EXPLORING THE CLINICAL UTILITY OF MOBILE APPLICATIONS FOR PROMOTING AFFECT REGULATION AMONG CLIENTS WITH BEHAVIORAL HEALTH PROBLEMS

Nearly 25 percent of adults in the United States are diagnosed with a behavioral health condition, most commonly depression, anxiety disorders and substance use disorders. Each of these diagnoses is associated with significant disruptions in affect regulation which encompasses the capacity to up and down regulate emotions. Best practice treatment for these conditions includes psychotropic medications combined with individual or group-based psychotherapeutic modalities which regardless of the therapist’s theoretical orientation attempt to promote affect regulation through skill transfer and strategies for observing one’s ability to regulate emotions. Similarly, attention to regulatory capacity is central to many emerging self-help technologies involving smart phone applications. These technologies encourage users to observe, track, and offer strategies for regulating feelings through sleep, exercise, nutrition, alcohol use and many others. However, while anecdotally reported, few studies have examined the ways in which smart phone applications are incorporated into psychotherapy. In response, the current exploratory study used focus groups comprised of masters prepared behavioral health clinicians (N=25) to examine the appropriateness, accessibility, practicality and acceptableness of smart phone technologies as an adjuvant tool in the clinical setting. More specifically this study explored the use of technology to promote self-observation, skill transfer and subsequently affect regulation. Results suggested clinicians frequently use smart phone technologies in their practice and find these applications to be appropriate for tracking a range of symptoms (e.g. mood, substance use, sleep disruptions) and for promoting coping skills (e.g. meditation applications). Clinicians also reported these applications were fairly accessible and practical for use. Results indicated clinicians are judicious in their use of smart phone applications based on the client’s developmental needs and their particular symptom presentation. While these technologies were deemed effective, accessible and practical, focus group participants were wary of the impact of technology on society and the developing mind, citing that overuse of technology could promote an exacerbation of social isolation and loneliness. Further, practitioners reported that use of technology in psychotherapy could disrupt the interpersonal relationship in treatment. Respondents also reported they were unclear how to vet applications and desired additional training on their use in treatment. In conclusion, while smart phone applications were used and helpful for promoting affect regulation, future research needs to further examine best practice strategies for integrating smart phone applications into psychotherapeutic treatment, as well as refine technologies to fit more closely with the goals of psychotherapy. Keywords: Technology, Mobile Applications, Affect Regulation, Clinical Utilit

Wearable and app-based resilience modelling in employees:exploring the possibilities to model psychological resilience using wearable-measured heart rate variability and sleep

Stress has a major impact on both an individual and a societal level. Early recognition of the negative impact of stress or reduced resilience can be used in personalized interventions that enable the user to break the identified pattern through timely feedback, and thus limit the emergence of stress-related problems. The emergence of wearable sensor technology makes it possible to continuously monitor relevant behavioral and physical parameters such as sleep and heart rate variability (HRV). Sleep and HRV have been linked to stress and resilience in population studies, but knowledge on whether these relationships also apply within individuals, which is necessary for the aforementioned personalization, is lacking. This thesis introduces a cyclical conceptual model for resilience and four observational studies that test relationships between sleep, HRV and subjective resilience-related outcomes within participants using different types of data analysis at different timeframes. The relationships from the conceptual model and the related hypotheses are broadly confirmed in these studies. Participants tended to have more favorable subjective stress- and resilience-related outcomes on days with a relatively high resting HRV or long total sleep duration. Also, having a resting HRV that fluctuates relatively little from day to day was related to less stress and somatization. However, the strength of the relationships found was modest. The current findings can therefore not yet be directly implemented to initiate meaningful feedback, but they do provide starting points for future research and take a relevant step towards the possible future development of automated resilience interventions

Smartphone-based safety planning and self-monitoring for suicidal patients: Rationale and study protocol of the CASPAR (Continuous Assessment for Suicide Prevention And Research) study

Background: It remains difficult to predict and prevent suicidal behaviour, despite growing understanding of the aetiology of suicidality. Clinical guidelines recommend that health care professionals develop a safety plan in collaboration with their high-risk patients, to lower the imminent risk of suicidal behaviour. Mobile health applications provide new opportunities for safety planning, and enable daily self-monitoring of suicide-related symptoms that may enhance safety planning. This paper presents the rationale and protocol of the Continuous Assessment for Suicide Prevention And Research (CASPAR) study. The aim of the study is two-fold: to evaluate the feasibility of mobile safety planning and daily mobile self-monitoring in routine care treatment for suicidal patients, and to conduct fundamental research on suicidal processes. Methods: The study is an adaptive single cohort design among 80 adult outpatients or day-care patients, with the main diagnosis of major depressive disorder or dysthymia, who have an increased risk for suicidal behaviours. There are three measurement points, at baseline, at 1 and 3 months after baseline. Patients are instructed to use their mobile safety plan when necessary and monitor their suicidal symptoms daily. Both these apps will be used in treatment with their clinician. Conclusion: The results from this study will provide insight into the feasibility of mobile safety planning and self-monitoring in treatment of suicidal patients. Furthermore, knowledge of the suicidal process will be enhanced, especially regarding the transition from suicidal ideation to behaviour

Virtues, ecological momentary assessment/intervention and smartphone technology

Virtues, broadly understood as stable and robust dispositions for certain responses across morally relevant situations, have been a growing topic of interest in psychology. A central topic of discussion has been whether studies showing that situations can strongly influence our responses provide evidence against the existence of virtues (as a kind of stable and robust disposition). In this review, we examine reasons for thinking that the prevailing methods for examining situational influences are limited in their ability to test dispositional stability and robustness; or, then, whether virtues exist. We make the case that these limitations can be addressed by aggregating repeated, cross-situational assessments of environmental, psychological and physiological variables within everyday life—a form of assessment often called ecological momentary assessment (EMA, or experience sampling). We, then, examine how advances in smartphone application (app) technology, and their mass adoption, make these mobile devices an unprecedented vehicle for EMA and, thus, the psychological study of virtue. We, additionally, examine how smartphones might be used for virtue development by promoting changes in thought and behavior within daily life; a technique often called ecological momentary intervention (EMI). While EMA/I have become widely employed since the 1980s for the purposes of understanding and promoting change amongst clinical populations, few EMA/I studies have been devoted to understanding or promoting virtues within non-clinical populations. Further, most EMA/I studies have relied on journaling, PDAs, phone calls and/or text messaging systems. We explore how smartphone app technology provides a means of making EMA a more robust psychological method, EMI a more robust way of promoting positive change, and, as a result, opens up new possibilities for studying and promoting virtues

Smartphone application for preventing depression: Study protocol for a workplace randomised controlled trial

© Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. Introduction Depression is the leading cause of life years lost due to disability. Appropriate prevention has the potential to reduce the incidence of new cases of depression, however, traditional prevention approaches face significant scalability issues. Prevention programmes delivered by via smartphone applications provide a potential solution. The workplace is an ideal setting to roll out this form of intervention, particularly among industries that are unlikely to access traditional health initiatives and whose workplace characteristics create accessibility and portability issues. The study aims to evaluate the effectiveness of a smartphone application designed to prevent depression and improve well-being. The effectiveness of the app as a universal, selective and indicated prevention tool will also be evaluated. Methods and analysis A multicentre randomised controlled trial, to determine the effectiveness of the intervention compared with an active mood monitoring control in reducing depressive symptoms (primary outcome) and the prevalence of depression at 3 months, with secondary outcomes assessing well-being and work performance. Employees from a range of industries will be invited to participate. Participants with likely current depression at baseline will be excluded. Following baseline assessment, participants, blinded to their allocation, will be randomised to receive one of two versions of the application: headgear (a 30-day mental health intervention) or a control application (mood monitoring for 30 days). Both versions of the app contain a risk calculator to provide a measure of future risk. Analyses will be conducted within an intention-To-Treat framework using mixed modelling, with additional analyses conducted to compare the moderating effect of baseline risk level and depression symptom severity on the intervention's effectiveness. Ethics and dissemination The current trial has received ethics approval from the University of New South Wales Human Research Ethics Committee (HC17021). Study results will be disseminated through peer-reviewed journals and conferences. Trial registration number ACTRN12617000548336; Results

Internet and Smartphone Use-Related Addiction Health Problems: Treatment, Education and Research

This Special Issue presents some of the main emerging research on technological topics of health and education approaches to Internet use-related problems, before and during the beginning of coronavirus disease 2019 (COVID-19). The objective is to provide an overview to facilitate a comprehensive and practical approach to these new trends to promote research, interventions, education, and prevention. It contains 40 papers, four reviews and thirty-five empirical papers and an editorial introducing everything in a rapid review format. Overall, the empirical ones are of a relational type, associating specific behavioral addictive problems with individual factors, and a few with contextual factors, generally in adult populations. Many have adapted scales to measure these problems, and a few cover experiments and mixed methods studies. The reviews tend to be about the concepts and measures of these problems, intervention options, and prevention. In summary, it seems that these are a global culture trend impacting health and educational domains. Internet use-related addiction problems have emerged in almost all societies, and strategies to cope with them are under development to offer solutions to these contemporary challenges, especially during the pandemic situation that has highlighted the global health problems that we have, and how to holistically tackle them

RESILIENCE AT THE TIP OF THE SPEAR: IDENTIFYING THE MINDFULNESS PRESCRIPTION FOR SPECIAL OPERATIONS FORCES

After 20 years of combat, continuous deployments have left special operations forces (SOF) searching for ways to improve their holistic health. One evidence-based avenue is mindfulness meditation, shown to decrease stress and improve performance. This research examined how mindfulness techniques affect SOF's ability to downregulate stress from routine, stress-inducing duties. Researchers conducted a randomized controlled trial to test the efficacy of informal mindfulness practice in reducing stress in SOF operators. Researchers assigned participants to 1 of 2 conditions: (a) an Oura ring-based mindfulness meditation five times a week for six weeks and (b) a no-treatment control group that also wore Oura rings but did not conduct mindfulness meditations. At the beginning and end of the study, researchers measured stress utilizing a stress event that induced physiological and cognitive stress. Measurements of stress included blood pressure, subjective surveys, and heart rate variability. The experimental group displayed a 28-second decrease in time taken to return to baseline blood pressure levels than the control group's 15-second decrease. Additionally, subjective surveys suggested Oura rings to increase overall health. Data supports the efficacy of informal mindfulness as a practical, portable, and low-cost manner for SOF to improve holistic health across the force; however, research must continue to narrow the prescription.Major, United States ArmyMajor, United States ArmyApproved for public release. Distribution is unlimited