Anxiety SymptomsNCT07607834
Real-Time and Retrospective Emotion Awareness With Cognitive Reappraisal Training
A study testing Wearable-Based Real-Time Emotional Awareness and Cognitive Reappraisal Training and Retrospective Emotion Journaling and Cognitive Reappraisal Training in people with Anxiety Symptoms and Depressive Symptoms, run by Asia University at 1 site in Taiwan.
Trial 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. Read more about this study
- Who is it for?
- Ages 18 to 45 years
- Conditions the study is for
- Anxiety Symptoms, Depressive Symptoms, Emotion Regulation
- What is being tested?
- Wearable-Based Real-Time Emotional Awareness and Cognitive Reappraisal Training and Retrospective Emotion Journaling and Cognitive Reappraisal Training
- Type of treatment
- Lifestyle or therapy programme
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 42 participants
- Where
- 1 siteTaiwan
- Study dates
- 25 Jan 2024to 20 Jun 2024
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 45 years
- All sexes
- No healthy volunteers
- Adult
Who may be able to join
- 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.
Who cannot join
- 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.
Trial locations and contacts
1 site in 1 country.
About this study
Official title: Real-Time and Retrospective Emotion Awareness With Cognitive Reappraisal: Effects on Anxious-Depressive Symptoms and Well-Being
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.
Read the detailed description
The study used a pilot randomized active-comparison design. Participants were adults aged 18 to 45 years with co-occurring anxiety and depressive symptoms. Eligible participants were randomly assigned to one of two intervention conditions: a real-time awareness condition or a retrospective awareness condition. The intervention lasted six weeks and included three assessment points: baseline/pretest, mid-intervention assessment, and post-intervention assessment.
The intervention consisted of two sequential phases. The first phase lasted approximately two weeks and focused on heart-rate baseline collection and emotional awareness training. Participants in the real-time awareness condition wore a smartwatch for three consecutive days to establish an individualized heart-rate baseline, followed by eleven days of real-time emotion identification training triggered by physiological prompts. When heart rate exceeded the individualized threshold, participants received a vibration prompt and selected the emotion category that best represented their current state. Participants in the retrospective awareness condition received no active intervention during this initial phase.
The second phase consisted of four weeks of cognitive reappraisal training for both groups. The reappraisal training was based on psychological distancing, particularly self-distancing and third-person perspective taking. During this phase, participants in the real-time awareness condition continued to receive physiological prompts and completed cognitive reappraisal exercises immediately after these prompts. Participants in the retrospective awareness condition completed daily evening reappraisal exercises based on emotionally salient events recalled from that day. Both groups attended weekly meetings with the researcher to review strategy use and discuss difficulties encountered during implementation.
Self-report outcomes were assessed at baseline, mid-intervention, and post-intervention. The study examined changes in anxiety symptoms, depressive symptoms, emotional clarity, mood repair, cognitive reappraisal, expressive suppression, and psychological well-being. The primary purpose was to characterize feasibility, preliminary effects, and temporal patterns of change associated with the two intervention formats rather than to establish definitive treatment efficacy.
- Conditions
- Anxiety Symptoms, Depressive Symptoms, Emotion Regulation
- Being tested
- Wearable-Based Real-Time Emotional Awareness and Cognitive Reappraisal Training, Retrospective Emotion Journaling and Cognitive Reappraisal Training
- Medical subject headings
- Anxiety Disorders, Depression, Emotional Regulation
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Wearable-Based Real-Time Emotional Awareness and Cognitive Reappraisal TrainingBehavioural
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.
Retrospective Emotion Journaling and Cognitive Reappraisal TrainingBehavioural
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.
| Study group | Role | What they receive |
|---|---|---|
| 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. Receives: 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. Receives: Behavioral: Retrospective Emotion Journaling and Cognitive Reappraisal Training |
What is being measured
The primary outcome is the main question the study is designed to answer.
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.
Measured: 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.
Measured: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.
Secondary outcomes (5)
Change in Emotional Clarity
Emotional clarity was assessed using the emotional clarity subscale of the Chinese version of the Trait Meta-Mood Scale (TMMS). Higher scores indicate greater perceived ability to identify and understand one's emotions.
Measured: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.
Change in Mood Repair
Mood repair was assessed using the mood repair subscale of the Chinese version of the Trait Meta-Mood Scale (TMMS). Higher scores indicate stronger perceived ability to regulate, alleviate, or repair negative emotional states.
Measured: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.
Change in Cognitive Reappraisal
Cognitive reappraisal was assessed using the cognitive reappraisal subscale of the Chinese version of the Emotion Regulation Questionnaire (ERQ). Higher scores indicate greater habitual use of cognitive reappraisal.
Measured: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.
Change in Expressive Suppression
Expressive suppression was assessed using the expressive suppression subscale of the Chinese version of the Emotion Regulation Questionnaire (ERQ). Higher scores indicate greater habitual use of expressive suppression.
Measured: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.
Change in Psychological Well-Being
Psychological well-being was assessed using the psychological well-being subscale of the Taiwan Subjective Well-Being Scale Short-Form (TSWBS-SF). The subscale consists of 4 items rated on a 4-point Likert scale, with total scores ranging from 4 to 16. Higher scores indicate greater psychological well-being.
Measured: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted26 May 2026
- Study start25 Jan 2024
- Primary completion20 Jun 2024
- Study completion20 Jun 2024
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Anxiety SymptomsStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Enrolment
- 42 participants (actual)
Sponsor and investigators
- Lead sponsor
- Asia University
- Sponsor type
- University, hospital or other
- Responsible party
- Sponsor
- Investigators
- Han-Yun Chang, Ph.D., Principal investigator, Asia University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT07607834
- Sponsor's protocol ID
- CRREC-112-036
- Status last verified
- May 2026
- First submitted
- 21 May 2026
- Last updated
- 26 May 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- Yes: De-identified individual participant data and analytic code may be available from the authors upon reasonable request, subject to ethical approval and participant confidentiality restrictions.
Study at a glance
From the registry record, last updated by the sponsor on 26 May 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Real-Time and Retrospective Emotion Awareness With Cognitive Reappraisal: Effects on Anxious-Depressive Symptoms and Well-Being
- ClinicalTrials.gov ID
- NCT07607834
- Acronym / sponsor ID
- CRREC-112-036
- Conditions
- Anxiety Symptoms, Depressive Symptoms, Emotion Regulation
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 42 participants (actual)
- Lead sponsor
- Asia UniversityUniversity, hospital or other
- Study start
- 25 Jan 2024 (actual)
- Primary completion
- 20 Jun 2024 (actual)
- Study completion
- 20 Jun 2024 (actual)
- First posted
- 26 May 2026 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
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.
Detailed description
The study used a pilot randomized active-comparison design. Participants were adults aged 18 to 45 years with co-occurring anxiety and depressive symptoms. Eligible participants were randomly assigned to one of two intervention conditions: a real-time awareness condition or a retrospective awareness condition. The intervention lasted six weeks and included three assessment points: baseline/pretest, mid-intervention assessment, and post-intervention assessment.
The intervention consisted of two sequential phases. The first phase lasted approximately two weeks and focused on heart-rate baseline collection and emotional awareness training. Participants in the real-time awareness condition wore a smartwatch for three consecutive days to establish an individualized heart-rate baseline, followed by eleven days of real-time emotion identification training triggered by physiological prompts. When heart rate exceeded the individualized threshold, participants received a vibration prompt and selected the emotion category that best represented their current state. Participants in the retrospective awareness condition received no active intervention during this initial phase.
The second phase consisted of four weeks of cognitive reappraisal training for both groups. The reappraisal training was based on psychological distancing, particularly self-distancing and third-person perspective taking. During this phase, participants in the real-time awareness condition continued to receive physiological prompts and completed cognitive reappraisal exercises immediately after these prompts. Participants in the retrospective awareness condition completed daily evening reappraisal exercises based on emotionally salient events recalled from that day. Both groups attended weekly meetings with the researcher to review strategy use and discuss difficulties encountered during implementation.
Self-report outcomes were assessed at baseline, mid-intervention, and post-intervention. The study examined changes in anxiety symptoms, depressive symptoms, emotional clarity, mood repair, cognitive reappraisal, expressive suppression, and psychological well-being. The primary purpose was to characterize feasibility, preliminary effects, and temporal patterns of change associated with the two intervention formats rather than to establish definitive treatment efficacy.
Study design
- Primary purpose
- Supportive care
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- None (open label)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Real-Time Awareness With Cognitive Reappraisal | Experimental | Behavioral: Wearable-Based Real-Time Emotional Awareness and Cognitive Reappraisal TrainingParticipants 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. |
| Retrospective Awareness With Cognitive Reappraisal | Active comparator | Behavioral: Retrospective Emotion Journaling and Cognitive Reappraisal TrainingParticipants 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. |
Who may qualify
- Ages
- 18 to 45 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult
Key inclusion criteria (5 listed)
- 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.
Key exclusion criteria (7 listed)
- 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.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Wearable-Based Real-Time Emotional Awareness and Cognitive Reappraisal TrainingThis 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. | Behavioural | Real-Time Awareness With Cognitive Reappraisal |
| Retrospective Emotion Journaling and Cognitive Reappraisal TrainingThis 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. | Behavioural | Retrospective Awareness With Cognitive Reappraisal |
Primary outcome
Change in Anxiety Symptoms
Time frame: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.
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.
Change in Depressive Symptoms
Time frame: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.
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.
5 secondary outcomes
Change in Emotional Clarity
Time frame: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.
Change in Mood Repair
Time frame: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.
Change in Cognitive Reappraisal
Time frame: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.
Change in Expressive Suppression
Time frame: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.
Change in Psychological Well-Being
Time frame: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 26 May 2026.
- Individual participant dataSharing planned: Yes. De-identified individual participant data and analytic code may be available from the authors upon reasonable request, subject to ethical approval and participant confidentiality restrictions.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Han-Yun Chang, Ph.D. principal investigator
Asia University
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing Wearable-Based Real-Time Emotional Awareness and Cognitive Reappraisal Training and Retrospective Emotion Journaling and Cognitive Reappraisal Training in people with Anxiety Symptoms and Depressive Symptoms, run by Asia University at 1 site in Taiwan.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 26 May 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Taiwan. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Change in Anxiety Symptoms (time frame: Baseline, mid-intervention approximately 2 weeks after baseline, and post-intervention approximately 6 weeks after baseline.). The study lists 2 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 26 May 2026.