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.

Psychological Resilience Factors and Their Association With Weekly Stressor Reactivity During the COVID-19 Outbreak in Europe: Prospective Longitudinal Study.

BACKGROUND: Cross-sectional relationships between psychosocial resilience factors (RFs) and resilience, operationalized as the outcome of low mental health reactivity to stressor exposure (low "stressor reactivity" [SR]), were reported during the first wave of the COVID-19 pandemic in 2020. OBJECTIVE: Extending these findings, we here examined prospective relationships and weekly dynamics between the same RFs and SR in a longitudinal sample during the aftermath of the first wave in several European countries. METHODS: Over 5 weeks of app-based assessments, participants reported weekly stressor exposure, mental health problems, RFs, and demographic data in 1 of 6 different languages. As (partly) preregistered, hypotheses were tested cross-sectionally at baseline (N=558), and longitudinally (n=200), using mixed effects models and mediation analyses. RESULTS: RFs at baseline, including positive appraisal style (PAS), optimism (OPT), general self-efficacy (GSE), perceived good stress recovery (REC), and perceived social support (PSS), were negatively associated with SR scores, not only cross-sectionally (baseline SR scores; all P<.001) but also prospectively (average SR scores across subsequent weeks; positive appraisal (PA), P=.008; OPT, P<.001; GSE, P=.01; REC, P<.001; and PSS, P=.002). In both associations, PAS mediated the effects of PSS on SR (cross-sectionally: 95% CI -0.064 to -0.013; prospectively: 95% CI -0.074 to -0.0008). In the analyses of weekly RF-SR dynamics, the RFs PA of stressors generally and specifically related to the COVID-19 pandemic, and GSE were negatively associated with SR in a contemporaneous fashion (PA, P<.001; PAC,P=.03; and GSE, P<.001), but not in a lagged fashion (PA, P=.36; PAC, P=.52; and GSE, P=.06). CONCLUSIONS: We identified psychological RFs that prospectively predict resilience and cofluctuate with weekly SR within individuals. These prospective results endorse that the previously reported RF-SR associations do not exclusively reflect mood congruency or other temporal bias effects. We further confirm the important role of PA in resilience.

Dynamic Modelling of Mental Resilience in Young Adults: Protocol for a Longitudinal Observational Study (DynaM-OBS).

BACKGROUND: Stress-related mental disorders are highly prevalent and pose a substantial burden on individuals and society. Improving strategies for the prevention and treatment of mental disorders requires a better understanding of their risk and resilience factors. This multicenter study aims to contribute to this endeavor by investigating psychological resilience in healthy but susceptible young adults over 9 months. Resilience is conceptualized in this study as the maintenance of mental health or quick recovery from mental health perturbations upon exposure to stressors, assessed longitudinally via frequent monitoring of stressors and mental health. OBJECTIVE: This study aims to investigate the factors predicting mental resilience and adaptive processes and mechanisms contributing to mental resilience and to provide a methodological and evidence-based framework for later intervention studies. METHODS: In a multicenter setting, across 5 research sites, a sample with a total target size of 250 young male and female adults was assessed longitudinally over 9 months. Participants were included if they reported at least 3 past stressful life events and an elevated level of (internalizing) mental health problems but were not presently affected by any mental disorder other than mild depression. At baseline, sociodemographic, psychological, neuropsychological, structural, and functional brain imaging; salivary cortisol and α-amylase levels; and cardiovascular data were acquired. In a 6-month longitudinal phase 1, stressor exposure, mental health problems, and perceived positive appraisal were monitored biweekly in a web-based environment, while ecological momentary assessments and ecological physiological assessments took place once per month for 1 week, using mobile phones and wristbands. In a subsequent 3-month longitudinal phase 2, web-based monitoring was reduced to once a month, and psychological resilience and risk factors were assessed again at the end of the 9-month period. In addition, samples for genetic, epigenetic, and microbiome analyses were collected at baseline and at months 3 and 6. As an approximation of resilience, an individual stressor reactivity score will be calculated. Using regularized regression methods, network modeling, ordinary differential equations, landmarking methods, and neural net-based methods for imputation and dimension reduction, we will identify the predictors and mechanisms of stressor reactivity and thus be able to identify resilience factors and mechanisms that facilitate adaptation to stressors. RESULTS: Participant inclusion began in October 2020, and data acquisition was completed in June 2022. A total of 249 participants were assessed at baseline, 209 finished longitudinal phase 1, and 153 finished longitudinal phase 2. CONCLUSIONS: The Dynamic Modelling of Resilience-Observational Study provides a methodological framework and data set to identify predictors and mechanisms of mental resilience, which are intended to serve as an empirical foundation for future intervention studies. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/39817.

Effectiveness of emotion regulation strategies measured by self-report and EMG as a result of strategy used, negative emotion strength and participants' baseline HRV.

We investigated how emotion regulation (ER) effectiveness-on both a self-reported rating as well as emotional expression (corrugator supercilii muscle activity) level-is affected by the characteristics of the situation (low vs. high negativity), the strategy used (reinterpretation, distraction, suppression, no regulation control condition) and individual dispositions (low vs. high baseline Heart Rate Variability) as well as their interaction. For this purpose, 54 adult women participated in a laboratory study. All the included factors significantly influenced both corrugator activity and appraisals of pictures' negativity (in specific experimental conditions). For example, for high HRV participants, (1) distraction, suppression and reinterpretation significantly decreased corrugator activity compared to the control condition, and (2) distraction decreased appraised picture negativity for high negativity photos. For low HRV participants, distraction and suppression were most effective in decreasing corrugator responses, while suppression was more effective than reinterpretation in decreasing perceived picture negativity in the high negativity condition. Subjectively reported effort and success in applying ER strategies were also dependent on manipulated and dispositional factors. Overall, our results lend support to the flexible emotion regulation framework, showing that emotion regulation effectiveness relies on situational context as well as individual dispositions and their interaction.

Standalone Smartphone Cognitive Behavioral Therapy-Based Ecological Momentary Interventions to Increase Mental Health: Narrative Review.

BACKGROUND: A growing number of psychological interventions are delivered via smartphones with the aim of increasing the efficacy and effectiveness of these treatments and providing scalable access to interventions for improving mental health. Most of the scientifically tested apps are based on cognitive behavioral therapy (CBT) principles, which are considered the gold standard for the treatment of most mental health problems. OBJECTIVE: This review investigates standalone smartphone-based ecological momentary interventions (EMIs) built on principles derived from CBT that aim to improve mental health. METHODS: We searched the MEDLINE, PsycINFO, EMBASE, and PubMed databases for peer-reviewed studies published between January 1, 2007, and January 15, 2020. We included studies focusing on standalone app-based approaches to improve mental health and their feasibility, efficacy, or effectiveness. Both within- and between-group designs and studies with both healthy and clinical samples were included. Blended interventions, for example, app-based treatments in combination with psychotherapy, were not included. Selected studies were evaluated in terms of their design, that is, choice of the control condition, sample characteristics, EMI content, EMI delivery characteristics, feasibility, efficacy, and effectiveness. The latter was defined in terms of improvement in the primary outcomes used in the studies. RESULTS: A total of 26 studies were selected. The results show that EMIs based on CBT principles can be successfully delivered, significantly increase well-being among users, and reduce mental health symptoms. Standalone EMIs were rated as helpful (mean 70.8%, SD 15.3; n=4 studies) and satisfying for users (mean 72.6%, SD 17.2; n=7 studies). CONCLUSIONS: Study quality was heterogeneous, and feasibility was often not reported in the reviewed studies, thus limiting the conclusions that can be drawn from the existing data. Together, the studies show that EMIs may help increase mental health and thus support individuals in their daily lives. Such EMIs provide readily available, scalable, and evidence-based mental health support. These characteristics appear crucial in the context of a global crisis such as the COVID-19 pandemic but may also help reduce personal and economic costs of mental health impairment beyond this situation or in the context of potential future pandemics.

Flexible Emotion Regulation: How Situational Demands and Individual Differences Influence the Effectiveness of Regulatory Strategies.

The number of studies and theoretical contributions on emotion regulation has grown rapidly. In this article we describe the concept of flexible emotion regulation. We argue that the effectiveness of specific emotion regulation strategies depends on the interaction of the features of a situation and personality characteristics of the individual regulating his/her emotions. We review a few recent theoretical contributions and studies that have attempted to capture some aspects of the flexibility of emotion regulation rather than distinguish between overly adaptive and maladaptive strategies. Moreover, we discuss potential personality determinants of effectiveness of particular regulatory strategies. We claim that further studies should address the interaction of situational and dispositional factors in shaping the effectiveness of particular emotion regulation strategies. So far, situational and personality determinants have been studied rather separately.

Flow injection method for the determination of silver concentration in drinking water for spacecrafts.

A flow injection method has been developed for determination of silver. The method is based on a reduction reaction with sodium borohydride which leads to the formation of a colloidal species which is monitored at a wavelength of 390 nm. The reaction variables flow rate, sodium borohydride concentration and pH, which affect sensitivity, were investigated and their effects were established using a two-levels, three-factor experimental design. Further optimization of manifold variables (reaction coil and injection volume) allowed us to determine silver in the range 0.050-5.0 mg L(-1) with a minimum detectable concentration of 0.050 mg L(-1). Silver is added, as biocide, to drinking water for spacecrafts. The chemical species of silver, present in this kind of sample, were characterized by a procedure based on the selective retention of Ag(+) onto a 2.2.2. cryptand based substrate followed by determination of the non-bound and bound (after elution) Ag(+) by the FIA method. The method optimized was applied to a drinking water sample provided for the launch with the Automated Transfer Vehicle (ATV) module Jule Verne to the International Space Station (March 9, 2008).

Determination of thermal conductivity of thin layers used as transparent contacts and antireflection coatings with a photothermal method.

A photothermal experiment with mirage detection was used to determine the thermal conductivity of various thin films deposited on semiconductor substrates. The first type consisted of conducting oxide films: ZnO and CdO deposited on GaSb:Te, while the other contained high dielectric constant HfO(2) layers on Si. All films were fabricated using a magnetron sputtering technique. Experimental results showed that the value of the thermal conductivity of ZnO and CdO films is lower than the value obtained for HfO(2). Thermal conductivities of investigated thin films are about 2 orders of magnitude lower than those corresponding to bulk materials.

Detector effects in photothermal deflection experiments.

We report on the theoretical analysis of a detector type influence on the normal deflection signal in photothermal experiments. Two cases are examined. In the first, the quadrant photodiode was considered as the detector; in the second the signal from the position detector, which measures the central moment displacement of the probe beam, was analyzed. Both analyses were carried out within the framework of the complex ray theory. The normal photodeflection signal was found to depend on the type of detector used in the photothermal deflection experiments for some parameters of its setup.

The influence of lateral implicit visual affective stimuli on the evaluation of neutral stimuli in humans.

It is now well established that implicit affect influences explicit judgments. Findings from neurobiological studies indicate a relationship between the functioning of the human cerebral hemispheres and emotions. The aim of the present research was to examine: (1) the direction of influence on neutral targets of suboptimal primes exposed for a duration of 16 ms, (2) whether the influence of affective suboptimal primes on neutral targets depends on the hemisphere to which the prime is directed. We predicted that affective primes exposed centrally would influence the evaluation of neutral target stimuli in a direction opposite to that of their explicit effect. Second, we posited that the influence of primes on the evaluation of neutral target stimuli would be different depending on the visual field in which the primes were exposed. We present combined data from four experiments, conducted in a visual affective priming paradigm. Neutral target stimuli (ideographs exposed for a duration of 2 seconds) were sub-optimally primed by photographs of faces expressing joy or disgust exposed in either the LVF, RVF or CVF. Subjects were asked "to state how negative/positive the character trait that is represented by a given ideograph is". The hypotheses were supported. The evaluation of ideographs after negative priming was more positive than the evaluation of ideographs after positive priming (indicating a contrast effect). This effect appeared only when affective priming stimuli were exposed in the central visual field. The evaluation of ideographs differed depending on the visual field of prime exposure conditions: exposure of affective primes in the right visual field resulted in more positive evaluations of ideographs than ideographs following primes in the left visual field.