Emotion Regulation Skills Research Articles

EMOTION REGULATION IN AUTISM SPECTRUM DISORDER: EFFECTS ON ANXIETY AND DEPRESSION- A SCOPING REVIEW

Comorbid conditions, such as anxiety and depression, pose diagnostic challenges due to their complex interaction with core autism spectrum disorder features. Emotion regulation is a key concept in the transdiagnostic framework which suggests shared cognitive and behavioral processes among mental disorders. The review aims to examine the emotion regulation effects on anxiety and depression in autism spectrum disorder. A systematic search was conducted from December 2022. to May 2023., using SCOPUS and Google Scholar, with predefined eligibility criteria. Analysis of the twelve included publications unveiled emotion regulation challenges in individuals with autism spectrum disorder. Importantly, these maladaptive strategies were found to be significantly linked to symptoms of anxiety and depression. These findings emphasize the need for interventions that specifically target and improve emotion regulation in individuals with autism spectrum disorder. By enhancing their emotional regulation skills, it may be possible to reduce the symptoms of anxiety and depression in this population.

Association Between Emotional Intelligence and Turnover Intention: Its Effects on Job Performance in the Banking Sector

Studies in the banking sector in Pakistan showed that emotional intelligence (EI) and retention of employees had been found to be essential components in the job performance. Hence, this study tries to assess the relationship between emotional intelligence and job performance and turnover intention in the Pakistani banking industry. By examining how emotional intelligence might help with employee retention and performance, it aims to address the problem of high turnover rates. A total of 190 questionnaires were distributed to employees in various banks in Peshawar and Lahore, of which 169 questionnaires were collected back with a return rate of 89. Using AMOS version 26, the model was tested using a two-stage SEM methodology; first, the measurement model was used to assess the validity and reliability of the instrument, and then the structural model was estimated. The findings revealed that there was a positive and significant connection between EI and job performance, the relationship of turnover intention was found to be negative and significantly linked to EI. The results further show a positive but insignificant relationship between turnover intention and job performance. The results imply the prioritization of EI development among bank employees. This can be achieved through training and development programs that focus on improving emotional awareness, emotional regulation, empathy, and social skills.

Profil Resiliensi Mahasiswa Broken Home (Studi pada Mahasiswa BK Universitas PGRI Sumatera Barat)

This research is motivated by the observation that students from broken homes often exhibit avoidant behavior when discussing their family, struggle to regulate their emotions, including crying, when talking about their family, and frequently withdraw from social situations.. This study aims to determine the level of resilience in students broken home seen from; 1) emotion regulation, 2) impulse control, 3) empathy, 4) a optimism, and 5) problem analysis that contribute to student resilience profiles. This study used a quantitative descriptive method with a research population of 60 students selected by the method total sampling with the number of samples taken 60 students. The instrument used is a questionnaire. The aspects of resilience studied include emotion regulation, impulse control, optimism, empathy, and problem analysis skills. Data were analyzed descriptively quantitatively to describe the resilience profile of BK students with different backgrounds broken home. The results of the analysis show that the profile of student resilience is based on background broken home in the PGRI University West Sumatra BK study program are in the medium category. Here are the details; 1) the emotion regulation aspect is in the medium category, 2) the impulse control aspect is in the high category, 3) the empathy aspect is in the medium category, 4) the optimistic aspect is in the moderate category, 5) the problem analysis aspect is in the medium category. Even so, all aspects of resilience have variations in students who have family backgrounds broken home. This research can provide information about the resilience profile description, and this description can be a reference in improving student resilience profiles as well as being a benchmark in developing student resilience profiles broken home become even better.Keywords: Student Broken home, Resilience

Unified Protocol

Unified Protocol (UP) is a transdiagnostic treatment aimed at promoting emotion regulation skills in patients with emotional disorders. The approach targets maintaining factors common to many disorders, in line with recent knowledge about broad dimensions of personality underlying various diagnoses. It allows for the simultaneous treatment of comorbid disorders and can simplify training and treatment implementation. Central to emotional disorders is the individual’s negative reaction to their own emotions, and attempts to cope with them through avoidance or suppression. The goal of UP is to strengthen core skills that enable more adaptive ways of dealing with one’s emotions. These skills include understanding emotions, non-judgemental awareness, flexible thinking, the ability to do the opposite of avoidance behaviours, increased tolerance for physical sensations, and the ability to plan and carry out emotional exposure. In this article, we provide an overview of what a UP approach entails and illustrate this through the case of ‘Nadine’. Keywords: psychotherapy, transdiagnostic, Unified Protocol, emotion regulation, emotional disorders

Systems Training for Emotional Predictability and Problem Solving for older adults with borderline personality disorder symptoms

Objective:Systems Training for Emotional Predictability and Problem Solving (STEPPS) is a 20-week group treatment program for patients with borderline personality disorders (BPD). STEPPS is an evidence-based treatment to reduce BPD symptoms. However, the mean age of patients studied thus far is 33 years. Studies evaluating STEPPS in older adults are lacking. Aim of this study was to investigate the feasibility of STEPPS in older adults with BPD symptoms.Method:A naturalistic, pre- vs post-treatment pilot study design. Twenty-four patients (mean age 64 years) completed the Dutch version of the STEPPS program. Primary outcome was BPD symptoms and secondary outcome was psychological distress and maladaptive personality functioning.Preliminary results of the ongoing study:The STEPPS pilot in older adults demonstrated a significant decrease in BPD symptoms (Cohen’s d = 1.6), improved self-control of emotions and impulses (r = 0.58), and improved identity integration (Cohen’s d = 0.5). No significant differences were found for psychological distress.Conclusion:STEPPS is feasible for older adults with BPD symptoms. The treatment program led to a decreased in BPD symptoms and improvement of emotion regulation skills in older adults.Future perspectives:To further improve the feasibility of STEPSS in older adults a Delphi study was performed with seven experts in the field. The results of this Delphi study will additionally be discussed in this presentation. Most important recommendations were the addition of age-specific topics to the STEPPS program, e.g., changing social roles, life review, and/or physical limitations.

Adaptive and maladaptive emotion regulation skills are associated with food intake following a hunger-induced increase in negative emotions

Many individuals would like to lose weight and often attempt to do so by dieting. However, dieting attempts often backfire and contribute to the risk of weight gain and obesity. Food restriction inevitably leads to hunger and hunger, in turn, induces negative emotions. The inability to regulate such a hunger-induced increase in negative emotions in an adaptive way may be responsible for overeating. The current study aimed to gain a better understanding of this potential psychological mechanism underlying failed dieting attempts. Adaptive and maladaptive emotion regulation (ER) were assessed with an online questionnaire in women with a healthy weight. Subsequently, participants were assigned to the fasted condition (fasting for 14h, n = 49) or the satiated condition (eating between 2 h and 30 min before the lab session, n = 59) and attended a lab session in which they completed tasks while given the opportunity to eat chips and M&M's. We did not find an association between any ER variable and the likelihood to begin eating. Among those who began eating, higher scores on adaptive cognitive ER and on maladaptive behavioral ER were associated with lower caloric intake in fasted individuals. Higher scores on adaptive behavioral ER were associated with higher caloric intake in fasted individuals. Utilizing adaptive cognitive ER when experiencing a hunger-induced increase in negative emotions may help individuals manage their food intake and maintain a healthy weight.

Prediction of the Tendency to Smoke Based on Emotional Dyslexia and Cognitive Control

Background: Smoking is a serious health threat, killing about 5 million people worldwide each year. By 2030, the number of diseases and deaths from tobacco use will reach 8 million per year. This study aims to investigate the prediction of smoking tendency based on emotional dyslexia and perceptual control with the mediation of risk perception.
 Method: This was a descriptive-correlational research conducted on all the 45,000 employees of Tehran Municipality who were working in 2019. The statistical sample consisted of 215 members of the aforementioned statistical population, which was determined using the usual sampling method in correlation studies and the multi-stage cluster sampling method. The instruments used included the smoking tendency questionnaire, the emotional nonverbal questionnaire, and the perceptual control questionnaire. The collected data were analyzed using SPSS software version 25 and Amos software version 22 at two descriptive (mean, standard deviation, etc.) and inferential (structural equation analysis) levels.
 Results: The coefficient of the direct path between alexithymia and the tendency to smoke was 0.380. It can be concluded that there was a positive and significant relationship between alexithymia and the tendency to smoke. In addition, the coefficient of the direct path between perceptual control and the tendency to smoke was -0.250.
 Conclusion: There is a negative and significant relationship between cognitive control and the tendency to smoke. Therefore, by teaching people emotional regulation skills, a person can be prepared to face and solve problems and have constructive relationship with others.

Differences by Emotion Regulation in the Association Between Discrimination and Tobacco Use Among Sexual Minority Young Adults

ABSTRACT Little research has examined factors, such as emotion regulation strategies, that amplify or mitigate associations between discrimination and tobacco use among sexual minority young adults (SMYAs). SM-identifying YA (ages 18–34) women (N = 450; M age = 24.11; 31.1% racial or ethnic minority) and men (N = 254; M age = 24.68; 28.0% racial or ethnic minority) residing in 6 US metropolitan areas were surveyed. Bivariate analyses examined associations of sociodemographics (i.e. age, race, ethnicity, education), discrimination, and emotion regulation strategies (i.e. cognitive reappraisal, expressive suppression) with tobacco use outcomes (i.e. past 30-day cigarette, e-cigarette, other tobacco [aggregated across cigars, hookah] use). Multivariable logistic regressions were built for each tobacco use outcome and included sociodemographic covariates, discrimination and emotion regulation strategies, and interactions between discrimination and emotion regulation strategies. Among SMYA women, a significant interaction of discrimination and cognitive reappraisal indicated that discrimination was associated with greater odds of past 30-day e-cigarette use only among women with lower levels of cognitive reappraisal. Discrimination and emotion regulation were not significantly associated with tobacco use among men. SMYA women with lesser use of cognitive reappraisal may be at heightened risk for e-cigarette use if they experience discrimination. Tobacco cessation programs for SM women should incorporate emotion regulation skills.

Emotional competencies and psychological distress: Is loneliness a mediating factor?

Emotional competencies, such as emotion regulation and empathy, are essential for social interaction. Impairment of these skills has been associated with increased rates of anxiety/depressive symptoms and loneliness, which has been defined as the discrepancy between the desired and actual quality and quantity of social relationships a person maintains. The aim of the present study was to shed light on the associations between these constructs and to examine the possible mediating role of loneliness in the relationship between emotional competencies and anxiety/depressive symptoms in a sample of non-clinical individuals. A total of 298 participants were recruited for this study and were asked to complete a series of measures assessing difficulties in emotion regulation, empathy, loneliness, and anxiety/depressive symptoms. Regression and mediation models were tested to analyze the associations between these variables. Results showed that reduced emotional competencies in emotion regulation and empathy were both directly and indirectly associated with increased anxiety/depressive symptoms and emotional loneliness, which in turn was related to higher levels of psychological distress (with a partial mediation of loneliness). Overall, the present findings seem to indicate that emotional competencies play a key role in the experience of loneliness and psychological distress. Therefore, individuals reporting high levels of loneliness in combination with anxious/depressive symptoms should receive appropriate assessment and treatment of emotion regulation and empathic skills.

A Review on Mobile Phone Addiction among Teenagers

This papers major goals are to check the key causes of teen phone addiction and investigate techniques for identifying and avoiding addictive behaviours. Seven studies were analyzed to detect the development of addiction among adolescents and its potential influencing factors. This report provides a comprehensive assessment of the impact of family factors, friends, and self-regulation ability on adolescents phone addiction. According to the findings, adolescent cell phone addiction is positively correlated with a negative family environment. while positive relationships and self-control can reduce the likelihood of addiction. The paper suggests that educators and parents should proactively assist teenagers in developing emotional regulation skills or seek guidance from psychological professionals to address the underlying causes of phone addiction. Limitations of the current research include the lack of specific case analyses and the limited diversity of the sample backgrounds, which may limit the generalizability of the findings to all adolescents. Further research is necessary to strengthen the conclusions.

Vicarious abusive supervision among restaurant frontline employees: the role of employee industry tenure

PurposeVicarious abusive supervision (VAS) has recently garnered the attention of hospitality researchers. VAS is prevalent in hospitality work settings characterized by long production chains and open operating environments. Based on the conservation of resources (CORs) theory, this study aims to examine how VAS influences hospitality employees’ work behaviours (i.e. supervisor-directed deviance, silence and helping behaviour) via affective rumination, with the moderating role of industry tenure as an individual contingency on the relationship between VAS and affective rumination.Design/methodology/approachThe data were gathered from 233 restaurant frontline employees and their supervisors in Turkey. The authors tested the proposed model using partial least squares method through SmartPLS 3.FindingsThe results reveal that VAS triggers affective rumination, which, in turn, is positively related to supervisor-directed deviance and silence, and negatively related to helping behaviour. Moreover, industry tenure, as a buffer resource, significantly moderates the relationship between VAS and affective rumination.Practical implicationsTo reduce the occurrence of VAS and mitigate its negative effects, managers should establish a work environment that embraces understanding and respect, pay attention to how they communicate with employees, implement appropriate interventions when VAS occurs and conduct stress management training and improve employees’ emotion regulation skills in ways that correspond to the employees’ industry experience.Originality/valueThis study advances research on VAS by offering insight into how VAS impacts employees’ work behaviours via the underlying mechanism of affective rumination through a COR lens. The findings also shed light on the salient buffering effect of industry tenure as an individual contingency.

The role of emotional regulation difficulties in unusual sensory experiences

ABSTRACT Background Emotional regulation difficulties have been linked to unusual sensory experiences (USEs) in the general population. However, the multi-factorial nature of emotional regulation is relatively understudied. This study examined emotional regulation difficulties, alexithymia and interpersonal emotional regulation across six USEs in a psychosis-proneness sample. Methods This study used a cross-sectional correlational research design with predictive models. Data was gathered using an online survey methodology, with convenience purposive sampling. Results A series of hierarchical linear regressions tested the predictive power of the emotional regulation variables on USEs, controlling for self-identified psychiatric diagnoses. Emotional regulation difficulties were a significant predictor in all six USEs. Alexithymia was a significant predictor in three USEs. Interpersonal emotion regulation was not a significant predictor. Discussion The consistency of the relationship between emotional regulation difficulties and USEs emphasised its importance in psychological models and the potential to utilise the large emotional dysregulation evidence base with psychosis populations. Emotional regulation is a multi-factorial construct. Further exploration of emotional regulation difficulties in USEs, and utilising emotional regulation skills with clinical samples are warranted.

Relationship between home literacy environment and emotional regulation in children: the mediating effect of the parent-child relationship

To study the impact of the home literacy environment on children's emotional regulation skills and the mediating role of the parent-child relationship between them. A stratified cluster sampling approach was employed to select 1 626 preschool children from five kindergartens in Nanjing. Questionnaires were used to collect detailed information on the home literacy environment, children's emotional regulation skills, and the parent-child relationship. A mediation model was established using the Process program in SPSS macro, and the significance of the mediation effect was tested using the Bootstrap method. The findings revealed a positive correlation between the home literacy environment and children's emotional regulation skills (r=0.217, P<0.001), as well as parent-child intimacy (r=0.065, P<0.01). Conversely, a negative correlation was found between the home literacy environment and parent-child conflict (r=-0.129, P<0.001). Additionally, parent-child conflict demonstrated a negative correlation with children's emotional regulation skills (r=-0.443, P<0.001), while parent-child intimacy exhibited a positive correlation (r=0.247, P<0.001). The home literacy environment exerted a significant direct effect on children's emotional regulation skills (β=0.162, P<0.001), and the mediating effect of the parent-child relationship accounted for 25.54% of the total effect. The home literacy environment significantly influences children's emotional regulation skills, with the parent-child relationship partially mediating this relationship.

The Impact of Emotion Regulation Improvements on Intolerance of Uncertainty During Emotion Regulation Therapy

Both intolerance of uncertainty (IU) and impoverished emotion regulation repertoires characterize generalized anxiety disorder (GAD). Across two treatment studies, we explored relationships between two emotion regulation skills, decentering and reappraisal, and IU during emotion regulation therapy (ERT). Participants were treatment-seeking individuals diagnosed with GAD. Study 1 included data from two open trials of ERT (N = 52), and Study 2 examined data from a randomized controlled trial of ERT (n = 28) versus a minimal attention control (n = 25). IU and emotion regulation skills were measured at pre-, mid-, and post-treatment. Mediation models explored indirect effects of emotion regulation skills on the relationship between time (Study 1) or group (Study 2) and intolerance of uncertainty. Results demonstrated improvements in emotion regulation skills and reductions in IU during ERT. Greater use of reappraisal and decentering was associated with reduced IU over time. Tests of indirect effects suggested that observed between-group differences in IU can be explained by changes in emotion regulation skills. The findings from these studies highlight the utility of non-IU-specific interventions to help individuals tolerate uncertainty. Exploring the impact of emotion regulation skills on IU could lead to improvements in treating GAD.

An Examination of the Association between Emotion Regulation and Emetophobia Symptoms.

Specific phobia of vomiting, referred to as emetophobia, is a specific phobia characterized by persistent and severe fear of vomit. Individuals with emetophobia engage in a variety of emotional and behavioral avoidance strategies to distance themselves from perceived vomit-related threat. As such, individuals may struggle to effectively use emotion regulation (ER) skills; however, to date, limited work has examined the association between emotion regulation and emetophobia symptoms. The present study aimed to address this gap in the literature and examine the association between ER and emetophobia symptoms. Participants (N = 508) were a remote, clinical sample of individuals recruited via social media forums dedicated to the disorder who self-identified as experiencing emetophobia. Hierarchical linear regressions were used to assessed unique contributions of ER to emetophobia symptoms. Age, gender, and depressive symptoms were entered as covariates in the hierarchical regression. Results demonstrated ER was significantly related to emetophobia symptoms above and beyond the effects of depressive symptoms, age and gender in the current sample. The findings provide initial support for an association between ER and emetophobia, and suggest future directions for refining the conceptualization of emetophobia. Limitations and considerations include the recruitment strategy via social media websites for individuals with emetophobia, limited diversity of the sample, and cross-sectional nature.

Emotion activity education assistance program for therapists and psychologists: Efforts to train emotional regulation skills in children with special needs

Abstrak. One of the problems Children with Special Needs that needs to be addressed is the ability of children with special needs to recognize various kinds of emotions as well as how to manage the emotions they are feeling so that children with special needs can adjust to all situations they face. This community service activity aims to provide educational assistance to therapists and psychologists for service partners how to train emotional regulation skills in children with special needs using emotional activity media. The goal is that therapists and psychologists can train emotional regulation skills in children with special needs using instruments that are easy to apply, interesting, and fun. This assistance is carried out by using socialization methods and simulating the practice of using emotional activity media to therapists and psychologists. The activity went smoothly and was full of enthusiasm from the participants. Therapists and psychologists are able to understand the importance of emotional regulation skills in children with special needs and know easy, interesting, and fun learning methods for children with special needs. Keywords : Children with special needs, emotional activities, emotional regulation

Effectiveness of DIR/Floor Time Play Therapy in Social Skills and Emotion Regulation of Children with Autism Spectrum Disorder

Background: Children with autism spectrum disorder (ASD) and their families need to use rehabilitation services to improve their functions in social interactions and communication skills. Objectives: The present study aimed to investigate the effectiveness of DIR/floor time play therapy in the social skills and emotion regulation of children with ASD. Methods: The present study was a quasi-experimental with a pretest/posttest design. The statistical population included all the autistic children visiting Golhay-e Behesht Autism Center in Qom, Qom Province, Iran. The convenience sampling method was employed to select 30 participants, who were randomly assigned to an experimental group (n = 15) and a control group (n = 15). The experimental group received the DIR/floor time play therapy intervention for 23 twenty-minute sessions. The research instrument included Bellini’s Social Skills Profile Questionnaire and Emotion Regulation Checklist. Descriptive statistics and the repeated measures ANOVA were adopted for data analysis in SPSS 22. Results: According to the results, the DIR/floor time play therapy method improved emotion regulation components (i.e., instability/negativity and emotion regulation) and the indices of social skills (i.e., social interaction, social participation, and detrimental behavior). The results lasted until the follow-up step (P &lt; 0.001). Conclusions: The DIR/floor time play therapy method caused positive changes to emotion regulation and social skills in autistic children. Therefore, it can be an effective intervention in children with ASD.

Anger and Stress Management Techniques for Successful Educational Leadership

This study aimed to investigate the effectiveness of an anger and stress management intervention program on school leaders' burnout, stress, anger, and leadership skills. The study utilized a pre-test, post-test, and follow-up design and collected quantitative data using standardized measures. The study also collected qualitative data through focus group discussions with school leaders at the end of the intervention phase. The data were analyzed using descriptive statistics, paired-sample t-tests, repeated-measures ANOVA, and thematic analysis. The quantitative results showed significant improvements in burnout, stress, anger, and leadership skills among the school leaders who participated in the intervention program. The qualitative findings revealed four main themes: increased self-awareness and emotional regulation, improved communication and conflict resolution skills, enhanced problem-solving and decision-making skills, and improved work-life balance and well-being. The study suggests that anger and stress management interventions can be effective in improving school leaders' well-being and leadership skills. These findings have practical implications for educational institutions and policymakers to implement anger and stress management interventions to support the well-being of school leaders and improve the quality of education

Optimization of a Transdiagnostic Mobile Emotion Regulation Intervention for University Students: Protocol for a Microrandomized Trial.

Many university students experience mental health problems such as anxiety and depression. To support their mental health, a transdiagnostic mobile app intervention has been developed. The intervention provides short exercises rooted in various approaches (eg, positive psychology, mindfulness, self-compassion, and acceptance and commitment therapy) that aim to facilitate adaptive emotion regulation (ER) to help students cope with the various stressors they encounter during their time at university. The goals of this study are to investigate whether the intervention and its components function as intended and how participants engage with them. In addition, this study aims to monitor changes in distress symptoms and ER skills and identify relevant contextual factors that may moderate the intervention's impact. A sequential explanatory mixed methods design combining a microrandomized trial and semistructured interviews will be used. During the microrandomized trial, students (N=200) will be prompted via the mobile app twice a day for 3 weeks to evaluate their emotional states and complete a randomly assigned intervention (ie, an exercise supporting ER) or a control intervention (ie, a health information snippet). A subsample of participants (21/200, 10.5%) will participate in interviews exploring their user experience with the app and the completed exercises. The primary outcomes will be changes in emotional states and engagement with the intervention (ie, objective and subjective engagement). Objective engagement will be evaluated through log data (eg, exercise completion time). Subjective engagement will be evaluated through exercise likability and helpfulness ratings as well as user experience interviews. The secondary outcomes will include the distal outcomes of the intervention (ie, ER skills and distress symptoms).Finally, the contextual moderators of intervention effectiveness will be explored (eg, the time of day and momentary emotional states). The study commenced on February 9, 2023, and the data collection was concluded on June 13, 2023. Of the 172 eligible participants, 161 (93.6%) decided to participate. Of these 161 participants, 137 (85.1%) completed the first phase of the study. A subsample of participants (18/172, 10.5%) participated in the user experience interviews. Currently, the data processing and analyses are being conducted. This study will provide insight into the functioning of the intervention and identify areas for improvement. Furthermore, the findings will shed light on potential changes in the distal outcomes of the intervention (ie, ER skills and distress symptoms), which will be considered when designing a follow-up randomized controlled trial evaluating the full-scale effectiveness of this intervention. Finally, the results and data gathered will be used to design and train a recommendation algorithm that will be integrated into the app linking students to relevant content. ClinicalTrials.gov NCT05576883; https://www.clinicaltrials.gov/study/NCT05576883. DERR1-10.2196/46603.

In-Home Virtual Reality Program for Chronic Lower Back Pain: A Randomized Sham-Controlled Effectiveness Trial in a Clinically Severe and Diverse Sample

ObjectiveTo determine whether an 8-week, self-administered in-home, behavioral skills virtual reality program for chronic low back pain (RelieVRx) that trains diaphragmatic breathing, biofeedback, cognition and emotion regulation, mindfulness, and pain education skills, is superior to a strong active Sham at day 56 for improving pain intensity and pain interference, in a large real-world sample. Patients and MethodsParticipants included a national sample of demographically diverse individuals with self-reported nonmalignant chronic low back pain ≥3 months duration with an average pain intensity and pain interference of ≥4/10. Participants were randomized 1:1 to RelieVRx or active Sham, and data were collected from January 31, 2022, to October 31, 2022. We evaluated group differences in brief pain inventory, pain intensity, and pain interference to day 56 (end of treatment). ResultsOf the 1067 participants (772 women, 293 men, and 2 others; mean ± SD age, 50.8±13.2 years) randomized (1:1) into 2 groups: RelieVRx (n=536) and Sham (n=531) comprised the modified intention-to-treat analytic dataset. RelieVRx was superior to Sham for pain intensity and pain interference reductions from pretreatment to day 56 (difference from Sham, pain intensity: 0.406 [0.170-0.642] and pain interference: 0.523 [0.285-0.760]). Pain intensity and interference reductions for RelieVRx at day 56 were clinically meaningful (pain intensity: 2.0 [out of 10] points [1.73-2.06], pain interference: 2.3 points [1.99-2.33]). ConclusionAn 8-week self-administered behavioral skills virtual reality program was found to impart clinically meaningful improvements above a strong active control comparison on pain intensity and pain interference in clinically severe and diverse adults with chronic low back pain. Trial Registrationclinicaltrials.gov Identifier: NCT05263037