The Effectiveness of Acceptance and Commitment Therapy (ACT) on Dysfunctional Attitudes and Difficulties in Emotion Regulation Among University Students in Malaysia

April 28, 2026 updated by: Wei Jun Tan, Universiti Sains Malaysia

The Effectiveness of Acceptance and Commitment Therapy (ACT) on Dysfunctional Attitudes and Difficulties in Emotion Regulation Among University Students in Malaysia.

The goal of this clinical trial is to learn if Acceptance and Commitment Therapy (ACT) can reduce dysfunctional attitudes and difficulties in emotion regulation among university students in Malaysia.The main questions it aims to answer are:

  • Will participants who receive ACT show statistically significant reduction in dysfunctional attitudes scores compared to those in the control group?
  • Will participants who receive ACT show statistically significant reduction in difficulties in emotion regulation scores compared to those in the control group?
  • Will participants who receive ACT show statistically significant reduction in dysfunctional attitudes scores from pre-test to intermediate-test and from pre-test to post-test?
  • Will participants who receive ACT show statistically significant reduction in difficulties in emotion regulation scores from pre-test to intermediate test and from pre-test to post-test?

Researchers will compare ACT group to a waitlist control group to see if ACT work to reduce dysfunctional attitudes and difficulties in emotion regulation.

Participants in the ACT group will

  • attend six weekly individual sessions of ACT intervention (1 hour per session) conducted online
  • complete the outcome measures at three different time points (week 1, week 3, and week 6)

Meanwhile, participants in the waitlist control group

  • will not receive any intervention during the data collection period
  • will be asked to complete same outcome measures at three different time points (week 1, week 3, and week 6)

Study Overview

Status

Status

Indicates the current recruitment status or the expanded access status.
Completed

Conditions

Conditions

The disease, disorder, syndrome, illness, or injury that is being studied. On ClinicalTrials.gov, conditions may also include other health-related issues, such as lifespan, quality of life, and health risks.

Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.

Study Type

Study Type

Describes the nature of a clinical study. Study types include interventional studies (also called clinical trials), observational studies (including patient registries), and expanded access.
Interventional

Enrollment (Actual)

Enrollment

The number of participants in a clinical study. The "anticipated" enrollment is the target number of participants that the researchers need for the study.
32

Phase

Phase

The stage of a clinical trial studying a drug or biological product, based on definitions developed by the U.S. Food and Drug Administration (FDA). The phase is based on the study's objective, the number of participants, and other characteristics. There are five phases: Early Phase 1 (formerly listed as Phase 0), Phase 1, Phase 2, Phase 3, and Phase 4. Not Applicable is used to describe trials without FDA-defined phases, including trials of devices or behavioral interventions.
  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Malaysia
      • Kuala Lumpur, Malaysia
        • Universiti Sains Malaysia

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Eligibility Criteria

The key requirements that people who want to participate in a clinical study must meet or the characteristics they must have. Eligibility criteria consist of both inclusion criteria (which are required for a person to participate in the study) and exclusion criteria (which prevent a person from participating). Types of eligibility criteria include whether a study accepts healthy volunteers, has age or age group requirements, or is limited by sex.

Ages Eligible for Study

  • Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Malaysian citizens
  • currently enrolled as a university student
  • be proficient in both Malay and English languages
  • aged between 18 and 32 years old
  • reported mild to moderate depression, anxiety, and/or stress levels according to the DASS-21

Exclusion Criteria:

  • reported severe depression, anxiety, and/or stress on the DASS-21
  • expected to graduate before study ends
  • had been diagnosed with any psychological disorder prior to the study
  • were currently receiving psychotherapeutic medication and/or psychological interventions.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Supportive Care
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Single

Arms and Interventions

Participant Group / Arm

Participant Group / Arm

A group or subgroup of participants in a clinical trial that receives a specific intervention/treatment, or no intervention, according to the trial's protocol.
Intervention / Treatment

Intervention / Treatment

A process or action that is the focus of a clinical study. Interventions include drugs, medical devices, procedures, vaccines, and other products that are either investigational or already available. Interventions can also include noninvasive approaches, such as education or modifying diet and exercise.
Experimental: ACT Intervention Group
Participants in the intervention group attended six weekly individual sessions of ACT intervention (1 hour per session) conducted online via the Webex platform.
Other: Acceptance and Commitment Therapy (ACT)

Six sessions of ACT were conducted

Session 1:

Introduction. Theme: Broaden your horizon. Values and value-based actions. Identifying what matters the most in your life and acting accordingly.

Session 2: Theme: Present moment. Mindfully notice your internal and external experiences, notice the movement of your breath. Live in the present moment. To address difficulties in emotion regulation.

Session 3: Theme: Cognitive defusion. The power of thoughts. Identify your unwanted thoughts and emotions and learn to describe, name, and welcome them. To address dysfunctional attitudes.

Session 4: Theme: The observer's stance. Learn to view your thoughts and emotions from an observer's stance. To address difficulties in emotion regulation.

Session 5: Theme: Toward an attitude of acceptance. Let go of your struggle and learn acceptance towards your wakefulness and unwanted thoughts. To address dysfunctional attitudes.

Session 6: Theme: Summary of the programme. Plans committed action.
No Intervention: Waitlist Control Group
Participants in the control group were placed on a waitlist and completed the same outcome measures at three different time points (week 1, week 3, and week 6). After the completion of data collection, they were then divided into two groups and attended two group sessions of ACT (1.5 hours per session), each covering three of the six ACT main components.

What is the study measuring?

Primary Outcome Measures

Primary Outcome Measures

In a clinical study's protocol, the planned outcome measure that is the most important for evaluating the effect of an intervention/treatment. Most clinical studies have one primary outcome measure, but some have more than one.
Outcome Measure
Measure Description
Time Frame
Difficulties in Emotion Regulation
Time Frame: Baseline, Week 3, and Week 6
It is measured as the total score on the Difficulties in Emotion Regulation Scale-18 Malay, where a higher score indicates a greater degree of difficulties in emotion regulation.
Baseline, Week 3, and Week 6
Dysfunctional Attitudes
Time Frame: Baseline, Week 3, and Week 6
It is measured as the total score on the Dysfunctional Attitude Scale-Malay, where a higher score indicates a greater degree of dysfunctional attitude.
Baseline, Week 3, and Week 6

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Sponsor

The organization or person who initiates the study and who has authority and control over the study.
Universiti Sains Malaysia

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

Study Start

The actual date on which the first participant was enrolled in a clinical study. The "anticipated" study start date is the date that the researchers think will be the study start date.
February 10, 2025

Primary Completion (Actual)

Primary Completion

The date on which the last participant in a clinical study was examined or received an intervention to collect final data for the primary outcome measure. Whether the clinical study ended according to the protocol or was terminated does not affect this date. For clinical studies with more than one primary outcome measure with different completion dates, this term refers to the date on which data collection is completed for all the primary outcome measures. The "anticipated" primary completion date is the date that the researchers think will be the primary completion date for the study.
March 20, 2025

Study Completion (Actual)

Study Completion

The date on which the last participant in a clinical study was examined or received an intervention/treatment to collect final data for the primary outcome measures, secondary outcome measures, and adverse events (that is, the last participant's last visit). The "anticipated" study completion date is the date that the researchers think will be the study completion date.
April 25, 2025

Study Registration Dates

First Submitted

First Submitted

The date on which the study sponsor or investigator first submitted a study record to ClinicalTrials.gov. There is typically a delay of a few days between the first submitted date and the record's availability on ClinicalTrials.gov (the first posted date).
November 19, 2025

First Submitted That Met QC Criteria

First Submitted That Met QC Criteria

The date on which the study sponsor or investigator first submits a study record that is consistent with National Library of Medicine (NLM) quality control (QC) review criteria. The sponsor or investigator may need to revise and submit a study record one or more times before NLM's QC review criteria are met. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
November 19, 2025

First Posted (Actual)

First Posted

The date on which the study record was first available on ClinicalTrials.gov after National Library of Medicine (NLM) quality control (QC) review has concluded. There is typically a delay of a few days between the date the study sponsor or investigator submitted the study record and the first posted date.
December 1, 2025

Study Record Updates

Last Update Posted (Actual)

Last Update Posted

The most recent date on which changes to a study record were made available on ClinicalTrials.gov. There may be a delay between when the changes were submitted to ClinicalTrials.gov by the study's sponsor or investigator (the last update submitted date) and the last update posted date.
April 30, 2026

Last Update Submitted That Met QC Criteria

Last Update Submitted That Met QC Criteria

The most recent date on which the study sponsor or investigator submitted changes to a study record that are consistent with National Library of Medicine (NLM) quality control (QC) review criteria. It is the responsibility of the sponsor or investigator to ensure that the study record is consistent with the NLM QC review criteria.
April 28, 2026

Last Verified

Last Verified

The most recent date on which the study sponsor or investigator confirmed the information about a clinical study on ClinicalTrials.gov as accurate and current. If a study with a recruitment status of recruiting; not yet recruiting; or active, not recruiting has not been confirmed within the past 2 years, the study's recruitment status is shown as unknown.
October 1, 2025

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

Other Study ID Numbers

Identifiers or ID numbers other than the NCT number that are assigned to a clinical study by the study's sponsor, funders, or others. These numbers may include unique identifiers from other trial registries and National Institutes of Health grant numbers.
  • USM/JEPeM/KK/24080672

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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