Emotion regulation and insomnia as candidate processes of change in a digital mental health intervention.

Résumé

BACKGROUND: Digital mental health interventions can improve distress and well-being, but the processes statistically accounting for these effects remain unclear. We examined emotion regulation and insomnia as candidate processes in university students.METHODS: Data came from a three-arm randomized trial of the ETUCARE program, an eight-week multicomponent program for French university students. The ITT dataset contained 1064 participants (online: n = 460; hybrid: n = 235; control: n = 369); 947 contributed to FIML estimation. Parallel mediation estimated indirect effects through emotion regulation and insomnia. A ≥70%-adherence sample provided a per-protocol sensitivity analysis, and an exploratory cross-lagged model examined longitudinal associations.RESULTS: ETUCARE assignment was associated with improved emotion regulation (β = .166, p