User Perspectives on a Resilience-Building App (JoyPop): Qualitative Study.

BACKGROUND: Resilience is the capability, resources, and processes that are available to a person or system to adapt successfully in the face of stress or adversity. Given that resilience can be enhanced, using advances in technology to deliver and evaluate the impact of resilience interventions is warranted. Evidence supports the effectiveness of the resilience-building JoyPop app in improving resilience-related outcomes after use; however, experiential data from users is also needed to provide a more comprehensive account of its utility. OBJECTIVE: The aim of this study was to explore users' experiences with the JoyPop app and their perspectives on its utility. METHODS: This qualitative description study involved a combination of group and one-on-one semistructured interviews with a subset of first-year undergraduate students who participated in a larger evaluation of the JoyPop app. Participants used the app for a 4-week period and were subsequently asked about their frequency of app use, most and least used features (and associated reasons), most and least helpful features (and associated reasons), barriers to use, facilitators of use and continuation, and recommendations for improvement. Data were coded and categorized through inductive content analysis. RESULTS: The sample of 30 participants included 24 females and 6 males, with a mean age of 18.77 years (SD 2.30). App use ranged from 1 to 5 times daily (mean 2.11, SD 0.74), with the majority indicating that they used the app at least twice daily. The Rate My Mood, Journal, and SquareMoves features were reported to be used most often, while the Rate My Mood, Journal, and Breathing Exercises features were identified as the most helpful. A number of themes and subthemes pertaining to facilitators of app use (prompts, creating routine, self-monitoring opportunities, expressive opportunities), barriers to app use (editing, lack of variety, student lifestyle), outcomes of app use (increased awareness, checking in with oneself, helpful distraction, emotional control), and recommendations for app improvement (adding more features, enhancing existing features, enhancing tracking abilities, providing personalization) were identified. CONCLUSIONS: This study provides insight into the aspects of the JoyPop app that motivated and benefitted users, as well as measures that can be taken to improve user experiences and promote longer-term uptake. Users were willing to engage with the app and incorporate it into their routine, and they valued the ability to self-monitor, express emotion, and engage in distraction.

Adverse Childhood Experiences and Building Resilience With the JoyPop App: Evaluation Study.

BACKGROUND: The effects of adverse childhood experiences (ACEs) on mental health, self-regulatory capacities, and overall resilience are well-known. Given such effects, ACEs may play a role in how individuals adjust to challenges later in life. Of interest in this study is the transition to university, a time of heightened stress when adapting to circumstances is required and when those with ACEs may need additional in-the-moment support to exercise resilience. A smartphone app may provide a worthwhile and readily accessible medium for a resilience intervention, provided behavioral outcomes are adequately evaluated. OBJECTIVE: This study evaluates the impact of an innovative, smartphone app-based resilience intervention. The JoyPop app was designed to promote resilience through the use of self-regulatory skills such as emotion regulation and executive functioning. Among a sample of first-year undergraduate students, we explored whether use of the app would be associated with positive changes in resilience and related outcomes, and whether these benefits were influenced by level of childhood adversity. METHODS: Participants (N=156) were requested to use the JoyPop app for 4 weeks, at least twice daily. Changes in resilience, emotion regulation, executive functioning, and depression were assessed after 2 and 4 weeks of app usage using multilevel modeling. RESULTS: The sample of 156 participants included 123 females and 33 males, with a mean age of 19.02 years (SD 2.90). On average participants used the app on 20.43 of the possible 28 days (SD 7.14). App usage was associated with improvements in emotion regulation (χ21=44.46; P<.001), such that it improved by 0.25 points on the 18-point scale for each additional day of app usage, and symptoms of depression (χ21=25.12; P<.001), such that depression symptoms were reduced by .08 points on the 9-point scale with each additional day of app usage. An interaction between ACEs and days of app usage existed for emotion regulation, such that participants with more adversity evidenced a faster rate of change in emotion regulation (P=.02). CONCLUSIONS: Results highlight that daily incorporation of an app-based resilience intervention can help youth who have experienced adversity to improve emotion regulation skills and experience reductions in depression. The JoyPop app represents an important step forward in the integration of resilience intervention research with a technology-based medium that provides in-the-moment support.

Investigating the effects of norepinephrine α1 receptor blockade on dopamine levels: A pilot PET study with [11 C]-(+)-PHNO in controls.

Interest in a role for norepinephrine (NE) in substance use disorders has increased over recent years. In particular, its interaction with dopamine (DA) is of importance. In this study, positron emission tomography (PET) was used to explore the impact of prazosin (an alpha 1 NE antagonist) on DA levels. Healthy volunteers were administered prazosin for approximately 4 weeks at the daily dose of 15 mg to reach steady state. Participants were scanned with PET imaging and the [11 C]-(+)-PHNO tracer at baseline (before prazosin), at steady state, and after a wash out period. Prazosin administration was associated with an increase of [11 C]-(+)-PHNO binding potential in the dorsal caudate relative to baseline, which corresponds to a decrease in DA levels. This study is the first to demonstrate interactions between DA and NE in healthy humans.