Randomized Controlled Trial Testing Mobile-Based Attention-Bias Modification for Posttraumatic Stress Using Personalized Word Stimuli

Niles, Andrea N.; Woolley, Joshua; Tripp, Paige; Pesquita, Ana; Vinogradov, Sophia; Neylan, Thomas C.; O’Donovan, Aoife

doi:10.1177/2167702620902119

Cited by 24 publications

(21 citation statements)

References 59 publications

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“…The sample had high levels of depressive (m = 13.6 [SD = 11.9]), anxiety (m = 9.9 [SD = 9.9]), and PTSD (m = 24.5 [SD = 19.9]) symptoms, consistent with recruitment of people experiencing trauma-related psychological symptoms in 2017/2018 ( Niles et al, 2020 ). Using diagnostic cutoffs, 44.2% had elevated depression, 43.4% had elevated anxiety, and 32.6% had probable PTSD.…”

Section: Resultsmentioning

confidence: 60%

“…The sample included community-dwelling U.S. adults who indicated interest in a treatment study for PTSD symptoms in 2017–2018 ( Niles et al, 2020 ) and participated in a 30-minute online Qualtrics survey on COVID-19 experiences between August 4-September 19, 2020. Eligible individuals (age ≥ 18) provided electronic consent and received a $5 Amazon e-gift card upon survey completion.…”

Section: Methodsmentioning

confidence: 99%

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Clusters of COVID-19 protective and risky behaviors and their associations with pandemic, socio-demographic, and mental health factors in the United States

Nishimi

Borsari

Marx

et al. 2022

Preventive Medicine Reports

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Individual behaviors are critical for preventing the spread of coronavirus disease 2019 (COVID-19) infection. Given that both protective and risky behaviors influence risk of infection, it is critical that we understand how such behaviors cluster together and in whom. Using a data-driven approach, we identified clusters of COVID-19-related protective and risky behaviors and examined associations with socio-demographic, pandemic, and mental health factors. Data came from a cross-sectional online U.S. nationwide study of 832 adults with high levels of pre-pandemic trauma. Latent class analysis was performed with ten protective (e.g., washing hands, wearing masks) and eight risky (e.g., attending indoor restaurants, taking a flight) behaviors for COVID-19. Then, we examined distributions of socio-demographic and pandemic factors across behavior classes using ANOVA or Chi-square tests, and associations between mental health factors (depressive, anxiety, posttraumatic stress symptoms) and behavior classes using multinomial logistic regression. We identified four classes, including three classes with relatively low risky but high (28.8%), moderate (33.5%) and minimal (25.5%) protective behaviors and one high risky behaviors class with associated moderate protective behaviors (12.1%). Age, sexual orientation, political preference, and most pandemic factors differed significantly across behavior classes. Anxiety and posttraumatic stress symptoms, but not depression, were higher in the High Risk, but also Highly and Moderately Protective classes, relative to Minimally Protective. Prevention and intervention efforts should examine constellations of protective and risky behaviors to comprehensively understand risk, and consider current anxiety and posttraumatic stress symptoms as potential risk indicators.

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Section: Resultsmentioning

confidence: 60%

Section: Methodsmentioning

confidence: 99%

Clusters of COVID-19 protective and risky behaviors and their associations with pandemic, socio-demographic, and mental health factors in the United States

Nishimi

Borsari

Marx

et al. 2022

Preventive Medicine Reports

Self Cite

View full text Add to dashboard Cite

show abstract

“…To estimate symptom reduction as a function of time, we fit piecewise multilevel models in R (version 4.0.2; The R Foundation for Statistical Computing) using the package "lmerTest" (version 3.1-2) [41]. Consistent with prior work, we selected a piecewise approach to capture a typical pattern of symptom reduction observed in treatment studies where symptoms initially decrease sharply and then level out as time progresses [42][43][44][45][46][47]. In these models, we regressed the symptom outcome measure (GAD-7 score or PHQ score) onto the number of days since subscribing to the app.…”

Section: Aim 2: Effectivenessmentioning

confidence: 99%

Acceptability and Effectiveness of Artificial Intelligence Therapy for Anxiety and Depression (Youper): Longitudinal Observational Study

Mehta¹,

Niles²,

Vargas³

et al. 2021

J Med Internet Res

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Background Youper is a widely used, commercially available mobile app that uses artificial intelligence therapy for the treatment of anxiety and depression. Objective Our study examined the acceptability and effectiveness of Youper. Further, we tested the cumulative regulation hypothesis, which posits that cumulative emotion regulation successes with repeated intervention engagement will predict longer-term anxiety and depression symptom reduction. Methods We examined data from paying Youper users (N=4517) who allowed their data to be used for research. To characterize the acceptability of Youper, we asked users to rate the app on a 5-star scale and measured retention statistics for users’ first 4 weeks of subscription. To examine effectiveness, we examined longitudinal measures of anxiety and depression symptoms. To test the cumulative regulation hypothesis, we used the proportion of successful emotion regulation attempts to predict symptom reduction. Results Youper users rated the app highly (mean 4.36 stars, SD 0.84), and 42.66% (1927/4517) of users were retained by week 4. Symptoms decreased in the first 2 weeks of app use (anxiety: d=0.57; depression: d=0.46). Anxiety improvements were maintained in the subsequent 2 weeks, but depression symptoms increased slightly with a very small effect size (d=0.05). A higher proportion of successful emotion regulation attempts significantly predicted greater anxiety and depression symptom reduction. Conclusions Youper is a low-cost, completely self-guided treatment that is accessible to users who may not otherwise access mental health care. Our findings demonstrate the acceptability and effectiveness of Youper as a treatment for anxiety and depression symptoms and support continued study of Youper in a randomized clinical trial.

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“…Community‐dwelling adults residing in the United States were recruited from a prior PTSD‐focussed study conducted in 2017–2018 (Niles et al, 2020 ). Participants were recruited from all 50 States via Craigslist advertisements and Reddit forums related to trauma or post‐traumatic stress.…”

Section: Methodsmentioning

confidence: 99%

Worse sleep, worsening post‐traumatic stress disorder (PTSD): Poor sleep quality associated with increases in PTSD symptoms amongst those experiencing high threat of the COVID‐19 pandemic

Straus

Dolsen

Nishimi

et al. 2022

Journal of Sleep Research

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Summary The coronavirus disease 2019 (COVID‐19) pandemic is a global health crisis with the potential to elicit and worsen psychiatric symptoms, particularly post‐traumatic stress disorder (PTSD) symptoms. Identifying modifiable protective factors is critical for preventing and treating PTSD symptoms both during and following the COVID‐19 pandemic. The present study examined associations of self‐reported sleep quality and anticipatory threat appraisals of the pandemic with PTSD symptoms 6 months later in a sample enriched for pre‐pandemic trauma exposure and PTSD. The sample included 590 adults (mean age 38.2 years) who completed a baseline survey in August/September 2020 and follow‐up survey in March/April 2021. The sample was recruited from a pool of participants interested in a prior study about traumatic stress. Participants self‐reported sleep quality and pandemic‐related anticipatory threat appraisals at baseline. PTSD symptoms were assessed at baseline and follow‐up. Baseline sleep quality was associated with PTSD symptoms at follow‐up controlling for baseline PTSD symptoms ( B = −2.49, p = 0.001). Perceived anticipatory threat of the pandemic moderated this association such that worse sleep quality was related to more severe PTSD symptoms at follow‐up for participants with higher ( B = −4.07, p < 0.001) but not lower ( B = −0.43, p = 0.679) anticipatory threat about the COVID‐19 pandemic. These findings suggest that poor sleep quality may enhance vulnerability to later PTSD symptoms during the pandemic, particularly among those individuals who perceived the pandemic as threatening for their future. Treatments that address sleep problems may be beneficial for reducing trauma‐related symptoms during and following the global health crisis.

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Randomized Controlled Trial Testing Mobile-Based Attention-Bias Modification for Posttraumatic Stress Using Personalized Word Stimuli

Cited by 24 publications

References 59 publications

Clusters of COVID-19 protective and risky behaviors and their associations with pandemic, socio-demographic, and mental health factors in the United States

Clusters of COVID-19 protective and risky behaviors and their associations with pandemic, socio-demographic, and mental health factors in the United States

Acceptability and Effectiveness of Artificial Intelligence Therapy for Anxiety and Depression (Youper): Longitudinal Observational Study

Worse sleep, worsening post‐traumatic stress disorder (PTSD): Poor sleep quality associated with increases in PTSD symptoms amongst those experiencing high threat of the COVID‐19 pandemic

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