Accepted for/Published in: JMIR Formative Research
Date Submitted: Dec 29, 2025
Date Accepted: Apr 21, 2026
Impact of the restriction/resumption protocol on mood and anxiety in healthy adults: a randomised controlled trial
ABSTRACT
Background:
Simple behavioural and cognitive actions can reduce symptoms of anxiety and depression. However, there is limited research investigating whether restricting those same actions increases symptoms and then whether resuming those actions resolves symptoms.
Objective:
The primary aim was to examine the impact of restricting, then resuming, five groups of actions called the Things You Do (TYD), on symptoms of depression and anxiety. Participant satisfaction with life and perceptions of changes in behaviour and mental health were also evaluated.
Methods:
Seventy adults were randomly allocated to an intervention group (IG) or a control group (CG). IG participants completed a three-phase protocol over eight weeks: a two-week baseline period (A), two weeks of restricted TYD actions (B), and a four-week resumption phase (C). CG participants were instructed to maintain their usual activities and routines. Primary outcomes included symptoms of depression (PHQ-9), anxiety (GAD-7), and frequency of TYD actions. Secondary outcomes included satisfaction with life and perceived changes in mental wellbeing. Outcomes were measured weekly throughout the eight-week trial and again post-trial at week 9.
Results:
Scores on outcome measures did not differ between groups during Phase A and at post-trial. However, by the end of Phase B, IG participants showed significantly increased symptoms of depression and anxiety compared to the CG. Large within-group effect sizes were observed on the PHQ-9 and GAD-7 from baseline to the end of Phase B (ds > 1.8), and from Phase B to post-trial (ds > 1.9). Changes in satisfaction with life and evaluations of mental health corresponded with symptom changes.
Conclusions:
These findings demonstrate a relationship between the frequency of performing specific actions and symptoms of depression and anxiety. The restriction/resumption protocol has the potential to increase our understanding of causal mechanisms underlying common mental disorders and may lead to the development of new models of prevention and treatment. Clinical Trial: : Australian and New Zealand Clinical Trials Registry (ACTRN12624001491550)
Citation
Request queued. Please wait while the file is being generated. It may take some time.
Copyright
© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.