Jmir Mental Health最新文献

{"title":"Problematic Digital Technology Use Measures in Children Aged 0 to 6 Years: Scoping Review.","authors":"Špela Selak, Janja Horvat, Mark Žmavc","doi":"10.2196/59869","DOIUrl":"10.2196/59869","url":null,"abstract":"<p><strong>Background: </strong>In the interest of accurately assessing the effects of digital technology use in early childhood, researchers and experts have emphasized the need to conceptualize and measure children's digital technology use beyond screen time. Researchers have argued that many patterns of early digital technology use could be problematic, resulting in the emerging need to list and examine their measures.</p><p><strong>Objective: </strong>We aimed to review existing empirical literature that is using measures for problematic digital technology use in preschool children with the end goal of identifying a set of reliable and valid measures, predicting negative outcomes for children's health, development, or well-being.</p><p><strong>Methods: </strong>We conducted a scoping review across the Web of Science, PubMed, and Google Scholar databases to identify peer-reviewed publications that were published from January 2012 to December 2023, were written in the English language, described an empirical study, and included a measure of problematic digital technology use beyond exposure (ie, screen time) in children aged 0 to 6 years.</p><p><strong>Results: </strong>The search yielded 95 empirical studies, in which 18 composite measures of problematic use and 23 measures of specific problematic use aspects were found. Existing composite measures conceptualize problematic use as either a group of risky behaviors or as a group of symptoms of a presumed underlying disorder, with the latter being more common. Looking at their conceptual background and psychometric properties, existing composite measures fall short of reliably assessing all the crucial aspects of problematic digital technology use in early childhood. Therefore, the benefits and shortcomings of single-aspect problematic digital technology use measures are evaluated and discussed.</p><p><strong>Conclusions: </strong>On the basis of current research, early exposure to digital technologies, device use before sleep, and solitary device use represent measures that have been consistently associated with negative outcomes for children. In addition, potential measures of problematic use include device use during meals, device use for emotional regulation, device multitasking, and technoference, warranting further research. Public health benefits of defining problematic digital technology use as a group of risky behaviors rather than a group of addiction symptoms are discussed.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e59869"},"PeriodicalIF":4.8,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11962332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659104","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 Views of Young People, Including Those With a History of Self-Harm, on the Use of Their Routinely Generated Data for Mental Health Research: Web-Based Cross-Sectional Survey Study.","authors":"Dana Dekel, Amanda Marchant, Marcos Del Pozo Banos, Mohamed Mhereeg, Sze Chim Lee, Ann John","doi":"10.2196/60649","DOIUrl":"10.2196/60649","url":null,"abstract":"<p><strong>Background: </strong>Secondary use of routinely collected health care data has great potential benefits in epidemiological studies primarily due to the large scale of preexisting data.</p><p><strong>Objective: </strong>This study aimed to engage respondents with and without a history of self-harm, gain insight into their views on the use of their data for research, and determine whether there were any differences in opinions between the 2 groups.</p><p><strong>Methods: </strong>We examined young people's views on the use of their routinely collected data for mental health research through a web-based survey, evaluating any differences between those with and without a history of self-harm.</p><p><strong>Results: </strong>A total of 1765 respondents aged 16 to 24 years were included. Respondents' views were mostly positive toward the use and linkage of their data for research purposes for public benefit, particularly with regard to the use of health care data (mental health or otherwise), and generally echoed existing evidence on the opinions of older age groups. Individuals who reported a history of self-harm and subsequently contacted health services more often reported being \"extremely likely\" or \"likely\" to share mental health data (contacted: 209/609, 34.3%; 95% CI 28.0-41.2; not contacted: 169/782, 21.6%; 95% CI 15.8-28.7) and physical health data (contacted: 117/609, 19.2%; 95% CI 12.7-27.8; not contacted: 96/782, 12.3%; 95% CI 6.7-20.9) compared with those who had not contacted services. Respondents were overall less likely to want to share their social media data, which they considered to be more personal compared to their health care data. Respondents stressed the importance of anonymity and the need for an appropriate ethical framework.</p><p><strong>Conclusions: </strong>Young people are aware, and they care about how their data are being used and for what purposes, irrespective of having a history of self-harm. They are largely positive about the use of health care data (mental or physical) for research and generally echo the opinions of older age groups raising issues around data security and the use of data for the public interest.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e60649"},"PeriodicalIF":4.8,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11947630/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617561","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":"Longitudinal Associations Between Adolescents' mHealth App Use, Body Dissatisfaction, and Physical Self-Worth: Random Intercept Cross-Lagged Panel Study.","authors":"Hayriye Gulec, Michal Muzik, David Smahel, Lenka Dedkova","doi":"10.2196/60844","DOIUrl":"10.2196/60844","url":null,"abstract":"<p><strong>Background: </strong>Longitudinal investigation of the association between mobile health (mHealth) app use and attitudes toward one's body during adolescence is scarce. mHealth apps might shape adolescents' body image perceptions by influencing their attitudes toward their bodies. Adolescents might also use mHealth apps based on how they feel and think about their bodies.</p><p><strong>Objective: </strong>This prospective study examined the longitudinal within-person associations between mHealth app use, body dissatisfaction, and physical self-worth during adolescence.</p><p><strong>Methods: </strong>The data were gathered from a nationally representative sample of Czech adolescents aged between 11 and 16 years (N=2500; n=1250, 50% girls; mean age 13.43, SD 1.69 years) in 3 waves with 6-month intervals. Participants completed online questionnaires assessing their mHealth app use, physical self-worth, and body dissatisfaction at each wave. The mHealth app use was determined by the frequency of using sports, weight management, and nutritional intake apps. Physical self-worth was assessed using the physical self-worth subscale of the Physical Self Inventory-Short Form. Body dissatisfaction was measured with the items from the body dissatisfaction subscale of the Eating Disorder Inventory-3. The random intercept cross-lagged panel model examined longitudinal within-person associations between the variables. A multigroup design was used to compare genders. Due to the missing values, the final analyses used data from 2232 adolescents (n=1089, 48.8% girls; mean age 13.43, SD 1.69 years).</p><p><strong>Results: </strong>The results revealed a positive within-person effect of mHealth app use on the physical self-worth of girls: increased mHealth app use predicted higher physical self-worth 6 months later (β=.199, P=.04). However, this effect was not consistent from the 6th to the 12th month: a within-person increase in using apps in the 6th month did not predict changes in girls' physical self-worth in the 12th month (β=.161, P=.07). Regardless of gender, the within-person changes in the frequency of using apps did not influence adolescents' body dissatisfaction. In addition, neither body dissatisfaction nor physical self-worth predicted app use frequency at the within-person level.</p><p><strong>Conclusions: </strong>This study highlighted that within-person changes in using mHealth apps were differentially associated with adolescents' body-related attitudes. While increased use of mHealth apps did not influence body dissatisfaction across genders, it significantly predicted higher physical self-worth in adolescent girls 6 months later. A similar association was not observed among boys after 6 months. These findings indicate that using mHealth apps is unlikely to have a detrimental impact on adolescents' body dissatisfaction and physical self-worth; instead, they may have a positive influence, particularly in boosting the physical self-worth o","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e60844"},"PeriodicalIF":4.8,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606121","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":"Understanding Problematic Smartphone and Social Media Use Among Adults in France: Cross-Sectional Survey Study.","authors":"Laurent Karila, Nathaniel Scher, Clement Draghi, Delphine Lichte, Ilan Darmon, Hanene Boudabous, Hanah Lamallem, Olivier Bauduceau, Marc Bollet, Alain Toledano","doi":"10.2196/63431","DOIUrl":"10.2196/63431","url":null,"abstract":"<p><strong>Background: </strong>The Evaluation of Digital Addiction (EVADD) study investigates problematic smartphone use in the digital age, as global smartphone users reached 55.88 million in France in 2023. With increased screen time from digital devices, especially smartphones, the study highlights adult use issues and associated risks.</p><p><strong>Objective: </strong>The aim of the study is to assess the prevalence of compulsive smartphone use among French adults and identify patterns of problematic behaviors, including their impact on daily activities, sleep, and safety.</p><p><strong>Methods: </strong>The EVADD study used a cross-sectional, nonprobability sample design, conducted from May 3 to June 5, 2023. Participants were recruited through the French mutual insurance company PRO-BTP. Data were collected anonymously via a digital questionnaire, including the Smartphone Compulsive Use Test, capturing information on social network engagement, device ownership, and daily screen use.</p><p><strong>Results: </strong>A total of 21,244 adults (average age 53, SD 15 years; 9844 female participants) participated. Among 21,244 participants, 8025 of 12,034 (66.7%) respondents exhibited compulsive smartphone use (P<.001). Additionally, 7,020 (36.7%) participants scored ≥8 on the Smartphone Compulsion Test, indicating addiction. Younger participants (18-39 years) were significantly more likely to show signs of addiction (2504/4394, 57%; odds ratio 2.5, 95% CI 1.9-3.2) compared to participants aged ≥60 years. Problematic behaviors included unsafe smartphone use while driving (5736/12,953, 44.3%), frequent smartphone use before bedtime (9136/21,244, 43%), and using smartphones in the bathroom (7659/21,244, 36.1%). Sleep disturbances and risky behaviors correlated strongly with higher compulsion scores (P<.01).</p><p><strong>Conclusions: </strong>The EVADD study highlights the complex relationship between adults and smartphones, revealing the prevalence of compulsive behaviors and their impact on daily life, sleep, and safety. These findings emphasize the need for public awareness campaigns, preventive strategies, and therapeutic interventions to mitigate health risks associated with excessive smartphone use.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e63431"},"PeriodicalIF":4.8,"publicationDate":"2025-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905869/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568521","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 Effect of Predicted Compliance With a Web-Based Intervention for Anxiety and Depression Among Latin American University Students: Randomized Controlled Trial.","authors":"Corina Benjet, Nur Hani Zainal, Yesica Albor, Libia Alvis-Barranco, Nayib Carrasco Tapia, Carlos C Contreras-Ibáñez, Jacqueline Cortés-Morelos, Lorena Cudris-Torres, Francisco R de la Peña, Noé González, Raúl A Gutierrez-Garcia, Eunice Vargas-Contreras, Maria Elena Medina-Mora, Pamela Patiño, Sarah M Gildea, Chris J Kennedy, Alex Luedtke, Nancy A Sampson, Maria V Petukhova, Jose R Zubizarreta, Pim Cuijpers, Alan E Kazdin, Ronald C Kessler","doi":"10.2196/64251","DOIUrl":"10.2196/64251","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Web-based cognitive behavioral therapy (wb-CBT) is a scalable way to reach distressed university students. Guided wb-CBT is typically superior to self-guided wb-CBT over short follow-up periods, but evidence is less clear over longer periods.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aimed to compare short-term (3 months) and longer-term (12 months) aggregate effects of guided and self-guided wb-CBT versus treatment as usual (TAU) in a randomized controlled trial of Colombian and Mexican university students and carry out an initially unplanned secondary analysis of the role of differential predicted compliance in explaining these differences.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The 1319 participants, recruited either through email and social media outreach invitations or from waiting lists of campus mental health clinics, were undergraduates (1038/1319, 78.7% female) with clinically significant baseline anxiety (Generalized Anxiety Disorder-7 score≥10) or depression (Patient Health Questionnaire-9 score≥10). The intervention arms comprised guided wb-CBT with weekly asynchronous written human feedback, self-guided wb-CBT with the same content as the guided modality, and TAU as provided at each university. The prespecified primary outcome was joint remission (Generalized Anxiety Disorder-7 score=0-4 and Patient Health Questionnaire-9 score=0-4). The secondary outcome was joint symptom reduction (mean scores on the Patient Health Questionnaire Anxiety and Depression Scale) at 3 and 12 months after randomization.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;As reported previously, 3-month outcomes were significantly better with guided wb-CBT than self-guided wb-CBT (P=.02) or TAU (P=.02). However, subsequent follow-up showed that 12-month joint remission (adjusted risk differences=6.0-6.5, SE 0.4-0.5, and P&lt;.001 to P=.007; adjusted mean differences=2.70-2.69, SE 0.7-0.8, and P&lt;.001 to P=.001) was significantly better with self-guided wb-CBT than with the other interventions. Participants randomly assigned to the guided wb-CBT arm spent twice as many minutes logged on as those in the self-guided wb-CBT arm in the first 12 weeks (mean 12.5, SD 36.9 vs 5.9, SD 27.7; χ&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;1&lt;/sub&gt;=107.1, P&lt;.001), whereas participants in the self-guided wb-CBT arm spent twice as many minutes logged on as those in the guided wb-CBT arm in weeks 13 to 52 (mean 0.4, SD 7.5 vs 0.2, SD 4.4; χ&lt;sup&gt;2&lt;/sup&gt;&lt;sub&gt;1&lt;/sub&gt;=10.5, P=.001). Subgroup analysis showed that this longer-term superiority of self-guided wb-CBT was confined to the 40% (528/1319) of participants with high predicted self-guided wb-CBT compliance beyond 3 months based on a counterfactual nested cross-validated machine learning model. The 12-month outcome differences were nonsignificant across arms among other participants (all P&gt;.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The results have important practical implications for precision intervention targeting to maximize longer-term wb-CB","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e64251"},"PeriodicalIF":4.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11909483/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576035","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 Narrative Review to Identify Promising Approaches for Digital Health Interventions to Support Emotion Regulation for Adolescents With Attention-Deficit/Hyperactivity Disorder.","authors":"Aja Louise Murray, Melissa Thye, Ingrid Obsuth, Shufang Cai, Michael Lui, Corina Orr, Anusha Saravanan","doi":"10.2196/56066","DOIUrl":"10.2196/56066","url":null,"abstract":"<p><p>Emotion regulation difficulties affect many adolescents with attention-deficit/hyperactivity disorder (ADHD), and previous research has highlighted a need for accessible interventions to support them in this domain, especially in real-life contexts. Digital health interventions (DHIs) can be embedded in adolescents' daily lives and thus offer considerable promise for meeting this need. However, there is a lack of information to guide the development of suitable emotion regulation DHIs for this population. The goal of this study is, therefore, to identify recommendations to guide the development of emotion regulation DHIs for adolescents with ADHD. This narrative review synthesizes diverse relevant evidence to inform their development, including promising therapeutic approaches and components and relevant design and development considerations. We find that there is very little direct evidence of \"what works\" for emotion regulation DHIs and emotion regulation interventions more generally for adolescents with ADHD; however, we identify promising therapeutic approaches for new DHIs. We also recommend following a co-design or coproduction approach with adolescents with ADHD, including exploring elements designed to motivate and engage young people to support sustained adherence. We conclude that DHIs are a promising approach for emotion regulation interventions for adolescents with ADHD, could draw on a range of existing therapeutic approaches, and should be co-designed with users themselves.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e56066"},"PeriodicalIF":4.8,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11907170/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143576033","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":"Patterns of Skills Review in Smartphone Cognitive Behavioral Therapy for Depression: Observational Study of Intervention Content Use.","authors":"Emily E Bernstein, Katharine E Daniel, Peyton E Miyares, Susanne S Hoeppner, Kate H Bentley, Ivar Snorrason, Lauren B Fisher, Jennifer L Greenberg, Hilary Weingarden, Oliver Harrison, Sabine Wilhelm","doi":"10.2196/63497","DOIUrl":"10.2196/63497","url":null,"abstract":"<p><strong>Background: </strong>Smartphones could enhance access to effective cognitive behavioral therapy (CBT). Users may frequently and flexibly access bite-size CBT content on personal devices, review and practice skills, and thereby achieve better outcomes.</p><p><strong>Objective: </strong>We explored the distribution of actual interactions participants had with therapeutic content in a trial of smartphone CBT for depression and whether interactions were within assigned treatment modules or revisits to prior module content (ie, between-module interactions).</p><p><strong>Methods: </strong>We examined the association between the number of within- and between-module interactions and baseline and end-of-treatment symptom severity during an 8-week, single-arm open trial of a therapist-guided CBT for depression mobile health app.</p><p><strong>Results: </strong>Interactions were more frequent early in treatment and modestly declined in later stages. Within modules, most participants consistently made more interactions than required to progress to the next module and tended to return to all types of content rather than focus on 1 skill. By contrast, only 15 of 26 participants ever revisited prior module content (median number of revisits=1, mode=0, IQR 0-4). More revisits were associated with more severe end-of-treatment symptom severity after controlling for pretreatment symptom severity (P<.05).</p><p><strong>Conclusions: </strong>The results suggest that the frequency of use is an insufficient metric of engagement, lacking the nuance of what users are engaging with and when during treatment. This lens is essential for developing personalized recommendations and yielding better treatment outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov NCT05386329; https://clinicaltrials.gov/study/NCT05386329?term=NCT05386329.</p>","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e63497"},"PeriodicalIF":4.8,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11894344/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143494385","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":"Multimodal Digital Phenotyping Study in Patients With Major Depressive Episodes and Healthy Controls (Mobile Monitoring of Mood): Observational Longitudinal Study.","authors":"Talayeh Aledavood, Nguyen Luong, Ilya Baryshnikov, Richard Darst, Roope Heikkilä, Joel Holmén, Arsi Ikäheimonen, Annasofia Martikkala, Kirsi Riihimäki, Outi Saleva, Ana Maria Triana, Erkki Isometsä","doi":"10.2196/63622","DOIUrl":"10.2196/63622","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Mood disorders are among the most common mental health conditions worldwide. Wearables and consumer-grade personal digital devices create digital traces that can be collected, processed, and analyzed, offering a unique opportunity to quantify and monitor individuals with mental disorders in their natural living environments.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study comprised (1) 3 subcohorts of patients with a major depressive episode, either with major depressive disorder, bipolar disorder, or concurrent borderline personality disorder, and (2) a healthy control group. We investigated whether differences in behavioral patterns could be observed at the group level, that is, patients versus healthy controls. We studied the volume and temporal patterns of smartphone screen and app use, communication, sleep, mobility, and physical activity. We investigated whether patients or controls exhibited more homogenous temporal patterns of activity when compared with other individuals in the same group. We examined which variables were associated with the severity of depression.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;In total, 188 participants were recruited to complete a 2-phase study. In the first 2 weeks, data from bed sensors, actigraphy, smartphones, and 5 sets of daily questions were collected. In the second phase, which lasted up to 1 year, only passive smartphone data and biweekly 9-item Patient Health Questionnaire data were collected. Survival analysis, statistical tests, and linear mixed models were performed.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Survival analysis showed no statistically significant difference in adherence. Most participants did not stay in the study for 1 year. Weekday location variance showed lower values for patients (control: mean -10.04, SD 2.73; patient: mean -11.91, SD 2.50; Mann-Whitney U [MWU] test P=.004). Normalized entropy of location was lower among patients (control: mean 2.10, SD 1.38; patient: mean 1.57, SD 1.10; MWU test P=.05). The temporal communication patterns of controls were more diverse compared to those of patients (MWU test P&lt;.001). In contrast, patients exhibited more varied temporal patterns of smartphone use compared to the controls. We found that the duration of incoming calls (β=-0.08, 95% CI -0.12 to -0.04; P&lt;.001) and the SD of activity magnitude (β=-2.05, 95% CI -4.18 to -0.20; P=.02) over the 14 days before the 9-item Patient Health Questionnaire records were negatively associated with depression severity. Conversely, the duration of outgoing calls showed a positive association with depression severity (β=0.05, 95% CI 0.00-0.09; P=.02).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our work shows the important features for future analyses of behavioral markers of mood disorders. However, among outpatients with mild to moderate depressive disorders, the group-level differences from healthy controls in any single modality remain relatively modest. Therefore, future studies need to com","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e63622"},"PeriodicalIF":4.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890149/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472968","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 Ethical Challenges of Conversational AI in Mental Health Care: Scoping Review.","authors":"Mehrdad Rahsepar Meadi, Tomas Sillekens, Suzanne Metselaar, Anton van Balkom, Justin Bernstein, Neeltje Batelaan","doi":"10.2196/60432","DOIUrl":"10.2196/60432","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Conversational artificial intelligence (CAI) is emerging as a promising digital technology for mental health care. CAI apps, such as psychotherapeutic chatbots, are available in app stores, but their use raises ethical concerns.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;We aimed to provide a comprehensive overview of ethical considerations surrounding CAI as a therapist for individuals with mental health issues.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a systematic search across PubMed, Embase, APA PsycINFO, Web of Science, Scopus, the Philosopher's Index, and ACM Digital Library databases. Our search comprised 3 elements: embodied artificial intelligence, ethics, and mental health. We defined CAI as a conversational agent that interacts with a person and uses artificial intelligence to formulate output. We included articles discussing the ethical challenges of CAI functioning in the role of a therapist for individuals with mental health issues. We added additional articles through snowball searching. We included articles in English or Dutch. All types of articles were considered except abstracts of symposia. Screening for eligibility was done by 2 independent researchers (MRM and TS or AvB). An initial charting form was created based on the expected considerations and revised and complemented during the charting process. The ethical challenges were divided into themes. When a concern occurred in more than 2 articles, we identified it as a distinct theme.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;We included 101 articles, of which 95% (n=96) were published in 2018 or later. Most were reviews (n=22, 21.8%) followed by commentaries (n=17, 16.8%). The following 10 themes were distinguished: (1) safety and harm (discussed in 52/101, 51.5% of articles); the most common topics within this theme were suicidality and crisis management, harmful or wrong suggestions, and the risk of dependency on CAI; (2) explicability, transparency, and trust (n=26, 25.7%), including topics such as the effects of \"black box\" algorithms on trust; (3) responsibility and accountability (n=31, 30.7%); (4) empathy and humanness (n=29, 28.7%); (5) justice (n=41, 40.6%), including themes such as health inequalities due to differences in digital literacy; (6) anthropomorphization and deception (n=24, 23.8%); (7) autonomy (n=12, 11.9%); (8) effectiveness (n=38, 37.6%); (9) privacy and confidentiality (n=62, 61.4%); and (10) concerns for health care workers' jobs (n=16, 15.8%). Other themes were discussed in 9.9% (n=10) of the identified articles.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Our scoping review has comprehensively covered ethical aspects of CAI in mental health care. While certain themes remain underexplored and stakeholders' perspectives are insufficiently represented, this study highlights critical areas for further research. These include evaluating the risks and benefits of CAI in comparison to human therapists, determining its appropriate roles in ther","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e60432"},"PeriodicalIF":4.8,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143472962","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 Migration of the Loewenstein Acevedo Scales for Semantic Interference and Learning (LASSI-L): Development and Validation Study in Older Participants.","authors":"Philip Harvey, Rosie Curiel-Cid, Peter Kallestrup, Annalee Mueller, Andrea Rivera-Molina, Sara Czaja, Elizabeth Crocco, David Loewenstein","doi":"10.2196/64716","DOIUrl":"10.2196/64716","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The early detection of mild cognitive impairment is crucial for providing treatment before further decline. Cognitive challenge tests such as the Loewenstein-Acevedo Scales for Semantic Interference and Learning (LASSI-L) can identify individuals at highest risk for cognitive deterioration. Performance on elements of the LASSI-L, particularly proactive interference, correlate with the presence of critical Alzheimer disease biomarkers. However, in-person paper tests require skilled testers and are not practical in many community settings or for large-scale screening in prevention.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study reports on the development and initial validation of a self-administered computerized version of the Loewenstein-Acevedo Scales for Semantic Interference (LASSI), the digital LASSI (LASSI-D). A self-administered digital version, with an artificial intelligence-generated avatar assistant, was the migrated assessment.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Cloud-based software was developed, using voice recognition technology, for English and Spanish versions of the LASSI-D. Participants were assessed with either the LASSI-L or LASSI-D first, in a sequential assessment study. Participants with amnestic mild cognitive impairment (aMCI; n=54) or normal cognition (NC; n=58) were also tested with traditional measures such as the Alzheimer Disease Assessment Scale-Cognition. We examined group differences in performance across the legacy and digital versions of the LASSI, as well as correlations between LASSI performance and other measures across the versions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Differences on recall and intrusion variables between aMCI and NC samples on both versions were all statistically significant (all P&lt;.001), with at least medium effect sizes (d&gt;0.68). There were no statistically significant performance differences in these variables between legacy and digital administration in either sample (all P&lt;.13). There were no language differences in any variables (P&gt;.10), and correlations between LASSI variables and other cognitive variables were statistically significant (all P&lt;.01). The most predictive legacy variables, proactive interference and failure to recover from proactive interference, were identical across legacy and migrated versions within groups and were identical to results of previous studies with the legacy LASSI-L. Classification accuracy was 88% for NC and 78% for aMCI participants.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;The results for the digital migration of the LASSI-D were highly convergent with the legacy LASSI-L. Across all indices of similarity, including sensitivity, criterion validity, classification accuracy, and performance, the versions converged across languages. Future studies will present additional validation data, including correlations with blood-based Alzheimer disease biomarkers and alternative forms. The current data provide convincing evidence of the use of a ","PeriodicalId":48616,"journal":{"name":"Jmir Mental Health","volume":"12 ","pages":"e64716"},"PeriodicalIF":4.8,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11864698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143460217","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}