Rauschenberg Christian, Boecking Benjamin, Paetzold Isabell, Schruers Koen, Schick Anita, van Amelsvoort Thérèse, Reininghaus Ulrich
Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands.
JMIR Ment Health. 2021 Aug 5;8(8):e25650. doi: 10.2196/25650.
Digital interventions offer new avenues for low-threshold prevention and treatment in young people. Ecological momentary interventions (EMIs) represent a powerful approach that allows for adaptive, real-time, and real-world delivery of intervention components in daily life by real-time processing of ecological momentary assessment (EMA) data. Compassion-focused interventions (CFIs) may be particularly amenable to translation into an EMI to strengthen emotional resilience and modify putative risk mechanisms, such as stress sensitivity, in the daily lives of young help-seeking individuals.
This study aims to investigate the feasibility, safety, and initial therapeutic effects of a novel, accessible, transdiagnostic, ecological momentary CFI for improving emotional resilience to stress (EMIcompass).
In this uncontrolled pilot study, help-seeking youth with psychotic, depressive, or anxiety symptoms were offered the EMIcompass intervention in addition to treatment as usual. The EMIcompass intervention consisted of a 3-week EMI (including enhancing, consolidating, and EMA-informed interactive tasks) administered through a mobile health app and three face-to-face sessions with a trained psychologist intended to provide guidance and training on the CFI exercises presented in the app (ie, training session, follow-up booster session, and review session).
In total, 10 individuals (mean age 20.3 years, SD 3.8; range 14-25) were included in the study. Most (8/10, 80%) participants were satisfied and reported a low burden of app usage. No adverse events were observed. In approximately one-third of all EMAs, individuals scored high on stress, negative affect, or threat anticipation during the intervention period, resulting in real-time, interactive delivery of the CFI intervention components in addition to weekly enhancing and daily consolidating tasks. Although the findings should be interpreted with caution because of the small sample size, reduced stress sensitivity, momentary negative affect, and psychotic experiences, along with increased positive affect, were found at postintervention and the 4-week follow-up. Furthermore, reductions in psychotic, anxiety, and depressive symptoms were found (r=0.30-0.65).
Our findings provide evidence on the feasibility and safety of the EMIcompass intervention for help-seeking youth and lend initial support to beneficial effects on stress sensitivity and mental health outcomes. An exploratory randomized controlled trial is warranted to establish the feasibility and preliminary evidence of its efficacy.
数字干预为年轻人提供了低门槛预防和治疗的新途径。生态瞬时干预（EMI）是一种强大的方法，它通过对生态瞬时评估（EMA）数据的实时处理，在日常生活中以适应性、实时和真实世界的方式提供干预成分。以同情心为重点的干预（CFI）可能特别适合转化为EMI，以增强情绪恢复力，并改变寻求帮助的年轻人日常生活中假定的风险机制，如压力敏感性。
本研究旨在调查一种新型、可及、跨诊断的生态瞬时CFI（EMIcompass）对提高情绪压力恢复力的可行性、安全性和初步治疗效果。
在这项非对照的试点研究中，除常规治疗外，为有精神病性、抑郁或焦虑症状的寻求帮助的青少年提供EMIcompass干预。EMIcompass干预包括通过移动健康应用程序进行的为期3周的EMI（包括强化、巩固和基于EMA的互动任务），以及与一名经过培训的心理学家进行的三次面对面会议，旨在为应用程序中呈现的CFI练习提供指导和培训（即培训课程、后续强化课程和复习课程）。
本研究共纳入10名个体（平均年龄20.3岁，标准差3.8；范围14 - 25岁）。大多数（8/10，80%）参与者表示满意，并报告应用程序使用负担较低。未观察到不良事件。在所有EMA中，约三分之一的个体在干预期内的压力、消极情绪或威胁预期得分较高，这导致除了每周的强化任务和每日的巩固任务外，还实时、交互式地提供CFI干预成分。尽管由于样本量小，研究结果应谨慎解释，但在干预后和4周随访时发现压力敏感性降低、瞬时消极情绪和精神病性体验减少，同时积极情绪增加。此外，还发现精神病性、焦虑和抑郁症状有所减轻（r = 0.30 - 0.65）。
我们的研究结果为EMIcompass干预对寻求帮助的青少年的可行性和安全性提供了证据，并初步支持其对压力敏感性和心理健康结果的有益影响。有必要进行一项探索性随机对照试验，以确定其可行性和疗效的初步证据。
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