Disgust-based approach-avoidance modification training for individuals suffering from elevated stress: A randomized controlled pilot study.

Perceived stress, a global health problem associated with various mental disorders, is assumed to be influenced by dysfunctional beliefs. It can be hypothesized that these beliefs can be modified with the help of approach-avoidance modification trainings (AAMTs). In the present study (conducted 2020-2022), we aimed to clarify whether the efficacy of AAMTs can be enhanced by utilizing the expression of emotions to move AAMT stimuli. For this purpose, we tested the feasibility and acceptability of a new AAMT paradigm in which the expression of disgust is used to move stress-increasing beliefs away from oneself and the expression of positive emotions is used to move stress-reducing beliefs towards oneself (AAMT-DP). Additionally, we explored the therapeutic potential of the AAMT-DP intervention by comparing it to an inactive control condition and to a conventional AAMT in which stimuli are moved by swipe movements (n = 10 in each condition). The primary outcome was perceived stress 1 week after the training as assessed with the Perceived Stress Scale. Findings indicate sufficient feasibility and acceptability of the intervention and that the decrease in perceived stress in the AAMT-DP condition was greater than in the inactive control condition (g = 0.72 [0.10, 1.72]) and than in the swipe control condition (g = 0.64 [0.01, 1.41]). In sum, findings provide preliminary evidence for the feasibility, acceptability, and the therapeutic potential of the AAMT-DP intervention.