Mak Winnie Ws, Tong Alan Cy, Yip Sindy Yc, Lui Wacy Ws, Chio Floria Hn, Chan Amy Ty, Wong Celia Cy
Diversity and Well-being Laboratory, Department of Psychology, The Chinese University of Hong Kong, Shatin, NT, China (Hong Kong).
Center for Personal Growth and Crisis Intervention of the Corporate Clinical Psychology Services, Hospital Authority, Hong Kong, China (Hong Kong).
JMIR Ment Health. 2018 Oct 11;5(4):e60. doi: 10.2196/mental.8597.
Mindfulness-based interventions, self-compassion training, and cognitive behavioral therapy have garnered much evidence in its salutary effects on mental health. With increasing application of smartphone and mobile technology on health promotion, this study investigated the efficacy and possible moderators of mindfulness, self-compassion, and cognitive behavioral psychoeducation training mobile apps in the improvement of mental health.
The aim of this study was to examine the efficacy of 3 mobile app-based programs: mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation program in improving mental well-being and reducing psychological distress. Changes in mindful awareness and self-compassion were also assessed. To further delineate the suitability of each program for different types of individuals, individual difference variables (ie, discomfort with emotions and tolerance for ambiguity) were explored for potential moderation.
This study was a 3-arm, randomized, controlled, noninferiority trial examining the efficacy of mindfulness-based program, self-compassion program, and cognitive behavioral psychoeducation. Participants were randomized into either 1 of the 3 conditions. Throughout the 4-week, 28-session program, participants spent 10-15 min daily reviewing the course content and practicing various related exercises. At preprogram, postprogram, and 3-month follow-up, participants also completed Web-based measures of mental well-being, psychological distress, mindful-awareness, and self-compassion as well as the proposed moderators.
Among the 2161 study participants, 508 and 349 completed the post- and 3-month follow-up assessment, respectively. All 3 conditions (mindfulness-based program: N=703; cognitive behavioral psychoeducation: N=753; self-compassion program: N=705) were found to be efficacious in improving mental well-being and reducing psychological distress. All conditions enhanced mindful awareness at postprogram. Significant interaction effect was found on self-compassion; cognitive behavioral psychoeducation and self-compassion program, but not mindfulness-based program, significantly enhanced self-compassion at postprogram. No significant differences regarding usage and users' satisfaction were found among the 3 conditions. None of the proposed moderators were found to be significant.
Mindfulness-based, self-compassion, and cognitive behavioral psychoeducation mobile apps were efficacious in improving mental well-being and reducing psychological distress among adults at postprogram and 3-month follow-up. Future app-based psychological training programs should consider gamification and personalization of content or feedback to enhance engagement and mitigate the high attrition rates that are common in app-based health promotion programs.
Chinese Clinical Trial Registry (ChiCTR) ChiCTR-TRC-13003468; http://www.chictr.org.cn/hvshowproject.aspx?id=6220 (Archived by WebCite at http://www.webcitation.org/734PlOz50).
基于正念的干预、自我同情训练和认知行为疗法在对心理健康的有益影响方面已积累了大量证据。随着智能手机和移动技术在健康促进方面的应用日益增加，本研究调查了正念、自我同情和认知行为心理教育训练移动应用程序在改善心理健康方面的功效及可能的调节因素。
本研究旨在检验3种基于移动应用程序的方案的功效：基于正念的方案、自我同情方案和认知行为心理教育方案，以改善心理健康和减轻心理困扰。还评估了正念意识和自我同情的变化。为进一步阐明每个方案对不同类型个体的适用性，探索了个体差异变量（即对情绪的不适感和对模糊性的耐受性）的潜在调节作用。
本研究是一项三臂、随机、对照、非劣效性试验，检验基于正念的方案、自我同情方案和认知行为心理教育的功效。参与者被随机分为3种情况中的一种。在为期4周、共28节的课程中，参与者每天花10 - 15分钟复习课程内容并练习各种相关练习。在课程开始前、课程结束后和3个月随访时，参与者还完成了基于网络的心理健康、心理困扰、正念意识和自我同情的测量以及所提出的调节因素的测量。
在2161名研究参与者中，分别有508名和349名完成了课程结束后的评估和3个月随访评估。发现所有3种情况（基于正念的方案：N = 703；认知行为心理教育：N = 753；自我同情方案：N = 705）在改善心理健康和减轻心理困扰方面均有效。所有情况在课程结束后均提高了正念意识。在自我同情方面发现了显著的交互作用；认知行为心理教育和自我同情方案，但基于正念的方案未显著提高课程结束后的自我同情。3种情况在使用和用户满意度方面未发现显著差异。未发现所提出的调节因素有显著意义。
基于正念、自我同情和认知行为心理教育的移动应用程序在课程结束后和3个月随访时对改善成年人的心理健康和减轻心理困扰有效。未来基于应用程序的心理训练方案应考虑内容或反馈的游戏化和个性化，以提高参与度并减轻基于应用程序的健康促进方案中常见的高流失率。
中国临床试验注册中心（ChiCTR）ChiCTR - TRC - 13003468；http://www.chictr.org.cn/hvshowproject.aspx?id=6220（由WebCite存档于http://www.webcitation.org/734PlOz50）
