Conceptualization and Scale Development of Excessive Emotional Behaviors

Development and Validation of the Excessive Emotional Behaviors Scale: Long and Short Forms Among Chinese Adults With Emotional Distress

Emotional disorders, including anxiety and depression, represent a major global health burden and are increasingly conceptualized within a transdiagnostic framework. Within this framework, emotional behaviors-defined as actions driven by attempts to regulate or control emotional experiences-are considered a central mechanism underlying the development and maintenance of emotional distress. Despite their theoretical importance in models such as the Unified Protocol (UP) and the Mindfulness Intervention for Emotional Distress (MIED), there is currently no dedicated, psychometrically validated instrument specifically designed to assess excessive emotional behaviors.

The present study aims to develop and validate a self-report scale of excessive emotional behaviors grounded in the theoretical frameworks of UP and MIED. Excessive emotional behaviors are conceptualized as behaviors whose frequency, intensity, or reliance exceeds adaptive levels in response to emotional experiences and contributes to functional impairment.

A mixed-method design will be employed. Study 1 will involve semi-structured cognitive interviews with approximately 18 participants experiencing anxiety or depressive distress to evaluate item clarity, experiential relevance, and content coverage, and to refine the initial item pool. Study 2 will consist of a quantitative survey with a larger sample to examine the scale's psychometric properties, including factor structure, reliability, and validity. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) will be conducted to establish the underlying structure of the scale. Convergent and discriminant validity will be assessed through correlations with measures of experiential avoidance (AAQ-II, BEAQ), anxiety (GAD-7), and depression (PHQ-9).

The expected outcome is a brief, reliable, and valid instrument that captures multiple dimensions of excessive emotional behaviors, such as behavioral avoidance, cognitive avoidance, safety behaviors, and emotion-driven actions. This scale will provide a theoretically grounded and clinically useful tool for transdiagnostic research, mechanism testing, and intervention evaluation in emotional disorders.

Study Overview

• Status: Not yet recruiting
• Conditions: Anxiety; Emotional Distress; Depression Anxiety Disorder

• Study Type: Observational
• Enrollment (Estimated): 550

Contacts and Locations

• Study Contact: Name: Yinan Zhang, PHD Candidate; Phone Number: 8615823339524; Email: yinan0524@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Non-Probability Sample

Study Population

Adult participants will be recruited from university counseling centers and the general community through online and offline advertisements. The study population will primarily consist of individuals experiencing varying levels of emotional distress, including symptoms of anxiety and depression, as well as individuals from the general population. All participants will be able to complete self-report questionnaires in Chinese.

Description

Inclusion Criteria:

Aged 18 years or older Current or recent experience of significant anxiety or depressive distress Adequate ability to understand and communicate in Chinese Able and willing to provide written informed consent

Exclusion Criteria:

Acute psychotic episode or other severe psychiatric disorder that would interfere with study participation Cognitive impairment that would prevent effective participation in the study

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
General Adult Sample

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Initial Excessive emotional Behaviors Scale	The Initial Excessive Emotional Behavior Scale (EEBS) consists of 40 items. Each item is rated on a 5-point scale, and the total score ranges from 40 to 200, with higher scores indicating more severe excessive emotional behavior and lower scores indicating fewer excessive emotional behaviors. Subscale scores are calculated as follows: Behavioral Avoidance: sum of Items 1-14 Cognitive Avoidance: sum of Items 15-21 Safety Signals: sum of Items 22-32 Emotion-Driven Behavior: sum of Items 33-40 The total EEBS score is obtained by summing all 40 items. Item 11 is reverse scored before computing the subscale and total scores. In addition to the total score, subscale scores may be analyzed separately to identify the individual's primary areas of difficulty.	Baseline and 1 month
The Acceptance and Action Questionnaire-II (AAQ-II)	The Acceptance and Action Questionnaire-II (AAQ-II) will be used to assess experiential avoidance and psychological inflexibility. The scale contains 7 items, each rated on a 7-point Likert scale, with a total score ranging from 7 to 49. Higher scores indicate greater experiential avoidance and psychological inflexibility, whereas lower scores indicate lower levels of experiential avoidance and greater psychological flexibility.	Baseline and 1 month
The Brief Experiential Avoidance Questionnaire (BEAQ)	The Brief Experiential Avoidance Questionnaire (BEAQ) will be used to assess experiential avoidance across multiple domains. The scale contains 15 items derived from the Multidimensional Experiential Avoidance Questionnaire (MEAQ). With each item rated on a 6-point Likert scale, the total score ranges from 15 to 90. Higher scores indicate greater experiential avoidance, whereas lower scores indicate lower levels of experiential avoidance.	Baseline and 1 month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Generalized Anxiety Disorder Scale (GAD-7)	The Generalized Anxiety Disorder Scale (GAD-7) will be used to assess anxiety symptoms. The scale contains 7 items, each rated on a 4-point Likert scale, with a total score ranging from 0 to 21. Higher scores indicate more severe anxiety symptoms, whereas lower scores indicate less severe anxiety symptoms.	Baseline and 1 month
Patient Health Questionnaire (PHQ-9)	The Patient Health Questionnaire-9 (PHQ-9) will be used to assess depressive symptoms. The scale contains 9 items, each rated on a 4-point Likert scale, with a total score ranging from 0 to 27. Higher scores indicate more severe depressive symptoms, whereas lower scores indicate less severe depressive symptoms.	Baseline and 1 month

Collaborators and Investigators

• Sponsor: Xinghua Liu

Study record dates

Study Major Dates

• Study Start (Estimated): April 28, 2026
• Primary Completion (Estimated): June 28, 2026
• Study Completion (Estimated): July 30, 2026

Study Registration Dates

• First Submitted: April 16, 2026
• First Submitted That Met QC Criteria: April 23, 2026
• First Posted (Actual): April 30, 2026

Study Record Updates

• Last Update Posted (Actual): April 30, 2026
• Last Update Submitted That Met QC Criteria: April 23, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: Mindfulness; Emotional Distress; Scale Development; Excessive Emotional Behaviors
• Additional Relevant MeSH Terms: Mental Disorders; Anxiety Disorders
• Other Study ID Numbers: E20260416

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be publicly shared due to concerns regarding participant privacy and confidentiality. The dataset contains potentially identifiable information related to mental health status. However, reasonable requests for access to de-identified data may be considered by the corresponding author.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No