Our combination of (i) comparing network structure of mental states across three diagnostically different groups and (ii) searching for trans-diagnostic network components across all pooled individuals showed that these two approaches yield different, complementary perspectives in the field of psychopathology. The network paradigm therefore may be useful to map transdiagnostic processes.

The review demonstrates that mobile health may be an important asset to the mental health field but underscores that it still is in its very early ages. In the discussion, we point toward ways of improving EMIs for severe mental illness, changing our perspective from testing feasibility to testing efficacy and ultimately implementing EMIs in routine mental health services.

Evidence is growing that vulnerability to depression may be characterized by strong negative feedback loops between mental states. It is unknown whether such dynamics between mental states can be altered by treatment. This study examined whether treatment with imipramine or treatment with Mindfulness-Based Cognitive Therapy (MBCT) reduces the connectivity within dynamic networks of mental states in individuals with depressive symptoms. In the Imipramine trial, individuals diagnosed with major depression were randomized to imipramine treatment or placebo-pill treatment (n = 50). In the Mind-Maastricht trial, individuals with residual depressive symptoms were randomized to Mindfulness-Based Cognitive Therapy (MBCT) or to a waiting-list control condition (n = 119). Lagged associations among mental states, as assessed with the Experience Sampling Method (ESM), were estimated at baseline and post-intervention. The results show that few of the dynamic network connections changed significantly over time and few of the changes after MBCT and imipramine treatment differed significantly from the control groups. The decrease in average node connectivity after MBCT did not differ from the decrease observed in the waiting-list control group. Our findings suggest that imipramine treatment and MBCT do not greatly change the dynamic network structure of mental states, even though they do reduce depressive symptomatology.

The current article describes the Acceptance and Commitment Therapy (ACT) in Daily Life (ACT-DL) training, a new mobile health treatment protocol for ACT applied in a randomized controlled trial in early psychosis individuals. Between weekly ACT therapy sessions, patients fill out brief questionnaires on an app about their mood, symptoms, activity, and current context, thus promoting awareness-a crucial component of ACT. The app also provides them with visual cues and exercises specifically related to the ACT sessions, to help them implement the techniques previously learned in therapy into their daily lives. Here we assess the feasibility of this protocol in 16 early psychosis individuals, as part of an ongoing randomized controlled trial. Specifically, we investigate the experienced usefulness of the ACT therapy and app, and burden of the protocol. Results indicate that participants find both the therapy sessions and the app useful, and that ACT-DL guides them in putting ACT into everyday practice, although the protocol may be moderately burdensome. These findings indicate that ACT-DL may help early psychosis patients applying ACT skills to diverse contexts of everyday life. Since ACT is not symptom-specific, ACT-DL may also be suited for different target populations. Limitations and future directions are discussed.