Upregulating positive emotion in generalized anxiety disorder: A randomized controlled trial of the SkillJoy ecological momentary intervention.
Open accessAbstract
OBJECTIVE: This study sought to determine if upregulating positive emotion both reduces symptoms and increases well-being for those with generalized anxiety disorder (GAD). METHOD: Eighty-five participants were diagnosed with GAD by both questionnaire and clinical interview. They were then randomly assigned to one of two seven-day smartphone-delivered ecological momentary interventions (EMIs). SkillJoy, a savoring ecological momentary intervention, prompted participants to attend to positive aspects of the present moment, engage in and savor planned enjoyable activities, record and reflect on recent positive experiences, note events that turned out well, and look forward to positive events. The active self-monitoring control (ASM) mirrored SkillJoy's activities and wording, yet omitted savoring. It included attending to current thoughts and feelings, planning everyday activities, remembering and recording daily events, and anticipating important events. Participants were assessed at pre- and posttreatment with a 30th day follow-up. Linear mixed models and simple slope analyses with multiple imputation examined outcome change between and within conditions. RESULTS: = -1.09 vs. -0.63) pre-to-follow-up, yet SkillJoy had greater effect sizes. SkillJoy significantly increased positive emotions and savoring pre-to-follow-up, yet ASM did not. CONCLUSION: SkillJoy may strengthen positive emotions and skills for enhancing them, while also reducing worry. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Within the Skilljoy condition, change in contrast avoidance during the first half of treatment predicted subsequent change in worry.
“Moreover, within the Skilljoy condition, change in contrast avoidance during the first half of the treatment predicted subsequent change in worry [114,115].”
From Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts (2022) · cites this paper as [114]
The Results (Penn State Worry Questionnaire; page unavailable) report that worry decreased within the SkillJoy condition. The Methods describe pre-to-post and pre-to-follow-up analyses, but the passages found do not report a first-half change in contrast avoidance predicting subsequent change in worry. That predictive relationship is unsupported by our copy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIn a study using an ecological momentary intervention called Skilljoy, Skilljoy led to significant decreases in both contrast avoidance and worry symptoms, whereas the active control treatment did not.
“Whereas Skilljoy led to significant decreases in both contrast avoidance and worry symptoms, the active control treatment did not.”
From Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts (2022) · cites this paper as [114]
The Results (Penn State Worry Questionnaire; page unavailable) report that SkillJoy significantly reduced worry from pretrial to posttrial while the active self-monitoring control did not. The paper discusses contrast avoidance as a rationale for the intervention, but the retrieved passages do not report a measured decrease in contrast avoidance. It also reports a significant worry decrease in the control group by follow-up, so the claim holds for worry only at posttrial. (LLM, conf=0.87)
Experimental — accuracy not yet measuredPositive mood enhancement strategies such as behavioral activation, lovingkindness, savoring, mindfulness of pleasure, gratitude, and moral elevation may be of interest, in line with preliminary but promising findings of interventions focused on extending and enhancing positive states.
“Positive mood enhancement strategies such as behavioral activation, lovingkindness, savoring, mindfulness of pleasure, gratitude, and moral elevation may be of interest, in line with preliminary but promising findings of interventions focused on extending and enhancing positive states [114,126].”
From Psychotherapeutic treatments for generalized anxiety disorder: cognitive and behavioral therapies, enhancement strategies, and emerging efforts (2022) · cites this paper as [114]
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- Authors
- LaFreniere, L. S., & Newman, M. G.
- Affiliations
- Skidmore College (US)
- Pennsylvania State University (US)
- Venue
- Journal of Consulting and Clinical Psychology
- Published
- 2023-06
- Volume
- 91
- Issue
- 6
- Pages
- 381-387
- ISSN
- 0022-006X (ISSN-L)
- 1939-2117
- PMC
- PMC10580378
- OpenAlex
- W4318483963
- Cited by
- 48
- References
- 8
- Citations by year
- 2026: 9 · 2025: 15 · 2024: 11 · 2023: 8 · 2022: 3 · 2021: 1 · 2020: 1
- FWCI
- 11.10
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Journal of Consulting and Clinical Psychology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- ScholarSphere (Penn State Libraries) (submittedVersion, cc-by)
- Funders
- National Institute of Mental Health (R01 MH115128)
- Topics
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Keywords
- generalized anxiety disorder, positive emotions, savoring, ecological momentary intervention, smartphone-based intervention, worry reduction, well-being, positive psychology interventions
- MeSH terms
- Anxiety, Anxiety Disorders, Emotions, Humans, Surveys and Questionnaires
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