Jongeneel Alyssa, Libedinsky Ilan, Reinbergen Anouk, Tromp Nynke, Delespaul Philippe, Riper Heleen, van der Gaag Mark, van den Berg David
Department of Clinical, Neuro- and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Van der Boechorststraat 7, 1081 BT Amsterdam, Netherlands.
Mark van der Gaag Research Centre, Parnassia Psychiatric Institute, Zoutkeetsingel 40, 2512 HN Den Haag, Netherlands.
Internet Interv. 2022 Oct 5;30:100580. doi: 10.1016/j.invent.2022.100580. eCollection 2022 Dec.
BACKGROUND: Temstem is a mobile application developed in cooperation with voice-hearing persons to help them cope with distressing voices. After psychoeducation about voice hearing, Temstem offers two functions: Silencing is a mode designed to inhibit voice activity through the processing of incompatible language; the Challenging mode introduces dual tasking (as used in eye movement desensitisation and reprocessing) designed to reduce the emotionality and vividness of a voice memory. Two different language games, Lingo Tapper and Word Link, are provided, containing both functions. This study aimed to explore the momentary effects of Temstem on voice-hearing distress, emotionality and vividness in a naturalistic sample of voice-hearing app users. METHOD: Temstem is freely available in the Netherlands. We collected data through the app from 1048 individual users who had given informed consent for the study. We assessed changes in pre- and post-session scores on distress, emotionality and vividness, and we evaluated differences in outcomes between the games and whether effects remained stable over multiple sessions. RESULTS: Users had been hearing voices for an average of 4.95 years; 79 % had been informed about Temstem by a mental health therapist or coach. After a Silencing session, voice-hearing distress was reduced, (958) = 27.12, < .001, = 0.49; the degree of reduction remained stable after repeated use, (1, 7905.57) = 1.91, = .167. After a Challenging session, emotionality, (651) = 23.16, < .001, = 0.74, and the vividness of voice memories were reduced, (651) = 22.20, < .001, = 0.71; both diminished slightly with frequent use, (1, 2222.86) = 7.21, < .05; (1, 2289.92) = 4.25, < .05. In comparison with Lingo Tapper, larger reductions were seen for a Word Link game: emotionality (226) = 2.88, < .005, = 0.21; vividness (226) = 2.29, < .05, = 0.17. DISCUSSION: In this heterogeneous sample of voice-hearing individuals, Temstem appeared to be a promising coping tool; momentary voice-hearing distress and the emotionality and vividness of voice statements were reduced after a Temstem session. Despite important limitations and the need for more research, naturalistic studies of user app data may yield interesting and generalisable findings.
背景：Temstem是一款与幻听患者合作开发的移动应用程序，旨在帮助他们应对困扰性幻听。在进行关于幻听的心理教育后，Temstem提供两项功能：静音模式旨在通过处理不兼容语言来抑制幻听活动；挑战模式引入了双重任务（如眼动脱敏再处理中所使用的），旨在降低幻听记忆的情感强度和生动程度。该应用提供了两款不同的语言游戏，即Lingo Tapper和Word Link，均具备这两项功能。本研究旨在探讨Temstem对幻听应用程序自然样本用户的幻听困扰、情感强度和生动程度的即时影响。 方法：Temstem在荷兰可免费获取。我们通过该应用收集了1048名已签署知情同意书参与本研究的个体用户的数据。我们评估了每次使用前后在困扰、情感强度和生动程度方面的得分变化，并评估了两款游戏在结果上的差异以及多次使用后效果是否保持稳定。 结果：用户幻听的平均时长为4.95年；79%的用户是由心理健康治疗师或教练告知其Temstem这款应用的。在一次静音模式使用后，幻听困扰减轻，（958）=27.12，<0.001，=0.49；反复使用后减轻程度保持稳定，（1，7905.57）=1.91，=0.167。在一次挑战模式使用后，情感强度，（651）=23.16，<0.001，=0.74，以及幻听记忆的生动程度降低，（651）=22.20，<0.001，=0.71；频繁使用后二者均略有下降，（1，2222.86）=7.21，<0.05；（1，2289.92）=4.25，<0.05。与Lingo Tapper相比，Word Link游戏在情感强度（226）=2.88，<0.005，=0.21；生动程度（226）=2.29，<0.05，=0.17方面的降低幅度更大。 讨论：在这个幻听个体的异质性样本中，Temstem似乎是一个有前景的应对工具；一次Temstem使用后，即时幻听困扰以及幻听陈述的情感强度和生动程度均有所降低。尽管存在重要局限性且需要更多研究，但对用户应用程序数据的自然主义研究可能会得出有趣且具有普遍性的发现。
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