Correlates of Mental Health Smartphone Application Use among Patients with Suicidal Ideation

Abstract

Mental health applications (apps) can improve access to evidence-based, mental health strategies. This study evaluated predictors of use for the Virtual Hope Box (VHB), a smartphone app designed to enhance coping among high-risk mental health populations. We also explored the impact of usage on health outcomes. We analyzed data drawn from the treatment arm of a randomized clinical trial of the VHB (n?=?58). Veterans at high risk of suicide used the app over 12 weeks and completed psychosocial assessments throughout the study. We received usage data from each participant’s smartphone. We then used negative binomial regression to evaluate demographic and clinical predictors of usage and generalized estimating equations to explore the longitudinal association between usage and psychosocial outcomes. The most commonly used subcomponents were designed to provide distractions and reminders of sources of meaning.

Lower levels of usage were associated with younger and having a 2-year college degree or higher. Exploratory findings suggested a possible relationship between usage and protective factors. Certain subgroups had lower VHB usage. The findings suggest usage may be associated with changes in health outcomes. Future studies should recruit larger, more diverse samples to further explore relationships between usage and demographic predictors.     

The transition to adulthood from care as a struggle for recognition

This article explores young people's experiences in the transition to adulthood from child welfare services and how Honneth's theory of recognition can be useful as an analytical tool to help us understand these experiences. The underpinning empirical research consisted of interviews and focus groups with 43 adolescents who had been in contact with Norwegian child welfare services. Three themes emerged as particularly important: having good relationships to caring adults, being listened to and able to influence their own lives, and receiving support and encouragement. The research shows how young people's difficulties in leaving care can be understood as experiences of misrecognition and points to some ways in which these can be overcome.     

Approaches to sample size calculation for clinical trials in rare diseases

We discuss 3 alternative approaches to sample size calculation: traditional sample size calculation based on power to show a statistically significant effect, sample size calculation based on assurance, and sample size based on a decision‐theoretic approach. These approaches are compared head‐to‐head for clinical trial situations in rare diseases. Specifically, we consider 3 case studies of rare diseases (Lyell disease, adult‐onset Still disease, and cystic fibrosis) with the aim to plan the sample size for an upcoming clinical trial. We outline in detail the reasonable choice of parameters for these approaches for each of the 3 case studies and calculate sample sizes. We stress that the influence of the input parameters needs to be investigated in all approaches and recommend investigating different sample size approaches before deciding finally on the trial size. Highly influencing for the sample size are choice of treatment effect parameter in all approaches and the parameter for the additional cost of the new treatment in the decision‐theoretic approach. These should therefore be discussed extensively.     

The Ecological and Spatial Structure of the Socio-Economic Characteristics of Winnipeg,1961

L'application de l'analyse des composantes principales aux donnees socio-economiques de 1961 pour Winnipeg nous permet d'extraire les dimensions sous-jacentes de la structure socio-economique de la population de la ville. On y fait la demonstration que les dimensions derivees correspondent dans une large mesure aux dimensions obtenues par l'analyse de l'aire sociale. II est de plus souligne que l'analyse des composantes principales constitue un instrument utile dans l'analyse des donnees urbaines multivariees; elle est egalement tres utile-a Pinterieur de certaines limites-dans les etudes empiriques portant sur la structure ecologique de la ville.
The application of principal components analysis to 1961 socio-economic data for Winnipeg derives the underlying dimensions of the socio-economic structure of the city's population. It is generally shown that the derived dimensions are quite similar to "social area analysis" dimensions. It is further indicated that principal components analysis provides a useful tool in the analysis of multivariate urban data and, subject to certain limitations, is extremely useful in empirical studies of the ecological structure of cities.     

Rethinking Professional Practice: The contributions of Social Constructionism and the Feminist 'Ethics of Care'

Correspondence to Professor Nigel Parton, Centre for Applied Childhood Studies, School of Human and Health Sciences, University of Huddersfield HD1 3DH, UK. E-mail: n.parton{at}hud.ac.uk Summary Drawing upon social constructionist and postmodern perspectives,together with recent feminist debates about ‘the ethicsof care’, this paper reflects upon the productive waysin which contemporary social work can be thought about, organizedand practised professionally. It argues that an emphasis on:process; plurality of both knowledge and voice; possibility;and the relational quality of knowledge are key elements intaking these issues forward. In contrast to the traditions ofabstract and instrumental reasoning where the pursuit of knowledgeis intertwined with the pursuit of control, the importance ofsensory knowledge, symbolized by the unity of hand, head andheart is underlined.     

The Go-Between — Strategic Therapy with Teenagers in Separated Families*

The adolescent's experience of divorce needs to be understood within a developmental and systemic framework. Problematic or symptomatic behaviour in teenagers from separated families often reflects on the family's difficulty in managing the transition to a new and different family organisation. The type of problem or symptom presented is shaped partly by the developmental characteristics of the adolescent period, as well as being indicative of unresolved problems within the broader family system. Problem resolution can often require the involvement of both separated parents and their children in a conjoint interview, in which case a strategic family therapy approach can be particularly useful. A strategic approach offers the therapist clear guidelines regarding the focus and process of the interview, and assists the therapist to be in charge whilst remaining neutral in the sense of not allying more with one side or another. Case illustrations are included of a strategic approach with teenagers and their separated families.     

Family Therapy with Adolescents: Giving Up The Struggle

This paper examines problems in adolescence from the perspective of a power struggle between parent(s) and teenager. The structural approach of Minuchin and the strategic approaches of Haley, Madanes, and the Mental Research Institute (M.R.I.) are considered in relation to the significance they attribute to power and power struggles in families with adolescents. It is argued that the M.R.I. approach has certain therapeutic advantages for working with problematic adolescents, primarily because of its focus on understanding and intervening in the power struggle itself. A focus on the power struggle as the ‘problem’ reminds the therapist of the circular nature of parent-adolescent interactions. This awareness assists the therapist to design indirect interventions that are less likely to become absorbed into this vicious cycle. It also encourages a therapeutic stance that prevents the therapist from becoming involved in a power struggle with family members.