A randomized controlled trial of a mobile ecological momentary stress management intervention for students with and without a history of emotional abuse

Abstract

College can be a stressful period of life, in which a history of interpersonal trauma is associated with greater risk of distress. Specifically, students with a history of childhood emotional abuse report more distress despite the lack of research on emotional abuse. Thus, it is imperative to develop interventions to help reduce distress in this population. One novel approach involves ecological momentary interventions (EMIs), which use mobile phone platforms to deliver near-real-time psychosocial interventions in daily life and can increase access to psychotherapeutic care. This study is the first randomized controlled trial to examine the feasibility and efficacy of an EMI for reducing psychological distress among students with and without an emotional abuse history. For 14 days, participants (N = 382) were randomly assigned to receive: 1) the EMI that teaches stress management skills or 2) an ecological momentary assessment (EMA), a self-monitoring control condition with assessments only. Participants completed pretest, posttest, and three-week follow-up measures. Linear mixed models indicated that there were no significant condition-by-time interaction effects, suggesting that changes over time occurred regardless of condition (EMI vs. EMA). There were different levels of EMI efficacy depending on emotional abuse history, in that the EMI was generally more effective for those with a history of emotional abuse and the EMA was more effective for those without such a history. Overall, the EMI appeared feasible, acceptable, and usable, although less effective than web-based versions. Because of this, college counseling centers might rather streamline resources to further promote web-based interventions. Future interventions could also target certain at-risk groups, based on their trauma history or baseline levels of distress.