Jmir Mental Health最新文献

{"title":"An Examination of Generative AI Response to Suicide Inquires: Content Analysis.","authors":"Laurie O Campbell, Kathryn Babb, Glenn W Lambie, B Grant Hayes","doi":"10.2196/73623","DOIUrl":"10.2196/73623","url":null,"abstract":"<p><strong>Background: </strong>Generative artificial intelligence (AI) chatbots are an online source of information consulted by adolescents to gain insight into mental health and wellness behaviors. However, the accuracy and content of generative AI responses to questions related to suicide have not been systematically investigated.</p><p><strong>Objective: </strong>This study aims to investigate general (not counseling-specific) generative AI chatbots' responses to questions regarding suicide.</p><p><strong>Methods: </strong>A content analysis was conducted of the responses of generative AI chatbots to questions about suicide. In phase 1 of the study, generative chatbots examined include: (1) Google Bard or Gemini; (2) Microsoft Bing or CoPilot; (3) ChatGPT 3.5 (OpenAI); and (4) Claude (Anthropic). In phase 2 of the study, additional generative chatbot responses were analyzed, which included Google Gemini, Claude 2 (Anthropic), xAI Grok 2, Mistral AI, and Meta AI (Meta Platforms). The two phases occurred a year apart.</p><p><strong>Results: </strong>Findings included a linguistic analysis of the authenticity and tone within the responses using the Linguistic Inquiry and Word Count program. There was an increase in the depth and accuracy of the responses between phase 1 and phase 2 of the study. There is evidence that the responses by the generative AI chatbots were more comprehensive and responsive during phase 2 than phase 1. Specifically, the responses were found to provide more information regarding all aspects of suicide (eg, signs of suicide, lethality, resources, and ways to support those in crisis). Another difference noted in the responses between the first and second phases was the emphasis on the 988 suicide hotline number.</p><p><strong>Conclusions: </strong>While this dynamic information may be helpful for youth in need, the importance of individuals seeking help from a trained mental health professional remains. Further, generative AI algorithms related to suicide questions should be checked periodically to ensure best practices regarding suicide prevention are being communicated.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e73623"},"PeriodicalIF":5.8,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371289/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144856767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anticipation and Motivation as Predictors of Leisure and Social Enjoyment and Engagement in Young People With Depression Symptoms: Ecological Momentary Assessment Study.","authors":"Angad Sahni, Ciara McCabe","doi":"10.2196/74427","DOIUrl":"10.2196/74427","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Participating in leisure and social activities can alleviate depression symptoms, yet effective strategies to enhance enjoyment and maintain long-term engagement remain scarce. Gaining insight into the reward subcomponents that influence daily experiences and drive behavior could uncover novel targets for intervention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study examines the role of anticipation and motivation in predicting enjoyment and engagement in leisure activities and socializing among young people, and how these relationships are moderated by depression severity, using intensive longitudinal ecological momentary assessments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Participants (N=80; mean age 20, SD 2.3 years) used the Psymate2 smartphone app to report mood, enjoyment, current and anticipated activities, and social company 7 times daily for 6 days. Activity categories were relaxation, exercise, other leisure, work or school, studying, chores, shopping, hygiene, eating or drinking, and traveling, and company categories were partner, friends, family, colleagues, acquaintances, strangers, and nobody. Anticipation (anticipatory pleasure and expectation) and motivation (interest and preference) for upcoming activities were rated on Likert scales. Participants were grouped by depression severity, measured using the Mood and Feelings Questionnaire (MFQ): high (HD, MFQ ≥27, N=42), moderate (MD, MFQ 16-27, N=16), and low, that is, controls (C, MFQ ≤16, N=22). Totally, 2316 assessments met inclusion criteria.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Leisure activities (relaxation, exercise, and other leisure) and social company (partner, friends, and family) were rated most enjoyable across all groups. Higher depression symptoms were associated with reduced enjoyment of studying (β=-.03; P=.005), eating or drinking (β=-.02; P=.02), and other leisure activities (β=-.02; P=.02), as well as lower engagement in work or school (β=-.26; P=.02) and hygiene (β=-.08; P=.03), and increased inactivity (β=.17; P=.03). Time-lagged multilevel analyses showed that anticipatory pleasure predicted greater enjoyment across all activities (β=.12; P&lt;.001) and social contexts (β=.33; P&lt;.001), with consistent effects in controls and the high depression group. However, the more an activity was expected to happen, the less enjoyment was experienced in the whole sample (β=-.006; P=.001) and high depression group (β=-.008; P=.001) but not controls. Anticipatory pleasure and motivation (preference) predicted leisure engagement in the whole sample (β=.19, P=.003; β=.11, P&lt;.001) and controls (β=.43, P=.005; β=.17, P=.048) but not the depression groups. Anticipatory pleasure predicted only leisure engagement in the high depression group when predictors and outcomes were matched for the same event (β=.22; P=.001). Anticipatory pleasure predicted social engagement in the whole sample (β=.095; P=.047) and controls (β=.34; P=.003), but not in the depression groups.&lt;/","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e74427"},"PeriodicalIF":5.8,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12349889/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144849438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Cost-Effectiveness of Digitally Supported Mental Well-Being Prevention and Promotion Targeting Nonclinical Adult Populations: Systematic Review.","authors":"Sara Claes, Fleur Van De Wielle, Els Clays, Lieven Annemans","doi":"10.2196/72458","DOIUrl":"https://doi.org/10.2196/72458","url":null,"abstract":"<p><strong>Background: </strong>In recent years, policymakers worldwide have been increasingly concerned with promoting public mental well-being. While digitally supported well-being interventions seem effective in general nonclinical populations, their cost-effectiveness remains unclear.</p><p><strong>Objective: </strong>This study aims to systematically synthesize evidence on the cost-effectiveness of digitally supported mental well-being interventions targeting the general population or adults with subclinical mental health symptoms.</p><p><strong>Methods: </strong>PubMed, Embase, Scopus, and Web of Science were systematically searched for health economic or cost-minimization studies. Eligibility criteria included interventions in the general population or adults showing risk factors or subclinical mental health symptoms, with at least 1 digital component. Study quality was comprehensively assessed using the Consensus Health Economic Criteria list.</p><p><strong>Results: </strong>Of 3455 records identified after duplicate removal, 12 studies were included: 3 studies evaluated universal prevention, 3 investigated selective prevention, and 6 covered indicated prevention. Six studies applied a societal perspective. Incremental cost-utility ratios were reported in 6 of the included studies and varied from dominant to €18,710 (US $ 23,185) per quality-adjusted life year. In general, digitally supported well-being interventions in nonclinical adults, and particularly indicated prevention strategies, seemed to generate improved health outcomes at lower costs from a societal perspective. The quality appraisal highlighted several shortcomings of the available literature.</p><p><strong>Conclusions: </strong>Overall, the use of digital tools for mental well-being prevention and promotion in nonclinical adult populations has the potential to be cost-effective. Nevertheless, to adequately guide policymaking, more evidence is still needed. Future studies should ensure valid argumentation for the applied time horizon and perspective, alongside rigorous sensitivity analyses in accordance with best practices to improve cost-effectiveness evidence. Furthermore, assessment methods more sensitive to changes in well-being such as the EQ Health and Well-being instrument could be considered.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e72458"},"PeriodicalIF":5.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12369993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144975213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of Telepresence Among Patients and Psychotherapists in the Actor-Partner Interdependence Model: Longitudinal Observational Study of 20 Dyads From a Randomized Trial on Video Consultations in Primary Care.","authors":"Markus W Haun, Deborah van Eickels, Isabella Stephan, Justus Tönnies, Mechthild Hartmann, Michel Wensing, Joachim Szecsenyi, Andrea Icks, Hans-Christoph Friederich","doi":"10.2196/70415","DOIUrl":"10.2196/70415","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic has accelerated the adoption of video consultations in mental health care, highlighting the importance of therapeutic alliances for successful treatment outcomes in both face-to-face and web-based settings. Telepresence, the sense of being present with the mental health specialist (MHS) rather than feeling remote, is a critical component of building a strong therapeutic alliance in video consultations. While patients often report high telepresence levels, MHSs express concerns about whether video consultations can replicate the quality of face-to-face interactions. Despite its importance, research on telepresence development in MHSs over time and the dyadic interplay between patients and MHSs remains limited.</p><p><strong>Objective: </strong>This study aimed to evaluate the mutual influence within patient-MHS dyads on telepresence development during video consultations, using data from a randomized controlled trial assessing the feasibility of video consultations for depression and anxiety disorders in primary care.</p><p><strong>Methods: </strong>The study included 22 patient-MHS dyads (22 patients, 4 MHSs). Telepresence was measured using the Telepresence in Videoconference Scale. Dyadic data were analyzed using the actor-partner interdependence model with a distinguishable dyad structural equation model. Actor effects refer to the impact of an individual's telepresence at time point 1 (T1) on their telepresence at time point 2 (T2), while partner effects represent the influence of one party's telepresence at T1 on the other's telepresence at T2. Sensitivity analyses excluded data from individual MHSs to account for their unique effects.</p><p><strong>Results: </strong>A significant actor effect for MHSs (P<.001) indicated a high temporal stability of telepresence between T1 and T2. In contrast, the actor effect for patients was not statistically significant, suggesting a greater variability between T1 and T2. No significant partner effects for both patients and MHSs were observed, suggesting no mutual influence between dyad members. Age was a significant covariate for telepresence in both groups.</p><p><strong>Conclusions: </strong>Consistent with prior findings, MHSs experienced increased telepresence over time, whereas patients reported high telepresence levels from the start of therapy. The lack of dyadic influence highlights the need for further exploration into factors affecting telepresence development, such as age, technical proficiency, and prior treatment experience. Future studies with larger samples and more sessions are necessary to enhance the generalizability of these findings and to optimize the use of video consultations in mental health care.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e70415"},"PeriodicalIF":5.8,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12338751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144876063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Virtual Reality-Based Cognitive Defusion Application for Youth Depression and Anxiety: Mixed Methods Experimental Study.","authors":"Imogen H Bell, Cassandra Li, Andrew Thompson, Carli Ellinghaus, Shaunagh O'Sullivan, Kate Alexandra Reynolds, Greg Wadley, Yang Liu, Sarah Bendall, John Gleeson, Lucia Valmaggia, Mario Alvarez-Jimenez","doi":"10.2196/70160","DOIUrl":"10.2196/70160","url":null,"abstract":"<p><strong>Background: </strong>Third-wave psychological treatments such as acceptance and commitment therapy can be effective for improving depression and anxiety in youth. However, third-wave therapeutic techniques such as cognitive defusion can be abstract, challenging to learn, and difficult to apply in real-world settings. Translating these techniques into virtual reality (VR) may provide interactive, enjoyable, and concrete learning opportunities, potentially enhancing engagement and effectiveness. This study evaluated a novel VR application that translates the technique of cognitive defusion into a brief, gamified VR experience.</p><p><strong>Objective: </strong>The objectives of this study were to evaluate the feasibility, acceptability, usability, and safety of the VR cognitive defusion application; examine whether it could improve negative thinking and mood states; and understand how it compared to a non-VR cognitive defusion exercise.</p><p><strong>Methods: </strong>In a mixed methods experimental study, 20 young people completed both a VR and audio cognitive defusion exercise in a randomized order within a single session. Quantitative state-based measures were taken before and after each exercise, and a qualitative interview at the end focused on how the two experiences compared.</p><p><strong>Results: </strong>It was feasible to recruit participants, and all participants completed both exercises and assessments. Both the VR and audio exercises were acceptable to participants, with qualitative themes highlighting a preference for VR due to the novel and engaging format; however, there was a need for better guidance and more personalized environments. No severe adverse events were reported, although one participant experienced distress during the VR exercise. Pretest-posttest effects showed improvements in thought discomfort, cognitive defusion, and state anger for both the VR and audio conditions (P<.05), with the latter showing broader improvements, including thought negativity, rumination, tension, depression, distress, and confusion (P<.05).</p><p><strong>Conclusions: </strong>The VR cognitive defusion application was feasible, safe, and acceptable for young people, with potential to enhance mental health treatment through an engaging and enjoyable approach to learning third-wave cognitive behavioral therapy techniques. While VR was preferred by participants, further refinements could improve effectiveness. Future research should focus on enhancing the VR application design based on user feedback, incorporating audio guidance, and conducting a larger trial in real-world settings to thoroughly evaluate the effectiveness and implementation of the VR application.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e70160"},"PeriodicalIF":5.8,"publicationDate":"2025-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12371279/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144795904","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Video Games and Gamification for Assessing Mild Cognitive Impairment: Scoping Review.","authors":"Yu Chen, Kathrin Gerling, Katrien Verbert, Vero Vanden Abeele","doi":"10.2196/71304","DOIUrl":"10.2196/71304","url":null,"abstract":"<p><strong>Background: </strong>Early assessment of mild cognitive impairment (MCI) in older adults is crucial, as it enables timely interventions and decision-making. In recent years, researchers have been exploring the potential of gamified interactive systems (GISs) to assess pathological cognitive decline. However, effective methods for integrating these systems and designing GISs that are both engaging and accurate in assessing cognitive decline are still under investigation.</p><p><strong>Objective: </strong>We aimed to comprehensively investigate GISs used to assess MCI. Specifically, we reviewed the existing systems to understand the different game types (including genres and interaction paradigms) used for assessment. In addition, we examined the cognitive functions targeted. Finally, we investigated the evidence for the performance of assessing MCI through GISs by looking at the quality of validation for these systems in assessing MCI and the diagnostic performance reported.</p><p><strong>Methods: </strong>We conducted a scoping search in IEEE Xplore, ACM Digital Library, and Scopus databases to identify interactive gamified systems developed for assessing MCI. Game types were categorized according to genres and interaction paradigms. The cognitive functions targeted by the systems were compared with those assessed in the Montreal Cognitive Assessment (MoCA). Finally, we examined the quality of validation against the reference standard (ground truth), relevance of controls, and sample size. Where provided, the diagnostic performance on sensitivity, specificity, and area under the curve was reported.</p><p><strong>Results: </strong>A total of 81 articles covering 49 GISs were included in this review. The primary game types used for MCI assessment were classified as casual games (30/49, 61%), simulation games (17/49, 35%), full-body movement games (4/49, 8%), and dedicated interactive games (3/49, 6%). Of the 49 systems, 6 (12%) assessed cognitive functions comprehensively, compared to those functions assessed via the MoCA. Of the 49 systems, 14 (29%) had validation studies, with sensitivities ranging from 70.7% to 100% and specificities ranging from 56.5% to 100%. The reported diagnostic performances of GISs were comparable to those of common screening instruments, such as Mini-Mental State Examination and MoCA, with some systems reporting near-perfect performance (area under the curve>0.98). However, these findings often stemmed from small samples and retrospective designs. Moreover, some of these systems' model training and validation exhibited substantial deficiencies.</p><p><strong>Conclusions: </strong>This review provides a comprehensive summary of GISs for assessing MCI, exploring the cognitive functions assessed by these systems and evaluating their diagnostic performance. The results indicate that current GISs hold promise for the assessment of MCI, with several systems demonstrating diagnostic performance comparable to establis","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e71304"},"PeriodicalIF":5.8,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12401070/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144785670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of YouTube Health Videos on Mental Health Literacy in Adolescents and Teachers: Randomized Controlled Trial.","authors":"Rebekka Schröder, Tim Hamer, Victoria Kruzewitz, Ellen Busch, Ralf Suhr, Lars König","doi":"10.2196/76004","DOIUrl":"10.2196/76004","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Adolescence is a critical period for mental health development, yet prevalences of mental health problems are high among young people. Enhancing mental health literacy in school settings could be an effective strategy for the promotion of mental well-being and prevention of mental health struggles. One promising approach to achieving this goal involves equipping both students and teachers with accessible multimedia resources-such as YouTube Health videos-to enhance their mental health literacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;The study evaluates the effectiveness of a short educational YouTube Health video for promoting mental health literacy in adolescents and teachers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Two independent samples of 352 adolescents and 502 teachers from Germany were recruited from a large panel, representative of the German population with internet access. Participants of each sample were allocated to an experimental group (176 adolescents and 254 teachers) and a control group (176 adolescents and 248 teachers) through randomization. The experimental group watched a YouTube Health video designed to increase mental health literacy, while the control group watched a video similar in style but on a different topic. Before and after watching the publicly available YouTube Health videos, mental health knowledge was assessed as a primary outcome through topic-specific quizzes and a self-report in a web-based survey. In addition, all participants were asked to rate the educational, visual, and overall quality of the YouTube Health videos and their usability in school settings. The primary hypotheses were tested with ANOVAs. The quality and usability items were analyzed descriptively.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;For the adolescents, there were significant main effects of time (F&lt;sub&gt;1,350&lt;/sub&gt;=46.34, P&lt;.001, η&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;p&lt;/sub&gt;=0.117) and group (F&lt;sub&gt;1,350&lt;/sub&gt;=6.05, P=.01, η&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;p&lt;/sub&gt;=0.017) and a significant time×group interaction (F&lt;sub&gt;1,350&lt;/sub&gt;=39.15, P&lt;.001, η&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;p&lt;/sub&gt;=0.101) on stress-specific knowledge, indicating a higher increase in knowledge in the experimental group than in the control group. Similarly, for teachers, significant main effects of time (F&lt;sub&gt;1,500&lt;/sub&gt;=107.31, P&lt;.001, η&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;p&lt;/sub&gt;=0.177) and group (F&lt;sub&gt;1,500&lt;/sub&gt;=58.07, P&lt;.001, η&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;p&lt;/sub&gt;=0.104) and a significant time×group interaction (F&lt;sub&gt;1,500&lt;/sub&gt;=82.59, P&lt;.001, η&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;p&lt;/sub&gt;=0.142) were found. The same pattern of results was observed for the knowledge self-reports in both the students (time: F&lt;sub&gt;1,347&lt;/sub&gt;=103.65, P&lt;.001, η&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;p&lt;/sub&gt;=0.230; group: F&lt;sub&gt;1,347&lt;/sub&gt;=8.59, P=.004, η&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;p&lt;/sub&gt;=0.024; time×group interaction: F&lt;sub&gt;1,347&lt;/sub&gt;=29.11, P&lt;.001, η&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;p&lt;/sub&gt;=0.077) and teachers (time: F&lt;sub&gt;1,500&lt;/sub&gt;=115.40, P&lt;.001, η&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;p&lt;/sub&gt;=0.188; group: F&lt;sub&gt;1,500&lt;/sub&gt;=41.16, P&lt;.0","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e76004"},"PeriodicalIF":5.8,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12355139/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Objectively Measured Smartphone Use and Nonsuicidal Self-Injury Among College Students: Cross-Sectional Study.","authors":"Wenhua Wang, Mingyang Wu, Xiaoxiao Yuan, Xue Wang, Le Ma, Lu Li, Lei Zhang","doi":"10.2196/71264","DOIUrl":"10.2196/71264","url":null,"abstract":"<p><strong>Background: </strong>The impact of smartphone use on mental health is being rigorously debated. Some questionnaire-based research suggests that smartphone use correlates with nonsuicidal self-injury (NSSI). Self-reported data seem unlikely to capture actual smartphone use precisely, requiring objective measures to advance this field.</p><p><strong>Objective: </strong>The aim of the study is to examine whether objectively measured smartphone use was associated with NSSI among college students.</p><p><strong>Methods: </strong>This multicenter cross-sectional study was conducted from 2022 to 2024, enrolling college students from 559 classes across 6 universities in China. NSSI was measured by the Ottawa Self-Injury Inventory including 10 items of NSSI without suicidal intent within the past month. Participants answering \"ever\" were classified as having NSSI. Objectively measured smartphone screen time and number of smartphone unlocks were obtained from screenshots of smartphone use records. The association between objectively measured smartphone use and NSSI was analyzed using binary logistic regression models and restricted cubic spline regression.</p><p><strong>Results: </strong>Of 16,668 included participants, 627 (3.8%) reported NSSI. Mean (SD) smartphone screen time and number of smartphone unlocks were 48.8 (28.8) hours per week and 271.6 (291.0) times per week. The models adjusted for different factors showed a significant association between smartphone use and NSSI. Compared to participants with 0-21 hours per week of smartphone screen time, those with ≥63 hours per week of smartphone screen time had higher odds of NSSI (odds ratio [OR] 1.63, 95% CI 1.32-2.01). Likewise, compared to participants with 0-50 times per week of smartphone unlocks, those with ≥400 times per week of smartphone unlocks had higher odds of NSSI (OR 1.53, 95% CI 1.25-1.88). No significant NSSI risk increase was observed for participants with 21-42 and 42-63 hours per week of smartphone screen time nor for those with 50-150 and 150-400 times per week of smartphone unlocks. Moreover, restricted cubic spline analyses showed that the increasing risk of NSSI was associated with elevated smartphone screen time and number of smartphone unlocks.</p><p><strong>Conclusions: </strong>These findings emphasize that ≥63 hours per week of smartphone screen time and ≥400 times per week of smartphone unlocks are risk factors for NSSI among college students, and interventions targeting NSSI should consider the apparent association with smartphone use.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e71264"},"PeriodicalIF":5.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12310150/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment Without Cost? Effects and Side Effects of an Internet-Based Intervention for Depression: Randomized Controlled Trial.","authors":"Anna Baumeister, Lea Schuurmans, Alina Bruhns, Steffen Moritz","doi":"10.2196/71274","DOIUrl":"10.2196/71274","url":null,"abstract":"<p><strong>Background: </strong>Internet-based interventions for depression are increasingly integrated into health care due to their effectiveness, availability, and cost-effectiveness. However, negative effects have largely been ignored.</p><p><strong>Objective: </strong>This study aimed to evaluate both positive and negative effects of an unguided intervention.</p><p><strong>Methods: </strong>In total, 303 participants were analyzed using mixed models for repeated measures to assess changes in depressive symptoms via Beck Depression Inventory-II (primary outcome) after 12 weeks compared to waitlist controls with care as usual. Secondary endpoints included depressive symptoms (Patient Health Questionnaire-9 [PHQ-9]), self-esteem, and quality of life. Negative effects were evaluated using the positive and negative effects of psychotherapy scale for internet-based interventions (PANEPS-I). Moderation analyses were conducted to explore influential effects on treatment outcomes.</p><p><strong>Results: </strong>The intervention group showed greater reduction in depressive symptoms compared to controls, with small to medium effect sizes (g=0.30-0.42) with averaged 14 logins. Although improvements in self-esteem and quality of life were not observed in intention-to-treat analyses, the completer sample indicated higher self-esteem in the intervention group. Negative effects were reported by 22% (22/100) to 68% (66/97), with the highest rates for program-related effects (eg, not addressing personal problems). No moderation effects were identified.</p><p><strong>Conclusions: </strong>The intervention effectively reduces depressive symptoms. Although negative effects were present, they did not impact treatment outcome, tentatively suggesting that overall benefits may outweigh the negative effects for users.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e71274"},"PeriodicalIF":5.8,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144745542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Digital Addiction: Umbrella Review.","authors":"Yun Han, Jiamin Qiu, Chengbin Shi, Shiqi Huang, Haokun Huang, Xinman Wang, Sui Zhu, Da-Lin Lu, Peng Lu, Fangfang Zeng","doi":"10.2196/66950","DOIUrl":"10.2196/66950","url":null,"abstract":"<p><strong>Background: </strong>Digital addiction, affecting a significant portion of the population, particularly young people, is linked to psychological issues and social problems, making its prevention and management a crucial public health issue.</p><p><strong>Objective: </strong>This umbrella review aimed to comprehensively analyze the factors influencing digital addiction by re-evaluating the methodologies and evidence quality of existing meta-analyses.</p><p><strong>Methods: </strong>Databases including PubMed, Web of Science, the Cochrane Library, and Embase were systematically searched for reviews and meta-analyses related to factors associated with digital addiction up to September 24, 2024. The methodological quality of the identified studies was assessed using the modified \"A Measurement Tool to Assess Systematic Reviews 2\" (AMSTAR 2) tool, while the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to evaluate the quality of the evidence presented in the literature.</p><p><strong>Results: </strong>A total of 18 articles were included in the review, with AMSTAR 2 assessments revealing 6 moderate-quality, 4 low-quality, and 8 very low-quality studies. In total, 29 significant factors associated with digital addiction were identified. Notably, 4 studies achieved both moderate AMSTAR 2 and GRADE ratings, indicating that positive parent-child relationship (r=-0.15, 95% CI-0.18 to -0.11; P<.05) effectively mitigate the risks of digital addiction. Conversely, urban residence (odds ratio [OR] 2.32, 95% CI 1.19-4.53; P<.001), adverse childhood experiences (r=0.21, 95% CI 0.18-0.24; P<.001), and social anxiety (r=0.34, 95% CI 0.19-0.48; P<.001) were identified as factors that may increase the risk of developing digital addiction.</p><p><strong>Conclusions: </strong>This study found that social factors such as urban residence were associated with an increased risk of digital addiction, whereas social support served as a protective factor against this risk. Nonetheless, the methodologies used in analyzing the factors related to digital addiction require further refinement.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e66950"},"PeriodicalIF":5.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303545/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144734156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}