Background: Digital interventions offer new avenues for low-threshold prevention and treatment in youth. Ecological momentary interventions (EMIs) represent a powerful approach that allows for adaptive, real-time, and real-world delivery of intervention components in daily life. Compassion-focused interventions may be particularly amenable to translation into an EMI to strengthen emotional resilience and modifying putative risk mechanisms in daily lives of young help-seeking individuals. Objective: To investigate initial therapeutic effects, feasibility, and safety of a novel, accessible, transdiagnostic, ecological momentary, compassion-focused intervention for improving emotional resilience to stress (‘EMIcompass’). Methods: In an uncontrolled phase I pilot study, help-seeking youths with psychotic, depressive, and/or anxiety symptoms were offered the EMIcompass intervention, which consisted of three sessions with a trained psychologist and a 3-week EMI administered through a mobile health app. Results: In total, ten individuals (Mage=20.3 years) were included in the study. Reduced stress sensitivity, momentary negative affect and psychotic experiences as well as increased positive affect were found at post-intervention and 4-week follow-up. Further, reductions in psychotic, anxiety, and depressive symptoms of medium to large effect size were found (r=0.30-0.65). Most participants reported to be satisfied (80%) and burden of app usage to be low (70-90%). No adverse events were observed. Conclusion: Our findings provide initial evidence on beneficial effects, feasibility, and safety of the EMIcompass intervention in help-seeking youth. A feasibility randomised controlled trial is warranted to establish efficacy.

The results of the present study support the effectiveness of the 7‑day multimodal intensive therapy for tinnitus. Posttreatment improvements were related to both tinnitus burden as well as stress and depressive symptoms and were maintained at the 5‑year follow-up.

ZusammenfassungZahlreiche Studien zeigen, dass Beeinträchtigungen bei chronischem Tinnitus eng mit psychosomatischen und anderen Begleiterscheinungen verwoben sind. In dieser Übersicht werden einige Arbeiten zu diesem Thema zusammengefasst und eingeordnet. Neben einer möglichen Hörminderung sind individuelle Wechselwirkungen aus medizinischen und psychosozialen Belastungsfaktoren sowie Ressourcen von zentraler Bedeutung. Tinnitusbelastung spiegelt eine große Anzahl interkorrelierter, psychosomatischer Einflussfaktoren wider – wie z. B. Persönlichkeitseigenschaften, Stressreaktivität sowie Depressions-, oder Angsterleben, die mit kognitiven Einschränkungen einhergehen können und im Rahmen eines Vulnerabilität-Stress-Reaktion Modells konzeptualisiert werden sollten. Des Weiteren können übergeordnete Faktoren wie Alter, Geschlecht oder Bildungsstand die Vulnerabilität für Belastungserleben erhöhen. Diagnostik und Therapie des chronischen Tinnitus müssen somit individualisiert, multidimensional und interdisziplinär erfolgen. Multimodale psychosomatische Therapieansätze zielen darauf ab, individuell konstellierte medizinische und audiologische Einflussfaktoren sowie psychologische Erlebensaspekte zu adressieren und die Lebensqualität Betroffener nachhaltig zu erhöhen. Ein Counselling im Erstkontakt ist für Diagnostik und Therapie ebenfalls unabdingbar.

Background: Most mental disorders first emerge in youth and, in their early stages, surface as subthreshold expressions of symptoms comprising a transdiagnostic phenotype. Elevated stress reactivity is one of the most widely studied psychological mechanisms underlying psychotic and affective mental health problems. Thus, targeting stress reactivity in youth is a promising indicated and translational preventive strategy for adverse mental health outcomes later in life and for improving resilience. Compassion-focused interventions (CFIs) offer a wide range of innovative therapeutic techniques particularly amenable to being implemented as an Ecological Momentary Intervention (EMI) to enable youth to access interventions in a given moment and context in daily life. This approach may bridge a gap in current youth mental health care. The aim of this study will be to investigate the clinical feasibility, candidate underlying mechanisms and initial signals of efficacy of a novel, accessible, transdiagnostic EMI for improving resilience to stress in youth (EMIcompass).Methods/Design: In an exploratory randomized controlled trial (RCT), youth aged 14-25 with current distress, a broad Clinical High At-Risk Mental State (CHARMS) or a first episode of a severe mental disorder will be randomly allocated to the EMIcompass intervention in addition to treatment as usual (TAU) or a control condition of TAU only. Primary (stress reactivity) and secondary candidate mechanisms (resilience, interpersonal sensitivity, threat anticipation, negative affective appraisals) as well as primary (psychological distress) and secondary outcomes (primary psychiatric symptoms, general psychopathology) will be assessed at baseline, post-intervention and 4-week follow-up. Discussion: The current study is the first to establish feasibility, evidence on underlying mechanisms, and preliminary signals of efficacy of a compassion-focused EMI in youth. If successful, a confirmatory RCT will be warranted. Overall, our approach has the potential to significantly advance preventive interventions in youth mental health provision. Trial registration number: German Trial Registry (DRKS), DRKS00017265; Date of registration: 31.07.2019.

The results of the present study support the effectiveness of the 7‑day multimodal intensive therapy for tinnitus. Posttreatment improvements were related to both tinnitus burden as well as stress and depressive symptoms and were maintained at the 5‑year follow-up.