or neutral third-person figure. They subsequently reported their post-reappraisal emotion category, emotional intensity, and new thoughts.

Retrospective Awareness With Cognitive Reappraisal

Eligibility Criteria

• Age: 18 Years - 45 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Adults aged 18 to 45 years.
• Self-reported co-occurring anxiety and depressive symptoms.
• Score of 8 or above on the Chinese version of the Beck Anxiety Inventory.
• Score between 14 and 28 on the Chinese version of the Beck Depression Inventory-II.
• Ability to provide written informed consent and complete the study procedures.

You may not qualify if:

• Illegal substance use.
• Excessive alcohol or caffeine consumption, defined as more than four caffeinated beverages or four cans of beer per day.
• Major psychiatric disorders or cognitive impairment, such as schizophrenia or neurocognitive disorders.
• Current psychiatric medication use.
• Ongoing psychological or psychiatric treatment.
• Pregnancy or current responsibility for caring for an infant.
• Severe depressive symptoms, defined as a Beck Depression Inventory-II score of 29 or above.

Sponsors & Collaborators

• Asia University: lead

Study Sites (1)

亞洲大學

Taichung, 41354, Taiwan

Location

MeSH Terms

Conditions

Anxiety Disorders; Depression; Emotional Regulation

Condition Hierarchy (Ancestors)

Mental Disorders; Behavioral Symptoms; Behavior; Self-Control; Social Behavior

Study Officials

• Han-Yun Chang, Ph.D.

  Asia University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: SUPPORTIVE CARE
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: May 21, 2026
• First Posted: May 26, 2026
• Study Start: January 25, 2024
• Primary Completion: June 20, 2024
• Study Completion: June 20, 2024
• Last Updated: May 26, 2026

Record last verified: 2026-05

Data Sharing

• IPD Sharing: Will share
• Shared Documents: ANALYTIC CODE
• Time Frame: De-identified individual participant data and analytic code will be available after publication and for five years.
• Access Criteria: De-identified individual participant data and analytic code may be shared with qualified researchers for research purposes upon reasonable request. Requests will be reviewed by the study team and will require appropriate ethical approval, a data-sharing agreement when applicable, and compliance with participant confidentiality restrictions.

Locations

TW (1)