Efficacy of PRIME, a Mobile App Intervention Designed to Improve Motivation in Young People With Schizophrenia

Abstract

The onset of schizophrenia occurs during a period critical for development of social relationships and functional independence. As such, interventions that target the early course of illness have the potential to stave off functional decline and restore functioning to pre-illness levels. In this entirely remote study, people with recent-onset schizophrenia spectrum disorders (SSDs) participated in a 12-week randomized controlled trial to determine the efficacy of PRIME (personalized real-time intervention for motivational enhancement), a mobile-based digital health intervention designed to improve motivation and quality of life. Participants were randomized into the PRIME (n = 22) or treatment-as-usual/waitlist (TAU/WL) condition (n = 21) and completed assessments at baseline, post-trial (12 wk), and for people in the PRIME condition, 3 months after the end of the trial. After 12-weeks, WL participants received PRIME, resulting in a total sample of 38 participants completing PRIME. In PRIME, participants worked towards self-identified goals with the support of a virtual community of age-matched peers with schizophrenia-spectrum disorders as well as motivation coaches. Compared to the WL condition, people in the PRIME condition had significantly greater improvements in self-reported depression, defeatist beliefs, self-efficacy, and a trend towards motivation/pleasure negative symptoms post-trial, and these improvements were maintained 3 months after the end of trial. We also found that people in the PRIME condition had significantly greater improvements in components of social motivation post-trial (anticipated pleasure and effort expenditure). Our results suggest that PRIME has the potential to be an effective mobile-based intervention for improving aspects of mood and motivation in young people with SSDs.

Social Media and Mental Health: Benefits, Risks, and Opportunities for Research and Practice

“…• Individuals with mental disorders can connect with care providers and access evidence-based services • Online peer support augments existing interventions to improve client engagement and compliance • Peer networks increase social connectedness and empowerment during recovery • Interactive peer-to-peer features of social media appear beneficial for social functioning • Mobile apps offer potential to monitor symptoms, prevent relapses and help users set goals • Digital peer-based interventions are feasible and acceptable for targeting fitness and weight loss in people with mental disorders • Online networks can extend support to caregivers of those with mental disorders (Alvarez-Jimenez et al 2013Aschbrenner et al 2018aAschbrenner et al , 2016bBiagianti et al 2018;Birnbaum et al 2017b;Gleeson et al 2017;Lal et al 2018;Naslund et al 2016bNaslund et al , 2018Schlosser et al 2016Schlosser et al , 2018 Challenges 1) Impact on symptoms…”

“…Among these apps, the development of PRIME (Personalized Real-time Intervention for Motivational Enhancement) has involved working closely with young people with schizophrenia to ensure that the design of the app has the look and feel of mainstream social media platforms, as opposed to existing clinical tools (Schlosser et al 2016). This unique approach to the design of the app is aimed at promoting engagement and ensuring that the app can effectively improve motivation and functioning through goal setting and promoting better quality of life of users with schizophrenia (Schlosser et al 2018).…”

Grant Report on Social Reward Learning in Schizophrenia

“…However, psychometrically validated social reward learning tasks have yet, to our knowledge, to be developed for use in clinical trials. The modified trust game developed by Campellone and colleagues [18], described above, was used to assess effects of a motivation-enhancing remediation [76]. Improvements were found in several aspects of motivated behavior but not in social reward (e.g., trust) behavior itself [76].…”

COVID-19, mobile health and serious mental illness

“…1) does not do justice to the many excellent apps not mentioned and the teams behind each one mentioned. FOCUS (Ben-Zeev et al, 2019) from Dr. Dror Ben-Zeev, and PRIME (Schlosser et al, 2018) from Dr. Danielle Schlosser, Intellicare from Dr. David Mohr (Mohr et al, 2017), and CBT2Go (Depp et al, 2019) from Dr. Colin Depp as just some examples of mobile health tools for SMI. Using digital phenotyping and smartphone surveys/sensors to better monitor patients' real time, longitudinal, and dynamic experience of mental health is feasible with apps like mindLAMP from our group , Cross Check from Dr. John Kane (Ben-Zeev et al, 2017) and many others like the MONARCHA by Dr. Jakob Bardram plus many more (Bardram and Mati, 2020) These smartphone digital data streams can be used predict relapse (Barnett et al, 2018), and create personalized care plans responsive to the psychological and social environments of patients.…”