The goal of this clinical trial is to learn if improv comedy helps reduce anxiety symptoms and improve mental well-being in Chinese young adults in Hong Kong. The main questions it aims to answer are: 1. Does improv comedy reduce anxiety symptoms? 2. Does improv comedy improve mental well-being? Researchers will compare participants who join the improv comedy workshops to participants who are placed on a waiting list to receive the workshops later, to see if improv comedy reduces anxiety and improves mental well-being. Participants will: 1. Attend weekly three-hour improv comedy workshops for 4 consecutive weeks 2. Complete four assessments and brief reflections during or around the workshop sessions 3. Take part in up to two individual interviews (optional)
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
150
Improv Against Anxiety (IAA) is a structured, group-based improv comedy program consisting of four weekly 3-hour sessions. Sessions use established improv games and exercises to reduce anxiety symptoms and enhance mental well-bein
Centre on Behavioral Health, The University of Hong Kong
Hong Kong, Hong Kong
RECRUITINGMean change from baseline in anxiety symptoms measured by the GAD-7 at Week 2, Week 4, and Week 6
The Generalized Anxiety Disorder 7-Item Scale (GAD-7) ranges from 0 to 21, with higher scores indicating greater anxiety symptoms.
Time frame: Baseline (pre-intervention), Week 2 (mid-treatment), Week 4 (post-intervention), and Week 6 (2-week follow-up)
Mean change from baseline in mental well-being measured by the WHO-5 at Week 2, Week 4, and Week 6
The World Health Organization-Five Well-Being Index (WHO-5) ranges from 0 to 25, with higher scores indicating better mental well-being.
Time frame: Baseline (pre-intervention), Week 2 (mid-treatment), Week 4 (post-intervention), and Week 6 (2-week follow-up)
Mean change from baseline in depression symptoms measured by the PHQ-9 at Week 2, Week 4, and Week 6
The Patient Health Questionnaire-9 (PHQ-9) ranges from 0 to 27, with higher scores indicating greater depression symptoms.
Time frame: Baseline (pre intervention), Week 2 (mid treatment), Week 4 (post intervention), and Week 6 (2 week follow up)
Mean change from baseline in worry measured by the PSWQ-A at Week 2, Week 4, and Week 6
The Penn State Worry Questionnaire - Abbreviated (PSWQ-A) ranges from 8 to 40, with higher scores indicating greater worry.
Time frame: Baseline (pre intervention), Week 2 (mid treatment), Week 4 (post intervention), and Week 6 (2 week follow up)
Mean change from baseline in sleep disturbance measured by the ISI at Week 2, Week 4, and Week 6
The Insomnia Severity Index (ISI) ranges from 0 to 28, with higher scores indicating greater sleep disturbance.
Time frame: Baseline (pre intervention), Week 2 (mid treatment), Week 4 (post intervention), and Week 6 (2 week follow up)
Mean change from baseline in perceived stress measured by the PSS-4 at Week 2, Week 4, and Week 6
The Perceived Stress Scale-4 (PSS-4) ranges from 0 to 16, with higher scores indicating greater perceived stress.
Time frame: Baseline (pre intervention), Week 2 (mid treatment), Week 4 (post intervention), and Week 6 (2 week follow up)
Mean changes from baseline in positive and negative affect measured by the I-PANAS-SF at Week 2, Week 4, and Week 6
The International Positive and Negative Affect Schedule Short Form (I-PANAS-SF) consists of five items measuring positive affect and five items measuring negative affect. Each subscale ranges from 5 to 25, with higher scores indicating a stronger presence of that specific affect.
Time frame: Baseline (pre intervention), Week 2 (mid treatment), Week 4 (post intervention), and Week 6 (2 week follow up)
Mean change from baseline in loneliness measured by the ULS-6 at Week 2, Week 4, and Week 6
The 6-item UCLA Loneliness Scale (ULS-6) ranges from 6 to 24, with higher scores indicating greater loneliness.
Time frame: Baseline (pre intervention), Week 2 (mid treatment), Week 4 (post intervention), and Week 6 (2 week follow up)
Mean change from baseline in self-esteem measured by the RSES at Week 2, Week 4, and Week 6
The Rosenberg Self-Esteem Scale (RSES) ranges from 10 to 40, with higher scores indicating higher self-esteem.
Time frame: Baseline (pre intervention), Week 2 (mid treatment), Week 4 (post intervention), and Week 6 (2 week follow up)
Mean change from baseline in intolerance of uncertainty measured by the IUS-12 at Week 2, Week 4, and Week 6
The 12-item Intolerance of Uncertainty Scale (IUS-12) consists of two subscales: prospective intolerance of uncertainty (items 1-7; range 7-35) and inhibitory intolerance of uncertainty (items 8-12; range 5-25). Higher scores on each subscale indicate greater intolerance of uncertainty in that domain.
Time frame: Baseline (pre intervention), Week 2 (mid treatment), Week 4 (post intervention), and Week 6 (2 week follow up)
Mean change from baseline in maximization tendency measured by the MTS-7 at Week 2, Week 4, and Week 6
The 7-item Maximizing Tendency Scale (MTS-7) ranges from 7 to 35, with higher scores indicating a greater tendency to choose the best option.
Time frame: Baseline (pre intervention), Week 2 (mid treatment), Week 4 (post intervention), and Week 6 (2 week follow up)
Mean change from baseline in fear of negative evaluation measured by the BFNE-S at Week 2, Week 4, and Week 6
The Brief Fear of Negative Evaluation Scale-Straightforward Version (BFNE-S) ranges from 8 to 40, with higher scores indicating a higher level of fear of negative evaluation.
Time frame: Baseline (pre intervention), Week 2 (mid treatment), Week 4 (post intervention), and Week 6 (2 week follow up)
Mean change from baseline in playfulness measured by the APTS-CN at Week 2, Week 4, and Week 6
The Adult Playfulness Trait Scale-Chinese Version (APTS-CN) consists of three subscales: fun-seeking motivation (nine items; range 9-45), uninhibitedness (five items; range 5-25), and spontaneity (five items; range 5-25). Higher scores on each subscale indicate greater playfulness in that domain.
Time frame: Baseline (pre intervention), Week 2 (mid treatment), Week 4 (post intervention), and Week 6 (2 week follow up)
Mean change from baseline in openness to experience measured by the CBF-PI-B at Week 2, Week 4, and Week 6
The Chinese Big Five Personality inventory brief version (CBF-PI-B) ranges from 8 to 48, with higher scores indicating greater openness to experience.
Time frame: Baseline (pre intervention), Week 2 (mid treatment), Week 4 (post intervention), and Week 6 (2 week follow up)
Mean change from baseline in fantastic reality ability measured by the FRAME-SF at Week 2, Week 4, and Week 6
The Fantastic Reality Ability Measurement-Short Form (FRAME-SF) consists of four subscales: coping (four items; range 4-28), control (two items; range 2-14), transcendence (four items; range 4-28), and playfulness (three items; range 3-21). Higher scores on each subscale indicate greater fantastic reality ability in that domain.
Time frame: Baseline (pre intervention), Week 2 (mid treatment), Week 4 (post intervention), and Week 6 (2 week follow up)
Within-session change in state anxiety across four intervention sessions measured by the VAS-A
State anxiety will be assessed at the start and end of each intervention session using a single-item anxiety visual analog scale (VAS-A), a continuous line from 0 ("not at all anxious") to 100 ("extremely anxious"), with higher scores reflecting greater state anxiety. The outcome will be defined as the mean pre- to post-session change in VAS-A scores across the four sessions.
Time frame: Immediately before and immediately after each weekly intervention, at Weeks 1, 2, 3, and 4.
Change in perceived group entitativity across four intervention sessions measured by the GEM-GP
The Group Entitativity Measure-Group Psychotherapy (GEM-GP) is a single-item, pictorial visual analog measure. It presents six configurations of circles that progressively move closer together. The central circle represents the respondent, and the surrounding four circles represent the other group members. Across the six images, the circles become increasingly close, illustrating a stronger sense of the group as a cohesive, unified entity. Participants select the configuration that best reflects how they currently experience the group; configurations with closer circles indicate higher perceived group entitativity.
Time frame: Immediately after each weekly intervention, at Weeks 1, 2, 3, and 4.
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