Forty percent of all general-practitioner appointments are related to mental illness, although less than 35% of individuals have access to therapy and psychological care, indicating a pressing need for accessible and affordable therapy tools. The ubiquity of smartphones offers a delivery platform for such tools. Previous research suggests that gamification-turning intervention content into a game format-could increase engagement with prevention and early-stage mobile interventions. This study aimed to explore the effects of a gamified mobile mental health intervention on improvements in resilience, in comparison with active and inactive control conditions. Differences between conditions on changes in personal growth, anxiety and psychological wellbeing, as well as differences in attrition rates, were also assessed. The eQuoo app was developed and published on all leading mobile platforms. The app educates users about psychological concepts including emotional bids, generalization, and reciprocity through psychoeducation, storytelling, and gamification. In total, 358 participants completed in a 5-week, 3-armed (eQuoo, "treatment as usual" cognitive behavioral therapy journal app, no-intervention waitlist) randomized controlled trial. Relevant scales were administered to all participants on days 1, 17, and 35. Repeated-measures ANOVA revealed statistically significant increases in resilience in the test group compared with both control groups over 5 weeks. The app also significantly increased personal growth, positive relations with others, and anxiety. With 90% adherence, eQuoo retained 21% more participants than the control or waitlist groups. Intervention delivered via eQuoo significantly raised mental well-being and decreased self-reported anxiety while enhancing adherence in comparison with the control conditions. Mobile apps using gamification can be a valuable and effective platform for well-being and mental health interventions and may enhance motivation and reduce attrition. Future research should measure eQuoo's effect on anxiety with a more sensitive tool and examine the impact of eQuoo on a clinical population.
Previous research on emotion processing revealed a positivity bias that progressively evolves across the adult age range. This study obtained gradual valence judgments of emotional faces across the adult age span, to see whether this positivity bias persists when positive and negative stimuli are matched for arousal; and whether bias relates to personality traits or to current mood. With increasing age subjects judged negative and neutral faces less negatively. Further, younger participants scoring high in "agreeableness" and "conscientiousness" scales showed a positivity bias when judging positive faces, suggesting an association of the positivity effect with trait variables.
Digital media, online programs, and electronic health systems are available and easily accessible for diagnostic, prevention, and intervention of somatic and psychiatric disorders. These modern tools can assess objective as well as subjective information about acute symptoms, wellbeing, life quality, sleep, physiological indicators, etc. Wearables and apps collect data over days and weeks in the real world of subjects. This information can be used to document baselines as well as changes over time influenced by events or interventions. Online treatment programs provide information for education about symptoms, course, origin, and treatment options of a disorder. They also support a patient's self-help via self-management, exercises, and techniques. We illustrate and discuss modern diagnostic and therapeutic eHealth options. We also review the empirical evidence for online interventions and refer to typical examples. Most studies have been conducted with subjects suffering from depression and anxiety. Electronic health systems do not work just by recommending a program or providing access to an online platform. Patients need to be motivated to lock in and work with a program. They need support and guidance through online programs. Therefore, we claim that therapists need to become experts in digital media and electronic health systems to support patients and to integrate apps and online programs into their treatment.
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