eMindLog: Self-Measurement of Anxiety and Depression Using Mobile Technology

Background

Quantifying anxiety and depressive experiences permits individuals to calibrate where they are and monitor intervention-associated changes. eMindLog is a novel self-report measure for anxiety and depression that is grounded in psychology with an organizing structure based on neuroscience.

Objective

Our aim was to explore the psychometric properties of eMindLog in a nonclinical sample of subjects.

Methods

In a cross-sectional study of eMindLog, a convenience sample of 198 adults provided informed consent and completed eMindLog and the Hospital Anxiety and Depression Scale (HADS) as a reference. Brain systems (eg, negative and positive valence systems, cognitive systems) and their functional states that drive behavior are measured daily as emotions, thoughts, and behaviors. Associated symptoms, quality of life, and functioning are assessed weekly. eMindLog offers ease of use and expediency, using mobile technology across multiple platforms, with dashboard reporting of scores. It enhances precision by providing distinct, nonoverlapping description of terms, and accuracy through guidance for scoring severity.

Results

eMindLog daily total score had a Cronbach alpha of .94. Pearson correlation coefficient for eMindLog indexes for anxiety and sadness/anhedonia were r=.66 (P<.001) and r=.62 (P<.001) contrasted with the HADS anxiety and depression subscales respectively. Of 195 subjects, 23 (11.8%) had cross-sectional symptoms above the threshold for Generalized Anxiety Disorder and 29 (29/195, 14.9%) for Major Depressive Disorder. Factor analysis supported the theoretically derived index derivatives for anxiety, anger, sadness, and anhedonia.

Conclusions

eMindLog is a novel self-measurement tool to measure anxiety and depression, demonstrating excellent reliability and strong validity in a nonclinical population. Further studies in clinical populations are necessary for fuller validation of its psychometric properties. Self-measurement of anxiety and depressive symptoms with precision and accuracy has several potential benefits, including case detection, tracking change over time, efficacy assessment of interventions, and exploration of potential biomarkers.

The Effects of a Brief Acceptance-Based Behavioral Treatment Versus Traditional Cognitive-Behavioral Treatment for Public Speaking Anxiety

Individuals with public speaking anxiety (PSA) experience fear and avoidance that can cause extreme distress, impaired speaking performance, and associated problems in psychosocial functioning. Most extant interventions for PSA emphasize anxiety reduction rather than enhancing behavioral performance. We compared the efficacy of two brief cognitive-behavioral interventions, a traditional cognitive-behavior treatment (tCBT) and an acceptance-based behavior treatment (ABBT), on public speaking performance and anxiety in a clinical sample of persons with PSA. The effects of treatment on prefrontal brain activation were also examined. Participants ( n = 21) were randomized to 90 min of an ABBT or a tCBT intervention. Assessments took place at pre- and post-treatment and included self-rated anxiety and observer-rated performance measures, a behavioral assessment, and prefrontal cortical activity measurements using functional near-infrared spectroscopy (fNIRS). Exploratory results indicated that participants in the ABBT condition experienced greater improvements in observer-rated performance relative to those in the tCBT condition, while those in the tCBT condition experienced greater reductions in subjective anxiety levels. Individuals in the ABBT condition also exhibited a trend toward greater treatment-related reductions in blood volume in the left dorsolateral prefrontal cortex relative to those who received tCBT. Overall, these findings preliminarily suggest that acceptance-based treatments may free more cognitive resources in comparison with tCBT, possibly resulting in greater improvements in objectively rated behavioral performances for ABBT interventions.

Treating young people with eating disorders: transition from child mental health to specialist adult eating disorder services

BACKGROUND

The transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS) of young people with eating disorders may pose a number of difficulties, including an inconsistent referral process and age boundaries.

METHODS

We compared young adults referred to a specialist Adult Eating Disorders Service (AEDS) who had previous involvement with CAMHS for the treatment of their eating disorder with those who did not. Information regarding the socio-demographic characteristics and eating disorders symptomatology of patients assessed by an AEDS over a 4-year period was collected.

RESULTS

Patients who had previous involvement with CAMHS (particularly the ones treated as in-patients) presented with a lower self-esteem and more maturity fears (MF) than those without previous involvement.

CONCLUSIONS

This study discusses the implication of these results in transitional arrangements between CAMHS and Adult services. It also highlights the need for heightened awareness of particular issues of self-esteem and maturation in these patients moving between services.

Clinical and socio-demographic characteristics of university students referred to an eating disorders service

This study describes the socio-demographic characteristics and eating disorders symptomatology of university students assessed by a specialised NHS eating disorders service in the UK over a 4-year period. Information was gathered on past treatment history, source of referral, details of university and course of study, whether the patient was still open to the service or discharged, and if the patient had dropped out of contact from services. The study also describes the diagnosis of the assessed patients as well as the results of the Eating Disorders Inventory (EDI), Rosenberg Self-Esteem Scale (RSES) and Revised Symptom Check List 90 (SCL-90-R) questionnaires. The study shows that the university students attending an eating disorder service often suffer from severe conditions, which are generally well-established before they start their university studies. The study discusses the implication of those results in service delivery and future service development.

A staging approach to measuring patient-centred subjective outcomes

INTRODUCTION

In assessing clinical change, measurement is often based on psychometric scales. However, change is best revealed within the constellation of problems salient to the patient, rather than in alterations in the abstract constructs, psychometrically measured. These patients' problems often serially unfold in qualitative stages, even before the full-blown disorder emerges. These qualitative stages constitute the natural history extending from early to late, fluctuating from mild to severe, and progressing from full-blown disorder to recovery.

METHOD

We reviewed the literature on clinimetrics and patient-centred subjective measures, and related these findings to the use of the discretized-analogue scaling method.

RESULTS

There is increasing recognition of clinimetric approaches that structure the pre-clinical and clinical material into a scale that reflects the symptoms, consequences and complications in a manner understandable to the patient, and enabling the quantification of severity or change. This monograph provides criteria and methods for developing these building blocks that enable the assessment of severity, stage or change. We show examples of their use in quantitative clinical outcome measurement.

CONCLUSION

We encourage further studies in the ideology and procedures for measuring clinical change in terms of personally subjective experiences.

Psychometric assessment and clinical application of the Correa-Barrick Depression Rating Scale

This article reports on the psychometric results of a new sef-report depression rating scale from three separate methodological research studies (pilot, main, and replication). Based on classical test theory, psychometric findings supported preliminary validity and reliability in the original study (N = 503), which consisted of a pilot study of 116 participants and a main study of 337 faculty and staff at a mid-Atlantic metropolitan university and 50 outpatients being treated for depression in a private psychiatric practice. The validity and reliability of the new scale was further supported in the replication study (N = 121), which consisted of 96 outpatients and 25 inpatients under treatment for depression. In all three studies, results revealed that severe depression is associated with altered perception, particularly impairment in color sensitivity. Implications for clinical application are discussed.