Jmir Mental Health最新文献

{"title":"Ecological Momentary Assessment of Self-Harm Thoughts and Behaviors: Systematic Review of Constructs From the Integrated Motivational-Volitional Model.","authors":"Lizzy Winstone, Jon Heron, Ann John, Olivia J Kirtley, Paul Moran, Jennifer Muehlenkamp, Rory C O'Connor, Becky Mars","doi":"10.2196/63132","DOIUrl":"10.2196/63132","url":null,"abstract":"<p><strong>Background: </strong>The integrated motivational-volitional model (IMV) is one of the leading theoretical models of suicidal thoughts and behavior. There has been a recent proliferation in the assessment of suicidal and nonsuicidal self-harm thoughts and behaviors (SHTBs) in daily life.</p><p><strong>Objective: </strong>This systematic review synthesized evidence from ecological momentary assessment (EMA) studies in the SHTB literature to address the following questions: (1) Which constructs in the IMV model have been assessed using EMA, and how have they been assessed? (2) Do different constructs from the IMV model fluctuate in daily life? (3) What is the relationship between the different IMV constructs and SHTBs in daily life?</p><p><strong>Methods: </strong>Consistent with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we conducted systematic searches of 5 databases-Web of Science, Embase, MEDLINE, PsycINFO, and Europe PMC Preprints-from inception to March 26, 2024.</p><p><strong>Results: </strong>Our searches resulted in the inclusion and narrative synthesis of 53 studies across 58 papers. A total of 15 IMV constructs were measured using EMA across the included papers. The most frequently measured constructs were thwarted belongingness (24/58, 41% of the papers), future thinking (20/58, 34% of the papers), and perceived burdensomeness (16/58, 28% of the papers). The least frequently measured constructs were humiliation, social problem-solving, mental imagery, and perceived capability for suicide. None of the included papers measured memory biases, goals, norms, or resilience using EMA. Comparison of intraclass correlation coefficients (45/58, 78% of the papers) revealed moderate but inconsistent within-person variance across all the examined constructs. We found evidence (39/58, 67% of the papers) of concurrent associations between almost all constructs and SHTBs in daily life, with some evidence that entrapment, shame, rumination, thwarted belongingness, hopelessness, social support, and impulsivity are additionally associated with SHTBs in lagged (ie, longitudinal) relationships.</p><p><strong>Conclusions: </strong>Comparisons were hindered by variation in methodology, including the populations studied, EMA sampling scheme, operationalization of IMV constructs and SHTBs, and statistical approach used. Our findings suggest that EMA studies are a useful methodology for examining risk factors for SHTBs; however, more research is needed for some IMV constructs. Quality assessment suggested several areas for improvement in the reporting of EMA studies in this field.</p><p><strong>Trial registration: </strong>PROSPERO CRD42022349514; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=349514.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"11 ","pages":"e63132"},"PeriodicalIF":4.8,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11667137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142802739","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 Use of a Digital Well-Being App (Stay Strong App) With Indigenous People in Prison: Randomized Controlled Trial.","authors":"Elke Perdacher, David Kavanagh, Jeanie Sheffield, Penny Dale, Edward Heffernan","doi":"10.2196/53280","DOIUrl":"10.2196/53280","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Indigenous Australians in custody experience much greater rates of poor mental health and well-being than those of the general community, and these problems are not adequately addressed. Digital mental health strategies offer innovative opportunities to address the problems, but little is known about their feasibility in or impact on this population.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to conduct a pilot trial evaluating the impact of adding the Stay Strong app to mental health and well-being services for Indigenous women and men in custody. The trial compared immediate and 3-month delayed use of the app by the health service, assessing its effects on well-being, empowerment, and psychological distress at 3 and 6 months after the baseline.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Indigenous participants were recruited from 3 high-security Australian prisons from January 2017 to September 2019. The outcome measures assessed well-being (Warwick-Edinburgh Mental Wellbeing Scale), empowerment (Growth and Empowerment Measure [GEM]-giving total, 14-item Emotional Empowerment Scale, and 12 Scenarios scores), and psychological distress (Kessler Psychological Distress Scale). Intention-to-treat effects on these outcomes were analyzed using linear mixed models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Substantial challenges in obtaining ethical and institutional approval for the trial were encountered, as were difficulties in timely recruitment and retention due to staff shortages and the release of participants from prison before follow-up assessments and an inability to follow up with participants after release. A total of 132 prisoners (age: mean 33, SD 8 y) were randomized into either an immediate (n=82) or a delayed treatment (n=52) group. However, only 56 (42.4%) could be assessed at 3 months and 37 (28%) at 6 months, raising questions concerning the representativeness of the results. Linear improvements over time were seen in all outcomes (GEM total: Cohen d=0.99; GEM 14-item Emotional Empowerment Scale: Cohen d=0.94; GEM 12 Scenarios: Cohen d=0.87; Warwick-Edinburgh Mental Wellbeing Scale: Cohen d=0.76; Kessler Psychological Distress Scale: Cohen d=0.49), but no differential effects for group or the addition of the Stay Strong app were found.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;We believe this to be Australia's first evaluation of a digital mental health app in prison and the first among Indigenous people in custody. While the study demonstrated that the use of a well-being app within a prison was feasible, staff shortages led to delayed recruitment and a consequent low retention, and significant beneficial effects of the app's use within a forensic mental health service were not seen. Additional staff resources and a longer intervention may be needed to allow a demonstration of satisfactory retention and impact in future research.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;ANZCTR ACTRN12624001261505; https://www.anzctr.","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"11 ","pages":"e53280"},"PeriodicalIF":4.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789660","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":"Text Messaging to Extend School-Based Suicide Prevention: Pilot Randomized Controlled Trial.","authors":"Anthony R Pisani, Peter A Wyman, Ian Cero, Caroline Kelberman, Kunali Gurditta, Emily Judd, Karen Schmeelk-Cone, David Mohr, David Goldston, Ashkan Ertefaie","doi":"10.2196/56407","DOIUrl":"10.2196/56407","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Suicide is the third-leading cause of death among US adolescents aged 10-19 years, and about 10% attempt suicide each year. School-based universal prevention may reduce youth suicidal behavior. Sources of Strength uses a peer leader network diffusion model to promote healthy norms across a school population. A key challenge within schoolwide programs is reaching a large and diverse array of students, especially those less engaged with their peers. Motivated by this challenge, we developed and field-tested Text4Strength-a program of automated text messages targeting help-seeking attitudes and norms, social coping resources, and emotion regulation skills.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study conducted a pilot randomized controlled trial of Text4Strength in 1 high school as an extension of an ongoing schoolwide program (Sources of Strength), to test its impact on targets that have the potential to reduce suicidal behavior.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Students at an upstate New York high school (N=223) received 1-2 text messages per week for 9 weeks, targeting strategies for coping with difficult feelings and experiences through clarifying emotions and focusing on positive affect concepts, awareness, and strengthening of youth-adult relationships; and positive help-seeking norms, skills, and resources. Surveys were administered at baseline, immediately post intervention and 3 months after texting ended. We measured proximal intervention targets (methods of coping during stressful events, ability to make sense of their own emotions, feelings of powerlessness during emotion management and recovery, relations with trusted adults at school, and help-seeking behaviors), symptoms and suicide ideation, and student replies to messages.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;No significant effects were observed for any outcome at either follow-up time point. Results showed that if there is a true (but undetected) intervention effect, it is small. Students with fewer friend nominations did not interact any more or less with the text messages. Exploratory moderation analyses observed no interaction between the intervention condition and the number of friends or baseline suicide ideation at any time point.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;In contrast to a promising previous field test, these results suggest that Text4Strength is unlikely to have impacted the outcomes of interest and that undetected moderate or large effects can be ruled out with high confidence. Although motivated by the need to reach more isolated students, students with fewer friends did not engage more or show a greater effect than other participants. This study was conducted in a single high school that was already implementing Sources of Strength, so the bar for showing a distinct effect from texting alone was high. Many further channels for reaching youth through private messaging remain unexplored. Alternative delivery systems should be investigated","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"11 ","pages":"e56407"},"PeriodicalIF":4.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11662186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789562","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":"Digital Health Interventions for Informal Family Caregivers of People With First-Episode Psychosis: Systematic Review on User Experience and Effectiveness.","authors":"Pauline Sarah Münchenberg, Dinara Yessimova, Dimitra Panteli, Tobias Kurth","doi":"10.2196/63743","DOIUrl":"10.2196/63743","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;First-episode psychosis (FEP) imposes a substantial burden not only on the individual affected but also on their families. Given that FEP usually occurs during adolescence, families overtake a big part of informal care. Early family interventions, especially psychoeducation, are crucial for informal family caregivers to best support the recovery of their loved one with FEP and to reduce the risk of a psychotic relapse as much as possible, but also to avoid chronic stress within the family due to the burden of care. Digital health interventions offer the possibility to access help quicker, use less resources, and improve informal family caregiver outcomes, for example, by reducing stress and improving caregiver quality of life.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to systematically identify studies on digital health interventions for informal family caregivers of people with FEP and to describe and synthesize the available literature on user experience, as well as the effectiveness of such digital applications on the clinical outcomes, consisting of (1) perceived caregiver stress, (2) expressed emotion, and (3) parental self-efficacy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A systematic search was carried out across 4 electronic databases. In addition, reference lists of relevant studies were hand-searched. This review aimed to include only primary studies on informal family caregivers, who had to care for a person with FEP between 15 years and 40 years of age and a diagnosis of FEP with onset of observed symptoms within the past 5 years. All types of digital interventions were included. This systematic review is aligned with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) 2020 guidelines.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The search identified 7 studies that reported on user experience or effectiveness of digital health interventions on perceived caregiver stress, expressed emotion, and parental self-efficacy, including 377 informal family FEP caregivers across trials. Digital health interventions-web-based, videoconferences, and mHealth-were well accepted and perceived as relevant, easy to use, and helpful by informal family FEP caregivers. Psychoeducational content was rated as the most important across studies. Perceived caregiver stress, expressed emotion, and parental self-efficacy improved in all studies that reported on these clinical outcomes.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The results of this review suggest that digital health interventions aimed at informal family caregivers of individuals with FEP can improve relevant clinical outcomes, with participants reporting a positive user experience. However, for some interventions reviewed, specialized in-person family care outperformed the digital intervention and partially led to better results in perceived caregiver stress and parental self-efficacy. Therefore, while digital interventions present a promising approach t","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"11 ","pages":"e63743"},"PeriodicalIF":4.8,"publicationDate":"2024-11-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11638689/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751996","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":"Avatar Intervention in Virtual Reality for Cannabis Use Disorder in Individuals With Severe Mental Disorders: Results From a 1-Year, Single-Arm Clinical Trial.","authors":"Sabrina Giguere, Mélissa Beaudoin, Laura Dellazizzo, Kingsada Phraxayavong, Stéphane Potvin, Alexandre Dumais","doi":"10.2196/58499","DOIUrl":"10.2196/58499","url":null,"abstract":"<p><strong>Background: </strong>The dual diagnosis of cannabis use disorder (CUD) and severe mental disorder (SMD) results in clinically complex individuals. Cannabis use is known to have negative consequences on psychiatric symptoms, medication compliance, and disease prognosis. Moreover, the effectiveness of currently available psychotherapeutic treatments is limited in this population. In this context, our research team developed avatar intervention, an approach using virtual reality as a therapeutic tool to treat CUD in individuals with SMD.</p><p><strong>Objective: </strong>This pilot clinical trial aimed to evaluate, until the 1-year follow-up, the efficacy of avatar intervention for CUD among 32 participants with a dual diagnosis of SMD and CUD.</p><p><strong>Methods: </strong>Over the course of the 8 intervention sessions, participants were given the opportunity to enter a dialogue in virtual reality with an avatar representing a person with a significant role in their consumption, who was animated in real time by a therapist. The primary outcomes were the quantity of cannabis consumed and the frequency of use. Secondary outcomes included severity of problematic cannabis use, motivation for change, protective strategies for cannabis use, consequences of cannabis use, psychiatric symptoms, and quality of life. Changes in reported outcomes during the assessment periods before the intervention; postintervention; and 3, 6, and 12 months after the end of the intervention were assessed using a linear mixed-effects model.</p><p><strong>Results: </strong>Significant reductions were observed in the quantity of cannabis consumed, and these were maintained until the 12-month follow-up visit (d=0.804; P<.001; confirmed by urine quantification). Frequency of cannabis use showed a small significant reduction at the 3-month follow-up (d=0.384; P=.03). Moreover, improvements were observed in the severity of CUD, cannabis-related negative consequences, the motivation to change cannabis use, and the strategies used to mitigate harms related to cannabis use. Finally, moderate benefits were observed for quality of life and psychiatric symptoms.</p><p><strong>Conclusions: </strong>Overall, this unique intervention shows promising results that seem to be maintained up to 12 months after the end of the intervention. With the aim of overcoming the methodological limitations of a pilot study, a single-blind randomized controlled trial is currently underway to compare the avatar intervention for CUD with a conventional addiction intervention.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"11 ","pages":"e58499"},"PeriodicalIF":4.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11612600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740838","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":"Effectiveness of a Novel Web-Based Intervention to Enhance Therapeutic Relationships and Treatment Outcomes in Adult Individual Psychotherapy: Randomized Controlled Trial and Analysis of Predictors of Dropouts.","authors":"Alberto Stefana, Paolo Fusar-Poli, Eduard Vieta, Eric A Youngstrom","doi":"10.2196/63234","DOIUrl":"10.2196/63234","url":null,"abstract":"<p><strong>Background: </strong>Routine process and outcome monitoring interventions added to psychotherapy are known to improve treatment outcomes, although they vary in format and effectiveness.</p><p><strong>Objective: </strong>This study aimed to evaluate whether a therapist-independent, internet-based routine process monitoring and feedback system could significantly reduce psychological distress and enhance the quality of the therapeutic relationship compared with a treatment-as-usual control group among individuals already engaged in individual psychotherapy.</p><p><strong>Methods: </strong>We randomized 475 participants into either the intervention group, which received access to an internet-based routine process monitoring and feedback system in addition to psychotherapy, or the control group, which received only psychotherapy. The trial lasted for 10 weeks. Follow-up assessments at 5 weeks and 10 weeks used the Clinical Outcomes in Routine Evaluation-Outcome Measure as the primary outcome, with the Working Alliance Inventory-Short Revised and the Real Relationship Inventory-Client form as secondary outcomes.</p><p><strong>Results: </strong>Per-protocol analyses (n=166) showed that psychological distress decreased in both groups, but there was no significant advantage for the intervention group. The intervention group experienced a decline in the genuineness dimension score of the real relationship, with an effect size of d=-0.27, compared with d=0.01 in the control group. In the intervention group (but not in the control group), dropouts showed significantly lower real relationship levels (P=.002), working alliance quality (P=.051), and emotional disclosure (P=.01) compared with those who completed the study. Additionally, logistic regression revealed distinct predictors of dropout within the control group and intervention group.</p><p><strong>Conclusions: </strong>The findings do not provide conclusive evidence for the efficacy of the new internet-based intervention in enhancing self-monitoring and prompting reflection on patients' emotional responses to their therapists. However, the intervention appears to influence patients' perceptions of the genuineness dimension in the therapeutic relationship, warranting further investigation. We hypothesize that this alteration in the genuineness dimension could be attributed to the intervention facilitating a more realistic and accurate perception of the therapeutic relationship among participants.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT06038747; https://clinicaltrials.gov/study/NCT06038747.</p><p><strong>International registered report identifier (irrid): </strong>RR2-10.2196/55369.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"11 ","pages":"e63234"},"PeriodicalIF":4.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635334/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142733600","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 a Digital Therapeutic Adjunct to Eating Disorder Treatment on Health Care Service Utilization and Clinical Outcomes: Retrospective Observational Study Using Electronic Health Records.","authors":"Jorge E Palacios, Kathryn K Erickson-Ridout, Jane Paik Kim, Stuart Buttlaire, Samuel Ridout, Stuart Argue, Jenna Tregarthen","doi":"10.2196/59145","DOIUrl":"10.2196/59145","url":null,"abstract":"<p><strong>Background: </strong>The need for scalable solutions facilitating access to eating disorder (ED) treatment services that are efficient, effective, and inclusive is a major public health priority. Remote access to synchronous and asynchronous support delivered via health apps has shown promise, but results are so far mixed, and there are limited data on whether apps can enhance health care utilization.</p><p><strong>Objective: </strong>This study aims to examine the effects of app-augmented treatment on clinical outcomes and health care utilization for patients receiving treatment for an ED in outpatient and intensive outpatient levels of care.</p><p><strong>Methods: </strong>Recovery Record was implemented in outpatient and intensive outpatient services in a California-based health maintenance organization. We examined outcomes for eligible patients with ED by comparing clinical and service utilization medical record data over a 6-month period after implementation with analogous data for the control group in the year prior. We used a logistic regression model and inverse-weighted estimates of the probability of treatment to adjust for treatment selection bias.</p><p><strong>Results: </strong>App-augmented treatment was associated with a significant decrease in emergency department visits (P<.001) and a significant increase in outpatient treatment utilization (P<.001). There was a significantly larger weight gain for patients in low-weight categories (ie, underweight, those with anorexia, or those with severe anorexia) with app-augmented treatment (treatment effect: 0.74, 0.25, and 0.35, respectively; P=.02), with a greater percentage of patients moving into a higher BMI class (P=.01).</p><p><strong>Conclusions: </strong>Integrating remote patient engagement apps into ED treatment plans can have beneficial effects on both clinical outcomes and service utilization. More research should be undertaken on long-term efficacy and cost-effectiveness to further explore the impact of digital health interventions in ED care.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"11 ","pages":"e59145"},"PeriodicalIF":4.8,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11635337/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142740777","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":"Exploring the Effects of Variety and Amount of Mindfulness Practices on Depression, Anxiety, and Stress Symptoms: Longitudinal Study on a Mental Health-Focused eHealth System for Patients With Breast or Prostate Cancer.","authors":"Francesca Malandrone, Sara Urru, Paola Berchialla, Pierre Gilbert Rossini, Francesco Oliva, Silvia Bianchi, Manuel Ottaviano, Sergio Gonzalez-Martinez, Vladimir Carli, Gaetano Valenza, Enzo Pasquale Scilingo, Sara Carletto, Luca Ostacoli","doi":"10.2196/57415","DOIUrl":"10.2196/57415","url":null,"abstract":"<p><strong>Background: </strong>Patients with cancer often face depression and anxiety, and mindfulness-based interventions, including internet-based versions, can effectively reduce these symptoms and improve their quality of life. This study aims to investigate the impact of internet-based mindfulness-based interventions (e-MBIs) on anxiety, depression, and stress symptoms in patients with prostate or breast cancer.</p><p><strong>Objective: </strong>The primary aims are to assess the association between the amount and variety of e-MBI practices and symptom reduction. Second, this study aims to examine how baseline information such as sociodemographic characteristics, dispositional mindfulness (DM), and dispositional self-compassion (DSC) correlate with both app usage and symptom reduction.</p><p><strong>Methods: </strong>Participants included 107 patients with cancer (68 women with breast cancer and 38 men with prostate cancer) enrolled in a hospital setting. They were assigned to the intervention group of the NEVERMIND project, using the e-BMI module via the NEVERMIND app. A longitudinal design involved Pearson correlation analysis to determine the relationship between the amount and duration of e-MBI practices. Linear regression analysis was conducted to gauge the dose-response effect, evaluating the impact of DM and DSC on depression, anxiety, and stress. Negative binomial regression was conudcted to study sociodemographic factors' influence on the amount of practice in e-MBIs.</p><p><strong>Results: </strong>The participants with more diverse and sustained mindfulness practices experienced significant reductions in depression, anxiety, and stress. A high correlation (0.94) between e-MBI practices and symptom reduction was also highlighted. Male, married, and highly educated patients were more likely to engage in mindfulness. Even if DM and DSC did not impact the amount or variety of practices correlated, they were correlated with symptom reduction, showing that higher levels were associated with significant reductions in depression, anxiety, and stress.</p><p><strong>Conclusions: </strong>While more e-MBI practice is linked to reduced anxiety, depression, and stress, this study emphasizes the crucial role of variety of practice over amount. DM and DSC are key in shaping intervention effectiveness and may act as protectors against psychological distress. Using app log data, our research provides a unique perspective on e-MBI impact, contributing to cancer care understanding and guiding future studies.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"11 ","pages":"e57415"},"PeriodicalIF":4.8,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11604212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142688909","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":"Building Mutually Beneficial Collaborations Between Digital Navigators, Mental Health Professionals, and Clients: Naturalistic Observational Case Study.","authors":"Carla Gorban, Sarah McKenna, Min K Chong, William Capon, Robert Battisti, Alison Crowley, Bradley Whitwell, Antonia Ottavio, Elizabeth M Scott, Ian B Hickie, Frank Iorfino","doi":"10.2196/58068","DOIUrl":"10.2196/58068","url":null,"abstract":"<p><strong>Unlabelled: </strong>Despite the efficacy of digital mental health technologies (DMHTs) in clinical trials, low uptake and poor engagement are common in real-world settings. Accordingly, digital technology experts or \"digital navigators\" are increasingly being used to enhance engagement and shared decision-making between health professionals and clients. However, this area is relatively underexplored and there is a lack of data from naturalistic settings. In this paper, we report observational findings from the implementation of a digital navigator in a multidisciplinary mental health clinic in Sydney, Australia. The digital navigator supported clients and health professionals to use a measurement-based DMHT (the Innowell platform) for improved multidimensional outcome assessment and to guide personalized decision-making. Observational data are reported from implementation logs, platform usage statistics, and response rates to digital navigator emails and phone calls. Ultimately, support from the digital navigator led to improved data collection and clearer communications about goals for using the DMHT to track client outcomes; however, this required strong partnerships between health professionals, the digital navigator, and clients. The digital navigator helped to facilitate the integration of DMHT into care, rather than providing a stand-alone service. Thus, collaborations between health professionals and digital navigators are mutually beneficial and empower clients to be more engaged in their own care.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"11 ","pages":"e58068"},"PeriodicalIF":4.8,"publicationDate":"2024-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11559438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142590973","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":"Virtual Reality Exposure Therapy for Reducing School Anxiety in Adolescents: Pilot Study.","authors":"Gesa Beele, Paula Liesong, Sabine Bojanowski, Kristian Hildebrand, Malte Weingart, Julia Asbrand, Christoph U Correll, Nexhmedin Morina, Peter J Uhlhaas","doi":"10.2196/56235","DOIUrl":"10.2196/56235","url":null,"abstract":"<p><strong>Background: </strong>Virtual reality exposure therapy (VRET) is a promising treatment approach for anxiety disorders. However, while its efficacy has been demonstrated in adults, research on the efficacy of VRET in the treatment of adolescents with anxiety disorders is largely lacking.</p><p><strong>Objective: </strong>A pilot study was carried out to test whether exposure to a virtual reality (VR) school environment elicits state anxiety and autonomic arousal in adolescents with school anxiety (diagnoses covering social anxiety disorder or specific phobia involving school contexts). In addition, we examined whether repeated VR exposure led to a reduction in this fear response, trait school anxiety, and social anxiety symptoms. Moreover, the relationship of presence, the subjective sense of \"being there,\" during VR exposure with anxiety measures and treatment response was examined.</p><p><strong>Methods: </strong>In a pilot study, 10 adolescents with school anxiety (age range 14 to 17 years) participated in five VRET sessions. Self-reported state anxiety, heart rate, and presence during exposure, as well as trait school anxiety and social anxiety before and after treatment, were measured.</p><p><strong>Results: </strong>The VR scenario induced state anxiety and autonomic arousal. After VRET, a significant reduction in state anxiety (η²=0.74) and social anxiety symptoms (d=0.82) as well as a trend toward a decrease in trait school anxiety were observed, while autonomic arousal did not change. In addition, presence during VR exposure was associated with state anxiety and treatment response.</p><p><strong>Conclusions: </strong>Our findings indicate the feasibility and potential effectiveness of VRET as a treatment method for symptoms of school and social anxiety in adolescents.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"11 ","pages":"e56235"},"PeriodicalIF":4.8,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11576610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142584475","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}