A fully automated self-help biopsychosocial transdiagnostic digital intervention to reduce anxiety and/or depression and improve emotional regulation and well-being: pre-follow-up single-arm feasibility trial
- Klein, Britt, Nguyen, Huy, McLaren, Suzanne, Andrews, Brooke, Shandley, Kerrie
- Authors: Klein, Britt , Nguyen, Huy , McLaren, Suzanne , Andrews, Brooke , Shandley, Kerrie
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Formative Research Vol. 7, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Anxiety disorders and depression are prevalent disorders with high comorbidity, leading to greater chronicity and severity of symptoms. Given the accessibility to treatment issues, more evaluation is needed to assess the potential benefits of fully automated self-help transdiagnostic digital interventions. Innovating beyond the current transdiagnostic one-size-fits-all shared mechanistic approach may also lead to further improvements. Objective: The primary objective of this study was to explore the preliminary effectiveness and acceptability of a new fully automated self-help biopsychosocial transdiagnostic digital intervention (Life Flex) aimed at treating anxiety and/or depression, as well as improving emotional regulation; emotional, social, and psychological well-being; optimism; and health-related quality of life. Methods: This was a real-world pre-during-post-follow-up feasibility trial design evaluation of Life Flex. Participants were assessed at the preintervention time point (week 0), during intervention (weeks 3 and 5), at the postintervention time point (week 8), and at 1- and 3-month follow-ups (weeks 12 and 20, respectively). Results: The results provided early support for the Life Flex program in reducing anxiety (Generalized Anxiety Disorder 7), depression (Patient Health Questionnaire 9), psychological distress (Kessler 6), and emotional dysregulation (Difficulties in Emotional Regulation 36) and increasing emotional, social, and psychological well-being (Mental Health Continuum-Short Form); optimism (Revised Life Orientation Test); and health-related quality of life (EQ-5D-3L Utility Index and Health Rating; all false discovery rate [FDR] < .001). Large within-group treatment effect sizes (range |d|=0.82 to 1.33) were found for most variables from pre- to postintervention assessments and at the 1- and 3-month follow-up. The exceptions were medium treatment effect sizes for EQ-5D-3L Utility Index (range Cohen d=
- Authors: Klein, Britt , Nguyen, Huy , McLaren, Suzanne , Andrews, Brooke , Shandley, Kerrie
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Formative Research Vol. 7, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Anxiety disorders and depression are prevalent disorders with high comorbidity, leading to greater chronicity and severity of symptoms. Given the accessibility to treatment issues, more evaluation is needed to assess the potential benefits of fully automated self-help transdiagnostic digital interventions. Innovating beyond the current transdiagnostic one-size-fits-all shared mechanistic approach may also lead to further improvements. Objective: The primary objective of this study was to explore the preliminary effectiveness and acceptability of a new fully automated self-help biopsychosocial transdiagnostic digital intervention (Life Flex) aimed at treating anxiety and/or depression, as well as improving emotional regulation; emotional, social, and psychological well-being; optimism; and health-related quality of life. Methods: This was a real-world pre-during-post-follow-up feasibility trial design evaluation of Life Flex. Participants were assessed at the preintervention time point (week 0), during intervention (weeks 3 and 5), at the postintervention time point (week 8), and at 1- and 3-month follow-ups (weeks 12 and 20, respectively). Results: The results provided early support for the Life Flex program in reducing anxiety (Generalized Anxiety Disorder 7), depression (Patient Health Questionnaire 9), psychological distress (Kessler 6), and emotional dysregulation (Difficulties in Emotional Regulation 36) and increasing emotional, social, and psychological well-being (Mental Health Continuum-Short Form); optimism (Revised Life Orientation Test); and health-related quality of life (EQ-5D-3L Utility Index and Health Rating; all false discovery rate [FDR] < .001). Large within-group treatment effect sizes (range |d|=0.82 to 1.33) were found for most variables from pre- to postintervention assessments and at the 1- and 3-month follow-up. The exceptions were medium treatment effect sizes for EQ-5D-3L Utility Index (range Cohen d=
Examining factors that influence the relationship between personality and stress
- Authors: Duggan, Leanne
- Date: 2021
- Type: Text , Thesis , PhD
- Full Text:
- Description: Individual differences in the stress response have been linked with numerous factors, including personality traits and mindfulness. Selye (1950) was among the first to detail the physiological stress response that takes place during a stressful event, or after exposure to a stressor. These responses include heart rate changes and the secretion of cortisol into the blood stream, which are key physiological indicators that a stress response is taking place. Lazarus and Folkman (1984) examined appraisal of stressful events, determining that this is crucial to the stress experience. An extension of Lazarus and Folkman’s cognitive appraisal theory was offered by Vollrath (2001), suggesting an individual’s personality accentuates our stress response, therefore, offering an explanation for the individual differences evident in stress responses. The relationship between personality and stress is not straight forward, and other factors, such as affect and mindfulness, may influence this relationship. Thus, this dissertation is divided into three studies. Study 1 examined the moderating and mediating factors of affect on the relationship between personality traits and perceived stress. A total of 290 adults (71% female; Mage = 35.0 years, SD = 12.92) completed an online questionnaire package, comprising of the Perceived Stress Scale, Big Five Inventory, Positive and Negative Affect Schedule, and a number of demographic questions. A hierarchical regression showed that 56% of the variance in perceived stress was explained by personality and affect, and when all personality traits were viewed concurrently and with affect, neuroticism was the only one to significantly explain variance in perceived stress. No moderation effects were found in Study 1 however, positive affect partially mediated the relationship between neuroticism and perceived stress. Study 2 aimed to further the findings of Study 1 by investigating whether trait mindfulness impacted the relationship between personality and stress. A total of 266 adults (70% female; Mage = 34.0 years, SD = 12.68) completed an online questionnaire package, consisting of the Perceived Stress Scale, Big Five Inventory, and Carolina Empirically Derived Mindfulness Scale. A hierarchical regression showed that 58% of the variance in perceived stress was explained by personality and trait mindfulness. When all personality traits and trait mindfulness were viewed together, neuroticism and agreeableness were the only personality traits to significantly explain variance in perceived stress. The sub-scale trait mindfulness attention significantly moderated the relationship between agreeableness and perceived stress, while a partial mediation was found between neuroticism and the sub-scale trait mindfulness acceptance. Study 3 investigated the effectiveness of a brief state-based mindfulness intervention on physiological (cortisol and heart rate) and psychological stress responses, in a participant matched design. A total of 20 participants (60% female; Mage = 34.60 years, SD = 14.68) were recruited from Studies 1 and/or 2 and matched based on gender, dominant personality trait (found in Study 1 and 2), and perceived stress. One participant in each matched pair was then randomly allocated to the mindfulness experimental, or control, group. The mindfulness experimental group completed a 10-minute breathing exercise, prior to completing the Trier Social Stress Test, a verbal presentation and arithmetic task, designed to induce stress. The control group did not complete any activity prior to the stress test. Comparison of the groups indicated that no significant differences in perceived stress were evident pre-post- intervention. Changes in heart rate were noted for all participants during the intervention, though no difference was evident between groups. The results of Study 3 indicate a mindfulness breathing exercise makes little difference to physiological stress responses during a stress task. The combined findings of this dissertation indicate that personality traits can influence the likelihood of an individual experiencing stress. Mindfulness and affect also impact on the relationship between personality and stress and offer some insight into the individual experience of stress responses.
- Description: Doctor of Philosophy
- Authors: Duggan, Leanne
- Date: 2021
- Type: Text , Thesis , PhD
- Full Text:
- Description: Individual differences in the stress response have been linked with numerous factors, including personality traits and mindfulness. Selye (1950) was among the first to detail the physiological stress response that takes place during a stressful event, or after exposure to a stressor. These responses include heart rate changes and the secretion of cortisol into the blood stream, which are key physiological indicators that a stress response is taking place. Lazarus and Folkman (1984) examined appraisal of stressful events, determining that this is crucial to the stress experience. An extension of Lazarus and Folkman’s cognitive appraisal theory was offered by Vollrath (2001), suggesting an individual’s personality accentuates our stress response, therefore, offering an explanation for the individual differences evident in stress responses. The relationship between personality and stress is not straight forward, and other factors, such as affect and mindfulness, may influence this relationship. Thus, this dissertation is divided into three studies. Study 1 examined the moderating and mediating factors of affect on the relationship between personality traits and perceived stress. A total of 290 adults (71% female; Mage = 35.0 years, SD = 12.92) completed an online questionnaire package, comprising of the Perceived Stress Scale, Big Five Inventory, Positive and Negative Affect Schedule, and a number of demographic questions. A hierarchical regression showed that 56% of the variance in perceived stress was explained by personality and affect, and when all personality traits were viewed concurrently and with affect, neuroticism was the only one to significantly explain variance in perceived stress. No moderation effects were found in Study 1 however, positive affect partially mediated the relationship between neuroticism and perceived stress. Study 2 aimed to further the findings of Study 1 by investigating whether trait mindfulness impacted the relationship between personality and stress. A total of 266 adults (70% female; Mage = 34.0 years, SD = 12.68) completed an online questionnaire package, consisting of the Perceived Stress Scale, Big Five Inventory, and Carolina Empirically Derived Mindfulness Scale. A hierarchical regression showed that 58% of the variance in perceived stress was explained by personality and trait mindfulness. When all personality traits and trait mindfulness were viewed together, neuroticism and agreeableness were the only personality traits to significantly explain variance in perceived stress. The sub-scale trait mindfulness attention significantly moderated the relationship between agreeableness and perceived stress, while a partial mediation was found between neuroticism and the sub-scale trait mindfulness acceptance. Study 3 investigated the effectiveness of a brief state-based mindfulness intervention on physiological (cortisol and heart rate) and psychological stress responses, in a participant matched design. A total of 20 participants (60% female; Mage = 34.60 years, SD = 14.68) were recruited from Studies 1 and/or 2 and matched based on gender, dominant personality trait (found in Study 1 and 2), and perceived stress. One participant in each matched pair was then randomly allocated to the mindfulness experimental, or control, group. The mindfulness experimental group completed a 10-minute breathing exercise, prior to completing the Trier Social Stress Test, a verbal presentation and arithmetic task, designed to induce stress. The control group did not complete any activity prior to the stress test. Comparison of the groups indicated that no significant differences in perceived stress were evident pre-post- intervention. Changes in heart rate were noted for all participants during the intervention, though no difference was evident between groups. The results of Study 3 indicate a mindfulness breathing exercise makes little difference to physiological stress responses during a stress task. The combined findings of this dissertation indicate that personality traits can influence the likelihood of an individual experiencing stress. Mindfulness and affect also impact on the relationship between personality and stress and offer some insight into the individual experience of stress responses.
- Description: Doctor of Philosophy
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