Emotional abuse moderates efficacy of an ecological momentary stress management intervention for college students

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14 Scopus citations


Web-based stress management interventions are effective for college students, particularly those with interpersonal trauma histories. However, these interventions have not been assessed among those reporting childhood emotional abuse, a group with the most distress. Ecological momentary interventions (EMIs), which use mobile phones to deliver near-real-time psychosocial interventions in daily life, offer the possibility of increasing intervention efficacy. This randomized controlled trial examined the feasibility and efficacy of an EMI for reducing psychological distress among students with and without an emotional abuse history. Undergraduate students (N = 382) were randomly assigned to receive (a) an EMI that taught stress management skills, or (b) an ecological momentary assessment (EMA) with self-monitoring of stressors and mood. Both the EMI and EMA lasted for 14 days. Participants completed outcome measures (e.g., depression, anxiety, stress symptoms) at pretest, posttest, and 3-week follow-up. Overall, the EMI appeared feasible, acceptable, and usable, with 80% to 91% completion rates. Linear mixed models indicated that there were no significant Condition × Time interaction effects in the total sample, with decreases in perceived stress and increases in positive affect over time regardless of condition (EMI vs. EMA). Moderation analyses indicated that the EMI was generally more effective for those with a history of emotional abuse and that the EMA was more effective for those without such a history. Post hoc analyses demonstrated that participants wrote less in the EMI than in a web-based version of the intervention. Future interventions could target at-risk groups based on trauma history or baseline distress.

Original languageEnglish (US)
Pages (from-to)461-472
Number of pages12
JournalJournal of counseling psychology
Issue number4
StatePublished - Jul 2019

Bibliographical note

Funding Information:
Portions of these data were previously presented at the International Society for Research on Internet Interventions (2017) and the Association for Psychological Science (2018) conferences. The protocol of the present study was preregistered with the Center for Open Science and is available at https://osf.io/hgfrt. Please see link for the data analysis plan and other details.

Publisher Copyright:
© 2019 American Psychological Association.


  • College students
  • Ecological momentary intervention
  • Emotional abuse
  • Online intervention
  • Stress management
  • Stress, Psychological/prevention & control
  • Humans
  • Ecological Momentary Assessment
  • Male
  • Treatment Outcome
  • Young Adult
  • Child Abuse/psychology
  • Female
  • Students/psychology
  • Anxiety/psychology
  • Child
  • Depression/psychology

PubMed: MeSH publication types

  • Randomized Controlled Trial
  • Journal Article


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