Systematic review and meta-analysis of adverse events in clinical trials of mental health apps.

Mental health apps are efficacious, yet they may pose risks in some. This review (CRD42024506486) examined adverse events (AEs) from mental health apps. We searched (May 2024) the Medline, PsycINFO, Web of Science, and ProQuest databases to identify clinical trials of mental health apps.

A dialectical behavior therapy skills training smartphone app for recurrent binge eating: a randomized clinical trial.

Background: Dialectical behavior therapy (DBT) is a specialized treatment that has a growing evidence base for binge-spectrum eating disorders. However, cost and workforce capacity limit wide-scale uptake of DBT since it involves over 20 in-person sessions with a trained professional (and six sessions for guided self-help format). Interventions translated for delivery through modern technology offer a solution to increase the accessibility of evidence-based treatments.

Autism spectrum disorder and anorexia nervosa: Investigating the behavioural and neurocognitive overlap.

Autism spectrum disorder (autism) and anorexia nervosa (AN) share many clinical features. Two key neurocognitive correlates of the autistic dyad, specifically, mentalising (social impairment) and set-shifting (restricted and repetitive behaviours/interests [RRBI]) were investigated in a sample of 327 adult participants with autism (n = 100; 50 females, 50 male), AN (n = 82; 54 females, 28 male), autism and AN (n = 45; 36 females, 9 male), and 100 (50 female, 50 male) control participants from the general population. A battery of self-report (Autism Spectrum Quotient, Eating Disorder Examination Questionnaire, Reflective Function Questionnaire, and Repetitive Behaviour Questionnaire 2 - Adult version) and performance-based (Wisconsin Card Sort Task [WCST] and Penn Emotion Recognition Test [ER-40]) measures were administered online.

Application of Machine Learning Techniques to the Prediction of Onset and Persistence of Binge Eating: A Prospective Study.

Objective: Machine learning (ML) techniques have shown promise for enhancing prediction of clinical outcomes; however, its application to predicting binge eating has been scarcely explored. We applied ML techniques to predict binge eating onset (vs. continued absence) and persistence (vs.

Body image facets as predictors of muscularity-oriented disordered eating in women: Findings from a prospective study.

Muscularity-oriented disordered eating (MODE) is becoming increasingly common among women and is characterized by dietary alterations (e.g., blending meals into liquid form to increase caloric intake) aimed towards gaining lean muscle.

The effectiveness of smartphone app-based interventions for insomnia and sleep disturbances: A meta-analysis of randomized controlled trials.

There is growing enthusiasm towards the role of smartphone app-based interventions in the management of insomnia and related sleep problems. A considerable number of apps designed to address insomnia have been developed in recent years, and randomized controlled trials (RCTs) have begun to explore their efficacy. We conducted a meta-analysis investigating the effectiveness of apps for insomnia and sleep disturbances.

Efficacy of mental health smartphone apps on stress levels: a meta-analysis of randomised controlled trials.

The management of stress has evolved in recent years due to widespread availability of mobile-device applications (apps) and their capacity to deliver psychological interventions. We evaluated the efficacy of mental health apps on stress and sought to identify characteristics associated with effect size estimates. Sixty-nine randomised controlled trials (RCTs) were included.

Resilience eDBT: Development and Usability Evaluation of a Dialectical Behavior Therapy Skills Training App for Eating Disorders.

Objective: Dialectical behavior therapy (DBT) is an evidence-based treatment for disorders characterized by recurrent binge eating. Yet, access to specialized treatment like DBT remains limited. To increase the accessibility of DBT, we developed a DBT skills training app (Resilience: eDBT) for the management of eating disorder (ED) symptoms.

Identifying factors that predict the onset and persistence of fasting for weight control: Prospective findings.

Objective: Fasting for weight control is an under-studied behaviour implicated in eating disorders. However, little is known about what factors account for its onset and persistence.

Method: This study sought to identify risk and maintenance factors for fasting among 1025 women recruited through an eating disorder self-help platform who completed study measures at baseline and 6 month follow-up.

Testing for longitudinal bidirectional associations between self-compassion, self-criticism, and positive body image components.

Previous cross-sectional studies have reported associations between self-compassion, self-criticism, and positive body image, yet prospective studies establishing the temporal order of these relationships are missing. The present study sought to clarify the nature of these associations by investigating possible longitudinal bi-directional links between self-compassion, self-criticism, and three components of positive body image (body appreciation, functionality appreciation, and body image flexibility). Data were analyzed from 2982 adult women who completed survey instruments at baseline (T0), four-month follow-up (T1), and eight-month follow-up (T2).

The Intuitive Eating Scale-3: Development and psychometric evaluation.

Intuitive eating has been found to protect against disordered eating and preserve well-being. Yet, there are methodological (length), conceptual (inconsideration of medical, value-based, and access-related reasons for food consumption), and psychometric (item wording) concerns with its most common measure, the Intuitive Eating Scale-2 (IES-2). To address these concerns, we developed the IES-3 and investigated its psychometric properties with U.

From "online brains" to "online lives": understanding the individualized impacts of Internet use across psychological, cognitive and social dimensions.

In response to the mass adoption and extensive usage of Internet-enabled devices across the world, a major review published in this journal in 2019 examined the impact of Internet on human cognition, discussing the concepts and ideas behind the "online brain". Since then, the online world has become further entwined with the fabric of society, and the extent to which we use such technologies has continued to grow. Furthermore, the research evidence on the ways in which Internet usage affects the human mind has advanced considerably.

A randomized controlled trial of an online single session intervention for body image in individuals with recurrent binge eating.

Objective: Theoretical models highlight body image disturbances as central to the maintenance of eating disorders, with empirical evidence finding negative body image to be a robust predictor of treatment nonresponse, relapse and symptom persistence. Accessible, scalable, and inexpensive interventions that can effectively target negative body image across the eating disorders are needed. We developed an online single session intervention (SSI) for negative body image and evaluated its acceptability and efficacy in a randomized controlled trial in individuals with recurrent binge eating.

Investigating change in network structure of eating disorder symptoms after delivery of a smartphone app-based intervention.

Background: Eating disorder (ED) research has embraced a network perspective of psychopathology, which proposes that psychiatric disorders can be conceptualized as a complex system of interacting symptoms. However, existing intervention studies using the network perspective have failed to find that symptom reductions coincide with reductions in strength of associations among these symptoms. We propose that this may reflect failure of alignment between network theory and study design and analysis.

A call to action for more rigorous research on compassion-focused interventions for eating disorders: Commentary on Paranjothy and Wade (2024).

Paranjothy and Wade's (2024) meta-analysis identifying relations between self-criticism, self-compassion, and disordered eating prompted recommendations for augmenting existing front-line interventions with compassion-focused therapy (CFT) principles among self-critical individuals. While in theory this sounds promising, the reality is that the evidence supporting the use of CFT for eating disorders (EDs) is limited. I argue that before any clinical recommendations can made, more research is needed to better understand the utility of CFT, as well as what precise role self-criticism and self-compassion play in the context of intervention.

Enhancing inferences and conclusions in body image focused non-experimental research via a causal modelling approach: A tutorial.

Causal inference is often the goal of psychological research. However, most researchers refrain from drawing causal conclusions based on non-experimental evidence. Despite the challenges associated with producing causal evidence from non-experimental data, it is crucial to address causal questions directly rather than avoiding them.

Target-user preferences, motivations, and acceptance for a dialectical behaviour therapy smartphone application for eating disorders.

Purpose: Evidence shows that dialectical behavioural therapy (DBT) is efficacious for eating disorders (ED), yet few people have access to specialized treatments like DBT. Translating key DBT skills for delivery via a smartphone application may broaden the dissemination of evidence-based interventions. However, prior to developing a DBT-based app, it is crucial to gather information on target-user needs and preferences.

Exploration of the individual and combined effects of predictors of engagement, dropout, and change from digital interventions for recurrent binge eating.

Objective: Our ability to predict responsiveness to digital interventions for eating disorders has thus far been poor, potentially for three reasons: (1) there has been a narrow set of predictors explored; (2) prediction has mostly focused on symptom change, ignoring other aspects of the user journey (uptake, early engagement); and (3) there is an excessive focus on the unique effects of predictors rather than the combined contributions of a predictor set. We evaluated the univariate and multivariate effects of outcome predictors in the context of a randomized trial (n = 398) of digitally delivered interventions for recurrent binge eating.

Method: Thirty baseline variables were selected as predictors, ranging from specific symptoms, to key protective factors, to technological acceptance, and to online treatment attitudes.

Bidirectional relationships between muscularity-oriented disordered eating and mental health constructs: a prospective study.

Muscularity-oriented disordered eating (MODE) is a novel class of eating behaviors characterised by abnormal dietary alterations aimed towards building lean muscle. Although traditionally shown to affect men, emerging evidence suggests that increasingly more women are striving for the muscular and lean ideal, resulting in engagement of MODE behaviors. Prior research examining MODE in women is limited, yet emerging evidence from cross-sectional studies have established associations between MODE and poor mental health indices in this population.

Body appreciation predicts lower levels of orthorexia nervosa symptoms: Prospective findings.

Recent evidence shows that negative body image may be a potential risk factor for symptoms of orthorexia nervosa (ON). However, whether positive body image plays a protective role against symptoms of ON remains unclear. Although prior research has established associations between body appreciation (a core component of positive body image) and ON symptoms, this research is limited to cross-sectional designs, precluding inferences of temporal precedence.

Current evidence on the efficacy of mental health smartphone apps for symptoms of depression and anxiety. A meta-analysis of 176 randomized controlled trials.

The mental health care available for depression and anxiety has recently undergone a major technological revolution, with growing interest towards the potential of smartphone apps as a scalable tool to treat these conditions. Since the last comprehensive meta-analysis in 2019 established positive yet variable effects of apps on depressive and anxiety symptoms, more than 100 new randomized controlled trials (RCTs) have been carried out. We conducted an updated meta-analysis with the objectives of providing more precise estimates of effects, quantifying generalizability from this evidence base, and understanding whether major app and trial characteristics moderate effect sizes.

An inflexible adherence to food rules mediates the longitudinal association between shape/weight overvaluation and binge eating.

Understanding factors that account for the persistence of binge eating is necessary for developing effective early intervention and treatment approaches. The cognitive-behavioral model of eating disorders proposes that judgements of self-worth contingent upon weight and shape encourage adoption of multiple demanding rules related to food, eating and dieting, in turn increasing vulnerability to binge eating. However, there is limited longitudinal evidence supporting this hypothesized sequence of events.

The efficacy of mindfulness apps on symptoms of depression and anxiety: An updated meta-analysis of randomized controlled trials.

Mindfulness apps have become popular tools for addressing symptoms of depression and anxiety. Since the publication of earlier meta-analyses evaluating the efficacy of mindfulness apps for depression and anxiety symptoms, over 20 randomized controlled trials (RCTs) have been conducted. There is a need for an updated meta-analysis that quantifies the effects of mindfulness apps on these symptoms and tests for potential moderators.

Digital health applications for eating disorders treatment.

Eating disorders (EDs) are characterized by multifaceted etiologies, difficulties in accessing care (especially in regional locations), and variable responsiveness to treatments. Digital technologies are viewed as an important innovation in the assessment and treatment of EDs. We discuss current implementation of these innovations as well as important future directions for the field.