评估InsightApp对焦虑、价值行为和心理弹性的有效性:纵向随机对照试验。

IF 5.8 2区 医学 Q1 PSYCHIATRY
Jmir Mental Health Pub Date : 2025-02-04 DOI:10.2196/57201
Victoria Amo, Falk Lieder
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引用次数: 0

摘要

背景:焦虑症是最常见的精神障碍之一,压力在其发展中起着重要作用。生态瞬间干预(EMIs)具有巨大的潜力,可以通过在现实生活中训练情绪调节和应对技能来帮助人们管理压力和焦虑。InsightApp是一个游戏化的EMI和研究工具,结合了基于证据的治疗方法的元素。它旨在增强人们的元认知技能,以应对具有挑战性的现实生活情况,并接受焦虑和其他情绪。目的:本随机对照试验旨在检验InsightApp在(1)改善个体应对压力和焦虑的元认知策略和(2)促进价值一致行为方面的有效性。它还评估了这些影响持续的时间。本实验促进了我们对元认知在应激情绪和行为反应中的作用的理解。方法:随机对照试验228例(完成率:n=197, 86.4%;平均年龄38岁,SD 11.50岁;年龄20-80岁;女性:n=101,占52.6%;White: n=175, 91.1%),他们被随机分配到治疗组或安慰剂对照组。在为期一周的干预阶段,治疗组使用InsightApp,而对照组的参与者使用提供执行功能培训的安慰剂版本的应用程序进行互动。我们评估了两组在心理健康和幸福感的测试后和随访评估方面的差异,同时控制了先前存在的差异。此外,我们使用了一个多层次模型来分析纵向数据,重点关注干预对日常压力源的情绪和行为反应的参与者内部因果效应。具体来说,我们测量了日常焦虑、与焦虑的斗争和价值一致的行为。结果:InsightApp提供的干预产生了不同的结果。一方面,我们发现在干预后或7天后,心理健康和幸福感的测试后得分均不显著(P < 0.05)。相比之下,当面对现实生活中的压力时,治疗组的焦虑增加率降低了15%(单尾t检验,t197=-2.4;P= 0.009),与焦虑作斗争的比例降低了12% (t197=-1.87;P= 0.031)。此外,与对照组相比,治疗组的个体表现出7%的倾向于将他们的行为与他们的价值观相一致(t197=3.23;P = .002)。干预期结束后,InsightApp在应对压力时与焦虑作斗争方面的积极作用持续存在,对压力的反应性降低了18% (t197=-2.84;P = .002)。结论:由于我们的研究结果好坏参半,需要进一步的研究来准确可靠地了解InsightApp的有效性。总的来说,我们的研究结果初步表明,通过游戏化的EMI指导人们应用适应性元认知策略来应对日常生活中的压力是一种有前途的方法,值得进一步评估。试验注册:OSF登记处OSF .io/k3b5d;https://osf.io/k3b5d。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Evaluating the Effectiveness of InsightApp for Anxiety, Valued Action, and Psychological Resilience: Longitudinal Randomized Controlled Trial.

Evaluating the Effectiveness of InsightApp for Anxiety, Valued Action, and Psychological Resilience: Longitudinal Randomized Controlled Trial.

Evaluating the Effectiveness of InsightApp for Anxiety, Valued Action, and Psychological Resilience: Longitudinal Randomized Controlled Trial.

Evaluating the Effectiveness of InsightApp for Anxiety, Valued Action, and Psychological Resilience: Longitudinal Randomized Controlled Trial.

Background: Anxiety disorders are among the most prevalent mental disorders, and stress plays a significant role in their development. Ecological momentary interventions (EMIs) hold great potential to help people manage stress and anxiety by training emotion regulation and coping skills in real-life settings. InsightApp is a gamified EMI and research tool that incorporates elements from evidence-based therapeutic approaches. It is designed to strengthen people's metacognitive skills for coping with challenging real-life situations and embracing anxiety and other emotions.

Objective: This randomized controlled trial aims to examine the effectiveness of InsightApp in (1) improving individuals' metacognitive strategies for coping with stress and anxiety and (2) promoting value-congruent action. It also evaluates how long these effects are retained. This experiment advances our understanding of the role of metacognition in emotional and behavioral reactivity to stress.

Methods: We conducted a randomized controlled trial with 228 participants (completion rate: n=197, 86.4%; mean age 38, SD 11.50 years; age range 20-80 years; female: n=101, 52.6%; and White: n=175, 91.1%), who were randomly assigned to either the treatment or the active placebo control group. During the 1-week intervention phase, the treatment group engaged with InsightApp, while participants in the control group interacted with a placebo version of the app that delivered executive function training. We assessed the differences between the 2 groups in posttest and follow-up assessments of mental health and well-being while controlling for preexisting differences. Moreover, we used a multilevel model to analyze the longitudinal data, focusing on the within-participant causal effects of the intervention on emotional and behavioral reactivity to daily stressors. Specifically, we measured daily anxiety, struggle with anxiety, and value-congruent action.

Results: The intervention delivered by InsightApp yielded mixed results. On one hand, we found no significant posttest scores on mental health and well-being measures directly after the intervention or 7 days later (all P>.22). In contrast, when confronted with real-life stress, the treatment group experienced a 15% lower increase in anxiety (1-tailed t test, t197=-2.4; P=.009) and a 12% lower increase in the struggle with anxiety (t197=-1.87; P=.031) than the control group. Furthermore, individuals in the treatment group demonstrated a 7% higher tendency to align their actions with their values compared to the control group (t197=3.23; P=.002). After the intervention period, InsightApp's positive effects on the struggle with anxiety in reaction to stress were sustained, and increased to an 18% lower reactivity to stress (t197=-2.84; P=.002).

Conclusions: As our study yielded mixed results, further studies are needed to obtain an accurate and reliable understanding of the effectiveness of InsightApp. Overall, our findings tentatively suggest that guiding people to apply adaptive metacognitive strategies for coping with real-life stress daily with a gamified EMI is a promising approach that deserves further evaluation.

Trial registration: OSF Registries osf.io/k3b5d; https://osf.io/k3b5d.

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来源期刊
Jmir Mental Health
Jmir Mental Health Medicine-Psychiatry and Mental Health
CiteScore
10.80
自引率
3.80%
发文量
104
审稿时长
16 weeks
期刊介绍: JMIR Mental Health (JMH, ISSN 2368-7959) is a PubMed-indexed, peer-reviewed sister journal of JMIR, the leading eHealth journal (Impact Factor 2016: 5.175). JMIR Mental Health focusses on digital health and Internet interventions, technologies and electronic innovations (software and hardware) for mental health, addictions, online counselling and behaviour change. This includes formative evaluation and system descriptions, theoretical papers, review papers, viewpoint/vision papers, and rigorous evaluations.
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