Protocol for a randomised controlled trial investigating an intervention to boost decentering in response to distressing mental experiences during adolescence: the decentering in adolescence study (DECADES)

Abstract

Introduction: Decentering describes the ability to voluntarily adopt an objective self-perspective from which to notice internal, typically distressing, stressors (eg, difficult thoughts, memories and feelings). The reinforcement of this skill may be an active ingredient through which different psychological interventions accrue reductions in anxiety and/or depression. However, it is unclear if decentering can be selectively trained at a young age and if this might reduce psychological distress. The aim of the current trial is to address this research gap.

Methods and analysis: Adolescents, recruited from schools in the UK and Ireland (n=57 per group, age range=16-19 years), will be randomised to complete 5 weeks of decentering training, or an active control group that will take part in a combination of light physical exercise and cognitive training. The coprimary training outcomes include a self-reported decentering inventory (ie, the Experiences Questionnaire) and the momentary use of decentering in response to psychological stressors, using experience sampling. The secondary mental health outcomes will include self-reported inventories of depression and anxiety symptoms, as well as psychological well-being. Initial statistical analysis will use between-group analysis of covariance to estimate the effect of training condition on self-rated inventories, adjusted for baseline scores. Additionally, experience sampling data will be examined using hierarchical linear models.

Ethics and dissemination: This study was approved by the Cambridge Psychology Research Ethics Committee, University of Cambridge (PRE.2019.109). Findings will be disseminated through typical academic routes including poster/paper presentations at (inter)national conferences, academic institutes and through publication in peer-reviewed journals.

Trial registration number: ISRCTN14329613.

Keywords: anxiety disorders; child & adolescent psychiatry; clinical trials; depression & mood disorders; preventive medicine.

Figure 1

A schematic overview of the intervention timeline. ADI, Adolescent Decentering Inventory; CAMM, Child and Adolescent Mindfulness Measure; CAS, COVID-19 Anxiety Scale; CERQ, Cognitive Emotion Regulation Questionnaire; CES-D, Center for Epidemiological Studies-Depression Scale; DERS, Difficulties in Emotion Regulation Scale; EQ, Experiences Questionnaire; ESM, experience sampling methods; ESST, Emotional Stop Signal Task; OBT, own-body transformation task; RCADS, Revised Child Anxiety and Depression Scale; SDQ, Strengths and Difficulties Questionnaire; STAXI, State-Trait Anger Expression Inventory-2 Child and Adolescent; WEMWBS, Warwick-Edinburgh Mental Well-being Scale.