274 research outputs found

    A CBT-based mobile intervention as an adjunct treatment for adolescents with symptoms of depression: a virtual randomized controlled feasibility trial

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    BackgroundHigh rates of adolescent depression demand for more effective, accessible treatment options. A virtual randomized controlled trial was used to assess the feasibility and acceptability of a 5-week, self-guided, cognitive behavioral therapy (CBT)-based mobile application, Spark, compared to a psychoeducational mobile application (Active Control) as an adjunct treatment for adolescents with depression during the COVID-19 pandemic.MethodsA community sample aged 13–21, with self-reported symptoms of depression, was recruited nationwide. Participants were randomly assigned to use either Spark or Active Control (NSpark = 35; NActive Control = 25). Questionnaires, including the PHQ-8 measuring depression symptoms, completed before, during, and immediately following completion of the intervention, evaluated depressive symptoms, usability, engagement, and participant safety. App engagement data were also analyzed.Results60 eligible adolescents (female = 47) were enrolled in 2 months. 35.6% of those expressing interest were consented and all enrolled. Study retention was high (85%). Spark users rated the app as usable (System Usability Scalemean = 80.67) and engaging (User Engagement Scale-Short Formmean = 3.62). Median daily use was 29%, and 23% completed all levels. There was a significant negative relationship between behavioral activations completed and change in PHQ-8. Efficacy analyses revealed a significant main effect of time, F = 40.60, p < .001, associated with decreased PHQ-8 scores over time. There was no significant Group × Time interaction (F = 0.13, p = .72) though the numeric decrease in PHQ-8 was greater for Spark (4.69 vs. 3.56). No serious adverse events or adverse device effects were reported for Spark users. Two serious adverse events reported in the Active Control group were addressed per our safety protocol.ConclusionRecruitment, enrollment, and retention rates demonstrated study feasibility by being comparable or better than other mental health apps. Spark was highly acceptable relative to published norms. The study's novel safety protocol efficiently detected and managed adverse events. The lack of significant difference in depression symptom reduction between Spark and Active Control may be explained by study design and study design factors. Procedures established during this feasibility study will be leveraged for subsequent powered clinical trials evaluating app efficacy and safety.Clinical Trial Registrationhttps://clinicaltrials.gov/ct2/show/NCT0452459

    Understanding anhedonia: Investigating the role of mind wandering in positive emotional disturbances

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    Depression is a highly debilitating illness for which there is currently sub-optimal treatment outcomes. Anhedonia (a loss of interest and pleasure) is a core symptom of depression that predicts poorer illness course and is currently not well repaired in psychological treatments. Acute and relapse prevention outcomes may be improved by clarifying which psychological mechanisms cause and maintain anhedonia, so that mechanisms can be systematically targeted in therapy. Mind wandering (a shift in contents of thoughts away from an ongoing task and/or events in the external environment to self-generated thoughts and feelings) has previously been linked to lower levels of happiness in the general population (e.g., Killingsworth & Gilbert, 2010). However, it has yet to be established if mind wandering relates to reduced positive affect in the context of depression. Therefore, the purpose of this thesis was to further explore the role of mind wandering in driving anhedonic symptoms. This thesis employed different research designs in order to establish if mind wandering is a causal mechanism driving anhedonia. Studies used a triangulation of measures to first establish correlational support (e.g. using self-report questionnaire measures, laboratory and real life positive mood inductions). Following this, studies aimed to examine if a causal relationship between mind wandering and positive affect exists by manipulating levels of mind wandering in the laboratory, real-world settings and using an empirically tested clinical intervention (Mindfulness Based Cognitive Therapy; MBCT). Using self-report measures of mindfulness and anhedonic symptoms, studies 1a and 1b found that the acting with awareness facet of mindfulness (a measure of trait mind wandering) was uniquely related to anhedonic depression symptoms in both a large community (n=440) and treatment-seeking previously depressed sample (n=409). These unique relationships remained significant when controlling for other facets of mindfulness and general depression symptoms. Study 2 (n=70) examined the relationship between mind wandering and reduced positive affect in both controlled laboratory and real world environments. Levels of mind wandering were found to be unrelated to emotional reactivity to positive laboratory mood induction tasks, but greater levels of mind wandering were significantly correlated with reduced happiness and increased sadness change to real world positive events. Next, two experimental studies were conducted on unselected samples which attempted to manipulate levels of mind wandering to observe the effect on emotional reactivity. In study 3 (n=90), a brief mindfulness manipulation of mind wandering proved unsuccessful, so it was not possible to determine how altering mind wandering impacted on positive reactivity. Analysis during the pre-manipulation mood induction revealed a significant correlation between greater spontaneous levels of mind wandering and lower self-reported happiness reactivity. In study 4 (n=95), participants followed audio prompts delivered via a smartphone application to manipulate mind wandering whilst completing everyday positive activities. This manipulation was successful but results revealed no significant condition differences in positive or negative emotional reactivity. Analysis during the pre-manipulation positive activity revealed greater mind wandering was trend correlated with reduced change in positive affect. A final empirical study (study 5; n=102) was designed to investigate the mediating role of mind wandering on the effect of MBCT on change in positive emotional experience. Recovered depressed participants undertaking MBCT were compared to recovered depressed participants in a no-intervention control group. Correlational analysis pre-intervention revealed no support for an association between mind wandering and positive reactivity to the mood induction tasks but mind wandering measured during everyday life (using experience sampling methodology; ESM) did relate to lower positive affect and higher negative affect. Participants in the MBCT group demonstrated a reduction in trait and ESM mind wandering, relative to participants in the control group. Furthermore, participants in the MBCT group demonstrated a significant decrease in anhedonic symptoms and increase in daily levels of positive affect. Change in trait mind wandering was found to mediate changes in self-reported anhedonic symptoms when controlling for change in other mindfulness facets, however change in ESM mind wandering did not mediate change in daily positive affect. MBCT also had no impact on emotional reactivity to positive mood induction tasks. Overall the findings from this thesis provide correlational support for the link between mind wandering and reduced positive affect in different testing environments. However, evidence of a causal relationship is currently limited. Consequently, a key recommendation from this thesis is to redirect attention to other driving mechanisms as targeting mind wandering in the treatment of anhedonic clients is unlikely to lead to large improvements. The theoretical, methodological and clinical implications of these findings are discussed along with suggestions for future research

    Quantifying Quality of Life

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    Describes technological methods and tools for objective and quantitative assessment of QoL Appraises technology-enabled methods for incorporating QoL measurements in medicine Highlights the success factors for adoption and scaling of technology-enabled methods This open access book presents the rise of technology-enabled methods and tools for objective, quantitative assessment of Quality of Life (QoL), while following the WHOQOL model. It is an in-depth resource describing and examining state-of-the-art, minimally obtrusive, ubiquitous technologies. Highlighting the required factors for adoption and scaling of technology-enabled methods and tools for QoL assessment, it also describes how these technologies can be leveraged for behavior change, disease prevention, health management and long-term QoL enhancement in populations at large. Quantifying Quality of Life: Incorporating Daily Life into Medicine fills a gap in the field of QoL by providing assessment methods, techniques and tools. These assessments differ from the current methods that are now mostly infrequent, subjective, qualitative, memory-based, context-poor and sparse. Therefore, it is an ideal resource for physicians, physicians in training, software and hardware developers, computer scientists, data scientists, behavioural scientists, entrepreneurs, healthcare leaders and administrators who are seeking an up-to-date resource on this subject

    Separation of Art and Science, That\u27s a WAP (Wasted Academic Potential)

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    Tasting the Rainbow: Perception, Hallucination, Act of God, or Just Plain Crazy?

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    Are You Depressed? Or are you just on birth control...

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    Consciousness: Our most basic state is more complicated than you think!

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