Preferences on Governance Models for Mental Health Data: Qualitative Study With Young People.

BACKGROUND: Improving access to mental health data to accelerate research and improve mental health outcomes is a potentially achievable goal given the substantial data that can now be collected from mobile devices. Smartphones can provide a useful mechanism for collecting mental health data from young people, especially as their use is relatively ubiquitous in high-resource settings such as the United Kingdom and they have a high capacity to collect active and passive data. This raises the interesting opportunity to establish a large bank of mental health data from young people that could be accessed by researchers worldwide, but it is important to clarify how to ensure that this is done in an appropriate manner aligned with the values of young people. OBJECTIVE: In this study, we discussed the preferences of young people in the United Kingdom regarding the governance, sharing, and use of their mental health data with the establishment of a global data bank in mind. We aimed to determine whether young people want and feel safe to share their mental health data; if so, with whom; and their preferences in doing so. METHODS: Young people (N=46) were provided with 2 modules of educational material about data governance models and background in scientific research. We then conducted 2-hour web-based group sessions using a deliberative democracy methodology to reach a consensus where possible. Findings were analyzed using the framework method. RESULTS: Young people were generally enthusiastic about contributing data to mental health research. They believed that broader availability of mental health data could be used to discover what improves or worsens mental health and develop new services to support young people. However, this enthusiasm came with many concerns and caveats, including distributed control of access to ensure appropriate use, distributed power, and data management that included diverse representation and sufficient ethical training for applicants and data managers. CONCLUSIONS: Although it is feasible to use smartphones to collect mental health data from young people in the United Kingdom, it is essential to carefully consider the parameters of such a data bank. Addressing and embedding young people's preferences, including the need for robust procedures regarding how their data are managed, stored, and accessed, will set a solid foundation for establishing any global data bank.

Evidencing the Impact of Web-Based Coproduction With Youth on Mental Health Research: Qualitative Findings From the MindKind Study.

BACKGROUND: Public involvement in research is a growing phenomenon as well as a condition of research funding, and it is often referred to as coproduction. Coproduction involves stakeholder contributions at every stage of research, but different processes exist. However, the impact of coproduction on research is not well understood. Web-based young people's advisory groups (YPAGs) were established as part of the MindKind study at 3 sites (India, South Africa, and the United Kingdom) to coproduce the wider research study. Each group site, led by a professional youth advisor, conducted all youth coproduction activities collaboratively with other research staff. OBJECTIVE: This study aimed to evaluate the impact of youth coproduction in the MindKind study. METHODS: To measure the impact of web-based youth coproduction on all stakeholders, the following methods were used: analysis of project documents, capturing the views of stakeholders using the Most Significant Change technique, and impact frameworks to assess the impact of youth coproduction on specific stakeholder outcomes. Data were analyzed in collaboration with researchers, advisors, and YPAG members to explore the impact of youth coproduction on research. RESULTS: The impact was recorded on 5 levels. First, at the paradigmatic level, a novel method of conducting research allowed for a widely diverse group of YPAG representations, influencing study priorities, conceptualization, and design. Second, at the infrastructural level, the YPAG and youth advisors meaningfully contributed to the dissemination of materials; infrastructural constraints of undertaking coproduction were also identified. Third, at the organizational level, coproduction necessitated implementing new communication practices, such as a web-based shared platform. This meant that materials were easily accessible to the whole team and communication streams remained consistent. Fourth, at the group level, authentic relationships developed between the YPAG members, advisors, and the rest of the team, facilitated by regular web-based contact. Finally, at the individual level, participants reported enhanced insights into mental well-being and appreciation for the opportunity to engage in research. CONCLUSIONS: This study revealed several factors that shape the creation of web-based coproduction, with clear positive outcomes for advisors, YPAG members, researchers, and other project staff. However, several challenges of coproduced research were also encountered in multiple contexts and amid pressing timelines. For systematic reporting of the impact of youth coproduction, we propose that monitoring, evaluation, and learning systems be designed and implemented early.

Young people's data governance preferences for their mental health data: MindKind Study findings from India, South Africa, and the United Kingdom.

Mobile devices offer a scalable opportunity to collect longitudinal data that facilitate advances in mental health treatment to address the burden of mental health conditions in young people. Sharing these data with the research community is critical to gaining maximal value from rich data of this nature. However, the highly personal nature of the data necessitates understanding the conditions under which young people are willing to share them. To answer this question, we developed the MindKind Study, a multinational, mixed methods study that solicits young people's preferences for how their data are governed and quantifies potential participants' willingness to join under different conditions. We employed a community-based participatory approach, involving young people as stakeholders and co-researchers. At sites in India, South Africa, and the UK, we enrolled 3575 participants ages 16-24 in the mobile app-mediated quantitative study and 143 participants in the public deliberation-based qualitative study. We found that while youth participants have strong preferences for data governance, these preferences did not translate into (un)willingness to join the smartphone-based study. Participants grappled with the risks and benefits of participation as well as their desire that the "right people" access their data. Throughout the study, we recognized young people's commitment to finding solutions and co-producing research architectures to allow for more open sharing of mental health data to accelerate and derive maximal benefit from research.

The Role of Emotion Regulation and Executive Functioning in the Intervention Outcome of Children with Emotional and Behavioural Problems.

Emotional and behavioural problems are closely associated with impairments in regulating emotions and in executive functions (EF). To examine this further, the aim of the present study was to determine whether EF and emotion regulation at baseline would predict emotional and behavioural problem scores post-intervention, and further explore the extent to which emotion regulation mediates these outcomes. Participants were 41 primary school children who exhibited emotional and/or behavioural problems, aged 8 to 11 years. All the children completed measures of emotional and behavioural problems, cognitive emotion regulation, anxiety symptoms, and performed two experimental tasks to measure working memory and response inhibition before and after participating in a transdiagnostic Cognitive Behaviour Therapy-based programme, "Super Skills for Life" (SSL), and at 3-months follow-up. Results revealed significant reduction in the use of maladaptive emotion regulation strategy catastrophising and other blame following the intervention. Additionally, EF and emotion regulation was associated with outcomes for emotional problems and conduct problems. More specifically maladaptive emotion regulation strategy such as catastrophising and other blame was closely related with self-reports of emotional problems, likewise other blame, was also linked with scores of conduct problems. This study provides preliminary empirical support for EF and emotion regulation in predicting outcomes of emotional and behavioural problems in children following intervention.

The Mediating Effects of Self-Esteem on Anxiety and Emotion Regulation.

Individuals with anxiety disorders maladaptively appraise interpersonal threat cues leading to inaccurate interpretations of the self and others. However, little is known about the factors that mediate this association, therefore, the main aim of this study was to examine the relationship between state and trait anxiety, self-esteem, and emotion regulation strategies: reappraisal and suppression. Young adults aged between 18-26 years participated in the study. They completed a set of self-reports measuring emotion regulation, self-esteem, state-trait anxiety, and positive and negative attributes. Participants also completed an experimental task, using the dot-probe paradigm, which measures threat bias and response inhibition. The findings showed that trait and state anxiety predicted suppression, reappraisal, and internalising problems, and is linked to response inhibition. Importantly, low self-esteem, significantly mediated the relationship between increased anxiety and suppression. Taken together, these results show specific associations between emotion regulation and anxiety, highlighting the significant impact of self-esteem in young adults.

Internet use during COVID-19 lockdown among young people in low- and middle-income countries: Role of psychological wellbeing.

Problematic internet use in adolescents has been shown to significantly increase over the past few years, with COVID-19 pandemic lockdowns reinforcing this phenomena globally. We sought to explore whether problematic internet use in specific countries was related to emotional well-being and importantly whether this is predicted by psychological distress. There is a growing number of studies showing that problematic internet use is increasingly prevalent in countries with emerging economies, however we have yet to find out to what extent other factors are influencing this behaviour in adolescents and young people. This study invited young people from countries such India, Mexico, Philippines and Turkey to complete a set of self-reports on their daily internet habits, social media use, alongside questions on psychological distress, self-esteem, loneliness and escapism. A total of 1182 young people aged between 16 and 25 years old completed these questionnaires online. The results showed that there were significant difference in problematic internet use scores among adolescents in the Philippines and Turkey. More specifically, social media use was significantly higher amongst young people from the Philippines whereas gaming addiction was significantly high in the Turkish sample. These findings also revealed that psychological distress, loneliness, and low self-esteem consistently predicted problematic internet use. Taken together these results emphasise that there are several factors underlying growing figures of problematic internet use in young people, these factors include emotional distress, need for escapism, loneliness, and social media use, however, going forward more nuanced cultural differences should also be considered.

Psychometric properties of the compulsive internet use scale among adolescents in India, Philippines and Turkey.

Research shows that internet addiction continues to grow globally, with wider access to the internet and changing use of smartphones. The compulsive internet use scale (CIUS) which has been found to be consistently associated with pathological internet use, is widely considered a measure for prolonged and problematic internet use. CIUS had been translated and adapted in several countries with reports of good reliability. However, to our knowledge this is the first study that examined the psychometric properties of the CIUS scale in three countries who share similar collectivistic attitudes and are a part of growing economies. This link was shared widely amongst young adults (aged 18-25 years), and a total of 837 participants completed the questionnaires. They completed the CIUS scale alongside a measure for escapism and self-esteem. These additional self-reports were added to assess the construct validity of the CIUS. The results from this study confirms the single factor structure of the CIUS as the best fit for this scale, this single factor solution was found for all the three countries. Similarly, high scores of internal reliability were observed for samples in India, Philippines and Turkey. We further found the CIUS to positively correlate with scores of escapism in the Turkish sample only. Taken together these results suggest that the CIUS is an effective measure regardless of country of residence, whilst highlighting the underlying differences in escapism that may need further attention.

The impact of COVID-19 lockdown on internet use and escapism in adolescents / El impacto del confinamiento por el COVID-19 en el uso de internet y la evasión en los adolescentes

The COVID-19 pandemic has had a significant impact on everyday functioning, considerable measures being taken to reduce the spread of the virus. Schools and social avenues have been placed on prolonged lockdowns, with people continuing to maintain physical distance. Adolescents and young people have had to endure significant stress alongside dealing with developmental characteristics. Amidst all of this, studies report an increase in gaming addiction and internet use with detrimental impact on psychosocial well-being. The aim of the present study was to examine the impact of lockdown on internet use in adolescents, comparing their habits from before the pandemic. Furthermore, this research aimed to investigate the relationship between gaming addiction, internet use and COVID-19 worries. Adolescents from several countries (e.g., India, Malaysia, Mexico and the UK) completed online questionnaires, shared via social media and youth networks. These measures included questions on internet, social media, gaming, depression, loneliness, escapism and COVID-19. Results show that adolescents generally have increased their use of social media sites and streaming services. Further, those who scored highly on gaming addiction, compulsive internet use and social media use also reported high scores of depression, loneliness, escapism, poor sleep quality and anxiety related to the pandemic. Our findings indicate that, regardless of country of residence, the COVID-19 outbreak has had a significant effect on adolescent internet use and psychosocial well-being. The need to address pandemic related distress to reduce the effect of maladaptive coping strategies is highlighted

La pandemia del COVID-19 ha tenido un impacto significativo en el funcionamiento diario, tomándose medidas importantes para reducir la propagación del virus. Las escuelas y los espacios públicos se han cerrado durante largos periodos, y la distancia física se ha impuesto. Los adolescentes y jóvenes han tenido que soportar un estrés significativo al tiempo que lidiar con las situaciones propias de su desarrollo. Los estudios informan de un aumento en la adicción al juego y al uso de Internet con un impacto perjudicial en el bienestar psicosocial. El objetivo del presente estudio fue examinar el impacto del confinamiento en el uso de Internet en los adolescentes, comparando sus hábitos con antes de la pandemia. Además, se estudia la relación entre la adicción al juego, el uso de Internet y las preocupaciones por el COVID-19. Adolescentes de varios países (India, Malasia, México y Reino Unido) completaron los cuestionarios online, que se distribuyeron a través de redes sociales y redes de jóvenes. Se incluyeron preguntas sobre Internet, redes sociales, juego, depresión, soledad, aversión y COVID-19. Los resultados muestran que los adolescentes en general han aumentado el uso de redes sociales y de servicios de transmisión. Además, los que obtuvieron puntuaciones altas en adicción al juego, uso compulsivo de Internet y uso de redes sociales también informaron de puntuaciones altas en depresión, soledad, aversión, mala calidad del sueño y ansiedad relacionada con la pandemia. Nuestros hallazgos indican que, independientemente del país de residencia, el confinamiento por COVID-19 ha tenido un efecto significativo en el uso de Internet y en el bienestar psicosocial de los adolescentes. Se destaca la necesidad de abordar el distrés relacionado con la pandemia para reducir el efecto de las estrategias de afrontamiento desadaptativas

Evaluating the real-world effectiveness of a cognitive behavior therapy-based transdiagnostic program for emotional problems in children in a regular school setting.

BACKGROUND: The present study examined the real-world effectiveness of a transdiagnostic prevention program, Super Skills for Life (SSL), among children with emotional problems in regular school settings. SSL is based on the principles of Cognitive Behavior Therapy (CBT), behavioral activation, and social skills training. METHODS: Participants were 205 children, aged 8-12 years, who were referred by their teachers as having significant emotional problems. All the children completed measures of emotional and behavioral problems and self-esteem, both before and after participating in SSL, and at six months after the intervention. The children's parents and class teachers also completed a questionnaire that measures children's general difficulties and positive attributes. Children also gave a 2-minute speech task in front of the video in sessions 1 and 8. RESULTS: There was agreement among self, parent, and teacher report, showing significant decreases of emotional symptoms from pretest to posttest and pretest to follow-up. Main effect of gender was significant for anxiety symptoms, emotional symptoms peer problems, and prosocial behavior. Video analysis of the 2-minute speech task showed significant improvement in length of eye gaze, vocal quality, length of speech, manifestation of comfort, and conversational flow. However, hypothesized increases in self-esteem did not act as a mediator of change in pre- to post-anxiety symptoms or social phobia subscale scores. LIMITATIONS: The present study used an open clinical trial design. CONCLUSIONS: This study provides initial support for the effectiveness of the manual-guided CBT for emotional problems in regular school settings when delivered by school services staff.