![]() Ideally, such interventions should be grounded on validated theories on stress. Thus, there is a need for effective and accessible interventions fostering effective stress management. On top of this trend, the COVID-19 pandemic has increased stress burden even further for many individuals. This also leads to higher direct and indirect stress-related costs for societies. Reasons for this assessment included data indicating that stress has significantly increased during the past decades and hence increasingly burdens individuals with significant physical (e.g., ) and mental (e.g., ) health risks. The World Health Organization has recently referred to stress as “the health epidemic of the twenty-first century”. The trial has been registered in the German Clinical Trials Register (Deutsches Register Klinischer Studien DRKS00023007 September 7, 2020). Future research needs to identify target groups benefitting from this intervention utilized either as stand-alone treatment or an add-on intervention that is combined with other evidence-based treatments. Moreover, if shown to be effective, the approach can be used as an automated smartphone-based intervention. The study will provide valuable information to improve the intervention and study design. We will compute effect sizes and conduct mixed ANOVAs to explore differences in change in outcomes between the eAAMT and control conditions. Secondary outcomes will be dysfunctional beliefs, symptoms of depression, emotion regulation skills, and physiological stress measures. The primary outcome will be perceived stress. Non-blinded assessments will be taken directly before and after the training and 1 week after training completion. Participants in the inactive control condition will complete the assessments via an online tool. Participants in the intervention groups will engage in four sessions of 20–30 min (e)AAMT training on consecutive days. Individuals with elevated stress levels will be randomized to one of eight study conditions ( n = 10 per condition) - one of six variants of the eAAMT, an active control intervention (swipe-based AAMT), or an inactive control condition. We will conduct a parallel randomized controlled pilot study at the Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany. For this purpose, we aim to evaluate the feasibility of the intervention and study design and explore the efficacy of an innovative emotion-based AAMT version (eAAMT) that uses the display of emotions to move stress-inducing beliefs away from and draw stress-reducing beliefs towards oneself. As previous research indicates that effects of AAMTs are small, there is a need for innovative ways of increasing the efficacy of these interventions. Potentially, such beliefs can be modified with approach-avoidance modification trainings (AAMT). Dysfunctional beliefs contribute to the development of stress. ![]() Stress levels and thus the risk of developing related physical and mental health conditions are rising worldwide.
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