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Danielson CK, Moreland A, Hahn A, Banks D, Ruggiero KJ. Development and Usability Testing of an mHealth Tool for Trauma-Informed Prevention of Substance Use, HIV Acquisition, and Risky Sexual Behaviors Among Adolescents: Mixed Methods Study. JMIR Form Res 2024; 8:e52835. [PMID: 38236634 PMCID: PMC10835591 DOI: 10.2196/52835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/14/2023] [Accepted: 11/28/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND Youth who experience traumatic events are at a substantially higher risk of engaging in substance use and sexual risk behaviors and problems (eg, HIV acquisition) than their non-trauma-exposed counterparts. Evidence-based substance use and risky sexual behavior prevention may reduce the risk of these outcomes. Trauma-focused mental health treatment provides a window of opportunity for the implementation of such preventive work with these youth. However, overburdened clinicians face challenges in adding prevention content while implementing evidence-based treatments. Mobile health (mHealth) tools can help reduce this burden in delivering prevention curricula. Trauma-Informed Prevention for Substance Use and Risky Sexual Behavior (TIPS) is an mHealth app that was developed to aid trauma-focused cognitive behavioral therapy (TF-CBT) clinicians in the implementation of an evidence-based risk behavior prevention curriculum. OBJECTIVE The goal of this paper is to describe the rationale for and development of the TIPS app and present the results of a mixed methods approach for the initial evaluation of its usability. METHODS Participants included clinicians (n=11), adolescents (n=11), and caregivers (n=10) who completed qualitative interviews and an adapted version of the Website Analysis and Measurement Inventory. RESULTS In total, 4 overarching themes emerged from the participants' answers to the qualitative interview questions, demonstrating a generally positive response to the app. The themes were (1) strength of app content, (2) suggestions about app content, (3) esthetics and usability, and (4) benefits to the patient and session implementation. Clinicians, adolescents, and caregivers all agreed that the content was very relevant to adolescents and used examples and language that adolescents could relate to. All 3 groups also discussed that the content was comprehensive and addressed issues often faced by adolescents. All 3 groups of users made suggestions about the esthetics, which mostly comprised suggestions to change the font, color, or pictures within the app. Of all the groups, adolescents were most positive about the esthetics and usability of the app. Results from the Website Analysis and Measurement Inventory further illustrated the users' favorable reaction to the TIPS app, with 100% (11/11) of clinicians, 100% (10/10) of caregivers, and most adolescents (7/11, 64%) selecting strongly agree or somewhat agree to the following statement: "This app has much that is of interest to me." Adolescents generally found the app easier to use than did caregivers and clinicians. CONCLUSIONS The TIPS app shows promise as an mHealth tool for TF-CBT clinicians to integrate evidence-based substance use, risky sexual behavior, and HIV prevention during treatment. Future research, including a randomized controlled trial comparing TF-CBT implementation with and without the inclusion of the app, is necessary to evaluate the feasibility and efficacy of the app in reducing the risk of substance use and risky sexual behavior among trauma-exposed adolescents. TRIAL REGISTRATION ClinicalTrials.gov NCT03710720; https://clinicaltrials.gov/study/NCT03710720.
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Affiliation(s)
- Carla Kmett Danielson
- Department of Psychiatry & Behavioral Science, Medical University of South Carolina, Charleston, SC, United States
| | - Angela Moreland
- Department of Psychiatry & Behavioral Science, Medical University of South Carolina, Charleston, SC, United States
| | - Austin Hahn
- Department of Psychiatry & Behavioral Science, Medical University of South Carolina, Charleston, SC, United States
| | - Devin Banks
- Department of Psychology, University of Missouri-Saint Louis, Saint Louis, MO, United States
| | - Kenneth J Ruggiero
- College of Nursing, Medical University of South Carolina, Charleston, SC, United States
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McLean CL, Ruork AK, Ramaiya MK, Fruzzetti AE. Feasibility and initial impact of single-session internet-delivered acceptance vs change skills for emotions for stress- and trauma-related problems: a randomized controlled trial. Behav Cogn Psychother 2023; 51:443-458. [PMID: 37288653 DOI: 10.1017/s1352465823000206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Current psychological trauma-focused interventions have left a gap for individuals who may not be ready for trauma-focused treatment and/or who present with other forms of clinically significant distress, such as subthreshold post-traumatic stress disorder (PTSD). Emotion regulation is a possible transdiagnostic mechanism of change that may promote and maintain some of the varied mental health problems related to trauma exposure. AIMS This study examines the feasibility and initial impact of two brief emotion regulation skill trainings targeting different processes hypothesized to reduce trauma-related problems, compared with an active control. METHOD Subjects (n = 156) were randomized to receive one of three brief internet-based trainings: (1) skill training on accepting emotions, (2) skill training on changing emotions, or (3) stress psychoeducation (control). Participants completed measures of emotion regulation, mindfulness, and affect intensity 24 hours pre- and immediately post-training. RESULTS Results suggested that a brief internet-based skills training programme was feasible and acceptable, with 91.9% completing the training programme to which they were randomized. Results showed that participants in all conditions demonstrated significant decreases in emotion regulation problems over time; yet these improvements did not vary by condition. Participants in the Change condition with higher PTSD symptoms were significantly more likely to have greater increases in positive affect compared with those with lower PTSD symptoms. CONCLUSIONS Although the three conditions did not show different outcomes, all three brief internet-delivered trainings were feasible. Results provide direction for future studies to evaluate the delivery of emotion regulation skills in individuals with trauma-related distress.
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Affiliation(s)
- Caitlin L McLean
- University of Nevada Reno, Reno, NV89557, USA
- VA San Diego Healthcare System and University of California San Diego, San Diego, CA92161, USA
| | - Allison K Ruork
- University of Nevada Reno, Reno, NV89557, USA
- Rutgers, The State University of New Jersey, New Brunswick, NJ08901, USA
| | - Megan K Ramaiya
- University of California San Francisco, San Francisco, CA94143, USA
| | - Alan E Fruzzetti
- University of Nevada Reno, Reno, NV89557, USA
- McLean Hospital and Harvard Medical School, Belmont, MA02478, USA
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Binet É, Ouellet MC, Lebel J, Békés V, Morin CM, Belleville G. Gender Differences in Usage and Subjective Appreciation of an Online Cognitive Behavioral Therapy for Wildfire Evacuees: Descriptive Study. J Clin Med 2022; 11:6649. [PMID: 36431126 PMCID: PMC9699434 DOI: 10.3390/jcm11226649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 11/03/2022] [Accepted: 11/08/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Based on the most common psychological difficulties of the evacuees from the 2016 Fort McMurray wildfires in Alberta, Canada, a therapist-guided cognitive behavioral self-treatment was developed. This study aimed to explore how gender influences the usage and subjective appreciation of the RESILIENT online treatment. METHODS Our study included 81 English-speaking evacuees with significant posttraumatic symptoms, or with some posttraumatic symptoms accompanied by at least mild depression symptoms or subclinical insomnia, and who logged into the platform at least once. Various usage and subjective appreciation variables were analyzed, including number of completed sessions, number of logins, number of words per session, perceived efforts, perception of usefulness and intention to continue using the different strategies. RESULTS No difference was detected in most objective usage indicators. The number of words written in sessions 7 and 10 was significantly greater for women than for men. Regarding subjective appreciation, men had a greater perception of having put strong efforts in the cognitive restructuring strategy, while women reported in a greater proportion that they wanted to continue using physical exercise as a behavioral activation strategy. CONCLUSIONS Our study offers a first look into how women and men use online treatments, and what their preferences are.
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Affiliation(s)
- Émilie Binet
- School of Psychology, Laval University, 2325 Rue de l’Université, Quebec, QC G1V 0A6, Canada
| | - Marie-Christine Ouellet
- School of Psychology, Laval University, 2325 Rue de l’Université, Quebec, QC G1V 0A6, Canada
| | - Jessica Lebel
- School of Psychology, Laval University, 2325 Rue de l’Université, Quebec, QC G1V 0A6, Canada
| | - Vera Békés
- Ferkauf Graduate School, Yeshiva University, 1165 Morris Park Ave, The Bronx, New York, NY 10461, USA
| | - Charles M. Morin
- School of Psychology, Laval University, 2325 Rue de l’Université, Quebec, QC G1V 0A6, Canada
| | - Geneviève Belleville
- School of Psychology, Laval University, 2325 Rue de l’Université, Quebec, QC G1V 0A6, Canada
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Zhu Y, Li Y, Xu X. Suicidal ideation and suicide attempts in psychiatric patients during the COVID-19: A systematic review and meta-analysis. Psychiatry Res 2022; 317:114837. [PMID: 36113254 PMCID: PMC9472469 DOI: 10.1016/j.psychres.2022.114837] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/25/2022] [Accepted: 09/04/2022] [Indexed: 01/04/2023]
Abstract
Current suicidal ideation and suicide attempts among psychiatric patients during the COVID-19 pandemic were studied through systematic review and meta-analysis. We searched the following electronic databases using the relevant search terms: Medline, Embase, PubMed and Web of Science, with the search time as of January 31,2022. Forest plots were obtained using Stata statistical software and a random-effects model was used to conduct a meta-analysis of the prevalence of suicidal ideation. We found 21 eligible studies, 11 of which provided suitable data for meta-analysis. 10 studies explored current suicidal ideation and reported a pooled prevalence of 20.4% (95%CI 14.0-26.8). Six studies examined suicide attempts, with a pooled prevalence of 11.4% (95%CI 6.2-16.6). The prevalence of suicidal ideation and suicide attempts varied by the study method used and by the study sites. This work highlights the need for real-time monitoring of suicidal ideation and suicide in psychiatric patients during the covid-19 pandemic r to inform clinical practice and help identify research questions for future epidemiological studies.
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Affiliation(s)
- Yingqian Zhu
- Medical College, Nantong University,19th Qixiu Road, Nantong, 226001, China
| | - Yanqing Li
- Medical College, Nantong University,19th Qixiu Road, Nantong, 226001, China
| | - Xiuqun Xu
- Department of Nursing, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China.
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van Meggelen M, Morina N, van der Heiden C, Brinkman WP, Yocarini IE, Tielman ML, Rodenburg J, van Ee E, van Schie K, Broekman ME, Franken IHA. A randomized controlled trial to pilot the efficacy of a computer-based intervention with elements of virtual reality and limited therapist assistance for the treatment of post-traumatic stress disorder. Front Digit Health 2022; 4:974668. [PMID: 36329832 PMCID: PMC9622938 DOI: 10.3389/fdgth.2022.974668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/26/2022] [Indexed: 11/05/2022] Open
Abstract
Although well-established therapies exist for post-traumatic stress disorder (PTSD), barriers to seek mental health care are high. Technology-based interventions may play a role in improving the reach of efforts to treat, especially when therapist availability is low. The goal of the current randomized controlled trial was to pilot the efficacy of a computer-based trauma intervention with elements of virtual reality (VR; 3MR system) and limited therapist involvement for the treatment of PTSD in a childhood sexual abuse (CSA) and war veteran sample and to compare this to "treatment as usual" (TAU). TAU consisted of evidence-based approaches such as imaginal exposure, EMDR, or narrative exposure therapy. A total of 44 patients with PTSD were included and randomly assigned to 12 sessions of 3MR intervention or TAU (completer n 3MR = 12, TAU = 18). Several measures (PCL-5, BDI-II, OQ-45-2, and the M.I.N.I. 5.0.0.) were administered to measure symptoms of PTSD and depression and scores of overall well-being at pre, post, and a three-month follow-up measurement. Analyses suggest that symptoms of PTSD and depression in the 3MR condition decreased, and overall well-being increased between pre and post measurements. Results did not indicate any clear differences between the treatment conditions over time which suggests that treatment gains of the 3MR intervention seem no less than those of TAU. Finally, both treatment conditions produced similar remission rates of PTSD and depression. Therefore, the 3MR intervention could possibly constitute an appropriate treatment alternative. The small sample size as well as evident drop-out rates in the 3MR condition (45%) do warrant further research. The procedures of this study were approved by the Medical Ethical Research Committee (MERC) of the Erasmus Medical Center in Rotterdam (MEC-NL46279.078.13) and pre-registered via ClinicalTrials.gov (Protocol Record CI1-12-S028-1).
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Affiliation(s)
- Marieke van Meggelen
- Department of Psychology, Child and Education Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
- Parnassia Group, Outpatient Treatment Center PsyQ, The Hague, Netherlands
| | - Nexhmedin Morina
- Department of Clinical Psychology and Psychotherapy, University of Münster, Münster, Germany
| | - Colin van der Heiden
- Department of Psychology, Child and Education Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
- Parnassia Group, Outpatient Treatment Center PsyQ, Rotterdam, Netherlands
| | - Willem-Paul Brinkman
- Department of Intelligent Systems, Delft University of Technology, Delft, Netherlands
| | - Iris E. Yocarini
- Leiden Institute of Advanced Computer Science, Leiden University, Leiden, Netherlands
| | - Myrthe L. Tielman
- Department of Intelligent Systems, Delft University of Technology, Delft, Netherlands
| | - Jan Rodenburg
- DeHemisfeer, Praktijk Voor Psychotrauma / Migratieproblematiek, ‘s-Hertogenbosch, Netherlands
| | - Elisa van Ee
- Reinier van Arkel, Psychotrauma Centrum Zuid-Nederland, ‘s-Hertogenbosch, Netherlands
- Behavioural Science Institute, Radboud University, Nijmegen, Netherlands
| | - Kevin van Schie
- Department of Psychology, Child and Education Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, United Kingdom
| | | | - Ingmar H. A. Franken
- Department of Psychology, Child and Education Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, Netherlands
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Luo X, Bugatti M, Molina L, Tilley JL, Mahaffey B, Gonzalez A. Conceptual Invariance, Trajectories, and Outcome Associations of Working Alliance in Unguided and Guided Internet-Based Psychological Interventions: Secondary Analysis of a Randomized Controlled Trial. JMIR Ment Health 2022; 9:e35496. [PMID: 35727626 PMCID: PMC9257617 DOI: 10.2196/35496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 05/03/2022] [Accepted: 05/06/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The role of working alliance remains unclear for many forms of internet-based interventions (IBIs), a set of effective psychotherapy alternatives that do not require synchronous interactions between patients and therapists. OBJECTIVE This study examined the conceptual invariance, trajectories, and outcome associations of working alliance across an unguided IBI and guided IBIs that incorporated clinician support through asynchronous text messaging or video messaging. METHODS Adults with high education attainment (n=145) with subclinical levels of anxiety, stress, or depressive symptoms were randomized to 1 of 3 treatment conditions for 7 weeks. All participants received treatments from MyCompass, an unguided IBI using cognitive behavior therapy. Participants in condition 2 and 3 received supplemental, asynchronous clinician support through text and video, respectively. Working alliance with the IBIs was measured weekly using select items from the 12-item version of the Agnew Relationship Measure. Symptom and functional outcomes were assessed at baseline, at the end of treatment, and 1-month follow-up. RESULTS Working alliance with the IBIs was conceptually invariant across the 3 conditions. Working alliance followed a quadratic pattern of change over time for all conditions and declined significantly only in the text-support condition. After controlling for baseline symptoms, higher baseline levels of working alliance predicted less depression and less functional impairment at follow-up, whereas faster increases in working alliance predicted less worry at the end of treatment and at follow-up, all of which only occurred in the video-support condition. CONCLUSIONS Working alliance with the IBIs was generally established in the initial sessions. Although working alliance is conceptually invariant across IBIs with or without clinician support, the associations between working alliance and treatment outcomes among IBIs may differ depending on clinician involvement and the modalities of support. TRIAL REGISTRATION ClinicalTrials.gov NCT05122429; https://clinicaltrials.gov/ct2/show/NCT05122429.
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Affiliation(s)
- Xiaochen Luo
- Department of Counseling Psychology, Santa Clara University, Santa Clara, CA, United States
| | - Matteo Bugatti
- Morgridge College of Education, University of Denver, Denver, CO, United States
| | - Lucero Molina
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, United States
| | - Jacqueline L Tilley
- Psychological and Child & Human Development Area Group, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Brittain Mahaffey
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, United States
| | - Adam Gonzalez
- Department of Psychiatry, Stony Brook University, Stony Brook, NY, United States
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Repine KM, Bawmann O, Mendlen M, Lowenstein SR. Investigating Wellness and Burnout Initiatives for Anesthesiology Resident Physicians: Time for Evidence-Based Investigation and Implementation. Anesthesiol Clin 2022; 40:275-285. [PMID: 35659400 DOI: 10.1016/j.anclin.2022.01.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Resident physician burnout and well-being are increasingly important and salient topics in medical training. Unfortunately, limited research exists regarding the efficacy of various burnout and wellness interventions for resident physicians. Better characterization of the causes of burnout and the components of well-being must necessarily precede implementation and evaluation of interventions. The authors advocate for an increased role for technology in implementing and studying wellness programming for resident physicians. In addition, they describe an intervention under development at the University of Colorado School of Medicine that uses a "Gratitude Journal" smartphone app to support trainee wellness.
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Affiliation(s)
- Kelsey M Repine
- Anesthesiology Department, University of Colorado School of Medicine, 12401 East 17th Avenue, 7th Floor, Aurora, CO 80045 USA.
| | - Oliver Bawmann
- Internal Medicine-Pediatrics Department, University of Colorado School of Medicine, 12631 East 17th Avenue, 8601, Aurora, CO 80045
| | - Madelyn Mendlen
- University of Colorado School of Medicine, 13001 E 17th Place, Aurora, CO 80045
| | - Steven R Lowenstein
- University of Colorado School of Medicine, 13001 East 17th Place, Campus Box C-290, Aurora, CO 80045, USA
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Drissi N, Ouhbi S, Amiri L, Al Mugaddam F, Jan RK, Isomursu M. A Conceptual Framework to Design Connected Mental Health Solutions in the United Arab Emirates: Questionnaire Study. JMIR Form Res 2022; 6:e27675. [PMID: 35129458 PMCID: PMC8861868 DOI: 10.2196/27675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/22/2021] [Accepted: 12/27/2021] [Indexed: 11/13/2022] Open
Abstract
Background Connected mental health (CMH) is a field presenting information and communications technology–based mental care interventions that could help overcome many mental care delivery barriers. Culture and background influence people’s attitudes, preferences, and acceptance of such solutions. Therefore, the suitability of CMH solutions to the targeted population is an important factor in their successful adoption. Objective The aim of this study is to develop a framework for the design and creation of CMH solutions suitable for the UAE context. The framework is based on investigating enablers and barriers of CMH adoption in the United Arab Emirates, from the mental health professional's (MHP) perspective and from related literature. Methods A survey of literature on relevant studies addressing the use of technology for mental care in Arab countries, and a web-based questionnaire-based survey with 17 MHPs practicing in the United Arab Emirates investigating their attitudes and views toward CMH was conducted. Results from the questionnaire and from related studies were analyzed to develop the design framework. Results On the basis of findings from the literature survey and analyzing MHP answers to the web-based survey, a framework for the design of CMH solutions for the UAE population was developed. The framework presents four types of recommendation categories: favorable criteria, which included blended care, anonymity, and ease of use; cultural factors including availability in multiple languages, mainly Arabic and English, in addition to religious and cultural considerations; technical considerations, including good-quality communication, availability in formats compatible with mobile phones, and providing technical support; and users’ health and data safety considerations, including users’ suitability testing, confidentiality, and ensuring MHP integrity. Conclusions CMH has the potential to help overcome many mental care barriers in the United Arab Emirates in particular and in the Arab world in general. CMH adoption in the United Arab Emirates has a potential for success. However, many factors should be taken into account, mainly cultural, religious, and linguistic aspects.
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Affiliation(s)
- Nidal Drissi
- Department of Computer Science & Software Engineering, College of Information Technology, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Sofia Ouhbi
- Department of Computer Science & Software Engineering, College of Information Technology, United Arab Emirates University, Abu Dhabi, United Arab Emirates
| | - Leena Amiri
- Department of Psychiatry and Behavioral Science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Fadwa Al Mugaddam
- Department of Psychiatry and Behavioral Science, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Reem K Jan
- College of Medicine, Mohammed Bin Rashid University Of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Minna Isomursu
- Faculty of Information Technology and Electrical Engineering, University of Oulu, Oulu, Finland
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Viskovich S, Pakenham KI, Fowler JA. A mixed-methods evaluation of experiential intervention exercises for values and committed action from an Acceptance and Commitment Therapy (ACT) mental health promotion program for university students. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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O'Brien KM, Sauber EW, Kearney MS, Venaglia RB, Lemay EP. Evaluating the Effectiveness of an Online Intervention to Educate College Students About Dating Violence and Bystander Responses. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP7516-NP7546. [PMID: 30755066 DOI: 10.1177/0886260519829769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
The purpose of this study was to conduct a randomized controlled trial to assess the efficacy of STOP Dating Violence, an online intervention developed to educate students about dating violence and appropriate bystander interventions on college campuses. College students (N = 317) were randomly assigned to one of the three conditions: (a) the STOP Dating Violence intervention, (b) a website containing information about dating violence, or (c) a control condition. Participants completed pre- and posttest quantitative and qualitative measures to assess knowledge of warning signs and appropriate bystander behaviors, attitudes about intervening as a bystander, willingness to intervene, and self-efficacy regarding intervening. The results indicated that students who participated in the STOP Dating Violence intervention were the most knowledgeable about jealous warning signs of dating violence and appropriate bystander interventions, had the greatest intent to assist a victim of dating violence, and were the most confident in their ability to intervene in dating violence situations, when compared with participants in the website and control conditions. Those who participated in the intervention also demonstrated greater knowledge regarding appropriate bystander behaviors 1 month following the intervention. No differences were found in attitudes regarding helping someone in an abusive dating relationship or engagement in bystander behaviors at follow-up. Qualitative analyses provided further support for the efficacy of STOP Dating Violence in increasing knowledge of barriers to bystander intervention and appropriate bystander intervention strategies in dating violence situations. Overall, the STOP Dating Violence intervention has the potential to educate undergraduates about dating violence and bystander interventions on college campuses.
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Nair B, Otaki F. Promoting University Students' Mental Health: A Systematic Literature Review Introducing the 4M-Model of Individual-Level Interventions. Front Public Health 2021; 9:699030. [PMID: 34249852 PMCID: PMC8267876 DOI: 10.3389/fpubh.2021.699030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 05/31/2021] [Indexed: 11/13/2022] Open
Abstract
Objective: The purpose of this study is to systematically review recently published individual student-level interventions aimed at alleviating the burden of mental health challenges faced by the students and/ or at equipping them with coping mechanism that will foster their resilience. Methods: This study relied on a systematic literature review. PubMed dataset was used; the search was confined to the following period: July 2016-December 2020. Results: A total of 1,399 records were identified by the electronic search, out of which 40 studies were included in this study. The authors inductively identified four overlapping categories of interventions across all included articles, and coded them as follows: Mindfulness, Movement, Meaning, and Moderator. Accordingly, each study was linked to at least one of four overlapping categories based on the nature of the intervention(s) under investigation, leading to differing assortments of categories. Conclusions: The 4M-Model generated by this study encourages focusing on devising holistic, university-based interventions that embrace the individuality of students to improve their mental health through elements of mindfulness, movement, meaning, and moderator. Through this focused approach, university counselors are enabled to design interventions that address students' physical, psychological, emotional, and social needs.
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Affiliation(s)
- Bhavana Nair
- Guidance & Counseling Office, Student Services & Registration, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Farah Otaki
- Strategy & Institutional Excellence, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
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Bunnell BE, Nemeth LS, Lenert LA, Kazantzis N, Deblinger E, Higgins KA, Ruggiero KJ. Barriers Associated with the Implementation of Homework in Youth Mental Health Treatment and Potential Mobile Health Solutions. COGNITIVE THERAPY AND RESEARCH 2021; 45:272-286. [PMID: 34108776 PMCID: PMC8183976 DOI: 10.1007/s10608-020-10090-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Homework, or between-session practice of skills learned during therapy, is integral to effective youth mental health TREATMENTS. However, homework is often under-utilized by providers and patients due to many barriers, which might be mitigated via mHealth solutions. METHODS Semi-structured qualitative interviews were conducted with nationally certified trainers in Trauma Focused Cognitive Behavioral Therapy (TF-CBT; n=21) and youth TF-CBT patients ages 8-17 (n=15) and their caregivers (n=12) to examine barriers to the successful implementation of homework in youth mental health treatment and potential mHealth solutions to those barriers. RESULTS The results indicated that many providers struggle to consistently develop, assign, and assess homework exercises with their patients. Patients are often difficult to engage and either avoid or have difficulty remembering to practice exercises, especially given their busy/chaotic home lives. Trainers and families had positive views and useful suggestions for mHealth solutions to these barriers in terms of functionality (e.g., reminders, tracking, pre-made homework exercises, rewards) and user interface (e.g., easy navigation, clear instructions, engaging activities). CONCLUSIONS This study adds to the literature on homework barriers and potential mHealth solutions to those barriers, which is largely based on recommendations from experts in the field. The results aligned well with this literature, providing additional support for existing recommendations, particularly as they relate to treatment with youth and caregivers.
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Affiliation(s)
- Brian E. Bunnell
- Department of Psychiatry and Behavioral Neurosciences, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
- Biomedical Informatics Center, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Lynne S. Nemeth
- Department of Nursing, College of Nursing, Medical University of South Carolina, Charleston, SC, USA
| | - Leslie A. Lenert
- Biomedical Informatics Center, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Nikolaos Kazantzis
- Cognitive Behavior Therapy Research Unit and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Esther Deblinger
- Child Abuse Research Education & Service (CARES) Institute, Rowan University School of Osteopathic Medicine, Stratford, New Jersey, USA
| | - Kristen A. Higgins
- Biomedical Informatics Center, College of Medicine, Medical University of South Carolina, Charleston, SC, USA
| | - Kenneth J. Ruggiero
- Technology Applications Center for Healthful Lifestyles, College of Nursing, Medical University of South Carolina, Charleston, SC, USA
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13
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Segal A, Wald I, Pine DS, Halpern P, Bar-Haim Y. Attention control therapy for acute stress disorder: A randomized controlled trial. Depress Anxiety 2020; 37:1017-1025. [PMID: 32442355 DOI: 10.1002/da.23040] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A subset of people exposed to traumatic events develop acute stress disorder (ASD), and approximately half of people with ASD develop posttraumatic stress disorder (PTSD). This randomized controlled trial examined the efficacy of internet-delivered attention control therapy (ACT), previously shown to reduce PTSD symptoms, as an adjuvant to treatment as usual in the community for patients with ASD. METHODS About 119 participants with ASD were randomly assigned to ACT or treatment as usual in the community within the first month following their traumatic event. PTSD symptoms and attention patterns were measured. RESULTS A significant reduction in stress-related symptoms was noted across participants with no difference between the two groups. Approximately half of the participants developed PTSD 2 months after the trauma. High attention bias variability was associated with elevated PTSD symptoms. However, attention bias variability did not change due to the therapy sessions. CONCLUSIONS Internet-delivered ACT was no more effective in reducing risk for PTSD in participants with ASD than treatment as usual in the community. Although elevated attention bias variability was detected in the patients with ASD, ACT failed to engage this cognitive target. Finally, ACT-based prevention research should proceed with caution given the possibility that this intervention might be associated with symptom worsening as indexed by the Clinical Global Impression scale.
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Affiliation(s)
- Adva Segal
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Ilan Wald
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel
| | - Daniel S Pine
- Section on Development and Affective Neuroscience, Emotion and Development Branch, Intramural Research Program, National Institutes of Mental Health, Bethesda, Maryland
| | - Pinchas Halpern
- Department of Emergency Medicine, The Tel Aviv Sourasky Medical Center, Tel Aviv, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yair Bar-Haim
- School of Psychological Sciences, Tel Aviv University, Tel Aviv, Israel.,Sagol School of Neuroscience, Tel Aviv University, Tel Aviv, Israel
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14
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Short NA, Morabito DM, Gilmore AK. Secondary prevention for posttraumatic stress and related symptoms among women whohave experienced a recent sexual assault: A systematic review and meta-analysis. Depress Anxiety 2020; 37:1047-1059. [PMID: 32442345 PMCID: PMC7680285 DOI: 10.1002/da.23030] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/23/2020] [Accepted: 04/19/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Women who have experienced a recent sexual assault (SA) are at high risk for posttraumatic stress disorder (PTSD) and related conditions, with approximately half of women experiencing SA meeting criteria for PTSD. There are no guidelines for the prevention of PTSD and other common mental health disorders after SA. Thus, the purpose of this systematic review and meta-analysis is to synthesize research on secondary preventions for PTSD after SA, determine efficacy whether any intervention seems promising, and ascertain when, how, and to whom interventions should be delivered. METHODS After searching electronic databases for secondary preventions for PTSD and related conditions among women who have experienced a recent SA, 17 studies were reviewed, their quality was rated on the clinical trial assessment measure, and 10 studies were meta-analyzed (7 were excluded, as they were not randomized controlled trials or due to the absence of heterogeneity). RESULTS Results suggested a small-to-moderate effect of prevention on reducing PTSD and related symptoms. There was no moderating effect of medication versus psychosocial interventions, timing, treatment modality, or targeted versus universal prevention. Half of the studies were of high quality. CONCLUSION Cognitive-behavioral secondary preventions for PTSD appear to be safe and effective among women who have experienced a recent SA. Future research should identify best practices and mechanisms of treatment, and once identified, it should move toward implementation science.
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Affiliation(s)
- Nicole A. Short
- Department of Anesthesiology, University of North Carolina, Chapel Hill, NC, USA
| | | | - Amanda K. Gilmore
- Department of Health Policy & Behavioral Sciences and Mark Chaffin Center for Healthy Development, School of Public Health, Georgia State University, Atlanta, GA
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15
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Brown M, Hooper N, James P, Scott D, Bodger O, John A. A Web-Delivered Acceptance and Commitment Therapy Intervention With Email Reminders to Enhance Subjective Well-Being and Encourage Engagement With Lifestyle Behavior Change in Health Care Staff: Randomized Cluster Feasibility Stud. JMIR Form Res 2020; 4:e18586. [PMID: 32763887 PMCID: PMC7442951 DOI: 10.2196/18586] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/29/2020] [Accepted: 05/26/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Poor mental health and emotional well-being can negatively impact ability to engage in healthy lifestyle behavior change. Health care staff have higher rates of sickness and absence than other public sector staff, which has implications at both individual and societal levels. Individual efforts to self-manage health and well-being which add to the UK mental health prevention agenda need to be supported. OBJECTIVE The objective of this study was to establish the feasibility and acceptability of the inclusion of a self-guided, automated, web-based acceptance and commitment therapy intervention in an existing health promotion program, to improve subjective well-being and encourage engagement with lifestyle behavior change. METHODS For this 12-week, 4-armed, randomized controlled cluster feasibility study, we recruited participants offline and randomly allocated them to 1 of 3 intervention arms or control (no well-being intervention) using an automated web-based allocation procedure. Eligibility criteria were current health care staff in 1 Welsh health board, age≥18 years, ability to read English, and ability to provide consent. The primary researcher was blinded to cluster allocation. Feasibility outcomes were randomization procedure, acceptance of intervention, and adherence to and engagement with the wider program. We evaluated health and well-being data via self-assessment at 2 time points, registration and postintervention, using the 14-item Warwick-Edinburgh Mental Well-Being Scale, the 4-item Patient Health Questionnaire, and the 7-item Acceptance and Action Questionnaire-Revised. RESULTS Of 124 participants who provided consent and were randomly allocated, 103 completed full registration and engaged with the program. Most participants (76/103) enrolled in at least one health behavior change module, and 43% (41/96) of those randomly allocated to an intervention arm enrolled in the well-being module. Adherence and engagement was low (7/103, 6.8%), but qualitative feedback was positive. CONCLUSIONS The procedure and randomization process proved feasible, and the addition of the well-being module proved acceptable to health care staff. However, participant engagement was limited, and no one completed the full 12-week program. User feedback should be used to develop the intervention to address poor engagement. Effectiveness should then be evaluated in a full-scale randomized controlled trial, which would be feasible with additional recruitment. TRIAL REGISTRATION International Standard Randomised Controlled Trial Number (ISRCTN) 50074817; http://www.isrctn.com/ISRCTN50074817.
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Affiliation(s)
- Menna Brown
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Nic Hooper
- Department of Health and Social Sciences, University of the West of England, Bristol, United Kingdom
| | - Phillip James
- Department of Computer Science, Swansea University, Swansea, United Kingdom
| | - Darren Scott
- Department of Computer Science, Swansea University, Swansea, United Kingdom
| | - Owen Bodger
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
| | - Ann John
- Swansea University Medical School, Swansea University, Swansea, United Kingdom
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16
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Fadul N, Elsayem AF, Bruera E. Integration of palliative care into COVID-19 pandemic planning. BMJ Support Palliat Care 2020; 11:40-44. [DOI: 10.1136/bmjspcare-2020-002364] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 05/11/2020] [Accepted: 05/17/2020] [Indexed: 01/08/2023]
Abstract
The COVID-19 pandemic is expected to surpass the healthcare system’s capacity to provide intensive care to all patients who deteriorate as a result of the disease. This poses a unique challenge to healthcare teams of rationing care during pandemic when resources are scarce. Healthcare providers will need to acquire new skills in care decision making and effective symptom control for patients who do not receive life-saving measures. In this review, we describe some of the important palliative care considerations that need to be incorporated into COVID-19 pandemic planning. The main aspects to be considered include decision algorithms for rationing care, training on effective symptoms management, alternative delivery methods of palliative care services such as telemedicine and finally death and bereavement support for surviving family members who are likely to be isolated from their loved one at the moment of death.
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17
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Schultchen D, Küchler AM, Schillings C, Weineck F, Karabatsiakis A, Ebert DD, Baumeister H, Pollatos O. Effectiveness of a guided online mindfulness-focused intervention in a student population: Study protocol for a randomised control trial. BMJ Open 2020; 10:e032775. [PMID: 32209621 PMCID: PMC7202707 DOI: 10.1136/bmjopen-2019-032775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 02/07/2020] [Accepted: 03/04/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Previous studies show that university students experience higher psychological stress than the general population, resulting in increased vulnerability for mental disorders for the student population. Online mindfulness interventions will be delivered to students as a potentially promising and more flexible approach compared to face-to-face interventions with the aim of improving their mental health. This study purposes to investigate the effectiveness of a guided online mindfulness-focused intervention for university students by using both self-reported and psychobiological measures. METHODS AND ANALYSES In this multicentre, two-armed randomised controlled trial with a parallel design, a guided version of the online mindfulness-focused intervention 'StudiCare Mindfulness' will be compared with a waitlist control group. In total, 120 participants will be recruited at different universities (of Applied Sciences) in (Neu-) Ulm. Data will be assessed prior to randomisation, after eight weeks (post-intervention) and six months after randomisation (follow-up). The primary outcome measure is mindfulness. The secondary outcome measures include depression, anxiety and stress levels, well-being, interoceptive sensibility, emotion regulation and alexithymia. Psychobiological parameters comprise interoceptive accuracy, hair cortisol and FKBP5 genotype. Sociodemographic variables, treatment expectations, side and adverse side effects, as well as intervention satisfaction and adherence will be assessed. All data analyses will be conducted according to the intention-to-treat principle. ETHICS AND DISSEMINATION All study procedures have been approved by the Ethics Committee of Ulm University (application No. 48/18). The findings will be disseminated widely through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER DRKS00014701.
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Affiliation(s)
- Dana Schultchen
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Ann-Marie Küchler
- Department of Clinical Psychology & Psychotherapy, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Christine Schillings
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Felicitas Weineck
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | | | - David D Ebert
- Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Harald Baumeister
- Department of Clinical Psychology & Psychotherapy, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Olga Pollatos
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
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18
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Lewis C, Roberts NP, Simon N, Bethell A, Bisson JI. Internet-delivered cognitive behavioural therapy for post-traumatic stress disorder: systematic review and meta-analysis. Acta Psychiatr Scand 2019; 140:508-521. [PMID: 31359407 DOI: 10.1111/acps.13079] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/24/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine whether Internet-delivered cognitive behavioural therapy (i-CBT) is an effective treatment for those who meet diagnostic criteria for post-traumatic stress disorder (PTSD). METHOD A systematic review was undertaken according to Cochrane Collaboration Guidelines. The primary outcome measures were reduction in PTSD symptoms and drop-out. Categorical outcomes were meta-analysed as risk ratios (RRs) and continuous outcomes as mean differences (MDs) or standardised mean differences (SMDs). RESULTS Ten studies with 720 participants were included. Evidence showed that i-CBT may be associated with a clinically important reduction in post-treatment PTSD symptoms compared with wait list (SMD -0.60, 95% confidence interval -0.97 to -0.24; N = 560); however, only three studies reported follow-up data, and there was no evidence to support the maintenance of symptom improvement at follow-up of 3-6 months. There was no evidence of a difference in PTSD symptoms between i-CBT and Internet-delivered non-CBT post-treatment. There was evidence of greater treatment effect from trauma-focused i-CBT than i-CBT without a trauma focus, as well as evidence that treatment effect was increased by the provision of guidance. CONCLUSIONS While the review found some beneficial effects of i-CBT for PTSD post-treatment, the quality of the evidence was very low because of the small number of included trials and there was insufficient evidence to support the maintenance of improvement at follow-up of 3-6 months. Further work is required to establish non-inferiority to current first-line interventions; to determine long-term efficacy; to explore mechanisms of effect; and to establish optimal levels of guidance.
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Affiliation(s)
- C Lewis
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - N P Roberts
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK.,Directorate of Psychology and Psychological Therapies, Cardiff & Vale University Health Board, Cardiff, UK
| | - N Simon
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - A Bethell
- Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK
| | - J I Bisson
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
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19
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Viskovich S, Pakenham KI. Randomized controlled trial of a web-based Acceptance and Commitment Therapy (ACT) program to promote mental health in university students. J Clin Psychol 2019; 76:929-951. [PMID: 31468528 DOI: 10.1002/jclp.22848] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This study evaluated a 4-week web-based Acceptance and Commitment Therapy (ACT) mental health promotion intervention for university students. METHOD Participants were randomized to intervention (n = 596) or waitlist control (n = 566). Assessment of primary outcomes (depression, anxiety, stress, well-being, self-compassion, life satisfaction, and academic performance) and ACT processes (acceptance, cognitive fusion, education values, valued living, and present moment awareness) occurred at pre- and post-intervention and 12-week follow-up for intervention participants, and the same pre-post interval for waitlist control participants. RESULTS Analyses showed significant improvements from pre- to post-intervention compared with waitlist control on all primary outcomes and ACT processes. All intervention gains were maintained at follow-up. Improvements on all primary outcomes were mediated by three or more ACT processes in both samples. Intervention effects were consistent across both sample groupings. CONCLUSION Findings provide support for a web-based ACT mental health promotion intervention for university students.
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Affiliation(s)
- Shelley Viskovich
- Doctor of Philosophy, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
| | - Kenneth Ian Pakenham
- Professor of Clinical and Health Psychology, School of Psychology, University of Queensland, Brisbane, Queensland, Australia
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20
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Tutus D, Plener PL, Niemitz M. [Quality criteria of internet-based cognitive-behavioral interventions for children and adolescents and their parents - A systematic review]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2018; 48:57-75. [PMID: 30526289 DOI: 10.1024/1422-4917/a000640] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Quality criteria of internet-based cognitive-behavioral interventions for children and adolescents and their parents - A systematic review Abstract. Introduction: This study provides an overview of existing internet-based evidence-based cognitive behavioral interventions (iCBT) for children/adolescents and their parents. The studies were evaluated based on preliminary defined quality criteria regarding their usability in the healthcare system. Methods: The review was performed according to PRISMA guidelines and evaluated the scientific literature concerning to iCBT. We conducted a comprehensive literature search of PubMed, PsychINFO, PsychARTICLES, PsychNDEX and Science Direct using relevant keywords. Studies were rated according to 10 previously predefined quality measures. Results: A total of 4,479 articles were screened, 62 of which were selected for further analysis. Thereof, 24 international iCBT programs with 50 randomized controlled trials (RCTs) were evaluated and met the quality criteria (M = 7.25, SD = 1.07). Further 13 publications showed preliminary efficacy for another 11 international iCBT programs and met the quality criteria (M = 7.45, SD = .82). There was no significant difference between programs evaluated within and without RCTs t(33) = -.56, p = .58. Conclusions: Our results indicate that multiple international iCBT programs exist. Because in Germany the waiting time for psychotherapeutic or psychiatric treatment is still about five months, iCBT programs have the potential to reduce this gap.
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Affiliation(s)
- Dunja Tutus
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinik Ulm, Deutschland
| | - Paul L Plener
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinik Ulm, Deutschland.,Universitätsklinik für Kinder- und Jugendpsychiatrie, Medizinische Universität Wien, Österreich
| | - Mandy Niemitz
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universitätsklinik Ulm, Deutschland
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21
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Benight CC, Shoji K, Yeager CM, Weisman P, Boult TE. Predicting Change in Posttraumatic Distress Through Change in Coping Self-Efficacy After Using the My Trauma Recovery eHealth Intervention: Laboratory Investigation. JMIR Ment Health 2018; 5:e10309. [PMID: 30497992 PMCID: PMC6293247 DOI: 10.2196/10309] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/19/2018] [Accepted: 09/20/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Technology offers a unique platform for delivering trauma interventions (ie, eHealth) to support trauma-exposed populations. It is important to evaluate mechanisms of therapeutic change in reducing posttraumatic distress in eHealth for trauma survivors. OBJECTIVE This study evaluated a proactive, scalable, and individually responsive eHealth intervention for trauma survivors called My Trauma Recovery. My Trauma Recovery is an eHealth intervention aiming to support trauma survivors and consisting of 6 modules: relaxation, triggers, self-talk, professional help, unhelpful coping, and social support. It was designed to enhance trauma coping self-efficacy (CSE). We tested 3 hypotheses. First, My Trauma Recovery would decrease posttraumatic stress symptoms (PTSS). Second, My Trauma Recovery would increase CSE. And last, changes in CSE would be negatively correlated with changes in PTSS. METHODS A total of 92 individuals exposed to trauma (78/92, 85% females, mean age 34.80 years) participated. Our study was part of a larger investigation and consisted of 3 sessions 1 week apart. Participants completed the baseline online survey assessing PTSS and CSE. Each session included completing assigned modules followed by the online survey assessing CSE. PTSS was remeasured at the end of the last module. RESULTS PTSS significantly declined from T1 to T9 (F1,90=23.63, P<.001, η2p=.21) supporting the clinical utility of My Trauma Recovery. Significant increases in CSE for sessions 1 and 2 (F8,83=7.51, P<.001) were found. No significant change in CSE was found during session 3 (N=92). The residualized scores between PTSS T1 and T9 and between CSE T1 and T9 were calculated. The PTSS residualized score and the CSE residualized score were significantly correlated, r=-.26, P=.01. Results for each analysis with a probable PTSD subsample were consistent. CONCLUSIONS The findings of our study show that participants working through My Trauma Recovery report clinically lower PTSS after 3 weeks. The results also demonstrate that CSE is an important self-appraisal factor that increased during sessions 1 and 2. These improvements are correlated with reductions in PTSS. Thus, changes in CSE may be an important mechanism for reductions in PTSS when working on a self-help trauma recovery website and may be an important target for eHealth interventions for trauma. These findings have important implications for trauma eHealth interventions.
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Affiliation(s)
- Charles C Benight
- Department of Psychology, University of Colorado, Colorado Springs, CO, United States.,Trauma, Health, and Hazards Center, University of Colorado, Colorado Springs, CO, United States
| | - Kotaro Shoji
- Trauma, Health, and Hazards Center, University of Colorado, Colorado Springs, CO, United States
| | - Carolyn M Yeager
- Department of Psychology, University of Colorado, Colorado Springs, CO, United States
| | - Pamela Weisman
- Department of Psychology, University of Colorado, Colorado Springs, CO, United States
| | - Terrance E Boult
- Department of Computer Science, University of Colorado, Colorado Springs, CO, United States
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22
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Burns VL, Eaton AA, Long H, Zapp D. Exploring the Role of Race and Gender on Perceived Bystander Ability and Intent: Findings Before and After Exposure to an Online Training Program to Prevent Sexual Assault on Campus. Violence Against Women 2018; 25:999-1017. [DOI: 10.1177/1077801218807089] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The current study explores the significance of race and gender on bystander attitudes before and after an online bystander intervention program to prevent sexual assault. A diverse sample of 750 college students participated in an online intervention and participants’ perceived bystander intervention ability and intent were assessed. The interaction of participant race and gender had a marginally significant impact on bystander ability and intent baseline scores. Furthermore, when analyzing gain scores from pre- to posttest, there was a significant race by gender interaction. Specifically, Latinx and Black men had higher preintervention scores, and White men had higher gains postintervention. Relevant cultural and social factors and directions for future research are discussed.
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Affiliation(s)
| | | | - Haiying Long
- Florida International University, Miami, FL, USA
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23
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Ennis N, Sijercic I, Monson CM. Internet-Delivered Early Interventions for Individuals Exposed to Traumatic Events: Systematic Review. J Med Internet Res 2018; 20:e280. [PMID: 30429113 PMCID: PMC6300083 DOI: 10.2196/jmir.9795] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 07/12/2018] [Accepted: 07/17/2018] [Indexed: 12/20/2022] Open
Abstract
Background Over 75% of individuals are exposed to a traumatic event, and a substantial minority goes on to experience mental health problems that can be chronic and pernicious in their lifetime. Early interventions show promise for preventing trauma following psychopathology; however, a face-to-face intervention can be costly, and there are many barriers to accessing this format of care. Objective The aim of this study was to systematically review studies of internet-delivered early interventions for trauma-exposed individuals. Methods A literature search was conducted in PsycINFO and PubMed for papers published between 1991 and 2017. Papers were included if the following criteria were met: (1) an internet-based intervention was described and applied to individuals exposed to a traumatic event; (2) the authors stated that the intervention was intended to be applied early following trauma exposure or as a preventive intervention; and (3) data on mental health symptoms at pre-and postintervention were described (regardless of whether these were primary outcomes). Methodological quality of included studies was assessed using the Downs and Black checklist. Results The interventions in the 7 studies identified were categorized as selected (ie, delivered to an entire sample after trauma regardless of psychopathology symptoms) or indicated (ie, delivered to those endorsing some level of posttraumatic distress). Selected interventions did not produce significant symptom improvement compared with treatment-as-usual or no intervention control groups. However, indicated interventions yielded significant improvements over other active control conditions on mental health outcomes. Conclusions Consistent with the notion that many experience natural recovery following trauma, results imply that indicated early internet-delivered interventions hold the most promise in future prevention efforts. More studies that use rigorous methods and clearly defined outcomes are needed to evaluate the efficacy of early internet-delivered interventions. Moreover, basic research on risk and resilience factors following trauma exposure is necessary to inform indicated internet-delivered interventions.
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Affiliation(s)
- Naomi Ennis
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Iris Sijercic
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Candice M Monson
- Department of Psychology, Ryerson University, Toronto, ON, Canada
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24
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Saleh D, Camart N, Sbeira F, Romo L. Can we learn to manage stress? A randomized controlled trial carried out on university students. PLoS One 2018; 13:e0200997. [PMID: 30183710 PMCID: PMC6124718 DOI: 10.1371/journal.pone.0200997] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 07/03/2018] [Indexed: 12/02/2022] Open
Abstract
In our research, we examined the efficacy of an Internet-based stress management program. Our interest in evaluating this type of intervention is based on the increasing accessibility of the Internet today, the growth of Internet-based interventions for various psychopathological problems, and the observation that despite the prevalence of stress among university students, only a fraction of students ever seek professional help. Methodology: “I’m managing my stress” (“Je gère mon stresse”), an Internet-based self-help program composed of four sessions, was examined in this study. The aforementioned program is based on cognitive-behavioral therapy and was inspired by the “Funambule” program in Quebec. Four questionnaires (Perceived Stress Scale, Rosenberg Self-Esteem Scale, Scale of Satisfaction in Studies, and General Health Questionnaire) uploaded online were answered thrice: during “preintervention”, “postintervention”, and “follow-up” stages, the latter of which occurred three months after the intervention. The sample comprised 128 university students, with the majority being women (81.25%). The subjects were divided randomly into two groups (an experimental group and a control group that did not follow the program). Results: The self-esteem scores of the control group were significantly higher than those of the experimental group at the preintervention stage, but this difference disappeared at the postintervention and follow-up stages. There were also significantly lower scores on the General Health Questionnaire subfactors of somatic symptoms and anxiety/insomnia in the experimental group than in the control group during the postintervention stage, though no differences were observed before the intervention. These differences no longer remained after three months. ANOVA revealed significant effects of the intervention over time in the experimental group. Effects were observed at both the postintervention and follow-up stages for self-esteem, perceived stress, satisfaction in studies, and in the somatic symptoms, anxiety and insomnia and severe depression aspects of the General Health Questionnaire (Cohen’s d = 0.38 to 4.58). In contrast, no effects were observed in the control group. Conclusion: This type of Internet-based program has the ability to reach a large number of students due to its rather short format and accessibility. It has already shown improvements in terms of the levels of perceived stress, psychological distress and satisfaction with studies. The option of online interventions could appeal specifically to students who do not seek professional help. However, even though these results are promising at the postintervention stage, they are limited, as indicated by the lack of significant differences between the two groups after the initial three months of follow-up. We still, specifically, need to improve this intervention program and, generally, need more research to address the methodological problems raised by this type of intervention. Trial registration: ISRCTN registry, ISRCTN13709272
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Affiliation(s)
- Dalia Saleh
- EA4430 CLIPSYD, UFR SPSE, Paris Nanterre University, Nanterre, France
- Counseling Psychology, Tishreen University, Latakia, Syria
- * E-mail:
| | - Nathalie Camart
- EA4430 CLIPSYD, UFR SPSE, Paris Nanterre University, Nanterre, France
| | - Fouad Sbeira
- Counseling Psychology, Tishreen University, Latakia, Syria
| | - Lucia Romo
- EA4430 CLIPSYD, UFR SPSE, Paris Nanterre University, Nanterre, France
- CMME, Centre Hospitalier Sainte Anne, Unité Inserm U864, CPN, Paris, France
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Viskovich S, Pakenham KI. Pilot evaluation of a web-based acceptance and commitment therapy program to promote mental health skills in university students. J Clin Psychol 2018; 74:2047-2069. [PMID: 29962090 DOI: 10.1002/jclp.22656] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 05/22/2018] [Accepted: 05/26/2018] [Indexed: 01/07/2023]
Abstract
OBJECTIVE This study evaluated a 4-week web-based acceptance and commitment therapy (ACT) mental health promotion program called YOLO (You Only Live Once) for university students. METHOD A total of 130 participants were randomized to one of three intervention groups investigating varied program delivery methods. Primary outcomes assessed: depression, anxiety, stress, well-being, self-compassion, alcohol use, and life satisfaction. ACT processes assessed: acceptance, cognitive fusion, education values, valued living, and mindfulness. RESULTS Improvement on the primary outcomes and ACT processes did not differ among the three intervention groups. Analyses showed significant improvements on all primary outcomes (except alcohol use), and on all ACT processes. All ACT processes mediated changes on one or more primary outcomes in the intent-to-treat sample. Intervention effects were consistent on most primary outcomes and ACT processes across three sample groupings. CONCLUSIONS These preliminary findings provide support for a web-based ACT mental health promotion program for university students.
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Affiliation(s)
- Shelley Viskovich
- School of Psychology, University of Queensland, St Lucia, Brisbane, Queensland, Australia
| | - Kenneth I Pakenham
- School of Psychology, University of Queensland, St Lucia, Brisbane, Queensland, Australia
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Yeager CM, Shoji K, Luszczynska A, Benight CC. Engagement With a Trauma Recovery Internet Intervention Explained With the Health Action Process Approach (HAPA): Longitudinal Study. JMIR Ment Health 2018; 5:e29. [PMID: 29636323 PMCID: PMC5938690 DOI: 10.2196/mental.9449] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 02/03/2018] [Accepted: 02/12/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND There has been a growing trend in the delivery of mental health treatment via technology (ie, electronic health, eHealth). However, engagement with eHealth interventions is a concern, and theoretically based research in this area is sparse. Factors that influence engagement are poorly understood, especially in trauma survivors with symptoms of posttraumatic stress. OBJECTIVE The aim of this study was to examine engagement with a trauma recovery eHealth intervention using the Health Action Process Approach theoretical model. Outcome expectancy, perceived need, pretreatment self-efficacy, and trauma symptoms influence the formation of intentions (motivational phase), followed by planning, which mediates the translation of intentions into engagement (volitional phase). We hypothesized the mediational effect of planning would be moderated by level of treatment self-efficacy. METHODS Trauma survivors from around the United States used the eHealth intervention for 2 weeks. We collected baseline demographic, social cognitive predictors, and distress symptoms and measured engagement subjectively and objectively throughout the intervention. RESULTS The motivational phase model explained 48% of the variance, and outcome expectations (beta=.36), perceived need (beta=.32), pretreatment self-efficacy (beta=.13), and trauma symptoms (beta=.21) were significant predictors of intention (N=440). In the volitional phase, results of the moderated mediation model indicated for low levels of treatment self-efficacy, planning mediated the effects of intention on levels of engagement (B=0.89, 95% CI 0.143-2.605; N=115). CONCLUSIONS Though many factors can affect engagement, these results offer a theoretical framework for understanding engagement with an eHealth intervention. This study highlighted the importance of perceived need, outcome expectations, self-efficacy, and baseline distress symptoms in the formation of intentions to use the intervention. For those low in treatment self-efficacy, planning may play an important role in the translation of intentions into engagement. Results of this study may help bring some clarification to the question of what makes eHealth interventions work.
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Affiliation(s)
- Carolyn M Yeager
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, United States.,Trauma Health and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - Kotaro Shoji
- Trauma Health and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States
| | - Aleksandra Luszczynska
- Trauma Health and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States.,SWPS University of Social Sciences & Humanities, Wroclaw, Poland
| | - Charles C Benight
- Department of Psychology, University of Colorado Colorado Springs, Colorado Springs, CO, United States.,Trauma Health and Hazards Center, University of Colorado Colorado Springs, Colorado Springs, CO, United States
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Kim JE, Dager SR, Jeong HS, Ma J, Park S, Kim J, Choi Y, Lee SL, Kang I, Ha E, Cho HB, Lee S, Kim EJ, Yoon S, Lyoo IK. Firefighters, posttraumatic stress disorder, and barriers to treatment: Results from a nationwide total population survey. PLoS One 2018; 13:e0190630. [PMID: 29304155 PMCID: PMC5755833 DOI: 10.1371/journal.pone.0190630] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 12/18/2017] [Indexed: 11/19/2022] Open
Abstract
Repeated exposure to traumatic experiences may put professional firefighters at increased risk of developing posttraumatic stress disorder (PTSD). To date, however, the rate of PTSD symptoms, unmet need for mental health treatment, and barriers to treatment have only been investigated in subsamples rather than the total population of firefighters. We conducted a nationwide, total population-based survey of all currently employed South Korean firefighters (n = 39,562). The overall response rate was 93.8% (n = 37,093), with 68.0% (n = 26,887) complete responses for all variables. The rate of current probable PTSD was estimated as 5.4%. Among those with current probable PTSD (n = 1,995), only a small proportion (9.7%) had received mental health treatment during the past month. For those who had not received treatment, perceived barriers of accessibility to treatment (29.3%) and concerns about potential stigma (33.8%) were reasons for not receiving treatment. Although those with higher PTSD symptom severity and functional impairment were more likely to seek treatment, greater symptom severity and functional impairment were most strongly associated with increased concerns about potential stigma. This nationwide study points to the need for new approaches to promote access to mental health treatment in professional firefighters.
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Affiliation(s)
- Jieun E. Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Stephen R. Dager
- Department of Radiology, University of Washington, Seattle, Washington, United States of America
- Department of Bioengineering, University of Washington, Seattle, Washington, United States of America
| | - Hyeonseok S. Jeong
- Department of Radiology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | - Jiyoung Ma
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Shinwon Park
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Jungyoon Kim
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Yera Choi
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Suji L. Lee
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Ilhyang Kang
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Eunji Ha
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - Han Byul Cho
- Department of Psychiatry, University of Utah, Salt Lake City, Utah, United States of America
| | - Sunho Lee
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
| | - Eui-Jung Kim
- Department of Psychiatry, Ewha Womans University, Seoul, South Korea
| | - Sujung Yoon
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
| | - In Kyoon Lyoo
- Ewha Brain Institute, Ewha Womans University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, Ewha Womans University, Seoul, South Korea
- * E-mail:
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Kia-Keating M, Santacrose D, Liu S. Photography and Social Media Use in Community-Based Participatory Research with Youth: Ethical Considerations. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2017; 60:375-384. [PMID: 28944473 PMCID: PMC5735042 DOI: 10.1002/ajcp.12189] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Community-based participatory researchers increasingly incorporate photography and social media into their work. Despite its relative infancy, social media has created a powerful network that allows individuals to convey messages quickly to a widespread audience. In addition to its potential benefits, the use of social media in research also carries risk, given the fast pace of exchanges, sharing of personal images and ideas in high accessibility, low privacy contexts and continually shifting options and upgrades. This article contributes to the literature examining ethical considerations for photography and social media use in community-based participatory research. We describe three key ethical dilemmas that we encountered during our participatory photography project with Latina/o youth: (a) use and content of images and risk; (b) incentives and coercion; and (c) social media activity and confidentiality. We provide our responses to these challenges, contextualized in theory and practice, and share lessons learned. We raise the question of how to contend with cultural shifts in boundaries and privacy. We propose that evaluating participant vulnerability versus potential empowerment may be more fitting than the standard approach of assessing risks and benefits. Finally, we recommend upholding the principles of participatory research by co-producing ethical practices with one's participants.
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Affiliation(s)
- Maryam Kia-Keating
- Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, CA, USA
| | - Diana Santacrose
- Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, CA, USA
| | - Sabrina Liu
- Department of Counseling, Clinical, and School Psychology, University of California, Santa Barbara, CA, USA
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Liu SR, Kia-Keating M. Improving Coping Self-Efficacy Among Distressed Students After Exposure to University Mass Violence: A Pilot Online Intervention. JOURNAL OF COLLEGE STUDENT PSYCHOTHERAPY 2017. [DOI: 10.1080/87568225.2017.1388754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Sabrina R. Liu
- Department of Counseling, Clinical, and School Psychology, Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, California, USA
| | - Maryam Kia-Keating
- Department of Counseling, Clinical, and School Psychology, Gevirtz Graduate School of Education, University of California, Santa Barbara, Santa Barbara, California, USA
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Gibson O, Reilly R, Harfield S, Tufanaru C, Ward J. Web-based therapeutic interventions for assessing, managing and treating health conditions in Indigenous people: a scoping review protocol. JBI DATABASE OF SYSTEMATIC REVIEWS AND IMPLEMENTATION REPORTS 2017; 15:2487-2494. [PMID: 29035960 DOI: 10.11124/jbisrir-2016-003324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
REVIEW OBJECTIVES/QUESTIONS The objective of the scoping review is to map the international scientific literature on web-based therapeutic interventions (WBTI) used by Indigenous people for assessing, managing and treating health conditions. The focus of this review is WBTIs for a broad range of health conditions, including but not limited to, communicable and non-communicable diseases, mental health conditions (including the broader concept of social and emotional wellbeing), use of harmful substances and gambling.The questions for the scoping review are.
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Affiliation(s)
- Odette Gibson
- 1Wardliparingga Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, Australia 2Infection and Immunity Aboriginal Health, South Australian Health and Medical Research Institute, Adelaide, Australia 3Joanna Briggs Institute, Faculty of Health and Medical Sciences, The University of Adelaide, Australia
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Hilty DM, Chan S, Hwang T, Wong A, Bauer AM. Advances in mobile mental health: opportunities and implications for the spectrum of e-mental health services. Mhealth 2017; 3:34. [PMID: 28894744 PMCID: PMC5583042 DOI: 10.21037/mhealth.2017.06.02] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 06/16/2017] [Indexed: 12/30/2022] Open
Abstract
Mobile health (mHealth), telemedicine and other technology-based services facilitate mental health service delivery and may be considered part of an e-mental health (eMH) spectrum of care. Web- and Internet-based resources provide a great opportunity for the public, patients, healthcare providers and others to improve wellness, practice prevention and reduce suffering from illnesses. Mobile apps offer portability for access anytime/anywhere, are inexpensive versus traditional desktop computers, and have additional features (e.g., context-aware interventions and sensors with real-time feedback. This paper discusses mobile mental health (mMH) options, as part of a broader framework of eMH options. The evidence-based literature shows that many people have an openness to technology as a way to help themselves, change behaviors and engage additional clinical services. Studies show that traditional video-based synchronous telepsychiatry (TP) is as good as in-person service, but mHealth outcomes have been rarely, directly compared to in-person and other eMH care options. Similarly, technology options added to in-person care or combined with others have not been evaluated nor linked with specific goals and desired outcomes. Skills and competencies for clinicians are needed for mHealth, social media and other new technologies in the eMH spectrum, in addition to research by randomized trials and study of health service delivery models with an emphasis on effectiveness.
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Affiliation(s)
- Donald M. Hilty
- Department of Psychiatry & Addiction Medicine, Kaweah Delta Medical Center, Visalia, California, USA
- Department of Psychiatry & Behavioral Sciences, Keck School of Medicine at USC, Los Angeles, California, USA
| | - Steven Chan
- Division of Hospital Medicine, Digital Health & Behavioral Sciences Research, University of California, California, USA
| | - Tiffany Hwang
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Alice Wong
- Department of Psychiatry, Maimonides Medical Center, Brooklyn, NY, USA
| | - Amy M. Bauer
- Department of Psychiatry & Behavioral Sciences, the University of Washington, Seattle, Washington, USA
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Lewis CE, Farewell D, Groves V, Kitchiner NJ, Roberts NP, Vick T, Bisson JI. Internet-based guided self-help for posttraumatic stress disorder (PTSD): Randomized controlled trial. Depress Anxiety 2017; 34:555-565. [PMID: 28557299 DOI: 10.1002/da.22645] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Revised: 02/27/2017] [Accepted: 02/27/2017] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND There are numerous barriers that limit access to evidence-based treatment for posttraumatic stress disorder (PTSD). Internet-based guided self-help is a treatment option that may help widen access to effective intervention, but the approach has not been sufficiently explored for the treatment of PTSD. METHODS Forty two adults with DSM-5 PTSD of mild to moderate severity were randomly allocated to internet-based self-help with up to 3 h of therapist assistance, or to a delayed treatment control group. The internet-based program included eight modules that focused on psychoeducation, grounding, relaxation, behavioural activation, real-life and imaginal exposure, cognitive therapy, and relapse prevention. The primary outcome measure was reduction in clinician-rated traumatic stress symptoms using the clinician administered PTSD scale for DSM-V (CAPS-5). Secondary outcomes were self-reported PTSD symptoms, depression, anxiety, alcohol use, perceived social support, and functional impairment. RESULTS Posttreatment, the internet-based guided self-help group had significantly lower clinician assessed PTSD symptoms than the delayed treatment control group (between-group effect size Cohen's d = 1.86). The difference was maintained at 1-month follow-up and dissipated once both groups had received treatment. Similar patterns of difference between the two groups were found for depression, anxiety, and functional impairment. The average contact with treating clinicians was 2½ h. CONCLUSIONS Internet-based trauma-focused guided self-help for PTSD is a promising treatment option that requires far less therapist time than current first line face-to-face psychological therapy.
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Affiliation(s)
| | | | | | | | | | - Tracey Vick
- Cardiff and Vale University Health Board, Cardiff, UK
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Lau Y, Htun TP, Wong SN, Tam WSW, Klainin-Yobas P. Therapist-Supported Internet-Based Cognitive Behavior Therapy for Stress, Anxiety, and Depressive Symptoms Among Postpartum Women: A Systematic Review and Meta-Analysis. J Med Internet Res 2017; 19:e138. [PMID: 28455276 PMCID: PMC5429436 DOI: 10.2196/jmir.6712] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 01/26/2017] [Accepted: 02/13/2017] [Indexed: 12/12/2022] Open
Abstract
Background A growing number of meta-analyses have supported the application of therapist-supported Internet-based cognitive behavior therapy (iCBT) for psychological disorders across different populations, but relatively few meta-analyses have concentrated on postpartum women. Objective This meta-analysis evaluated the efficacy of therapist-supported iCBT in improving stress, anxiety, and depressive symptoms among postpartum women. Methods A total of 10 electronic databases were used to search for published and unpublished trials. Cochrane Collaboration tool for assessing risk of bias was utilized to measure methodological quality. Meta-analysis was performed using the RevMan software (Review Manager version 5.3 for Windows from the Nordic Cochrane Centre, the Cochrane Collaboration, 2014). Among the 789 studies identified, 8 randomized controlled trials were selected, involving 1523 participants across 6 countries. Results More than half (65%) of the eligible studies had a low risk of bias with no heterogeneity. Results revealed that therapist-supported iCBT significantly improved stress (d=0.84, n=5), anxiety (d=0.36, n=6), and depressive symptoms (d=0.63, n=8) of the intervention group compared with those of the control group at post-intervention. Conclusions This review revealed that therapist-supported iCBT significantly improves stress, anxiety, and depressive symptoms among postpartum women with small to large effects. Future effectiveness studies should establish the essential components, format, and approach of iCBT with optimal levels of human support to maximize a long-term effect.
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Affiliation(s)
- Ying Lau
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Tha Pyai Htun
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Suei Nee Wong
- Medical Resource Team, National University of Singapore Libraries, Singapore, Singapore
| | - Wai San Wilson Tam
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Piyanee Klainin-Yobas
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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Tu AW, Watts AW, Chanoine JP, Panagiotopoulos C, Geller J, Brant R, Barr SI, Mâsse L. Does parental and adolescent participation in an e-health lifestyle modification intervention improves weight outcomes? BMC Public Health 2017; 17:352. [PMID: 28438202 PMCID: PMC5402679 DOI: 10.1186/s12889-017-4220-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2016] [Accepted: 04/01/2017] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Few studies have evaluated the effect of adherence to a lifestyle intervention on adolescent health outcomes. The objective of this study was to determine whether adolescent and parental adherence to components of an e-health intervention resulted in change in adolescent body mass index (BMI) and waist circumference (WC) z-scores in a sample of overweight/obese adolescents. METHODS In total, 159 overweight/obese adolescents and their parents participated in an 8-month e-health lifestyle intervention. Each week, adolescents and their parents were asked to login to their respective website and to monitor their dietary, physical activity, and sedentary behaviours. We examined participation (percentage of webpages viewed [adolescents]; number of weeks logged in [parents]) and self-monitoring (number of weeks behaviors were tracked) rates. Linear mixed models and multiple regressions were used to examine change in adolescent BMI and WC z-scores and predictors of adolescent participation and self-monitoring, respectively. RESULTS Adolescents and parents completed 28% and 23%, respectively, of the online component of the intervention. Higher adolescent participation rate was associated with a decrease in the slope of BMI z-score but not with change in WC z-score. No association was found between self-monitoring rate and change in adolescent BMI or WC z-scores. Parent participation was not found to moderate the relationship between adolescent participation and weight outcomes. CONCLUSIONS Developing strategies for engaging and promoting supportive interactions between adolescents and parents are needed in the e-health context. Findings demonstrate that improving adolescents' adherence to e-health lifestyle intervention can effectively alter the weight trajectory of overweight/obese adolescents.
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Affiliation(s)
- Andrew W. Tu
- School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
| | - Allison W. Watts
- School of Public Health, University of Minnesota, 1300 South Second St, Suite 300, Minneapolis, MN 55454 USA
| | - Jean-Pierre Chanoine
- Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver, BC V6H 3V4 Canada
| | | | - Josie Geller
- Department of Psychology, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC V6T 2A1 Canada
| | - Rollin Brant
- Department of Statistics, University of British Columbia, 4480 Oat Street, Vancouver, BC V6H 3V4 Canada
| | - Susan I. Barr
- Food Nutrition and Health, University of British Columbia, 2205 East Mall, Vancouver, BC V6T 1Z4 Canada
| | - Louise Mâsse
- BC Children’s Hospital Research Institute, School of Population and Public Health, University of British Columbia, 2206 East Mall, Vancouver, BC V6T 1Z3 Canada
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Saleh D, Camart N, Romo L. Intervention de gestion du stress par Internet chez les étudiants : revue de la littérature. ANNALES MEDICO-PSYCHOLOGIQUES 2017. [DOI: 10.1016/j.amp.2016.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Internet and mobile technologies: addressing the mental health of trauma survivors in less resourced communities. Glob Ment Health (Camb) 2017; 4:e16. [PMID: 29230312 PMCID: PMC5719483 DOI: 10.1017/gmh.2017.11] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2017] [Revised: 06/02/2017] [Accepted: 06/14/2017] [Indexed: 02/01/2023] Open
Abstract
Internet and mobile technologies offer potentially critical ways of delivering mental health support in low-resource settings. Much evidence indicates an enormous negative impact of mental health problems in low- and middle-income countries (LMICs), and many of these problems are caused, or worsened, by exposure to wars, conflicts, natural and human-caused disasters, and other traumatic events. Though specific mental health treatments have been found to be efficacious and cost-effective for low-resource settings, most individuals living in these areas do not have access to them. Low-intensity task-sharing interventions will help, but there is a limit to the scalability and sustainability of human resources in these settings. To address the needs of trauma survivors, it will be important to develop and implement Internet and mobile technology resources to help reduce the scarcity, inequity, and inefficiency of current mental health services in LMICs. Mobile and Internet resources are experiencing a rapid growth in LMICs and can help address time, stigma, and cost barriers and connect those who have been socially isolated by traumatic events. This review discusses current research in technological interventions in low-resource settings and outlines key issues and future challenges and opportunities. Though formidable challenges exist for large-scale deployment of mobile and Internet mental health technologies, work to date indicates that these technologies are indeed feasible to develop, evaluate, and deliver to those in need of mental health services, and that they can be effective.
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Evaluation of a web-based acceptance and commitment therapy program for women with trauma-related problems: A pilot study. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2017. [DOI: 10.1016/j.jcbs.2016.11.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Sijbrandij M, Kunovski I, Cuijpers P. EFFECTIVENESS OF INTERNET-DELIVERED COGNITIVE BEHAVIORAL THERAPY FOR POSTTRAUMATIC STRESS DISORDER: A SYSTEMATIC REVIEW AND META-ANALYSIS. Depress Anxiety 2016; 33:783-91. [PMID: 27322710 DOI: 10.1002/da.22533] [Citation(s) in RCA: 157] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Revised: 05/18/2016] [Accepted: 05/22/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Internet-delivered cognitive behavioral therapy (iCBT) is a relatively novel treatment method that may improve the accessibility of mental health care for individuals with posttraumatic stress disorder (PTSD). The aim of this meta-analysis was to evaluate the effectiveness of iCBT compared to inactive (waitlist control and treatment-as-usual (TAU)) and active other interventions in reducing PTSD symptoms. METHODS A meta-analysis of 12 randomized controlled trials (14 comparisons) and 1,306 participants was conducted. RESULTS The pooled effect size of the 11 comparisons (10 studies, 1,139 participants) that compared iCBT to waitlist and TAU control was moderate (g = 0.71, 95% CI [0.49-0.93], P < .001), and showed moderate heterogeneity. The pooled effect size of the three studies (three comparisons) comparing iCBT to other interventions was small (g = 0.28, 95% CI [-0.00 to 0.56], P = .05), with low heterogeneity. CONCLUSION The findings of this systematic review and meta-analysis show that iCBT is an effective treatment for individuals with PTSD and comorbid depressive symptoms. However, further research is needed for effective dissemination of iCBT in clinical practice.
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Affiliation(s)
- Marit Sijbrandij
- Department of Clinical Psychology, VU University Amsterdam, The Netherlands. .,EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, , VU University, , The Netherlands.
| | - Ivo Kunovski
- Department of Clinical Psychology, VU University Amsterdam, The Netherlands
| | - Pim Cuijpers
- Department of Clinical Psychology, VU University Amsterdam, The Netherlands.,EMGO Institute for Health and Care Research, VU University Medical Center Amsterdam, , VU University, , The Netherlands
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Whealin JM, Seibert-Hatalsky LA, Howell JW, Tsai J. E-mental health preferences of Veterans with and without probable posttraumatic stress disorder. ACTA ACUST UNITED AC 2016; 52:725-38. [PMID: 26562090 DOI: 10.1682/jrrd.2014.04.0113] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2014] [Revised: 06/03/2015] [Indexed: 11/05/2022]
Abstract
Mental health care practices supported by electronic communication, referred to as e-mental health, offer ways to increase access to mental health resources. In recent years, e-mental health interventions using clinical video teleconferencing, Internet-based interventions, social networking sites, and telephones have emerged as viable, cost-effective methods to augment traditional service delivery. Whereas some research evaluates attitudes about e-mental health, few studies have assessed interest in using these approaches in a contemporary sample of U.S. Veterans. This study sought to understand willingness to use e-mental health in a diverse group of Veterans residing in Hawaii. Mailed surveys were completed by 600 Operation Iraqi Freedom/Operation Enduring Freedom Veterans and National Guard members. Results suggest that overall willingness to use e-mental health ranged from 32.2% to 56.7% depending on modality type. Importantly, Veterans who screened positive for posttraumatic stress disorder (PTSD) were significantly less likely to report willingness to use each e-mental health modality than their peers without PTSD, despite their greater desire for mental health services. These results suggest that despite solutions to logistical barriers afforded via e-mental health services, certain barriers to mental health care may persist, especially among Veterans who screen positive for PTSD.
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Affiliation(s)
- Julia M Whealin
- Department of Veterans Affairs (VA) Pacific Islands Health Care System, Honolulu, HI
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Brown M, O'Neill N, van Woerden H, Eslambolchilar P, Jones M, John A. Gamification and Adherence to Web-Based Mental Health Interventions: A Systematic Review. JMIR Ment Health 2016; 3:e39. [PMID: 27558893 PMCID: PMC5014987 DOI: 10.2196/mental.5710] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 06/06/2016] [Accepted: 07/11/2016] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Adherence to effective Web-based interventions for common mental disorders (CMDs) and well-being remains a critical issue, with clear potential to increase effectiveness. Continued identification and examination of "active" technological components within Web-based interventions has been called for. Gamification is the use of game design elements and features in nongame contexts. Health and lifestyle interventions have implemented a variety of game features in their design in an effort to encourage engagement and increase program adherence. The potential influence of gamification on program adherence has not been examined in the context of Web-based interventions designed to manage CMDs and well-being. OBJECTIVE This study seeks to review the literature to examine whether gaming features predict or influence reported rates of program adherence in Web-based interventions designed to manage CMDs and well-being. METHODS A systematic review was conducted of peer-reviewed randomized controlled trials (RCTs) designed to manage CMDs or well-being and incorporated gamification features. Seven electronic databases were searched. RESULTS A total of 61 RCTs met the inclusion criteria and 47 different intervention programs were identified. The majority were designed to manage depression using cognitive behavioral therapy. Eight of 10 popular gamification features reviewed were in use. The majority of studies utilized only one gamification feature (n=58) with a maximum of three features. The most commonly used feature was story/theme. Levels and game leaders were not used in this context. No studies explicitly examined the role of gamification features on program adherence. Usage data were not commonly reported. Interventions intended to be 10 weeks in duration had higher mean adherence than those intended to be 6 or 8 weeks in duration. CONCLUSIONS Gamification features have been incorporated into the design of interventions designed to treat CMD and well-being. Further research is needed to improve understanding of gamification features on adherence and engagement in order to inform the design of future Web-based health interventions in which adherence to treatment is of concern. Conclusions were limited by varied reporting of adherence and usage data.
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Affiliation(s)
- Menna Brown
- Swansea University, Medical School, Swansea, United Kingdom.
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Issa T, Isaias P. Internet factors influencing generations Y and Z in Australia and Portugal: A practical study. Inf Process Manag 2016. [DOI: 10.1016/j.ipm.2015.12.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Touloumakos AK, Goozée R, Papadatou-Pastou M, Barley E, Haddad M, Tzotzoli P. Online support system for students in higher education: Proof-of-concept study. Digit Health 2016; 2:2055207616655012. [PMID: 29942560 PMCID: PMC6001197 DOI: 10.1177/2055207616655012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 05/20/2016] [Indexed: 11/16/2022] Open
Abstract
Background Providing support to the increasing numbers of students facing mental health difficulties in higher education (HE) can be difficult due to stigma or lack of resources. Alternative and/or complementary sources of support are needed, such as online interventions that are recognised for their therapeutic value and cost-effectiveness. Objectives We aim to provide evidence supporting the conceptual and practical value of a newly developed online multimedia intervention system for HE students who face mild to moderate symptoms of anxiety and depression and study-skills difficulties. Methods Students from five universities were invited to participate in a cross-sectional proof-of-concept study. Students were invited through the universities’ internal communication channels. Following demonstration of each part of the system, students completed a survey with quantitative and qualitative questions. Results Response was largely positive. Positive responses on the features of the questionnaire ranged between 65% and 86%; on the features of the workshops ranged between 57% and 91%; on ‘My place’ ranged between 65% and 79%; on the animated videos ranged between 79% and 92%; and on the overall system ranged between 78% and 89%. Participants indicated areas for improvement and ways in which such improvement could be accomplished; these then guided the development of the system. Conclusions The results confirm the need for such a system. It can complement student support services (SSS) by dealing with cases with mild to moderate difficulties, hence allowing SSS to prioritise and effectively address more severe cases. Potentially this method can provide a meaningful alternative to SSS; this is worth investigating further.
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Affiliation(s)
- Anna K Touloumakos
- Business College of Athens, Greece.,Centre for Skills, Knowledge and Organisational Performance, Oxford University, UK
| | - Rhianna Goozée
- Department of Psychosis Studies, King's College London, UK
| | - Marietta Papadatou-Pastou
- Research Centre for Psychophysiology and Education, National and Kapodistrian University of Athens, Greece.,Cognition and Health Research Group, University of Oxford, UK
| | - Elizabeth Barley
- Florence Nightingale Faculty of Nursing and Midwifery, King's College London, UK
| | - Mark Haddad
- School of Health Sciences, City University London, UK
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Realising the technological promise of smartphones in addiction research and treatment: An ethical review. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 36:47-57. [PMID: 27455467 DOI: 10.1016/j.drugpo.2016.05.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Revised: 05/25/2016] [Accepted: 05/25/2016] [Indexed: 01/20/2023]
Abstract
BACKGROUND Smartphone technologies and mHealth applications (or apps) promise unprecedented scope for data collection, treatment intervention, and relapse prevention when used in the field of substance abuse and addiction. This potential also raises new ethical challenges that researchers, clinicians, and software developers must address. AIMS This paper aims to identify ethical issues in the current uses of smartphones in addiction research and treatment. METHODS A search of three databases (PubMed, Web of Science and PsycInfo) identified 33 studies involving smartphones or mHealth applications for use in the research and treatment of substance abuse and addiction. A content analysis was conducted to identify how smartphones are being used in these fields and to highlight the ethical issues raised by these studies. RESULTS Smartphones are being used to collect large amounts of sensitive information, including personal information, geo-location, physiological activity, self-reports of mood and cravings, and the consumption of illicit drugs, alcohol and nicotine. Given that detailed information is being collected about potentially illegal behaviour, we identified the following ethical considerations: protecting user privacy, maximising equity in access, ensuring informed consent, providing participants with adequate clinical resources, communicating clinically relevant results to individuals, and the urgent need to demonstrate evidence of safety and efficacy of the technologies. CONCLUSIONS mHealth technology offers the possibility to collect large amounts of valuable personal information that may enhance research and treatment of substance abuse and addiction. To realise this potential researchers, clinicians and app-developers must address these ethical concerns to maximise the benefits and minimise risks of harm to users.
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Ashford MT, Olander EK, Ayers S. Computer- or web-based interventions for perinatal mental health: A systematic review. J Affect Disord 2016; 197:134-46. [PMID: 26991368 DOI: 10.1016/j.jad.2016.02.057] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 02/12/2016] [Accepted: 02/26/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Treating prenatal mental health issues is of great importance, but access to treatment is often poor. One way of accessing treatment is through computer- or web-based interventions. Reviews have shown that these interventions can be effective for a variety of mental health disorder across different populations. However, their effectiveness for women in the perinatal period has not been reviewed. This review therefore aimed to provide a first overview of computer- or web-based interventions for women's perinatal mental health issues by systematically identifying and reviewing their characteristics and efficacy. METHODS Twelve electronic databases were searched for published and unpublished literature using keywords, supplemented by hand searches. Data were extracted for characteristics of the intervention and the study, study findings and the methodological quality was assessed. RESULTS The majority of the eleven eligible studies were randomized controlled trials. Interventions were targeted at depression, stress, and complicated grief during the antenatal or postpartum period or the time after pregnancy loss. Findings suggest that computer- or web-based interventions targeted at improving mental health, especially depression and complicated grief, may be effective. LIMITATIONS Findings and their generalizability is limited by the heterogeneity of reviewed interventions and study designs, as well as methodological limitations. CONCLUSIONS This systematic review constitutes the first synthesis of research on computer- or web-based interventions for perinatal mental health issues and provides preliminary support that this could be a promising form of treatment during this period. However, there are significant gaps in the current evidence-base so further research is needed.
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Affiliation(s)
- Miriam T Ashford
- Centre for Maternal and Child Health Research, City University, London, UK.
| | - Ellinor K Olander
- Centre for Maternal and Child Health Research, City University, London, UK
| | - Susan Ayers
- Centre for Maternal and Child Health Research, City University, London, UK
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Ruzek JI, Kuhn E, Jaworski BK, Owen JE, Ramsey KM. Mobile mental health interventions following war and disaster. Mhealth 2016; 2:37. [PMID: 28293610 PMCID: PMC5344166 DOI: 10.21037/mhealth.2016.08.06] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 08/22/2016] [Indexed: 01/18/2023] Open
Abstract
Mobile technologies offer potentially critical ways of delivering mental health support to those experiencing war, ethnic conflict, and human-caused and natural disasters. Research on Internet interventions suggests that effective mobile mental health technologies can be developed, and there are early indications that they will be acceptable to war and disaster survivors, and prove capable of greatly increasing the reach of mental health services. Promising mhealth interventions include video teleconferencing, text messaging, and smartphone-based applications. In addition, a variety of social media platforms has been used during and immediately after disasters to increase agility in responding, and strengthen community and individual resilience. Globally, PTSD Coach has been downloaded over 243,000 times in 96 countries, and together with large-scale use of social media for communication during disasters, suggests the potential for reach of app technology. In addition to enabling improved self-management of post-trauma problems, mobile phone interventions can also enhance delivery of face-to-face care by mental health providers and increase the effectiveness of peer helpers and mutual aid organizations. More research is needed to establish the efficacy of mhealth interventions for those affected by war and disaster. Research should also focus on the identification of active elements and core processes of change, determination of effective ways of increasing adoption and engagement, and explore ways of combining the various capabilities of mobile technologies to maximize their impact.
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Affiliation(s)
- Josef I Ruzek
- National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - Eric Kuhn
- National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - Beth K Jaworski
- National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - Jason E Owen
- National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, USA
| | - Kelly M Ramsey
- National Center for PTSD, VA Palo Alto Health Care System, Menlo Park, CA, USA
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Ruggiero KJ, Bunnell BE, Andrews Iii AR, Davidson TM, Hanson RF, Danielson CK, Saunders BE, Soltis K, Yarian C, Chu B, Adams ZW. Development and Pilot Evaluation of a Tablet-Based Application to Improve Quality of Care in Child Mental Health Treatment. JMIR Res Protoc 2015; 4:e143. [PMID: 26717906 PMCID: PMC4712346 DOI: 10.2196/resprot.4416] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 06/29/2015] [Accepted: 06/29/2015] [Indexed: 12/03/2022] Open
Abstract
Background Children need access to high quality mental health care. Effective treatments now exist for a wide range of mental health conditions. However, these interventions are delivered with variable effectiveness in traditional mental health service settings. Innovative solutions are needed to improve treatment delivery quality and effectiveness. Objective The aim of this study was to develop a scalable, sustainable technology-based approach to improve the quality of care in child mental health treatment. Methods A tablet-based resource was developed with input from mental health training experts, mental health providers, and patients. A series of qualitative data collection phases (ie, expert interviews, patient and provider focus groups, usability testing) guided the initial concept and design of the resource, and then its refinement. The result was an iPad-based “e-workbook” designed to improve child engagement and provider fidelity in implementation of a best-practice treatment. We are currently conducting a small scale randomized controlled trial to evaluate the feasibility of e-workbook facilitated child mental health treatment with 10 providers and 20 families recruited from 4 local community-based mental health clinics. Results Usability and focus group testing yielded a number of strong, favorable reactions from providers and families. Recommendations for refining the e-workbook also were provided, and these guided several improvements to the resource prior to initiating the feasibility trial, which is currently underway. Conclusions This study aimed to develop and preliminarily evaluate a tablet-based application to improve provider fidelity and child engagement in child mental health treatment. If successful, this approach may serve as a key step toward making best-practice treatment more accessible to children and families. As various technologies continue to increase in popularity worldwide and within the health care field more specifically, it is essential to rigorously test the usability, feasibility, acceptability, and effectiveness of novel health technology solutions. It is also essential to ensure that patients and providers drive decision making that supports the development of these resources to ensure that they can be seamlessly integrated into practice. Trial Registration Clinicaltrials.gov NCT01915160; https://clinicaltrials.gov/ct2/show/NCT01915160 (Archived by WebCite at http://www.webcitation.org/6cPIiQDpu)
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Affiliation(s)
- Kenneth J Ruggiero
- Technology Applications Center for Healthful Lifestyles, College of Nursing, Medical University of South Carolina, Charleston, SC, United States.
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Abstract
During the past 15 years, much progress has been made in developing and testing Internet-delivered psychological treatments. In particular, therapist-guided Internet treatments have been found to be effective for a wide range of psychiatric and somatic conditions in well over 100 controlled trials. These treatments require (a) a secure web platform, (b) robust assessment procedures, (c) treatment contents that can be text based or offered in other formats, and (d) a therapist role that differs from that in face-to-face therapy. Studies suggest that guided Internet treatments can be as effective as face-to-face treatments, lead to sustained improvements, work in clinically representative conditions, and probably are cost-effective. Despite these research findings, Internet treatment is not yet disseminated in most places, and clinical psychologists should consider using modern information technology and evidence-based treatment programs as a complement to their other services, even though there will always be clients for whom face-to-face treatment is the best option.
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Affiliation(s)
- Gerhard Andersson
- Department of Behavioural Sciences and Learning, Linköping University, Campus Valla, Linköping SE-581 83, Sweden;
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Abstract
Abstract. The last several decades have witnessed a substantial increase in the number of individuals suffering from both diagnosable and subsyndromal mental health problems. Consequently, the development of cost-effective treatment methods, accessible to large populations suffering from different forms of mental health problems, became imperative. A very promising intervention is the method of expressive writing (EW), which may be used in both clinically diagnosable cases and subthreshold symptomatology. This method, in which people express their feelings and thoughts related to stressful situations in writing, has been found to improve participants’ long-term psychological, physiological, behavioral, and social functioning. Based on a thorough analysis and synthesis of the published literature (also including most recent meta-analyses), the present paper presents the expressive writing method, its short- and long-term, intra-and interpersonal effects, different situations and conditions in which it has been proven to be effective, the most important mechanisms implied in the process of recovery, advantages, disadvantages, and possible pitfalls of the method, as well as variants of the original technique and future research directions.
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Affiliation(s)
- Éva Kállay
- Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
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Ruggiero KJ, Price M, Adams Z, Stauffacher K, McCauley J, Danielson CK, Knapp R, Hanson RF, Davidson TM, Amstadter AB, Carpenter MJ, Saunders BE, Kilpatrick DG, Resnick HS. Web Intervention for Adolescents Affected by Disaster: Population-Based Randomized Controlled Trial. J Am Acad Child Adolesc Psychiatry 2015; 54:709-17. [PMID: 26299292 PMCID: PMC4548271 DOI: 10.1016/j.jaac.2015.07.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 07/01/2015] [Accepted: 07/06/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the efficacy of Bounce Back Now (BBN), a modular, Web-based intervention for disaster-affected adolescents and their parents. METHOD A population-based randomized controlled trial used address-based sampling to enroll 2,000 adolescents and parents from communities affected by tornadoes in Joplin, MO, and several areas in Alabama. Data collection via baseline and follow-up semi-structured telephone interviews was completed between September 2011 and August 2013. All families were invited to access the BBN study Web portal irrespective of mental health status at baseline. Families who accessed the Web portal were assigned randomly to 1 of 3 groups: BBN, which featured modules for adolescents and parents targeting adolescents' mental health symptoms; BBN plus additional modules targeting parents' mental health symptoms; or assessment only. The primary outcomes were adolescent symptoms of posttraumatic stress disorder (PTSD) and depression. RESULTS Nearly 50% of families accessed the Web portal. Intent-to-treat analyses revealed time × condition interactions for PTSD symptoms (B = -0.24, SE = 0.08, p < .01) and depressive symptoms (B = -0.23, SE = 0.09, p < .01). Post hoc comparisons revealed fewer PTSD and depressive symptoms for adolescents in the experimental versus control conditions at 12-month follow-up (PTSD: B = -0.36, SE = 0.19, p = .06; depressive symptoms: B = -0.42, SE = 0.19, p = 0.03). A time × condition interaction also was found that favored the BBN versus BBN + parent self-help condition for PTSD symptoms (B = 0.30, SE = 0.12, p = .02) but not depressive symptoms (B = 0.12, SE = 0.12, p = .33). CONCLUSION Results supported the feasibility and initial efficacy of BBN as a scalable disaster mental health intervention for adolescents. Technology-based solutions have tremendous potential value if found to reduce the mental health burden of disasters. CLINICAL TRIAL REGISTRATION INFORMATION Web-based Intervention for Disaster-Affected Youth and Families; http://clinicaltrials.gov; NCT01606514.
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Affiliation(s)
- Kenneth J Ruggiero
- Medical University of South Carolina (MUSC) and the Ralph H. Johnson VA Medical Center, Charleston, SC.
| | | | | | | | | | | | | | | | - Tatiana M Davidson
- Medical University of South Carolina (MUSC) and the Ralph H. Johnson VA Medical Center, Charleston, SC
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A meta-review of Internet computer-based psychological treatments for anxiety disorders. J Telemed Telecare 2015; 22:3-11. [DOI: 10.1177/1357633x15586491] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Accepted: 04/20/2015] [Indexed: 12/18/2022]
Abstract
Introduction Internet computer-based psychological treatments have enjoyed rapid growth. Today, there are a number of them available for many mental disorders and psychological problems. Internet-based psychological treatments for anxiety disorders and phobias are amongst the most frequently observed. Treatment results with these resources are promising, but inconclusive. Methods This paper reviews 11 systematic reviews and meta-analyses about the efficacy of Internet-based psychological treatments for anxiety disorders, including studies and clinical trials covering the majority of anxiety disorders and phobias, usually with adult patient samples. Results In general, these reviews agree on the efficacy of Internet-based psychological treatment as compared with non-treatment groups (with large effect sizes), finding similar efficacy compared with face-to-face therapies. Internet-based psychological treatments are further improved when combined with some type of therapist contact. On the negative side, some systematic reviews highlight high attrition rates of Internet-based psychological treatments. Discussion These findings remain inconclusive and more refined reviews (involving patient samples, therapy comparisons, type of therapist contact, etc.) are needed, in order to establish the scope and limits of Internet-based psychological treatments for anxiety disorders.
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