Internet Interventions-The Application of Information Technology in Mental and Behavioural Health最新文献_第3页

Five years of app evaluation: Insights from a framework in practice – a systematic review on the m-health index and navigation database 五年的应用程序评估：从实践框架的见解——对移动医疗索引和导航数据库的系统回顾

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-11-15 DOI: 10.1016/j.invent.2025.100888

Julian Herpertz , Bridget Dwyer , Ellen Wagner , Jane Mikkelson , Nils Opel , John Torous

Introduction

As the number of health apps continues to rise, concerns about their quality, privacy standards, and adherence to evidence-based healthcare remain. While multiple frameworks exist to assess app quality, a standardized, cross-domain approach is lacking. The M-Health Index and Navigation Database (MIND) comprises a structured framework for app evaluation and a publicly accessible database that applies this framework to rate individual apps. This allows for longitudinal tracking of quality metrics and comparisons across different health app categories.

Methods

We conducted a systematic review to identify studies that utilized either the MIND database or its framework to evaluate health apps. Studies were included if they used MIND in their methodology to evaluate health apps. Data were synthesized descriptively, and two-proportion z-tests were applied for comparisons.

Results

We identified 22 studies, including 16 evaluating commercially available health apps. The most frequently assessed metrics were privacy policies, operating system compatibility, cost, and evidence backing. Only 15 % of mental health apps were supported by feasibility or efficacy studies, nearly one-fourth lacked a privacy policy, and 44 % explicitly disclosed sharing personal health information with third parties. Similar deficiencies were found across non-mental health domains, indicating that concerns regarding app quality and data privacy may not be unique to mental health.

Discussion

Our findings suggest that evidence and privacy concerns are prevalent across almost all health app categories, highlighting the need for stronger regulatory oversight and improved validation standards. MIND serves as a valuable tool for evaluating digital health apps, supporting both app selection and cross-domain quality comparisons.

随着健康应用程序的数量不断增加，人们对它们的质量、隐私标准和对循证医疗保健的依从性的担忧仍然存在。虽然存在多种评估应用质量的框架，但缺乏标准化的跨领域方法。移动健康索引和导航数据库（MIND）包括一个用于应用程序评估的结构化框架和一个可公开访问的数据库，该数据库应用该框架对单个应用程序进行评级。这允许纵向跟踪质量指标，并在不同的健康应用类别之间进行比较。方法我们进行了一项系统综述，以确定利用MIND数据库或其框架评估健康应用程序的研究。如果他们在评估健康应用程序的方法中使用MIND，研究就会被纳入其中。对数据进行描述性综合，采用双比例z检验进行比较。我们确定了22项研究，其中16项评估了市售健康应用程序。最常评估的指标是隐私策略、操作系统兼容性、成本和证据支持。只有15%的心理健康应用程序得到了可行性或有效性研究的支持，近四分之一的应用程序缺乏隐私政策，44%的应用程序明确披露与第三方共享个人健康信息。在非心理健康领域也发现了类似的缺陷，这表明对应用程序质量和数据隐私的担忧可能并非心理健康所独有。我们的研究结果表明，证据和隐私问题在几乎所有健康应用类别中都很普遍，这突出了加强监管和改进验证标准的必要性。MIND是评估数字健康应用程序的宝贵工具，支持应用程序选择和跨域质量比较。

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引用次数: 0

Perspectives of patients, caregivers, and healthcare providers on how the Heart@Home mobile application improves self-management in heart failure care: A qualitative study 患者、护理人员和医疗保健提供者对Heart@Home移动应用程序如何改善心力衰竭护理的自我管理的看法：一项定性研究

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-11-15 DOI: 10.1016/j.invent.2025.100890

Alicha Chumintrachark , Kanokporn Pinyopornpanish , Chanchanok Aramrat , Chutamas Pairoj , Nida Buawangpong , Suphawita Pliannuom , Sarapee Seesopon , Mesaya Khangtanyakit , Nopakoon Nantsupawat , Wichuda Jiraporncharoen , Chaisiri Angkurawaranon , Arintaya Phrommintikul

Objectives

This study aims to investigate the perspectives of patients, caregivers, and healthcare providers on how the Heart@Home application improves self-management following a two-week period of usage and how to improve the application for further utilization.

Methods

This qualitative study used a case study approach. We conducted semi-structured in-depth interviews with patients, caregivers, and healthcare providers and evaluated patients' quality of life before and after using the application. Purposeful sampling was employed, and thematic analysis was performed for qualitative data analysis.

Result

Nine patients, seven caregivers, and two healthcare providers were included in the analysis. The potential benefits for health behavior modification were noted through several mechanisms, including increasing self-awareness of patient's current health status, guide for managing symptoms related to health status changes, and providing emotional assessment, reassurance and a sense of being cared for. In addition, more function in application is needed to increase engagement with application usage. Although the pre-post pilot analysis shows no statistically significant changes in participants' quality of life, as measured by the EQ-5D questionnaire, promising trends were observed in the domains of self-management and daily activity.

Conclusion

The Heart@Home mobile application shows promise in promoting self-management and behavior modification among heart failure patients. Future development should focus on improving technical stability, incorporating personalized feedback, and enabling direct messaging with healthcare providers to enhance the application's effectiveness in managing heart failure.

目的本研究旨在探讨病患、照护者和医疗保健提供者在使用Heart@Home应用程式两周后，如何改善自我管理，以及如何改进应用程式以供进一步使用。方法本定性研究采用个案研究法。我们对患者、护理人员和医疗保健提供者进行了半结构化的深度访谈，并在使用该应用程序前后评估了患者的生活质量。采用有目的的抽样，并进行专题分析进行定性数据分析。结果9名患者、7名护理人员和2名医护人员被纳入分析。健康行为改变的潜在好处是通过几种机制指出的，包括提高患者当前健康状况的自我意识，指导管理与健康状况变化有关的症状，以及提供情绪评估、安慰和被照顾的感觉。此外，应用程序中需要更多的功能来提高应用程序使用的参与度。通过EQ-5D问卷测量，虽然试验前后的分析显示参与者的生活质量没有统计学上的显著变化，但在自我管理和日常活动领域观察到有希望的趋势。结论Heart@Home移动应用程序在促进心力衰竭患者自我管理和行为改变方面具有良好的应用前景。未来的发展应侧重于提高技术稳定性，纳入个性化反馈，并支持与医疗保健提供者的直接消息传递，以提高应用程序在管理心力衰竭方面的有效性。

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引用次数: 0

Rapid relief online: A randomized trial of a single-session simple-swift reconstruction approach group during the COVID-19 surge 在线快速救援：在COVID-19激增期间，单次快速重建方法组的随机试验

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-11-14 DOI: 10.1016/j.invent.2025.100889

Junkai Yang , Yao Chen , Yin Fan , Yunge Bai , Zhang Lin , Huajian Li , Shuangge Sui

Background

Large-scale crises require brief, scalable, on-line mental-health interventions. We examined the effectiveness of a single 90–120 min videoconference group based on the Simple-Swift Reconstruction Approach (SSRA).

Methods

In a parallel-group randomized trial, 277 Chinese adults were assigned to SSRA (n = 143) or a waiting-list control (n = 134). Baseline and 2-week outcomes were the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and General Self-Efficacy Scale (GSES). The SSRA group also completed Subjective Units of Disturbance (SUD) ratings immediately before and after the session. Complete-case analyses used paired and independent t-tests with Cohen's d (two-tailed α = 0.05).

Results

One hundred twenty-one SSRA participants (19 % male; M = 34.9 years, SD = 11.3) attended the SSRA session and showed a large within-session SUD reduction (baseline M = 5.81, SD = 1.62; post M = 3.20, SD = 1.57; t(120) = 19.26, p < .001, d = 1.75). Two-week follow-up data were available for 71 SSRA and 19 control participants (retention = 32.5 %). Within the SSRA group, depressive symptoms (Δ = −2.14, d = 0.63), anxiety (Δ = −1.89, d = 0.66), and self-efficacy (Δ = +2.28, d = 0.41) improved descriptively. However, only the between-group difference for depression (PHQ-9) reached significance (t(24.7) = −2.60, p = .015, d = 0.76); between-group GAD-7 and GSES were nonsignificant. Age and sex did not moderate outcomes.

Conclusions

A one-off, on-line SSRA group produced a large within-session reduction in subjective distress and a significant between-group improvement in depressive symptoms over two weeks, supporting SSRA as a rapid, low-intensity option during public-health emergencies. Replication with larger samples and longer follow-up is recommended.

大规模危机需要简短、可扩展的在线心理健康干预。我们检查了基于简单-快速重建方法（SSRA）的单次90-120分钟视频会议组的有效性。方法在一项平行组随机试验中，277名中国成年人被分配到SSRA组（n = 143）或等待名单对照组（n = 134）。基线和2周的结果是患者健康问卷-9 （PHQ-9）、广泛性焦虑障碍-7 （GAD-7）和一般自我效能量表（GSES）。SSRA组还在治疗前后立即完成了主观障碍单元（SUD）评分。全病例分析采用Cohen’s d的配对和独立t检验（双尾α = 0.05）。结果121名SSRA参与者（19%为男性，M = 34.9岁，SD = 11.3）参加了SSRA会议，会议期间SUD大幅减少（基线M = 5.81, SD = 1.62；后M = 3.20, SD = 1.57; t(120) = 19.26, p < 0.001, d = 1.75）。71名SSRA参与者和19名对照参与者可获得两周随访数据（保留率为32.5%）。在SSRA组中，抑郁症状（Δ = - 2.14, d = 0.63）、焦虑（Δ = - 1.89, d = 0.66）和自我效能感（Δ = +2.28, d = 0.41）均有显著改善。但只有抑郁（PHQ-9）组间差异有显著性意义（t(24.7) =−2.60,p = 0.015, d = 0.76）；GAD-7和GSES组间差异无统计学意义。年龄和性别对结果没有影响。结论：一次性在线SSRA组在两周内显著减少了主观痛苦，并在组间显著改善了抑郁症状，支持SSRA作为突发公共卫生事件中快速、低强度的选择。建议使用更大的样本和更长的随访时间进行复制。

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引用次数: 0

Cost-effectiveness and cost-utility of a therapist-guided online intervention provided soon after trauma: Results from a randomized controlled trial 创伤后不久治疗师指导的在线干预的成本效益和成本效用：来自一项随机对照试验的结果

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-11-06 DOI: 10.1016/j.invent.2025.100886

Maria Bragesjö , Filip K. Arnberg , Erik Andersson

This study evaluated the cost-effectiveness and cost-utility of a therapist-guided, internet-delivered early intervention for trauma. Exposure to traumatic events is common and can lead to substantial psychological distress, functional impairment, and societal costs. Early psychological interventions have the potential to mitigate these effects. We developed Condensed Internet-delivered Prolonged Exposure (CIPE), a digital intervention delivered within two months of trauma exposure. In a randomized controlled trial (N = 102), CIPE was more effective than a waiting-list control in reducing post-traumatic stress symptoms at post-intervention (3 weeks) and at a prespecified 7-week follow-up while the waiting-list control remained intact (prior to crossover). In this study, we evaluated CIPE from a societal cost perspective, aggregating direct medical costs (healthcare contacts, medication) and indirect costs (sick leave, reduced productivity, domestic loss) with equal weight in total cost calculations using a self-report questionnaire. Cost-effectiveness was assessed using responder status (≥10-point symptom reduction) and subthreshold symptom status on the PTSD Checklist for DSM-5. Cost-utility was assessed using quality-adjusted life years (QALYs) from the EQ-5D. Incremental cost-effectiveness ratios (ICERs) were estimated using bootstrapped regression analyses and visualized in cost-effectiveness planes and acceptability curves. CIPE showed a 95 % probability of being cost-effective at a willingness-to-pay threshold of €939–1181 per additional responder or subthreshold case. The corresponding cost per QALY gained was €2929–3636. Effects were sustained at 12-month follow-up. These findings suggest that therapist-guided digital exposure therapy delivered soon after trauma can reduce symptoms at a relatively low cost to society. Future research should examine CIPE's long-term economic impact and potential for broader implementation.

本研究评估了一种治疗师指导的、互联网提供的创伤早期干预的成本效益和成本效用。暴露于创伤性事件是常见的，可导致严重的心理困扰、功能损害和社会成本。早期的心理干预有可能减轻这些影响。我们开发了浓缩互联网传递的延长暴露（CIPE），这是一种在两个月内提供创伤暴露的数字干预。在一项随机对照试验（N = 102）中，在干预后（3周）和预先指定的7周随访中，CIPE在减少创伤后应激症状方面比等候名单对照组更有效，而等候名单对照组保持完整（交叉之前）。在本研究中，我们从社会成本的角度对CIPE进行了评估，汇总了直接医疗成本（医疗联系、药物）和间接成本（病假、生产力下降、家庭损失），在总成本计算中占同等权重。使用DSM-5 PTSD检查表中的应答者状态（症状减轻≥10点）和阈下症状状态评估成本-效果。使用EQ-5D的质量调整寿命年（QALYs）评估成本效用。增量成本-效果比（ICERs）使用自适应回归分析估计，并在成本-效果平面和可接受度曲线中可视化。CIPE显示，在愿意支付阈值为939-1181欧元的情况下，每个额外的应答者或低于阈值的病例具有成本效益的可能性为95%。每个获得的QALY相应成本为2929-3636欧元。在12个月的随访中，效果持续。这些发现表明，创伤后不久由治疗师指导的数字暴露疗法可以以相对较低的社会成本减轻症状。未来的研究应该检查CIPE的长期经济影响和更广泛实施的潜力。

{"title":"Cost-effectiveness and cost-utility of a therapist-guided online intervention provided soon after trauma: Results from a randomized controlled trial","authors":"Maria Bragesjö , Filip K. Arnberg , Erik Andersson","doi":"10.1016/j.invent.2025.100886","DOIUrl":"10.1016/j.invent.2025.100886","url":null,"abstract":"<div><div>This study evaluated the cost-effectiveness and cost-utility of a therapist-guided, internet-delivered early intervention for trauma. Exposure to traumatic events is common and can lead to substantial psychological distress, functional impairment, and societal costs. Early psychological interventions have the potential to mitigate these effects. We developed Condensed Internet-delivered Prolonged Exposure (CIPE), a digital intervention delivered within two months of trauma exposure. In a randomized controlled trial (<em>N</em> = 102), CIPE was more effective than a waiting-list control in reducing post-traumatic stress symptoms at post-intervention (3 weeks) and at a prespecified 7-week follow-up while the waiting-list control remained intact (prior to crossover). In this study, we evaluated CIPE from a societal cost perspective, aggregating direct medical costs (healthcare contacts, medication) and indirect costs (sick leave, reduced productivity, domestic loss) with equal weight in total cost calculations using a self-report questionnaire. Cost-effectiveness was assessed using responder status (≥10-point symptom reduction) and subthreshold symptom status on the PTSD Checklist for DSM-5. Cost-utility was assessed using quality-adjusted life years (QALYs) from the EQ-5D. Incremental cost-effectiveness ratios (ICERs) were estimated using bootstrapped regression analyses and visualized in cost-effectiveness planes and acceptability curves. CIPE showed a 95 % probability of being cost-effective at a willingness-to-pay threshold of €939–1181 per additional responder or subthreshold case. The corresponding cost per QALY gained was €2929–3636. Effects were sustained at 12-month follow-up. These findings suggest that therapist-guided digital exposure therapy delivered soon after trauma can reduce symptoms at a relatively low cost to society. Future research should examine CIPE's long-term economic impact and potential for broader implementation.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100886"},"PeriodicalIF":4.1,"publicationDate":"2025-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465212","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Examining an entirely self-guided transdiagnostic internet-delivered intervention ‘in the wild’: A randomised controlled trial for anxiety and depression with minimal inclusion criteria 检查完全自我引导的互联网传递的跨诊断干预“在野外”：一个最小纳入标准的焦虑和抑郁的随机对照试验

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-11-02 DOI: 10.1016/j.invent.2025.100887

Blake F. Dear , Alana Fisher , Madelyne Bisby , Amelia Scott , Nickolai Titov

Entirely self-guided transdiagnostic internet-delivered psychological interventions have considerable potential for increasing access to care for adults with anxiety and depression. The current study sought to examine such an intervention under real-world conditions using minimal inclusion and exclusion criteria. Three-hundred and ninety participants were randomised to either an immediate treatment group or a waitlist control group. The intervention consisted of 5 core modules delivered over 8 weeks, according to a structured timetable and with automated emails. Fifty-three percent of participants completed ≥4 of the core modules, and 75 % reported being satisfied with the intervention. At post-treatment, significant improvements were observed in the treatment group compared with control in both anxiety (treatment = 19 % [95 % CI: 12, 26]; control = 8 % [95 % CI: 2, 15]) and depression (treatment = 21 % [95 % CI: 13, 28]; control = 5 % [95 % CI: −1, 12]). These improvements were reflected in significantly greater proportions of participants meeting criteria for clinically meaningful change (≥50 % reduction) in the treatment group for both anxiety (treatment = 25 % [95 % CI: 19, 31]; control = 9 % [95 % CI: 5, 16]) and depression (treatment = 27 % [95 % CI: 20, 36]; control = 8 % [95 % CI: 5, 14]), with numbers needed to treat (NNTs) of 6.6 and 5.3, respectively. The findings of the current study support the potential of entirely self-guided transdiagnostic internet-delivered interventions, particularly for people for whom speaking with a clinician represents a barrier to care, or contexts where the resources for clinician-guided intervention are not available.

完全自我引导的跨诊断互联网心理干预在增加焦虑和抑郁成年人获得护理方面具有相当大的潜力。目前的研究试图在现实世界条件下使用最小的纳入和排除标准来检验这种干预。390名参与者被随机分为立即治疗组和候补对照组。干预包括5个核心模块，在8周内完成，根据结构化的时间表和自动电子邮件。53%的参与者完成了≥4个核心模块，75%的参与者报告对干预措施感到满意。治疗后，治疗组在焦虑（治疗= 19% [95% CI: 12, 26]；对照组= 8% [95% CI: 2, 15]）和抑郁（治疗= 21% [95% CI: 13, 28]；对照组= 5% [95% CI: - 1, 12]）方面均较对照组有显著改善。这些改善反映在治疗组达到临床意义改变（≥50%减少）标准的参与者比例上，治疗组治疗焦虑症（治疗= 25% [95% CI: 19, 31]；对照组= 9% [95% CI: 5, 16]）和抑郁症（治疗= 27% [95% CI: 20, 36]；对照组= 8% [95% CI: 5, 14]），需要治疗的人数（NNTs）分别为6.6和5.3。目前的研究结果支持了完全自我引导的互联网跨诊断干预的潜力，特别是对于那些与临床医生交谈代表着护理障碍的人，或者在没有临床医生指导的干预资源的情况下。

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引用次数: 0

Unfinished business in virtual reality: Development and preliminary evaluation of an empty chair intervention grounded in emotion-focused therapy 虚拟现实中未完成的事业：以情感为中心的治疗为基础的空椅子干预的发展和初步评估

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-10-22 DOI: 10.1016/j.invent.2025.100885

Júlia Halamová , Lenka Ottingerová , Zuzana Berger Haladova , Leslie S. Greenberg

The immersive capabilities of virtual reality (VR) make it a promising medium for psychotherapeutic interventions. This randomized controlled trial aimed to develop and evaluate a VR-based adaptation of Emotion-Focused Therapy for Unfinished Business (EFT-UFB). Specifically, we examined its effects on unresolved emotional experiences, self-compassion, self-protection, self-criticism, and perceived stress. Participants (N = 52) were randomly assigned to either the intervention group (n = 26) or a waitlist control group (n = 26), with assessments conducted at pre-test, post-test, and follow-up. The primary between-group analyses revealed no statistically significant differences between the intervention and control groups at post-test (unfinished business: t(50) = −2.00, p = .051, Cohen's d = −0.38, 95 % CI [−0.77, 0.01]) or at follow-up (t(50) = 0.60, p = .551, d = 0.08, 95 % CI [−0.31, 0.47]). Within the intervention group, unfinished business demonstrated a large pre–post reduction that was sustained at follow-up, whereas other effects were small or transient. Effect size estimates suggested small advantages for the intervention arm across several outcomes, including unfinished business (d = −1.01 vs. 0.44 in controls), self-criticism (Inadequate Self d = −0.47), and perceived stress (helplessness d = −0.33; self-efficacy d = 0.37). Other domains, including self-compassion and self-protection, showed negligible or inconsistent differences. While the VR-based EFT-UFB did not outperform the waitlist condition, these pilot findings provide preliminary evidence of feasibility and potential benefits for unfinished business. Importantly, the intervention was effectively delivered by a non-psychotherapist (a trained psychologist), underscoring its potential scalability within digital mental health applications.

虚拟现实（VR）的沉浸式能力使其成为心理治疗干预的有前途的媒介。这项随机对照试验旨在开发和评估一种基于vr的未完成事业情绪聚焦疗法（EFT-UFB）。具体来说，我们研究了它对未解决的情绪体验、自我同情、自我保护、自我批评和感知压力的影响。参与者（N = 52）被随机分配到干预组（N = 26）或候补对照组（N = 26），并在测试前、测试后和随访中进行评估。初步组间分析显示，干预组与对照组在测试后（未完成的事情：t(50) = - 2.00, p = 0.051, Cohen’s d = - 0.38, 95% CI[- 0.77, 0.01]）或随访时（t(50) = 0.60, p = .551, d = 0.08, 95% CI[- 0.31, 0.47]）无统计学差异。在干预组中，未完成的事情显示出在随访中持续的大量前后减少，而其他影响很小或短暂。效应量估计表明，干预组在几个结果上有较小的优势，包括未完成的事业（d = - 1.01，对照组为0.44）、自我批评（d = - 0.47）和感知压力（无助d = - 0.33；自我效能d = 0.37）。其他领域，包括自我同情和自我保护，表现出微不足道或不一致的差异。虽然基于vr的EFT-UFB并没有超过等待名单条件，但这些试点结果为未完成的业务提供了可行性和潜在效益的初步证据。重要的是，干预是由非心理治疗师（训练有素的心理学家）有效地提供的，强调了其在数字心理健康应用中的潜在可扩展性。

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引用次数: 0

Adolescents' and youths' perceived barriers and facilitators to engaging with digital mental health interventions for depression and anxiety: A scoping review 青少年和青年参与抑郁症和焦虑症数字心理健康干预的感知障碍和促进因素：范围审查

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-10-21 DOI: 10.1016/j.invent.2025.100884

Vajisha Udayangi Wanniarachchi , Chris Greenhalgh , Jim Warren

Digital mental health interventions (DMHIs) can be effective for adolescents and young people experiencing depression and anxiety. However, maintaining engagement remains a persistent challenge. While internal factors such as interface design, interactivity and personalisation have been widely examined, less is known about how young people themselves perceive barriers and facilitators to engaging with these tools. This scoping review explores adolescents' and young people's perceived experiences of engagement with DMHIs. A systematic search in PubMed, Scopus and PsycInfo identified 37 studies that met the inclusion criteria. Analysis revealed a broad range of perceived facilitators, including accessibility, perceived usefulness, opportunities for social connection and supportive human involvement. Commonly reported barriers included stigma, privacy concerns, low motivation, lack of personalisation, technical difficulties and limited trust in the interventions. Notably, most studies reported these perceptions qualitatively, with limited systematic assessment of their impact on engagement. This highlights a gap in the evidence base and underscores the need for future research to quantify how perceived barriers and facilitators shape engagement and adherence. Addressing barriers while building on facilitators may enhance sustained engagement and improve the real-world effectiveness of DMHIs for adolescent mental health.

数字心理健康干预措施（DMHIs）对经历抑郁和焦虑的青少年和年轻人可能有效。然而，保持用户粘性仍然是一个持续的挑战。虽然界面设计、交互性和个性化等内部因素已经得到了广泛的研究，但对于年轻人自己如何看待使用这些工具的障碍和促进因素，人们知之甚少。本综述探讨了青少年和年轻人参与DMHIs的感知体验。在PubMed、Scopus和PsycInfo中进行了系统搜索，确定了37项符合纳入标准的研究。分析揭示了广泛的感知促进因素，包括可及性、感知有用性、社会联系机会和支持性的人类参与。通常报告的障碍包括耻辱、隐私问题、动机低、缺乏个性化、技术困难和对干预措施的信任有限。值得注意的是，大多数研究定性地报告了这些看法，对其对敬业度的影响进行了有限的系统评估。这突出了证据基础上的差距，并强调了未来研究的必要性，以量化感知到的障碍和促进因素如何影响参与和坚持。在建立促进者的基础上解决障碍，可以加强持续参与，提高DMHIs在青少年心理健康方面的实际有效性。

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引用次数: 0

Commentary: AI psychosis is not a new threat: Lessons from media-induced delusions 评论：人工智能精神病不是一个新的威胁：来自媒体诱导妄想的教训

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-10-13 DOI: 10.1016/j.invent.2025.100882

Per Carlbring , Gerhard Andersson

Background

Reports of artificial intelligence (AI) chatbots fueling delusions in vulnerable users have popularized the notion of “AI psychosis”. We argue the risk is not unprecedented. Individuals with psychosis have long incorporated books, films, music, and emerging technologies into their delusional thinking.

Methods

We review historical parallels, summarize why large language models (LLMs) may reinforce psychotic thinking via sycophancy (excessive agreement or flattery to avoid confrontation), and provide two vignettes contrasting unsafe and safe responses.

Results

Contemporary LLMs often avoid confrontation and may collude with delusions, contrary to clinical best practice.

Conclusion

The phenomenon is not new in principle, but interactivity potentially changes the risk profile. Clinically aware LLMs that detect and gently redirect early psychotic ideation, while encouraging professional help seeking, could reduce harm. Design should be guided by therapeutic principles and evidence about current model failures.

人工智能（AI）聊天机器人助长弱势用户妄想的报道使“人工智能精神病”的概念得到普及。我们认为，这种风险并非史无前例。精神病患者长期以来一直将书籍、电影、音乐和新兴技术纳入他们的妄想思维中。方法回顾历史对比，总结为什么大型语言模型（llm）可能通过阿谀奉承（过度同意或奉承以避免对抗）强化精神病思维，并提供两个对比不安全和安全反应的小片段。结果当代法学硕士往往避免对抗，并可能与妄想相勾结，与临床最佳实践相反。结论该现象在原则上并不新鲜，但互动性可能改变风险状况。临床意识清醒的法学硕士在鼓励寻求专业帮助的同时，发现并轻轻地引导早期精神病观念，可以减少伤害。设计应以治疗原则和当前模型失败的证据为指导。

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引用次数: 0

Natural language processing models for predicting treatment outcomes in internet-delivered cognitive behavioral therapy 网络认知行为治疗中预测治疗结果的自然语言处理模型

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-10-10 DOI: 10.1016/j.invent.2025.100879

Nils Hentati Isacsson , Lucía Gómez-Zaragozá , Fehmi Ben Abdesslem , Magnus Boman , Viktor Kaldo

Objective

Predicting treatment outcome has the potential to enhance Internet-delivered Cognitive Behavioral Therapy (ICBT). One aspect of guided ICBT is patient-therapist interaction through written messages. With Natural language processing (NLP) these could be leveraged to predict outcome; however current evidence is limited. This study investigates the predictive accuracy of NLP models for treatment outcomes and evaluates whether NLP provides additional predictive value beyond symptom variables.

Methods

Patient-therapist messages from 6613 patients undergoing 12 weeks of treatment were used to train three types of NLP models: Term Frequency-Inverse Document Frequency (TF-IDF), Bidirectional Encoder Representations from transformers (BERT), and BERT for Longer Text (BELT). These were trained both with and without symptom variables from the initial treatment period to predict post-treatment symptoms. A dummy model was also used, and a linear regression model acted as a symptoms only benchmark. Multiple imputation addressed missing data, and nested cross-validation was used.

Results

The symptom only model performed best. Only BERT outperformed the dummy model, achieving a Root Mean Squared Error (RMSE) of 0.17 compared to RMSE of 0.18. Adding symptom variables to the BERT model significantly increased its accuracy, but not the RMSE metric. The best linear regression benchmark based on symptoms only had a BACC of 70 % (F₁-score of 0.66) which outperformed the BERT model with 60 % (F₁: 0.55) and the combined BERT plus symptoms model achieved 68 % (F₁: 0.62).

Conclusion

These initial findings indicate a small predictive value from patient-therapist written message interaction but added no value beyond using only symptoms to predict post-treatment symptoms. Further research is needed to refine NLP-methods for use in psychological treatment, and more accurately assess the predictive potential of text-based interactions during ICBT.

目的预测治疗结果有可能增强互联网提供的认知行为治疗（ICBT）。指导性ICBT的一个方面是通过书面信息进行患者与治疗师的互动。有了自然语言处理（NLP），这些可以用来预测结果；然而，目前的证据有限。本研究探讨了NLP模型对治疗结果的预测准确性，并评估NLP是否提供了除症状变量之外的其他预测价值。方法使用6613例接受12周治疗的患者的患者-治疗师信息来训练三种类型的NLP模型：Term Frequency- inverse Document Frequency （TF-IDF）、双向编码器表示（BERT）和BERT for Longer Text （BELT）。对这些患者进行了有或无症状变量的训练，以预测治疗后的症状。还使用了虚拟模型，并使用线性回归模型作为仅症状基准。多重输入解决了缺失数据，并使用嵌套交叉验证。结果单纯症状模型效果最好。只有BERT优于虚拟模型，实现了0.17的均方根误差（RMSE），而RMSE为0.18。将症状变量添加到BERT模型中可以显著提高其准确性，但不能提高RMSE度量。基于症状的最佳线性回归基准的BACC仅为70% (F1-score为0.66)，优于BERT模型的60% (F1: 0.55)， BERT +症状联合模型达到68% （F1: 0.62）。结论这些初步发现表明，患者-治疗师书面信息互动的预测价值很小，但除了仅使用症状来预测治疗后症状之外，没有任何价值。需要进一步的研究来完善nlp方法用于心理治疗，并更准确地评估ICBT期间基于文本的互动的预测潜力。

{"title":"Natural language processing models for predicting treatment outcomes in internet-delivered cognitive behavioral therapy","authors":"Nils Hentati Isacsson , Lucía Gómez-Zaragozá , Fehmi Ben Abdesslem , Magnus Boman , Viktor Kaldo","doi":"10.1016/j.invent.2025.100879","DOIUrl":"10.1016/j.invent.2025.100879","url":null,"abstract":"<div><h3>Objective</h3><div>Predicting treatment outcome has the potential to enhance Internet-delivered Cognitive Behavioral Therapy (ICBT). One aspect of guided ICBT is patient-therapist interaction through written messages. With Natural language processing (NLP) these could be leveraged to predict outcome; however current evidence is limited. This study investigates the predictive accuracy of NLP models for treatment outcomes and evaluates whether NLP provides additional predictive value beyond symptom variables.</div></div><div><h3>Methods</h3><div>Patient-therapist messages from 6613 patients undergoing 12 weeks of treatment were used to train three types of NLP models: Term Frequency-Inverse Document Frequency (TF-IDF), Bidirectional Encoder Representations from transformers (BERT), and BERT for Longer Text (BELT). These were trained both with and without symptom variables from the initial treatment period to predict post-treatment symptoms. A dummy model was also used, and a linear regression model acted as a symptoms only benchmark. Multiple imputation addressed missing data, and nested cross-validation was used.</div></div><div><h3>Results</h3><div>The symptom only model performed best. Only BERT outperformed the dummy model, achieving a Root Mean Squared Error (RMSE) of 0.17 compared to RMSE of 0.18. Adding symptom variables to the BERT model significantly increased its accuracy, but not the RMSE metric. The best linear regression benchmark based on symptoms only had a BACC of 70 % (F<sub>1</sub>-score of 0.66) which outperformed the BERT model with 60 % (F<sub>1</sub>: 0.55) and the combined BERT plus symptoms model achieved 68 % (F<sub>1</sub>: 0.62).</div></div><div><h3>Conclusion</h3><div>These initial findings indicate a small predictive value from patient-therapist written message interaction but added no value beyond using only symptoms to predict post-treatment symptoms. Further research is needed to refine NLP-methods for use in psychological treatment, and more accurately assess the predictive potential of text-based interactions during ICBT.</div></div>","PeriodicalId":48615,"journal":{"name":"Internet Interventions-The Application of Information Technology in Mental and Behavioural Health","volume":"42 ","pages":"Article 100879"},"PeriodicalIF":4.1,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145266296","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Promoting prosocial behavior and well-being in adolescents through a gamified virtual reality intervention: A randomized controlled trial protocol 通过游戏化虚拟现实干预促进青少年的亲社会行为和幸福感：一项随机对照试验方案

IF 4.1 2区医学 Q1 HEALTH CARE SCIENCES & SERVICES

Internet Interventions-The Application of Information Technology in Mental and Behavioural Health

Pub Date : 2025-10-05 DOI: 10.1016/j.invent.2025.100883

Bryant P.H. Hui , Tao Zhang , Jeffrey C.F. Ho , Sophie Kai Lam Cheng , Chen Li , Rosetta Wong , Sylvia Xiaohua Chen

Background

Adolescent well-being is an urgent global concern. While engaging in prosocial behavior has been shown to enhance well-being, traditional interventions are often resource-intensive, contextually limited, and typically delivered in 2D formats. Virtual Reality (VR) offers a novel and immersive alternative by allowing adolescents to experience lifelike social scenarios and practice prosocial behaviors across diverse, everyday contexts.

Objective

This protocol outlines a randomized controlled trial to evaluate the feasibility, acceptability, and preliminary effectiveness of a gamified VR-based prosocial intervention, Cradle for Kids, among adolescents.

Methods

A total of 396 adolescents aged 10 to 16 will be randomly assigned to one of the three groups: a five-week VR-based intervention, a video-based intervention, or a waitlist control group. Prosocial behaviors and well-being will be assessed at baseline, immediately post-intervention, and at a one-month follow-up, with parents also completing proxy reports of participants' well-being at baseline and post-intervention. Daily diary assessments will also be collected throughout the intervention period. Feasibility and acceptability will be examined via completion rate, retention rate, and participant satisfaction. Data will be analyzed using repeated-measures ANOVA and multilevel modeling.

Discussion

To our knowledge, this will be the first trial to evaluate a gamified VR intervention designed to promote prosocial behavior and well-being in adolescents. Theoretically, it will contribute empirical evidence on the potential of immersive VR-based interventions to enhance well-being through prosocial engagement. Practically, if found effective, the program may offer a scalable and resource-efficient tool for schools and community organizations seeking to foster prosocial development in youth.

青少年福祉是一个紧迫的全球问题。虽然参与亲社会行为已被证明可以提高幸福感，但传统的干预措施往往是资源密集型的，背景有限，并且通常以2D格式提供。虚拟现实（VR）提供了一种新颖的沉浸式替代方案，允许青少年体验逼真的社交场景，并在各种日常环境中实践亲社会行为。目的：本协议概述了一项随机对照试验，以评估基于游戏化vr的亲社会干预——儿童摇篮——在青少年中的可行性、可接受性和初步有效性。方法共有396名10至16岁的青少年将被随机分配到三组中的一组：为期五周的基于vr的干预，基于视频的干预或等待名单对照组。亲社会行为和幸福感将在基线，干预后立即进行评估，并在一个月的随访中进行评估，父母也要完成参与者基线和干预后幸福感的代理报告。在整个干预期间，还将收集每日日记评估。可行性和可接受性将通过完成率、保留率和参与者满意度进行检查。数据将使用重复测量方差分析和多水平建模进行分析。据我们所知，这将是第一个评估游戏化虚拟现实干预的试验，旨在促进青少年的亲社会行为和福祉。从理论上讲，它将为基于沉浸式虚拟现实的干预措施通过亲社会参与提高福祉的潜力提供经验证据。实际上，如果发现有效，该项目可以为学校和社区组织提供一个可扩展和资源高效的工具，以促进青少年的亲社会发展。

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引用次数: 0