Building resilience through daily smartphone app use: results of a pilot study of the JoyPop app with social work students.

Background: The JoyPop™ smartphone app is a digital intervention designed to enhance day-to-day resilience in youth, particularly those exposed to traumatogenic events [adverse childhood experiences (ACEs)]. Processes of adaptation that foster resilience in response to high stress include affect, cognitive, and behavioral regulation, and social interaction. Digital interventions have application for youth and those who provide them support, including social work trainees navigating the stressors of university studies concurrent with practice internships. Research on resilience-enhancing apps is needed to understand the underlying mechanisms by which change occurs and who is most likely to benefit from these interventions. Methods: Social work student participants (N = 91) were invited to use the JoyPop app two times daily for 28 days. Baseline ACE exposure and change-over-time in affect regulation, stress responsivity, and social support were evaluated after 2 and 4 weeks of app use with t-tests and generalized estimating equation (GEE) modeling. Results: Participants identified predominantly as cisgender women of European descent, mean age 26 years (SD = 6.78), 70% undergraduates, and reported consistent daily app use (Mean days = 26.9, SD = 1.90). Self-reported baseline ACE exposure was high (30% ≥ 5+). We tested change-over-time with generalized estimating equation and saw improvement in affect regulation in the Abbreviated Dysregulation Inventory scale (ß = -3.38, p = <.001), and subscales of behavioral (ß = -1.63, p = <.001), affect (ß = -3.24, p = <.001), and cognitive regulation (ß = 1.50, p = .009). Perceived stress decreased with app use (ß = -2.65, p = <.001) and even more so for participants with reported exposure to more than 4 ACEs (ß = -3.786, p = .030). Conclusions: The exploratory findings from our pilot study suggest that consistent use of the app may enhance multidimensional resilience amongst university students who self-report higher than average levels of baseline traumatogenic exposures. Our findings support an approach modeling resilience as a complex, dynamic, multicomponent process supported by resources within and between individuals. Further testing of the mechanisms of adaptation in response to high stress that enhance resilience and identification of the JoyPop™ app features that influence this change is needed to validate that daily app use could help youth with experiences of past and current high stress to better regulate their affect, reduce stress reactivity, and increase resilience.

Pre-processing data to reduce biases: full matching incorporating an instrumental variable in population-based studies.

BACKGROUND: Epidemiologists are often concerned with unobserved biases that produce confounding in population-based studies. We introduce a new design approach-'full matching incorporating an instrumental variable (IV)' or 'Full-IV Matching'-and illustrate its utility in reducing observed and unobserved biases to increase inference accuracy. Our motivating example is tailored to a central question in humanitarian emergencies-the difference in sexual violence risk by displacement setting. METHODS: We conducted a series of 1000 Monte Carlo simulations generated from a population-based survey after the 2010 Haitian earthquake and included earthquake damage severity as an IV and the unmeasured variable of 'social capital'. We compared standardized mean differences (SMDs) for covariates after different designs to understand potential biases. Mean risk differences (RDs) were used to assess each design's accuracy in estimating the oracle of the simulated data set. RESULTS: Naive analysis and pair matching equivalently performed. Full matching reduced imbalances between exposed and comparison groups across covariates, except for the unobserved covariate of 'social capital'. Pair and full matching overstated differences in sexual violence risk when displaced to a camp vs a community [pair: RD = 0.13, 95% simulation interval (SI) 0.09-0.16; full: RD = 0.11, 95% SI 0.08-0.14). Full-IV Matching reduced imbalances across observed covariates and importantly 'social capital'. The estimated risk difference (RD = 0.07, 95% SI 0.03-0.11) was closest to the oracle (RD = 0.06, 95% SI 0.4-0.8). CONCLUSION: Full-IV Matching is a novel approach that is promising for increasing inference accuracy when unmeasured sources of bias likely exist.

'You fix my community, you have fixed my life': the disruption and rebuilding of ontological security in New Orleans.

Using the concept of ontological security, this paper examines the physical and psychological loss of home and community following Hurricane Katrina. This qualitative longitudinal study includes 40 heads of households with school-age children who lived in New Orleans during Hurricane Katrina. Participants describe a breakdown in their social fabric at the individual and structural/community levels that contributes to a sense of community loss and social displacement, disrupting their ontological security--their notion of safety, routine and trust in a stable environment. Three interrelated reactions were common: 1) experiencing nostalgia for their old neighbourhoods specifically and New Orleans in general; 2) experiencing a sense of loss of people and things that represented a level of security or constancy; 3) initiation of a process for re-establishing ontological security whether or not they returned to New Orleans. The paper concludes that intangible losses have an important psychological effect on community redevelopment and recovery from trauma.

Mental health recovery: Peer specialists with mental health and incarceration experiences.

Mental health recovery has not been examined widely in individuals with mental illnesses reentering the community from correctional settings. An important component of mental health recovery is engaging in work and many with lived mental health experiences become peer support specialists, yet little is known how this process unfolds for individuals who also have incarceration histories. Using life history phenomenological interviewing, this study investigates recovery pathways for peer support specialists with incarceration histories. Findings show that experiences of hope, connectedness, identity, meaningfulness, and empowerment were evident in individuals' recovery pathways of activating change, getting into recovery, integrating past and present, and living recovery every day. Notably, establishing a peer identity and drawing on past experiences were particularly salient. Training and working as a peer supported the recovery process through experiencing hope, facilitating connections, and witnessing disclosure. These findings can be applied to recovery-oriented services for those with experiences of mental illness and incarceration. (PsycInfo Database Record (c) 2020 APA, all rights reserved).