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Collins PY, Sinha M, Concepcion T, Patton G, Way T, McCay L, Mensa-Kwao A, Herrman H, de Leeuw E, Anand N, Atwoli L, Bardikoff N, Booysen C, Bustamante I, Chen Y, Davis K, Dua T, Foote N, Hughsam M, Juma D, Khanal S, Kumar M, Lefkowitz B, McDermott P, Moitra M, Ochieng Y, Omigbodun O, Queen E, Unützer J, Uribe-Restrepo JM, Wolpert M, Zeitz L. Making cities mental health friendly for adolescents and young adults. Nature 2024; 627:137-148. [PMID: 38383777 PMCID: PMC10917657 DOI: 10.1038/s41586-023-07005-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 12/15/2023] [Indexed: 02/23/2024]
Abstract
Urban life shapes the mental health of city dwellers, and although cities provide access to health, education and economic gain, urban environments are often detrimental to mental health1,2. Increasing urbanization over the next three decades will be accompanied by a growing population of children and adolescents living in cities3. Shaping the aspects of urban life that influence youth mental health could have an enormous impact on adolescent well-being and adult trajectories4. We invited a multidisciplinary, global group of researchers, practitioners, advocates and young people to complete sequential surveys to identify and prioritize the characteristics of a mental health-friendly city for young people. Here we show a set of ranked characteristic statements, grouped by personal, interpersonal, community, organizational, policy and environmental domains of intervention. Life skills for personal development, valuing and accepting young people's ideas and choices, providing safe public space for social connection, employment and job security, centring youth input in urban planning and design, and addressing adverse social determinants were priorities by domain. We report the adversities that COVID-19 generated and link relevant actions to these data. Our findings highlight the need for intersectoral, multilevel intervention and for inclusive, equitable, participatory design of cities that support youth mental health.
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Affiliation(s)
- Pamela Y Collins
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | | | - Tessa Concepcion
- Department of Global Health, University of Washington, Seattle, WA, USA
| | - George Patton
- Centre for Adolescent Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Thaisa Way
- Dumbarton Oaks, Harvard University, Washington, DC, USA
| | - Layla McCay
- Centre for Urban Design and Mental Health, London, UK
| | - Augustina Mensa-Kwao
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Helen Herrman
- Orygen, Melbourne, Victoria, Australia
- University of Melbourne, Melbourne, Victoria, Australia
| | - Evelyne de Leeuw
- Ecole de Sante Publique, Universite de Montreal, Montreal, Quebec, Canada
| | - Nalini Anand
- Fogarty International Center, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | | | - Yajun Chen
- Sun Yat Sen University, Guangzhou, China
| | | | - Tarun Dua
- World Health Organization, Geneva, Switzerland
| | | | | | - Damian Juma
- Healthy Brains Global Initiative, Nairobi, Kenya
| | | | - Manasi Kumar
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, USA
- University of Nairobi, Nairobi, Kenya
| | - Bina Lefkowitz
- Sacramento County Board of Education, Sacramento, CA, USA
- Lefkowitz Consulting, Sacramento, CA, USA
| | | | - Modhurima Moitra
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | | | - Emily Queen
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jürgen Unützer
- Department of Global Health, University of Washington, Seattle, WA, USA
| | | | | | - Lian Zeitz
- Climate Mental Health Network, Annapolis, MD, USA
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Walsh AEL, Naughton G, Sharpe T, Zajkowska Z, Malys M, van Heerden A, Mondelli V. A collaborative realist review of remote measurement technologies for depression in young people. Nat Hum Behav 2024; 8:480-492. [PMID: 38225410 PMCID: PMC10963268 DOI: 10.1038/s41562-023-01793-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 11/20/2023] [Indexed: 01/17/2024]
Abstract
Digital mental health is becoming increasingly common. This includes use of smartphones and wearables to collect data in real time during day-to-day life (remote measurement technologies, RMT). Such data could capture changes relevant to depression for use in objective screening, symptom management and relapse prevention. This approach may be particularly accessible to young people of today as the smartphone generation. However, there is limited research on how such a complex intervention would work in the real world. We conducted a collaborative realist review of RMT for depression in young people. Here we describe how, why, for whom and in what contexts RMT appear to work or not work for depression in young people and make recommendations for future research and practice. Ethical, data protection and methodological issues need to be resolved and standardized; without this, RMT may be currently best used for self-monitoring and feedback to the healthcare professional where possible, to increase emotional self-awareness, enhance the therapeutic relationship and monitor the effectiveness of other interventions.
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Affiliation(s)
- Annabel E L Walsh
- The McPin Foundation, London, UK.
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
| | | | - Thomas Sharpe
- Young People's Advisory Group, The McPin Foundation, London, UK
| | - Zuzanna Zajkowska
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Mantas Malys
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Alastair van Heerden
- Centre for Community-based Research, Human and Social Capabilities Department, Human Sciences Research Council, Johannesburg, South Africa
- MRC/Wits Developmental Pathways for Health Research Unit, Department of Paediatrics, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Valeria Mondelli
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- NIHR Maudsley Biomedical Research Centre, South London and Maudsley NHS Foundation Trust and King's College London, London, UK
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Yin H, Zhu H, Gu J, Qin H, Ding W, Guo N, Fu J, Yang Y. Mobile-based ecological momentary assessment and intervention: bibliometric analysis. Front Psychiatry 2024; 15:1300739. [PMID: 38469030 PMCID: PMC10925651 DOI: 10.3389/fpsyt.2024.1300739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 02/07/2024] [Indexed: 03/13/2024] Open
Abstract
Objective The aim of this article was to review existing documents in the field of mobile-based EMA and EMI, provide an overview of current hot topics, and predict future development trends. Methods We conducted a bibliometric study on mobile-based EMA and EMI publications that were collected from the Web of Science Core Collection database. Biblioshiny and CiteSpace were utilized to analyze scientific productions, leading sources, authors, affiliations, documents, research hot topics, keywords, and trend topics. Results A total of 2222 documents related to EMA and EMI published between 1992 and 2023 were retrieved. In recent years, scholarly publications have generally increased in mobile-based EMA and EMI research, particularly in the last decade. JMIR mHealth and uHealth (n=86), as well as JMIR (n=73), showed the highest number of publications. The United States (n=1038), Germany (n=218) and Netherlands (n=175) were leading countries. Regarding keyword co-occurrence and trend topics analysis, mental health, health behaviors, and feasibility were hot topics in mobile-based EMA and EMI research. Future research trends included using EMA for tailoring EMI, just-in-time adaptive interventions (JITAI), and digital phenotyping. Conclusion This bibliometric study on mobile-based EMA and EMI is a valuable resource for understanding the field's evolution and future trends. Our analysis indicates that EMA and EMI have great potential in health behaviors and mental health, but implementation should consider feasibility and reactivity issues carefully. Emerging trends include EMA-tailored EMI, JITAI, and digital phenotyping. In the future, strengthening multidisciplinary cooperation will be necessary to promote the continued development of the field.
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Affiliation(s)
- Hongfan Yin
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Hanjing Zhu
- Department of Urology, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jia Gu
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Hengwei Qin
- Department of Sports Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Wenjing Ding
- Reference Department, Library of Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ningyuan Guo
- School of Nursing, Shanghai Jiao Tong University, Shanghai, China
| | - Jingjing Fu
- Department of Nursing, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yan Yang
- Department of Nursing, Renji Hospital, Shanghai Jiao Tong University, Shanghai, China
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Weisz JR, Fitzpatrick OM, Venturo-Conerly KE, Sternberg A, Steinberg JS, Ng MY. Research Review: The internalizing paradox - youth anxiety and depression symptoms, psychotherapy outcomes, and implications for research and practice. J Child Psychol Psychiatry 2023; 64:1720-1734. [PMID: 37222162 PMCID: PMC10667566 DOI: 10.1111/jcpp.13820] [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] [Accepted: 03/28/2023] [Indexed: 05/25/2023]
Abstract
BACKGROUND Youth anxiety and depression have long been combined within the empirically derived internalizing syndrome. The two conditions show substantial comorbidity, symptom co-occurrence, and overlap in treatment procedures, but paradoxically diverge in psychotherapy outcomes: strong, positive effects for anxiety and weak effects for depression. METHODS Drawing on recent research, we examine candidate explanations for this paradox to help identify strategies for addressing it by improving outcomes for youth depression. RESULTS Candidate explanations include that youth depression, compared with youth anxiety, has more varied comorbidities and more heterogeneous symptom combinations, has greater uncertainty regarding mediators and mechanisms of change, is treated with more complex and potentially confusing protocols, and has characteristics that may impede client engagement. Candidate strategies for shrinking the psychotherapy effectiveness gap include personalizing through transdiagnostic modular treatment, simplifying therapy by focusing on empirically supported principles of change, developing effective strategies for engaging family members as intervention allies, using shared decision-making to inform clinical decisions and boost client engagement, capitalizing on youth-friendly technological advances, and shortening and digitizing treatments to enhance their accessibility and appeal. CONCLUSIONS Recent advances suggest explanations for the internalizing paradox, which in turn suggest strategies for shrinking the youth anxiety-depression psychotherapy outcome gap; these form an agenda for a promising new era of research.
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Affiliation(s)
- John R. Weisz
- Department of Psychology, Harvard University, Cambridge, MA 02138 USA
| | | | | | - Ariel Sternberg
- Department of Psychology, Harvard University, Cambridge, MA 02138 USA
| | | | - Mei Yi Ng
- Department of Psychology, Florida International University, Miami, FL 33199 USA
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Marciano L, Vocaj E, Bekalu MA, La Tona A, Rocchi G, Viswanath K. The Use of Mobile Assessments for Monitoring Mental Health in Youth: Umbrella Review. J Med Internet Res 2023; 25:e45540. [PMID: 37725422 PMCID: PMC10548333 DOI: 10.2196/45540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 06/12/2023] [Accepted: 07/06/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND Improving mental health in youth is a major concern. Future approaches to monitor and intervene in youth mental health problems should rely on mobile tools that allow for the daily monitoring of mental health both actively (eg, using ecological momentary assessments [EMAs]) and passively (eg, digital phenotyping) by capturing individuals' data. OBJECTIVE This umbrella review aims to (1) report the main characteristics of existing reviews on mental health and young people, including mobile approaches to mental health; (2) describe EMAs and trace data and the mental health conditions investigated; (3) report the main results; and (4) outline promises, limitations, and directions for future research. METHODS A systematic literature search was carried out in 9 scientific databases (Communication & Mass Media Complete, Psychology and Behavioral Sciences Collection, PsycINFO, CINAHL, ERIC, MEDLINE, the ProQuest Sociology Database, Web of Science, and PubMed) on January 30, 2022, coupled with a hand search and updated in July 2022. We included (systematic) reviews of EMAs and trace data in the context of mental health, with a specific focus on young populations, including children, adolescents, and young adults. The quality of the included reviews was evaluated using the AMSTAR (Assessment of Multiple Systematic Reviews) checklist. RESULTS After the screening process, 30 reviews (published between 2016 and 2022) were included in this umbrella review, of which 21 (70%) were systematic reviews and 9 (30%) were narrative reviews. The included systematic reviews focused on symptoms of depression (5/21, 24%); bipolar disorders, schizophrenia, or psychosis (6/21, 29%); general ill-being (5/21, 24%); cognitive abilities (2/21, 9.5%); well-being (1/21, 5%); personality (1/21, 5%); and suicidal thoughts (1/21, 5%). Of the 21 systematic reviews, 15 (71%) summarized studies that used mobile apps for tracing, 2 (10%) summarized studies that used them for intervention, and 4 (19%) summarized studies that used them for both intervention and tracing. Mobile tools used in the systematic reviews were smartphones only (8/21, 38%), smartphones and wearable devices (6/21, 29%), and smartphones with other tools (7/21, 33%). In total, 29% (6/21) of the systematic reviews focused on EMAs, including ecological momentary interventions; 33% (7/21) focused on trace data; and 38% (8/21) focused on both. Narrative reviews mainly focused on the discussion of issues related to digital phenotyping, existing theoretical frameworks used, new opportunities, and practical examples. CONCLUSIONS EMAs and trace data in the context of mental health assessments and interventions are promising tools. Opportunities (eg, using mobile approaches in low- and middle-income countries, integration of multimodal data, and improving self-efficacy and self-awareness on mental health) and limitations (eg, absence of theoretical frameworks, difficulty in assessing the reliability and effectiveness of such approaches, and need to appropriately assess the quality of the studies) were further discussed. TRIAL REGISTRATION PROSPERO CRD42022347717; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=347717.
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Affiliation(s)
- Laura Marciano
- Lee Kum Sheung Center for Health and Happiness, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Dana Farber Cancer Institute, Boston, MA, United States
| | - Emanuela Vocaj
- Lombard School of Cognitive-Neuropsychological Psychotherapy, Pavia, Italy
| | - Mesfin A Bekalu
- Lee Kum Sheung Center for Health and Happiness, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Dana Farber Cancer Institute, Boston, MA, United States
| | - Antonino La Tona
- Dipartimento di Scienze Umane e Sociali, Università degli Studi di Bergamo, Bergamo, Italy
| | - Giulia Rocchi
- Department of Dynamic, Clinical Psychology and Health Studies, Sapienza University, Rome, Italy
| | - Kasisomayajula Viswanath
- Lee Kum Sheung Center for Health and Happiness, Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Dana Farber Cancer Institute, Boston, MA, United States
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Huckvale K, Hoon L, Stech E, Newby JM, Zheng WY, Han J, Vasa R, Gupta S, Barnett S, Senadeera M, Cameron S, Kurniawan S, Agarwal A, Kupper JF, Asbury J, Willie D, Grant A, Cutler H, Parkinson B, Ahumada-Canale A, Beames JR, Logothetis R, Bautista M, Rosenberg J, Shvetcov A, Quinn T, Mackinnon A, Rana S, Tran T, Rosenbaum S, Mouzakis K, Werner-Seidler A, Whitton A, Venkatesh S, Christensen H. Protocol for a bandit-based response adaptive trial to evaluate the effectiveness of brief self-guided digital interventions for reducing psychological distress in university students: the Vibe Up study. BMJ Open 2023; 13:e066249. [PMID: 37116996 PMCID: PMC10151864 DOI: 10.1136/bmjopen-2022-066249] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
INTRODUCTION Meta-analytical evidence confirms a range of interventions, including mindfulness, physical activity and sleep hygiene, can reduce psychological distress in university students. However, it is unclear which intervention is most effective. Artificial intelligence (AI)-driven adaptive trials may be an efficient method to determine what works best and for whom. The primary purpose of the study is to rank the effectiveness of mindfulness, physical activity, sleep hygiene and an active control on reducing distress, using a multiarm contextual bandit-based AI-adaptive trial method. Furthermore, the study will explore which interventions have the largest effect for students with different levels of baseline distress severity. METHODS AND ANALYSIS The Vibe Up study is a pragmatically oriented, decentralised AI-adaptive group sequential randomised controlled trial comparing the effectiveness of one of three brief, 2-week digital self-guided interventions (mindfulness, physical activity or sleep hygiene) or active control (ecological momentary assessment) in reducing self-reported psychological distress in Australian university students. The adaptive trial methodology involves up to 12 sequential mini-trials that allow for the optimisation of allocation ratios. The primary outcome is change in psychological distress (Depression, Anxiety and Stress Scale, 21-item version, DASS-21 total score) from preintervention to postintervention. Secondary outcomes include change in physical activity, sleep quality and mindfulness from preintervention to postintervention. Planned contrasts will compare the four groups (ie, the three intervention and control) using self-reported psychological distress at prespecified time points for interim analyses. The study aims to determine the best performing intervention, as well as ranking of other interventions. ETHICS AND DISSEMINATION Ethical approval was sought and obtained from the UNSW Sydney Human Research Ethics Committee (HREC A, HC200466). A trial protocol adhering to the requirements of the Guideline for Good Clinical Practice was prepared for and approved by the Sponsor, UNSW Sydney (Protocol number: HC200466_CTP). TRIAL REGISTRATION NUMBER ACTRN12621001223820.
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Affiliation(s)
- Kit Huckvale
- Centre for Digital Transformation of Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Leonard Hoon
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Eileen Stech
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jill M Newby
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
- School of Psychology, UNSW Sydney, Sydney, New South Wales, Australia
| | - Wu Yi Zheng
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jin Han
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Rajesh Vasa
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Sunil Gupta
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Scott Barnett
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Manisha Senadeera
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Stuart Cameron
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Stefanus Kurniawan
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Akash Agarwal
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Joost Funke Kupper
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Joshua Asbury
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - David Willie
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Alasdair Grant
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Henry Cutler
- Centre for the Health Economy, Macquarie University, Sydney, New South Wales, Australia
| | - Bonny Parkinson
- Centre for the Health Economy, Macquarie University, Sydney, New South Wales, Australia
| | | | - Joanne R Beames
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Rena Logothetis
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Marya Bautista
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Jodie Rosenberg
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Artur Shvetcov
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Thomas Quinn
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Andrew Mackinnon
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Santu Rana
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Truyen Tran
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Simon Rosenbaum
- School of Psychiatry, UNSW Sydney, Sydney, New South Wales, Australia
| | - Kon Mouzakis
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | | | - Alexis Whitton
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Svetha Venkatesh
- Applied Artificial Intelligence Institute, Deakin University, Melbourne, Victoria, Australia
| | - Helen Christensen
- Black Dog Institute, UNSW Sydney, Sydney, New South Wales, Australia
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Marciano L, Saboor S. Reinventing mental health care in youth through mobile approaches: Current status and future steps. Front Psychol 2023; 14:1126015. [PMID: 36968730 PMCID: PMC10033533 DOI: 10.3389/fpsyg.2023.1126015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/17/2023] [Indexed: 03/12/2023] Open
Abstract
In this perspective, we aim to bring together research on mobile assessments and interventions in the context of mental health care in youth. After the COVID-19 pandemic, one out of five young people is experiencing mental health problems worldwide. New ways to face this burden are now needed. Young people search for low-burden services in terms of costs and time, paired with high flexibility and easy accessibility. Mobile applications meet these principles by providing new ways to inform, monitor, educate, and enable self-help, thus reinventing mental health care in youth. In this perspective, we explore the existing literature reviews on mobile assessments and interventions in youth through data collected passively (e.g., digital phenotyping) and actively (e.g., using Ecological Momentary Assessments—EMAs). The richness of such approaches relies on assessing mental health dynamically by extending beyond the confines of traditional methods and diagnostic criteria, and the integration of sensor data from multiple channels, thus allowing the cross-validation of symptoms through multiple information. However, we also acknowledge the promises and pitfalls of such approaches, including the problem of interpreting small effects combined with different data sources and the real benefits in terms of outcome prediction when compared to gold-standard methods. We also explore a new promising and complementary approach, using chatbots and conversational agents, that encourages interaction while tracing health and providing interventions. Finally, we suggest that it is important to continue to move beyond the ill-being framework by giving more importance to intervention fostering well-being, e.g., using positive psychology.
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Affiliation(s)
- Laura Marciano
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
- Lee Kum Sheung Center for Health and Happiness and Dana Farber Cancer Institute, Boston, MA, United States
- *Correspondence: Laura Marciano,
| | - Sundas Saboor
- Harvard T.H. Chan School of Public Health, Boston, MA, United States
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Szlyk HS, Li X, Kasson E, Peoples JE, Montayne M, Kaiser N, Cavazos-Rehg P. How do teens with a history of suicidal behavior and self-harm interact with social media? J Adolesc 2023. [PMID: 36864641 DOI: 10.1002/jad.12154] [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: 07/07/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND This study examines how engagement with depression-related social media content varies by teens who report suicidal ideation, suicide attempts, and nonsuicidal self-injury (NSSI) versus those who had not experienced each behavior. METHODS Teens aged 15-17 years old (N = 93) were recruited from social media platforms from October 2016 to August 2018. Participants were asked three open-ended questions about the advantages and disadvantages of networking about depression-related content on social media. We conducted a qualitative analysis to capture themes in responses by question item. Univariate analyses were conducted to compare differences in the frequency of themes endorsed among the behavioral groups versus their counterparts. RESULTS Among participants (female, 73%; non-White, 45%; sexual minority, 57%), most (93%, n = 87) endorsed depressive symptoms. Sixty-five percent (n = 60) endorsed suicidal ideation within the past year, who were more likely to indicate unhelpful social interactions (p = .02) as a disadvantage of following depression content than peers who did not endorse suicidal ideation within the past year. Eighty percent (n = 74) endorsed lifetime experience of NSSI, who were more likely to indicate negative impact on relationships (p = .01) from posting depression content than peers who did not experience NSSI. Fifty-eight percent (n = 54) endorsed a lifetime suicide attempt, who were more likely to mention offering solutions (p = .03) to someone posting concerning content than peers who did not endorse a lifetime suicide attempt. CONCLUSIONS This study provides diverse and unique perspectives on how engagement with depression-related social media varies by mental health behaviors and informs the use of social media for recruitment and outreach for teens.
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Affiliation(s)
- Hannah S Szlyk
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Xiao Li
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Erin Kasson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - JaNiene E Peoples
- Brown School of Social Work, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Mandy Montayne
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Nina Kaiser
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Patricia Cavazos-Rehg
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri, USA
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Feng G, Xu X, Lei J. Tracking perceived stress, anxiety, and depression in daily life: a double-downward spiral process. Front Psychol 2023; 14:1114332. [PMID: 37143594 PMCID: PMC10151810 DOI: 10.3389/fpsyg.2023.1114332] [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: 12/02/2022] [Accepted: 03/31/2023] [Indexed: 05/06/2023] Open
Abstract
Introduction Previous studies using retrospective questionnaires have suggested a complex relationship between perceived stress and related negative emotions and emphasized their importance in mental health. However, how daily perceived stress, anxiety, and depression interact dynamically in a natural context remains largely unexplored. Methods This study conducted a longitudinal survey that applied experience sampling methodology to data from 141 Chinese college students (58% women, mean age = 20.1 ± 1.63 years). Results The hierarchical linear models confirmed that daily perceived stress and negative emotions (i.e., perceived depression and anxiety) could reciprocally reinforce one another with the characteristic dynamics of a cognitive-emotional downward spiral. Additionally, anxiety and depression could further circularly aggravate each other imminently. These two intertwined downward-spiral processes constitute a double-downward-spiral model. Discussion The findings contribute to a better understanding of the interactive mechanisms underlying perceived stress and its related negative emotions in everyday life and highlight the significance of early emotion regulation and stress relief in healthy people.
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Affiliation(s)
- Guo Feng
- Psychological Research and Counseling Center, Southwest Jiaotong University, Chengdu, Sichuan, China
- Institute of Applied Psychology, Southwest Jiaotong University, Chengdu, Sichuan, China
- *Correspondence: Guo Feng,
| | - Xiaxia Xu
- Psychological Research and Counseling Center, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Jiawei Lei
- Psychological Research and Counseling Center, Southwest Jiaotong University, Chengdu, Sichuan, China
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Orsolini L, Appignanesi C, Pompili S, Volpe U. The role of digital tools in providing youth mental health: results from an international multi-center study. Int Rev Psychiatry 2022; 34:809-826. [PMID: 36786119 DOI: 10.1080/09540261.2022.2118521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
Since the traditional mental health system showed significant limitations in the early identification, diagnosis and treatment of the current new youth psychopathological trajectories, by substantially failing in targeting the needs of the current young generation, there is the demand to redesign and digitally adapt youth mental health care and systems. Indeed, the level of digital literacy and the level of digital competency and knowledge in the field of digital psychiatry is still under-investigated among mental health professionals, particularly in youth mental health. Therefore, we aimed at: (a) carrying out a post-hoc analysis of an international multi-centre study, to investigate the opinions of mental health professionals regarding the feasibility, efficacy and clinical experience in delivering digital mental health interventions (DMHIs) in youths; (b) providing a comprehensive overview on the integrated digitally-based youth mental health care models and innovations. Mental health professionals declared the lack of a formal training in digital psychiatry, particularly in youth mental health. Subjects who received a formal theoretical/practical training on DMHIs displayed a statistical trend towards a positive feasibility of digital psychiatry in youth mental health (p = 0.053) and a perceived increased efficacy of digital psychiatry in youths (p = 0.051). Respondents with higher Digital Psychiatry Opinion (DPO) scores reported a positive perceived feasibility of DMHIs in youths (p < 0.041) and are more prone to deliver DMHIs to young people (p < 0.001). Respondents with higher knowledge scores (KS) declared that DMHIs are more effective in youth mental health (p < 0.001). Overall, the digitalisation indeed allowed young people to keep in touch with a mental health professional, facilitating a more dynamic and fluid mental health care access and monitoring, generally preferred and considered more feasible by post-Millennial youngsters. Accordingly, our findings demonstrated that mental health professionals are more prone to offer DMHIs in youth mental health, particularly whether previously trained and knowledgeable on the topic.
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Affiliation(s)
- Laura Orsolini
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Cristina Appignanesi
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Simone Pompili
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
| | - Umberto Volpe
- Unit of Clinical Psychiatry, Department of Clinical Neurosciences/DIMSC, Polytechnic University of Marche, Ancona, Italy
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Medina JC, Paz C, García-Mieres H, Niño-Robles N, Herrera JE, Feixas G, Montesano A. Efficacy of psychological interventions for young adults with mild-to-moderate depressive symptoms: A meta-analysis. J Psychiatr Res 2022; 152:366-374. [PMID: 35793580 DOI: 10.1016/j.jpsychires.2022.06.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 05/26/2022] [Accepted: 06/10/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Psychological interventions are commonly used to treat mild-to-moderate depression, but their efficacy in young adults has not been exhaustively addressed. This meta-analysis aims to establish it in comparison to no treatment, wait-list, usual treatment, passive interventions, and other bona-fide treatments. METHODS The search was conducted in Scopus, MEDLINE, PsycINFO, ClinicalTrials.gov, the ISRCTN Registry, Cochrane CENTRAL, Clarivate BIOSIS Previews and the METAPSY database, retrieving studies from the start of records to April 2020. Eligibility criteria included samples of 16-30 years experiencing mild-to-moderate depressive symptoms and participating in randomized controlled trials (RCTs), non-RCTs, or pre-post studies measuring depressive symptomatology and featuring psychological treatments. RESULTS Up to 45 studies met criteria, consisting of 3,947 participants, assessed using the Quality Assessment Tool for Quantitative Studies and their results meta-analyzed assuming random effects. Psychological interventions proved to be efficacious in RCTs compared to no treatment (g = -0.68; 95% CI = -0.87, -0.48) and wait-list (g = -1.04; 95% CI = -1.25, -0.82), while depressive symptoms also improved in pre-post studies (g = -0.99; 95% CI = -1.32, -0.66). However, intervention efficacy was similar to usual care, passive, and bona-fide comparators. The heterogeneity found, a likely reporting bias and the low quality of most studies must be considered when interpreting these results. CONCLUSIONS Psychological treatments are efficacious to reduce depressive symptoms in young adults, but comparable to other interventions in the mild-to-moderate range. Moderators like depression severity or therapist involvement significantly influenced their efficacy, with results encouraging clinicians to adopt flexible and personalized approaches.
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Affiliation(s)
- J C Medina
- Department of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain; Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain.
| | - C Paz
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - H García-Mieres
- Etiopathogenesis and Treatment of Severe Mental Disorders (MERITT), Teaching, Research & Innovation Unit, Institut de Recerca Sant Joan de Déu, Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; Centro Investigación Biomédica en Red Salud Mental (CIBERSAM), Madrid, Spain
| | - N Niño-Robles
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
| | - J E Herrera
- School of Psychology, Universidad de Las Américas, Quito, Ecuador
| | - G Feixas
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain; Institute of Neurosciences, Universitat de Barcelona, Barcelona, Spain
| | - A Montesano
- Department of Psychology and Education Sciences, Universitat Oberta de Catalunya, Barcelona, Spain
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Beames JR, Kikas K, O'Gradey-Lee M, Gale N, Werner-Seidler A, Boydell KM, Hudson JL. A New Normal: Integrating Lived Experience Into Scientific Data Syntheses. Front Psychiatry 2021; 12:763005. [PMID: 34777064 PMCID: PMC8585932 DOI: 10.3389/fpsyt.2021.763005] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 10/07/2021] [Indexed: 01/30/2023] Open
Affiliation(s)
- Joanne R Beames
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | - Katarina Kikas
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | | | - Nyree Gale
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | | | | | - Jennifer L Hudson
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
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