Online behavioural activation during the COVID-19 pandemic decreases depression and negative affective bias

Abstract Background The COVID-19 pandemic highlighted the need for mental health interventions that can be easily disseminated during a crisis. Behavioural activation (BA) is a cost-effective treatment that can be administered by non-specialists; however, it is unclear whether it is still effective during a time of lockdown and social distancing, when opportunities for positive activity are significantly constrained. Methods Between May and October 2020, we randomised 68 UK participants with mild to moderate low mood to either a 4-week online programme of non-specialist administered BA or to a passive control group. Before and after the intervention, we collected self-report data on mood and COVID-related disruption, as well as measuring emotional cognition as an objective marker of risk for depression. Results In comparison to the control group, the BA group showed a significant decrease in depression, anxiety and anhedonia after the intervention, as well as an increase in self-reported activation and social support. Benefits persisted at 1-month follow-up. BA also decreased negative affective bias on several measures of the Facial Emotion Recognition Task and early change in bias was associated with later therapeutic gain. Participants rated the intervention as highly acceptable. Conclusion This study highlights the benefits of online BA that can be administered by non-specialists after brief training. These findings can help inform the policy response towards the rising incidence of mental health problems during a crisis situation such as a pandemic. They also highlight the use of objective cognitive markers of risk across different treatment modalities.

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An App-Based Intervention for Adolescents Exposed to Cyberbullying in Norway: Protocol for a Randomized Controlled Trial

JMIR Research Protocols ◽

10.2196/31789 ◽

2021 ◽

Vol 10 (11) ◽

pp. e31789

Author(s):

Sabine Kaiser ◽

Monica Martinussen ◽

Frode Adolfsen ◽

Kyrre Breivik ◽

Henriette Kyrrestad

Keyword(s):

Mental Health ◽

Randomized Controlled Trial ◽

Mental Health Problems ◽

Controlled Trial ◽

Evaluation Studies ◽

Well Being ◽

Mobile App ◽

Self Report ◽

Control Group ◽

Randomized Controlled

Background Adolescents exposed to negative online events are at high risk to develop mental health problems. Little is known about what is effective for treatment in this group. NettOpp is a new mobile app for adolescents who have been exposed to cyberbullying or negative online experiences in Norway. Objective The aim of this paper is to provide a description of the content of the intervention and about a randomized controlled trial that will be conducted to examine the effectiveness of NettOpp. This protocol is written in accordance with the Spirit 2013 Checklist. Methods An effectiveness study with a follow-up examination after 3 months will be conducted to evaluate the mobile app. Adolescents will be recruited through schools and will be randomly assigned to the intervention (NettOpp) group and a waiting-list control group. The adolescents (aged 11 to 16 years) will respond to self-report questionnaires on the internet. Primary outcomes will be changes in mental health assessed with the Strengths and Difficulties Questionnaire, the WHO-Five Well-being Index, and the Child and Adolescent Trauma Screen. Results Recruitment will start in January 2022. The results from this study will be available in 2023. Conclusions There are few published evaluation studies on app-based interventions. This project and its publications will contribute new knowledge to the field. Trial Registration ClinicalTrials.gov NCT04176666; https://clinicaltrials.gov/ct2/show/NCT04176666 International Registered Report Identifier (IRRID) PRR1-10.2196/31789

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An App-Based Intervention for Adolescents Exposed to Cyberbullying in Norway: Protocol for a Randomized Controlled Trial (Preprint)

10.2196/preprints.31789 ◽

2021 ◽

Author(s):

Sabine Kaiser ◽

Monica Martinussen ◽

Frode Adolfsen ◽

Kyrre Breivik ◽

Henriette Kyrrestad

Keyword(s):

Mental Health ◽

Randomized Controlled Trial ◽

Mental Health Problems ◽

Controlled Trial ◽

Evaluation Studies ◽

Well Being ◽

Mobile App ◽

Self Report ◽

Control Group ◽

Randomized Controlled

BACKGROUND Adolescents exposed to negative online events are at high risk to develop mental health problems. Little is known about what is effective for treatment in this group. NettOpp is a new mobile app for adolescents who have been exposed to cyberbullying or negative online experiences in Norway. OBJECTIVE The aim of this paper is to provide a description of the content of the intervention and about a randomized controlled trial that will be conducted to examine the effectiveness of NettOpp. This protocol is written in accordance with the Spirit 2013 Checklist. METHODS An effectiveness study with a follow-up examination after 3 months will be conducted to evaluate the mobile app. Adolescents will be recruited through schools and will be randomly assigned to the intervention (NettOpp) group and a waiting-list control group. The adolescents (aged 11 to 16 years) will respond to self-report questionnaires on the internet. Primary outcomes will be changes in mental health assessed with the Strengths and Difficulties Questionnaire, the WHO-Five Well-being Index, and the Child and Adolescent Trauma Screen. RESULTS Recruitment will start in January 2022. The results from this study will be available in 2023. CONCLUSIONS There are few published evaluation studies on app-based interventions. This project and its publications will contribute new knowledge to the field. CLINICALTRIAL ClinicalTrials.gov NCT04176666; https://clinicaltrials.gov/ct2/show/NCT04176666 INTERNATIONAL REGISTERED REPORT PRR1-10.2196/31789

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Mental Health Among Adolescents from Returned Portuguese Immigrant Families

Swiss Journal of Psychology ◽

10.1024/1421-0185/a000015 ◽

2010 ◽

Vol 69 (3) ◽

pp. 131-139 ◽

Cited By ~ 5

Author(s):

Félix Neto

Keyword(s):

Mental Health ◽

Health Outcomes ◽

Mental Health Problems ◽

Immigrant Families ◽

Health Problems ◽

Mental Health Outcomes ◽

Control Group ◽

Older Adolescents ◽

The Mean ◽

Portuguese Adolescents

This study investigated mental health problems and their predictors among adolescents from returned immigrant families. The sample consisted of 360 returned adolescents (mean age = 16.8 years; SD = 1.9). The mean duration of a sojourn in Portugal for the sample was 8.2 years (SD = 4.5). A control group of 217 Portuguese youths were also included in the study. Adolescents from immigrant families reported mental health levels similar to those of Portuguese adolescents who have never migrated. Girls showed more mental health problems than boys. Younger adolescents showed fewer mental health problems than older adolescents. Adaptation variables contributed to mental health outcomes even after acculturation variables were accounted for. Implications of the study for counselors are discussed.

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Physical and Psychological Benefits of Written Emotional Expression

European Psychologist ◽

10.1027/1016-9040/a000231 ◽

2015 ◽

Vol 20 (4) ◽

pp. 242-251 ◽

Cited By ~ 3

Author(s):

Éva Kállay

Keyword(s):

Mental Health ◽

Expressive Writing ◽

Mental Health Problems ◽

Cost Effective ◽

Health Problems ◽

Future Research ◽

Psychological Benefits ◽

Cost Effective Treatment ◽

Meta Analyses

Abstract. The last several decades have witnessed a substantial increase in the number of individuals suffering from both diagnosable and subsyndromal mental health problems. Consequently, the development of cost-effective treatment methods, accessible to large populations suffering from different forms of mental health problems, became imperative. A very promising intervention is the method of expressive writing (EW), which may be used in both clinically diagnosable cases and subthreshold symptomatology. This method, in which people express their feelings and thoughts related to stressful situations in writing, has been found to improve participants’ long-term psychological, physiological, behavioral, and social functioning. Based on a thorough analysis and synthesis of the published literature (also including most recent meta-analyses), the present paper presents the expressive writing method, its short- and long-term, intra-and interpersonal effects, different situations and conditions in which it has been proven to be effective, the most important mechanisms implied in the process of recovery, advantages, disadvantages, and possible pitfalls of the method, as well as variants of the original technique and future research directions.

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Self-Report Depression Scales in the Elderly: The Relationship between the CES-D and ZUNG

The International Journal of Psychiatry in Medicine ◽

10.2190/8xgr-yufh-0gvm-k4xb ◽

1989 ◽

Vol 18 (4) ◽

pp. 325-338 ◽

Cited By ~ 22

Author(s):

Bruce R. Deforge ◽

Jeffery Sobal

Keyword(s):

Mental Health ◽

Sex Differences ◽

Mental Health Problems ◽

Psychological Symptoms ◽

Somatic Symptoms ◽

The Elderly ◽

Self Report ◽

Common Mental Health Problems ◽

Depression Scales ◽

The Relationship

Depression is one of the most common mental health problems in the elderly, but there is little consensus about the best way to assess depression in the aged. The relationship between the CES-D and the ZUNG self-report depression scales was investigated in seventy-eight elderly people with osteoarthritis (mean age 71). The correlation between the scales was r = .69, with the CES-D classifying 15 percent of the participants as depressed, as compared to 6 percent by the ZUNG. Psychological symptoms had the strongest relationship with overall depression scores on both scales. No sex differences were found on psychological items on either scale, but females reported more somatic symptoms on the ZUNG. People over age seventy-four reported more psychological symptoms than their younger counterparts.

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Mental Health Problems and Help-Seeking among Adolescents

Sibirskiy psikhologicheskiy zhurnal ◽

10.17223/17267080/79/11 ◽

2021 ◽

pp. 189-202

Author(s):

E.V. Rezun ◽

◽

H.R. Slobodskaya ◽

N.B. Semenova ◽

T.O. Rippinen ◽

...

Keyword(s):

Mental Health ◽

Health Care ◽

Mental Health Care ◽

Help Seeking ◽

Sleep Disturbances ◽

Mental Health Problems ◽

Health Problems ◽

Self Report ◽

Emotional And Behavioral Problems ◽

Seeking Help

The mental health problems among adolescents have long-lasting effects throughout life. However, research evidence indicates that only 10–30% of adolescents who needed mental health care had received specialized help. The present study reports the prevalence of mental health problems and help-seeking among adolescents, taking into account gender and age differences. The sample included 1752 adolescents (47 % boys,) aged 12-17 years. Data were collected on in two Siberian cities (Novosibirsk and Krasnoyarsk) using an international self-report questionnaire developed for the school-based Eurasian Child Mental Health Study. Participants were recruited from 18 schools, students completed questionnaires anonymously during school lessons. Statistical analysis included analysis of variance (ANOVA), multiple regression analysis, and crosstabs using a chi-squared test. The level of emotional and behavioral problems in Siberian adolescents was slightly higher than that found in European and Asian countries. Twenty three percent of adolescents reported frequent headaches (at least once a week), 11 % reported frequent abdominal pain and 14% suffered from frequent sleep disturbances (3–5 times a week or more). Girls reported a significantly higher level of problems than boys, with the largest gender differences for emotional problems, recurrent pains and sleep disturbances. Weekly consumption of alcohol and daily use of nicotine among boys was more common than among girls (3 % and 6 %, respectively), whereas less frequent use of alcohol and nicotine was commoner in girls (16 %) than in boys (10 %); 7 % of boys and girls had tried drugs at least once. Suicidal thoughts were reported by 22 % of adolescents, 6 % reported suicide attempts and 6 % reported repeated self-harm. One third of adolescents considered seeking outside help and 9 % had actually done so. Girls reported more help-seeking than boys; older girls sought help more often than younger and middle-aged ones. Around one third of adolescents sought help from their relatives; 26 % from friends, the Internet or other non-professional sources; 5 % reported seeking help from a doctor or nurse, and 3 % from a psychologist. The most important independent predictors of seeking help were emotional symptoms, suicidal ideation and hyperactivity/inattention. The results suggest a need for future investigation of the factors associated with help-seeking behavior among adolescents. It is also necessary to develop mental health promotion programs for adolescents, interventions to improve mental health literacy and access to mental health care.

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Efficacy of ‘Foundations’, a Digital Mental Health App to Improve Mental Well-Being, during COVID-19: A Proof-of-Principle Randomised Controlled Trial (Preprint)

10.2196/preprints.30976 ◽

2021 ◽

Author(s):

Silvina Catuara-Solarz ◽

Bartlomiej Skorulski ◽

Inaki Estella ◽

Claudia Avella-Garcia ◽

Sarah Shepherd ◽

...

Keyword(s):

Mental Health ◽

Perceived Stress ◽

Intervention Group ◽

Well Being ◽

Self Report ◽

World Health ◽

Randomised Control Trial ◽

Control Group ◽

Mental Well Being ◽

Proof Of Principle

BACKGROUND Against a long-term trend of increasing demand, the COVID-19 pandemic has led to a global rise in common mental disorders. Now more than ever, there is an urgent need for scalable, evidence-based interventions to support mental well-being. OBJECTIVE The aim of this proof-of-principle study was to evaluate the efficacy of a mobile-based app in adults with self-reported symptoms of anxiety and stress in a randomised control trial that took place during the first wave of the COVID-19 pandemic in the UK. METHODS Adults with mild to severe anxiety and moderate to high levels of perceived stress were randomised to either the intervention or control arm. Participants in the intervention arm were given access to the app, Foundations, for the duration of the 4-week study. All participants were required to self-report a range of validated measures of mental well-being (10-item Connor-Davidson Resilience scale [CD-RISC-10]; 7-item Generalised Anxiety Disorder scale [GAD-7]; Office of National Statistics Four Subjective Well-being Questions [ONS-4]; World Health Organisation-5 Well-Being Index [WHO-5]) and sleep (Minimal Insomnia Scale [MISS]) at baseline and weeks 2 and 4; and, in addition, on perceived stress weekly (10-item Perceived Stress Score [PSS]). RESULTS 136 participants completed the study and were included in the final analysis. The intervention group (n=62) showed significant improvements compared to the control group (n=74) on measures of anxiety (GAD-7 score, delta from baseline to week 2 in the intervention group: -1.35 [SD 4.43]; control group: -0.23 [SD 3.24]; t134= 1.71 , P=.04), resilience (CD-RISC score, delta from baseline to week 2 in the intervention group: 1.79 [± SD 4.08]; control group: -0.31 [± SD 3.16]; t134 -3.37, P<.001), sleep (MISS score, delta from baseline to week 2 in the intervention group: -1.16 [± SD 2.67]; control group: -0.26 [± SD 2.29]; t134= 2.13, P=.01), and mental well-being (WHO-5 score, delta from baseline to week 2 in the intervention group: 1.53 [5.30]; control group: -0.23 [± SD 4.20]; t134= -2.16, P=.02) within 2 weeks of using Foundations, with further improvements emerging at week 4. Perceived stress was also reduced within the intervention group, although the results did not reach statistical significance relative to the control group (PSS score, delta from baseline to week 2 in the intervention group: -2.94 [± SD 6.84]; control group: -2.05 [± SD 5.34]; t134= 0.84, P=.20). CONCLUSIONS This study provides proof-of-principle that the digital mental health app, Foundations, can improve measures of mental well-being, anxiety, resilience, and sleep within 2 weeks of use, with greater effects after 4 weeks. It therefore offers potential as a scalable, cost-effective, and accessible solution to enhance mental well-being, even during times of crisis such as the COVID-19 pandemic.

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Nationwide assessment of the mental health of UK Doctoral Researchers

10.31234/osf.io/cs73g ◽

2021 ◽

Author(s):

Cassie M Hazell ◽

Jeremy Niven ◽

Laura Chapman ◽

Paul Roberts ◽

Sam Cartwright-Hatton ◽

...

Keyword(s):

Mental Health ◽

Mental Health Problems ◽

Health Problems ◽

Poor Mental Health ◽

Academic Community ◽

Anxiety And Depression ◽

Control Group ◽

Evidence Based ◽

Preventative Measures ◽

Common Mental Health Problems

Doctoral Researchers (DRs) are an important part of the academic community and, after graduating, make substantial social and economic contributions. Despite this importance, DR wellbeing has long been of concern. Recent studies have concluded that DRs may be particularly vulnerable to poor mental health problems, but direct comparisons of the prevalence of mental health problems between them and a control group is lacking. Here, by comparing DRs with educated working controls, we show that DRs report significantly greater anxiety and depression, and that this difference is not explained by a higher rate of pre-existing mental health problems. Moreover, most DRs perceive poor mental health as a ‘normal’ part of the PhD process. Thus, our findings suggest a hazardous impact of PhD study on mental health, with DRs being particularly at risk of developing common mental health problems. This provides an evidence-based mandate for universities and funders to reflect upon practices related to DR training and mental health. Our attention should now be directed towards understanding what factors may explain heightened anxiety and depression among DRs so as to inform preventative measures and interventions.

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Online Mental Health Assessments of COVID-19 Patients in South Korea

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.685445 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jung Hyun Lee ◽

Dayoung Lee ◽

Soyoen Hyun ◽

Ji Sun Hong ◽

Chang-Hoon Kim ◽

...

Keyword(s):

Mental Health ◽

High Risk ◽

Mental Health Problems ◽

Health Problems ◽

Self Report ◽

Patient Health Questionnaire ◽

Health Questionnaire ◽

Post Traumatic Stress ◽

Patient Health ◽

Post Traumatic

Experiences of infectious diseases cause stressful and traumatic life events, hence, coronavirus disease 2019 (COVID-19) patients could suffer from various mental health problems requiring psychological support services. This study investigates the severity of mental health problems among confirmed COVID-19 patients. From March to November 2020, we collected the data from 118 COVID-19 patients who voluntarily participated in the National Center for Disaster Trauma's online mental health assessment consisting of self-report scales like Primary Care of Posttraumatic Stress Disorder screen (PC-PTSD), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), Patient Health Questionnaire-15 (PHQ-15), and P4 Suicidality Screener. For control, 116 other disaster-experienced and 386 non-COVID-19-experienced participants were recruited. The COVID-19 patients showed more severe symptoms including post-traumatic symptoms, depression, anxiety, and somatic symptoms than control groups across all four screening scales (p < 0.001). Regarding high-risk, COVID-19 patients had an increased association with high-risk compared to the comparison groups (PC-PTSD: OR = 24.16, 95% CI = 13.52–43.16 p < 0.001; PHQ-9: OR = 14.45, 95% CI = 8.29–25.19, p < 0.001; GAD-7: OR=20.71, 95% CI = 10.74–39.96, p < 0.001; PHQ-15: OR = 5.65, 95% CI = 3.44–9.25, p < 0.001; P4: OR = 14.67, 95% CI = 8.95–25.07, p < 0.001). This study's results imply that there is a high-risk of overall mental health problems, especially stronger associations of post-traumatic stress symptoms, in COVID-19 patients. These findings help inform practitioners about the psychological responses to COVID-19 experiences and to prepare appropriate interventions and services for the incremental number of confirmed cases.

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Physical Health Profile and Associated Behavior During the COVID-19 Pandemic in Patients With Bipolar Disorder

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.759694 ◽

2021 ◽

Vol 12 ◽

Author(s):

Jon Dyg Sperling ◽

Nina Dalkner ◽

Christina Berndt ◽

Eva Fleischmann ◽

Michaela Ratzenhofer ◽

...

Keyword(s):

Mental Health ◽

Physical Health ◽

Public Mental Health ◽

Brief Symptom Inventory ◽

Self Report ◽

Control Group ◽

Healthy Controls ◽

Physical And Mental Health ◽

Healthy Control ◽

Mental And Physical Health

Background: The COVID-19 pandemic has led to an increased psychological strain on public mental health and may impact behavioral, mental, and physical health, presumably with effects on patients with severe mental disorders. This study examines pandemic-related physical and mental health and (compensatory) behavioral changes, in patients with BD as compared to healthy control individuals.Method: Physical and mental health and self-reported changes in daily structure and behavior due to the pandemic were assessed using a self-constructed questionnaire and the brief symptom inventory (BSI) in Germany, Austria, and Denmark in individuals with BD and a healthy control group.Results: The present study included 118 individuals with BD and 215 healthy controls. Individuals with BD reported statistically significant higher physical risk burden, increased weight gain, more physical comorbidities, and a decrease in physical activity and they further reported higher rates of COVID-19 testing, had more worries concerning health, and experienced more anxiety but less social distancing.Conclusion: The COVID-19 pandemic seems to have a greater impact on physical health in individuals with BD than in healthy controls. Individuals with BD appear to be having more difficulties compensating their behavior due to the pandemic which could amplify the effect of risk factors associated with poorer physical health. This highlights the necessity for optimizing and targeting the overall treatment of both mental and physical health in patients with BD during periods with far-reaching changes such as the COVID-19 pandemic.Limitations: Sampling issues and self-report forms, selectivity (missing elderly, and those lacking access or knowledge of technology).

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