Reducing worry and rumination in young adults via a mobile phone app: study protocol of the ECoWeB (Emotional Competence for Well-Being in Young Adults) randomised controlled trial focused on repetitive negative thinking.

BACKGROUND: Promoting well-being and preventing poor mental health in young people is a major global priority. Building emotional competence skills via a mobile app may be an effective, scalable and acceptable way to do this. A particular risk factor for anxiety and depression is elevated worry and rumination (repetitive negative thinking, RNT). An app designed to reduce RNT may prevent future incidence of depression and anxiety. METHOD/DESIGN: The Emotional Competence for Well-Being in Young Adults study developed an emotional competence app to be tested via randomised controlled trials in a longitudinal prospective cohort. This off-shoot study adapts the app to focus on targeting RNT (worry, rumination), known risk factors for poor mental health. In this study, 16-24 year olds in the UK, who report elevated worry and rumination on standardised questionnaires are randomised to (i) receive the RNT-targeting app immediately for 6 weeks (ii) a waiting list control who receive the app after 6 weeks. In total, the study will aim to recruit 204 participants, with no current diagnosis of major depression, bipolar disorder or psychosis, across the UK. Assessments take place at baseline (pre-randomisation), 6 and 12 weeks post-randomisation. Primary endpoint and outcome for the study is level of rumination assessed on the Rumination Response Styles Questionnaire at 6 weeks. Worry, depressive symptoms, anxiety symptoms and well-being are secondary outcomes. Compliance, adverse events and potentially mediating variables will be carefully monitored. DISCUSSION: This trial aims to better understand the benefits of tackling RNT via an mobile phone app intervention in young people. This prevention mechanism trial will establish whether targeting worry and rumination directly via an app provides a feasible approach to prevent depression and anxiety, with scope to become a widescale public health strategy for preventing poor mental health and promoting well-being in young people. TRIAL REGISTRATION: ClinicalTrials.gov , NCT04950257 . Registered 6 July 2021 - Retrospectively registered.

Clustering Individuals on Limited Features of a Vector Autoregressive Model.

Dynamical interplays in emotions have been investigated using vector autoregressive (VAR) models, whose estimates can be used to cluster participants into unknown groups. The present study evaluated a clustering algorithm, the alternating least square (ALS) algorithm, for accuracy in predicting individual group membership. We systematically manipulated (a) the number of variables in a model, (b) the size of group differences in regression coefficients, and (c) the number of regression coefficients that vary across the groups (i.e., effective features). The ALS algorithm works reliably when there are at least 5 effective features with very large group differences in a 5-variable model; and 9 effective features with very large group differences in a 10-variable model. These findings suggest that the ALS algorithm is sensitive to group differences that are present only in several coefficients of a VAR model, but that the group differences have to be large. We also found that the ALS algorithm outperforms another clustering method, Gaussian mixture modeling. The ALS algorithm was further evaluated with unbalanced sample sizes between groups and with a greater number of groups in data (Study 2). A real data application was provided to illustrate how to interpret the detected group differences (Study 3).

Assessing repetitive negative thinking in daily life: Development of an ecological momentary assessment paradigm.

Repetitive negative thinking (RNT) is a transdiagnostic process and a promising target for prevention and treatment of mental disorders. RNT is typically assessed via self-report questionnaires with most studies focusing on one type of RNT (i.e., worry or rumination) and one specific disorder (i.e., anxiety or depression). However, responses to such questionnaires may be biased by memory and metacognitive beliefs. Recently, Ecological Momentary Assessment (EMA) has been employed to minimize these biases. This study aims to develop an EMA paradigm to measure RNT as a transdiagnostic process in natural settings. Based on empirical and theoretical considerations, an item pool was created encompassing RNT content and processes. We then (1) tested model fit of a content-related and a process-related model for assessing RNT as an individual difference variable, (2) investigated the reliability and construct validity of the proposed scale(s), and (3) determined the optimal sampling design. One hundred fifty healthy participants aged 18 to 40 years filled out baseline questionnaires on rumination, worry, RNT, symptoms of depression, anxiety, and stress. Participants received 8 semi-random daily prompts assessing RNT over 14 days. After the EMA phase, participants answered questionnaires on depression, anxiety, and stress again. Multilevel confirmatory factor analysis revealed excellent model fit for the process-related model but unsatisfactory fit for the content-related model. Different hybrid models were additionally explored, yielding one model with satisfactory fit. Both the process-related and the hybrid scale showed good reliability and good convergent validity and were significantly associated with symptoms of depression, anxiety, and stress after the EMA phase when controlling for baseline scores. Further analyses found that a sampling design of 5 daily assessments across 10 days yielded the best tradeoff between participant burden and information retained by EMA. In sum, this paper presents a promising paradigm for assessing RNT in daily life.

Addictive Potential of Internet Applications and Differential Correlates of Problematic Use in Internet Gamers versus Generalized Internet Users in a Representative Sample of Adolescents.

AIMS: This paper examines the addictive potential of 8 different Internet applications, distinguishing male and female users. Moreover, differential correlates of problematic use are investigated in Internet gamers (IG) and generalized Internet users (GIU). METHOD: In a representative sample of 5,667 adolescents aged 12-19 years, use of Internet applications, problematic Internet use, psychopathologic symptoms (emotional problems, hyperactivity/inattention, and psychosomatic complaints), personality (conscientiousness and extraversion), psychosocial correlates (perceived stress and self-efficacy), and coping strategies were assessed. The addictive potential of Internet applications was examined in boys and girls using regression analysis. MANOVAs were conducted to examine differential correlates of problematic Internet use between IG and GIU. RESULTS: Chatting and social networking most strongly predicted problematic Internet use in girls, while gaming was the strongest predictor in boys. Problematic IG exhibited multiple psychosocial problems compared to non-problematic IG. In problematic Internet users, GIU reported even higher psychosocial burden and displayed dysfunctional coping strategies more frequently than gamers. CONCLUSION: The results extend previous findings on the addictive potential of Internet applications and validate the proposed distinction between specific and generalized problematic Internet use. In addition to Internet gaming disorder, future studies should also focus on other highly addictive Internet applications, that is, chatting or social networking, regarding differential correlates of problematic use.

Measuring Somatic Complaints in Primary School Children: Validation and Revision of the German Children's Somatization Inventory (CSI) and its Parental Version.

The objective was a psychometric examination of a German translation of the Children's Somatization Inventory (CSI) and its parents' version (P-CSI) and a replication of the item selection process of Walker et al. in J Pediatr Psychol 34:430-440 [5] for their revised version to create shorter German versions. Based on a school sample of 1,539 parents and 731 children, we explored the psychometric properties and dimensionality of the original and a shortened revised version. A clinical sample of 70 parental reports served as an additional sample. Walker et al.'s item selection could be largely replicated. Dimensionality differed between samples and versions (original vs. revised), but original DSM-III symptom clusters could mostly be identified. Symptom intensity was associated with age and mental health. Internal consistency, test-retest- and inter-rater reliability were good. Both German versions, the CSI and the P-CSI can be regarded as a useful screening instrument for somatic complaints in children.