4 - (SYM 86) More or Better? Changes in Negative Affect and Emotion Regulation in Response to Brief, Virtual Skill Trainings

Despite thousands of randomized controlled trials testing packages of cognitive behavior therapies (CBTs), remission rates for disorders targeted by these treatments range from 38-65% (Cuijpers et al., 2014; Springer et al., 2018). The majority of CBTs teach patients cognitive, behavioral, and/or acceptance-based skills to regulate their emotions. However, some treatments (e.g., cognitive therapy) teach patients a limited number of skills more intensively whereas others (e.g., dialectical behavior therapy) teach patients a wide range of skills through more didactic means. Recently, researchers have shown that using a larger repertoire of skills leads to reductions in anxiety, whereas more frequent use of behavioral skills specifically leads to reductions in depression among patients with mood and anxiety disorders in the Unified Protocol (Southward & Sauer-Zavala, 2022). To isolate the unique effects of these approaches to skills training on emotion regulation skills use and affective outcomes, we are collecting data on a randomized controlled trial of a virtual skill training paradigm. People with elevated emotion dysregulation (N = 260) will complete two weeks of naturalistic reporting on their emotion regulation skills and negative affect (PANAS-X) eight times a day. They will then be randomized to receive training in either one skill (their self-identified personal strength) or three skills, balanced for the duration of each training. For two more weeks, participants will report on their emotion regulation skill use and negative affect and receive reminder prompts regarding the skills from the training if they report not using the skills. We will test (a) if participants use skills more frequently following the training than before the training, (b) if participants report lower negative affect following the training than before the training, and (c) if participants randomized to learn one skill report unique improvements in the quality of their skill use and if participants randomized to learn three skills report unique improvements in the variety and frequency of their skill use, in line with the goals of each approach. These results will characterize the strength and durability of these brief digital interventions and provide initial information regarding the specificity of the mechanism by which each intervention leads to changes in affect.