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Internet interventions, technologies and digital innovations for mental health and behavior change
JMIR Mental Health (JMH, ISSN 2368-7959) is a PubMed-indexed, peer-reviewed sister journal of JMIR, the leading eHealth journal by Impact Factor. (The projected inofficial impact factor for JMIR Mental Health is about 3.0)
JMIR Mental Health focusses on digital health and Internet interventions, technologies and electronic innovations (software and hardware) for mental health, addictions, online counselling and behaviour change. This includes formative evaluation and system descriptions, theoretical papers, review papers, viewpoint/vision papers, and rigorous evaluations.
JMIR Mental Health publishes even faster and has a broader scope with including papers which are more technical or more formative/developmental than what would be published in the Journal of Medical Internet Research.
JMIR Mental Health features a rapid and thorough peer-review process, professional copyediting, professional production of PDF, XHTML, and XML proofs. The journal is indexed in PubMed, PubMed Central, and ESCI (Emerging Sources Citation Index).
JMIR Mental Health adheres to the same quality standards as JMIR and all articles published here are also cross-listed in the Table of Contents of JMIR, the worlds' leading medical journal in health sciences / health services research and health informatics.
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Background: Lifestyle diseases continuously rise, with aging, epidemics, and life stressors altogether contributing to a growing need for solutions in mental health care. Mobile and wearable solutions...
Background: Lifestyle diseases continuously rise, with aging, epidemics, and life stressors altogether contributing to a growing need for solutions in mental health care. Mobile and wearable solutions have a large potential in this domain. Despite a significant growth in the availability of mobile apps in the past years, little is known about the characteristics of these applications and the end users’ perspectives about them, especially considering novel smart watch applications dedicated to promote mental health. Objective: To understand the current state-of-the-art smartwatch solutions for mental health, characterizing them in terms of features, benefits and drawbacks focusing on the end users’ perspectives, to identify opportunities to improve next-generation solutions. Methods: A comprehensive analysis of the existing applications for Apple Watch dedicated to mental health care, to characterize their state-of-the-art and provide a unified view of existing solutions, an analysis of their purposes, features, and users’ perspectives from online reviews and discussion boards to identify the main benefits and drawbacks with existing solutions Results: The smart watch applications analyzed focus mainly on intervention, rather than monitoring and tracking users’ affective states; they also focus on wellness and wellbeing and the sources tend to be non-medical; multimodal contents are explored to provide interventions, including audio, images and vibration; users enjoy the customization options and tend to use the applications in a regular basis, mainly to improve sleep quality, to focus, relax, meditate and distract themselves in adverse situations. Conclusions: There is a vast potential for wrist-worn applications for solutions in mental health, but the domain is still underexplored. Existing applications focus on interventions, and further development and research efforts are needed to advance on monitoring and personalized interventions. Privacy-enhanced solutions for access control and protection of human subjects and their data are essential in the development of mobile applications for mental health, still those remain as open questions to be addressed in the future.
Background: Management of severe and persistent mental illness is a complex, resource-intensive challenge for individuals, their families, their treaters, and the healthcare system at large. Community...
Background: Management of severe and persistent mental illness is a complex, resource-intensive challenge for individuals, their families, their treaters, and the healthcare system at large. Community based rehabilitation, in which peer specialists provide support for individuals managing their own condition, has demonstrated effectiveness, but has only been implemented in specialty centers. It remains unclear how the peer based community rehabilitation model could be expanded, given that it requires significant resources to both establish and maintain. Objective: Here, we describe the results from a study of one such program implemented within Waverley Place, a community support program at McLean Hospital emphasizing psychiatric rehabilitation for individuals with severe and persistent mental illness. Key questions were whether the patients could and would successfully use the app. Methods: The smartphone app offered multiple features relevant to psychiatric rehabilitation, including daily task lists and text messaging with peer specialists. Thirteen patients downloaded the app and used it for up to 90 days. Results: Only two patients were not able to complete app installation. Five patients were able to use the app regularly as part of their daily lives. No demographic or clinical features predicted ability to use the app in this way, but receiving a message from the certified peer specialist on the first day after installing the app did. Reasons for success or failure were highly individualistic. Conclusions: Smartphone apps may become a useful tool for psychiatric rehabilitation, addressing both psychiatric and co-occurring medical problems. Individualizing functions to each patient and facilitating connection with a certified peer specialist may be an important feature of useful apps.
The interactive software “Feeling Master” (a Cartoon Facial Recognition Tool) was developed to investigate the deficit in facial emotion recognition (FER) with a sample of patients with schizophre...
The interactive software “Feeling Master” (a Cartoon Facial Recognition Tool) was developed to investigate the deficit in facial emotion recognition (FER) with a sample of patients with schizophrenia in a pilot project framework. 24 persons with schizophrenia and 17 healthy control (HC) subjects completed the “Feeling Master” including five emotions (happiness, sadness, anger, fear and surprise). Regarding the group with schizophrenia they were evaluated with the Personal and Situational Attribution Questionnaire (IPSAQ) and the Hinting Task (Theory of Mind) to evaluate social cognition. Descriptive data showed suitable usability, adaptability, effectiveness and efficiency of “feeling master”. Patients with schizophrenia showed impairments in emotion recognition. The individuals with schizophrenia remained slower than the HC in the recognition of each emotion. Regarding the impairment in the recognition of each emotion we only have found significant error rates on fear discrimination (P=.07). And the correlations between correct response on the “Feeling Master” and the Hinting Task showed significant values in the correlation of surprise and Theory of Mind (P=.46). In conclusion, the study puts forward the usability of the “feeling master” in FER for people with schizophrenia. These findings lend support to the notion that difficulties in emotion recognition are more prevalent in people with schizophrenia, and those are associated with an imparment in ToM, suggesting the potential utility of the FER in the rehabilitation of people with schizophrenia.
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This piece draws from a patient’s perspective on their treatment using mobile health technology in conjunction with weekly group and individual psychotherapy. Research has demonstrated that utilizin...
This piece draws from a patient’s perspective on their treatment using mobile health technology in conjunction with weekly group and individual psychotherapy. Research has demonstrated that utilizing telepsychology as part of mental health treatment shows great promise to help advance the field of psychotherapy. Utilizing mobile health technology, such as cell phone applications, allows for collaboration with patients and their providers. This was written after several consultations with individual with borderline personality disorder, who would prefer to remain anonymous but was forthcoming with information regarding his use of mobile health technology in order to benefit the field of mental telepsychology.
Background: Despite a growing interest in the use of technology in order to support the treatment of psychotic disorders, limited knowledge exists about the viability and acceptability of these electr...
Background: Despite a growing interest in the use of technology in order to support the treatment of psychotic disorders, limited knowledge exists about the viability and acceptability of these electronic health (e-Health) interventions in relation to the clinical characteristics of patients. Objective: The aim of this study was to assess the access, use, experiences and interest in new technologies using a survey of patients diagnosed with first-episode psychosis (FEP) compared to a survey of patients diagnosed with chronic psychotic disorders (CP). Methods: A structured questionnaire was designed. This questionnaire was divided into five parts: 1) clinical and demographic information, 2) access and use of the internet, 3) use of the internet in relation to mental health, 4) experiences with technology, and 5) patient’s interest in e-Health services. In total, 105 patients were recruited from FEP units and recovery units. Depending on the length of the illness, the patients were assigned to either the FEP group (n=65, mean= 28.8 months) or to the CP group (n=40, mean= 253.3 months). Results: The mean age of the patients was 38.1 years (SD=13), and 72.4% (76/105) of them were male. The patients were mainly single (84.8%, 89/105) and had achieved a medium level of education (compulsory or secondary schooling) (61.9%, 65/105). The patients in the FEP group were younger than those in the CP group (t=-6.09, P<.001) and had more functional employment statuses (employed or student, 52.3% 34/65) than the CP group (12.5%, 5/40). Of the patients, 84.8% (89/105) had access to the internet, and 88.6% (93/105) owned an electronic internet device. In total, 71.3% (57/80) of patients who owned a smartphone were interested in e-Health systems; however, 28.7% (23/80) were not interested, and 38.2% (37/97) reported negative experiences related to internet usage. Differences between the groups were found in terms of device ownership (X2=13.77, P=.02), the frequency of internet access (X2=31.84, P<.001), the use of social media (X2=13.89, P=.01) and in seeking health information (X2=11.49, P=.04) and were found to be higher in the FEP group. No differences between the groups were found in terms of the use of internet in relation to mental health, experiences and opinions about the internet or in terms of interest in e-Health interventions (X2=3.85, P=.43). Conclusions: The availability and use of technology for the participants in our survey were equivalent to those for the general population. The differences found between the groups in relation to the access or use of technology seemed to be age-related factors. The use of technology involving mental health and the interest in e-Health interventions were mainly positive and equivalent between the groups. Accordingly, this group of patients is a suitable target for the emerging e-Health interventions, regardless of the clinical status of these patients. However, between 20-30% of the patients studied rejected the use of the internet or had unpleasant experiences related to its usage, so more in-depth studies are needed to better define the profile of psychotic patients who may benefit from e-Health treatments.
Background: Previous research into effects of personality on internet addiction in adolescents has produced inconclusive results. Adolescents are considered to be at risk of Internet addiction because...
Background: Previous research into effects of personality on internet addiction in adolescents has produced inconclusive results. Adolescents are considered to be at risk of Internet addiction because of their physical and psychological immaturity and negative effects of Internet use are more obvious in this age group. Objective: To determine the characteristics of adolescent personality that are most often associated with normal, moderate or serious Internet addiction and how these characteristics reflect on the six dimensions of Internet addiction. Methods: The study included 1078 male and female adolescents aged 11-18 years from Croatia, Poland, and Finland. The Internet addiction was assessed using Young's Internet Addition Test. A 30-item five-factor personality inventory, i.e., a Croatian version of the Goldberg's International Personality Item Pool, was used for personality assessment. Data were analyzed using a correlation analysis. Results: The level of Internet addiction did not significantly vary across different levels of neuroticism (P<.001); extraversion (P=.053); openness to experience (P<.001), and conscientiousness (P=.022). High and very high levels of openness were found in (46/241, 19%) of adolescents without Internet addiction and (92/241, 38%) adolescents with moderate and serious Internet addiction. Thus, openness was more pronounced in those more addicted to the Internet. Adolescents with moderate and serious Internet addiction showed higher levels of neuroticism, openness to new experience, and conscientiousness in comparison with adolescents evaluated as normal Internet users, whereas no difference was found for extraversion and agreeableness (P>.05). Conclusions: Analysis of correlation between five big personality traits and Internet addiction indicated that neuroticism, extraversion, and openness to new experience were more common among adolescents with moderate and serious Internet addictio