Medical students experience high rates of depression, and often face barriers to receiving traditional mental health services. Internet-based cognitive behavioral therapy (iCBT) programs offer a more ...accessible method of receiving care. Here, we conducted an open trial of an iCBT program for medical students and characterize program usage, program users, and self-reported psychosocial symptoms and coping skills.
All incoming first year medical students at a large state-run university were invited to use an iCBT program which focused on mood management and mood symptom prevention. Participants received access to the 16-week program and completed measures of perceived stress, quality of life, and the development of cognitive and behavioral coping skills at baseline and end of program.
Of the 194 students in the class, 53 (27.32%) signed up to use the program. While the program attracted a representative portion of underrepresented minority students, program engagement among males was particularly low. Repeated use of the program was low. Self-reported symptoms of depression and anxiety were low at baseline, and continued to be low at end of program. Slight increases were observed from baseline to end of program in the self-reported use of cognitive coping skills.
Digital mental health tools appear to be of interest to first year medical students, but need to be better designed to support continued program use and to attract specific subgroups of students who may face additional barriers to seeking mental health services.
•In a first-year medical school class of 194 students, 53 (27.32%) signed up to use an internet-based cognitive behavioral therapy (iCBT) program focused on mood management and mood symptom prevention.•The program attracted a reasonable portion of underrepresented minority students, program engagement among males was particularly low.•Repeated use of the program was low overall.•First year medical students appear to be interested in digital mental health tools, but these programs need to be better designed to support continued program use
Objective
Medical school presents a time of psychological distress for many students, who are less likely than the general population to seek mental health treatment due to multiple treatment ...barriers. Internet-based cognitive behavioral therapy (iCBT) programs may be an acceptable option for medical students. This study aims to assess acceptability and usability of ThinkFeelDo, an iCBT program, and to examine the impact of the program on perceived stress, quality of life, and the development of cognitive and behavioral coping skills.
Method
Fourteen medical students (M age = 25.4 years, 50% female) participated in the 6-week ThinkFeelDo program and completed baseline and end of treatment assessments.
Results
ThinkFeelDo was used (login M = 11.9, SD = 9.8) and was rated as somewhat useful. Participants requested further refinement of lessons to better fit the typical narrative of a medical student and endorsed interest in the program being offered at the beginning of medical school. At end of program, participants increased the frequency with which they used cognitive and behavioral coping skills,
t
(10) = −3.400,
p
= .007.
Conclusions
Results of this study indicate that medical students are willing to utilize online mental health programs and may receive benefit. However, the sample was small, self-selected, and without a comparison group. Feedback collected through this study provides insight on how to effectively integrate iCBT programs into the medical school experience.
Fear of recurrence (FoR) is a prevalent concern among breast cancer survivors (BCS), yet few accessible interventions exist. This study evaluated a targeted eHealth intervention, "FoRtitude," to ...reduce FoR using cognitive behavioral skills training and telecoaching.
BCS (N = 196) were recruited from an academic medical center and 3 National Cancer Institute Community Oncology Research Program community sites, had stage 0-III breast cancer, were 1-10 years postprimary treatment, with moderate to high FoR and familiarity with the internet. Using the Multiphase Optimization Strategy, participants were independently randomly assigned to 3 cognitive behavioral skills (relaxation, cognitive restructuring, worry practice) vs an attention control condition (health management content HMC) and to telecoaching (motivational interviewing) vs no telecoaching. Website content was released across 4 weeks and included didactic lessons, interactive tools, and a text-messaging feature. BCS completed the Fear of Cancer Recurrence Inventory at baseline and at 4 and 8 weeks. Fear of Cancer Recurrence Inventory scores over time were compared using mixed-effects models. All statistical tests were 2-sided.
FCRI scores SD decreased statistically significantly from baseline to postintervention (T0 = 53.1 17.4, T2 = 41.9 16.2, P < .001). The magnitude of reduction in FCRI scores was comparable across cognitive behavior therapy (CBT) and attention control HMC conditions and was predicted by increased self-efficacy. Telecoaching was associated with lower attrition and greater website use (mean adherence score SD = 26.6 7.2 vs 21.0 10.5, P < .001).
BCS experienced statistically significant reductions in FoR postintervention, but improvements were comparable between CBT and attention controls. Telecoaching improved adherence and retention. Future research is needed on optimal integration of CBT and HMC, dose, and features of eHealth delivery that contributed to reducing FoR. In the COVID-19 era, remote delivery has become even more essential for reaching survivors struggling with FoR.
Objectives
The rate of depression among college students has increased significantly, reducing vitality and ability to flourish. Mindfulness interventions delivered via technological platforms offer ...great promise for reducing depression symptoms and supporting positive wellbeing outcomes for college students. The present study aimed to understand the broader positive wellbeing outcomes that accompany a reduction in psychological distress following use of a technology-delivered mindfulness intervention.
Methods
Using a randomized controlled treatment design, this study evaluated the benefits of a mindfulness-based mobile application (app), Headspace, on various aspects of wellbeing in depressed college students. Students (
n
= 145) were randomly assigned to 2 months of app-based intervention or to a waitlist control. Participants completed self-report surveys assessing mental health and wellbeing at pre-intervention, midpoint (1 month), post-intervention (2 months), and follow-up (3 months).
Results
Using intent-to-treat analysis, those randomized to use the app, compared to those on the waitlist, demonstrated a reduction in depression symptoms, and in other indicators of psychological distress (e.g., anxiety, stress, negative affect), over time. Self-reported positive wellbeing outcomes included an increase in positive affect and happiness, enhanced capacity to savor the moment, enhanced compassion, self-regulation, and trait mindfulness. These statistically significant benefits were medium to large in size and lasted into the 1-month follow-up period. Further, students’ patterns of app use point to the critical gap that evidence-based technology-delivered interventions can fill.
Conclusions
Building on previous research, the present study illustrated that a technology-delivered mindfulness intervention comprehensively improved aspects of psychological distress
and
positive wellbeing in a sustained manner in college students.
Preregistration
This study was registered at OSF,
https://osf.io/3trzk
.
Anxiety is prevalent and poorly managed among persons with multiple sclerosis (MS). Physical activity (PA) may reduce anxiety, yet little is known about PA and its theory-based correlates in persons ...with MS who report elevated anxiety. Such research is important for the design and delivery of behavioral interventions targeting PA for the treatment of anxiety in MS. This study examined PA and social cognitive theory (SCT) variables (i.e., self-efficacy, barriers, outcome expectations, goal-setting/planning, social support, and functional limitations) in persons with MS who report elevated anxiety.
324 participants with MS (aged 48.59.5 years) completed SCT, anxiety, and PA measures, and wore accelerometers for 7 days as a device-measure of PA. The sample was categorized into subsamples with non-elevated (n = 218) and elevated anxiety (n = 106) based on the cut-off score of 8 for the Hospital Anxiety Depression Scale Anxiety subscale. We examined levels of PA and SCT variables between the two subsamples.
There were no differences in PA levels between the subsamples when controlling for group differences in age, education, and disease duration. Social support was lower and perceived functional limitations were higher in those with elevated anxiety and were significantly associated with PA. Regression analyses identified planning, social support, and perceived functional limitations as correlates of PA in those with elevated anxiety.
This study may guide research on SCT-based behavioral interventions for increasing PA as an approach for reduced anxiety among persons with MS and elevated anxiety by targeting exercise planning, social support, and perception of functional limitations.
•Physical activity(PA) in persons with multiple sclerosis(PwMS) and elevated anxiety is understudied.•Social-cognitive theory (SCT) helps understand PA behavior in MS.•This study examined SCT correlates of PA in persons with MS and elevated anxiety.•Planning, support, and limitations are important SCT-correlates of PA in PwMS and elevated anxiety.•SCT-based interventions may increase PA and improve anxiety in PwMS and elevated anxiety.
We examine the feasibility of using accelerometer data exclusively collected during typing on a custom smartphone keyboard to study whether typing dynamics are associated with daily variations in ...mood and cognition. As part of an ongoing digital mental health study involving mood disorders, we collected data from a well-characterized clinical sample (N = 85) and classified accelerometer data per typing session into orientation (upright vs. not) and motion (active vs. not). The mood disorder group showed lower cognitive performance despite mild symptoms (depression/mania). There were also diurnal pattern differences with respect to cognitive performance: individuals with higher cognitive performance typed faster and were less sensitive to time of day. They also exhibited more well-defined diurnal patterns in smartphone keyboard usage: they engaged with the keyboard more during the day and tapered their usage more at night compared to those with lower cognitive performance, suggesting a healthier usage of their phone.
PDF
