Smartphone-Based Psychotherapeutic Micro-Interventions to Improve Mood in a Real-World Setting

Abstract

Background: Using mobile communication technology as new personalized approach to treat mental disorders or to more generally improve quality of life is highly promising. Knowledge about intervention components that target key psychopathological processes in terms of transdiagnostic psychotherapy approaches is urgently needed. We explored the use of smartphone-based micro-interventions based on psychotherapeutic techniques, guided by short video-clips, to elicit mood changes.Method: As part of a larger neurofeedback study, all subjects—after being randomly assigned to an experimental or control neurofeedback condition—underwent daily smartphone-based micro-interventions for 13 consecutive days. They were free to choose out of provided techniques, including viscerosensory attention, emotional imagery, facial expression, and contemplative repetition. Changes in mood were assessed in real world using the Multidimensional Mood State Questionnaire (scales: good–bad, GB; awake–tired, AT; and calm–nervous, CN).Results: Twenty-seven men participated on at least 11 days and were thus included in the analyses. Altogether, they underwent 335, generally well-tolerated, micro-intervention sessions, with viscerosensory attention (178 sessions, 53.13%) and contemplative repetition (68 sessions, 20.30%) being the most frequently applied techniques. Mixed models indicated that subjects showed better mood [GB: b = 0.464, 95%confidence interval (CI) [0.068, 0.860], t(613.3) = 2.298, p = 0.022] and became more awake [AT: b = 0.514, 95%CI [0.103, 0.925], t(612.4) = 2.456, p = 0.014] and calmer [CN: b = 0.685, 95%CI [0.360, 1.010], t(612.3) = 4.137, p < 0.001] from pre- to post-micro-intervention. These mood improvements from pre- to post-micro-intervention were associated with changes in mood from the 1st day until the last day with regard to GB mood (r = 0.614, 95%CI [0.297, 0.809], p < 0.001), but not AT mood (r = 0.279, 95%CI [−0.122, 0.602], p = 0.167) and CN mood (r = 0.277, 95%CI [0.124, 0.601], p = 0.170).Discussion: Our findings provide evidence for the applicability of smartphone-based micro-interventions eliciting short-term mood changes, based on techniques used in psychotherapeutic approaches, such as mindfulness-based psychotherapy, transcendental meditation, and other contemplative therapies. The results encourage exploring these techniques' capability to improve mood in randomized controlled studies and patients. Smartphone-based micro-interventions are promising to modify mood in real-world settings, complementing other psychotherapeutic interventions, in line with the precision medicine approach. The here presented data were collected within a randomized trial, registered at ClinicalTrials.gov (Identifier: NCT01921088) https://clinicaltrials.gov/ct2/show/NCT01921088.

Engagement with a cognitive behavioural therapy mobile phone app predicts changes in mental health and wellbeing: MoodMission

“…Participants in all the studies summarised above (Kinderman et al, 2016;Meinlschmidt et al, 2016;Mohr et al, 2017;Roepke et al, 2015) were experiencing significant depression and/or anxiety symptoms, so it is unclear whether the MHapps would be effective for users experiencing subclinical symptoms. This has important implications for the recommendation of MHapps to different users.…”

“…Comparative measurements of depression, anxiety, and mental wellbeing were also absent. Similarly, Meinlschmidt et al (2016) found that a MHapp that coached 27 male participants through CBT-based "micro-interventions" resulted in short-term mood improvements, but the long-term effects of the app were unclear. Mohr et al (2017) reported the efficacy of a suite of "IntelliCare" apps in significantly reducing depression, as measured by the 9-item Patient Health Questionnaire (PHQ-9), and anxiety, measured by the 7-item Generalised Anxiety Disorder scale (GAD-7).…”

Cognitive performance of breast cancer survivors in daily life: Role of fatigue and depressed mood

“…For either women, the times when she responds more slowly than her own average may reflect times when she reports more fatigue or depressed mood than her usual (within‐person differences). This information may facilitate the development of interventions to be directed to the right patients at the right time …”

“…This information may facilitate the development of interventions to be directed to the right patients at the right time. 10 Much of the previous research on CACD has examined factors that differ between persons such as treatment modality, 11 cognitive reserve, 12 symptomatology (eg, fatigue and depression), 13 In the current paper, we report on the results of an EMA study of cognitive performance in breast cancer patients. Participants completed three EMA cognitive tasks and rated their depressed mood and fatigue up to five times a day for a 2-week period.…”

“…Multilevel model results for Symbol Search, Dot Memory, and Card Matching Note. Results are from 47 women assessed up to five times a day (prompt; 1-5) across the 2-week assessment period (days in study:[1][2][3][4][5][6][7][8][9][10][11][12][13][14]. EMA patient reported outcomes reflect differences between breast cancer patients (person mean) and within-person variation (daily fluctuation).Abbreviation: EMA, ecological momentary assessment.…”