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Gual-Montolio P, Suso-Ribera C, García-Palacios A, Castilla D, Zaragoza I, Bretón-López J. Enhancing Internet-based psychotherapy for adults with emotional disorders using ecological momentary assessments and interventions: Study protocol of a feasibility trial with "My EMI, Emotional Well-being" app. Internet Interv 2023; 31:100601. [PMID: 36686334 PMCID: PMC9852876 DOI: 10.1016/j.invent.2023.100601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/20/2022] [Accepted: 01/04/2023] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Emotional disorders are the most frequent mental health problems globally. To ensure the dissemination of psychological treatments for these conditions, novel forms of delivery (e.g., Internet or mobile apps) and more scalable forms of psychotherapy (e.g., transdiagnostic interventions) have become increasingly popular. Research, however, shows that a significant number of patients, around 40 % according to some studies, do not respond to the interventions as expected (i.e., not-on-track patients). Ecological momentary assessments (EMAs) and ecological momentary interventions (EMIs) could simplify tailoring treatments to the patients' progress and rapidly respond to undesired outcomes during psychotherapy. Therefore, these would facilitate measurement-based care with little therapist involvement. This study aims to explore the feasibility of an app-based system called My EMI, Emotional Well-being for people with emotional disorders. According to daily EMAs, the app will provide personalized EMIs while participants receive a self-applied online transdiagnostic treatment. The app will be used as an add-tool to the online intervention to address emotion dysregulation, foster adherence, and reinforce contents. The current study describes the study protocol for this trial. METHOD AND ANALYSIS A single-group, open trial design will be used. Participants will be 30 adults suffering from emotional disorders. Primary outcomes will be app usability, acceptability, and response rates. Secondary outcomes will be either evaluated in Qualtrics at pre-treatment, post-treatment, and 3-month follow-up (depression and anxiety severity, and transdiagnostic dimensions of emotional disorders) or daily throughout the study with the app (EMAs of mood and five transdiagnostic mechanisms of therapeutic change). EMIs will consist of brief, evidence-based transdiagnostic CBT digital content (images, infographics, or videos) delivered just-in-time. Only if problems persist, short phone calls or episodic videocalls will be conducted. The Ethics Committee of the Jaume I University approved the study and all its procedures (CD/111/2021) in December 2021. DISCUSSION Identifying personalized and scalable interventions is paramount to improve mental health care, especially its accessibility, and to reduce the psychological distress of people with mental health problems. Feasibility data of the app (EMA and EMI system) supported by a self-applied online transdiagnostic intervention will be important to explore whether this modern approach is a real option to move forward personalized psychological interventions for persons with emotional disorders. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05109780. Registered 05 November 2021, https://clinicaltrials.gov/ct2/show/NCT05109780.
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Affiliation(s)
- Patricia Gual-Montolio
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain
| | - Carlos Suso-Ribera
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain,Corresponding author at: Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain.
| | - Azucena García-Palacios
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Diana Castilla
- Department of Personality, Assessment, and Psychological Treatments, Universidad de Valencia, 46010 Valencia, Spain,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Irene Zaragoza
- Department of Personality, Assessment, and Psychological Treatments, Universidad de Valencia, 46010 Valencia, Spain,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
| | - Juana Bretón-López
- Department of Basic and Clinical Psychology and Psychobiology, Jaume I University, Avda. Vicent Sos Baynat s/n, 12071 Castellon de la Plana, Spain,CIBER Fisiopatología Obesidad y Nutrición (CIBERObn), Instituto Salud Carlos III, Madrid, Spain
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Gual-Montolio P, Martínez-Borba V, Paredes-Mealla M, Osma J, Suso-Ribera C. Evaluando las creencias irracionales de forma fiable y rápida: refinando y acortando la versión en español de la “Escala de actitudes y creencias”. Behav Psychol 2022. [DOI: 10.51668/bp.8322312s] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
La “Escala de actitudes y creencias” (EAC) es una medida de creencias irracionales (CI) muy utilizada, pero con problemas psicométricos. Nuestro objetivo fue mejorar la calidad psicométrica de la versión española de la EAC. Se combinó la teoría clásica de los tests, teoría de respuesta al ítem y análisis factorial confirmatorio para obtener una versión corta de la escala utilizando dos muestras, una general (n= 565) y otra con dolor crónico (n= 514). Se realizaron correlaciones de Pearson con CI, personalidad y medidas de salud para investigar las fuentes de validez de constructo. Tras eliminar la mitad de los ítems (12), el ajuste factorial de la escala fue bueno (RMSEA< 0,08; CFI y TLI> 0,95). Las CI se asociaron con más neuroticismo (0,21≤ r≤0,61; p≤ 0,001), peor salud mental (-0,17≤ r≤ -0,56; p≤ 0,001), menor extraversión y responsabilidad (-0,14≤ r≤ -0,41; p≤ 0,01). Estos resultados se replicaron en ambas muestras, pero las CI sólo se asociaron con una peor salud física en la muestra general. La versión española abreviada de la EAC es válida, fiable y puede administrarse rápidamente en entornos clínicos.
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Gual-Montolio P, Martínez-Borba V, Paredes-Mealla M, Osma J, Suso-Ribera C. Assessing irrational beliefs reliably and quickly: Refining and shortening the Spanish version of the Attitudes and Beliefs Scale. Behav Psychol 2022. [DOI: 10.51668/bp.8322312n] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The Attitudes and Beliefs Scale (ABS) is a widely used measure of irrational beliefs (IBs) but has important psychometric problems. Our objective is to improve the psychometric quality of a Spanish version of the scale. Classical test theory, item response theory, and confirmatory factor analyses were combined to obtain a shorter version of the scale using 2 samples: one from the general population (n= 565) and another with chronic pain (n= 514). Pearson correlations were performed with IBs, personality and health measures to investigate sources of construct validity. After eliminating half of the items (12), the factorial fit of the scale became very good (RMSEA< .08; CFI and TLI> .95). IBs were associated with more neuroticism (.21≤ r≤ .61, p≤ .001) and poorer mental health (-.17≤ r≤ -.56, p≤ .001), as well as a less extraversion and conscientiousness (-.14≤ r≤ -.41, p≤ .01). These results were replicated in both samples, but IBs were only associated with poorer physical health in the general population sample. The shortened Spanish version of the ABS is a valid and reliable instrument that can be rapidly administered in clinical settings.
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