Stress (Psychology)
Conditions
Keywords
Stress, Resilience, Self-Management, Positive Psychology, Mobile Applications, Young Adult
Brief summary
The goal of this clinical trial is to learn if a mobile self-management program that combines Positive Psychology (PP) and Behavioral Activation (BA) helps reduce stress in young adults in South Korea. It will also examine how the program affects depression, anxiety, and resilience. The main questions it aims to answer are: Does the program lower stress levels in young adults with high stress? Does the program improve other aspects of mental health, such as depression, anxiety, and resilience? Researchers will compare the mobile program to a wait-list control group to see if the program works to improve stress management. Participants will: Be randomly assigned to either the program group or a wait-list control group Use the mobile program for 4 weeks with guided activities, followed by 4 weeks of self-directed use Complete surveys at the start, week 2, week 4, and week 8 about their stress, depression, anxiety, and resilience
Interventions
BEHAVIORALMobile Self-Management Program integrated with Positive Psychology and Behavioral Activation
The mobile self-management program consisted of a 4-week guided intervention phase followed by a 4-week self-directed period to encourage continued use. The guided phase was organized around weekly objectives: (1) experiencing positive affect, (2) identifying personal strengths, (3) applying strengths in daily life, and (4) planning a positive future. Program activities included emotional check-ins, gratitude journaling, mindfulness practice, positive behavioral tasks, and goal setting. During the self-directed phase (Weeks 5-8), participants selected from 10 recommended activities tailored to their strengths, promoting sustained engagement and self-management. The program integrated Positive Psychology and Behavioral Activation strategies to reduce stress, enhance resilience, and foster positive behavioral change.
Sponsors
The Catholic University of Korea
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
19 Years to 34 Years
Healthy volunteers
Yes
Inclusion criteria
* Age 19-34 years at the time of participation * Proficiency in using digital devices * Use of an Android-based smartphone or tablet * Score of ≥14 on the Perceived Stress Scale-10 (PSS-10) * Provision of informed consent for random assignment
Exclusion criteria
* Score \<14 on the Perceived Stress Scale-10 (PSS-10) * Declines random assignment
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Stress at Week 8 | Week 8 | Stress was measured using the Korean version of the Perceived Stress Scale - 10 items (PSS-10). The total score ranges from 0 to 40, with higher scores indicating greater perceived stress. Although the scale does not provide a standardized cut-off, prior studies have used a score of 14 or higher to define moderate-to-high levels of stress, and this threshold was applied in the present study. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Stress at Week 2 | Week 2 | Stress was measured using the Korean version of the Perceived Stress Scale - 10 items (PSS-10). The total score ranges from 0 to 40, with higher scores indicating greater perceived stress. Although the scale does not provide a standardized cut-off, prior studies have used a score of 14 or higher to define moderate-to-high levels of stress, and this threshold was applied in the present study. |
| Stress at Week 4 | Week 4 | Stress was measured using the Korean version of the Perceived Stress Scale - 10 items (PSS-10). The total score ranges from 0 to 40, with higher scores indicating greater perceived stress. Although the scale does not provide a standardized cut-off, prior studies have used a score of 14 or higher to define moderate-to-high levels of stress, and this threshold was applied in the present study. |
| Depression (PHQ-9) at Baseline | Baseline | Depression was assessed using the Korean version of the Patient Health Questionnaire-9 items (PHQ-9). The PHQ-9 consists of nine items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 27, with higher scores indicating more severe depression. |
| Depression (PHQ-9) at Week 2 | Week 2 | Depression was assessed using the Korean version of the Patient Health Questionnaire-9 items (PHQ-9). The PHQ-9 consists of nine items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 27, with higher scores indicating more severe depression. |
| Depression (PHQ-9) at Week 4 | Week 4 | Depression was assessed using the Korean version of the Patient Health Questionnaire-9 items (PHQ-9). The PHQ-9 consists of nine items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 27, with higher scores indicating more severe depression. |
| Depression (PHQ-9) at Week 8 | Week 8 | Depression was assessed using the Korean version of the Patient Health Questionnaire-9 items (PHQ-9). The PHQ-9 consists of nine items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 27, with higher scores indicating more severe depression. |
| Anxiety (GAD-7) at Baseline | Baseline | Anxiety was measured using the Korean version of the Generalized Anxiety Disorder-7 items (GAD-7). The GAD-7 consists of seven items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 21, with higher scores indicating more severe anxiety. |
| Stress at Baseline | Baseline | Stress was measured using the Korean version of the Perceived Stress Scale - 10 items (PSS-10). The total score ranges from 0 to 40, with higher scores indicating greater perceived stress. Although the scale does not provide a standardized cut-off, prior studies have used a score of 14 or higher to define moderate-to-high levels of stress, and this threshold was applied in the present study. |
| Anxiety (GAD-7) at Week 4 | Week 4 | Anxiety was measured using the Korean version of the Generalized Anxiety Disorder-7 items (GAD-7). The GAD-7 consists of seven items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 21, with higher scores indicating more severe anxiety. |
| Anxiety (GAD-7) at Week 8 | Week 8 | Anxiety was measured using the Korean version of the Generalized Anxiety Disorder-7 items (GAD-7). The GAD-7 consists of seven items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 21, with higher scores indicating more severe anxiety. |
| Resilience ( BRS) at Baseline | Baseline | Resilience was assessed using the Korean version of the Brief Resilience Scale (BRS). The BRS consists of six items rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Total scores range from 6 to 30, with higher scores indicating greater resilience. |
| Resilience (BRS) at Week 2 | Week 2 | Resilience was assessed using the Korean version of the Brief Resilience Scale (BRS). The BRS consists of six items rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Total scores range from 6 to 30, with higher scores indicating greater resilience. |
| Resilience (BRS) at Week 4 | Week 4 | Resilience was assessed using the Korean version of the Brief Resilience Scale (BRS). The BRS consists of six items rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Total scores range from 6 to 30, with higher scores indicating greater resilience. |
| Resilience (BRS) at Week 8 | Week 8 | Resilience was assessed using the Korean version of the Brief Resilience Scale (BRS). The BRS consists of six items rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Total scores range from 6 to 30, with higher scores indicating greater resilience. |
| Anxiety (GAD-7) at Week 2 | Week 2 | Anxiety was measured using the Korean version of the Generalized Anxiety Disorder-7 items (GAD-7). The GAD-7 consists of seven items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 21, with higher scores indicating more severe anxiety. |
Countries
South Korea
Participant flow
Pre-assignment details
a score of ≥14 on the Perceived Stress Scale-10 (PSS-10)
Participants by arm
| Arm | Count |
|---|---|
| Intervention Group Participants receive a mobile self-management intervention that integrates Positive Psychology and Behavioral Activation. The program includes 4 weeks of guided sessions followed by 4 weeks of self-directed use.
Mobile Self-Management Program integrated with Positive Psychology and Behavioral Activation: The mobile self-management program consisted of a 4-week guided intervention phase followed by a 4-week self-directed period to encourage continued use. The guided phase was organized around weekly objectives: (1) experiencing positive affect, (2) identifying personal strengths, (3) applying strengths in daily life, and (4) planning a positive future. Program activities included emotional check-ins, gratitude journaling, mindfulness practice, positive behavioral tasks, and goal setting. During the self-directed phase (Weeks 5-8), participants selected from 10 recommended activities tailored to their strengths, promoting sustained engagement and self-management. The program integrated Positive Psychology and Behavioral Activation strategies to reduce stress, enhance resilience, and foster positive behavioral change. | 92 |
| Wait-list Control Participants do not receive the intervention during the first 8 weeks but are offered access to the program after the study period. | 87 |
| Total | 179 |
Withdrawals & dropouts
| Period | Reason | FG000 | FG001 |
|---|---|---|---|
| Overall Study | Lost to Follow-up | 43 | 15 |
Baseline characteristics
| Characteristic | Wait-list Control | Total | Intervention Group |
|---|---|---|---|
| Age, Categorical <=18 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical >=65 years | 0 Participants | 0 Participants | 0 Participants |
| Age, Categorical Between 18 and 65 years | 87 Participants | 179 Participants | 92 Participants |
| Age, Continuous | 27.46 years STANDARD_DEVIATION 4.42 | 27.66 years STANDARD_DEVIATION 4.28 | 27.85 years STANDARD_DEVIATION 4.16 |
| Race and Ethnicity Not Collected | — | 0 Participants | — |
| Region of Enrollment South Korea | 87 Participants | 179 Participants | 92 Participants |
| Sex: Female, Male Female | 72 Participants | 151 Participants | 79 Participants |
| Sex: Female, Male Male | 15 Participants | 28 Participants | 13 Participants |
| Stress | 19.76 units on a scale STANDARD_DEVIATION 3.64 | 21.24 units on a scale STANDARD_DEVIATION 5.08 | 22.64 units on a scale STANDARD_DEVIATION 5.82 |
Adverse events
| Event type | EG000 affected / at risk | EG001 affected / at risk |
|---|---|---|
| deaths Total, all-cause mortality | 0 / 92 | 0 / 87 |
| other Total, other adverse events | 0 / 92 | 0 / 87 |
| serious Total, serious adverse events | 0 / 92 | 0 / 87 |
Outcome results
Primary
Stress at Week 8
Stress was measured using the Korean version of the Perceived Stress Scale - 10 items (PSS-10). The total score ranges from 0 to 40, with higher scores indicating greater perceived stress. Although the scale does not provide a standardized cut-off, prior studies have used a score of 14 or higher to define moderate-to-high levels of stress, and this threshold was applied in the present study.
Time frame: Week 8
Population: Participants with available PSS-10 data at week 8 were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Stress at Week 8 | 19.41 score on a scale | Standard Deviation 6.2 |
| Wait-list Control | Stress at Week 8 | 18.35 score on a scale | Standard Deviation 4.05 |
Generalized estimating equations (GEE)
Secondary
Anxiety (GAD-7) at Baseline
Anxiety was measured using the Korean version of the Generalized Anxiety Disorder-7 items (GAD-7). The GAD-7 consists of seven items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 21, with higher scores indicating more severe anxiety.
Time frame: Baseline
Population: Participants with available GAD-7 data at baseline were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Anxiety (GAD-7) at Baseline | 8.20 score on a scale | Standard Deviation 5.75 |
| Wait-list Control | Anxiety (GAD-7) at Baseline | 7.68 score on a scale | Standard Deviation 4.88 |
Secondary
Anxiety (GAD-7) at Week 2
Anxiety was measured using the Korean version of the Generalized Anxiety Disorder-7 items (GAD-7). The GAD-7 consists of seven items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 21, with higher scores indicating more severe anxiety.
Time frame: Week 2
Population: Participants with available GAD-7 data at week 2 were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Anxiety (GAD-7) at Week 2 | 6.88 score on a scale | Standard Deviation 5.65 |
| Wait-list Control | Anxiety (GAD-7) at Week 2 | 7.13 score on a scale | Standard Deviation 5.23 |
Secondary
Anxiety (GAD-7) at Week 4
Anxiety was measured using the Korean version of the Generalized Anxiety Disorder-7 items (GAD-7). The GAD-7 consists of seven items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 21, with higher scores indicating more severe anxiety.
Time frame: Week 4
Population: Participants with available GAD-7 data at week 4 were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Anxiety (GAD-7) at Week 4 | 6.43 score on a scale | Standard Deviation 5.61 |
| Wait-list Control | Anxiety (GAD-7) at Week 4 | 7.03 score on a scale | Standard Deviation 5.21 |
Secondary
Anxiety (GAD-7) at Week 8
Anxiety was measured using the Korean version of the Generalized Anxiety Disorder-7 items (GAD-7). The GAD-7 consists of seven items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 21, with higher scores indicating more severe anxiety.
Time frame: Week 8
Population: Participants with available GAD-7 data at week 8 were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Anxiety (GAD-7) at Week 8 | 7.63 score on a scale | Standard Deviation 6.11 |
| Wait-list Control | Anxiety (GAD-7) at Week 8 | 6.36 score on a scale | Standard Deviation 4.87 |
Secondary
Depression (PHQ-9) at Baseline
Depression was assessed using the Korean version of the Patient Health Questionnaire-9 items (PHQ-9). The PHQ-9 consists of nine items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 27, with higher scores indicating more severe depression.
Time frame: Baseline
Population: Participants with available PHQ-9 data at baseline were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Depression (PHQ-9) at Baseline | 10.21 score on a scale | Standard Deviation 5.89 |
| Wait-list Control | Depression (PHQ-9) at Baseline | 9.24 score on a scale | Standard Deviation 5.42 |
Secondary
Depression (PHQ-9) at Week 2
Depression was assessed using the Korean version of the Patient Health Questionnaire-9 items (PHQ-9). The PHQ-9 consists of nine items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 27, with higher scores indicating more severe depression.
Time frame: Week 2
Population: Participants with available PHQ-9 data at week 2 were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Depression (PHQ-9) at Week 2 | 8.34 score on a scale | Standard Deviation 5.44 |
| Wait-list Control | Depression (PHQ-9) at Week 2 | 8.51 score on a scale | Standard Deviation 5.63 |
Secondary
Depression (PHQ-9) at Week 4
Depression was assessed using the Korean version of the Patient Health Questionnaire-9 items (PHQ-9). The PHQ-9 consists of nine items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 27, with higher scores indicating more severe depression.
Time frame: Week 4
Population: Participants with available PHQ-9 data at week 4 were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Depression (PHQ-9) at Week 4 | 7.72 score on a scale | Standard Deviation 5.91 |
| Wait-list Control | Depression (PHQ-9) at Week 4 | 7.95 score on a scale | Standard Deviation 5.36 |
Secondary
Depression (PHQ-9) at Week 8
Depression was assessed using the Korean version of the Patient Health Questionnaire-9 items (PHQ-9). The PHQ-9 consists of nine items rated on a 4-point Likert scale (0 = not at all to 3 = nearly every day), assessing symptom frequency over the past two weeks. The total score ranges from 0 to 27, with higher scores indicating more severe depression.
Time frame: Week 8
Population: Participants with available PHQ-9 data at week 8 were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Depression (PHQ-9) at Week 8 | 8.37 score on a scale | Standard Deviation 6.38 |
| Wait-list Control | Depression (PHQ-9) at Week 8 | 7.69 score on a scale | Standard Deviation 5.5 |
Secondary
Resilience ( BRS) at Baseline
Resilience was assessed using the Korean version of the Brief Resilience Scale (BRS). The BRS consists of six items rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Total scores range from 6 to 30, with higher scores indicating greater resilience.
Time frame: Baseline
Population: Participants with available BRS data at baseline were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Resilience ( BRS) at Baseline | 15.24 score on a scale | Standard Deviation 5.06 |
| Wait-list Control | Resilience ( BRS) at Baseline | 17.79 score on a scale | Standard Deviation 1.71 |
Secondary
Resilience (BRS) at Week 2
Resilience was assessed using the Korean version of the Brief Resilience Scale (BRS). The BRS consists of six items rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Total scores range from 6 to 30, with higher scores indicating greater resilience.
Time frame: Week 2
Population: Participants with available BRS data at week 2 were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Resilience (BRS) at Week 2 | 15.37 score on a scale | Standard Deviation 5.1 |
| Wait-list Control | Resilience (BRS) at Week 2 | 17.59 score on a scale | Standard Deviation 1.76 |
Secondary
Resilience (BRS) at Week 4
Resilience was assessed using the Korean version of the Brief Resilience Scale (BRS). The BRS consists of six items rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Total scores range from 6 to 30, with higher scores indicating greater resilience.
Time frame: Week 4
Population: Participants with available BRS data at week 4 were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Resilience (BRS) at Week 4 | 16.06 score on a scale | Standard Deviation 5.68 |
| Wait-list Control | Resilience (BRS) at Week 4 | 17.87 score on a scale | Standard Deviation 1.93 |
Secondary
Resilience (BRS) at Week 8
Resilience was assessed using the Korean version of the Brief Resilience Scale (BRS). The BRS consists of six items rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree). Total scores range from 6 to 30, with higher scores indicating greater resilience.
Time frame: Week 8
Population: Participants with available BRS data at week 8 were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Resilience (BRS) at Week 8 | 16.14 score on a scale | Standard Deviation 5.87 |
| Wait-list Control | Resilience (BRS) at Week 8 | 17.54 score on a scale | Standard Deviation 1.85 |
Secondary
Stress at Baseline
Stress was measured using the Korean version of the Perceived Stress Scale - 10 items (PSS-10). The total score ranges from 0 to 40, with higher scores indicating greater perceived stress. Although the scale does not provide a standardized cut-off, prior studies have used a score of 14 or higher to define moderate-to-high levels of stress, and this threshold was applied in the present study.
Time frame: Baseline
Population: Participants with available PSS-10 data at baseline were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Stress at Baseline | 22.64 score on a scale | Standard Deviation 5.82 |
| Wait-list Control | Stress at Baseline | 19.76 score on a scale | Standard Deviation 3.64 |
Secondary
Stress at Week 2
Stress was measured using the Korean version of the Perceived Stress Scale - 10 items (PSS-10). The total score ranges from 0 to 40, with higher scores indicating greater perceived stress. Although the scale does not provide a standardized cut-off, prior studies have used a score of 14 or higher to define moderate-to-high levels of stress, and this threshold was applied in the present study.
Time frame: Week 2
Population: Participants with available PSS-10 data at week 2 were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Stress at Week 2 | 20.57 score on a scale | Standard Deviation 5.78 |
| Wait-list Control | Stress at Week 2 | 19.00 score on a scale | Standard Deviation 3.98 |
Secondary
Stress at Week 4
Stress was measured using the Korean version of the Perceived Stress Scale - 10 items (PSS-10). The total score ranges from 0 to 40, with higher scores indicating greater perceived stress. Although the scale does not provide a standardized cut-off, prior studies have used a score of 14 or higher to define moderate-to-high levels of stress, and this threshold was applied in the present study.
Time frame: Week 4
Population: Participants with available PSS-10 data at week 4 were included in the analysis.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| Intervention Group | Stress at Week 4 | 20.08 score on a scale | Standard Deviation 6.62 |
| Wait-list Control | Stress at Week 4 | 18.71 score on a scale | Standard Deviation 4 |