151. A Personalized, Transdiagnostic Smartphone Intervention (Mello) Targeting Repetitive Negative Thinking in Young People With Depression and Anxiety: Pilot Randomized Controlled Trial.
- Author
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Bell I, Arnold C, Gilbertson T, D'Alfonso S, Castagnini E, Chen N, Nicholas J, O'Sullivan S, Valentine L, and Alvarez-Jimenez M
- Subjects
- Adolescent, Humans, Depression diagnosis, Depression therapy, Pilot Projects, Australia, Anxiety therapy, Anxiety diagnosis, Smartphone, Pessimism
- Abstract
Background: Repetitive negative thinking (RNT) is a key transdiagnostic mechanism underpinning depression and anxiety. Using "just-in-time adaptive interventions" via smartphones may disrupt RNT in real time, providing targeted and personalized intervention., Objective: This pilot randomized controlled trial evaluates the feasibility, acceptability, and preliminary clinical outcomes and mechanisms of Mello-a fully automated, personalized, transdiagnostic, and mechanistic smartphone intervention targeting RNT in young people with depression and anxiety., Methods: Participants with heightened depression, anxiety, and RNT were recruited via social media and randomized to receive Mello or a nonactive control over a 6-week intervention period. Assessments were completed via Zoom sessions at baseline and at 3 and 6 weeks after baseline., Results: The findings supported feasibility and acceptability, with high rates of recruitment (N=55), uptake (55/64, 86% of eligible participants), and retention (52/55, 95% at 6 weeks). Engagement was high, with 90% (26/29) and 59% (17/29) of the participants in the Mello condition still using the app during the third and sixth weeks, respectively. Greater reductions in depression (Cohen d=0.50), anxiety (Cohen d=0.61), and RNT (Cohen d=0.87) were observed for Mello users versus controls. Mediation analyses suggested that changes in depression and anxiety were accounted for by changes in RNT., Conclusions: The results indicate that mechanistic, targeted, and real-time technology-based solutions may provide scalable and effective interventions that advance the treatment of youth mental ill health., Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12621001701819; http://tinyurl.com/4d3jfj9f., (©Imogen Bell, Chelsea Arnold, Tamsyn Gilbertson, Simon D’Alfonso, Emily Castagnini, Nicola Chen, Jennifer Nicholas, Shaunagh O’Sullivan, Lee Valentine, Mario Alvarez-Jimenez. Originally published in the Journal of Medical Internet Research (https://www.jmir.org), 13.12.2023.)
- Published
- 2023
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