Stress Management Apps: Systematic Search and Multidimensional Assessment of Quality and Characteristics.

BACKGROUND: Chronic stress poses risks for physical and mental well-being. Stress management interventions have been shown to be effective, and stress management apps (SMAs) might help to transfer strategies into everyday life. OBJECTIVE: This review aims to provide a comprehensive overview of the quality and characteristics of SMAs to give potential users or health professionals a guideline when searching for SMAs in common app stores. METHODS: SMAs were identified with a systematic search in the European Google Play Store and Apple App Store. SMAs were screened and checked according to the inclusion criteria. General characteristics and quality were assessed by 2 independent raters using the German Mobile Application Rating Scale (MARS-G). The MARS-G assesses quality (range 1 to 5) on the following four dimensions: (1) engagement, (2) functionality, (3) esthetics, and (4) information. In addition, the theory-based stress management strategies, evidence base, long-term availability, and common characteristics of the 5 top-rated SMAs were assessed and derived. RESULTS: Of 2044 identified apps, 121 SMAs were included. Frequently implemented strategies (also in the 5 top-rated SMAs) were psychoeducation, breathing, and mindfulness, as well as the use of monitoring and reminder functions. Of the 121 SMAs, 111 (91.7%) provided a privacy policy, but only 44 (36.4%) required an active confirmation of informed consent. Data sharing with third parties was disclosed in only 14.0% (17/121) of the SMAs. The average quality of the included apps was above the cutoff score of 3.5 (mean 3.59, SD 0.50). The MARS-G dimensions yielded values above this cutoff score (functionality: mean 4.14, SD 0.47; esthetics: mean 3.76, SD 0.73) and below this score (information: mean 3.42, SD 0.46; engagement: mean 3.05, SD 0.78). Most theory-based stress management strategies were regenerative stress management strategies. The evidence base for 9.1% (11/121) of the SMAs could be identified, indicating significant group differences in several variables (eg, stress or depressive symptoms) in favor of SMAs. Moreover, 38.0% (46/121) of the SMAs were no longer available after a 2-year period. CONCLUSIONS: The moderate information quality, scarce evidence base, constraints in data privacy and security features, and high volatility of SMAs pose challenges for users, health professionals, and researchers. However, owing to the scalability of SMAs and the few but promising results regarding their effectiveness, they have a high potential to reach and help a broad audience. For a holistic stress management approach, SMAs could benefit from a broader repertoire of strategies, such as more instrumental and mental stress management strategies. The common characteristics of SMAs with top-rated quality can be used as guidance for potential users and health professionals, but owing to the high volatility of SMAs, enhanced evaluation frameworks are needed.

Accuracy for subtle facial emotional expressions among individuals with borderline personality disorder symptoms and diagnoses.

Many studies, yielding mixed results, have examined whether individuals with borderline personality disorder (BPD) have skills or deficits in facial emotion recognition (FER). The present studies explored this issue in 2 samples using 3 novel approaches: First, we examined BPD symptoms continuously in a nonclinical sample. Second, we examined the ability of individuals with BPD or elevated BPD symptoms to accurately identify emotions in static faces presented with emotional expressions ranging from neutral to subtle to fully expressed emotion. Third, we parsed accuracy into both correctly identifying an emotion and correctly ruling out an emotion that is not present. In Study 1, the relation between FER and BPD symptoms was examined in a nonclinical sample of undergraduates. In Study 2, individuals with BPD were compared with individuals with current major depression and healthy controls. In the nonclinical sample, BPD symptoms were unrelated to FER. In the clinical sample, we found evidence for enhanced accuracy for subtle and fully expressed facial emotions among individuals with BPD. Specifically, the ability to rule out an emotion when it was in fact not displayed emerged as the source of this increased accuracy. In addition, we did not find evidence of a bias for incorrectly labeling neutral faces as negative emotional expressions in either sample. Our results expand upon existing FER research in BPD that has largely relied on fully expressed emotional stimuli by demonstrating higher accuracy among individuals with BPD for identifying subtle emotional states. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Facebook photo activity associated with body image disturbance in adolescent girls.

The present study examined the relationship between body image and adolescent girls' activity on the social networking site (SNS) Facebook (FB). Research has shown that elevated Internet "appearance exposure" is positively correlated with increased body image disturbance among adolescent girls, and there is a particularly strong association with FB use. The present study sought to replicate and extend upon these findings by identifying the specific FB features that correlate with body image disturbance in adolescent girls. A total of 103 middle and high school females completed questionnaire measures of total FB use, specific FB feature use, weight dissatisfaction, drive for thinness, thin ideal internalization, appearance comparison, and self-objectification. An appearance exposure score was calculated based on subjects' use of FB photo applications relative to total FB use. Elevated appearance exposure, but not overall FB usage, was significantly correlated with weight dissatisfaction, drive for thinness, thin ideal internalization, and self-objectification. Implications for eating disorder prevention programs and best practices in researching SNSs are discussed.