Digital Positive Emotion Enhancement for Anxiety and Depression: A 6-Week Randomized Controlled Trial

This groundbreaking clinical trial investigates the effectiveness of a fully digital positive affect intervention (PAI) compared to standard self-monitoring techniques for individuals experiencing mild to moderate anxiety and depression symptoms. Conducted by researchers at the National University of Singapore, this large-scale study will enroll 2,400 participants in a rigorous parallel-group randomized controlled design.

The 6-week intervention delivers evidence-based therapeutic content through two digital platforms: weekly sessions via Qualtrics surveys and daily ecological momentary prompts through the mEMA Ilumivu mobile application. The active control group will use the same mobile platform exclusively for mood self-monitoring, allowing researchers to isolate the specific benefits of positive emotion enhancement strategies.

Key features of the study include:

• Comprehensive assessment at multiple time points (baseline, week 3, week 6, and 3/6/12-month follow-ups)
• Measurement of both symptom reduction and positive psychological growth
• Evaluation of potential mediators and moderators of treatment effects
• Focus on digital delivery to enhance accessibility and scalability

The trial specifically targets adults aged 21-64 with moderate symptoms (GAD-7 scores 5-14 or PHQ-9 scores 5-19) who are physically located in Singapore. Exclusion criteria help ensure participant safety by screening out those with severe symptoms or certain psychiatric conditions.

Primary outcomes focus on changes in anxiety (GAD-7) and depression (PHQ-9) symptoms, while secondary outcomes examine broader aspects of emotional functioning including:

• Emotion regulation strategies (ERQ)
• Automatic thoughts (ATQ)
• Attentional control (ACS)
• Self-compassion (SCS-SF)
• Positive and negative affect (PANAS)
• Sleep quality (PSQI)
• Various aspects of psychological well-being

This study represents an important step forward in digital mental health research by testing whether explicitly cultivating positive emotions can complement traditional symptom-focused approaches. Results may inform the development of more comprehensive, accessible mental health interventions suitable for integration into stepped-care frameworks.