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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: Forensic psychiatric patients are often diagnosed with psychiatric disorders characterized by high levels of impulsivity as well as comorbid substance use disorders (SUD). The combination...
Background: Forensic psychiatric patients are often diagnosed with psychiatric disorders characterized by high levels of impulsivity as well as comorbid substance use disorders (SUD). The combination of psychiatric disorders and SUD increases the risk of future violence. Chronic substance abuse can lead to a structural state of disinhibition, resulting in more drug taking and eventually loss of control over drug intake. When treating SUD, it is crucial to address high levels of impulsivity and lack of inhibitory control. Objective: The current study set out to investigate the effects of a theta/Sensorimotor rhythm (SMR) neurofeedback training protocol on levels of impulsivity, levels of drug craving and actual drug intake in a population of forensic psychiatric patients with a diagnosis of SUD. Methods: 21 participants received 20 sessions of SMR/theta neurofeedback training in combination with treatment as usual (TAU). Results were compared to 21 participants who received TAU only. Results: SMR magnitude showed a significant (P = .02) increase post-training for patients in the neurofeedback training group, whereas theta magnitude did not change (P >.05). Levels of drug craving as well as scores on the ‘motor’ subscale of the BIS-11 decreased equally for patients in the neurofeedback training group and the TAU group. Other measures of impulsivity, as well as drug intake, did not change post-treatment (P > .05). Therefore, neurofeedback + TAU was not more effective than TAU only. Conclusions: The current study demonstrated evidence that forensic psychiatric patients are able to increase SMR magnitude over the course of neurofeedback training. However, at the group level, the increase in SMR activity was not related to any of the included impulsivity or drug craving measures. Further research should focus on which patients will be able to benefit from neurofeedback training at an early stage of the employed training sessions. Clinical Trial: Dutch National Trial Register NTR5386; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5386 (Archived by WebCite at http://www.webcitation.org/6nXLQuoLl)
Background: Depression, anxiety, and at-risk drinking are highly prevalent in primary care settings. Many jurisdictions experience geographical barriers to accessing mental health services, necessitat...
Background: Depression, anxiety, and at-risk drinking are highly prevalent in primary care settings. Many jurisdictions experience geographical barriers to accessing mental health services, necessitating the development and validation of alternative models of care delivery. Existing evidence supports the acceptability and effectiveness of providing mental health care by telephone. Objective: This analysis assesses patient’s acceptability of computer-aided telephone support delivered by lay providers to primary care patients with depression, anxiety, or at-risk drinking. Methods: PARTNERs is a research trial comparing a computer-aided telephone-based intervention to usual care enhanced by periodic assessments in adult primary care patients referred for treatment of depression, anxiety, or at-risk drinking; no part of the study involves in-person contact. For this analysis, the following data were obtained: reasons provided for declining consent; reasons provided for withdrawing from the study; study retention rate; and a thematic analysis of a satisfaction survey upon study completion. Results: During the consent process, 53.7% of 667 patients referred to the study declined to participate, and attributed their refusal to research-related factors (i.e., randomization and time commitment); a further 16.8% declined due to the telephone delivery of the intervention. Among 377 participants who were randomized to the one-year intervention, the overall retention rate was 81.8%. Almost no participants who withdrew from the study identified the telephone components of the study as their reason for withdrawal. Analysis of a qualitative satisfaction survey revealed that 97.4% of comments related to the telephone components were positive, with key reported positive attributes being accessibility, convenience, and privacy. Conclusions: Our results suggest that a computer-aided telephone support is highly acceptable to primary care patients with depression, anxiety, or at-risk drinking. In particular, these patients appreciate its accessibility, flexibility, and privacy. Clinical Trial: Trial registration: ClinicalTrials.gov Identifier: NCT02345122
Background: Background: Given the criticisms of life event (LE) checklists and the costs associated with interviews, LE research requires a sophisticated measure for research and clinical practice. Th...
Background: Background: Given the criticisms of life event (LE) checklists and the costs associated with interviews, LE research requires a sophisticated measure for research and clinical practice. Therefore, the Computerised Life Events and Assessment Record (CLEAR), based on the Life Events and Difficulties Schedule (LEDS), was developed. Objective: To test CLEAR’s reliability, validity, and association with depression. Methods: CLEAR, the General Health Questionnaire, and the List of Threatening Experiences Questionnaire (LTE-Q) was completed by 328 participants (126 students; 202 matched midlife sample: 127 controls, 75 recurrent depression cases). Test-retest reliability over 3-4 weeks was examined, and validity determined by comparing CLEAR with LEDs and LTE-Q. Both CLEAR and LTE-Q were examined in relation to depression. Results: CLEAR demonstrated good test-retest reliability for overall number of events (.89) but only fair reliability for overall agreement of events at both points (.21). Event characteristics for those that agreed had good reliability. Long-term problems (LTPs) showed similar findings. For validity, CLEAR had moderate sensitivity of 59% and specificity of 65% when compared to LEDS on matched events. Associations by category were good e.g. education (.81), work (.70) and health (.59), with high levels of specificity in these domains. CLEAR demonstrated moderate sensitivity (43.1%) and specificity (78.6%) when compared to LTE-Q. CLEAR severe LEs and LTPs were significantly associated with depression (OR = 3.50, 95% CI: 2.10-5.85, P < .001; OR = 3.38, 95% CI: 2.02-5.67, P < .001) whereas LTE-Q events were not (OR=1.06, 95% CI: .43-2.60, P =.90). Conclusions: CLEAR has acceptable reliability and validity and predicts depression. It therefore has great potential for effective use in research and clinical practice identifying stress factors in depression and related disorders.
Background: Dementia is a growing public health concern with approximately 50 million people affected worldwide in 2017 and this number is expected to reach more than 131 million by 2050. The toll on...
Background: Dementia is a growing public health concern with approximately 50 million people affected worldwide in 2017 and this number is expected to reach more than 131 million by 2050. The toll on caregivers and relatives cannot be underestimated as dementia changes family relationships, leaves people socially isolated, and affects the finances of all those involved. Objective: The aim of this study was to explore using automated analysis (i) the age and gender of people who post to the social media forum Reddit about dementia diagnoses, (ii) the affected person and their diagnosis, (iii) relevant subreddits authors are posting to, (iv) the types of messages posted and (v) the content of these posts. Methods: We analysed Reddit posts concerning dementia diagnoses. We used a previously developed text analysis pipeline to determine attributes of the posts as well as their authors to characterise online communications about dementia diagnoses. The posts were also examined by manual curation for the diagnosis provided and the person affected. Furthermore, we investigated the communities these people engage in and assessed the contents of the posts with an automated topic gathering technique. Results: Our results indicate that the majority of posters in our data set are women, and it is mostly close relatives such as parents and grandparents that are mentioned. Both the communities frequented and topics gathered reflect not only the sufferer's diagnosis but also potential outcomes, e.g. hardships experienced by the caregiver. The trends observed from this dataset are consistent with findings based on qualitative review, validating the robustness of social media automated text processing. Conclusions: This work demonstrates the value of social media data sources as a resource for in-depth studies of those affected by a dementia diagnosis and the potential to develop novel support systems based on their real time processing in line with the increasing digitalisation of medical care.
Background: There is growing interest in using technology-based tools to support mental health recovery. Yet, despite evidence suggesting widespread access to technology among people with mental illne...
Background: There is growing interest in using technology-based tools to support mental health recovery. Yet, despite evidence suggesting widespread access to technology among people with mental illnesses, interest in using technology to support mental health, and effectiveness of technology-based tools developed by researchers, such tools have not been widely adopted within mental health settings. Little is currently known about how mental health consumers are using technology to address mental health needs in real-world settings outside of controlled research studies. Objective: This qualitative study examined current practices and orientations toward technology among consumers in three mental health settings in the U.S. Methods: Ethnographic observations and semi-structured interviews were conducted. Observations focused on if and how technology was salient within the setting and documented relevant behaviors, interactions, and dialogue in fieldnotes. Ethnographic data informed the development of a semi-structured interview that inquired into technology use and interest among consumers (n=15) in a community mental health setting. Fieldnotes and interview transcripts were reviewed and coded by multiple researchers. Key concepts and patterns identified were refined by the research team to develop the main findings. Results: Ownership of technology, although common, was not ubiquitous and was varied across the sites. Participants had varying levels of awareness regarding the key capabilities of modern technologies. Participants used technology for many purposes, but there was limited evidence of technology use to support mental health. Technology-based tools specific to mental health were not routinely used although some participants found widely available mobile apps to be helpful in recovery. Conclusions: Qualitative findings suggest that most but not all clients will be interested in using technology to support mental health needs. The variability in type and quality of technology owned by participants suggests the need to design for a range of functionality in the development of mental health tools. Findings also suggest thinking broadly about using existing platforms and widely available tools to support consumers in mental health recovery.
Background: Over 90% of adults in the U.S. have at least one social media (SM) account and lesbian, gay, and bisexual (LGB) persons are more socially active on SM than heterosexuals. Rates of depressi...
Background: Over 90% of adults in the U.S. have at least one social media (SM) account and lesbian, gay, and bisexual (LGB) persons are more socially active on SM than heterosexuals. Rates of depression among LGB persons are between 1.5- and 2-fold higher than those of heterosexual counterparts. SM allows users to connect, interact, express ideas, emotions, feelings, and thoughts. Thus, social media use (SMU) might represent both a protective and risk factor for depression among LGB persons. Studying the nature of the relationship between SMU and depression among LGB individuals is a necessary step to inform public health interventions for this population. Objective: We conducted a systematic review to synthesize and critique the evidence on SMU and depression among LGB populations. Methods: We conducted a literature search for quantitative and qualitative studies published between January 2003 and June 2017 using 3 electronic databases. Articles were included if they were peer-reviewed, in English language, assessed SMU either quantitatively or qualitatively, measured depression, and focused on LGB populations. A minimum of 2 authors independently extracted data from each study using an a priori developed abstraction form. We assessed appropriate reporting of studies using the Strengthening the Reporting of Observational Studies in Epidemiology and the Consolidated Criteria for Reporting Qualitative Research for quantitative and qualitative studies, respectively. Results: Eleven articles were included in the review. Nine studies were quantitative and cross-sectional, two were qualitative. Appropriate reporting of results varied greatly. Across quantitative studies, we found heterogeneity in how SMU was defined and measured. Cyberbullying was the most studied SM experience, and was associated with depression and suicidality. Qualitative studies found that while SM provides a space to disclose minority experiences and share ways to cope and get support, constant surveillance of one’s SM profile can become a stressor, potentially leading to depression. In most studies, sexual minority participants were identified inconsistently. Conclusions: This review supports the need for research on the role of SMU on depression outcomes among LBG persons. SMU may be both a protective and risk factor for depression among LGB individuals. Support gained via SM may buffer the impact of geographic isolation and loneliness. Negative SM experiences such as cyberbullying and other patters of SMU may be associated with depression. Future research would benefit from more consistent definitions of both SMU and study populations. Moreover, use of larger samples and accounting for patterns of SMU and individuals’ experiences on SM may help to better understand the factors that impact LGB mental health disparities.