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Patrickson B, Shams L, Fouyaxis J, Strobel J, Schubert KO, Musker M, Bidargaddi N. Evolving Adult ADHD Care: Preparatory Evaluation of a Prototype Digital Service Model Innovation for ADHD Care. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:582. [PMID: 38791796 PMCID: PMC11121032 DOI: 10.3390/ijerph21050582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/10/2024] [Accepted: 04/14/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Given the prevalence of ADHD and the gaps in ADHD care in Australia, this study investigates the critical barriers and driving forces for innovation. It does so by conducting a preparatory evaluation of an ADHD prototype digital service innovation designed to help streamline ADHD care and empower individual self-management. METHODS Semi-structured interviews with ADHD care consumers/participants and practitioners explored their experiences and provided feedback on a mobile self-monitoring app and related service innovations. Interview transcripts were double coded to explore thematic barriers and the enablers for better ADHD care. RESULTS Fifteen interviews (9 consumers, 6 practitioners) revealed barriers to better ADHD care for consumers (ignorance and prejudice, trust, impatience) and for practitioners (complexity, sustainability). Enablers for consumers included validation/empowerment, privacy, and security frameworks, tailoring, and access. Practitioners highlighted the value of transparency, privacy and security frameworks, streamlined content, connected care between services, and the tailoring of broader metrics. CONCLUSIONS A consumer-centred approach to digital health service innovation, featuring streamlined, private, and secure solutions with enhanced mobile tools proves instrumental in bridging gaps in ADHD care in Australia. These innovations should help to address the gaps in ADHD care in Australia. These innovations should encompass integrated care, targeted treatment outcome data, and additional lifestyle support, whilst recognising the tensions between customised functionalities and streamlined displays.
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Affiliation(s)
- Bronwin Patrickson
- Digital Health Research Lab, College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia; (L.S.); (J.F.); (J.S.)
| | - Lida Shams
- Digital Health Research Lab, College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia; (L.S.); (J.F.); (J.S.)
| | - John Fouyaxis
- Digital Health Research Lab, College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia; (L.S.); (J.F.); (J.S.)
| | - Jörg Strobel
- Digital Health Research Lab, College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia; (L.S.); (J.F.); (J.S.)
- Division of Mental Health, Barossa Hills Fleurieu Local Health Network, 29 North St, Angaston 5353, Australia
| | - Klaus Oliver Schubert
- Division of Mental Health, Northern Adelaide Local Health Network, 7-9 Park Terrace, Salisbury 5108, Australia;
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, North Terrace, Adelaide 5005, Australia
- The Headspace Adelaide Early Psychosis, Sonder, 173 Wakefield St, Adelaide 5000, Australia
| | - Mike Musker
- Clinical Health Sciences, Mental Health and Suicide Prevention Research and Education Group, University of South Australia, City East, Centenary Building, North Terrace, Adelaide 5000, Australia;
| | - Niranjan Bidargaddi
- Digital Health Research Lab, College of Medicine and Public Health, Flinders University, Adelaide 5042, Australia; (L.S.); (J.F.); (J.S.)
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Robledo-Castro C, Lerma-Castaño PR, Bonilla-Santos G. Effect of Cognitive Training Programs Based on Computer Systems on Executive Functions in Children With ADHD: A Systematic Review. J Atten Disord 2023; 27:1467-1487. [PMID: 37477014 DOI: 10.1177/10870547231187164] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
BACKGROUND The purpose of this systematic review is to synthesize the existing literature reporting the effects of computerized cognitive trainings on the executive functions of children with ADHD. METHOD A systematic review was carried out following the PRISMA statement; the primary sources used were five electronic databases (Scopus, Science Direct, Pubmed, Springer, Taylor & Francis). RESULTS 20 articles met the eligibility criteria, data on the training characteristics and the effects on executive functions were extracted, followed by an analysis of bias and the methodological quality of the studies. The results of the studies were widely heterogeneous, largely associated with the variety of training programs and the measurement instruments used. The most studied executive functions were working memory and inhibitory control. Some of the studies reported that the intervention led to significant effects on working memory and attention (N = 7), and improvements in inhibitory control (N = 5) and planning (N = 4) were also reported. At the same time, others did not report the effects of the intervention on these processes. The assessment of the quality of the evidence showed important risk biases among the reviewed studies. CONCLUSION Some training based on computer systems showed positive effects on the executive functions of working memory, attention, and inhibitory control in children with ADHD. However, other training sessions did not show significant effects. In general, the evidence shows mixed results, a high diversity of measurement instruments, and high risks of bias between the studies. Therefore, the evidence has not been consistent about the general benefits of computerized training on the executive functions of children with ADHD.
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Affiliation(s)
| | - Piedad Rocio Lerma-Castaño
- Universidad Autónoma de Manizales, Caldas, Colombia
- Fundación Universitaria María Cano, Neiva Huila, Colombia
| | - Gisella Bonilla-Santos
- Fundación Universitaria María Cano, Neiva Huila, Colombia
- Universidad Surcolombiana, Neiva, Colombia
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Selaskowski B, Reiland M, Schulze M, Aslan B, Kannen K, Wiebe A, Wallbaum T, Boll S, Lux S, Philipsen A, Braun N. Chatbot-supported psychoeducation in adult attention-deficit hyperactivity disorder: randomised controlled trial. BJPsych Open 2023; 9:e192. [PMID: 37827996 PMCID: PMC10594162 DOI: 10.1192/bjo.2023.573] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 08/02/2023] [Accepted: 08/31/2023] [Indexed: 10/14/2023] Open
Abstract
BACKGROUND Although psychoeducation is generally recommended for the treatment of adult attention-deficit hyperactivity disorder (ADHD), participation in clinical psychoeducation groups is impeded by waiting times and the constrained number of patients who can simultaneously attend a group. Digital psychoeducation attempts are promising, but the rapidly expanding number of apps lack evidence and are mostly limited to only a few implemented interactive elements. AIMS To determine the potential of digital, self-guided psychoeducation for adult ADHD, a newly developed interactive chatbot was compared with a previously validated, conventional psychoeducation app. METHOD Forty adults with ADHD were randomised, of whom 17 participants in each group completed self-guided psychoeducation based on either a chatbot or conventional psychoeducation app between October 2020 and July 2021. ADHD core symptoms were assessed before and after the 3-week interventions, using both the blinded observer-rated Integrated Diagnosis of ADHD in Adulthood interview and the self-rated ADHD Self-Assessment Scale (ADHS-SB). RESULTS Observer- and patient-rated ADHD symptoms were significantly reduced from pre- to post-intervention (observer-rated: mean difference -6.18, 95% CI -8.06 to -4.29; patient-rated: mean difference -2.82, 95% CI -4.98 to -0.67). However, there were no group × intervention interaction effects that would indicate a stronger therapeutic benefit of one of the interventions. Likewise, administered psychoeducational knowledge quizzes did not show differences between the groups. No adverse events were reported. CONCLUSIONS Self-guided psychoeducation based on a chatbot or a conventional app appears similarly effective and safe for improving ADHD core symptoms. Future research should compare additional control interventions and examine patient-related outcomes and usability preferences in detail.
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Affiliation(s)
| | - Meike Reiland
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Germany
| | - Marcel Schulze
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Germany
| | - Behrem Aslan
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Germany
| | - Kyra Kannen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Germany
| | - Annika Wiebe
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Germany
| | - Torben Wallbaum
- Department of Information and Communication, Flensburg University of Applied Sciences, Germany
| | - Susanne Boll
- Department of Computing Science, University of Oldenburg, Germany
| | - Silke Lux
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Germany
| | - Alexandra Philipsen
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Germany
| | - Niclas Braun
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Germany
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Tsirmpas C, Nikolakopoulou M, Kaplow S, Andrikopoulos D, Fatouros P, Kontoangelos K, Papageorgiou C. A Digital Mental Health Support Program for Depression and Anxiety in Populations With Attention-Deficit/Hyperactivity Disorder: Feasibility and Usability Study. JMIR Form Res 2023; 7:e48362. [PMID: 37819688 PMCID: PMC10600652 DOI: 10.2196/48362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 07/27/2023] [Accepted: 08/20/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND A total of 1 in 2 adults with attention-deficit/hyperactivity disorder (ADHD) struggles with major depressive or anxiety disorders. The co-occurrence of these disorders adds to the complexity of finding utility in as well as adherence to a treatment option. Digital therapeutic solutions may present a promising alternative treatment option that could mitigate these challenges and alleviate symptoms. OBJECTIVE This study aims to investigate (1) the feasibility and acceptance of a digital mental health intervention, (2) participants' engagement and retention levels, and (3) the potential efficacy with respect to anxiety and depression symptoms in a population with ADHD. Our main hypothesis was that a digital, data-driven, and personalized intervention for adults with coexisting ADHD and depressive or anxiety symptoms would show high engagement and adherence, which would be accompanied by a decrease in depressive and anxiety symptoms along with an increase in quality of life and life satisfaction levels. METHODS This real-world data, single-arm study included 30 adult participants with ADHD symptomatology and coexisting depressive or anxiety symptoms who joined a 16-week digital, data-driven mental health support program. This intervention is based on a combination of evidence-based approaches such as cognitive behavioral therapy, mindfulness, and positive psychology techniques. The targeted symptomatology was evaluated using the Patient Health Questionnaire-9, Generalized Anxiety Disorder-7, and Barkley Adult ADHD Rating Scale-IV. Quality of life aspects were evaluated using the Satisfaction With Life Scale and the Life Satisfaction Questionnaire, and user feedback surveys were used to assess user experience and acceptability. RESULTS The study retention rate was 97% (29/30), and high engagement levels were observed, as depicted by the 69 minutes spent on the app per week, 5 emotion logs per week, and 11.5 mental health actions per week. An average decrease of 46.2% (P<.001; r=0.89) in depressive symptoms and 46.4% (P<.001; r=0.86) in anxiety symptoms was observed, with clinically significant improvement for more than half (17/30, 57% and 18/30, 60%, respectively) of the participants. This was followed by an average increase of 23% (P<.001; r=0.78) and 20% (P=.003; r=0.8) in Satisfaction With Life Scale and Life Satisfaction Questionnaire scores, respectively. The overall participant satisfaction level was 4.3 out of 5. CONCLUSIONS The findings support the feasibility, acceptability, and value of the examined digital program for adults with ADHD symptomatology to address the coexisting depressive or anxiety symptoms. However, controlled trials with larger sample sizes and more diverse participant profiles are required to provide further evidence of clinical efficacy.
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Affiliation(s)
| | | | - Sharon Kaplow
- Feel Therapeutics Inc., San Francisco, CA, United States
| | | | | | - Konstantinos Kontoangelos
- First Department of Psychiatry, Eginition Hospital, Medical School National and Kapodistrian University of Athens, Athens, Greece
- Neurosciences and Precision Medicine Research Institute "Costas Stefanis", University Mental Health, Athens, Greece
| | - Charalabos Papageorgiou
- Neurosciences and Precision Medicine Research Institute "Costas Stefanis", University Mental Health, Athens, Greece
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Murray A, Speyer L, Thye M, Stewart T, Obsuth I, Kane J, Whyte K, Devaney J, Rohde LA, Ushakova A, Rhodes S. Illuminating the daily life experiences of adolescents with and without ADHD: protocol for an ecological momentary assessment study. BMJ Open 2023; 13:e077222. [PMID: 37775284 PMCID: PMC10546102 DOI: 10.1136/bmjopen-2023-077222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 08/31/2023] [Indexed: 10/01/2023] Open
Abstract
INTRODUCTION Adolescents with attention-deficit/hyperactivity disorder (ADHD) are at elevated risk of a range of difficulties, among which emotion regulation, peer and co-occurring mental health problems are prominent challenges. To better support adolescents with ADHD, ecologically valid interventions that can be embedded in daily life to target the most proximal antecedents of these challenges are needed. Ecological momentary assessment (EMA) designs are ideally suited to meeting this need. METHODS AND ANALYSES In the mental health in the moment ADHD study, we will use an EMA design to capture the daily life experiences of approximately 120 adolescents aged 11-14 years with a clinical diagnosis of ADHD and the same number of age-matched and gender-matched peers without a diagnosis of ADHD. We will combine this with comprehensive information gathered from online surveys. Analysing the data using techniques such as dynamic structural equation modelling, we will examine, among other research questions, the role of emotion regulation and peer problems in mediating the links between characteristics of ADHD and commonly co-occurring outcomes such as anxiety, depression and conduct problems. The results can help inform interventions to support improved peer functioning and emotion regulation for adolescents with ADHD. ETHICS AND DISSEMINATION This study received a favourable ethical opinion through the National Health Service ethical review board and the University of Edinburgh PPLS Research Ethics panel. The results will be disseminated through journal publications, conferences and seminar presentations and to relevant stakeholders, such as those with ADHD, their families and clinicians.
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Affiliation(s)
- Aja Murray
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Lydia Speyer
- Department of Psychology, Lancaster University, Edinburgh, UK
| | - Melissa Thye
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Tracy Stewart
- Moray House of Education and Sport, University of Edinburgh, Edinburgh, UK
| | - Ingrid Obsuth
- Clinical and Health Psychology Department, University of Edinburgh, Edinburgh, UK
| | - Jennifer Kane
- Clinical and Health Psychology Department, University of Edinburgh, Edinburgh, UK
| | - Katie Whyte
- Department of Psychology, St Andrew's University, St Andrews, UK
| | - John Devaney
- School of Social and Political Science, University of Edinburgh, Edinburgh, UK
| | - Luis Augusto Rohde
- ADHD Outpatient Program and Developmental Psychiatry Program, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- National Institute of Developmental Psychiatry & National Center for Research and Innovation in Mental Health, Sao Paolo, Brazil
- UniEduk, Brazil, Brazil
| | - Anastasia Ushakova
- Centre for Computing, Health Informatics and Statistics, Lancaster University, Lancaster, UK
| | - Sinead Rhodes
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
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Forsström D, Oscarsson M, Buhrman M, Rozental A. A study protocol of a randomized controlled study of internet-based cognitive behavioral therapy for adult attention deficit hyperactivity disorder. Internet Interv 2023; 33:100652. [PMID: 37529408 PMCID: PMC10388197 DOI: 10.1016/j.invent.2023.100652] [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: 01/02/2023] [Revised: 07/17/2023] [Accepted: 07/19/2023] [Indexed: 08/03/2023] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a disorder characterized by hyperactivity, impulsivity and lack of attention. It can have a major impact on everyday life and result in negative consequences for one's personal, academic, and work situation. For individuals with symptoms of ADHD, increased levels of anxiety and depression are common, and an overall reduction of quality of life is often present. This study protocol describes a clinical trial of internet-based cognitive behavioral therapy (iCBT), using a randomized controlled study design, with the primary aim to increase quality of life, as well as to reduce symptoms of ADHD, anxiety, depression, and stress. A second aim is to investigate, by qualitative means, what aspects of treatment were perceived as helpful and hindering when it comes to completing iCBT. Two hundred participants with symptoms of ADHD will be included and randomized to two conditions (treatment and wait-list control). The treatment period is comprised of a maximum of ten weeks, with two mandatory modules and ten modules from which the participants can choose freely. Self-report measures will be completed by the participants at baseline and end of treatment, as well as at a six-month follow-up. The treatment is guided by therapists and consists of weekly correspondence with the participants. The study will utilize an intention to treat design, with ANOVAs and Reliable Change Index to evaluate treatment effects. The qualitative part of the project will be interview-based and employ thematic analysis. Lastly, a psychometric evaluation of a common instrument for determining ADHD-symptoms will also be made. The results will hopefully contribute to the evidence base for iCBT for individuals with symptoms of ADHD and help disseminate potentially effective interventions.
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Affiliation(s)
- David Forsström
- Department of Psychology, Uppsala University, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
- Department of Psychology, Stockholm University, Sweden
| | | | | | - Alexander Rozental
- Department of Psychology, Uppsala University, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden
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Douet Vannucci V, Marchand T, Hennequin A, Caci H, Staccini P. The EPIDIA4Kids protocol for a digital epidemiology study on brain functioning in children, based on a multimodality biometry tool running on an unmodified tablet. Front Public Health 2023; 11:1185565. [PMID: 37325324 PMCID: PMC10267880 DOI: 10.3389/fpubh.2023.1185565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 04/28/2023] [Indexed: 06/17/2023] Open
Abstract
Introduction Neurodevelopment and related mental disorders (NDDs) are one of the most frequent disabilities among young people. They have complex clinical phenotypes often associated with transnosographic dimensions, such as emotion dysregulation and executive dysfunction, that lead to adverse impacts in personal, social, academic, and occupational functioning. Strong overlap exists then across NDDs phenotypes that are challenging for diagnosis and therapeutic intervention. Recently, digital epidemiology uses the rapidly growing data streams from various devices to advance our understanding of health's and disorders' dynamics, both in individuals and the general population, once coupled with computational science. An alternative transdiagnostic approach using digital epidemiology may thus better help understanding brain functioning and hereby NDDs in the general population. Objective The EPIDIA4Kids study aims to propose and evaluate in children, a new transdiagnostic approach for brain functioning examination, combining AI-based multimodality biometry and clinical e-assessments on an unmodified tablet. We will examine this digital epidemiology approach in an ecological context through data-driven methods to characterize cognition, emotion, and behavior, and ultimately the potential of transdiagnostic models of NDDs for children in real-life practice. Methods and analysis The EPIDIA4Kids is an uncontrolled open-label study. 786 participants will be recruited and enrolled if eligible: they are (1) aged 7 to 12 years and (2) are French speaker/reader; (3) have no severe intellectual deficiencies. Legal representative and children will complete online demographic, psychosocial and health assessments. During the same visit, children will perform additionally a paper/pencil neuro-assessments followed by a 30-min gamified assessment on a touch-screen tablet. Multi-stream data including questionnaires, video, audio, digit-tracking, will be collected, and the resulting multimodality biometrics will be generated using machine- and deep-learning algorithms. The trial will start in March 2023 and is expected to end by December 2024. Discussion We hypothesize that the biometrics and digital biomarkers will be capable of detecting early onset symptoms of neurodevelopment compared to paper-based screening while as or more accessible in real-life practice.
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Affiliation(s)
- Vanessa Douet Vannucci
- R&D Lab, O-Kidia, Nice, France
- URE Risk Epidemiology Territory INformatics Education and Health (URE RETINES), Université Côte d’Azur, Nice, France
| | - Théo Marchand
- R&D Lab, O-Kidia, Nice, France
- Bioelectronic Lab, Ecole des Mines de Saint-Étienne, Gardanne, France
| | | | - Hervé Caci
- Hôpitaux Pédiatriques de Nice CHU Lenval, Nice, France
- Centre de Recherche en Épidémiologie and Santé des Populations (CESP), INSERM U1018, Villejuif, France
| | - Pascal Staccini
- URE Risk Epidemiology Territory INformatics Education and Health (URE RETINES), Université Côte d’Azur, Nice, France
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Corrigan N, Păsărelu CR, Voinescu A. Immersive virtual reality for improving cognitive deficits in children with ADHD: a systematic review and meta-analysis. VIRTUAL REALITY 2023; 27:1-20. [PMID: 36845650 PMCID: PMC9938513 DOI: 10.1007/s10055-023-00768-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Accepted: 02/05/2023] [Indexed: 06/17/2023]
Abstract
Virtual reality (VR) shows great potential in treating and managing various mental health conditions. This includes using VR for training or rehabilitation purposes. For example, VR is being used to improve cognitive functioning (e.g. attention) among children with attention/deficit-hyperactivity disorder (ADHD). The aim of the current review and meta-analysis is to evaluate the effectiveness of immersive VR-based interventions for improving cognitive deficits in children with ADHD, to investigate potential moderators of the effect size and assess treatment adherence and safety. The meta-analysis included seven randomised controlled trials (RCTs) of children with ADHD comparing immersive VR-based interventions with controls (e.g. waiting list, medication, psychotherapy, cognitive training, neurofeedback and hemoencephalographic biofeedback) on measures of cognition. Results indicated large effect sizes in favour of VR-based interventions on outcomes of global cognitive functioning, attention, and memory. Neither intervention length nor participant age moderated the effect size of global cognitive functioning. Control group type (active vs passive control group), ADHD diagnostic status (formal vs. informal) and novelty of VR technology were not significant moderators of the effect size of global cognitive functioning. Treatment adherence was similar across groups and there were no adverse effects. Results should be cautiously interpreted given the poor quality of included studies and small sample.
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Affiliation(s)
- Niamh Corrigan
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY UK
| | - Costina-Ruxandra Păsărelu
- Department of Clinical Psychology and Psychotherapy, The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babe-Bolyai University, No.37, Republicii Street, 400015 Cluj-Napoca, Romania
| | - Alexandra Voinescu
- Department of Psychology, University of Bath, Claverton Down, Bath, BA2 7AY UK
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The Development and Usability of a Mobile App for Parents of Children with ADHD. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10010164. [PMID: 36670714 PMCID: PMC9857426 DOI: 10.3390/children10010164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/10/2023] [Accepted: 01/11/2023] [Indexed: 01/17/2023]
Abstract
BACKGROUND Attention-Deficit/ Hyperactivity Disorder (ADHD) is one of the most prevalent mental health problems in children. Behavioral parent training (BPT) is the first-line treatment recommended by clinical guidelines; however, parental dropout is high. Mobile apps could be used as an adjunct to BPT in order to increase treatment adherence, homework compliance, and parental engagement. In this paper, we describe the development process of a mobile app for parents of children with ADHD. METHODS We conducted a study to investigate parents' perceived usability of the ADHD Coping Card. RESULTS The mobile app developed has a high usability. Future improvements in the app were suggested by parents. CONCLUSIONS Given the increasing importance of digital mental health interventions in psychotherapy, it is important that future research is conducted with a higher number of participants to investigate the key factors implicated in choosing such an intervention in the future, both by parents and by mental health specialists. A mobile app can be used as an add-on in psychotherapy with parents of children with ADHD. Digital health interventions could help surpass gaps in treatment access for child mental health problems.
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Păsărelu CR, David D, Dobrean A, Noje A, Roxana Ș, Predescu E. ADHDCoach-a virtual clinic for parents of children with ADHD: Development and usability study. Digit Health 2023; 9:20552076231161963. [PMID: 36923370 PMCID: PMC10009016 DOI: 10.1177/20552076231161963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2022] [Accepted: 02/17/2023] [Indexed: 03/12/2023] Open
Abstract
Attention-deficit/ hyperactivity disorder (ADHD) is one of the most common mental health problems in childhood. Despite the fact that evidence-based treatments exist, behavioral parent training programs are the gold standard in the care of children with ADHD, a significant percentage of parents of children with ADHD do not access such interventions. Internet-delivered interventions are effective for a range of mental health problems, however, there is limited research conducted on the efficacy of such interventions in the treatment of ADHD. Objective: The aim of this study is to present the development and feasibility of an Internet-delivered intervention for parents of children with ADHD. Methods: The intervention was based on Behavioral Parent Training and Rational Emotive Behavior Therapy. Participants were mental health specialists (N = 16) and parents of children diagnosed with ADHD (N = 24). Results: Our results indicated high usability and parental satisfaction with the intervention. Conclusion: In conclusion, an Internet-delivered intervention addressed to parents of children diagnosed with ADHD is a promising approach. Future research should investigate the efficacy of this Internet-delivered intervention in a randomized controlled trial.
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Affiliation(s)
- Costina-Ruxandra Păsărelu
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania.,The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Daniel David
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania.,The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Anca Dobrean
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania.,The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Cluj-Napoca, Romania
| | - Alexandru Noje
- Department of Neuroscience, Iuliu Hațieganu University of Medicine and Pharmacology, Cluj Napoca, Romania
| | - Șipoș Roxana
- Department of Neuroscience, Iuliu Hațieganu University of Medicine and Pharmacology, Cluj Napoca, Romania
| | - Elena Predescu
- Department of Neuroscience, Iuliu Hațieganu University of Medicine and Pharmacology, Cluj Napoca, Romania
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Smartphone-assisted psychoeducation in adult attention-deficit/hyperactivity disorder: A randomized controlled trial. Psychiatry Res 2022; 317:114802. [PMID: 36041353 DOI: 10.1016/j.psychres.2022.114802] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2022] [Revised: 08/15/2022] [Accepted: 08/18/2022] [Indexed: 11/22/2022]
Abstract
Psychoeducation is generally recommended in the treatment of adult Attention-Deficit/Hyperactivity Disorder (ADHD), but only few studies have systematically assessed the effects of structured clinical psychoeducation. Moreover, although a considerable number of psychoeducational mobile applications exist, none have provided scientific evidence for their effectiveness or safety. Therefore, the present randomized controlled trial investigated a newly developed, free-to-use psychoeducation app for adults with ADHD as a support to a clinical psychoeducation group. 236 adults with ADHD were contacted for study participation, of whom 60 were finally randomized to a psychoeducation group supported either by our developed smartphone app (n = 30) or by traditional pen-and-paper brochures (n = 30). Psychoeducation treatments were conducted in groups of 10, with 8 weekly one-hour sessions between March 2019 and November 2020. Observer-rated ADHD symptom severity (IDA-R interview) was examined as the primary outcome parameter before and after treatment. Across both interventions, ADHD core symptoms were significantly reduced. Notably, the smartphone-assisted psychoeducation was significantly more effective in improving inattention and impulsivity and led to higher homework compliance than the brochure-assisted psychoeducation. No adverse events were reported.
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Hoque Tania M, Hossain MR, Jahanara N, Andreev I, Clifton DA. Thinking Aloud or Screaming Inside: Exploratory Study of Sentiment Around Work. JMIR Form Res 2022; 6:e30113. [PMID: 36178712 PMCID: PMC9568814 DOI: 10.2196/30113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 07/03/2022] [Accepted: 08/10/2022] [Indexed: 11/30/2022] Open
Abstract
Background Millions of workers experience work-related ill health every year. The loss of working days often accounts for poor well-being because of discomfort and stress caused by the workplace. The ongoing pandemic and postpandemic shift in socioeconomic and work culture can continue to contribute to adverse work-related sentiments. Critically investigating state-of-the-art technologies, this study identifies the research gaps in recognizing workers’ need for well-being support, and we aspire to understand how such evidence can be collected to transform the workforce and workplace. Objective Building on recent advances in sentiment analysis, this study aims to closely examine the potential of social media as a tool to assess workers’ emotions toward the workplace. Methods This study collected a large Twitter data set comprising both pandemic and prepandemic tweets facilitated through a human-in-the-loop approach in combination with unsupervised learning and meta-heuristic optimization algorithms. The raw data preprocessed through natural language processing techniques were assessed using a generative statistical model and a lexicon-assisted rule-based model, mapping lexical features to emotion intensities. This study also assigned human annotations and performed work-related sentiment analysis. Results A mixed methods approach, including topic modeling using latent Dirichlet allocation, identified the top topics from the corpus to understand how Twitter users engage with discussions on work-related sentiments. The sorted aspects were portrayed through overlapped clusters and low intertopic distances. However, further analysis comprising the Valence Aware Dictionary for Sentiment Reasoner suggested a smaller number of negative polarities among diverse subjects. By contrast, the human-annotated data set created for this study contained more negative sentiments. In this study, sentimental juxtaposition revealed through the labeled data set was supported by the n-gram analysis as well. Conclusions The developed data set demonstrates that work-related sentiments are projected onto social media, which offers an opportunity to better support workers. The infrastructure of the workplace, the nature of the work, the culture within the industry and the particular organization, employers, colleagues, person-specific habits, and upbringing all play a part in the health and well-being of any working adult who contributes to the productivity of the organization. Therefore, understanding the origin and influence of the complex underlying factors both qualitatively and quantitatively can inform the next generation of workplaces to drive positive change by relying on empirically grounded evidence. Therefore, this study outlines a comprehensive approach to capture deeper insights into work-related health.
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Affiliation(s)
- Marzia Hoque Tania
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Md Razon Hossain
- School of Information System, Queensland University of Technology, Brisbane, Australia
| | - Nuzhat Jahanara
- Department of Psychology, University of Dhaka, Dhaka, Bangladesh
| | - Ilya Andreev
- School of Engineering and the Built Environment, Anglia Ruskin University, Cambridge, United Kingdom
| | - David A Clifton
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
- Oxford Centre for Advanced Research (OSCAR), University of Oxford, Suzhou, China
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13
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Seery C, Wrigley M, O'Riordan F, Kilbride K, Bramham J. What adults with ADHD want to know: A Delphi consensus study on the psychoeducational needs of experts by experience. Health Expect 2022; 25:2593-2602. [PMID: 35999687 PMCID: PMC9615057 DOI: 10.1111/hex.13592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction A lack of knowledge about attention‐deficit/hyperactivity disorder (ADHD) can contribute to feelings of distress and difficulty in seeking and accepting an ADHD diagnosis. The present study uses a Delphi consensus design to investigate the psychoeducational needs of adults with ADHD and the information about ADHD they would like included in digital health interventions for adults with ADHD. Inclusion of perspectives of service users in developing such interventions ensures that they are evidence based and addresses the risks of engagement barriers. Methods The expert panel consisted of 43 adults with ADHD (age range: 23–67 years). Panel members were asked to rate the importance of the proposed topics and provide additional suggestions. Suggested topics and topics that did not achieve consensus were included for ranking in the second round. Results Interquartile ratings were used to determine consensus. A high consensus was achieved in both rounds, with an agreement on 94% of topics in the first round and 98% in the second round. Most topics were rated as important or essential. Conclusions The findings highlighted that adults with ADHD want to learn about many different aspects of ADHD and the importance of considering their perspectives when developing psychosocial interventions. Findings can be applied when creating psychoeducational content for adult ADHD. Patient or Public Contribution Adults with ADHD were recruited to the Delphi panel to use an experts‐by‐experience approach. In doing so, we are engaging service users in the development of a psychoeducational smartphone app. The evaluation of the app will involve interviews with app users. Additionally, the present study was developed and conducted with ADHD Ireland, a charity based in Ireland that advocates for people with ADHD.
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Affiliation(s)
- Christina Seery
- UCD School of Psychology, University College Dublin, Dublin, Ireland
| | - Margo Wrigley
- National Clinical Programme for ADHD in Adults, Health Service Executive, Dublin, Ireland
| | - Fiona O'Riordan
- National Clinical Programme for ADHD in Adults, Health Service Executive, Dublin, Ireland
| | | | - Jessica Bramham
- UCD School of Psychology, University College Dublin, Dublin, Ireland
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Knouse LE, Hu X, Sachs G, Isaacs S. Usability and feasibility of a cognitive-behavioral mobile app for ADHD in adults. PLOS DIGITAL HEALTH 2022; 1:e0000083. [PMID: 36812621 PMCID: PMC9931323 DOI: 10.1371/journal.pdig.0000083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 06/29/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Cognitive-behavioral therapy (CBT) has growing evidence of efficacy for Attention-Deficit/Hyperactivity Disorder (ADHD) in adults. Mobile health apps are promising tools for delivering scalable CBT. In a 7-week open study of Inflow, a CBT-based mobile app, we assessed usability and feasibility to prepare for a randomized controlled trial (RCT). METHOD 240 adults recruited online completed baseline and usability assessments at 2 (n = 114), 4 (n = 97) and after 7 weeks (n = 95) of Inflow use. 93 participants self-reported ADHD symptoms and impairment at baseline and 7 weeks. RESULTS Participants rated Inflow's usability favorably, used the app a median of 3.86 times per week, and a majority of those using the app for 7 weeks self-reported decreases in ADHD symptoms and impairment. CONCLUSION Inflow demonstrated usability and feasibility among users. An RCT will determine whether Inflow is associated with improvement among more rigorously assessed users and beyond non-specific factors.
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Affiliation(s)
- Laura E. Knouse
- Department of Psychology, University of Richmond, Richmond, Virginia, United States of America
- * E-mail:
| | - Xiaodi Hu
- Department of Psychology, University of Richmond, Richmond, Virginia, United States of America
- Master of Science in Human-Computer Interaction Program, College of Information Studies, University of Maryland, College Park, Maryland, United States of America
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15
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Puzio D, Makowska I, Rymarczyk K. Raising the Child-Do Screen Media Help or Hinder? The Quality over Quantity Hypothesis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:9880. [PMID: 36011514 PMCID: PMC9408637 DOI: 10.3390/ijerph19169880] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/07/2022] [Accepted: 08/08/2022] [Indexed: 06/15/2023]
Abstract
Screen media are ubiquitous in human life across all age, cultural and socioeconomic groups. The ceaseless and dynamic growth of technological possibilities has given rise to questions regarding their effect on the well-being of children. Research in this area largely consists of cross-sectional studies; experimental and randomized studies are rare, which makes drawing causative conclusions difficult. However, the prevailing approach towards the use of screen media by children has focused on time limitations. The emerging evidence supports a more nuanced perspective. It appears that the older the child, the more important how the screen media are used becomes. Concentrating on the quality of the screen, time has become increasingly relevant in the recent COVID-19 pandemic, which necessitated a transfer of educational and social functioning from real-life to the digital world. With this review, we aimed at gathering current knowledge on the correlations of different screen media use and development outcomes, as well as providing an overview of potential benefits that new technologies may provide to the pediatric population. To summarize, if one cannot evade screen time in children, how can we use it for children's maximum advantage?
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Affiliation(s)
- Diana Puzio
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 90-419 Lodz, Poland
| | - Iwona Makowska
- Department of Child and Adolescent Psychiatry, Medical University of Lodz, 90-419 Lodz, Poland
| | - Krystyna Rymarczyk
- Department of Biological Psychology, University of Social Sciences and Humanities in Warsaw, 03-815 Warszawa, Poland
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16
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Păsărelu CR, Dobrean A, Florean IS, Predescu E. Parental stress and child mental health: a network analysis of Romanian parents. CURRENT PSYCHOLOGY 2022; 42:1-13. [PMID: 35967498 PMCID: PMC9362691 DOI: 10.1007/s12144-022-03520-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2022] [Indexed: 11/03/2022]
Abstract
Parental stress is related to child mental health problems, with numerous evidence indicating that it is an important predictor of parenting and parent-child relationship. New approaches to psychopathology could be particularly informative for clinical research, however, there is limited research that employs network analysis with parents. Network analysis could contribute to a better understanding of the relationship between child mental health problems and parental stress by highlighting the most central nodes and how the two constructs influence each other. The scope of the study was to identify potential new intervention targets to reduce the mental health problems of children and prevent contagion between parent stress and child psychopathology. Furthermore, we also sought to test whether the dynamic between parental stress and child psychopathology differs across the level of parent stress and child total difficulties. In this endeavor, we had three main directions. First, we estimated a network at the level of child mental health problems and identified the most central nodes. Second, we mapped the main paths through which parent stress and child mental health problems communicate with each other. Third, we investigated the network invariance across the level of parent stress (high vs moderate) and child mental health problems (low vs. high total difficulties). Participants (N = 1014) were parents of children with ages between four and 17 years old. The analyses were conducted in RStudio. Results indicated that perceived coping was a central node, bridging the two constructs. The global strength of the network was higher for parents who reported high levels of stress compared to those who reported only moderate levels of stress. In contrast, we found that the global strength of the network was lower for children with high levels of total difficulties compared to those with low levels of total difficulties. In conclusion, we argue the importance of focusing on the targeting nodes with high bridge centrality, such as perceived coping, for designing prevention and intervention programs. Future research should use temporal dynamics between parental stress and child mental health problems and explore mechanisms between the two constructs. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-022-03520-1.
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Affiliation(s)
- Costina-Ruxandra Păsărelu
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Republicii St., No. 37, 400015 Cluj-Napoca, Romania
| | - Anca Dobrean
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Republicii St., No. 37, 400015 Cluj-Napoca, Romania
| | - Ionuț Stelian Florean
- Department of Clinical Psychology and Psychotherapy, Babeș-Bolyai University, Cluj-Napoca, Romania
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeș-Bolyai University, Republicii St., No. 37, 400015 Cluj-Napoca, Romania
| | - Elena Predescu
- Iuliu Hațieganu University of Medicine and Pharmacology, Cluj Napoca, Romania
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17
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Caring for adolescents and young adults with attention-deficit/hyperactivity disorder in primary care: seizing opportunities to address youth mental health needs. Curr Opin Pediatr 2022; 34:306-312. [PMID: 35792652 DOI: 10.1097/mop.0000000000001127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW To provide primary care providers (PCPs) with updated practical guidance around the assessment and management of attention-deficit/hyperactivity disorder (ADHD) in adolescents and young adults (AYA). RECENT FINDINGS Of the three different presentations of ADHD delineated in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the Predominantly Inattentive presentation is the most common among AYA. Multiple rating scales exist to assist clinicians in identifying ADHD symptoms and monitoring treatment effects. Importantly, ADHD frequently persists into adulthood with negative impacts in many life domains if left untreated. It is important for PCPs to provide support for AYA as they transition to adulthood, as treatment adherence often drops sharply at that time, and, once treatment is discontinued, it is rarely restarted. Further, clinicians should be aware of the negative psychological, behavioral, and social impacts that COVID-19 has had on AYA with ADHD. SUMMARY AYA with ADHD often seek care first from PCPs. However, diagnosis and management of ADHD among AYA are challenging, and many clinicians feel ill-equipped, creating concern that many youth may go undiagnosed and untreated. Despite these long-standing challenges, recent advances have opened up critical opportunities for PCPs to proactively address ADHD in primary care settings and make a profound impact on youth as they seek to realize their full potential.
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18
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Surman C, Boland H, Kaufman D, DiSalvo M. Personalized Remote Mobile Surveys of Adult ADHD Symptoms and Function: A Pilot Study of Usability and Utility for Pharmacology Monitoring. J Atten Disord 2022; 26:1001-1010. [PMID: 34693788 DOI: 10.1177/10870547211044213] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Validate the usability and treatment-sensitivity of a remote SMS-based ADHD monitoring method. METHOD 206 adults taking stimulants for ADHD participated. Participants selected ADHD symptoms and functional impairments that they anticipated to be stimulant-sensitive, which were rated via mobile messages up to 20 times over 10 days. RESULTS A majority of participants found it only somewhat or not at all difficult to identify an ADHD symptom sensitive to presence of stimulant medication, and 79% responded to at least one survey message. As expected, a majority of participants endorsed it was "easy" to participate, and less burdensome than a paper diary. Surveys significantly discriminated between on and off medication states, both between days, and within the same day. CONCLUSION Our findings suggest SMS-based monitoring of patient-selected ADHD-related challenges is both feasible and sensitive to stimulant treatment. This remote assay method may be a meaningful adjunct to in-visit treatment monitoring.
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19
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Eis S, Solà-Morales O, Duarte-Díaz A, Vidal-Alaball J, Perestelo-Pérez L, Robles N, Carrion C. Mobile Applications in Mood Disorders and Mental Health: Systematic Search in Apple App Store and Google Play Store and Review of the Literature. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19042186. [PMID: 35206373 PMCID: PMC8871536 DOI: 10.3390/ijerph19042186] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/03/2022] [Accepted: 02/10/2022] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The main objective of this work was to explore and characterize the current landscape of mobile applications available to treat mood disorders such as depression, bipolar disorder, and dysthymia. METHODS We developed a tool that makes both the Apple App Store and the Google Play Store searchable using keywords and that facilitates the extraction of basic app information of the search results. All app results were filtered using various inclusion and exclusion criteria. We characterized all resultant applications according to their technical details. Furthermore, we searched for scientific publications on each app's website and PubMed, to understand whether any of the apps were supported by any type of scientific evidence on their acceptability, validation, use, effectiveness, etc. Results: Thirty apps were identified that fit the inclusion and exclusion criteria. The literature search yielded 27 publications related to the apps. However, these did not exclusively concern mood disorders. 6 were randomized studies and the rest included a protocol, pilot-, feasibility, case-, or qualitative studies, among others. The majority of studies were conducted on relatively small scales and 9 of the 27 studies did not explicitly study the effects of mobile application use on mental wellbeing. CONCLUSION While there exists a wealth of mobile applications aimed at the treatment of mental health disorders, including mood disorders, this study showed that only a handful of these are backed by robust scientific evidence. This result uncovers a need for further clinically oriented and systematic validation and testing of such apps.
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Affiliation(s)
- Sophie Eis
- Fundació HiTT (Health Innovation Technology Transfer), 08015 Barcelona, Spain;
| | - Oriol Solà-Morales
- Fundació HiTT (Health Innovation Technology Transfer), 08015 Barcelona, Spain;
- Correspondence:
| | - Andrea Duarte-Díaz
- Canary Islands Health Research Institute Foundation (FIISC), 38109 Tenerife, Spain;
| | - Josep Vidal-Alaball
- Health Promotion in Rural Areas Research Group, Gerència Territorial de la Catalunya Central, Institut Català de la Salut, 08272 Barcelona, Spain;
- Unitat de Suport a la Recerca de la Catalunya Central, Fundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina, 08007 Barcelona, Spain
- Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
| | | | - Noemí Robles
- eHealth Lab Research Group, School of Health Sciences and eHealth Centre, Universitat Oberta de Catalunya (UOC), 08035 Barcelona, Spain; (N.R.); (C.C.)
| | - Carme Carrion
- eHealth Lab Research Group, School of Health Sciences and eHealth Centre, Universitat Oberta de Catalunya (UOC), 08035 Barcelona, Spain; (N.R.); (C.C.)
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20
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Zangiacomi A, Flori V, Greci L, Scaglione A, Arlati S, Bernardelli G. An immersive virtual reality-based application for treating ADHD: A remote evaluation of acceptance and usability. Digit Health 2022; 8:20552076221143242. [DOI: 10.1177/20552076221143242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 11/17/2022] [Indexed: 12/13/2022] Open
Abstract
Introduction Virtual reality (VR) is a digital technology currently considered to implement rehabilitation programs for children with ADHD, a disorder characterised by inattention, overactivity and impulsiveness. This study presents the results of the acceptance and usability of a VR application developed for children with ADHD aiming to provide an environment capable of supporting the development of the different attentional components. Due to COVID-19 restrictions, this study had the secondary aim of assessing whether a remote evaluation was feasible and meaningful. Methods A sample of 20 clinical experts (neuro and psychomotor therapists of the developmental age) was involved in assessing the proposed environment. Two different tools have been applied: the Technology Acceptance Model (TAM-3) questionnaire and a semi-structured interview were self-administered. Six sessions were planned in total, and each one lasted 30 min. Results With respect to the acceptance of the system, the mean of the answers given is for most of the constructs greater than 4, showing agreement among experts. Cronbach alpha and correlations of subscales seem to confirm the reliability of measures. According to results from the interviews, the developed application has shown versatility in being able to be applied to the heterogeneity of the disorder and it was also possible to obtain valuable insights on possible additional features and functionalities. Regarding the secondary aim, the collected outcomes were positive: all the participants were satisfied with what they could perceive about the application. Conclusions The results of this work pave the way for a future validation study with children due to the active participation of clinicians and their unanimous positive judgement confirming that the application was considered user-friendly and well accepted.
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Affiliation(s)
- Andrea Zangiacomi
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, National Research Council, Milan, Italy
| | - Valeria Flori
- Scientific Institute IRCCS Eugenio Medea, Bosisio Parini, Italy
| | - Luca Greci
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, National Research Council, Milan, Italy
| | | | - Sara Arlati
- Institute of Intelligent Industrial Technologies and Systems for Advanced Manufacturing, National Research Council, Lecco, Italy
| | - Giuseppina Bernardelli
- Università degli Studi di Milano, Milano, Italy
- IRCCS Istituto Auxologico Italiano, Milan, Italy
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21
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Feasibility and clinical utility of a transdiagnostic Internet-delivered rational emotive and behavioral intervention for adolescents with anxiety and depressive disorders. Internet Interv 2021; 26:100479. [PMID: 34804812 PMCID: PMC8581498 DOI: 10.1016/j.invent.2021.100479] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/29/2021] [Accepted: 11/01/2021] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Transdiagnostic interventions delivered for children and adolescents show promising results. In order to increase access to treatment, recent developments in technology have led to alternatives to face-to-face interventions. Transdiagnostic Internet-delivered interventions can be effective for adult anxiety and depressive disorders, but research is more limited regarding the efficacy of such treatments for young populations diagnosed with anxiety and or depressive disorders. OBJECTIVE This study aims to investigate the feasibility and clinical utility of a transdiagnostic Internet-delivered intervention based on Rational emotive behavior therapy for adolescents diagnosed with anxiety and depressive disorders. METHODS We tested the preliminary efficacy of a six-week intervention in an open trial, pre-post design. RESULTS Our results suggest that the intervention is feasible and can be included as a treatment for adolescents with anxiety and depressive disorders, being associated with moderate to large pre-post effect sizes on self-reported anxiety and depressive symptoms, as well as on negative patterns of thinking and knowledge acquisition. Satisfaction with the intervention was high. CONCLUSIONS Transdiagnostic Internet-delivered interventions for adolescents with anxiety and depressive symptoms are feasible. Future testing of the efficacy of such interventions in randomized controlled trials should be conducted.
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22
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Ouellet-Morin I, Robitaille MP, Juster RP. Applications mobiles pour soutenir la santé mentale des jeunes : opportunités et défis. SANTE MENTALE AU QUEBEC 2021. [DOI: 10.7202/1081508ar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction L’adolescence est une période sensible pendant laquelle plusieurs changements ont le potentiel d’affecter le développement cognitif et psychosocial de l’individu. C’est aussi au cours de cette période que l’on note la plus forte augmentation des troubles de santé mentale. Plusieurs initiatives cherchent à prévenir l’émergence ou la détérioration de ces troubles auprès de jeunes en situation de vulnérabilité parce que vivant des difficultés émotionnelles ou du comportement, ou bien en raison d’expériences adverses auxquelles ils sont (ou ont été) confrontés. À ces efforts, le recours à la technologie est habituellement perçu comme naturel, voire souhaitable, auprès de ces « natifs du numérique ».
Objectif Cette recension critique propose d’examiner les avantages et inconvénients documentés dans la littérature et rencontrés dans le cadre du développement d’une application mobile (app) afin d’évaluer leur potentiel à soutenir la santé mentale et la résilience des jeunes en contextes d’adversité et les facteurs susceptibles d’amoindrir ces impacts.
Résultats/Constats Les apps, par leur format et mode d’utilisation, permettent de transmettre aux jeunes une information juste et fondée sur les meilleures connaissances tout en étant arrimée à leur réalité. Les apps représentent aussi une opportunité d’engager certains jeunes dans un processus de changement ou de les soutenir dans une éventuelle demande d’aide. Bien qu’elles soient disponibles en tout temps et qu’elles peuvent respecter leurs besoins d’autonomie et de confidentialité, de nombreux défis demeurent afin qu’elles puissent soutenir la santé mentale des jeunes, incluant le peu d’attention accordée à la validation scientifique, la protection des données personnelles et la capacité de rétention et d’engagement des jeunes.
Conclusion. Cette analyse critique des connaissances propose une réflexion qui pourrait s’avérer utile afin de soutenir le développement de futures apps rencontrant les meilleurs standards auprès d’une multitude d’acteurs susceptibles de les créer et de les utiliser.
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Affiliation(s)
- Isabelle Ouellet-Morin
- Centre de recherche, Institut universitaire en santé mentale de Montréal
- École de criminologie, Université de Montréal
| | | | - Robert-Paul Juster
- Centre de recherche, Institut universitaire en santé mentale de Montréal
- Département de psychiatrie et d’addictologie, Université de Montréal
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Robe A, Păsărelu CR, Dobrean A. Exploring autonomic regulation in children with ADHD with and without comorbid anxiety disorder through three systematic levels of cardiac vagal control analysis: Rest, reactivity, and recovery. Psychophysiology 2021; 58:e13850. [PMID: 34046904 DOI: 10.1111/psyp.13850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 04/29/2021] [Accepted: 04/29/2021] [Indexed: 11/25/2022]
Abstract
Autonomic nervous system (ANS) dysregulation, characterized by reduced vagally mediated Heart Rate Variability (HRV), has been associated with Attention-Deficit/ Hyperactivity Disorder (ADHD). This study investigated the dynamic vagal modulation of cardiac output in response to shifts in environmental demands in children and adolescents with ADHD, with and without a comorbid anxiety disorder. High-frequency HRV (HF-HRV) measures were obtained from 46 children and adolescents ranging from 6 to 17 (M = 9.38; SD = 2.31) years old, during three successive experimental conditions: a baseline recording followed by a sustained attention task, and a post-task recovery period. Findings support the reliability of the d2 Test, a cancelation test of attention and concentration, to induce parasympathetic withdrawal and extend prior work on "vagal flexibility". Further, these findings suggest a pattern of group differences in ANS functioning in children with ADHD, with and without a comorbid anxiety disorder. Only the ADHD without comorbid anxiety group showed a normative autonomic response to the cognitive challenge (reduced HF-HRV). The participants did not display an adaptive process of restoration following the cognitive challenge; the HRV suppression was prolonged during post-task recovery period, suggesting that ANS responded as if the cognitive stressor was still present. The current paper covers and discusses theoretical implications for the abnormalities in neurophysiological functioning and the different physiological responses in the two ADHD subtypes.
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Affiliation(s)
- Andreea Robe
- Doctoral School "Evidence-based Assessment and Psychological Interventions, Babeʂ-Bolyai University, Cluj-Napoca, Romania.,The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeʂ-Bolyai University, Cluj-Napoca, Romania
| | - Costina-Ruxandra Păsărelu
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeʂ-Bolyai University, Cluj-Napoca, Romania.,Department of Clinical Psychology and Psychotherapy, Babeʂ-Bolyai University, Cluj-Napoca, Romania
| | - Anca Dobrean
- The International Institute for the Advanced Studies of Psychotherapy and Applied Mental Health, Babeʂ-Bolyai University, Cluj-Napoca, Romania.,Department of Clinical Psychology and Psychotherapy, Babeʂ-Bolyai University, Cluj-Napoca, Romania
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24
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Developing a Fuzzy TOPSIS Model Combining MACBETH and Fuzzy Shannon Entropy to Select a Gamification App. MATHEMATICS 2021. [DOI: 10.3390/math9091034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Due to the important advantages it offers, gamification is one of the fastest-growing industries in the world, and interest from the market and from users continues to grow. This has led to the development of more and more applications aimed at different fields, and in particular the education sector. Choosing the most suitable application is increasingly difficult, and so to solve this problem, our study designed a model which is an innovative combination of fuzzy Technique for Order of Preference by Similarity to Ideal Solution (TOPSIS) with the Measuring Attractiveness by a Categorical Based Evaluation Technique (MACBETH) and Shannon entropy theory, to choose the most suitable gamification application for the Industrial Manufacturing and Organisation Systems course in the degree programmes for Electrical Engineering and Industrial and Automatic Electronics at the Higher Technical School of Industrial Engineering of Ciudad Real, part of the University of Castilla-La Mancha. There is no precedent in the literature that combines MACBETH and fuzzy Shannon entropy to simultaneously consider the subjective and objective weights of criteria to achieve a more accurate model. The objective weights computed from fuzzy Shannon entropy were compared with those calculated from De Luca and Termini entropy and exponential entropy. The validity of the proposed method is tested through the Preference Ranking Organisation METHod for Enrichment of Evaluations (PROMETHEE) II, ELimination and Choice Expressing REality (ELECTRE) III, and fuzzy VIKOR method (VIsekriterijumska optimizacija i KOmpromisno Resenje). The results show that Quizizz is the best option for this course, and it was used in two academic years. There are no precedents in the literature using fuzzy multicriteria decision analysis techniques to select the most suitable gamification application for a degree-level university course.
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Camp A, Pastrano A, Gomez V, Stephenson K, Delatte W, Perez B, Syas H, Guiseppi-Elie A. Understanding ADHD: Toward an Innovative Therapeutic Intervention. Bioengineering (Basel) 2021; 8:56. [PMID: 34062853 PMCID: PMC8147268 DOI: 10.3390/bioengineering8050056] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 04/16/2021] [Accepted: 04/27/2021] [Indexed: 11/21/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a pervasive condition affecting persons across all age groups, although it is primarily diagnosed in children. This neurological condition affects behavior, learning, and social adjustment and requires specific symptomatic criteria to be fulfilled for diagnosis. ADHD may be treated with a combination of psychological or psychiatric therapeutic interventions, but it often goes unattended. People with ADHD face societal bias challenges that impact how they manage the disorder and how they view themselves. This paper summarizes the present state of understanding of this disorder, with particular attention to early diagnosis and innovative therapeutic intervention. Contemporary understanding of the mind-brain duality allows for innovative therapeutic interventions based on neurological stimulation. This paper introduces the concept of neurostimulation as a therapeutic intervention for ADHD and poses the question of the relationship between patient adherence to self-administered therapy and the aesthetic design features of the neurostimulation device. By fabricating devices that go beyond safety and efficacy to embrace the aesthetic preferences of the patient, it is proposed that there will be improvements in patient adherence to a device intended to address ADHD.
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Affiliation(s)
- Allyson Camp
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Amanda Pastrano
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Valeria Gomez
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Kathleen Stephenson
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - William Delatte
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Brianna Perez
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Hunter Syas
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
| | - Anthony Guiseppi-Elie
- Center for Bioelectronics, Biosensors and Biochips (C3B), Department of Biomedical Engineering, Texas A&M University, College Station, TX 77843, USA; (A.C.); (A.P.); (V.G.); (K.S.); (W.D.); (B.P.); (H.S.)
- Houston Methodist Institute for Academic Medicine and Houston Methodist Research Institute, 6670 Bertner Ave., Houston, TX 77030, USA
- Department of Electrical and Computer Engineering, College of Engineering, Anderson University, Anderson, SC 29621, USA
- ABTECH Scientific, Inc., Biotechnology Research Park, 800 East Leigh Street, Richmond, VA 23219, USA
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Abstract
PURPOSE OF REVIEW Technological advancement has led to the development of novel treatment approaches for attention deficit hyperactivity disorder (ADHD). This review aims to review recent studies which employ the use of technology to treat ADHD, with particular focus on studies published during a 1-year period from February 2019 to February 2020. RECENT FINDINGS Most recent studies involved children aged 12 years and below. Interventions included cognitive training through games, neurofeedback and a combination of several approaches. More novel approaches included trigeminal nerve stimulation and brain-computer interface, and studies had utilized technology such as X-box Kinect and eye tracker. There was a shift towards delivering intervention at home and in school, enabled by technology. The study outcomes were variable and mainly included executive functioning measures and clinical ratings. These interventions were generally safe with few reported adverse events. SUMMARY Technology has enabled interventions to be delivered outside of the clinic setting and presented an opportunity for increased access to care and early intervention. Better quality studies are needed to inform on the efficacy of these interventions.
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Affiliation(s)
- Choon Guan Lim
- Department of Developmental Psychiatry, Institute of Mental Health, Singapore, Singapore
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