Mobile mental health: a challenging research agenda

Miranda Olff, Miranda Olff

Abstract

The field of mobile health ("m-Health") is evolving rapidly and there is an explosive growth of psychological tools on the market. Exciting high-tech developments may identify symptoms, help individuals manage their own mental health, encourage help seeking, and provide both preventive and therapeutic interventions. This development has the potential to be an efficient cost-effective approach reducing waiting lists and serving a considerable portion of people globally ("g-Health"). However, few of the mobile applications (apps) have been rigorously evaluated. There is little information on how valid screening and assessment tools are, which of the mobile intervention apps are effective, or how well mobile apps compare to face-to-face treatments. But how feasible is rigorous scientific evaluation with the rising demands from policy makers, business partners, and users for their quick release? In this paper, developments in m-Health tools-targeting screening, assessment, prevention, and treatment-are reviewed with examples from the field of trauma and posttraumatic stress disorder. The academic challenges in developing and evaluating m-Health tools are being addressed. Evidence-based guidance is needed on appropriate research designs that may overcome some of the public and ethical challenges (e.g., equity, availability) and the market-driven wish to have mobile apps in the "App Store" yesterday rather than tomorrow.

Keywords: PTSD; depression; e-Health; global health; internet intervention; m-Health; mobile apps/applications; mobile health; smartphone; trauma.

References

    1. Almirall D, Nahum-Shani I, Sherwood N. E, Murphy S. A. Introduction to SMART designs for the development of adaptive interventions: With application to weight loss research. Translational Behavioral Medicine. 2014;4(3):260–274. doi: 10.1007/s13142-014-0265-0.
    1. Bendelin N, Hesser H, Dahl J, Carlbring P, Nelson K. Z, Andersson G. Experiences of guided Internet-based cognitive-behavioural treatment for depression: A qualitative study. BMC Psychiatry. 2011;11:107. doi: 10.1186/1471-244X-11-107.
    1. Bisson J. I. Disseminating and implementing evidence-based practice. European Journal of Psychotraumatology. 2013;4 21252, doi: .
    1. Bisson J. I, Roberts N. P, Andrew M, Cooper R, Lewis C. Psychological therapies for chronic post- traumatic stress disorder (PTSD) in adults. Cochrane Database of Systematic Reviews. 2013;12:CD003388. doi: 10.1002/14651858.CD003388.pub4.
    1. Bockting C. L, Kok G. D, Van der Kamp L, Smit F, Van Valen E, Schoevers R, et al. Disrupting the rhythm of depression using Mobile Cognitive Therapy for recurrent depression: Randomized controlled trial design and protocol. BMC Psychiatry. 2011;11:12. doi: 10.1186/1471-244X-11-12.
    1. Bolton A, Dorstyn D. Telepsychology for posttraumatic stress disorder: A systematic review. Journal of Telemedicine and Telecare. 2015 doi: 10.1177/1357633X15571996. [Epub ahead of print].
    1. Cuijpers P, Van Straten A, Andersson G. Internet-administered cognitive behavior therapy for health problems: A systematic review. Journal of Behavioral Medicine. 2008;31(2):169–177. doi: 10.1007/s10865-007-9144-1.
    1. Delahanty D. L, Gabert-Quillen C, Ostrowski S. A, Nugent N. R, Fischer B, Morris A, et al. The efficacy of initial hydrocortisone administration at preventing posttraumatic distress in adult trauma patients: A randomized trial. CNS Spectrums. 2013;18(2):103–111. doi: 10.1017/s1092852913000096.
    1. Engelhard I. M, Van Uijen S. L, Van den Hout M. A. The impact of taxing working memory on negative and positive memories. European Journal of Psychotraumatology. 2010;1 5623, doi: .
    1. Erbes C. R, Stinson R, Kuhn E, Polusny M, Urban J, Hoffman J, et al. Access, utilization, and interest in m-Health applications among veterans receiving outpatient care for PTSD. Military Medicine. 2014;179(11):1218–1222. doi: 10.7205/milmed-d-14-00014.
    1. Forbes D, Creamer M, Bisson J. I, Cohen J. A, Crow B. E, Foa E. B, et al. A guide to guidelines for the treatment of PTSD and related conditions. Journal of Traumatic Stress. 2010;23(5):537–552. doi: 10.1002/jts.20565.
    1. Frewen P. A, Evans B, Goodman J, Halliday A, Boylan J, Moran G, et al. Development of a childhood attachment and relational trauma screen (CARTS): A relational-socioecological framework for surveying attachment security and childhood trauma history. European Journal of Psychotraumatology. 2013;4 20232, doi: .
    1. Frijling J, Van Zuiden M, Koch S, Nawijn L, Veltman D, Olff M. Boosting the oxytocin system in acute trauma victims at risk for PTSD: The rationale and design of a randomized controlled trial. European Journal of Psychotraumatology. 2012;3 19379, doi: .
    1. Holmes E. A, James E. L, Coode-Bate T, Deeprose C. Can playing the computer game “Tetris” reduce the build-up of flashbacks for trauma? A proposal from cognitive science. PLoS One. 2009;4(1):e4153. doi: 10.1371/journal.pone.0004153.
    1. Jongh A. D, Broeke E. T. Response to “Treatment compliance and effectiveness in complex PTSD patients with co-morbid personality disorder undergoing stabilizing cognitive behavioral group treatment: A preliminary study.”. European Journal of Psychotraumatology. 2014;5 23489, doi: .
    1. Kaltenthaler E, Brazier J, De Nigris E, Tumur I, Ferriter M, Beverley C, et al. Computerised cognitive behaviour therapy for depression and anxiety update: A systematic review and economic evaluation. Health Technology Assessment. 2006;10(33):1–168. iii, xi–xiv.
    1. Knaevelsrud C, Maercker A. Internet-based treatment for PTSD reduces distress and facilitates the development of a strong therapeutic alliance: A randomized controlled clinical trial. BMC Psychiatry. 2007;7:13. doi: 10.1186/1471-244X-7-13.
    1. Kuhn E, Eftekhari A, Hoffman J. E, Crowley J. J, Ramsey K. M, Reger G. M, et al. Clinician perceptions of using a smartphone app with prolonged exposure therapy. Administration and Policy in Mental Health and Mental Health Services Research. 2014;41(6):800–807. doi: 10.1007/s10488-013-0532-2.
    1. Kuhn E, Greene C, Hoffman J, Nguyen T, Wald L, Schmidt J, et al. Preliminary evaluation of PTSD coach, a smartphone app for posttraumatic stress symptoms. Military Medicine. 2014;179(1):12–18. doi: 10.7205/milmed-d-13-00271.
    1. Lange A, Rietdijk D, Hudcovicova M, Van de Ven J. P, Schrieken B, Emmelkamp P. M. Interapy: A controlled randomized trial of the standardized treatment of posttraumatic stress through the internet. Journal of Consulting and Clinical Psychology. 2003;71(5):901–909. doi: 10.1037/0022-006X.71.5.901.
    1. Lewis C, Pearce J, Bisson J. I. Efficacy, cost-effectiveness and acceptability of self-help interventions for anxiety disorders: Systematic review. The British Journal of Psychiatry. 2012;200(1):15–21. doi: 10.1192/bjp.bp.110.084756.
    1. Miron-Shatz T, Shatz I, Becker S, Patel J, Eysenbach G. Promoting business and entrepreneurial awareness in health care professionals: Lessons from venture capital panels at medicine 2.0 conferences. Journal of Medical Internet Research. 2014;16(8):e184. doi: 10.2196/jmir.3390.
    1. Mouthaan J, Sijbrandij M, De Vries G.-J, Reitsma J. B, Van de Schoot R, Goslings J. C, et al. Internet-based early intervention to prevent posttraumatic stress disorder in injury patients: randomized controlled trial. Journal of Medical Internet Research. 2013;15(8) doi: 10.2196/jmir.2460. [online].
    1. Mouthaan J, Sijbrandij M, Reitsma J. B, Gersons B. P. R, Olff M. Internet-based prevention of posttraumatic stress symptoms in injured trauma patients: Design of a randomized controlled trial. European Journal of Psychotraumatology. 2011;2 8294, doi: .
    1. Musiat P, Goldstone P, Tarrier N. Understanding the acceptability of e-mental health—Attitudes and expectations towards computerised self-help treatments for mental health problems. BMC Psychiatry. 2014;14:109. doi: 10.1186/1471-244X-14-109.
    1. Olff M. Bonding after trauma: On the role of social support and the oxytocin system in traumatic stress. European Journal of Psychotraumatology. 2012;3 18597, doi: .
    1. Olff M, Shalev A. Stress and Trauma Ecological Momentary Assessments (STEMA) shortly after trauma. in prep.
    1. Price M, Yuen E. K, Goetter E. M, Herbert J. D, Forman E. M, Acierno R, et al. mHealth: A mechanism to deliver more accessible, more effective mental health care. Clinical Psychology & Psychotherapy. 2014;21(5):427–436. doi: 10.1002/cpp.1855.
    1. Reger G. M, Hoffman J, Riggs D, Rothbaum B. O, Ruzek J, Holloway K. M, et al. The “PE Coach” smartphone application: An ovative approach to improving implementation, fidelity, and homework adherence during prolonged exposure. Psychological Services. 2013;10(3):342–349.
    1. Rothbaum B. O, Kearns M. C, Price M, Malcoun E, Davis M, Ressler K. J, et al. Early intervention may prevent the development of posttraumatic stress disorder: A randomized pilot civilian study with modified prolonged exposure. Biological Psychiatry. 2012;72(11):957–963. doi: 10.1016/j.biopsych.2012.06.002.
    1. Ruggiero K. J, Resnick H. S, Paul L. A, Gros K, McCauley J. L, Acierno R, et al. Randomized controlled trial of an internet-based intervention using random-digit-dial recruitment: The Disaster Recovery Web project. Contemporary Clinical Trials. 2012;33(1):237–246. doi: 10.1016/j.cct.2011.10.001.
    1. Ruzek J. I, Weingardt K, Kuhn E, Hoffman J. E. Caring for trauma survivors in large health care systems: Towards Internet-facilitated treatment. European Journal of Psychotraumatology. 2011;2 7232, doi: .
    1. Sanson-Fisher R. W, D'Este C. A, Carey M. L, Noble N, Paul C. L. Evaluation of systems-oriented public health interventions: Alternative research designs. Annual Review of Public Health. 2014;35:9–27. doi: 10.1146/annurev-publhealth-032013-182445.
    1. Shen N, Levitan M. J, Johnson A, Bender J. L, Hamilton-Page M, Jadad A. A, et al. Finding a depression app: A review and content analysis of the depression app marketplace. JMIR Mhealth Uhealth. 2015;3(1):e16. doi: 10.2196/mhealth.3713.
    1. Sullivan S. D, Mauskopf J. A, Augustovski F, Jaime Caro J, Lee K. M, Minchin M, et al. Budget impact analysis-principles of good practice: Report of the ISPOR 2012 Budget Impact Analysis Good Practice II Task Force. Value Health. 2014;17(1):5–14. doi: 10.1016/j.jval.2013.08.2291.
    1. Van de Schoot R. Latent growth mixture models to estimate PTSD trajectories. European Journal of Psychotraumatology. 2015a;6 27503, doi: .
    1. Van de Schoot R. Latent trajectory studies: The basics, how to interpret the results, and what to report. European Journal of Psychotraumatology. 2015b;6 27514, doi: .
    1. Van de Schoot R, Broere J. J, Perryck K. H, Zondervan-Zwijnenburg M, Van Loey N. E. Analyzing small data sets using Bayesian estimation: The case of posttraumatic stress symptoms following mechanical ventilation in burn survivors. European Journal of Psychotraumatology. 2015;6 25216, doi: .
    1. Van der Meer C. A. I, Bakker A, Broeksteeg J, Schrieken B, Olff M. Enhancing self-screening for trauma related symptoms through a mobile application: The rationale and design of a validation study. Miami, FL: Poster presented at the ISTSS; 2014. Nov, 2014.
    1. Wang J. P, Maercker A. Web-based interventions for traumatized people in mainland China. European Journal of Psychotraumatology. 2014;5 26519, doi: .
    1. Warmerdam L, Riper H, Klein M, Van den Ven P, Rocha A, Ricardo Henriques M. Innovative ICT solutions to improve treatment outcomes for depression: The ICT4Depression project. Studies in health Technology and Informatics. 2012;181:339–343.

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