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2. The Acceptability, Engagement, and Feasibility of Mental Health Apps for Marginalized and Underserved Young People: Systematic Review and Qualitative Study

Author

Bear, Holly Alice, Nunes, Lara Ayala, Ramos, Giovanni, Manchanda, Tanya, Fernandes, Blossom, Chabursky, Sophia, Walper, Sabine, Watkins, Edward, and Fazel, Mina

Subjects
Health Services and Systems, Public Health, Health Sciences, Social Determinants of Health, Health Disparities, Health Services, Behavioral and Social Science, Clinical Research, Clinical Trials and Supportive Activities, Mental Health, 7.1 Individual care needs, 3.1 Primary prevention interventions to modify behaviours or promote wellbeing, Mental health, Generic health relevance, Good Health and Well Being, Humans, Mobile Applications, Male, Qualitative Research, Young Adult, Adolescent, Feasibility Studies, Vulnerable Populations, Adult, Mental Health Services, Patient Acceptance of Health Care, Smartphone, Female, adolescent mental health, marginalized groups, smartphone apps, engagement, implementation science, mobile app, smartphone, mobile health, mHealth, mental health, challenges, acceptability, young, effectiveness, mobile phone, Information and Computing Sciences, Medical and Health Sciences, Psychology and Cognitive Sciences, Medical Informatics, Health services and systems
Abstract

BackgroundSmartphone apps may provide an opportunity to deliver mental health resources and interventions in a scalable and cost-effective manner. However, young people from marginalized and underserved groups face numerous and unique challenges to accessing, engaging with, and benefiting from these apps.ObjectiveThis study aims to better understand the acceptability (ie, perceived usefulness and satisfaction with an app) and feasibility (ie, the extent to which an app was successfully used) of mental health apps for underserved young people. A secondary aim was to establish whether adaptations can be made to increase the accessibility and inclusivity of apps for these groups.MethodsWe conducted 2 sequential studies, consisting of a systematic literature review of mental health apps for underserved populations followed by a qualitative study with underserved young male participants (n=20; age: mean 19). Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, an electronic search of 5 databases was conducted in 2021. The search yielded 18,687 results, of which 14 articles met the eligibility criteria.ResultsThe included studies comprised a range of groups, including those affected by homelessness, having physical health conditions, living in low- and middle-income countries, and those with sexual and gender minority identities. Establishing and maintaining user engagement was a pervasive challenge across mental health apps and populations, and dropout was a reported problem among nearly all the included studies. Positive subjective reports of usability, satisfaction, and acceptability were insufficient to determine users' objective engagement.ConclusionsDespite the significant amount of funding directed to the development of mental health apps, juxtaposed with only limited empirical evidence to support their effectiveness, few apps have been deliberately developed or adapted to meet the heterogeneous needs of marginalized and underserved young people. Before mental health apps are scaled up, a greater understanding is needed of the types of services that more at-risk young people and those in limited-resource settings prefer (eg, standard vs digital) followed by more rigorous and consistent demonstrations of acceptability, effectiveness, and cost-effectiveness. Adopting an iterative participatory approach by involving young people in the development and evaluation process is an essential step in enhancing the adoption of any intervention, including apps, in "real-world" settings and will support future implementation and sustainability efforts to ensure that marginalized and underserved groups are reached.Trial registrationPROSPERO CRD42021254241; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=254241.

Published
2024

3. A systematic review and network meta-analysis of psychological, psychosocial, pharmacological, physical and combined treatments for adults with a new episode of depression

Author

Mavranezouli, Ifigeneia, Megnin-Viggars, Odette, Pedder, Hugo, Welton, Nicky J., Dias, Sofia, Watkins, Edward, Nixon, Neil, Daly, Caitlin H., Keeney, Edna, Eadon, Hilary, Caldwell, Deborah M., O'Donoghue, Katriona J.M., Stockton, Sarah, Arnold, Stephanie, Thomas, James, Kapur, Navneet, and Pilling, Stephen

Published
2024
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6. State rumination predicts inhibitory control failures and dysregulation of default, salience, and cognitive control networks in youth at risk of depressive relapse: Findings from the RuMeChange trial

Author

Roberts, Henrietta, Schreiner, Mindy Westlund, Pocius, Stephanie, Dillahunt, Alina K., Farstead, Brian, Feldman, Daniel, Bessette, Katie L., Kaufman, Erin A., Slattery, Will, Jacobs, Rachel H., Jago, David, Crowell, Sheila E., Watkins, Edward R, and Langenecker, Scott A.

Published
2024
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7. Rumination-Focused Cognitive Behavioral Therapy Reduces Rumination and Targeted Cross-network Connectivity in Youth With a History of Depression: Replication in a Preregistered Randomized Clinical Trial

Author

Langenecker, Scott A., Westlund Schreiner, Mindy, Bessette, Katie L., Roberts, Henrietta, Thomas, Leah, Dillahunt, Alina, Pocius, Stephanie L., Feldman, Daniel A., Jago, Dave, Farstead, Brian, Pazdera, Myah, Kaufman, Erin, Galloway, Jennica A., Kerig, Patricia K., Bakian, Amanda, Welsh, Robert C., Jacobs, Rachel H., Crowell, Sheila E., and Watkins, Edward R.

Published
2024
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10. Prognostic factors and effect modifiers for personalisation of internet-based cognitive behavioural therapy among university students with subthreshold depression: A secondary analysis of a factorial trial

Author

Toyomoto, Rie, Sakata, Masatsugu, Yoshida, Kazufumi, Luo, Yan, Nakagami, Yukako, Uwatoko, Teruhisa, Shimamoto, Tomonari, Sahker, Ethan, Tajika, Aran, Suga, Hidemichi, Ito, Hiroshi, Sumi, Michihisa, Muto, Takashi, Ito, Masataka, Ichikawa, Hiroshi, Ikegawa, Masaya, Shiraishi, Nao, Watanabe, Takafumi, Watkins, Edward R., Noma, Hisashi, Horikoshi, Masaru, Iwami, Taku, and Furukawa, Toshi A.

Published
2023
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22. Mechanisms of rumination change in adolescent depression (RuMeChange): study protocol for a randomised controlled trial of rumination-focused cognitive behavioural therapy to reduce ruminative habit and risk of depressive relapse in high-ruminating adolescents

Author

Roberts, Henrietta, Jacobs, Rachel H., Bessette, Katie L., Crowell, Sheila E., Westlund-Schreiner, Mindy, Thomas, Leah, Easter, Rebecca E., Pocius, Stephanie L., Dillahunt, Alina, Frandsen, Summer, Schubert, Briana, Farstead, Brian, Kerig, Patricia, Welsh, Robert C., Jago, David, Langenecker, Scott A., and Watkins, Edward R.

Published
2021
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25. Efficacy of Internet‐based rumination‐focused cognitive behavioral therapy and mindfulness‐based intervention with guided support in reducing risks of depression and anxiety: A randomized controlled trial.

Author

Mak, Winnie W. S., Tong, Alan C. Y., Fu, Amanda C. M., Leung, Ivy W. Y., Jung, Olivia H. C., Watkins, Edward R., and Lui, Wacy W. S.

Subjects
COGNITIVE therapy, MINDFULNESS-based cognitive therapy, RANDOMIZED controlled trials, ANXIETY, MENTAL depression, MINDFULNESS
Abstract

Rumination and worry are common risk factors of depression and anxiety. Internet‐based transdiagnostic interventions targeting individuals with these specific risks may be an effective way to prevent depression and anxiety. This three‐arm randomized controlled trial compared the efficacy of Internet‐based rumination‐focused cognitive behavioral therapy (RFCBT), mindfulness‐based intervention (MBI), and psychoeducation (EDU) control among 256 at‐risk individuals. Participants' levels of rumination, worry, depressive, and anxiety symptoms were assessed at post‐intervention (6 weeks), 3‐month, and 9‐month follow‐ups. Linear mixed model analysis results showed similar levels of improvement in all outcomes across the three conditions. Changes in rumination differed comparing RFCBT and MBI, where a significant reduction in rumination was noted at a 3‐month follow‐up among participants in RFCBT, and no significant long‐term effect among participants in MBI was noted at a 9‐month follow‐up. All three conditions showed similar reductions in risks and symptoms, implying that the two active interventions were not superior to EDU control. The high attrition at follow‐ups suggested a need to exercise caution when interpreting the findings. Future studies should tease apart placebo effect and identify ways to improve adherence. [ABSTRACT FROM AUTHOR]

Published
2024
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26. Rumination Induction Task in fMRI: Test-Retest Reliability in Youth and Potential Mechanisms of Change with Intervention

Author

Westlund Schreiner, Mindy, primary, Miller, Raina Helen, additional, Jacobsen, Anna M, additional, Crowell, Sheila E, additional, Kaufman, Erin A, additional, Farstead, Brian, additional, Feldman, Daniel A, additional, Thomas, Leah, additional, Bessette, Katie L, additional, Welsh, Robert C, additional, Watkins, Edward R, additional, and Langenecker, Scott A, additional

Published
2023
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28. Treatment of worry and comorbid symptoms within depression, anxiety, and insomnia with a group-based rumination-focused cognitive-behaviour therapy in a primary health care setting: a randomised controlled trial

Author

Wallsten, Daniel, primary, Norell, Annika, additional, Anniko, Malin, additional, Eriksson, Oskar, additional, Lamourín, Varja, additional, Halldin, Ida, additional, Kindbom, Tina, additional, Hesser, Hugo, additional, Watkins, Edward, additional, and Tillfors, Maria, additional

Published
2023
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30. The Virtual Experiences Portals — A Reconfigurable Platform for Immersive Visualization

Author

Peake, Ian D., Blech, Jan Olaf, Watkins, Edward, Greuter, Stefan, Schmidt, Heinz W., Hutchison, David, Series editor, Kanade, Takeo, Series editor, Kittler, Josef, Series editor, Kleinberg, Jon M., Series editor, Mattern, Friedemann, Series editor, Mitchell, John C., Series editor, Naor, Moni, Series editor, Pandu Rangan, C., Series editor, Steffen, Bernhard, Series editor, Terzopoulos, Demetri, Series editor, Tygar, Doug, Series editor, Weikum, Gerhard, Series editor, De Paolis, Lucio Tommaso, editor, and Mongelli, Antonio, editor

Published
2016
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31. The effects of improving sleep on mental health (OASIS): a randomised controlled trial with mediation analysis

Author

Freeman, Daniel, Sheaves, Bryony, Goodwin, Guy M, Yu, Ly-Mee, Nickless, Alecia, Harrison, Paul J, Emsley, Richard, Luik, Annemarie I, Foster, Russell G, Wadekar, Vanashree, Hinds, Christopher, Gumley, Andrew, Jones, Ray, Lightman, Stafford, Jones, Steve, Bentall, Richard, Kinderman, Peter, Rowse, Georgina, Brugha, Traolach, Blagrove, Mark, Gregory, Alice M, Fleming, Leanne, Walklet, Elaine, Glazebrook, Cris, Davies, E Bethan, Hollis, Chris, Haddock, Gillian, John, Bev, Coulson, Mark, Fowler, David, Pugh, Katherine, Cape, John, Moseley, Peter, Brown, Gary, Hughes, Claire, Obonsawin, Marc, Coker, Sian, Watkins, Edward, Schwannauer, Matthias, MacMahon, Kenneth, Siriwardena, A Niroshan, and Espie, Colin A

Published
2017
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33. We need timely access to mental health data: implications of the Goldacre review

Author

Astle, Duncan E, primary, Moore, Anna, additional, Marryat, Louise, additional, Viding, Essi, additional, Mansfield, Karen L, additional, Fazel, Mina, additional, Pierce, Matthias, additional, Abel, Kathryn M, additional, Green, Jonathan, additional, John, Ann, additional, Broome, Matthew R, additional, Upthegrove, Rachel, additional, Bould, Helen, additional, Minnis, Helen, additional, Gajwani, Ruchika, additional, Groom, Madeleine J, additional, Hollis, Chris, additional, Liddle, Elizabeth, additional, Sayal, Kapil, additional, Berry, Vashti, additional, Collishaw, Stephan, additional, Dawes, Helen, additional, Cortese, Samuele, additional, Violato, Mara, additional, Pollard, Jack, additional, MacCabe, James H, additional, Blakemore, Sarah-Jayne, additional, Simonoff, Emily, additional, Watkins, Edward, additional, Hiller, Rachel M, additional, Townsend, Ellen, additional, Armour, Cherie, additional, Geddes, John R, additional, Thompson, Lucy, additional, Schwannauer, Matthias, additional, Nicholls, Dasha, additional, Hotopf, Matthew, additional, Downs, Johnny, additional, Rahman, Atif, additional, Sharma, Aditya Narain, additional, and Ford, Tamsin J, additional

Published
2023
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34. Negative association between non‐suicidal self‐injury in adolescents and default mode network activation during the distraction blocks of a rumination task

Author

Westlund Schreiner, Mindy, primary, Roberts, Henrietta, additional, Dillahunt, Alina K., additional, Farstead, Brian, additional, Feldman, Daniel, additional, Thomas, Leah, additional, Jacobs, Rachel H., additional, Bessette, Katie L., additional, Welsh, Robert C., additional, Watkins, Edward R., additional, Langenecker, Scott A., additional, and Crowell, Sheila E., additional

Published
2023
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35. Treatment of worry and comorbid symptoms within depression, anxiety, and insomnia with a group-based rumination-focused cognitive-behaviour therapy in a primary health care setting : a randomised controlled trial

Author

Wallsten, Daniel, Norell, Annika, Anniko, Malin, Eriksson, Oskar, Lamourin, Varja, Halldin, Ida, Kindbom, Tina, Hesser, Hugo, Watkins, Edward, Tillfors, Maria, Wallsten, Daniel, Norell, Annika, Anniko, Malin, Eriksson, Oskar, Lamourin, Varja, Halldin, Ida, Kindbom, Tina, Hesser, Hugo, Watkins, Edward, and Tillfors, Maria

Abstract

IntroductionRepetitive negative thinking (RNT) has been described as a maintaining transdiagnostic factor for psychopathology within the areas of depression, anxiety and insomnia. We investigated the effects of rumination-focused cognitive-behaviour therapy (RF-CBT) in a group format at a primary health care centre on symptoms of depression, anxiety, insomnia, RNT, and quality of life. The participants presented clinical symptom levels of worry and at least two disorders among anxiety disorders, major depressive disorder, and insomnia disorder.MethodsA randomised controlled superiority parallel arm trial was used. 73 participants were included and randomised in pairs to either group-administered RF-CBT or a waiting list condition. The primary outcomes were self-rated worry and transdiagnostic symptoms (depression, anxiety, and insomnia). Intention-to-treat analyses of group differences were conducted using linear mixed models. Adverse side effects and incidents were presented descriptively.ResultsGroup RF-CBT significantly reduced self-reported insomnia at post-treatment and self-reported insomnia and depression at the 2 month-follow-up, relative to the wait-list control group. There was no significant difference in change in RNT, anxiety, or quality of life.DiscussionThe current study suggests that group-administered RF-CBT may be effective for insomnia and potentially effective for depression symptomatology. However, the study was underpowered to detect small and moderate effects and the results should therefore be interpreted with caution.

Published
2023
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36. Prognostic factors and effect modifiers for personalisation of internet-based cognitive behavioural therapy among university students with subthreshold depression: A secondary analysis of a factorial trial

Author

40593653, 80368240, 60437291, Toyomoto, Rie, Sakata, Masatsugu, Yoshida, Kazufumi, Luo, Yan, Nakagami, Yukako, Uwatoko, Teruhisa, Shimamoto, Tomonari, Sahker, Ethan, Tajika, Aran, Suga, Hidemichi, Ito, Hiroshi, Sumi, Michihisa, Muto, Takashi, Ito, Masataka, Ichikawa, Hiroshi, Ikegawa, Masaya, Shiraishi, Nao, Watanabe, Takafumi, Watkins, Edward R., Noma, Hisashi, Horikoshi, Masaru, Iwami, Taku, Furukawa, Toshi A., 40593653, 80368240, 60437291, Toyomoto, Rie, Sakata, Masatsugu, Yoshida, Kazufumi, Luo, Yan, Nakagami, Yukako, Uwatoko, Teruhisa, Shimamoto, Tomonari, Sahker, Ethan, Tajika, Aran, Suga, Hidemichi, Ito, Hiroshi, Sumi, Michihisa, Muto, Takashi, Ito, Masataka, Ichikawa, Hiroshi, Ikegawa, Masaya, Shiraishi, Nao, Watanabe, Takafumi, Watkins, Edward R., Noma, Hisashi, Horikoshi, Masaru, Iwami, Taku, and Furukawa, Toshi A.

Abstract

BACKGROUND: Internet-cognitive behavioural therapy (iCBT) for depression can include multiple components. This study explored depressive symptom improvement prognostic factors (PFs) and effect modifiers (EMs) for five common iCBT components including behavioural activation, cognitive restructuring, problem solving, self-monitoring, and assertion training. METHODS: We used data from a factorial trial of iCBT for subthreshold depression among Japanese university students (N = 1093). The primary outcome was the change in PHQ-9 scores at 8 weeks from baseline. Interactions between each component and various baseline characteristics were estimated using a mixed-effects model for repeated measures. We calculated multiplicity-adjusted p-values at 5 % false discovery rate using the Benjamini-Hochberg procedure. RESULTS: After multiplicity adjustment, the baseline PHQ-9 total score emerged as a PF and exercise habits as an EM for self-monitoring (adjusted p-values <0.05). The higher the PHQ-9 total score at baseline (range: 5-14), the greater the decrease after 8 weeks. For each 5-point increase at baseline, the change from baseline to 8 weeks was bigger by 2.8 points. The more frequent the exercise habits (range: 0-2 points), the less effective the self-monitoring component. The difference in PHQ-9 change scores between presence or absence of self-monitoring was smaller by 0.94 points when the participant exercised one level more frequently. Additionally, the study suggested seven out of 36 PFs and 14 out of 160 EMs examined were candidates for future research. LIMITATIONS: Generalizability is limited to university students with subthreshold depression. CONCLUSIONS: These results provide some helpful information for the future development of individualized iCBT algorithms for depression.

Published
2023

37. Using Mendelian Randomisation methods to understand whether diurnal preference is causally related to mental health

Author

O’Loughlin, Jessica, Casanova, Francesco, Jones, Samuel E., Hagenaars, Saskia P., Beaumont, Robin N., Freathy, Rachel M., Watkins, Edward R., Vetter, Céline, Rutter, Martin K., Cain, Sean W., Phillips, Andrew J. K., Windred, Daniel P., Wood, Andrew R., Weedon, Michael N., and Tyrrell, Jessica

Abstract

Late diurnal preference has been linked to poorer mental health outcomes, but the understanding of the causal role of diurnal preference on mental health and wellbeing is currently limited. Late diurnal preference is often associated with circadian misalignment (a mismatch between the timing of the endogenous circadian system and behavioural rhythms), so that evening people live more frequently against their internal clock. This study aims to quantify the causal contribution of diurnal preference on mental health outcomes, including anxiety, depression and general wellbeing and test the hypothesis that more misaligned individuals have poorer mental health and wellbeing using an actigraphy-based measure of circadian misalignment. Multiple Mendelian Randomisation (MR) approaches were used to test causal pathways between diurnal preference and seven well-validated mental health and wellbeing outcomes in up to 451,025 individuals. In addition, observational analyses tested the association between a novel, objective measure of behavioural misalignment (Composite Phase Deviation, CPD) and seven mental health and wellbeing outcomes. Using genetic instruments identified in the largest GWAS for diurnal preference, we provide robust evidence that early diurnal preference is protective for depression and improves wellbeing. For example, using one-sample MR, a twofold higher genetic liability of morningness was associated with lower odds of depressive symptoms (OR: 0.92, 95% CI: 0.88, 0.97). It is possible that behavioural factors including circadian misalignment may contribute in the chronotype depression relationship, but further work is needed to confirm these findings.

Published
2024
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47. A randomised controlled feasibility trial (the HARMONIC Trial) of a novel modular transdiagnostic intervention—Shaping Healthy Minds—versus psychological treatment-as-usual, for clinic-attending adults with comorbid mood, stressor-related and anxiety disorders

Author

Black, Melissa, primary, Johnston, David, additional, Elliott, Rachel, additional, O'Leary, Cliodnha, additional, Patel, Shivam, additional, Smith, Alicia, additional, Parker, Jenna, additional, Griffiths, Kirsty, additional, Klaus, Kristel, additional, Clarke, James, additional, Watson, Peter, additional, Lafortune, Louise, additional, Rae, Sarah, additional, Watkins, Edward R, additional, Gilbody, Simon, additional, Kuyken, Willem, additional, Hitchcock, Caitlin, additional, Newby, Jill, additional, Bevan, Anna, additional, and Dalgleish, Tim, additional

Published
2023
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48. Early Emergence of Rumination has no Association with Performance on a Non-affective Inhibitory Control Task

Author

Thomas, Leah R., primary, Bessette, Katie L., additional, Westlund Schreiner, Melinda, additional, Dillahunt, Alina K., additional, Frandsen, Summer B., additional, Pocius, Stephanie L., additional, Schubert, Briana Lee, additional, Farstead, Brian W., additional, Roberts, Henrietta, additional, Watkins, Edward R., additional, Kerig, Patricia K., additional, Crowell, Sheila E., additional, and Langenecker, Scott A., additional

Published
2023
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50. Corrigendum to “Prognostic factors and effect modifiers for personalisation of internet-based cognitive behavioural therapy among university students with subthreshold depression: A secondary analysis of a factorial trial” [J. Affect. Disord. 322 (2023) 156-162]

Author

Toyomoto, Rie, primary, Sakata, Masatsugu, additional, Yoshida, Kazufumi, additional, Luo, Yan, additional, Nakagami, Yukako, additional, Uwatoko, Teruhisa, additional, Shimamoto, Tomonari, additional, Sahker, Ethan, additional, Tajika, Aran, additional, Suga, Hidemichi, additional, Ito, Hiroshi, additional, Sumi, Michihisa, additional, Muto, Takashi, additional, Ito, Masataka, additional, Ichikawa, Hiroshi, additional, Ikegawa, Masaya, additional, Shiraishi, Nao, additional, Watanabe, Takafumi, additional, Watkins, Edward R., additional, Noma, Hisashi, additional, Horikoshi, Masaru, additional, Iwami, Taku, additional, and Furukawa, Toshi A., additional

Published
2023
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