Investigating two mobile just-in-time adaptive interventions to foster psychological resilience: research protocol of the DynaM-INT study

Digital interventions in mental health: An overview and future perspectives

As e-health offerings rapidly expand, they are transforming and challenging traditional mental health care systems globally, presenting both promising opportunities and significant risks. This article critically examines the potential and pitfalls of integrating digital technologies into mental health care, particularly in the realms of diagnosis, prevention, and treatment. It explores current advancements and evidence-based practices, and provides a vision for how future technologies can evolve responsibly to meet mental health needs. The article concludes with the TEQUILA framework, addressing essential elements and challenges for fostering a beneficial and ethical future. A responsible future for digital mental health requires building Trust by ensuring data privacy, security, and transparency in AI-driven decisions, along with Evidence-based and robust regulatory oversight to maintain Quality. Usability, design, usability tailored to diverse needs, and ethical alignment with users' Interests will all be essential, while Liability and Accreditation standards will safeguard accountability in this evolving landscape.

Real-Time Assessment of Resilience in Individuals With Spinal Cord Injury and Chronic Pain: A Feasibility, Reliability, and Validity Study

OBJECTIVE

This observational study examined the feasibility, between-person reliability, and convergent and discriminant validity of an ecological momentary assessment (EMA) measure of resilience in individuals with spinal cord injury (SCI) and chronic pain.

DESIGN

Participants completed self-report assessments of resilience twice a day for 7 days using a 6-item EMA measure adapted from the SCI Quality of Life (QOL) Resilience Item Bank. Data were collected via a smartphone.

SETTING

General community.

PARTICIPANTS

Individuals with SCI and chronic pain (N=53; 54.7% men and 45.3% women).

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Besides the 6-item EMA resilience measure, we included the full SCI-QOL Resilience Item Bank, the Connor-Davidson Resilience Scale, the Patient-Reported Outcomes Measurement Information System Depression Short Form, the SCI-QOL Anxiety Short Form, the National Institutes of Health Toolbox Perceived Stress Survey, the SCI-QOL Positive Affect and Well-Being Short Form, and the SCI-QOL Ability to Participate in Social Roles and Activities.

RESULTS

Our results showed that the resilience EMA measure revealed high feasibility, with an overall response rate of 88%, and strong between-person reliability (>0.90). The measure also demonstrated good convergent validity with related constructs, such as depression, anxiety, and social participation, and good discriminant validity with unrelated factors, like age and injury level.

CONCLUSIONS

Our findings suggest that the EMA resilience measure is a reliable and valid tool for capturing the dynamic nature of resilience in real-time. Our study highlights the importance of the application of a real-time assessment, given that understanding daily functioning contributes to more person-centered rehabilitation interventions for individuals with SCI and chronic pain.

New norm values of the brief resilience scale (BRS) from the German general population with new post-COVID-19 data

BACKGROUND

The concept of psychological resilience has spurred extensive research across various fields, with the Brief Resilience Scale (BRS) emerging as a concise tool to measure an individual's ability to rebound from stress. It has been translated into multiple languages, including German, but the validation of the German version occurred prior to the COVID-19 pandemic. Therefore, the main objective of this study was to examine new norm values and psychometric properties of the BRS.

METHODS

Norm values, the factor structure, reliability and validity of the BRS were examined using data from a representative survey of the German general population (N = 2522).

RESULTS

The results indicated that the method-factor model showed the best fit, suggesting a nuanced understanding of resilience beyond a single-factor approach. The BRS demonstrated good convergent and discriminant validity based on both latent and manifest correlations. Moreover, the study revealed increasing postpandemic resilience scores.

CONCLUSIONS

The results of this study provide support for the psychometric reliability and validity of the German version of the BRS after the COVID-19 pandemic and underscore the importance of assessing resilience amidst evolving societal challenges and highlight the need for further exploration in diverse populations.

Burst versus continuous delivery design in digital mental health interventions: Evidence from a randomized clinical trial

Objective

Digital mental health interventions delivered via smartphone-based apps effectively treat various conditions; however, optimizing their efficacy while minimizing participant burden remains a key challenge. In this study, we investigated the potential benefits of a burst delivery design (i.e. interventions delivered only in pre-defined time intervals) in comparison to the continuous delivery of interventions.

Methods

We randomly assigned 93 participants to the continuous delivery (CD) or burst delivery (BD) group. The CD group engaged in ReApp, a mobile app that increases positive cognitive reappraisal with a consistent delivery schedule that provides five prompts per day throughout the 3-week-long study, while the BD group received five daily prompts only in the first and third weeks of the study.

Results

No significant differences were found between the groups in terms of adherence, mental health outcomes (specifically depressive and anxiety symptoms), level of perceived stress, and perceived helpfulness of intervention. The BD group showed a significantly decreased perceived difficulty of intervention over time.

Conclusions

The results suggest that the burst delivery may be as suitable for digital mental health interventions as the continuous delivery. The perceived difficulty of the intervention declined more steeply for the BD group, indicating that it improved the feasibility of the positive cognitive reappraisal intervention without hurting its efficacy. This outcome may inform the design of less burdensome interventions with improved outcomes in future research.