There is a pressing need to create resources to promote mental health literacy among young people. Digital media is one of the methods that can be used to successfully promote mental health literacy. ...Although digital mental health resources are generally favorably perceived by young people, one of the essential factors in whether they choose to use these interventions is trust.
The objective of this study was to explore young people's trust-related concerns about and recommendations for the cocreated mental health website "What's Up With Everyone" by using TrustScapes. Our aim was to use the findings to improve the trustworthiness of the website and to inform future creators of web-based mental health resources.
In total, 30 young people (mean age 19, SD 1.509; range 17-21 years) participated in TrustScapes focus groups. Thematic analysis was carried out to analyze both the TrustScapes worksheets and audio transcripts.
Qualitative analysis revealed that the mental health website contains elements perceived to be both trustworthy and untrustworthy by young people. The relatable and high-quality design, which was achieved by cocreating the website with a team of design professionals and young people, was considered to increase trust. Creators' credibility also positively affected trust, but the logos and other information about the creators were recommended to be more salient for users. Suggestions were made to update the privacy policy and cookie settings and include communication functions on the platform to improve the trustworthiness of the website.
Factors perceived to be trustworthy included the website's relatable, high-quality design and creators' credibility, whereas those perceived to be untrustworthy included the privacy policy and cookie settings. The findings highlighted the significance of collaborating with end users and industrial partners and the importance of making the trust-enabling factors salient for users. We hope that these findings will inform future creators of web-based mental health resources to make these resources as trustworthy and effective as possible.
Postpartum depression (PPD) is treatable and preventable, but most women do not seek professional help for their perinatal depressive symptoms. One increasingly popular approach of improving access ...to care is the use of web-based intervention programs.
The objective of this study was 2-fold: first, to assess the efficacy of Be a Mom, a brief web-based selective or indicated preventive intervention, in reducing depressive and anxiety symptoms of women at high risk for PPD; and second, to examine mechanisms of change linking modifiable self-regulatory skills (ie, emotion regulation, self-compassion, and psychological flexibility) to improved perinatal mental health outcomes.
This 2-arm, open-label randomized controlled trial involved a sample of 1053 perinatal women presenting high risk for PPD who were allocated to the Be a Mom intervention group or a waitlist control group and completed self-report measures at baseline and postintervention assessments. Univariate latent change score models were computed to determine changes over time in adjustment processes and outcomes, with a multigroup-model approach to detect differences between the intervention and control groups and a 2-wave latent change score model to examine whether changes in processes were related to changes in outcomes.
Be a Mom was found to be effective in reducing depressive (intervention group: µΔ=-3.35; P<.001 vs control group: µΔ=-1.48; P<.001) and anxiety symptoms (intervention group: µΔ=-2.24; P<.001 vs control group: µΔ=-0.43; P=.04) in comparison with the control group, where such changes were inexistent or much smaller. All 3 psychological processes under study improved statistically significantly in posttreatment assessments: emotion regulation ability (Δχ
=12.3; P=.007) and psychological flexibility (Δχ
=34.9; P<.001) improved only in the intervention group, and although self-compassion increased in both groups (Δχ
=65.6; P<.001), these improvements were considerably greater in the intervention group.
These results suggest that Be a Mom, a low-intensity cognitive behavioral therapy program, is a promising first-line intervention for helping perinatal women, particularly those with early-onset PPD symptoms.
ClinicalTrials.gov NCT03024645; https://clinicaltrials.gov/ct2/show/NCT03024645.
Recent developments in artificial intelligence technologies have come to a point where machine learning algorithms can infer mental status based on someone’s photos and texts posted on social media. ...More than that, these algorithms are able to predict, with a reasonable degree of accuracy, future mental illness. They potentially represent an important advance in mental health care for preventive and early diagnosis initiatives, and for aiding professionals in the follow-up and prognosis of their patients. However, important issues call for major caution in the use of such technologies, namely, privacy and the stigma related to mental disorders. In this paper, we discuss the bioethical implications of using such technologies to diagnose and predict future mental illness, given the current scenario of swiftly growing technologies that analyze human language and the online availability of personal information given by social media. We also suggest future directions to be taken to minimize the misuse of such important technologies.
Mental crises have high prevalences in adolescence. Early interventions appear to be highly important to diminish the risk of the deterioration, recurrence, or chronification of symptoms. In recent ...years, various providers have started offering live chat support in psychological crises. The messenger-based psychological counseling service krisenchat aims to support young people in crises and, if necessary, provide a recommendation for a referral to the health care system or to seek further help from a trusted adult person.
This study aimed to investigate the impact of using the counseling service of krisenchat on the further help-seeking behavior of young people, and to identify associated factors of further help-seeking.
This longitudinal study analyzed anonymous data from 247 individuals who used krisenchat between October 2021 and March 2022, and received a recommendation for further help-seeking. An online survey directly after the chat assessed the perceived helpfulness of the chat and well-being after the chat. After 4 weeks, further help-seeking, facilitators and barriers to help-seeking, and self-efficacy were assessed in an online follow-up survey.
The most frequently recommended services or persons to seek further help from included a psychotherapist or social psychiatric service (75/225, 33.3%), a school psychologist or school social worker (52/225, 23.1%), and the user's parents (45/225, 20.0%). Of the 247 users, 120 (48.6%) indicated that they contacted the recommended service or person, and of these, 87 (72.5%) stated that they already had an appointment (or talk) with the respective service or person or that an appointment (or talk) was scheduled. The most frequently reported facilitators for further help-seeking were mental health literacy (54/120, 45.0%), improvement of self-efficacy (55/120, 45.8%), and symptom recognition (40/120, 33.3%). In users not displaying further help-seeking behavior, the most frequent barriers included stigmatization (60/127, 47.2%), lack of mental health literacy (59/127, 46.5%), need for self-reliance and autonomy (53/127, 41.7%), and negative family beliefs regarding help services (53/127, 41.7%). Subgroup comparisons indicated significantly higher levels of self-efficacy in users displaying further help-seeking behavior than in those not displaying further help-seeking behavior. Both subgroups did not differ in gender, age, recommended service or person, chat topics, perceived helpfulness, and well-being.
The findings of this study indicate that children and young adults receiving counseling on krisenchat benefit in terms of seeking further help. Further help-seeking seems to be associated with higher levels of self-efficacy.
Deutsches Register Klinischer Studien DRKS00026671; https://tinyurl.com/4fm5xe68.
Extant gaps in mental health services are intensified among first-generation college students. Improving access to empirically based interventions is critical, and mobile health (mHealth) ...interventions are growing in support. Acceptance and commitment therapy (ACT) is an empirically supported intervention that has been applied to college students, via mobile app, and in brief intervals.
This study evaluated the safety, feasibility, and effectiveness of an ACT-based mHealth intervention using a microrandomized trial (MRT) design.
Participants (N=34) were 18- to 19-year-old first-generation college students reporting distress, who participated in a 6-week intervention period of twice-daily assessments and randomization to intervention. Participants logged symptoms, moods, and behaviors on the mobile app Lorevimo. After the assessment, participants were randomized to an ACT-based intervention or no intervention. Analyses examined proximal change after randomization using a weighted and centered least squares approach. Outcomes included values-based and avoidance behavior, as well as depressive symptoms and perceived stress.
The findings indicated the intervention was safe and feasible. The intervention increased values-based behavior but did not decrease avoidance behavior. The intervention reduced depressive symptoms but not perceived stress.
An MRT of an mHealth ACT-based intervention among distressed first-generation college students suggests that a larger MRT is warranted. Future investigations may tailor interventions to contexts where intervention is most impactful.
ClinicalTrials.gov NCT04081662; https://clinicaltrials.gov/show/NCT04081662.
RR2-10.2196/17086.
The COVID-19 pandemic brought digital practices and engagement to the forefront of society, which were based on behavioral changes associated with adhering to different government mandates. Further ...behavioral changes included transitioning from working in the office to working from home, with the use of various social media and communication platforms to maintain a level of social connectedness, especially given that many people who were living in different types of communities, such as rural, urban, and city spaces, were socially isolated from friends, family members, and community groups. Although there is a growing body of research exploring how technology is being used by people, there is limited information and insight about the digital practices employed across different age cohorts living in different physical spaces and residing in different countries.
This paper presents the findings from an international multisite study exploring the impact of social media and the internet on the health and well-being of individuals in different countries during the COVID-19 pandemic.
Data were collected via a series of online surveys deployed between April 4, 2020, and September 30, 2021. The age of respondents varied from 18 years to over 60 years across the 3 regions of Europe, Asia, and North America. On exploring the associations of technology use, social connectedness, and sociodemographic factors with loneliness and well-being through bivariate and multivariate analyses, significant differences were observed.
The levels of loneliness were higher among respondents who used social media messengers or many social media apps than among those who did not use social media messengers or used ≤1 social media app. Additionally, the levels of loneliness were higher among respondents who were not members of an online community support group than among those who were members of an online community support group. Psychological well-being was significantly lower and loneliness was significantly higher among people living in small towns and rural areas than among those living in suburban and urban communities. Younger respondents (18-29 years old), single adults, unemployed individuals, and those with lower levels of education were more likely to experience loneliness.
From an international and interdisciplinary perspective, policymakers and stakeholders should extend and explore interventions targeting loneliness experienced by single young adults and further examine how this may vary across geographies. The study findings have implications across the fields of gerontechnology, health sciences, social sciences, media communication, computers, and information technology.
RR2-10.3389/fsoc.2020.574811.
Background
Remote measurement technologies, such as smartphones and wearable devices, can improve treatment outcomes for depression through enhanced illness characterization and monitoring. However, ...little is known about digital outcomes that are clinically meaningful to patients and clinicians. Moreover, if these technologies are to be successfully implemented within treatment, stakeholders’ views on the barriers to and facilitators of their implementation in treatment must be considered.
Objective
This study aims to identify clinically meaningful targets for digital health research in depression and explore attitudes toward their implementation in psychological services.
Methods
A grounded theory approach was used on qualitative data from 3 focus groups of patients with a current diagnosis of depression and clinicians with >6 months of experience with delivering psychotherapy (N=22).
Results
Emerging themes on clinical targets fell into the following two main categories: promoters and markers of change. The former are behaviors that participants engage in to promote mental health, and the latter signal a change in mood. These themes were further subdivided into external changes (changes in behavior) or internal changes (changes in thoughts or feelings) and mapped with potential digital sensors. The following six implementation acceptability themes emerged: technology-related factors, information and data management, emotional support, cognitive support, increased self-awareness, and clinical utility.
Conclusions
The promoters versus markers of change differentiation have implications for a causal model of digital phenotyping in depression, which this paper presents. Internal versus external subdivisions are helpful in determining which factors are more susceptible to being measured by using active versus passive methods. The implications for implementation within psychotherapy are discussed with regard to treatment effectiveness, service provision, and patient and clinician experience.
