Mental Health Apps Research Articles

Characteristic of mental health app usage: a cross-sectional survey in the general population.

Mental health apps (MHA) have gained popularity in recent years. Most freely available apps are of low quality and lack evidence for effectiveness. Yet, download rates indicate high usage. MHA are potentially beneficial for individuals with no/low symptom severity as prevention, or as an option to reach underserviced populations. However, currently very little is known about the characteristics of MHA users in the general population, about the kind of MHA used, or the motivation behind MHA usage. We collected survey-data from N = 1,247 individuals from the general population to investigate MHA usage. Descriptive statistics revealed that 41% had used MHA in the past 12 months; prescription app-use however was low (1.5% of MHA users). Mindfulness, moodtracking, and relaxation were the most popular categories of MHA. Perceived helpfulness, fun, and availability were the top reasons for MHA usage. Non-users reported distrust, lack of perceived need, and data security concerns as usage barriers. MHA users and non-users did not differ regarding sociodemographic variables. Multiple regression analyses revealed that sub-threshold symptoms of psychological disorders as well as higher levels of anxiety and stress were linked to higher probability of MHA usage. Higher levels of depression were associated with lower likelihood of MHA usage in general, but increased likelihood of usage of self-help apps specifically for depression. It follows that MHA use is common in the general population independent of sociodemographic characteristics. MHA can reach people who might benefit, but more awareness and better structure of the market is needed to reduce distrust, increase usage of high-quality MHA, and improve the fit between app and user.

Mining User Reviews for Key Design Features in Cognitive Behavioral Therapy-Based Mobile Mental Health Apps.

Background: Cognitive behavioral therapy (CBT)-based mobile apps have been shown to improve CBT-based interventions effectiveness. Despite the proliferation of these apps, user-centered guidelines pertaining to their design remain limited. The study aims to identify design features of CBT-based apps using online app reviews. Methods: We used 4- and 5-star reviews, preprocessed the reviews, and represented the reviews using word-level bigrams. Then, we leveraged latent Dirichlet allocation (LDA) and visualization techniques using python library for interactive topic model visualization to analyze the review and identify design features that contribute to the success and effectiveness of the app. Results: A total of 24,902 reviews were analyzed. LDA optimization resulted in 86 topics that were labeled by two independent researchers, with an interrater Cohen's kappa value of 0.86. The labeling and grouping process resulted in a total of six main design features for effective CBT-based mobile apps, namely, mental health management and support, credibility support, self-understanding and personality insights, therapeutic approaches and tools, beneficial rescue sessions, and personal growth and development. Conclusions: The high-level design features identified in this study could evidently serve as the backbone of successful CBT-based mobile apps for mental health.

Gender differences in preferences for mental health apps in the general population – a choice-based conjoint analysis from Germany

BackgroundMen and women differ in the mental health issues they typically face. This study aims to describe gender differences in preferences for mental health treatment options and specifically tries to identify participants who prefer AI-based therapy over traditional face-to-face therapy.MethodA nationally representative sample of 2,108 participants (53% female) aged 18 to 74 years completed a choice-based conjoint analysis (CBCA). Within the CBCA, participants evaluated twenty choice sets, each describing three treatment variants in terms of provider, content, costs, and waiting time.ResultsCosts (relative importance [RI] = 55%) emerged as the most critical factor when choosing between treatment options, followed by provider (RI = 31%), content (RI = 10%), and waiting time (RI = 4%). Small yet statistically significant differences were observed between women and men. Women placed greater importance on the provider, while men placed greater importance on cost and waiting time. Age and previous experience with psychotherapy and with mental health apps were systematically related to individual preferences but did not alter gender effects. Only a minority (approximately 8%) of participants preferred AI-based treatment to traditional therapy.ConclusionsOverall, affordable mental health treatments performed by human therapists are consistently favored by both men and women. AI-driven mental health apps should align with user preferences to address psychologist shortages. However, it is uncertain whether they alone can meet the rising demand, highlighting the need for alternative solutions.

Mental health apps in India: regulatory landscape and future directions

Mental health apps in India: regulatory landscape and future directions

Inclusion of Individuals With Lived Experiences in the Development of a Digital Intervention for Co-Occurring Depression and Cannabis Use: Mixed Methods Investigation.

Existing interventions for co-occurring depression and cannabis use often do not treat both disorders simultaneously and can result in higher rates of symptom relapse. Traditional in-person interventions are often difficult to obtain due to financial and time limitations, which may further prevent individuals with co-occurring depression and cannabis use from receiving adequate treatment. Digital interventions can increase the scalability and accessibility for these individuals, but few digital interventions exist to treat both disorders simultaneously. Targeting transdiagnostic processes of these disorders with a digital intervention-specifically positive valence system dysfunction-may yield improved access and outcomes. Recent research has highlighted a need for the inclusion of individuals with lived experiences to assist in the co-design of interventions to enhance scalability and relevance of an intervention. Thus, the purpose of this study is to describe the process of eliciting feedback from individuals with elevated depressed symptoms and cannabis use and co-designing a digital intervention, Amplification of Positivity-Cannabis Use Disorder (AMP-C), focused on improving positive valence system dysfunction in these disorders. Ten individuals who endorsed moderate to severe depressive symptoms and regular cannabis use (2-3×/week) were recruited online via Meta ads. Using a mixed methods approach, participants completed a 1-hour mixed methods interview over Zoom (Zoom Technologies Inc) where they gave their feedback and suggestions for the development of a mental health app, based on an existing treatment targeting positive valence system dysfunction, for depressive symptoms and cannabis use. The qualitative approach allowed for a broader investigation of participants' wants and needs regarding the engagement and scalability of AMP-C, and the quantitative approach allowed for specific ratings of intervention components to be potentially included. Participants perceived the 13 different components of AMP-C as overall helpful (mean 3.9-4.4, SD 0.5-1.1) and interesting (mean 4.0-4.9, SD 0.3-1.1) on a scale from 1 (not at all) to 5 (extremely). They gave qualitative feedback for increasing engagement in the app, including adding a social component, using notifications, and being able to track their symptoms and progress over time. This study highlights the importance of including individuals with lived experiences in the development of interventions, including digital interventions. This inclusion resulted in valuable feedback and suggestions for improving the proposed digital intervention targeting the positive valence system, AMP-C, to better match the wants and needs of individuals with depressive symptoms and cannabis use.

Emotional competence self-help app versus cognitive behavioural self-help app versus self-monitoring app to prevent depression in young adults with elevated risk (ECoWeB PREVENT): an international, multicentre, parallel, open-label, randomised controlled trial.

Effective, scalable interventions are needed to prevent poor mental health in young people. Although mental health apps can provide scalable prevention, few have been rigorously tested in high-powered trials built on models of healthy emotional functioning or tailored to individual profiles. We aimed to test a personalised emotional competence app versus a cognitive behavioural therapy (CBT) self-help app versus a self-monitoring app to prevent an increase in depression symptoms in young people. This multicentre, parallel, open-label, randomised controlled trial, within a cohort multiple randomised trial (including a parallel trial of wellbeing promotion) was done at four university trial sites in the UK, Germany, Spain, and Belgium. Participants were recruited from schools, universities, and social media from the four respective countries. Eligible participants were aged 16-22 years with increased vulnerability indexed by baseline emotional competence profile, without current or past diagnosis of major depression. Participants were randomly assigned (1:1:1) to usual practice plus either the personalised emotional competence self-help app, the generic CBT self-help app, or the self-monitoring app by an independent computerised system, minimised by country, age, and self-reported gender, and followed up for 12 months post-randomisation. Outcome assessors were masked to group allocation. The primary outcome was depression symptoms (according to Patient Health Questionnaire-9 [PHQ-9]) at 3-month follow-up, analysed in participants who completed the 3-month follow-up assessment. The study is registered with ClinicalTrials.gov, NCT04148508, and is closed. Between Oct 15, 2020, and Aug 3, 2021, 1262 participants were enrolled, including 417 to the emotional competence app, 423 to the CBT app, and 422 to the self-monitoring app. Mean age was 18·8 years (SD 2·0). Of 1262 participants self-reporting gender, 984 (78·0%) were female, 253 (20·0%) were male, 15 (1·2%) were neither, and ten (0·8%) were both. 178 participants in the emotional competence app group, 191 in the CBT app group, and 199 in the self-monitoring app group completed the follow-up assessment at 3 months. At 3 months, depression symptoms were lower with the CBT app than the self-monitoring app (mean difference in PHQ-9 -1·18 [95% CI -2·01 to -0·34]; p=0·006), but depression symptoms did not differ between the emotional competence app and the CBT app (0·63 [-0·22 to 1·49]; p=0·15) or the self-monitoring app and emotional competence app (-0·54 [-1·39 to 0·31]; p=0·21). 31 of the 541 participants who completed any of the follow-up assessments received treatment in hospital or were admitted to hospital for mental health-related reasons considered unrelated to interventions (eight in the emotional competence app group, 15 in the CBT app group, and eight in the self-monitoring app group). No deaths occurred. The CBT app delayed increases in depression symptoms in at-risk young people relative to the self-monitoring app, although this benefit faded by 12 months. Against hypotheses, the emotional competence app was not more effective at reducing depression symptoms than the self-monitoring app. CBT self-help apps might be valuable public mental health interventions for young people given their scalability, non-consumable nature, and affordability. European Commission.

Digital atmospheres of mental health apps: A new materialist exploration of the experience of managing mental (ill)health using an app

Apps are an increasingly commonplace source of support and authority for managing mental (ill)health symptoms. This article analyses their increasingly agential role in support practices through their capacity to reconfigure individual and collective understandings of mental health. New materialist research acknowledges the agency of both human and non-human actors and considers the on-going relations of bodies and technology within social contexts. We apply the concept of digital atmosphere to trace the material-affective forces constituting the experience of using a mental health app. Our findings demonstrate the multiplicity of ways people improvise with their use, situated within their own unique contexts and environments, and the influence of relationships on individual perceptions and engagements with the apps. Furthermore, we consider the different ways in which participants perceive their mental (ill)health, sometimes in fractious conflict with the apps. Finally, we highlight that features of for-profit apps can reshape understanding of mental (ill)health needs and perceptions of responsibility, resulting in the capacity for apps to be simultaneously disciplining and liberating. The findings provide insight of significant value to mental health policy and practice.

Bridging the Gap: Use of Mental Health Apps in the Adolescent Population.

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“Effectiveness of School-based Scaling up Teen Mental Health Program through peer synergy (SUTMP) on mental health promotion, mental health literacy, and resilience among senior secondary students of Sikkim, India- A Cluster Randomized Controlled Trial Protocol.”

BackgroundMental health conditions are a significant burden during adolescence, with up to 50% starting before age 14. Suicide is among the top three causes of death in this age group, highlighting the need for effective mental health interventions. ObjectiveThe primary objective of the study is to determine the effectiveness of school-based Scaling up Teen Mental Health Program through peer synergy (SUTMP) on mental health literacy among senior secondary students. MethodsA cluster randomized controlled trial will be conducted among the students of government senior secondary schools. The intervention comprises five modules focusing on mental health literacy, mental health promotion, peer synergy on first aid in mental health, strengthening resilience, and the fifth module focuses on relaxation exercises, meditation and deep breathing techniques, and mindfulness with “Teen mental health app.” Students will be assessed using the Resilience Scale, Mental Health Promotion Knowledge Scale, Peer Mental Health Stigmatization Scale, Teen Mental Health Literacy Scale, and Peer Synergy on Mental Health First Aid Scale. Assessment will be done before the intervention, one week after, at three and six months post-intervention. Expected ResultsThe anticipated outcome of the study is that the school-based Scaling up Teen Mental Health Program (SUTMP) will increase mental health literacy among school students, strengthen their resilience skills, and increase the use of a peer-led approach for providing initial mental health first aid. ConclusionThe study will employ an innovative module for delivering the intervention, integrating on-site and app-based approaches in a blended manner.

Analysis of cognitive behavioural therapy apps for generalised anxiety disorder: Evidence-based content and user experience

Mental illness substantially contributes to the global burden of disease, with anxiety high in prevalence. The increase of mobile technology, mental health apps have potential to lessen this burden. However, within apps, the use of evidence-based interventions, such as cognitive behavioural therapy (CBT) are limited. Regardless, many commercially available mental health apps are highly rated by users, highlighting the need to understand what makes mental health apps valuable to the user. The contribution of this study was to uncover apps that support generalised anxiety disorder (GAD) and worry with a CBT basis, explore app functionality, and user experience. Firstly, by identifying apps that support GAD and worry and included CBT. Secondly, by identifying and analysing therapeutic and engagement functions within the apps, and finally, by thematically analysing user reviews. Six apps were identified to support GAD and worry that purported to be CBT-based. However, CBT therapeutic features and engagement features were minimally present in the apps. User reviews yielded 112 comments about the apps and key themes were identified about the app users’ global experiences with the app, and about the combination of technological (e.g., useability, reliability) and therapeutic experiences (e.g., learning and using skills). Future development of quality apps to support GAD and worry must consider the empirical standing of both therapeutic and technology aspects, to provide efficacious and engaging interventions.

Implementing a mental health app intervention in a university setting: multi-methods evaluation study

Purpose The number of university students seeking mental health support is rapidly increasing. To provide additional psychological support to students accessing well-being services, this study aimed to pilot a mental health Web application (app) called Orpheus®. Design/methodology/approach Guided by student consultations, a multi-methods approach was adopted, including an examination of in-app data, chart reviews of routinely collected student information and interviews with mental health practitioners. Usage data were analysed descriptively. Changes in mental health outcomes were examined using means, standard deviations and reliable change indices for anxiety and depression scores. Inductive and deductive thematic analysis was conducted on qualitative data from staff interviews and student feedback. Findings A total of 26 students registered an account with 39 completed app visits. On 37 of the 39 (94.9%) occasions, students reported reductions in the intensity of unwanted negative emotions. Statistically significant reductions in the average pooled anxiety and depression scores were observed. Of the 15 students who completed pre- and post-routine outcome measures, between 20% and 60% showed reliable and meaningful symptom improvements. Students reported that the app was helpful and easy to set up and use, with no adverse events. Practitioners highlighted barriers and facilitators related to the technology features, situational contexts and individual differences. Originality/value Integrating Orpheus in real-world settings resulted in promising implementation processes, potential for future uptake and positive outcomes. However, ongoing research, staff training and app testing are needed to further improve the implementation processes for digital mental health interventions.

Mobile mental health application use, and app feature preferences among individuals with mental disorders in Ethiopia: A cross-sectional survey

BackgroundMobile health applications have been shown to assist in the treatment of mental illnesses, yet their potential remains underutilized. As supportive care, mental health applications use may be useful tools in improving mental health literacy and treatment outcomes, but patients’ use of and interest in using these apps have not been studied in low-income countries like Ethiopia. This study explores the determinants of patients’ mental health app use interests and app feature preferences. MethodsA cross-sectional study was conducted with 419 outpatient individuals with mental health disorders at Amanuel Mental Specialized Hospital, Ethiopia, between October and November 2023, using a convenience sampling method. Patients’ self-reported mental health app use, interests, attitudes, and app feature preferences were collected. A multivariate logistic regression model was used to identify the associated factors. ResultsOverall prevalence of not interested, somewhat interested, interested, and extremely interested in mental health app use was 5.3 %, 16.9 %, 27.7 %, and 50.1 % respectively. The proportion of current mental health apps use was low (21.2 %). Current mental health app use is associated with living in an urban area (AOR = 6.69, CI: 3.19–14) and having a higher education level (4.12 (2.02–8.04). Furthermore, app features such as psychoeducation, symptom tracking, and self-management techniques ranked as the most preferred app features. ConclusionsMost study participants were interested in using mental health apps, but only about one in four were using mental health apps. This suggests promise for their utility in the Ethiopian context. App developers and policymakers should consider rural residents’, lower educational levels, and patient app preferences when developing these applications.

Examining the role of personality functioning in a hierarchical taxonomy of psychopathology using two years of ambulatory assessed data

The Hierarchical Taxonomy of Psychopathology (HiTOP) arranges phenotypes of mental disorders based on empirical covariation, ranging from narrowly defined symptoms to higher-order spectra of psychopathology. Since the introduction of personality functioning (PF) in DSM-5 and ICD-11, several studies have identified PF as a predictor of transdiagnostic aspects of psychopathology. However, the role of PF in the HiTOP classification system has not been systematically examined. This study investigates how PF can be integrated into HiTOP, whether PF accounts for transdiagnostic variance captured in higher-order spectra, and how its predictive value for future affective well-being (AWB) and psychosocial impairment (PSI) compares to the predictive value of specific psychopathology beyond PF. To this end, we examined two years of ambulatory assessed data on psychopathology, PF, PSI, and AWB of N = 27,173 users of a mental health app. Results of bass-ackwards analyses largely aligned with the current HiTOP working model. Using bifactor modeling, aspects of PF were identified to capture most of the internalizing, thought disorder, and externalizing higher-order factor variance. In longitudinal prediction analyses employing bifactor-(S-1) modeling, PF explained 58.6% and 30.6% of variance in PSI and AWB when assessed across one year, respectively, and 33.1% and 23.2% of variance when assessed across two years. Results indicate that personality functioning may largely account for transdiagnostic variance captured in the higher-order components in HiTOP as well as longitudinal outcomes of PSI and AWB. Clinicians and their patients may benefit from assessing PF aspects such as identity problems or internal relationship models in a broad range of mental disorders. Further, incorporating measures of PF may advance research in biological psychiatry by providing empirically sound phenotypes.

Development of a Mental Health Apps Recommender Platform.

The aim of the paper is to establish the requirements and methodology for the development and implementation of a recommender system for mental health apps to support patients in self-managing their mental health while awaiting formal treatment. The system was developed using an algorithm-based approach, including: (1) user needs assessment through literature review and interviews with various stakeholders, (2) software modelling and prototype creation, and (3) bench testing of the prototype with health experts and users. Based on initial exploration of users' requirements, relevant standards and regulations, a library of trusted mental health apps was compiled and a recommendation engine was built to generate accurate user profiles and deliver personalised health recommendations, which will be further tested to ensure quality. Developing a constructive mental health recommendation system requires the establishment of clear and comprehensive requirements, as well as a robust methodology adressing concerns related to data security, confidentiality, safety, and reliability. Subsequent research may compare various indicators of mental health outcomes at the start and end of patients' waiting period to gain more insights into how the recommender system could be further improved to enhance user experience and their overall well-being.

Dreaming big with little therapy devices: automated therapy from India

This paper examines the aspirations, imaginaries and utopias of designers of an AI-based mental health app in India. By looking at automated therapy as both technological fix and sociotechnical object, I ask, What can we learn from engaging with psy technologists’ imaginaries and practices of health care futures? What are the assumptions they encode in the app? How does automated therapy reconfigure the geographies and temporalities of care? While automated therapy as instantiated by Wysa provides, I argue, a modest mental health intervention, the scalar aspirations of designers are anything but small. The paper proceeds in three steps. First, it turns to designers’ imaginaries of what it means to care for current mental health needs in digitally saturated lifeworlds and how they inscribe them into the app. It identifies nonjudgmental listening, anonymity, acceptance, reframing, and agency as key ideas encoded in Wysa’s sociotechnical algorithms, along with a congruence between entrepreneurial and encoded ethics of care. Second, it situates automated therapy within anthropological scholarship on ‘little’ technical devices in global health to argue that automated therapy devices such as Wysa articulate dreams for minimalist interventions with macro effects. Finally, it explores the new geographies and temporalities of care that automated therapy spurs, tracing the ways the app bridges various spatial and temporal gaps and obstacles of human therapy and upends common global health pathways. This paper contributes to recent scholarship on aspirations, dreams and utopias and on digitization and datafication in global health.

Mental health apps within the healthcare system: associations with stigma and mental health literacy

BackgroundMental health apps (MHA) as a new form of self-help have gained popularity over the last years. Tentative evidence has suggested that MHA might also present a first step into the help-seeking process, because their anonymity circumvents stigma. Using MHA might also increase mental health literacy and reduce stigma through psychoeducation, which could encourage formal help-seeking. To date, it remains unclear how MHA usage relates to stigma, mental health literacy, and utilization of professional help within the public healthcare system.MethodsWe conducted a cross-sectional survey with N = 1,263 individuals from the general population (mean age 32.56 ± 11.51, 58.2% female) and employed structural equation modeling to investigate associations between stigma (against individuals with psychological disorders and against help-seeking), mental health literacy, MHA usage, and service utilization within the public healthcare system for mental health problems.ResultsMHA usage is high within the general population (40.5% of participants). Results indicate that higher stigma against help-seeking is associated with and increased likelihood of MHA usage, which in turn is positively associated with increased likelihood of service utilization. Symptoms of psychological disorder were associated with higher likelihood of service utilization, but not MHA usage.ConclusionsIt can be concluded that MHA appeal especially to individuals with higher stigma against help-seeking and therefore might provide an opportunity to reach underserviced individuals. At the current time, MHA usage appears to take place mostly in a preventative manner or as a supplement to treatment. Better integration into the public healthcare system might help to exploit both preventative and interventional benefits of MHA.

Evaluating mobile mental health apps using the mobile application rating scale (MARS) in the U.S.

ABSTRACT Objective The objectives of this study were to comprehensively review and evaluate the quality of mobile mental health apps using the MARS and to identify high-quality apps. Method A quantitative content analysis was undertaken. A systematic search of the U.S. Apple App Store and Google resulted in the selection of 25 mobile mental health applications. Coders evaluated these applications using a set of criteria derived from the literature. The intraclass correlation coefficient was employed to assess two-way mixed interrater reliability. Descriptive statistics, including frequency and mean (SD) scores, were calculated for each criterion. Results MARS has two parts: classification category and app quality criteria. For the classification category, we found the majority of apps (1) focused on relieving negative emotions, (2) relied on principles of Cognitive Behavior Therapy (CBT) and Acceptance and Commitment Therapy (ACT), and (3) offered reminders to perform an activity and required login information. Regarding app quality, the 25 apps scored highest in functionality, followed by aesthetics, engagement, and information among the four categories. Wysa was the highest-scoring mental health app, followed by Woebot and Youper. Discussion The study offers descriptive and technical information about the mobile mental health applications, including their focus, theoretical background, and technical aspects. The findings demonstrates that the majority of these applications are of high quality. Consequently, the results facilitate an objective and comprehensive understanding of commercial mental health mobile apps.

Mental health app boost my mood (BMM) as preventive early intervention for adolescents with (sub)clinical depressive symptoms

BackgroundDepression is a common mental disorder. Detecting (sub)clinical depressive symptoms in adolescents at an early stage and offering a low-threshold early intervention can minimize the risk of serious and/or long-term depression. As such, a digital intervention can be a low-threshold preventive and early intervention. This study aims to examine whether the Boost My Mood (BMM)-app is a suitable preventive early intervention for adolescents with (sub)clinical depressive symptoms.MethodsThis naturalistic single-arm evaluation study (N = 50) was conducted in adolescents aged 16–21 with (sub)clinical depressive symptoms. Furthermore, the BMM-app was studied in relation to anxiety, worrying, stress, and sleeping problems. An exploratory objective was to determine whether positive expectations and social support are related to app use.ResultsThe study showed a significant decrease in not only depressive symptoms, but also anxiety, worrying and stress while using the BMM-app. Sleeping problems did not significantly decrease over time while using the BMM-app. The degree of use of the BMM-app and telling significant others about using the BMM-app were both not related to a decrease in depressive symptoms. The BMM-app was used significantly more when the adolescent had told relatives about their depressive symptoms.ConclusionsA digital intervention, such as the BMM-app, can be a low-threshold preventive and early intervention for adolescents with (sub)clinical depressive symptoms. Beneficial effects of the BMM-app were reported on depressive symptoms as well as other aspects of quality of life, such as anxiety, worrying, and stress. Whereas several factors may have played a role in the current findings on depressive symptoms, there are reasons to assume that part of the reduction in symptoms could be attributed to the BMM-app. Although no causality can be assumed, this study is a first step in the implementation of preventive apps in mental health care.

Mental health apps and U.S. military veterans: Perceived importance and utilization of the National Center for Posttraumatic Stress Disorder app portfolio.

U.S. veterans have historically experienced more mental health concerns as compared to the general population, yet face a variety of barriers to accessing care. Evidence-based and accessible resources, such as mobile apps, are needed to respond to the unique needs of a diverse veteran population. The U.S. Department of Veterans Affairs (VA's) National Center for Posttraumatic Stress Disorder has created a one-of-a-kind portfolio of mental health apps to target the needs of veterans and support the self-management of common concerns related to posttraumatic stress disorder. Using data from a nationally representative sample of U.S. veterans, the present study sought to examine how veterans perceived the importance of making each self-management app available to other Veterans; factors impacting veterans' intent to try each app; and actual uptake of each app. Results revealed that while 46.7%-75.0% of veterans reported that the apps are important for veterans, 5.8%-19.2% reported that they would be likely to download the apps, and only 5.0% reported having ever used any of them. Veterans who used any of the apps were more likely to be employed, have served two or more deployments, be married or partnered, use the VA as their primary source of health care, had more medical conditions, and were less likely to identify as Black. With respect to future app use, Black veterans were to 2-5 times more likely than White veterans to indicate a desire to download each of the apps. Other variables that showed consistent associations with increased likelihood of app download included greater smartphone utilization, being married or having a partner, lower household income, and history of mental health treatment. Implications of these results for the broader dissemination of mental health apps and promotion of their uptake are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Does it matter how meditation feels? An experience sampling study.

Meditation apps are the most widely used mental health apps. The precise mechanisms underlying their effects remain unclear. In particular, the degree to which affect experienced during meditation is associated with outcomes has not been established. We used the meditation app arm of a recently completed randomized controlled trial comparing a self-guided meditation app (Healthy Minds Program) to a waitlist control. Predominantly distressed public school employees (n = 243, 80.9% with clinically elevated depression and/or anxiety) reported positive and negative affect during meditation practice. Data were analyzed using two-level multivariate latent growth curve models (observations nested within participants) that simultaneously attended to both positive and negative affect. We examined whether positive and negative affect during meditation changed over time and whether these changes were associated with changes in psychological distress (parent trial's preregistered primary outcome) at posttest or 3-month follow-up. On average, participants reported decreased negative affect but no change in positive affect during meditation over time. Increased positive affect and decreased negative affect during meditation were associated with improvements in distress at posttest and follow-up. Change in positive affect was a stronger predictor of distress at follow-up than change in negative affect. Despite notions embedded within mainstream mindfulness meditation training that deemphasize the importance of the affective experience of practice (i.e., nonjudgmental awareness of present moment experience, regardless of valence), results indicate that these experiences contain signals associated with outcomes. Monitoring affect during meditation may be worthwhile to guide intervention delivery (i.e., measurement-based care, precision medicine). (PsycInfo Database Record (c) 2024 APA, all rights reserved).