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Abstract Background Dysfunctional depressogenic cognitions are considered a key factor in the etiology and maintenance of depression. In cognitive behavioral therapy (CBT), the current gold-standard psychotherapeutic treatment for depression, cognitive restructuring techniques are employed to address dysfunctional cognitions. However, high drop-out and non-response rates suggest a need to boost the efficacy of CBT for depression. This might be achieved by enhancing the role of emotional and kinesthetic (i.e., body movement perception) features of interventions. Therefore, we aim to evaluate the efficacy of a cognitive restructuring task augmented with the performance of anti-depressive facial expressions in individuals with and without depression. Further, we aim to investigate to what extent kinesthetic markers are intrinsically associated with and, hence, allow for the detection of, depression. Methods In a four-arm, parallel, single-blind, randomized controlled trial (RCT), we will randomize 128 individuals with depression and 128 matched controls without depression to one of four study conditions: (1) a cognitive reappraisal training (CR); (2) CR enhanced with instructions to display anti-depressive facial expressions (CR + AFE); (3) facial muscle training focusing on anti-depressive facial expressions (AFE); and (4) a sham control condition. One week after diagnostic assessment, a single intervention of 90–120-minute duration will be administered, with a subsequent follow-up two weeks later. Depressed mood will serve as primary outcome. Secondary outcomes will include current positive mood, symptoms of depression, current suicidality, dysfunctional attitudes, automatic thoughts, emotional state, kinesthesia (i.e., facial expression, facial muscle activity, body posture), psychophysiological measures (e.g., heart rate (variability), respiration rate (variability), verbal acoustics), as well as feasibility measures (i.e., treatment integrity, compliance, usability, acceptability). Outcomes will be analyzed with multiple methods, such as hierarchical and conventional linear models and machine learning. Discussion If shown to be feasible and effective, the inclusion of kinesthesia into both psychotherapeutic diagnostics and interventions may be a pivotal step towards the more prompt, efficient, and targeted treatment of individuals with depression. Trial registration The study was preregistered in the Open Science Framework on August 12, 2022 ( https://osf.io/mswfg/ ) and retrospectively registered in the German Clinical Trials Register on November 25, 2024. Clinical Trial Number: DRKS00035577.

Background: Dysfunctional depressogenic cognitions are considered a key factor in the etiology and maintenance of depression. In cognitive behavioral therapy (CBT), the current gold-standard psychotherapeutic treatment for depression, cognitive restructuring techniques are employed to address dysfunctional cognitions. However, high drop-out and non-response rates suggest a need to boost the efficacy of CBT for depression. This might be achieved by enhancing the role of emotional and kinesthetic (i.e., body movement perception) features of interventions. Therefore, we aim to evaluate the efficacy of a cognitive restructuring task augmented with the performance of anti-depressive facial expressions in individuals with and without depression. Further, we aim to investigate to what extent kinesthetic markers are intrinsically associated with and, hence, allow for the detection of, depression. Methods: In a four-arm, parallel, single-blind, randomized controlled trial (RCT), we will randomize 128 individuals with depression and 128 matched controls without depression to one of four study conditions: (1) a cognitive reappraisal training (CR); (2) CR enhanced with instructions to display anti-depressive facial expressions (CR + AFE); (3) facial muscle training focusing on anti-depressive facial expressions (AFE); and (4) a sham control condition. One week after diagnostic assessment, a single intervention of 90–120-minute duration will be administered, with a subsequent follow-up two weeks later. Depressed mood will serve as primary outcome. Secondary outcomes will include current positive mood, symptoms of depression, current suicidality, dysfunctional attitudes, automatic thoughts, emotional state, kinesthesia (i.e., facial expression, facial muscle activity, body posture), psychophysiological measures (e.g., heart rate (variability), respiration rate (variability), verbal acoustics), as well as feasibility measures (i.e., treatment integrity, compliance, usability, acceptability). Outcomes will be analyzed with multiple methods, such as hierarchical and conventional linear models and machine learning. Discussion: If shown to be feasible and effective, the inclusion of kinesthesia into both psychotherapeutic diagnostics and interventions may be a pivotal step towards the more prompt, efficient, and targeted treatment of individuals with depression. Trial registration: The study was preregistered in the Open Science Framework on August 12, 2022 (https://osf.io/mswfg/) and retrospectively registered in the German Clinical Trials Register on November 25, 2024. Clinical Trial Number: DRKS00035577. [ABSTRACT FROM AUTHOR]

Background: Comfort, anxiety, and pain significantly impact the quality of life and treatment adherence in cancer patients undergoing chemotherapy. Virtual reality (VR) technology offers a novel non-pharmacological intervention to address these primary concerns. While vital signs provide objective physiological data, they are considered secondary outcomes that may reflect changes in patients’ subjective experiences. Objective: This study aims to evaluate the effectiveness of smartphone-based virtual reality relaxation (SVR) interventions on improving comfort and reducing anxiety and pain (primary outcomes) in patients with cancer undergoing chemotherapy. Additionally, it assesses the impact on blood pressure and pulse rate (secondary outcomes). Methods: This prospective, two-arm, randomized controlled trial involved 99 cancer patients undergoing chemotherapy who were randomized into the SVR group (n = 50) and control group (n = 49) from March to May 2023. The SVR group received a 10-min immersive VR experience featuring 360-degree natural scenery videos with relaxing sounds, while participants in the control group received standard care and guided imagery leaflets. The primary outcomes—comfort, anxiety, and pain—were evaluated at various time points: comfort was assessed at baseline and post-chemotherapy, while anxiety and pain were assessed at four stages (pre-chemotherapy, pre-VR, immediate post-intervention, and post-chemotherapy). Secondary outcomes included vital signs (blood pressure and pulse rate), which were assessed at the same four stages. Cybersickness symptoms were examined post-chemotherapy. Data analysis involved independent t tests, linear regression, and Generalized Estimating Equations (GEE). Results: Among 99 randomized patients, the SVR group reported significantly higher comfort levels (p = 0.01; Cohen’s d = 0.4), reduced anxiety (p = 0.01; Cohen’s d = 0.50), and pain (p = 0.015; Cohen’s d = 0.35) compared to the control group. No significant differences were found in heart rate (p = 0.92), systolic blood pressure (p = 0.36), or diastolic blood pressure (p = 0.95). The majority of participants (66–96%) in the SVR group did not report cybersickness symptoms. Conclusions: SVR shows promise as an intervention for improving comfort and reducing anxiety and pain in cancer patients undergoing chemotherapy. Healthcare providers at chemotherapy centers should consider incorporating VR devices and curated content into patient care routines. Trial registration: ClinicalTrials.gov: NCT05756465, registered on January 22, 2023. [ABSTRACT FROM AUTHOR]

We examined the feasibility, acceptability, and clinical potential of a smartphone-based Approach-Avoidance Modification Training (AAMT) that required users to deliberately display anger and positive emotions (AAMT-AP) to move (dys-)functional stress-related beliefs away from and towards themselves, respectively. The per protocol sample consisted of N = 30 participants randomized to an AAMT-AP condition, a swipe control condition, or an inactive control condition. Feasibility and acceptability of the intervention and study design were assessed directly and changes in clinical outcomes (perceived stress (primary outcome), dysfunctional beliefs, symptoms of depression, and emotion regulation skills) one week after intervention completion. The results indicated that AAMT-AP was feasible and acceptable to participants. Moreover, notable effect sizes for clinical outcomes in comparison with both control conditions provided preliminary evidence for its therapeutic potential. Future research should evaluate the efficacy of AAMT-AP in sufficiently powered randomized controlled trials. [ABSTRACT FROM AUTHOR]

Yuru He,1,2 Xing Wang,1,2 Zuowei Wang,3,4 Ping Zhang,5 Xiaojia Huang,3,4 Meihong Yu,5 Jill K Murphy,6 Erin E Michalak,6 Jing Liu,6 Tao Yang,1,2 Xiaorui Yang,7 Yiru Fang,1,8,9 Raymond W Lam,6 Jun Chen1,2 1Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 2Shanghai Key Laboratory of Psychotic Disorders, Shanghai, People’s Republic of China; 3Division of Mood Disorders, Shanghai Hongkou Mental Health Center, Shanghai, People’s Republic of China; 4Clinical Research Center for Mental Health, School of Medicine, Shanghai University, Shanghai, People’s Republic of China; 5Fengxian District Mental Health Center, Shanghai, People’s Republic of China; 6Department of Psychiatry, University of British Columbia, Vancouver, Canada; 7Department of Psychology, Shanghai Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 8Department of Psychiatry & Affective Disorders Center, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 9CAS Center for Excellence in Brain Science and Intelligence Technology, Shanghai, People’s Republic of ChinaCorrespondence: Jun Chen, Clinical Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People’s Republic of China, Tel +86 21-34773367, Email doctorcj2010@gmail.com Raymond W Lam, Department of Psychiatry, University of British Columbia, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada, Tel +1 604-822-7325, Email r.lam@ubc.caPurpose: To validate the efficacy of enhanced measurement-based care against standard measurement-based care in patients with major depressive disorder.Patients and Methods: In this pilot study of an ongoing multicenter cluster randomized controlled trails, 160 patients diagnosed with major depressive disorder were enrolled from 2 mental health centers, with a plan to include 12 centers in total. One hundred patients engaged in a six-month evaluation using a technology-enhanced measurement-based care tool, including assessments of clinical symptoms, side effects, and functionality at baseline, two months, four months and six months. Simultaneously, the remaining 60 patients underwent standard paper-based measurement-based care, utilizing the same set of scales over the same six-month period, with assessments at the same time points.Results: Patients utilizing the enhanced measurement-based care tool demonstrated a significantly higher reduction rate in PHQ-9 scores compared to those using standard paper-based measurement-based care during the two-month follow-up. Additionally, a notable positive correlation was observed between the frequency of enhanced measurement-based care tool usage and the quality of life during the two-month follow-up.Conclusion: Enhanced measurement-based care has the effect of reducing depressive symptoms. Our study emphasized that using enhanced measurement-based care via smartphones is a feasible tool for patients with major depressive disorder. Our future study, including results from additional research centers, may further validate the effectiveness of enhanced measurement-based care.Keywords: major depressive disorder, measurement-based care, enhanced measurement-based care, smartphone-based intervention

Perceived stress, a global health problem associated with various mental disorders, is assumed to be influenced by dysfunctional beliefs. It can be hypothesized that these beliefs can be modified with the help of approach‐avoidance modification trainings (AAMTs). In the present study (conducted 2020–2022), we aimed to clarify whether the efficacy of AAMTs can be enhanced by utilizing the expression of emotions to move AAMT stimuli. For this purpose, we tested the feasibility and acceptability of a new AAMT paradigm in which the expression of disgust is used to move stress‐increasing beliefs away from oneself and the expression of positive emotions is used to move stress‐reducing beliefs towards oneself (AAMT‐DP). Additionally, we explored the therapeutic potential of the AAMT‐DP intervention by comparing it to an inactive control condition and to a conventional AAMT in which stimuli are moved by swipe movements (n = 10 in each condition). The primary outcome was perceived stress 1 week after the training as assessed with the Perceived Stress Scale. Findings indicate sufficient feasibility and acceptability of the intervention and that the decrease in perceived stress in the AAMT‐DP condition was greater than in the inactive control condition (g = 0.72 [0.10, 1.72]) and than in the swipe control condition (g = 0.64 [0.01, 1.41]). In sum, findings provide preliminary evidence for the feasibility, acceptability, and the therapeutic potential of the AAMT‐DP intervention. [ABSTRACT FROM AUTHOR]

Abstract Background Problematic drinking is common among college students and associated with various somatic and mental health problems. Given significant evidence for the efficacy of smartphone-based interventions and the frequent use of smartphones among college students, it can be assumed that such interventions have great potential to facilitate access to evidence-based interventions for students suffering from problematic drinking. Thus, we developed a brief intervention that combined a counseling session with an app that utilizes approach-avoidance modification training to reduce alcohol consumption. Methods To test the feasibility and explore the potential efficacy of the intervention, we conducted a before-after single-arm study with N = 11 participants reportedly engaging in problematic drinking, who were instructed to practice with the app for 14 days. Feasibility was assessed with the System Usability Scale (SUS). Outcomes included the reduction of self-reported problematic drinking behavior, dysfunctional attitudes about alcohol, and craving, as well as implicit associations between alcohol and self during the training period. Additionally, self-reported problematic drinking behavior was assessed at a 4-week follow-up. Results On average, participants rated app usability on the SUS (possible range: 0 to 100) with M = 84.32 (SD = 6.53). With regard to efficacy, participants reported a significant reduction of problematic drinking behavior (d pre vs. post = 0.91) which was sustained at follow-up (d follow-up vs. baseline = 1.07). Additionally, participants reported a significant reduction of dysfunctional attitudes about alcohol (d pre vs. post = 1.48). Results revealed no significant changes in craving nor in implicit associations regarding alcohol. Conclusions Findings from this feasibility study provide preliminary evidence that smartphone-based interventions might help reduce problematic drinking in college students. Further research needs to replicate these findings with larger samples in randomized controlled trials. Trial registration DRKS00014675 (retrospectively registered).

Abstract Background Self-harm in young people is a public health concern connected with severe mental health problems, such as personality pathology. Currently, there are no specific evidence-based interventions available for young people who self-harm. Therefore, we developed PRe-Intervention Monitoring of Affect and Relationships in Youth (PRIMARY), a smartphone-based intervention, co-designed by clinicians and young people with lived experience of mental ill-health. PRIMARY combines the Experience Sampling Method (ESM) with weekly report sessions. The study aims to examine the effectiveness of PRIMARY with regard to reducing self-harm, and improving emotion regulation and quality of relationships. Methods This study is a multicenter, parallel groups, randomized controlled trial (RCT) comparing the PRIMARY intervention to a waiting list control group. PRIMARY comprises 28 consecutive days of questionnaires five times each day (i.e., ESM) and four weekly report sessions. Participants will comprise 180 young people referred for treatment to the participating Dutch mental healthcare institutions and (1) are aged 12 to 25 years, and (2) engaged in ≥ 1 act of self-harm in the past year. Participants are randomly allocated to a study group after screening in a 1:1 ratio by an independent researcher using computer-generated randomization sequences with stratified block randomization by age (12 to 15 years / 16 to 25 years). Staff will conduct assessments with all participants at baseline (Wave 1), after 28 days (Wave 2), and in a subsample after 10 weeks of subsequent specialized treatment (Wave 3). The primary outcomes are self-harm, emotion regulation, and quality of relationships. Secondary outcomes include patient and clinician satisfaction. Exploratory analyses of ESM data will examine the relationship between emotions, social relationships, and self-harm. Discussion The results of this trial will clarify whether an innovative smartphone-based intervention is effective for reducing self harm and improving emotion regulation and the quality of social relationships. It has the potential to fill a treatment gap of interventions specifically targeting self-harm. If proven effective, it would provide an accessible, easy-to-implement, low-cost intervention for young people. Furthermore, the ESM-data will allow detailed analyses into the processes underlying self-harm, which will contribute to theoretical knowledge regarding the behavior. Trial registration ISRCTN42088538 ( https://doi.org/10.1186/ISRCTN42088538 ), retrospectively registered on the 26th of October 2022.

Background: Problematic drinking is common among college students and associated with various somatic and mental health problems. Given significant evidence for the efficacy of smartphone-based interventions and the frequent use of smartphones among college students, it can be assumed that such interventions have great potential to facilitate access to evidence-based interventions for students suffering from problematic drinking. Thus, we developed a brief intervention that combined a counseling session with an app that utilizes approach-avoidance modification training to reduce alcohol consumption. Methods: To test the feasibility and explore the potential efficacy of the intervention, we conducted a before-after single-arm study with N = 11 participants reportedly engaging in problematic drinking, who were instructed to practice with the app for 14 days. Feasibility was assessed with the System Usability Scale (SUS). Outcomes included the reduction of self-reported problematic drinking behavior, dysfunctional attitudes about alcohol, and craving, as well as implicit associations between alcohol and self during the training period. Additionally, self-reported problematic drinking behavior was assessed at a 4-week follow-up. Results: On average, participants rated app usability on the SUS (possible range: 0 to 100) with M = 84.32 (SD = 6.53). With regard to efficacy, participants reported a significant reduction of problematic drinking behavior (dpre vs. post = 0.91) which was sustained at follow-up (dfollow-up vs. baseline = 1.07). Additionally, participants reported a significant reduction of dysfunctional attitudes about alcohol (dpre vs. post = 1.48). Results revealed no significant changes in craving nor in implicit associations regarding alcohol. Conclusions: Findings from this feasibility study provide preliminary evidence that smartphone-based interventions might help reduce problematic drinking in college students. Further research needs to replicate these findings with larger samples in randomized controlled trials. Trial registration: DRKS00014675 (retrospectively registered). [ABSTRACT FROM AUTHOR]

Abstract Background Stress levels and thus the risk of developing related physical and mental health conditions are rising worldwide. Dysfunctional beliefs contribute to the development of stress. Potentially, such beliefs can be modified with approach-avoidance modification trainings (AAMT). As previous research indicates that effects of AAMTs are small, there is a need for innovative ways of increasing the efficacy of these interventions. For this purpose, we aim to evaluate the feasibility of the intervention and study design and explore the efficacy of an innovative emotion-based AAMT version (eAAMT) that uses the display of emotions to move stress-inducing beliefs away from and draw stress-reducing beliefs towards oneself. Methods We will conduct a parallel randomized controlled pilot study at the Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany. Individuals with elevated stress levels will be randomized to one of eight study conditions (n = 10 per condition) — one of six variants of the eAAMT, an active control intervention (swipe-based AAMT), or an inactive control condition. Participants in the intervention groups will engage in four sessions of 20–30 min (e)AAMT training on consecutive days. Participants in the inactive control condition will complete the assessments via an online tool. Non-blinded assessments will be taken directly before and after the training and 1 week after training completion. The primary outcome will be perceived stress. Secondary outcomes will be dysfunctional beliefs, symptoms of depression, emotion regulation skills, and physiological stress measures. We will compute effect sizes and conduct mixed ANOVAs to explore differences in change in outcomes between the eAAMT and control conditions. Discussion The study will provide valuable information to improve the intervention and study design. Moreover, if shown to be effective, the approach can be used as an automated smartphone-based intervention. Future research needs to identify target groups benefitting from this intervention utilized either as stand-alone treatment or an add-on intervention that is combined with other evidence-based treatments. Trial registration The trial has been registered in the German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS00023007 ; September 7, 2020).

ObjectiveTo prevent the exacerbation of mental health burdens, a growing body of research has recommended a balanced approach that emphasizes both the delivery of mental health treatments to individuals with common mental disorders (CMDs) and the strengthening of protective factors for CMDs among nonclinical populations. This randomized controlled trial (RCT) evaluated the efficacy of a smartphone-delivered multicomponent lifestyle medicine (LM) intervention, Lifestyle Hub, for improving mental health among a nonclinical population of Chinese adults.MethodsA total of 106 participants with Patient Health Questionnaire-9 total score

Work-related stress significantly jeopardizes employees' physical and mental health due to the considerable time they spend at work. Smartphone-based interventions provide a promising solution, eliminating traditional face-to-face interventions' barriers. However, the elements that influence workers' intentions to use this still remain unexplored. This study explores the link between health belief model (HBM) and technology acceptance model (TAM) factors. In this study, 336 Italian workers (64% female) answered an online questionnaire. We employed a structural equation model (SEM) to analyze the data. The results unveiled an indirect relationship: individuals perceiving health risks were more inclined to use stress-management apps, mediated by perceived utility (PU). This study underscores the significant potential of integrating the HBM with the TAM in predicting users' preparedness for smartphone-based health interventions. These findings not only hold substantial value but also illuminate a path forward for professionals and organizations, offering insights to tailor and optimize smartphone tools for stress management and the promotion of workplace well-being. Ultimately, this research paves the way for the cultivation of healthier work environments, marking a noteworthy contribution to the field. [ABSTRACT FROM AUTHOR]

Background: Self-harm in young people is a public health concern connected with severe mental health problems, such as personality pathology. Currently, there are no specific evidence-based interventions available for young people who self-harm. Therefore, we developed PRe-Intervention Monitoring of Affect and Relationships in Youth (PRIMARY), a smartphone-based intervention, co-designed by clinicians and young people with lived experience of mental ill-health. PRIMARY combines the Experience Sampling Method (ESM) with weekly report sessions. The study aims to examine the effectiveness of PRIMARY with regard to reducing self-harm, and improving emotion regulation and quality of relationships. Methods: This study is a multicenter, parallel groups, randomized controlled trial (RCT) comparing the PRIMARY intervention to a waiting list control group. PRIMARY comprises 28 consecutive days of questionnaires five times each day (i.e., ESM) and four weekly report sessions. Participants will comprise 180 young people referred for treatment to the participating Dutch mental healthcare institutions and (1) are aged 12 to 25 years, and (2) engaged in ≥ 1 act of self-harm in the past year. Participants are randomly allocated to a study group after screening in a 1:1 ratio by an independent researcher using computer-generated randomization sequences with stratified block randomization by age (12 to 15 years / 16 to 25 years). Staff will conduct assessments with all participants at baseline (Wave 1), after 28 days (Wave 2), and in a subsample after 10 weeks of subsequent specialized treatment (Wave 3). The primary outcomes are self-harm, emotion regulation, and quality of relationships. Secondary outcomes include patient and clinician satisfaction. Exploratory analyses of ESM data will examine the relationship between emotions, social relationships, and self-harm. Discussion: The results of this trial will clarify whether an innovative smartphone-based intervention is effective for reducing self harm and improving emotion regulation and the quality of social relationships. It has the potential to fill a treatment gap of interventions specifically targeting self-harm. If proven effective, it would provide an accessible, easy-to-implement, low-cost intervention for young people. Furthermore, the ESM-data will allow detailed analyses into the processes underlying self-harm, which will contribute to theoretical knowledge regarding the behavior. Trial registration: ISRCTN42088538 (https://doi.org/10.1186/ISRCTN42088538), retrospectively registered on the 26th of October 2022. [ABSTRACT FROM AUTHOR]

Background and Objectives Family caregivers often experience a high level of stress, social isolation, a sedentary lifestyle, and poor mental and physical health. An exergame intervention was developed to promote physical activity and well-being in family caregivers and to test social support as a mechanism for behavior change. Research Design and Methods The current study was a randomized pilot trial (N = 76) to compare the effectiveness of Go&Grow (social vs nonsocial exergame) to promote well-being through increased social support and physical activity for family caregivers over a 6-week intervention. Results The treatment group increased significantly more than the control group in well-being (management of distress) and social support (satisfaction with contact quality). Social support served as a mechanism (mediator and moderator): The treatment group increased more than the control group in satisfaction with social contact quality, which led to more positive affect and less loneliness. Moreover, those in the treatment group who increased more in overall social support and knowing others' experiences increased their steps more than those with less support, whereas the change in steps for the control group was not related to a support level. Those in the treatment group who used more social features of the app had a greater increase in steps compared with those who used it less. Discussion and Implications Social support in technology interventions is a promising direction to promote caregivers' well-being and physical activity. Social support served as a mechanism of behavior change that can inform more engaging, sustainable, portable, and scalable interventions in the future for sedentary and socially isolated family caregivers. Clinical Trial Registration Number: NCT05032872 [ABSTRACT FROM AUTHOR]

Background: Stress levels and thus the risk of developing related physical and mental health conditions are rising worldwide. Dysfunctional beliefs contribute to the development of stress. Potentially, such beliefs can be modified with approach-avoidance modification trainings (AAMT). As previous research indicates that effects of AAMTs are small, there is a need for innovative ways of increasing the efficacy of these interventions. For this purpose, we aim to evaluate the feasibility of the intervention and study design and explore the efficacy of an innovative emotion-based AAMT version (eAAMT) that uses the display of emotions to move stress-inducing beliefs away from and draw stress-reducing beliefs towards oneself. Methods: We will conduct a parallel randomized controlled pilot study at the Friedrich-Alexander-Universität Erlangen-Nürnberg, Germany. Individuals with elevated stress levels will be randomized to one of eight study conditions (n = 10 per condition) — one of six variants of the eAAMT, an active control intervention (swipe-based AAMT), or an inactive control condition. Participants in the intervention groups will engage in four sessions of 20–30 min (e)AAMT training on consecutive days. Participants in the inactive control condition will complete the assessments via an online tool. Non-blinded assessments will be taken directly before and after the training and 1 week after training completion. The primary outcome will be perceived stress. Secondary outcomes will be dysfunctional beliefs, symptoms of depression, emotion regulation skills, and physiological stress measures. We will compute effect sizes and conduct mixed ANOVAs to explore differences in change in outcomes between the eAAMT and control conditions. Discussion: The study will provide valuable information to improve the intervention and study design. Moreover, if shown to be effective, the approach can be used as an automated smartphone-based intervention. Future research needs to identify target groups benefitting from this intervention utilized either as stand-alone treatment or an add-on intervention that is combined with other evidence-based treatments. Trial registration: The trial has been registered in the German Clinical Trials Register (Deutsches Register Klinischer Studien; DRKS00023007; September 7, 2020). [ABSTRACT FROM AUTHOR]

Social anxiety is an increasing mental health concern for adolescents in the international community, including China, where access to psychotherapy is still limited. Training in cognitive bias modification of interpretation (CBM-I) for ambiguous social situations has demonstrated efficacy in improving social anxiety. Smartphone-based CBM-I has the potential to be an accessible tool to help address the mental health needs of adolescents. However, no prior studies have explored smartphone-based CBM-I targeting social anxiety in adolescents. We examined the effect of an eight-session smartphone-based training of cognitive bias modification of interpretation (CBM-I) on the social anxiety of Chinese adolescents. Twenty-eight participants who scored in the top ten percent of Social Anxiety Scale (SAS-A) and the Brief Fear of Negative Evaluation (BFNE) were randomly assigned to the training group and the waitlist group. Both groups completed pre- and post-tests of interpretation bias and social anxiety. Participants in the training group logged into the smartphone-based CBM-I application twice a week for four weeks to receive the intervention. The waitlist group received the same pre-and post-tests only during the 4-week waiting time. Results revealed that the CBM-I training group significantly increased positive interpretation bias and decreased negative interpretation bias, social anxiety, and fear of negative evaluation. The waitlist group did not have any significant changes in the above measures. The eight-session smartphone-based CBM-I intervention showed the expected intervention effect for Chinese adolescents coping with social anxiety, demonstrating its potential as an effective tool for reducing social anxiety for the population. Highlights: Developed an 8-session smartphone-based training of CBM-I for social anxiety reduction. Developed culturally and developmentally adapted CBM-I training materials for Chinese adolescents. Found a significant reduction in social anxiety and fear of negative evaluation in the CBM-I training group. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the efficacy and credibility of a smartphone-delivered multicomponent lifestyle medicine (LM) intervention, Lifestyle Hub, as a primary modality for managing depressive symptoms in an adult Chinese population. Method: Participants with at least a moderate level of depressive symptoms (n = 79), as indicated by a Patient Health Questionnaire-9 score of ≥10, were randomly assigned to an LM intervention group (LMG; n = 39; eight weekly sessions) or a waitlist control group (WLG; n = 40). Results: The intention-to-treat analysis revealed significant improvements in depressive symptoms (d = 0.66), generalized anxiety symptoms (d = 0.93), insomnia symptoms (d = 0.20), functional impairment (d = 0.22), and health-related quality of life (HRQoL; d = 0.11) from Week 0 (baseline) to Week 9 (immediate post-intervention assessment) in the LMG relative to the WLG. Moreover, significantly more health-promoting behaviors (overall health behaviors, health responsibility, physical activity level, nutrition, spiritual growth, and stress management) (d = 0.40–0.89) and higher levels of total activity (d = 0.55) and walking activity (d = 0.55) were found at Week 9 in the LMG relative to the WLG. However, no significant differences were observed in interpersonal relationships, vigorous and moderate exercise levels, sedentary behavior levels, or food frequency questionnaire measures at Week 9 between the LMG and the WLG. From Week 9 to Week 13 (1-month follow-up assessment), a significant within-group reduction in HRQoL (d = 0.50) and an increase in alcohol intake (d = 0.41) were observed in the LMG. Conclusions: The smartphone-delivered multicomponent LM intervention Lifestyle Hub may serve as a primary modality for managing depressive symptoms. What is the public health significance of this article?: This is the first study to demonstrate the efficacy and credibility of a smartphone-based multicomponent LM intervention as a primary modality for managing depressive symptoms. The LM approach, which addresses service users' needs and preferences, could be a viable approach to facilitate the management of depressive symptoms. [ABSTRACT FROM AUTHOR]

Occupational Psychology faces challenges concerning the promotion of employees' well-being and health. The use of emergent technologies (e.g. smartphone) has revealed new opportunities to deliver effective, cheap and early interventions. By following the international PRISMA statement guidelines, this systematic review aims to bring together workplace smartphone-based interventions, targeting employees' well-being and psycho-physical health, to address the lack of studies focused on workplace settings. Results were drawn from 31 quantitative and qualitative studies, testing smartphone applications. The authors extracted multiple information for each article: focus, target, theoretical background, users' engagement and study design. Findings show the lack of theoretical background, reliable study design and the prevalence of physical health interventions. Moreover, our review identifies the importance of users' engagement for an intervention's effectiveness. It is relevant to design specific mHealth interventions, to provide employees with the skills to cope with and manage work-stress and enhance their general health and well-being. [ABSTRACT FROM AUTHOR]

Research indicates that it might be possible to change personality traits through intervention, but this clinical research has primarily focused on changing neuroticism. To date, there are no established, proven techniques for changing other domains of personality, such as conscientiousness and openness. This research examined the effects of a two‐week smartphone‐based intervention to either change one facet of conscientiousness (i.e. self‐discipline) or one facet of openness to experience (i.e. openness to action). Two intervention studies (total N = 255) with two active intervention groups for mutual comparisons were conducted. Results of self‐reports and observer reports showed that people who wanted to become more self‐disciplined were less self‐disciplined at pretest. Similarly, people who wanted to become more open to action were less open to action at pretest. The results showed that people who chose the self‐discipline intervention showed greater increases in self‐discipline, and people who chose the openness to action intervention showed greater increases in openness to action compared with the other group. Changes were maintained until follow‐up two and six weeks after the end of the intervention. Future work is needed to examine whether these personality changes are enduring or reflect temporary accentuation as a result of participation in the intervention. © 2020 European Association of Personality Psychology [ABSTRACT FROM AUTHOR]

This study extended the assessment of a smartphone-based intervention designed to support occupational engagement, provide an opportunity of physical exercise, and promote personal enjoyment in people with significant neurodevelopmental disorders. Six participants were included in the study. A Samsung Galaxy J4 Plus smartphone with Android 8.1 operating system and near-field communication function was automated through the MacroDroid application to fit the intervention conditions. The participants were required to place cards with frequency identification tags into an elevated box with an embedded smartphone. The smartphone identified each of the cards the participant placed into the box and played preferred song segments matching those cards. The smartphone also provided a verbal prompt/encouragement to respond if preset time intervals elapsed without any card response. All participants showed significant increases in their frequency of card responses, in their heart rates, and in their indices of enjoyment during the intervention sessions as opposed to baseline or control sessions. The results were discussed in relation to previous data in the area and in terms of their apparent relevance for daily contexts. [ABSTRACT FROM AUTHOR]

Background: Cancer is related to not only physical but also mental suffering. Notably, body image disturbances are highly relevant to cancer-related changes often persisting beyond recovery from cancer. Scalable and low-barrier interventions that can be blended with face-to-face psychotherapy for cancer survivors are highly warranted., Objective: The aim of the study is to investigate whether smartphone-based bodily interventions are more effective to improve the mood of patients with cancer than smartphone-based fairy tale interventions (control intervention)., Methods: We recruited patients with cancer in 2 Swiss hospitals and conducted daily, fully automated smartphone-based interventions 6 times a week for 5 consecutive weeks, blended with weekly face-to-face group body psychotherapy. We applied 2 types of smartphone-based interventions using a within-subject design, randomly assigning patients daily to either bodily interventions or fairy tales. Each intervention type was presented 3 times a week. For this secondary analysis, 3-level mixed models were estimated with mood assessed by the 3 Multidimensional Mood Questionnaire subscales for good-bad mood, wakefulness, and calmness as key indicators. In addition, the effects on experience of presence, vitality, and burden assessed with visual analog scales were investigated., Results: Based on the data from s=732 interventions performed by 36 participants, good-bad mood improved (β=.27; 95% CI 0.062-0.483), and participants became calmer (β=.98; 95% CI 0.740-1.211) following smartphone-based interventions. Wakefulness did not significantly change from pre- to postsmartphone-based intervention (β=.17; 95% CI -0.081 to 0.412). This was true for both intervention types. There was no interaction effect of intervention type with change in good-bad mood (β=-.01; 95% CI -0.439 to 0.417), calmness (β=.22; 95% CI -0.228 to 0.728), or wakefulness (β=.14; 95% CI -0.354 to 0.644). Experience of presence (β=.34; 95% CI 0.271-0.417) and vitality (β=.35; 95% CI 0.268-0.426) increased from pre- to postsmartphone-based intervention, while experience of burden decreased (β=-0.40; 95% CI -0.481 to 0.311). Again, these effects were present for both intervention types. There were no significant interaction effects of intervention type with pre- to postintervention changes in experience of presence (β=.14; 95% CI -0.104 to 0.384), experience of vitality (β=.06; 95% CI -0.152 to 0.265), and experience of burden (β=-.16; 95% CI -0.358 to 0.017)., Conclusions: Our results suggest that both smartphone-based audio-guided bodily interventions and fairy tales have the potential to improve the mood of cancer survivors., Trial Registration: ClinicalTrials.gov NCT03707548; https://clinicaltrials.gov/study/NCT03707548., International Registered Report Identifier (irrid): RR2-10.1186/s40359-019-0357-1., (©Gunther Meinlschmidt, Astrid Grossert, Cornelia Meffert, Noa Roemmel, Viviane Hess, Christoph Rochlitz, Miklos Pless, Sabina Hunziker, Brigitta Wössmer, Ulfried Geuter, Rainer Schaefert. Originally published in JMIR Cancer (https://cancer.jmir.org), 28.08.2023.)

Background: Implicit theories of health describe individuals' beliefs about the malleability of health. Individuals with an incremental theory of health believe that health, in general, is malleable, whereas individuals with an entity theory of health endorse the idea that health is largely fixed and predetermined. Previous research has shown that an incremental theory of health is associated with beneficial health outcomes and behaviors. A mobile health implicit theories intervention could be an effective way to increase health-promoting behaviors in the general population., Objective: The aim of this study was to estimate the effect of a smartphone-based intervention designed to promote an incremental theory of health on the frequency of health-promoting behaviors in everyday life. The study used ecological momentary assessment to measure health behavior change., Methods: This 2-arm, single-blind, delayed intervention design included 149 German participants (mean age 30.58, SD 9.71 years; n=79 female). Participants were asked to report their engagement in 10 health-promoting behaviors throughout the day for 3 weeks. Participants were randomly assigned to either an early intervention group (n=72) or a delayed intervention group (n=77). The intervention materials, designed to promote an incremental theory of health, were provided to participants after 1 week (early intervention group) or 2 weeks (delayed intervention group) of baseline behavior measurement. Data for this study were collected between September 2019 and October 2019., Results: A paired-samples 2-tailed t test revealed that participants reported a stronger incremental theory after responding to the intervention materials (mean 5.58, SE 0.07) compared with incremental theory measured in an entry questionnaire (mean 5.29, SE 0.08; t 148 =4.07, SE 0.07; P<.001; 95% CI 0.15-0.43; d=0.33). Multilevel analyses showed that participants reported engaging in health-promoting behaviors more often after being presented with the intervention materials compared with baseline across conditions (b=0.14; t 146.65 =2.06, SE 0.07; P=.04; 95% CI 0.01-0.28). However, when the analysis was conducted separately for the early and delayed intervention groups, the intervention effect was only significant for the delayed intervention group (b=0.27; t 1492.37 =3.50, SE 0.08; P<.001; 95% CI 0.12-0.42). There was no significant increase in health-promoting behaviors for the early intervention group (b=0.02; t 69.23 =0.14, SE 0.11;P=.89; 95% CI -0.2 to 0.23)., Conclusions: This study suggests that a smartphone-based intervention designed to promote an incremental theory of health is a cost- and time-effective approach to increase the frequency of engaging in health-promoting behaviors. However, research is needed to understand the reasons for the difference in intervention effects between the early and delayed intervention groups. The results of this study can guide the development of future digital health interventions that focus on implicit theories to promote health behavior change., Trial Registration: DRKS - German Clinical Trials Register DRKS00017379; https://drks.de/search/de/trial/DRKS00017379., (©Mike Schreiber, Simone Dohle. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 15.06.2023.)

Despite the highly publicized beneficial effects of physical activity, 51.1% of middle-aged US adults do not achieve the recommended minimum of aerobic physical activity needed to maintain health. A sedentary lifestyle can be attributed in part to a lack of self-control and there is some evidence that self-control strategies can be improved with targeted interventions. The overall aim of this study is to test self-control as a behavior change mechanism for physical activity and to investigate whether a smartphone-based self-control intervention can increase physical activity among sedentary middle-aged adults. This protocol describes the design of a randomized controlled trial with two experimental conditions: The self-control treatment group and the control group. Both groups track their daily physical activity using a Fitbit step counter for eight weeks. Additionally, the self-control intervention group receives a 7-week smartphone-based self-control intervention to learn strategies how to potentiate desirable impulses or weaken undesirable ones. It is expected that the self-control treatment group will show greater increases in physical activity and that changes last longer compared to the control group. All participants will be assessed at pretest (baseline), at the end of each week (weeks 1–7), at posttest (week 8), and at follow-up (week 12). If this self-control intervention proves effective, this digital approach would represent a low-threshold and cost-effective approach to increasing physical activity. Such an intervention could be delivered to a large number of people to improve their health outcomes in the long run. Trial Registration: ClinicalTrials.gov : NCT04522141 [ABSTRACT FROM AUTHOR]