EMI for Reducing Psychological Distress in Young Adults With Multiple ACEs: A Feasibility Study

This single-arm feasibility study aims to evaluate the feasibility and acceptability of an ecological momentary intervention (EMI) designed to reduce psychological distress among young adults with high levels of adverse childhood experiences (ACEs). The intervention targets three potentially modifiable transdiagnostic psychological processes: emotional clarity, self-esteem, and catastrophizing. Approximately 20 young adults aged 18-29 years who have experienced at least two types of ACEs and report elevated psychological distress will be enrolled. All participants will receive a 2-week smartphone-based EMI delivered in daily life. Feasibility, acceptability, and safety will be evaluated using recruitment, retention, intervention use, participant satisfaction, perceived burden, and adverse events. Changes in psychological distress and related psychological outcomes from baseline to post-intervention will also be explored as exploratory outcomes.

Inclusion Criteria: * Aged 18-29 years. * History of relatively high exposure to adverse childhood experiences (ACEs), defined as having experienced at least two types of ACEs. * Presence of psychological distress, defined as a score of 5 or higher on the 6-item Kessler Psychological Distress Scale (K6). * Able to read and understand Chinese fluently. * Owns a smartphone with reliable internet access and is able to perform basic smartphone operations. * Willing to participate in the study and provide informed consent. Exclusion Criteria: * Current or previous diagnosis of a mental disorder by a psychiatrist. * High suicide risk as assessed using the self-report screening version of the Columbia-Suicide Severity Rating Scale (C-SSRS).