A self-control training app to increase self-control and reduce aggression - A full factorial design

Clarifying the relationship between trait aggression and self-control using random item slope regression

OBJECTIVE

Myriad psychological research evinces a negative association between self-control and aggression with some arguing for self-control failure as a cause of aggression. Recent literature suggests that the relationship between aggression and self-control is likely more complex and even positive in some cases. One source of such conflict in the literature could be the presence of unaccounted for random item slopes in commonly used measures of self-control which may inflate the likelihood of Type I errors. This study (N = 1386) tested the hypothesis that self-control would share random item slopes with the facets of trait aggression using random item slope regression.

METHOD

We measured trait aggression and self-control via two common self-reports: the Buss-Perry Questionnaire and the Brief Self-Control Scale.

RESULTS

Our analyses revealed that the facets of trait aggression shared significant random item slopes with self-control and that many of these slopes were positive, rather than negative. We also found that Type I error inflation was evident in models that did not account for these random slopes.

CONCLUSIONS

These findings may in part explain some of the conflicting results in the literature and that researchers interested in studying self-control and aggression should test for random item slopes.

Deviant peer affiliation, self-control, and aggression during early adolescence: within-person effects and between-person differences

Abundant studies have explored the relations among deviant peer affiliation, self-control, and aggression without separating within-person from between-person effects. Moreover, it is unclear whether self-control mediates the associations between deviant peer affiliation and aggression during early adolescence. This longitudinal study used Random Intercept Cross-Lagged Panel Model to examine the dynamic relations among deviant peer affiliation, self-control, and aggression within individuals, including examining whether self-control mediated the relations between deviant peer affiliation and aggression. A total of 4078 early adolescents (54% boys, Mage = 9.91, SD = 0.73) completed questionnaires on four occasions across 2 years. Results indicated: (a) Deviant peer affiliation and aggression positively predicted each other; (b) Self-control and aggression negatively predicted each other but were unstable; (c) Deviant peer affiliation and self-control negatively predicted each other; and (d) Self-control mediated the path from aggression to deviant peer affiliation, but not vice versa. The results more precisely identify the relations among deviant peer affiliation, self-control, and aggression within individuals, providing valuable information for prevention and intervention programs targeted at alleviating early adolescent aggression.

The Digital Therapeutics Real-World Evidence Framework: An Approach for Guiding Evidence-Based Digital Therapeutics Design, Development, Testing, and Monitoring

Digital therapeutics (DTx) are a promising way to provide safe, effective, accessible, sustainable, scalable, and equitable approaches to advance individual and population health. However, developing and deploying DTx is inherently complex in that DTx includes multiple interacting components, such as tools to support activities like medication adherence, health behavior goal-setting or self-monitoring, and algorithms that adapt the provision of these according to individual needs that may change over time. While myriad frameworks exist for different phases of DTx development, no single framework exists to guide evidence production for DTx across its full life cycle, from initial DTx development to long-term use. To fill this gap, we propose the DTx real-world evidence (RWE) framework as a pragmatic, iterative, milestone-driven approach for developing DTx. The DTx RWE framework is derived from the 4-phase development model used for behavioral interventions, but it includes key adaptations that are specific to the unique characteristics of DTx. To ensure the highest level of fidelity to the needs of users, the framework also incorporates real-world data (RWD) across the entire life cycle of DTx development and use. The DTx RWE framework is intended for any group interested in developing and deploying DTx in real-world contexts, including those in industry, health care, public health, and academia. Moreover, entities that fund research that supports the development of DTx and agencies that regulate DTx might find the DTx RWE framework useful as they endeavor to improve how DTxcan advance individual and population health.

Challenges and opportunities in mobile e-coaching

Background

Mobile e-health technologies have proven to provide tailored assessment, intervention, and coaching capabilities for various usage scenarios. Thanks to their spread and adoption, smartphones are one of the most important carriers for such applications.

Problem

However, the process of design, realization, evaluation, and implementation of these e-health solutions is wicked and challenging, requiring multiple stakeholders and expertise.

Method

Here, we present a tailorable intervention and interaction e-health solution that allows rapid prototyping, development, and evaluation of e-health interventions at scale. This platform allows researchers and clinicians to develop ecological momentary assessment, just-in-time adaptive interventions, ecological momentary intervention, cohort studies, and e-coaching and personalized interventions quickly, with no-code, and in a scalable way.

Result

The Twente Intervention and Interaction Instrument (TIIM) has been used by over 320 researchers in the last decade. We present the ecosystem and synthesize the main scientific output from clinical and research studies in different fields.

Discussion

The importance of mobile e-coaching for prediction, management, and prevention of adverse health outcomes is increasing. A profound e-health development strategyand strategic, technical, and operational investments are needed to prototype, develop, implement, and evaluate e-health solutions. TIIM ecosystem has proven to support these processes. This paper ends with the main research opportunities in mobile coaching, including intervention mechanisms, fine-grained monitoring, and inclusion of objective biomarker data.

The link between exposure to violent media, normative beliefs about aggression, self-control, and aggression: A comparison of traditional and cyberbullying

Adolescence is a high-risk age for exposure to violent media (EVM) and bullying. Some previous theories and empirical studies have highlighted a moderated mediating model that normative beliefs about aggression (NBA) as a mediator and self-control (SC) as a moderator for the link between EVM and aggressive behaviors (including bullying behaviors). However, most previous studies analyzed traditional bullying (TB) and cyberbullying (CB) separately, which is not conducive to finding the differences between the two bullying behaviors. Therefore, this study aims to compare the differences between risk prediction models of TB and CB among adolescents. A total of 777 Chinese adolescent students (336 girls; M_age  = 13.57 ± 0.98) completed questionnaires including EVM, NBA, TB, CB, and SC. The results showed that: (1) EVM was positively related to adolescent TB/CB; (2) NBA mediated the above relations; and (3) SC buffers the direct effect of EVM on TB and the effect of NBA on TB. However, SC buffers the effect of NBA on adolescent CB but not buffers the direct effect of EVM on CB. This study highlights the necessity of distinguishing offline and online situations in aggressive behavior research. We suggested "online disinhibit hypothesis" would be adopted to explain why protector factors (e.g., SC) do not buffer the link between aggression-related risk factors (e.g., EVM) and online aggression (e.g., CB).

Emotional Recognition Training Enhances Attention to Emotional Stimuli Among Male Juvenile Delinquents

Objective

Juvenile delinquents have deficits in emotional recognition that might play a critical role in the development of aggression. The present study aimed to investigate the effect of emotional recognition training and its consequences on emotional attention and aggression.

Methods

Seventy-three male juvenile delinquents were randomly assigned to two groups. One group was the modification group, which received eight days of training on an emotional recognition task. The purpose of the training was to modify interpretative biases in emotion recognition to encourage the perception of happiness over anger in ambiguous expressions. The other group was the waitlist group, which did not perform a task and continued with their usual programme. Before and after the training, participants completed the aggression questionnaire (AQ) and two behavioural tasks, including the emotional recognition task and a visual search task with happy and angry faces as targets.

Results

The modification group recognized more faces as happy after emotional recognition training than the waitlist group. Furthermore, the hostility in the modification group decreased significantly. Importantly, emotional recognition training further affected attention to emotional faces as participants responded faster in searching for happy and angry faces after training.

Conclusion

Emotional recognition training could modify juvenile delinquents' emotional recognition, enhance their visual attention to emotional faces and reduce hostility.

A mobile self-control training app to improve self-control and physical activity in people with severe mental illness: Protocol for two single-case experiment designs (Preprint)

BACKGROUND

Lack of physical activity is a common issue with detrimental consequences for the health of people with severe mental illness (SMI). Existing physical activity interventions show suboptimal effects as they require substantial cognitive skills, including goal setting and writing, whereas cognitive deficits are common in this population. To bolster the effectiveness of physical activity interventions, self-control training (SCT), in which users practice the ability to override unwanted thoughts and behaviors, can be used in addition. Recent research has demonstrated the initial effectiveness of a mobile SCT app, but this has not been studied in psychiatric clinical practice.

OBJECTIVE

This study aims to evaluate to what extent adding a mobile SCT app designed for and with people with SMI to a mobile lifestyle intervention aimed at increasing physical activity increases physical activity and self-control levels.

METHODS

A mixed methods approach incorporating 2 single-case experimental designs (SCEDs) and qualitative interviews was used to evaluate and optimize SCT. Overall, 12 participants with SMI will be recruited from 2 organizations offering outpatient and inpatient care to people with SMI. Each experiment will include 6 patients. SCED I is a concurrent multiple-baseline design across participants that explores initial effectiveness and optimal intervention duration. Using accelerometry and experience sampling questionnaires, participants' physical activity and self-control will be monitored for ≥5 days from baseline, followed by the sequential introduction of Google Fit, the physical activity intervention, for 7 days and the addition of SCIPP: Self-Control Intervention App for 28 days. SCED II is an introduction/withdrawal design in which optimized SCT will be introduced and withdrawn to validate the findings from SCED I. In both experiments, the daily average of total activity counts per hour and the state level of self-control will serve as the primary and secondary outcome measures. Data will be analyzed using visual analysis and piecewise linear regression models.

RESULTS

The study was designated as not subject to the Dutch Medical Research Involving Human Subjects Act by the Medical Research Ethical Committee Oost-Nederland and approved by the Ethics Committee/domain Humanities and Social Sciences of the Faculty of Behavioural, Management, and Social Sciences at the University of Twente. Participant recruitment started in January 2022, and we expect to publish the results in early 2023.

CONCLUSIONS

The mobile SCT app is expected to be feasible and effective. It is self-paced and scalable and can increase patient motivation, making it a suitable intervention for people with SMI. SCED is a relatively novel yet promising method for gaining insights into whether and how mobile apps work that can handle heterogeneous samples and makes it possible to involve a diverse population with SMI without having to include a large number of participants.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/37727.

A Perspective on the Integration of eHealth in Treatment of Offenders: Combining Technology and the Risk-Need-Responsivity Model

While there are multiple ways in which eHealth interventions such as online modules, apps and virtual reality can improve forensic psychiatry, uptake in practice is low. To overcome this problem, better integration of eHealth in treatment is necessary. In this perspective paper, we describe how the possibilities of eHealth can be connected to the risk-need-responsivity (RNR) model. To account for the risk-principle, stand-alone eHealth interventions might be used to offer more intensive treatment to high-risk offenders. The need-principle can be addressed by connecting novel experience-based interventions such as VR and apps to stable and acute dynamic risk factors. Finally, using and combining personalized interventions is in line with the responsivity-principle. Based on research inside and outside of forensic psychiatry, we conclude that there are many possibilities for eHealth to improve treatment-not just based on RNR, but also on other models. However, there is a pressing need for more development, implementation and evaluation research.