A smartphone application to reduce problematic drinking: a feasibility trial.

BACKGROUND: Problematic drinking is common among college students and associated with various somatic and mental health problems. Given significant evidence for the efficacy of smartphone-based interventions and the frequent use of smartphones among college students, it can be assumed that such interventions have great potential to facilitate access to evidence-based interventions for students suffering from problematic drinking. Thus, we developed a brief intervention that combined a counseling session with an app that utilizes approach-avoidance modification training to reduce alcohol consumption. METHODS: To test the feasibility and explore the potential efficacy of the intervention, we conducted a before-after single-arm study with N = 11 participants reportedly engaging in problematic drinking, who were instructed to practice with the app for 14 days. Feasibility was assessed with the System Usability Scale (SUS). Outcomes included the reduction of self-reported problematic drinking behavior, dysfunctional attitudes about alcohol, and craving, as well as implicit associations between alcohol and self during the training period. Additionally, self-reported problematic drinking behavior was assessed at a 4-week follow-up. RESULTS: On average, participants rated app usability on the SUS (possible range: 0 to 100) with M = 84.32 (SD = 6.53). With regard to efficacy, participants reported a significant reduction of problematic drinking behavior (dpre vs. post = 0.91) which was sustained at follow-up (dfollow-up vs. baseline = 1.07). Additionally, participants reported a significant reduction of dysfunctional attitudes about alcohol (dpre vs. post = 1.48). Results revealed no significant changes in craving nor in implicit associations regarding alcohol. CONCLUSIONS: Findings from this feasibility study provide preliminary evidence that smartphone-based interventions might help reduce problematic drinking in college students. Further research needs to replicate these findings with larger samples in randomized controlled trials. TRIAL REGISTRATION: DRKS00014675 (retrospectively registered).

A Gamified Smartphone-Based Intervention for Depression: Randomized Controlled Pilot Trial.

BACKGROUND: Available smartphone-based interventions for depression predominantly use evidence-based strategies from cognitive-behavioral therapy (CBT), but patient engagement and reported effect sizes are small. Recently, studies have demonstrated that smartphone-based interventions combining CBT with gamified approach-avoidance bias modification training (AAMT) can foster patient engagement and reduce symptoms of several mental health problems. OBJECTIVE: Based on these findings, we developed a gamified smartphone-based intervention, mentalis Phoenix (MT-Phoenix), and hypothesized the program would both engage patients and produce preliminary evidence for the reduction of depressive symptoms. METHODS: To test this hypothesis, we evaluated MT-Phoenix in a randomized controlled pilot trial including 77 individuals with elevated depression scores (Patient Health Questionnaire-9 scores ≥5). Participants were either instructed to train for 14 days with MT-Phoenix or assigned to a waitlist control condition. Engagement with the intervention was measured by assessing usage data. The primary outcome was reduction in depressive symptom severity at postassessment. RESULTS: Data from this pilot trial shows that participants in the intervention group used the smartphone-based intervention for 46% of all days (6.4/14) and reported a significantly greater reduction of depressive symptoms than did participants in the control condition (F1,74=19.34; P=.001), with a large effect size (d=1.02). Effects were sustained at a 3-month follow-up. CONCLUSIONS: A gamified smartphone-based intervention combining CBT with AAMT may foster patient engagement and effectively target depressive symptoms. Future studies should evaluate the effectiveness of this intervention in a phase 3 trial using clinical samples. Moreover, the intervention should be compared to active control conditions. TRIAL REGISTRATION: German Clinical Trial Registry DRKS00012769; https://tinyurl.com/47mw8du7.

Blending group-based psychoeducation with a smartphone intervention for the reduction of depressive symptoms: results of a randomized controlled pilot study.

BACKGROUND: Given their ubiquity and technological facilities, smartphone-based interventions (SBIs) hold potential to support the cost-effective dissemination of evidence-based treatments for depression. As technologically enriched, blended approach-avoidance modification trainings (AAMTs) have recently been shown effective for symptom reduction in various mental health problems, we developed a blended SBI combining group-based psychoeducation and 14 days of app training utilizing principles from AAMT to reduce depressive symptoms. METHODS: In this pilot trial, N = 16 individuals with heightened depression scores were randomized to either an intervention group using the mentalis Phoenix app or a wait list control condition. As outcomes, we descriptively explored usability of the app, engagement with the intervention, and possible reductions of depressive symptoms. RESULTS: Data analyses suggest that the SBI tested in this pilot trial possesses high usability, is frequently engaged with, and reduces depressive symptoms in participants in the intervention group when compared to wait list controls. CONCLUSIONS: This pilot study provides preliminary evidence that an SBI utilizing AAMT can reduce depressive symptoms. Future studies should replicate these findings using larger samples and disentangle possible mechanisms of change. TRIAL REGISTRATION: DRKS-ID: DRKS00021613 (retrospectively registered).

Smartphone-based emotion recognition skills training for alexithymia - A randomized controlled pilot study.

BACKGROUND: Neurobiological studies suggest that deficits in emotion recognition are common phenomena in alexithymia. Thus, effective treatments for alexithymia often include skills training in the domain of emotion recognition. Given that smartphone-based interventions (SBIs) offering skills training have been shown to be promising adjuncts to psychological treatments, a blended SBI facilitating the training of emotional skills might be effective in reducing alexithymia. METHODS: In this pilot trial, N = 29 individuals reporting elevated alexithymia levels were randomly assigned to a blended SBI including a psychoeducation session and 14 days of training with the mindtastic alexithymia app (MT-ALEX) or a psychoeducation-only control condition. Primary outcome was emotion recognition skills as assessed in a computer-based two-choice task paradigm. RESULTS: On average, participating in the SBI was associated with a significant increase in computer-assessed emotion recognition skills compared to the control condition (d = 0.97). CONCLUSIONS: Study findings provide preliminary evidence that SBIs can improve emotion recognition skills in alexithymic individuals. Research using larger samples and targeting clinical populations is necessary to further evaluate the potential of MT-ALEX.

Reducing procrastination using a smartphone-based treatment program: A randomized controlled pilot study.

BACKGROUND: Procrastination affects a large number of individuals and is associated with significant mental health problems. Despite the deleterious consequences individuals afflicted with procrastination have to bear, there is a surprising paucity of well-researched treatments for procrastination. To fill this gap, this study evaluated the efficacy of an easy-to-use smartphone-based treatment for procrastination. METHOD: N = 31 individuals with heightened procrastination scores were randomly assigned to a blended smartphone-based intervention including two brief group counseling sessions and 14 days of training with the mindtastic procrastination app (MT-PRO), or to a waitlist condition. MT-PRO fosters the approach of functional and the avoidance of dysfunctional behavior by systematically utilizing techniques derived from cognitive bias modification approaches, gamification principles, and operant conditioning. Primary outcome was the course of procrastination symptom severity as assessed with the General Procrastination Questionnaire. RESULTS: Participating in the smartphone-based treatment was associated with a significantly greater reduction of procrastination than was participating in the control condition (η2  = .15). CONCLUSION: A smartphone-based intervention may be an effective treatment for procrastination. Future research should use larger samples and directly compare the efficacy of smartphone-based interventions and traditional interventions for procrastination.

Deficits in general emotion regulation skills-Evidence of a transdiagnostic factor.

OBJECTIVE: Deficits in emotion regulation (ER) skills are discussed as a transdiagnostic factor contributing to the development and maintenance of various mental disorders. However, systematic comparisons of a broad range of ER skills across diagnostic groups that are based on comparable definitions and measures of ER are still rare. METHOD: Therefore, we conducted two studies assessing a broad range of ER skills with the Emotion Regulation Skills Questionnaire in individuals meeting criteria for mental disorders (N1  = 1448; N2  = 137) and in a general population sample (N = 214). RESULTS: Consistent across the two studies, participants in the clinical samples reported lower general and lower specific ER skills than participants in the general population sample. Also consistent across the two studies, diagnostic subgroups of the clinical samples differed significantly with regard to general and specific ER skills. CONCLUSION: The studies provide evidence that deficits in ER are associated with various forms of psychopathology. However, mental disorders seem to differ with regard to how strongly they are linked to ER skills.

An app-based blended intervention to reduce body dissatisfaction: A randomized controlled pilot study.

OBJECTIVE: As a common experience in the general population, dissatisfaction with one's body is associated with a variety of psychological problems and unhealthy behaviors, including the development of eating disorders. Therefore, the purpose of the present study was to develop and evaluate an app-based intervention to reduce body dissatisfaction. METHOD: Participants reporting elevated levels of body dissatisfaction were randomly allocated to an app-based intervention (n = 26) or to a wait list group (n = 27). The app-based intervention included a brief counseling session and 14 days of training with the Mindtastic Body Dissatisfaction app (MT-BD). The MT-BD app uses gamification strategies to systematically foster approach of functional and avoidance of dysfunctional stimuli. The primary outcome was body dissatisfaction as assessed with the Body Dissatisfaction scale of the Eating Disorder Inventory-2 (Garner, 1991). Secondary outcome measures included severity of eating disorder symptoms and depressive symptoms. RESULTS: Participants in the intervention group showed significantly greater reductions in body dissatisfaction compared to the wait list group (d = -0.62). The intervention group also showed greater reductions in eating disorder symptoms compared to the wait list group (d = -0.46). Reductions in body dissatisfaction and eating disorder symptoms were sustained at a 1-month follow-up. CONCLUSION: We found preliminary evidence that an app-based intervention may significantly reduce body dissatisfaction. Further research using larger samples and targeting clinical populations is necessary to evaluate the potential of interventions such as MT-BD. (PsycINFO Database Record