Anxiety, Depression Anxiety Disorder, Emotional Distress
Conditions
Keywords
Mindfulness, Emotional Distress, Excessive Emotional Behaviors, Scale Development
Brief summary
Emotional disorders, including anxiety and depression, represent a major global health burden and are increasingly conceptualized within a transdiagnostic framework. Within this framework, emotional behaviors-defined as actions driven by attempts to regulate or control emotional experiences-are considered a central mechanism underlying the development and maintenance of emotional distress. Despite their theoretical importance in models such as the Unified Protocol (UP) and the Mindfulness Intervention for Emotional Distress (MIED), there is currently no dedicated, psychometrically validated instrument specifically designed to assess excessive emotional behaviors. The present study aims to develop and validate a self-report scale of excessive emotional behaviors grounded in the theoretical frameworks of UP and MIED. Excessive emotional behaviors are conceptualized as behaviors whose frequency, intensity, or reliance exceeds adaptive levels in response to emotional experiences and contributes to functional impairment. A mixed-method design will be employed. Study 1 will involve semi-structured cognitive interviews with approximately 18 participants experiencing anxiety or depressive distress to evaluate item clarity, experiential relevance, and content coverage, and to refine the initial item pool. Study 2 will consist of a quantitative survey with a larger sample to examine the scale's psychometric properties, including factor structure, reliability, and validity. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) will be conducted to establish the underlying structure of the scale. Convergent and discriminant validity will be assessed through correlations with measures of experiential avoidance (AAQ-II, BEAQ), anxiety (GAD-7), and depression (PHQ-9). The expected outcome is a brief, reliable, and valid instrument that captures multiple dimensions of excessive emotional behaviors, such as behavioral avoidance, cognitive avoidance, safety behaviors, and emotion-driven actions. This scale will provide a theoretically grounded and clinically useful tool for transdiagnostic research, mechanism testing, and intervention evaluation in emotional disorders.
Interventions
None listed
Sponsors
Xinghua Liu
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Aged 18 years or older Current or recent experience of significant anxiety or depressive distress Adequate ability to understand and communicate in Chinese Able and willing to provide written informed consent
Exclusion criteria
Acute psychotic episode or other severe psychiatric disorder that would interfere with study participation Cognitive impairment that would prevent effective participation in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Initial Excessive emotional Behaviors Scale | Baseline and 1 month | The Initial Excessive Emotional Behavior Scale (EEBS) consists of 40 items. Each item is rated on a 5-point scale, and the total score ranges from 40 to 200, with higher scores indicating more severe excessive emotional behavior and lower scores indicating fewer excessive emotional behaviors. Subscale scores are calculated as follows: Behavioral Avoidance: sum of Items 1-14 Cognitive Avoidance: sum of Items 15-21 Safety Signals: sum of Items 22-32 Emotion-Driven Behavior: sum of Items 33-40 The total EEBS score is obtained by summing all 40 items. Item 11 is reverse scored before computing the subscale and total scores. In addition to the total score, subscale scores may be analyzed separately to identify the individual's primary areas of difficulty. |
| The Acceptance and Action Questionnaire-II (AAQ-II) | Baseline and 1 month | The Acceptance and Action Questionnaire-II (AAQ-II) will be used to assess experiential avoidance and psychological inflexibility. The scale contains 7 items, each rated on a 7-point Likert scale, with a total score ranging from 7 to 49. Higher scores indicate greater experiential avoidance and psychological inflexibility, whereas lower scores indicate lower levels of experiential avoidance and greater psychological flexibility. |
| The Brief Experiential Avoidance Questionnaire (BEAQ) | Baseline and 1 month | The Brief Experiential Avoidance Questionnaire (BEAQ) will be used to assess experiential avoidance across multiple domains. The scale contains 15 items derived from the Multidimensional Experiential Avoidance Questionnaire (MEAQ). With each item rated on a 6-point Likert scale, the total score ranges from 15 to 90. Higher scores indicate greater experiential avoidance, whereas lower scores indicate lower levels of experiential avoidance. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Generalized Anxiety Disorder Scale (GAD-7) | Baseline and 1 month | The Generalized Anxiety Disorder Scale (GAD-7) will be used to assess anxiety symptoms. The scale contains 7 items, each rated on a 4-point Likert scale, with a total score ranging from 0 to 21. Higher scores indicate more severe anxiety symptoms, whereas lower scores indicate less severe anxiety symptoms. |
| Patient Health Questionnaire (PHQ-9) | Baseline and 1 month | The Patient Health Questionnaire-9 (PHQ-9) will be used to assess depressive symptoms. The scale contains 9 items, each rated on a 4-point Likert scale, with a total score ranging from 0 to 27. Higher scores indicate more severe depressive symptoms, whereas lower scores indicate less severe depressive symptoms. |
Countries
China
Outcome results
None listed