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一款针对惊恐障碍和广场恐惧症的移动应用程序:来自多方法可行性研究的见解。

A mobile application for panic disorder and agoraphobia: Insights from a multi-methods feasibility study.

作者信息

Ebenfeld Lara, Kleine Stegemann Stefan, Lehr Dirk, Ebert David Daniel, Funk Burkhardt, Riper Heleen, Berking Matthias

机构信息

Leuphana University, Lueneburg, Germany.

Friedrich-Alexander-University Nuremberg-Erlangen, Germany.

出版信息

Internet Interv. 2019 Nov 25;19:100296. doi: 10.1016/j.invent.2019.100296. eCollection 2020 Mar.

Abstract

BACKGROUND

Panic disorder with and without agoraphobia (PD) is a common psychological disorder. Internet-based interventions have the potential to offer highly scalable low-threshold evidence-based care to people suffering from PD. GET.ON Panic is a newly developed internet-based intervention addressing symptoms of PD. In order to transfer the training into the daily life of the individuals, we integrated mobile components in the training and created a so-called hybrid online training. The development and beta-testing of such a training requires a novel interdisciplinary approach between IT specialists and psychologists. From this point of view, we would like to share our experiences in this exploratory paper.

METHODS

This initial feasibility study ( = 10) offers, on the one hand, a brief overview of the interdisciplinary development phase of the mobile application and on the other hand, provides first insights into the usage, usability and acceptance of this mobile application using qualitative interview data as well quantitative measures of 8 completing participants. For these reasons, we used a pre-posttest design without a control group. Furthermore, we present initial clinical outcomes of the intervention on e.g. panic symptom severity, depressive symptoms as well additional anxiety measures. Finally, we end with implications for further research in the relatively new field of mobile mental health.

RESULTS

Overall, usability, user satisfaction, motivational value and technology acceptance of the app were perceived as high. The usage of app components was diverse: The use of interoceptive exposure exercises and daily summaries on anxiety and mood was highest while using in-vivo exposure exercises and monitoring panic symptoms was perceived as difficult. Furthermore, participants showed after the training less clinical symptoms as at baseline-assessment.

DISCUSSION

The current feasibility study contributes to an in-depth understanding of the potential of mobile technology in e-mental health. Overall, the GET.ON Panic app appears to be an acceptable and motivational part of a CBT-based hybrid online training for PD that has the potential to promote training success. After some suggested adjustments have been made, the efficacy should be investigated in a randomized controlled trial.

摘要

背景

伴或不伴有广场恐惧症的惊恐障碍(PD)是一种常见的心理障碍。基于互联网的干预措施有潜力为患有惊恐障碍的人提供高度可扩展的低门槛循证护理。GET.ON Panic是一种新开发的针对惊恐障碍症状的基于互联网的干预措施。为了将训练融入个体的日常生活,我们在训练中整合了移动组件,并创建了一种所谓的混合在线训练。这种训练的开发和测试需要信息技术专家和心理学家之间一种全新的跨学科方法。从这个角度出发,我们想在这篇探索性论文中分享我们的经验。

方法

这项初步可行性研究(n = 10)一方面简要概述了移动应用的跨学科开发阶段,另一方面使用定性访谈数据以及8名完成参与的受试者的定量测量结果,首次深入了解了该移动应用的使用情况、可用性和可接受性。出于这些原因,我们采用了无对照组的前后测设计。此外,我们展示了干预措施在例如惊恐症状严重程度、抑郁症状以及其他焦虑测量指标方面的初步临床结果。最后,我们阐述了对移动心理健康这一相对较新领域进一步研究的启示。

结果

总体而言,该应用程序的可用性、用户满意度、激励价值和技术接受度被认为较高。应用组件的使用情况各不相同:内感受性暴露练习以及焦虑和情绪的每日总结的使用频率最高,而现场暴露练习的使用以及惊恐症状的监测则被认为较难。此外,与基线评估相比,参与者在训练后临床症状有所减轻。

讨论

当前的可行性研究有助于深入理解移动技术在电子心理健康中的潜力。总体而言,GET.ON Panic应用程序似乎是基于认知行为疗法的PD混合在线训练中可接受且具有激励作用的一部分,有可能促进训练的成功。在进行一些建议的调整后,应在随机对照试验中对其疗效进行研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/acdb/6926267/ba8dd6b1dfec/gr1.jpg

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