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Attention control for external information and cognitive control for internal information play a causal role in emotion regulation according to different theories and empirical research. Former research in the lab of the investigators has shown positive effects of an interactive attention control/interpretation training, in which participants learned to unscramble scrambled sentences ("life is my a party mess") in a positive way ("my life is a party") by getting eye-tracking feedback about attention for positive ("party") vs. negative information ("mess"). After the training, participants could better reinterpret negative photos in a positive way. Attention- and cognitive control mechanisms prior to negative stressors (proactive control) and after negative stressors (reactive control) seem to play a role in this. Moreover, research has shown that low perceived control and negative expectations about future emotion regulation skills results in lower proactive control and a higher need of reactive control. Based on this, the assumption can be made that the effects of attention control training - targeting reactive control - could benefit from adding techniques that affect proactive control (e.g. psycho-education). In the present study this is investigated by testing a new two weeks attention control training to see if this has a positive effect on stress related complaints, depressive symptoms and emotion regulation. Given that the current COVID-19 pandemic is perceived as very stressful by a lot of people, the training could help here. Participants between 18 to 65 years of age are recruited during this corona crisis. The attention control training is a new smartphone based application. Participants have to unscramble scrambled sentences into grammatically correct sentences. In the training condition, participants are asked to unscramble the scrambled sentences in a positive way. By swiping, participants can see part of the sentences. This gives the investigators an image about the processing of the sentences. This procedure allows to measure how long participants attend to positive and negative words. In the training condition participants get feedback about the duration they process positive and negative words. In the control group participants unscramble the sentences as fast as possible without feedback on emotional attention. Participants only get feedback about the speed at which sentences are unscrambled. Before and after the 10 training sessions, attention of the participants is measured to see the effects of the training. Questionnaires on depressive and anxiety complaints, emotion regulation strategies, well-being and stress are administered before and after the training. There is also a follow-up measure 2 months after the training. Both groups (training and control) watch a psycho-education video before the start of the training.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Active Comparator: PSE + OCAT-sham | Active Comparator | Psycho-education video + an active placebo training, consisting of 10 sessions of ±15 minutes each (during an intervention period of two weeks), will be administered. The training task is an undirected scrambled sentences task with online contingent feedback. |
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| Experimental: PSE + OCAT | Experimental | Psycho-education video + an attention training, consisting of 10 sessions of ±15 minutes each (during an intervention period of two weeks), will be administered. The training task is a positively directed scrambled sentences task with online contingent feedback. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Behavioral: OCAT-sham | Behavioral | Placebo version of the online contingent attention training preceded by psycho-education movieclip. |
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| Measure | Description | Time Frame |
|---|---|---|
| Changes in depression-, anxiety- and psychosomatic stress symptoms | Measured by Mood and Anxiety Symptom Questionnaire (MASQ-30). It measures the dimensions of Clark and Watson's tripartite model, covering both shared and distinct symptoms of depression and anxiety. It has three sub-scales: Negative Affect (NA), associated with both depression and anxiety; lack of Positive Affect (PA), associated with depressive moods; and Somatic Arousal (SA), associated with anxiety. Scores are ranging from 10 to 50, with higher scores indicating more severe psychopathology. | pre-test (before starting the training), post-test (immediately after the training), follow-up (two months after the training) |
| Measure | Description | Time Frame |
|---|---|---|
| Changes in rumination. | Measured by Rumination Response Scale (RRS). This 22-item questionnaire provides a total rumination score (range: 22 - 88), as well as Brooding and Reflection sub-scale scores (range: 5 - 20). Brooding is characterized by a passive style of moody pondering. Higher scores indicate a worse outcome. | pre-test (before starting the training), post-test (immediately after the training), follow-up (two months after the training) |
| Measure | Description | Time Frame |
|---|---|---|
| How variables related to COVID-19 and the quarantine affect the life of participants | Measured by the COVID questionnaire (designed by the researchers). | pre-test (before starting the training) |
| Changes in depressive complaints |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Rudi De Raedt, PhD | University Ghent | Principal Investigator |
| Ernst Koster, PhD | University Ghent | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ghent University | Ghent | Oost-Vlaanderen | 9000 | Belgium |
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| ID | Term |
|---|---|
| D000079562 | Rumination Syndrome |
| D001008 | Anxiety Disorders |
| D003863 | Depression |
| ID | Term |
|---|---|
| D005767 | Gastrointestinal Diseases |
| D004066 | Digestive System Diseases |
| D001068 | Feeding and Eating Disorders |
| D001523 | Mental Disorders |
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| Behavioral: OCAT | Behavioral | Online contingent attention training preceded by psycho-education movieclip. |
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| psycho-education video | Other | Both groups get to see a psycho-education video before the smartphone training starts. |
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| Changes in cognitive emotion regulation strategies. | Measured by the Cognitive Emotion Regulation Questionnaire (CERQ). Which measures different emotion regulation strategies. This questionnaire has 9 sub-scales: self-blame, other-blame, rumination, catastrophizing, putting into perspective, positive refocusing, positive reappraisal, acceptance and planning. Each sub-scale has a scoring range between 4 and 20. A higher score represents a greater frequency of engaging in that emotion regulation strategy. | pre-test (before starting the training), post-test (immediately after the training), follow-up (two months after the training) |
| Changes in emotional attention | Measured by a baseline measure in our OCAT app and measure of the end of the training period. | pre-test (before starting the training), post-test (immediately after the training) |
Measured by Center for Epidemiological Studies - Depression (CES-D), which has 20 items. A higher score represents more depressive feelings (range: 0 - 60).
| pre-test (before starting the training), post-test (immediately after the training), follow-up (two months after the training) |
| Changes in symptoms of anxiety | Measured by the Generalized Anxiety Disorder 7 item scale (GAD-7). Scores may vary from 0 to >15. A higher score represents more symptoms of anxiety. | pre-test (before starting the training), post-test (immediately after the training), follow-up (two months after the training) |
| Changes in well-being | Measured by the Warwick-Edinburgh Mental Well-being Scales (WE-MWB). This 14-item scale indexes positive aspects of mental health. Scores may vary between 14 and 70. A higher score represents a more positive mental health. | pre-test (before starting the training), post-test (immediately after the training), follow-up (two months after the training) |
| Changes in perceived stress | Measured by a Visual Analogue Stress Scale, is scored from 1 (not at all) - 10 (a lot). | pre-test (before starting the training), post-test (immediately after the training), follow-up (two months after the training) |
| Treatment Credibility and Expectancy | Measured by the Credibility/Expectancy Questionnaire (CEQ). It measures participants' credibility and expectancy of the training. In the credibility scale the items are rated on 9- point scales ranging from 1 (Not at all logical/useful/confident) to 9 (Very logical/effective/confident). This leads to a total score on this scale between 3 and 27. In the expectancy scale the same 9-point scale is used and an 11-point scale (from 0% to 100%). Responses are standardized to get the total expectancy score. Higher scores represent higher credibility and expectancy. | post-test (immediately after the training) |
| Perceived pleasantness of the training | A question was added to determine how pleasant the training is perceived by the participants. It is scored on a scale from 0 to 10 where 0 stands for "very unpleasant" and 10 stands for "very pleasant". | post-test (immediately after the training) |
| D001526 | Behavioral Symptoms |
| D001519 | Behavior |