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Paganini S, Meier E, Terhorst Y, Wurst R, Hohberg V, Schultchen D, Strahler J, Wursthorn M, Baumeister H, Messner EM. Stress Management Apps: Systematic Search and Multidimensional Assessment of Quality and Characteristics. JMIR Mhealth Uhealth 2023; 11:e42415. [PMID: 37642999 PMCID: PMC10498318 DOI: 10.2196/42415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 06/06/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Chronic stress poses risks for physical and mental well-being. Stress management interventions have been shown to be effective, and stress management apps (SMAs) might help to transfer strategies into everyday life. OBJECTIVE This review aims to provide a comprehensive overview of the quality and characteristics of SMAs to give potential users or health professionals a guideline when searching for SMAs in common app stores. METHODS SMAs were identified with a systematic search in the European Google Play Store and Apple App Store. SMAs were screened and checked according to the inclusion criteria. General characteristics and quality were assessed by 2 independent raters using the German Mobile Application Rating Scale (MARS-G). The MARS-G assesses quality (range 1 to 5) on the following four dimensions: (1) engagement, (2) functionality, (3) esthetics, and (4) information. In addition, the theory-based stress management strategies, evidence base, long-term availability, and common characteristics of the 5 top-rated SMAs were assessed and derived. RESULTS Of 2044 identified apps, 121 SMAs were included. Frequently implemented strategies (also in the 5 top-rated SMAs) were psychoeducation, breathing, and mindfulness, as well as the use of monitoring and reminder functions. Of the 121 SMAs, 111 (91.7%) provided a privacy policy, but only 44 (36.4%) required an active confirmation of informed consent. Data sharing with third parties was disclosed in only 14.0% (17/121) of the SMAs. The average quality of the included apps was above the cutoff score of 3.5 (mean 3.59, SD 0.50). The MARS-G dimensions yielded values above this cutoff score (functionality: mean 4.14, SD 0.47; esthetics: mean 3.76, SD 0.73) and below this score (information: mean 3.42, SD 0.46; engagement: mean 3.05, SD 0.78). Most theory-based stress management strategies were regenerative stress management strategies. The evidence base for 9.1% (11/121) of the SMAs could be identified, indicating significant group differences in several variables (eg, stress or depressive symptoms) in favor of SMAs. Moreover, 38.0% (46/121) of the SMAs were no longer available after a 2-year period. CONCLUSIONS The moderate information quality, scarce evidence base, constraints in data privacy and security features, and high volatility of SMAs pose challenges for users, health professionals, and researchers. However, owing to the scalability of SMAs and the few but promising results regarding their effectiveness, they have a high potential to reach and help a broad audience. For a holistic stress management approach, SMAs could benefit from a broader repertoire of strategies, such as more instrumental and mental stress management strategies. The common characteristics of SMAs with top-rated quality can be used as guidance for potential users and health professionals, but owing to the high volatility of SMAs, enhanced evaluation frameworks are needed.
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Affiliation(s)
- Sarah Paganini
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Evelyn Meier
- University of Education Freiburg, Freiburg, Germany
| | - Yannik Terhorst
- Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - Ramona Wurst
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Vivien Hohberg
- Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, Basel, Switzerland
| | - Dana Schultchen
- Clinical and Health Psychology, Ulm University, Ulm, Germany
| | - Jana Strahler
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Max Wursthorn
- Department of Public and Nonprofit Management, University of Freiburg, Freiburg, Germany
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Küchler AM, Schultchen D, Dretzler T, Moshagen M, Ebert DD, Baumeister H. A Three-Armed Randomized Controlled Trial to Evaluate the Effectiveness, Acceptance, and Negative Effects of StudiCare Mindfulness, an Internet- and Mobile-Based Intervention for College Students with No and "On Demand" Guidance. Int J Environ Res Public Health 2023; 20:3208. [PMID: 36833903 PMCID: PMC9965996 DOI: 10.3390/ijerph20043208] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/05/2023] [Accepted: 02/06/2023] [Indexed: 06/18/2023]
Abstract
The college years can be accompanied by mental distress. Internet- and mobile-based interventions (IMIs) have the potential to improve mental health but adherence is problematic. Psychological guidance might promote adherence but is resource intensive. In this three-armed randomized controlled trial, "guidance on demand" (GoD) and unguided (UG) adherence-promoting versions of the seven-module IMI StudiCare Mindfulness were compared with a waitlist control group and each other. The GoD participants could ask for guidance as needed. A total of 387 students with moderate/low mindfulness were recruited. Follow-up assessments took place after 1 (t1), 2 (t2), and 6 (t3) months. Post-intervention (t2), both versions significantly improved the primary outcome of mindfulness (d = 0.91-1.06, 95% CI 0.66-1.32) and most other mental health outcomes (d = 0.25-0.69, 95% CI 0.00-0.94) compared with WL, with effects generally persisting after 6 months. Exploratory comparisons between UG and GoD were mostly non-significant. Adherence was low but significantly higher in GoD (39%) vs. UG (28%) at the 6-month follow-up. Across versions, 15% of participants experienced negative effects, which were mostly mild. Both versions effectively promoted mental health in college students. Overall, GoD was not associated with substantial gains in effectiveness or adherence compared with UG. Future studies should investigate persuasive design to improve adherence.
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Affiliation(s)
- Ann-Marie Küchler
- Department of Clinical Psychology and Psychotherapy, Ulm University, 89081 Ulm, Germany
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Ulm University, 89081 Ulm, Germany
| | - Tim Dretzler
- Department of Clinical Psychology and Psychotherapy, Ulm University, 89081 Ulm, Germany
| | - Morten Moshagen
- Department of Quantitative Methods in Psychology, Ulm University, 89081 Ulm, Germany
| | - David D. Ebert
- Department for Sport and Health Sciences, Technical University of Munich, 80992 Munich, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Ulm University, 89081 Ulm, Germany
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Schillings C, Meissner D, Erb B, Schultchen D, Bendig E, Pollatos O. A chatbot-based intervention with ELME to improve stress and health-related parameters in a stressed sample: Study protocol of a randomised controlled trial. Front Digit Health 2023; 5:1046202. [PMID: 36937250 PMCID: PMC10014895 DOI: 10.3389/fdgth.2023.1046202] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 01/25/2023] [Indexed: 03/06/2023] Open
Abstract
Background Stress levels in the general population had already been increasing in recent years, and have subsequently been exacerbated by the global pandemic. One approach for innovative online-based interventions are "chatbots" - computer programs that can simulate a text-based interaction with human users via a conversational interface. Research on the efficacy of chatbot-based interventions in the context of mental health is sparse. The present study is designed to investigate the effects of a three-week chatbot-based intervention with the chatbot ELME, aiming to reduce stress and to improve various health-related parameters in a stressed sample. Methods In this multicenter, two-armed randomised controlled trial with a parallel design, a three-week chatbot-based intervention group including two daily interactive intervention sessions via smartphone (á 10-20 min.) is compared to a treatment-as-usual control group. A total of 130 adult participants with a medium to high stress levels will be recruited in Germany. Assessments will take place pre-intervention, post-intervention (after three weeks), and follow-up (after six weeks). The primary outcome is perceived stress. Secondary outcomes include self-reported interoceptive accuracy, mindfulness, anxiety, depression, personality, emotion regulation, psychological well-being, stress mindset, intervention credibility and expectancies, affinity for technology, and attitudes towards artificial intelligence. During the intervention, participants undergo ecological momentary assessments. Furthermore, satisfaction with the intervention, the usability of the chatbot, potential negative effects of the intervention, adherence, potential dropout reasons, and open feedback questions regarding the chatbot are assessed post-intervention. Discussion To the best of our knowledge, this is the first chatbot-based intervention addressing interoception, as well as in the context with the target variables stress and mindfulness. The design of the present study and the usability of the chatbot were successfully tested in a previous feasibility study. To counteract a low adherence of the chatbot-based intervention, a high guidance by the chatbot, short sessions, individual and flexible time points of the intervention units and the ecological momentary assessments, reminder messages, and the opportunity to postpone single units were implemented. Trial registration The trial is registered at the WHO International Clinical Trials Registry Platform via the German Clinical Trials Register (DRKS00027560; date of registration: 06 January 2022). This is protocol version No. 1. In case of important protocol modifications, trial registration will be updated.
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Affiliation(s)
- C. Schillings
- Department of Clinical and Health Psychology, Ulm University, Ulm, Germany
- Correspondence: C. Schillings @stineschillings
| | - D. Meissner
- Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - B. Erb
- Institute of Distributed Systems, Ulm University, Ulm, Germany
| | - D. Schultchen
- Department of Clinical and Health Psychology, Ulm University, Ulm, Germany
| | - E. Bendig
- Department of Clinical Psychology and Psychotherapy, Ulm University, Ulm, Germany
| | - O. Pollatos
- Department of Clinical and Health Psychology, Ulm University, Ulm, Germany
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Messner EM, Sturm N, Terhorst Y, Sander LB, Schultchen D, Portenhauser A, Schmidbaur S, Stach M, Klaus J, Baumeister H, Walter BM. Mobile Apps for the Management of Gastrointestinal Diseases: Systematic Search and Evaluation Within App Stores. J Med Internet Res 2022; 24:e37497. [PMID: 36197717 PMCID: PMC9582913 DOI: 10.2196/37497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/30/2022] [Accepted: 07/29/2022] [Indexed: 11/29/2022] Open
Abstract
Background Gastrointestinal diseases are associated with substantial cost in health care. In times of the COVID-19 pandemic and further digitalization of gastrointestinal tract health care, mobile health apps could complement routine health care. Many gastrointestinal health care apps are already available in the app stores, but the quality, data protection, and reliability often remain unclear. Objective This systematic review aimed to evaluate the quality characteristics as well as the privacy and security measures of mobile health apps for the management of gastrointestinal diseases. Methods A web crawler systematically searched for mobile health apps with a focus on gastrointestinal diseases. The identified mobile health apps were evaluated using the Mobile Application Rating Scale (MARS). Furthermore, app characteristics, data protection, and security measures were collected. Classic user star rating was correlated with overall mobile health app quality. Results The overall quality of the mobile health apps (N=109) was moderate (mean 2.90, SD 0.52; on a scale ranging from 1 to 5). The quality of the subscales ranged from low (mean 1.89, SD 0.66) to good (mean 4.08, SD 0.57). The security of data transfer was ensured only by 11 (10.1%) mobile health apps. None of the mobile health apps had an evidence base. The user star rating did not correlate with the MARS overall score or with the individual subdimensions of the MARS (all P>.05). Conclusions Mobile health apps might have a positive impact on diagnosis, therapy, and patient guidance in gastroenterology in the future. We conclude that, to date, data security and proof of efficacy are not yet given in currently available mobile health apps.
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Affiliation(s)
- Eva-Maria Messner
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Niklas Sturm
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
| | - Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany.,Department of Research Methods, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Lasse B Sander
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University Freiburg, Freiburg at Breisgau, Germany
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Alexandra Portenhauser
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Simone Schmidbaur
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
| | - Michael Stach
- Institute of Databases and Information Systems, University of Ulm, Ulm, Germany
| | - Jochen Klaus
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Benjamin M Walter
- Department of Internal Medicine I, University Hospital Ulm, Ulm, Germany
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Schillings C, Karanassios G, Schulte N, Schultchen D, Pollatos O. The Effects of a 3-Week Heartbeat Perception Training on Interoceptive Abilities. Front Neurosci 2022; 16:838055. [PMID: 35615275 PMCID: PMC9124832 DOI: 10.3389/fnins.2022.838055] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
Recent studies showed promising short-term effects of heartbeat perception training on interoceptive abilities. Research on the effects of heartbeat perception training on interoceptive abilities over time is sparse. Therefore, the aim of this study was to examine the short-term effects and the effects of a 3-week heartbeat perception training over time on interoceptive abilities, namely, cardiac interoceptive accuracy (IAc) and interoceptive sensibility (IS). A total of 40 healthy participants were randomized to the intervention group (n = 20) or the control group (n = 20). The intervention group conducted three cardiac biofeedback sessions (one per week) at the laboratory, whereas the control group watched a documentary instead. Interoceptive abilities were assessed via the heartbeat perception task (IAc) and confidence ratings (IS) at baseline, after each laboratory session, and 1 week after the last session (post-measurement). IAc was significantly increased in the intervention group compared to the control group after the first training session (short-term effect). There were no significant improvements in IS due to the first session, and neither on IAc nor IS over time. Descriptive trends of improved interoceptive abilities over time were found in both groups. Single session of heartbeat perception training seems to be a promising approach to improve IAc. Future research should further investigate the long-term effects of diverse heartbeat perception training varying in frequency and intensity of the training sessions in diverse samples aiming to improve interoceptive abilities.
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Affiliation(s)
- Christine Schillings
- Department of Clinical and Health Psychology, Faculty of Engineering, Computer Science and Psychology, Institute of Psychology and Education, University of Ulm, Ulm, Germany
- *Correspondence: Christine Schillings,
| | - Georgios Karanassios
- Department of Clinical and Health Psychology, Faculty of Engineering, Computer Science and Psychology, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Niklas Schulte
- Department of Work and Organizational Psychology, Faculty of Engineering, Compurter Science and Psychology, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Faculty of Engineering, Computer Science and Psychology, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Olga Pollatos
- Department of Clinical and Health Psychology, Faculty of Engineering, Computer Science and Psychology, Institute of Psychology and Education, University of Ulm, Ulm, Germany
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Paganini S, Terhorst Y, Sander LB, Catic S, Balci S, Küchler AM, Schultchen D, Plaumann K, Sturmbauer S, Krämer LV, Lin J, Wurst R, Pryss R, Baumeister H, Messner EM. Quality of Physical Activity Apps: Systematic Search in App Stores and Content Analysis. JMIR Mhealth Uhealth 2021; 9:e22587. [PMID: 34106073 PMCID: PMC8262667 DOI: 10.2196/22587] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 11/30/2020] [Accepted: 01/05/2021] [Indexed: 01/23/2023] Open
Abstract
Background Physical inactivity is a major contributor to the development and persistence of chronic diseases. Mobile health apps that foster physical activity have the potential to assist in behavior change. However, the quality of the mobile health apps available in app stores is hard to assess for making informed decisions by end users and health care providers. Objective This study aimed at systematically reviewing and analyzing the content and quality of physical activity apps available in the 2 major app stores (Google Play and App Store) by using the German version of the Mobile App Rating Scale (MARS-G). Moreover, the privacy and security measures were assessed. Methods A web crawler was used to systematically search for apps promoting physical activity in the Google Play store and App Store. Two independent raters used the MARS-G to assess app quality. Further, app characteristics, content and functions, and privacy and security measures were assessed. The correlation between user star ratings and MARS was calculated. Exploratory regression analysis was conducted to determine relevant predictors for the overall quality of physical activity apps. Results Of the 2231 identified apps, 312 met the inclusion criteria. The results indicated that the overall quality was moderate (mean 3.60 [SD 0.59], range 1-4.75). The scores of the subscales, that is, information (mean 3.24 [SD 0.56], range 1.17-4.4), engagement (mean 3.19 [SD 0.82], range 1.2-5), aesthetics (mean 3.65 [SD 0.79], range 1-5), and functionality (mean 4.35 [SD 0.58], range 1.88-5) were obtained. An efficacy study could not be identified for any of the included apps. The features of data security and privacy were mainly not applied. Average user ratings showed significant small correlations with the MARS ratings (r=0.22, 95% CI 0.08-0.35; P<.001). The amount of content and number of functions were predictive of the overall quality of these physical activity apps, whereas app store and price were not. Conclusions Apps for physical activity showed a broad range of quality ratings, with moderate overall quality ratings. Given the present privacy, security, and evidence concerns inherent to most rated apps, their medical use is questionable. There is a need for open-source databases of expert quality ratings to foster informed health care decisions by users and health care providers.
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Affiliation(s)
- Sarah Paganini
- Department of Sport Psychology, Institute of Sports and Sport Science, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Lasse Bosse Sander
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Selma Catic
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Sümeyye Balci
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Ann-Marie Küchler
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Katrin Plaumann
- Institute of Media Informatics, Ulm University, Ulm, Germany
| | - Sarah Sturmbauer
- Chair of Health Psychology, Department of Psychology, Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Lena Violetta Krämer
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Jiaxi Lin
- Department of Psychiatry and Psychotherapy Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Ramona Wurst
- Department of Sport Psychology, Institute of Sports and Sport Science, Albert-Ludwigs-University Freiburg, Freiburg, Germany
| | - Rüdiger Pryss
- Institute of Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Eva-Maria Messner
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Ulm, Germany
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7
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Terhorst Y, Messner EM, Schultchen D, Paganini S, Portenhauser A, Eder AS, Bauer M, Papenhoff M, Baumeister H, Sander LB. Systematic evaluation of content and quality of English and German pain apps in European app stores. Internet Interv 2021; 24:100376. [PMID: 33718002 PMCID: PMC7933737 DOI: 10.1016/j.invent.2021.100376] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 01/05/2021] [Accepted: 02/17/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Pain spans a broad spectrum of diseases and types that are highly prevalent and cause substantial disease burden for individuals and society. Up to 40% of people affected by pain receive no or inadequate treatment. Providing a scalable, time-, and location-independent way for pain diagnostic, management, prevention and treatment mobile health applications (MHA) might be a promising approach to improve health care for pain. However, the commercial app market is rapidly growing and unregulated, resulting in an opaque market. Studies investigating the content, privacy and security features, quality and scientific evidence of the available apps are highly needed, to guide patients and clinicians to high quality MHA.Contributing to this challenge, the present study investigates the content, quality, and privacy features of pain apps available in the European app stores. METHODS An automated search engine was used to identify pain apps in the European Google Play and Apple App store. Pain apps were screened and checked for systematic criteria (pain-relatedness, functionality, availability, independent usability, English or German). Content, quality and privacy features were assessed by two independent reviewers using the German Mobile Application Rating Scale (MARS-G). The MARS-G assesses quality on four objectives (engagement, functionality, aesthetics, information quality) and two subjective scales (perceived impact, subjective quality). RESULTS Out of 1034 identified pain apps 218 were included. Pain apps covered eight different pain types. Content included basic information, advice, assessment and tracking, and stand-alone interventions. The overall quality of the pain apps was average M = 3.13 (SD = 0.56, min = 1, max = 4.69). The effectiveness of less than 1% of the included pain apps was evaluated in a randomized controlled trial. Major problems with data privacy were present: 59% provided no imprint, 70% had no visible privacy policy. CONCLUSION A multitude of pain apps is available. Most MHA lack scientific evaluation and have serious privacy issues, posing a potential threat to users. Further research on evidence and improvements privacy and security are needed. Overall, the potential of pain apps is not exploited.
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Affiliation(s)
- Yannik Terhorst
- Department of Research Methods, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89069 Ulm, Germany
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Lise-Meitner-Str. 16, 89081 Ulm, Germany
| | - Eva-Maria Messner
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Lise-Meitner-Str. 16, 89081 Ulm, Germany
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89069 Ulm, Germany
| | - Sarah Paganini
- Department of Sport Psychology, University of Freiburg, Schwarzwaldstraße 175, 79117 Freiburg, Germany
| | - Alexandra Portenhauser
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Lise-Meitner-Str. 16, 89081 Ulm, Germany
| | - Anna-Sophia Eder
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Lise-Meitner-Str. 16, 89081 Ulm, Germany
| | - Melanie Bauer
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89069 Ulm, Germany
| | - Mike Papenhoff
- Pain Medicine Clinic, BG Klinikum Duisburg, Grossenbaumer Allee 250, D-47249 Duisburg, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Lise-Meitner-Str. 16, 89081 Ulm, Germany
| | - Lasse Bosse Sander
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University Freiburg, Engelberger Str. 41, 79106 Freiburg im Breisgau, Germany
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8
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Weineck F, Schultchen D, Dunker F, Hauke G, Lachenmeir K, Schnebel A, Karačić M, Meule A, Voderholzer U, Pollatos O. Discrepancies Between Explicit Feelings of Power and Implicit Power Motives Are Related to Anxiety in Women With Anorexia Nervosa. Front Psychol 2021; 11:618650. [PMID: 33633629 PMCID: PMC7901641 DOI: 10.3389/fpsyg.2020.618650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2020] [Accepted: 12/21/2020] [Indexed: 11/21/2022] Open
Abstract
Background Several studies identified low subjective feelings of power in women with anorexia nervosa (AN). However, little is known about implicit power motives and the discrepancy between explicit feelings of power and implicit power motives in AN. Aim The study investigated the discrepancy between explicit feelings of power and implicit power motives and its relationship to anxiety in patients with AN. Method Fifty-three outpatients and inpatients with AN and 48 participants without AN were compared regarding subjective feelings of power and anxiety. Explicit power [investigated with the Personal Sense of Power Scale (trait focus) and a visual analog scale (state focus)], implicit power motives [investigated with the Multi-Motive Grid (MMG)] and trait anxiety [measured with the State-Trait Anxiety Inventory (STAI)], were assessed. Results Explicit feelings of power (state and trait level) were lower in patients with AN compared to non-AN participants. No differences in implicit power motives were found when comparing the groups against each other. However, looking at the groups separately, women with AN had similar levels of implicit fear of losing power and hope for power, whereas woman without AN had significantly lower fear of losing power than hope for power. Focusing on discrepancies between powerful feelings and power motives, results were mixed, depending on the subscale of the MMG. Lastly, discrepancies between implicit power motives and explicit feelings of power were positively correlated with trait anxiety in AN patients. Conclusion These findings underline that individuals with AN display significantly lower explicit feelings of power, however, they show similar implicit power motives compared to individuals without AN. The discrepancy between explicit feelings of power and implicit power motives is related to anxiety in AN and may represent a vulnerability factor to illness maintenance.
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Affiliation(s)
- Felicitas Weineck
- Department of Clinical and Health Psychology, Ulm University, Ulm, Germany
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Ulm University, Ulm, Germany
| | - Freya Dunker
- Department of Clinical and Health Psychology, Ulm University, Ulm, Germany
| | - Gernot Hauke
- Department of Clinical and Health Psychology, Ulm University, Ulm, Germany
| | - Karin Lachenmeir
- Treatment Center for Eating Disorders, Dritter Orden Hospital, Munich, Germany
| | | | | | - Adrian Meule
- Schön Klinik Roseneck, Prien am Chiemsee, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - Ulrich Voderholzer
- Schön Klinik Roseneck, Prien am Chiemsee, Germany.,Department of Psychiatry and Psychotherapy, University Hospital, Ludwig Maximilian University, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Freiburg, Germany
| | - Olga Pollatos
- Department of Clinical and Health Psychology, Ulm University, Ulm, Germany
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Portenhauser AA, Terhorst Y, Schultchen D, Sander LB, Denkinger MD, Stach M, Waldherr N, Dallmeier D, Baumeister H, Messner EM. Mobile Apps for Older Adults: Systematic Search and Evaluation Within Online Stores. JMIR Aging 2021; 4:e23313. [PMID: 33605884 PMCID: PMC8081158 DOI: 10.2196/23313] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 11/10/2020] [Accepted: 11/13/2020] [Indexed: 12/17/2022] Open
Abstract
Background Through the increasingly aging population, the health care system is confronted with various challenges such as expanding health care costs. To manage these challenges, mobile apps may represent a cost-effective and low-threshold approach to support older adults. Objective This systematic review aimed to evaluate the quality, characteristics, as well as privacy and security measures of mobile apps for older adults in the European commercial app stores. Methods In the European Google Play and App Store, a web crawler systematically searched for mobile apps for older adults. The identified mobile apps were evaluated by two independent reviewers using the German version of the Mobile Application Rating Scale. A correlation between the user star rating and overall rating was calculated. An exploratory regression analysis was conducted to determine whether the obligation to pay fees predicted overall quality. Results In total, 83 of 1217 identified mobile apps were included in the analysis. Generally, the mobile apps for older adults were of moderate quality (mean 3.22 [SD 0.68]). Four mobile apps (5%) were evidence-based; 49% (41/83) had no security measures. The user star rating correlated significantly positively with the overall rating (r=.30, P=.01). Obligation to pay fees could not predict overall quality. Conclusions There is an extensive quality range within mobile apps for older adults, indicating deficits in terms of information quality, data protection, and security precautions, as well as a lack of evidence-based approaches. Central databases are needed to identify high-quality mobile apps.
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Affiliation(s)
- Alexandra A Portenhauser
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Yannik Terhorst
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany.,Department of Psychological Research Methods, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Lasse B Sander
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg im Breisgau, Germany
| | - Michael D Denkinger
- Agaplesion Bethesda Clinic, Geriatric Research, University of Ulm, Ulm, Germany
| | - Michael Stach
- Institute of Databases and Information Systems, University of Ulm, Ulm, Germany
| | - Natalie Waldherr
- Agaplesion Bethesda Clinic, Geriatric Research, University of Ulm, Ulm, Germany
| | - Dhayana Dallmeier
- Agaplesion Bethesda Clinic, Geriatric Research, University of Ulm, Ulm, Germany.,Department of Epidemiology, Boston University School of Public Health, Boston, MA, United States
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
| | - Eva-Maria Messner
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University of Ulm, Ulm, Germany
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10
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Schultchen D, Schneider C, Berberich G, Zaudig M, Erle TM, Pollatos O. On the Relationship of Interoceptive Accuracy and Attention: A Controlled Study With Depressed Inpatients and a Healthy Cohort. Front Psychol 2021; 11:597488. [PMID: 33597903 PMCID: PMC7882488 DOI: 10.3389/fpsyg.2020.597488] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/22/2020] [Indexed: 11/13/2022] Open
Abstract
Objective Previous research has shown reduced interoceptive accuracy (IAcc) in depression. Attention deficit represents a key symptom of depression. Moreover, IAcc is positively correlated with attention. There is no study that investigates the effect of depression on IAcc and attention. The aim of this study is to examine the mediating effect of IAcc on depression and attention. Methods Thirty-six depressed patients from the Psychosomatic Clinic in Windach were matched with 36 healthy controls according to age and sex and were assessed at Ulm University. All participants completed the Beck Depression Inventory-II, the heartbeat perception task to examine IAcc, and the d2 test assessing selective attention. Results Depressed patients showed attention deficits—both for general visual attention and IAcc—compared to healthy controls. The mediation analyses revealed that the relationship between depression and attention is not mediated via IAcc. Furthermore, depression predicts IAcc and attention, but these effects are direct and largely unaffected by the respective other variable. Discussion The results of the present study highlight both interoceptive as well as attention deficits in depressed patients. No clear mediation between these variables could be shown in this study. More elaborative research is needed to clarify whether different approaches to improve IAcc are effective for these deficits in depressed patients and could therefore be of importance as an additional aspect of therapy in depression.
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Affiliation(s)
- Dana Schultchen
- Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Carolin Schneider
- Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Götz Berberich
- Psychosomatic Clinic Windach am Ammersee, Windach, Germany
| | - Michael Zaudig
- Psychotherapeutisches Gesundheitszentrum und Medizinisches Versorgungszentrum am Goetheplatz, Munich, Germany
| | - Thorsten M Erle
- Department of Social Psychology, School of Social and Behavioral Sciences, Tilburg University, Tilburg, Netherlands
| | - Olga Pollatos
- Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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11
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Küchler AM, Schultchen D, Pollatos O, Moshagen M, Ebert DD, Baumeister H. StudiCare mindfulness-study protocol of a randomized controlled trial evaluating an internet- and mobile-based intervention for college students with no and "on demand" guidance. Trials 2020; 21:975. [PMID: 33243300 PMCID: PMC7691111 DOI: 10.1186/s13063-020-04868-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 11/04/2020] [Indexed: 11/17/2022] Open
Abstract
Background College is an exciting but also challenging time with an increased risk for mental health issues. Only a minority of the college students concerned get professional help, a problem that might be improvable by internet- and mobile-based interventions (IMIs). However, adherence of IMIs is a concern. While guidance might be a solution, it is resource-intensive, derailing potential implementation on population level. The first aim of this trial is to evaluate the efficacy of the IMI StudiCare Mindfulness (StudiCare-M) for college students with “on demand” and no guidance. The second aim is to examine potential moderators and mediators, contributing to the questions of “how” and “for whom” such interventions work. Methods In this three-armed randomized controlled trial, both an unguided and “guidance on demand” (GoD) condition of StudiCare-M are compared to a waitlist control group. StudiCare-M is based on principles of acceptance and commitment therapy and stress management and consists of 7 modules plus two booster sessions. Participants in the GoD condition may ask their e-coach for support whenever needed. A total of 387 college students with moderate to low mindfulness are recruited at 15+ cooperating universities in Germany, Austria, and Switzerland via circular emails. Assessments take place before as well as 1, 2, and 6 months after randomization. The primary outcome is mindfulness. Secondary outcomes include stress, depression, anxiety, interoception, presenteeism, wellbeing, intervention satisfaction, adherence, and potential side effects. Among examined moderators and mediators are sociodemographic variables, pre-treatment symptomatology, treatment expectancy, self-efficacy, cognitive fusion, emotion regulation, and alexithymia. All data will be analyzed according to intention-to-treat (ITT) principles. Discussion Providing effective interventions to help college students become more resilient can make a valuable contribution to the health and functionality of future society. If effective under the condition of minimal or no guidance, StudiCare-M offers a low-threshold potentially resource-efficient possibility to enhance college student mental health on a population level. Moderation- and mediation analyses will deliver further insights for optimization of target groups and intervention content. Trial registration WHO International Clinical Trials Registry Platform via the German Clinical Studies Trial Register DRKS00014774. Registered on 18 May 2018.
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Affiliation(s)
- Ann-Marie Küchler
- Department of Clinical Psychology and Psychotherapy, Institute for Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89081, Ulm, Germany.
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Ulm University, Ulm, Germany
| | - Olga Pollatos
- Department of Clinical and Health Psychology, Ulm University, Ulm, Germany
| | - Morten Moshagen
- Department of Quantitative Methods in Psychology, Ulm University, Ulm, Germany
| | - David D Ebert
- Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute for Psychology and Education, Ulm University, Albert-Einstein-Allee 47, 89081, Ulm, Germany
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12
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Schultchen D, Terhorst Y, Holderied T, Stach M, Messner EM, Baumeister H, Sander LB. Stay Present with Your Phone: A Systematic Review and Standardized Rating of Mindfulness Apps in European App Stores. Int J Behav Med 2020; 28:552-560. [PMID: 33215348 PMCID: PMC8384800 DOI: 10.1007/s12529-020-09944-y] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Mindfulness-based interventions show positive effects on physical and mental health. For a better integration of mindfulness techniques in daily life, the use of apps may be promising. However, only a few studies have examined the quality of mindfulness apps using a validated standardized instrument. This review aims to evaluate the content, quality, and privacy features of mindfulness-focused apps from European commercial app stores. METHODS An automated search engine (webcrawler) was used to identify mindfulness-focused apps in the European Apple App- and Google Play store. Content, quality, and privacy features were evaluated by two independent reviewers using the Mobile Application Rating Scale (MARS). The MARS assesses the subscales engagement, functionality, aesthetics, and information quality. RESULTS Out of 605 identified apps, 192 met the inclusion criteria. The overall quality was moderate (M = 3.66, SD = 0.48). Seven apps were tested in a randomized controlled trial (RCT). Most of the apps showed a lack of data security and no privacy policy. The five apps with the highest ratings are from a credible source, include a privacy policy, and are also based on standardized mindfulness and behavior change techniques. CONCLUSIONS The plethora of often low-quality apps in commercial app stores makes it difficult for users to identify a suitable app. Above that, the lack of scientific verification of effectiveness and shortcomings in privacy protection and security poses potential risks. So far, the potential of mindfulness-focused apps is not exploited in commercial app stores.
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Affiliation(s)
- Dana Schultchen
- Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 41, Ulm, Germany.
| | - Yannik Terhorst
- Research Methods, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, Ulm, Germany.,Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, Ulm, Germany
| | - Tanja Holderied
- Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 41, Ulm, Germany
| | - Michael Stach
- Institute of Databases and Information Systems, Ulm University, James-Franck-Ring, 89081, Ulm, Germany
| | - Eva-Maria Messner
- Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, Ulm, Germany
| | - Harald Baumeister
- Clinical Psychology and Psychotherapy, Institute of Psychology and Education, Ulm University, Albert-Einstein-Allee 47, Ulm, Germany
| | - Lasse B Sander
- Institute of Psychology, Department of Rehabilitation Psychology and Psychotherapy, Albert-Ludwigs-University of Freiburg, Engelbersger Str. 41, 79085, Freiburg, Germany
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13
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Terhorst Y, Philippi P, Sander LB, Schultchen D, Paganini S, Bardus M, Santo K, Knitza J, Machado GC, Schoeppe S, Bauereiß N, Portenhauser A, Domhardt M, Walter B, Krusche M, Baumeister H, Messner EM. Validation of the Mobile Application Rating Scale (MARS). PLoS One 2020; 15:e0241480. [PMID: 33137123 PMCID: PMC7605637 DOI: 10.1371/journal.pone.0241480] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 10/15/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Mobile health apps (MHA) have the potential to improve health care. The commercial MHA market is rapidly growing, but the content and quality of available MHA are unknown. Instruments for the assessment of the quality and content of MHA are highly needed. The Mobile Application Rating Scale (MARS) is one of the most widely used tools to evaluate the quality of MHA. Only few validation studies investigated its metric quality. No study has evaluated the construct validity and concurrent validity. OBJECTIVE This study evaluates the construct validity, concurrent validity, reliability, and objectivity, of the MARS. METHODS Data was pooled from 15 international app quality reviews to evaluate the metric properties of the MARS. The MARS measures app quality across four dimensions: engagement, functionality, aesthetics and information quality. Construct validity was evaluated by assessing related competing confirmatory models by confirmatory factor analysis (CFA). Non-centrality (RMSEA), incremental (CFI, TLI) and residual (SRMR) fit indices were used to evaluate the goodness of fit. As a measure of concurrent validity, the correlations to another quality assessment tool (ENLIGHT) were investigated. Reliability was determined using Omega. Objectivity was assessed by intra-class correlation. RESULTS In total, MARS ratings from 1,299 MHA covering 15 different health domains were included. Confirmatory factor analysis confirmed a bifactor model with a general factor and a factor for each dimension (RMSEA = 0.074, TLI = 0.922, CFI = 0.940, SRMR = 0.059). Reliability was good to excellent (Omega 0.79 to 0.93). Objectivity was high (ICC = 0.82). MARS correlated with ENLIGHT (ps<.05). CONCLUSION The metric evaluation of the MARS demonstrated its suitability for the quality assessment. As such, the MARS could be used to make the quality of MHA transparent to health care stakeholders and patients. Future studies could extend the present findings by investigating the re-test reliability and predictive validity of the MARS.
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Affiliation(s)
- Yannik Terhorst
- Department of Research Methods, Institute of Psychology and Education, University Ulm, Ulm, Germany
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University Ulm, Ulm, Germany
| | - Paula Philippi
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University Ulm, Ulm, Germany
| | - Lasse B. Sander
- Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, Albert-Ludwigs-University Freiburg, Freiburg im Breisgau, Germany
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Institute of Psychology and Education, University Ulm, Ulm, Germany
| | - Sarah Paganini
- Department of Sport Psychology, Institute of Sports and Sport Science, University of Freiburg, Freiburg, Germany
| | - Marco Bardus
- Department of Health Promotion and Community Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon
| | - Karla Santo
- Academic Research Organization, Hospital Israelita Albert Einstein, São Paulo, Brazil
- Westmead Applied Research Centre, Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
- Cardiovascular Division, The George Institute for Global Health, Sydney, Australia
| | - Johannes Knitza
- Department of Internal Medicine 3 – Rheumatology and Immunology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | - Gustavo C. Machado
- Institute for Musculoskeletal Health, Sydney, New South Wales, Australia
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Stephanie Schoeppe
- School of Health, Medical and Applied Sciences, Appleton Institute, Physical Activity Research Group, Central Queensland University, Rockhampton, Queensland, Australia
| | - Natalie Bauereiß
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University Ulm, Ulm, Germany
| | - Alexandra Portenhauser
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University Ulm, Ulm, Germany
| | - Matthias Domhardt
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University Ulm, Ulm, Germany
| | - Benjamin Walter
- Department of Internal Medicine I, Gastroenterology, University Hospital Ulm, Ulm, Germany
| | - Martin Krusche
- Department of Rheumatology and Clinical Immunology, Charité – Universitätsmedizin Berlin, Berlin, Germany
| | - Harald Baumeister
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University Ulm, Ulm, Germany
| | - Eva-Maria Messner
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology and Education, University Ulm, Ulm, Germany
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14
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Abstract
Abstract. The brain and peripheral bodily organs continuously exchange information. Exemplary, interoception refers to the processing and perception of ascending information from the body to the brain. Stress responses involve a neurobehavioral cascade, which includes the activation of peripheral organs via neural and endocrine pathways and can thus be seen as an example for descending information on the brain-body axis. Hence, the interaction of interoception and stress represents bi-directional communication on the brain-body axis. The main hypothesis underlying this review is that the dysregulation of brain-body communication represents an important mechanism for the generation of physical symptoms in stress-related disorders. The aims of this review are, therefore, (1) to summarize current knowledge on acute stress effects on different stages of interoceptive signal processing, (2) to discuss possible patterns of abnormal brain-body communication (i.e., alterations in interoception and physiological stress axes activation) in mental disorders and chronic physical conditions, and (3) to consider possible approaches to modify interoception. Due to the regulatory feedback loops underlying brain-body communication, the modification of interoceptive processes (ascending signals) may, in turn, affect physiological stress axes activity (descending signals), and, ultimately, also physical symptoms.
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Affiliation(s)
- André Schulz
- Research Group Self-Regulation and Health, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Dana Schultchen
- Department of Clinical and Health Psychology, Ulm University, Germany
| | - Claus Vögele
- Research Group Self-Regulation and Health, Institute for Health and Behaviour, Department of Behavioural and Cognitive Sciences Faculty of Humanities, Education and Social Sciences, University of Luxembourg, Esch-sur-Alzette, Luxembourg
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15
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Pannicke B, Reichenberger J, Schultchen D, Pollatos O, Blechert J. Affect Improvements and Measurement Concordance Between a Subjective and an Accelerometric Estimate of Physical Activity. European Journal of Health Psychology 2020. [DOI: 10.1027/2512-8442/a000050] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Objectives: Physical activity (PA) positively influences several aspects of mental well-being including affect improvements. Yet, the fact that subjective and objective measures of PA often diverge challenges research on the relationship of PA and affect. Methods: Subjective (ecological momentary assessment, EMA) and objective (combined heart rate and accelerometric activity tracker) measures of PA alongside repeated ratings of positive and negative affects were obtained from 37 participants over 7 consecutive days. Results: Subjective and objective PA were significantly positively correlated. Affect improvements, that is, negative affect decrease as well as positive affect increase, were predicted by both subjective (EMA) and objective (activity tracker) data. Conclusions: Measurement concordance supports the validity of both assessment strategies. Affect improvements result from both subjective representations of one’s own activity as well as from physiological mechanisms of PA that one is not aware of, suggesting two independent routes to affect improvements.
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Affiliation(s)
- Björn Pannicke
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Austria
| | - Julia Reichenberger
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Austria
| | - Dana Schultchen
- Department of Clinical & Health Psychology, Ulm University, Ulm, Germany
| | - Olga Pollatos
- Department of Clinical & Health Psychology, Ulm University, Ulm, Germany
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive Neuroscience, Paris-Lodron-University of Salzburg, Austria
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16
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Schultchen D, Küchler AM, Schillings C, Weineck F, Karabatsiakis A, Ebert DD, Baumeister H, Pollatos O. Effectiveness of a guided online mindfulness-focused intervention in a student population: Study protocol for a randomised control trial. BMJ Open 2020; 10:e032775. [PMID: 32209621 PMCID: PMC7202707 DOI: 10.1136/bmjopen-2019-032775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 02/07/2020] [Accepted: 03/04/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Previous studies show that university students experience higher psychological stress than the general population, resulting in increased vulnerability for mental disorders for the student population. Online mindfulness interventions will be delivered to students as a potentially promising and more flexible approach compared to face-to-face interventions with the aim of improving their mental health. This study purposes to investigate the effectiveness of a guided online mindfulness-focused intervention for university students by using both self-reported and psychobiological measures. METHODS AND ANALYSES In this multicentre, two-armed randomised controlled trial with a parallel design, a guided version of the online mindfulness-focused intervention 'StudiCare Mindfulness' will be compared with a waitlist control group. In total, 120 participants will be recruited at different universities (of Applied Sciences) in (Neu-) Ulm. Data will be assessed prior to randomisation, after eight weeks (post-intervention) and six months after randomisation (follow-up). The primary outcome measure is mindfulness. The secondary outcome measures include depression, anxiety and stress levels, well-being, interoceptive sensibility, emotion regulation and alexithymia. Psychobiological parameters comprise interoceptive accuracy, hair cortisol and FKBP5 genotype. Sociodemographic variables, treatment expectations, side and adverse side effects, as well as intervention satisfaction and adherence will be assessed. All data analyses will be conducted according to the intention-to-treat principle. ETHICS AND DISSEMINATION All study procedures have been approved by the Ethics Committee of Ulm University (application No. 48/18). The findings will be disseminated widely through peer-reviewed publications and conference presentations. TRIAL REGISTRATION NUMBER DRKS00014701.
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Affiliation(s)
- Dana Schultchen
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Ann-Marie Küchler
- Department of Clinical Psychology & Psychotherapy, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Christine Schillings
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Felicitas Weineck
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
| | | | - David D Ebert
- Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Harald Baumeister
- Department of Clinical Psychology & Psychotherapy, Ulm University, Ulm, Baden-Württemberg, Germany
| | - Olga Pollatos
- Department of Clinical & Health Psychology, Ulm University, Ulm, Baden-Württemberg, Germany
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17
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Schultchen D, Bayer J, Kühnel J, Melchers KG, Pollatos O. Interoceptive accuracy is related to long‐term stress via self‐regulation. Psychophysiology 2019; 56:e13429. [DOI: 10.1111/psyp.13429] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 05/24/2019] [Accepted: 05/29/2019] [Indexed: 12/13/2022]
Affiliation(s)
- Dana Schultchen
- Clinical and Health Psychology, Institute of Psychology and Education Ulm University Ulm Germany
| | - Julia Bayer
- Clinical and Health Psychology, Institute of Psychology and Education Ulm University Ulm Germany
- Work and Organizational Psychology, Institute of Psychology and Education Ulm University Ulm Germany
| | - Jana Kühnel
- Work and Organizational Psychology, Institute of Psychology and Education Ulm University Ulm Germany
| | - Klaus G. Melchers
- Work and Organizational Psychology, Institute of Psychology and Education Ulm University Ulm Germany
| | - Olga Pollatos
- Clinical and Health Psychology, Institute of Psychology and Education Ulm University Ulm Germany
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18
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Schultchen D, Zaudig M, Krauseneck T, Berberich G, Pollatos O. Interoceptive deficits in patients with obsessive-compulsive disorder in the time course of cognitive-behavioral therapy. PLoS One 2019; 14:e0217237. [PMID: 31125377 PMCID: PMC6534313 DOI: 10.1371/journal.pone.0217237] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/07/2019] [Indexed: 01/07/2023] Open
Abstract
Interoception is impaired in different psychiatric disorders and is also associated with emotions. Only one study could show a higher interoceptive accuracy (IAcc) in patients with obsessive-compulsive disorder (OCD). Based on the predictive coding system we assume contrary results, indicating a decreased IAcc in patients with OCD. So far, there is no study investigating the effect of cognitive-behavioral therapy on IAcc in patients with OCD. Therefore, we hypothesize that patients with OCD improve their IAcc during the time course of therapy compared to healthy controls. Twenty-six patients with OCD from the Psychosomatic Clinic in Windach were examined in the time course of cognitive-behavioral therapy. They were compared to 26 matched healthy controls. IAcc via the heartbeat perception task as well as questionnaire data (OCD-, depression- and anxiety symptoms) were assessed. Results showed that IAcc, OCD-, depression- and anxiety symptoms were attenuated in patients with OCD. Patients recovered in the time course of therapy regarding OCD-, depression- and anxiety symptoms. Interoceptive deficits did not change in the time course of cognitive-behavioral therapy. We demonstrated that IAcc is affected in patients with OCD and this deficit does not change during the time course of a standardized therapy. Future studies should investigate, whether an inaccuracy in perceiving one's bodily signals constitutes a risk factor for relapse. Further, it could be examined if IAcc can be increased via self- and body focus interventions in patients with OCD.
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Affiliation(s)
- Dana Schultchen
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
- * E-mail:
| | | | | | | | - Olga Pollatos
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
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19
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Schultchen D, Reichenberger J, Mittl T, Weh TRM, Smyth JM, Blechert J, Pollatos O. Bidirectional relationship of stress and affect with physical activity and healthy eating. Br J Health Psychol 2019; 24:315-333. [PMID: 30672069 PMCID: PMC6767465 DOI: 10.1111/bjhp.12355] [Citation(s) in RCA: 99] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Revised: 12/30/2018] [Indexed: 11/30/2022]
Abstract
Objectives Physical activity and healthy eating seem to be protective against experiencing stress and negative affect as well as increase positive affect. At the same time, previous studies showed that people reduce salutogenic behaviours such as physical activity and healthy eating in the face of stress and negative affect while increasing such behaviours in the context of positive affect. Due to daily fluctuations of these behaviours, the present study examined these relationships in daily life using ecological momentary assessment (EMA). Design and methods Fifty‐one university students responded to six daily prompts during 7 days via smartphone‐based EMA. Items examined stress, emotional experience, physical activity duration, and healthy eating. Results Higher stress and negative affect, as well as lower positive affect, were related to a reduction in subsequent physical activity. Higher physical activity levels, in turn, were associated with less subsequent stress and negative affect, as well as more positive affect. No such effects for stress and affect on healthy eating or vice versa were found. Conclusions Engaging in physical activity is related to better mood and less stress/negative affect over the next several hours in daily life. Prevention efforts therefore may benefit by focusing on promoting physical activity, particularly when stress/negative affect is high to ‘break the cycle’ of inactivity, stress, and negative affect. Potential effects of healthy eating might be more subtle and characterized by interindividual differences or state effects. Statement of contribution What is already known on this subject? Physical activity can reduce stress as well as negative emotions and can enhance positive emotions. People tend to eat less healthy food during stressful times, and healthy eating can increase general health. Physical activity and healthy eating have been mostly assessed separately and through retrospective methods.
What does this study add? This is an EMA study investigating bidirectional effects of stress, emotions, and salutogenic behaviour. After physical activity, people felt less stressed/negative and more positive; feeling better and less stressed resulted in more physical activity. Healthy eating was not associated with stress or emotion level and vice versa.
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Affiliation(s)
- Dana Schultchen
- Department of Clinical and Health Psychology, Ulm University, Germany
| | - Julia Reichenberger
- Centre for Cognitive Neuroscience, University of Salzburg, Austria.,Department of Psychology, University of Salzburg, Austria
| | - Theresa Mittl
- Department of Clinical and Health Psychology, Ulm University, Germany
| | - Tabea R M Weh
- Department of Clinical and Health Psychology, Ulm University, Germany
| | - Joshua M Smyth
- Department of Biobehavioral Health and Medicine, Pennsylvania State University, State College, Pennsylvania, USA
| | - Jens Blechert
- Centre for Cognitive Neuroscience, University of Salzburg, Austria.,Department of Psychology, University of Salzburg, Austria
| | - Olga Pollatos
- Department of Clinical and Health Psychology, Ulm University, Germany
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