mHealth in the wild: A global examination of a publicly available app for depression (Preprint)

BACKGROUND The scope and impact of depression worldwide is breathtaking. Reducing the global burden of depression will require a multi-pronged approach. OBJECTIVE The purpose of this study is to examine naturalistic user behavior of MoodTools, a publicly available, self-guided mHealth app designed to improve symptoms of depression, in a global community sample. METHODS Mobile analytics data was collected from all unique downloads of the Android version of MoodTools between March 1, 2016 and February 28, 2018. RESULTS MoodTools was used by 158,930 people from 198 countries. 51.14% of users returned to the app after initial download. The typical person used the app for 3 sessions for a total of 12 minutes over the span of 90 days. Users most often visited tools designed for self-monitoring of symptoms and for targeting a core mechanism of depressive psychopathology, negative cognitions. CONCLUSIONS Results suggest that there is global interest in a publicly available app for improving depression. Self-guided apps like MoodTools, therefore, could be a tool in the toolbox to address the global burden of depression. Future research is needed to determine whether people who use self-guided apps experience improvement in depressive symptoms. Given the low motivation and behavioral avoidance associated with the disorder, a key challenge for self-guided apps for depression is to engage and to retain users. CLINICALTRIAL none, not a trial

Origanum vulgare Essential Oil against Tenebrio molitor (Coleoptera: Tenebrionidae): Composition, Insecticidal Activity, and Behavioral Response

Tenebrio molitor is one of the main stored product pests. This study characterized oregano essential oil (OEO) by gas chromatography (GC/FID and GC/MS) and assessed its insecticidal properties against T. molitor. Mortality, survival, respiration, and behavioral response in larva, pupa, and adult of this insect were determined. The major components of OEO were carvacrol (25.6%), p-cymene (12.3%), linalool (8.71%), thymol (7.22%), γ-terpinene (7.21%), caryophyllene oxide (4.67%), α-pinene (2.71%), and eucalyptol (2.69%). OEO caused high contact toxicity in larvae (LD50 = 3.03 µg insect–1), pupae (LD50 = 5.01 µg insect–1), and adults (LD50 = 5.12 µg insect−1) of T. molitor. Survival rates were 100% in larvae, pupae, and adults of T. molitor not treated with OEO, declining to 65–54%, 38–44%, 30–23%, and 6–2% in insects treated with LD25, LD50, LD75, and LD90, respectively. Low respiration rates of T. molitor at different developmental stages was observed after OEO exposure. Additionally, OEO exposure affects behavioral avoidance response and causes repellency in larvae and adults. These findings show that OEO exerts insecticidal and repellent effects against T. molitor, suggesting a potent alternative to synthetic insecticides for controlling the beetle.

Deficiency of innate immunity against P. aeruginosa enhances behavioral avoidance via the HECW-1/NPR-1 module in C. elegans

To antagonize infection of pathogenic bacteria in soil and confer increased survival, Caenorhabditis elegans employs innate immunity and behavioral avoidance synchronously as the two main defensive strategies. Although both biological processes and their individual signaling pathways have been partially elucidated, knowledge of their interrelationship remains limited. The current study reveals that deficiency of innate immunity triggered by mutation of the classic immune gene pmk-1 promotes avoidance behavior in C. elegans ; and vice versa. Restoration of pmk-1 expression using the tissue-specific promoters suggested that the functional loss of both intestinal and neuronal pmk-1 is necessary for the enhanced avoidance. Additionally, PMK-1 co-localized with the E3 ubiquitin ligase HECW-1 in OLL neurons and regulated the expressional level of the latter, which consequently affected the production of NPR-1, a G-protein-coupled receptor homologous to the mammalian neuropeptide Y receptor, in RMG neurons in a non-cell-autonomous manner. Collectively, our study illustrates, once the innate immunity is impaired when C. elegans antagonizes bacterial infection, the other defensive strategy of behavioral avoidance can be enhanced accordingly via the HECW-1/NPR-1 module, suggesting that GPCRs in neural circuits may receive the inputs from immune system and integrate those two systems for better adapting to the real-time status.

Countering Avoidant Behaviors

The key concept for this session is emotion avoidance, which means any strategies we use to avoid feeling strong emotions or to prevent our emotions from becoming more intense. Although these responses may be useful in some situations, they rarely work well in the long term, and they can increase the intensity of our emotions when we encounter a similar situation in the future. During this session, clients learn how suppression of thoughts and emotions can be counterproductive. Clients are taught to identify three types of avoidance, which are behavioral avoidance (obvious and subtle), cognitive avoidance, and safety signals.

Therapist Materials for Countering Avoidant Behaviors

The session in this chapter looks at how suppression of thoughts and emotions can be counterproductive. Suppression or attempted avoidance may control things somewhat in the short term but rarely works in the long term, and it increases intensity of emotion when a similar situation is encountered in the future. Subtle behavioral avoidance, cognitive avoidance, and safety signals are introduced, and clients are asked to provide their own examples. Habitual avoidance of emotion creates negative messages about our capabilities and robs us of the chance to learn that the emotion is tolerable and will pass on its own without our efforts to avoid or escape. In this countering avoidant behavior session, clients are taught how to do the opposite of avoidance by developing a willingness to lean into emotions, or approach them, and thereby learn new lessons about emotion, situations, and themselves.

Protocol for the Reducing Fear-Avoidance of Memory Loss (REFRAME) Study: A randomized controlled trial investigating the feasibility of a low-intensity psychological intervention for fear of memory loss and quality of life in older adults. (Preprint)

BACKGROUND Dementia is the most feared disease associated with aging. These fears can have harmful consequences even in the absence of cognitive decline. Fear of dementia is associated with poorer health outcomes, reduced psychological wellbeing and increased memory failures in older adults. OBJECTIVE We will conduct a randomized controlled trial to determine the feasibility of a tailored, web-based mindfulness program to reduce fear of memory loss and increase quality of life in older adults experiencing heightened fear. METHODS One group will receive psychoeducation along with brief mindfulness training, which facilitates non-judgmental awareness to manage psychological distress. A second group will receive psychoeducation, mindfulness training and additional modules targeting maladaptive behavioral avoidance (i.e., social and cognitive withdrawal). RESULTS Our recent etiological model posits that maladaptive behavioral avoidance strategies critically underlie psycho-social dysfunction associated with fear of memory loss. Thus, we predict better outcomes in the second group, including fear of memory loss (primary outcome), fear of Alzheimer’s disease, quality of life, anxiety and subjective memory failures (secondary outcomes). Outcome measures will be applied at five time points (pre-, baseline, interim-, and post-intervention as well as at 3-month follow up). CONCLUSIONS Data will be analyzed using mixed models, correlations and t-tests. This study was approved by the IRB at Northwestern University (USA) and data collection will take place between May and August 2021. CLINICALTRIAL Trial Registration Number: NCT04821960

Trust in Science, Perceived Vulnerability to Disease, and Adherence to Pharmacological and Non-pharmacological COVID-19 Recommendations

Protection motivation theory (PMT) is a theoretical framework informative for understanding behavioral intentions and choices during exceptional and uncommon circumstances, such as a pandemic of respiratory infectious disease. PMT postulates both the threat appraisal and the coping appraisal as predictors of health behaviors. Recent advances in the field of behavioral immune system (BIS) research suggest that humans are equipped with a set of psychological adaptations enabling them to detect the disease-threat and activate behavioral avoidance of pathogens. The present study, set within PMT framework and informed by the BIS research, aimed to explain and predict voluntary adherence to COVID-19 guidelines by perceived personal risk and vulnerability to disease as threat appraisal variables, and trust in science as the response efficacy element of coping appraisal. Gender, age, belief in the second wave, perceived personal risk, germ aversion, and trust in science were all found to be significant positive predictors of the intent to adhere to non-pharmacological COVID-19 recommendations, with the belief in the second wave, germ aversion, and trust in science being the most important ones. On the other hand, only the belief in the second wave and trust in science were significant positive predictors of the intent to adhere to pharmacological COVID-19 recommendations (i.e., to vaccinate). Interventions aimed at enhancing preventative measures adherence should take into account that the psychological mechanisms underlying adherence to these two types of recommendations are not identical.

Individual differences in avoiding feelings of disgust: Development and construct validity of the disgust avoidance questionnaire

We developed and examined the construct validity of the Disgust Avoidance Questionnaire (DAQ) as a measure of people’s inclination to prevent experiencing disgust (disgust prevention) and to escape from the experience of disgust (disgust escape). In a stepwise item-reduction (Study 1; N = 417) using Exploratory Factor Analysis (EFA) based on a 4-subscale distinction (behavioral prevention, cognitive prevention, behavioral escape, cognitive escape), we selected 17 items from a pool of potential items. In order to incorporate the conceptual overlap between dimensions of disgust avoidance, focus (prevention vs. escape), and strategy (behavioral avoidance vs. cognitive avoidance), we specified an adapted model. In this model, we allowed each item to load on one type of dimension and one type of strategy, resulting in four overlapping factors (prevention, escape, behavioral avoidance, cognitive avoidance). Evaluation of this overlapping 4-factor model (Study 2; N = 513) using Exploratory Structural Equation Modeling (ESEM) and Confirmatory Factor Analysis (CFA) showed promising model fit indices, factor loadings, factor correlations, and reliability estimates for three of the four factors (prevention, behavioral avoidance, cognitive avoidance). Those three subscales also showed good convergent validity. In contrast, the results related to the escape factor may call the suitability of self-report to assess disgust escape into question. In light of the exploratory nature of the project, future examinations of the DAQ’s validity and applicability to more diverse samples are essential. A critical next step for future research would be to examine the DAQ’s criterion validity and the distinctive roles of the DAQ subscales in (clinical) psychological constructs and processes.