None listed
Conditions
Brief summary
Problem anger after experiencing trauma is a common mental health issue. Shift is a new cognitive-behavioral based just-in-time-adaptive intervention (JITAI), co-designed with users and experts, that works by prompting users to report their current anger state, and delivering personalised support to manage anger accordingly. A micro-randomised trial will be implemented with 65 adults with problem anger and a history of trauma exposure. For 30 days, four times a day, each participant will be prompted to self-report their current anger state, and will be randomised to be shown intervention components tailored to their anger state, or not. Post intervention surveys, and app use and engagement indices will be analysed to evaluate the acceptability of the intervention. The aim of the study is to test whether the intervention components designed within Shift actually reduce anger intensity. To test this, we are using a novel type of method, called a micro-randomised trial, where every participant will recieve both the intervention and the control at different times. This will be the first digital trial using micro-randomisation to optimise a JITAI for problem anger in a population who have experienced trauma, and one of the few micro-randomised trials to optimise digital mental health tools to manage dysregulated mood.
Interventions
Shift is a just-in-time-adaptive intervention that has been co-designed with people who have experienced trauma and problem anger, as well as digital health experts and mental health professionals. Shift leverages ecological momentary assessments (EMAs) to determine an individual’s current anger state, and then delivers personalised cognitive behavioral components that focus on managing anger from a physiological, cognitive, or behavioral perspective. The intervention components of Shift leverag
Shift is a just-in-time-adaptive intervention that has been co-designed with people who have experienced trauma and problem anger, as well as digital health experts and mental health professionals. Shift leverages ecological momentary assessments (EMAs) to determine an individual’s current anger state, and then delivers personalised cognitive behavioral components that focus on managing anger from a physiological, cognitive, or behavioral perspective. The intervention components of Shift leverage: 1) best practice approaches to manage anger rumination, improve unhealthy communication, and increase cognitive reframing; 2) an evidence-based method to decrease physiological arousal (i.e., cyclic sighing and isometric exercises) 3) circuit breakers for when anger is out of control; and 4) support for managing negative mood states after an anger outburst. EMAs are sent four times per day, within a personalised schedule, and three reminders to complete each EMA are sent within the hour. Each EMA takes less than 30 seconds to complete. Adherence is recorded via the number of EMAs completed throughout the 30 days. Shift tracks mood and anger triggers via self-report, provides external crisis support in the form of crisis helplines, and includes a virtual supportive Coach embedded in the app. The virtual Coach provides the welcome and rationale for the app, the voice overs for explaining skills, and supportive advice after an individual experiences an anger outburst. Accompanying the Shift app, users have the option of also using a wearable, that tracks sleep, activity, and stress levels, and alerts the user when stress levels are high. Users can then choose to open Shift and access the intervention components, if they want to. Participants will use their personal Android or iOS device to operate Shift. Wearable devices (Garmin activity trackers) will be provided to participants to monitor physiological stress and sleep. Those who do not choose to use the wearable will not track their sleep or stress through other methods. This study will conduct a micro-randomized trial to test Shift's effect on anger intensity at the next decision point. Every participant at each decision point (i.e., 4 EMAs per day) will be randomised with 0.5 probability to be shown a additional app content tailored to the anger state, and with 0.5 probability to be shown nothing.
Sponsors
University of Melbourne
Study design
Allocation
Randomised controlled trial
Intervention model
Other
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to 50 Years
Healthy volunteers
No
Inclusion criteria
1. be 18+ years; 2. have problem anger ( equal to or greater than 12 points on the Dimensions of Anger Reactions Scale); 3. report having experienced a previous traumatic event; 4. be physically located in Australia; 5. own an internet connected Android or iOS and have unhindered access during the study period
Exclusion criteria
1. a recent history of significant violence (i.e., such as assault with a weapon, choking/strangulation, and/or inflicting an injury that requires medical assistance in the past six months) 2. currently undergoing psychological treatment for anger.
Outcome results
None listed