@Article{info:doi/10.2196/47860,
author="Bell, Imogen
and Arnold, Chelsea
and Gilbertson, Tamsyn
and D'Alfonso, Simon
and Castagnini, Emily
and Chen, Nicola
and Nicholas, Jennifer
and O'Sullivan, Shaunagh
and Valentine, Lee
and Alvarez-Jimenez, Mario",
title="A Personalized, Transdiagnostic Smartphone Intervention (Mello) Targeting Repetitive Negative Thinking in Young People With Depression and Anxiety: Pilot Randomized Controlled Trial",
journal="J Med Internet Res",
year="2023",
month="Dec",
day="13",
volume="25",
pages="e47860",
keywords="repetitive negative thinking; rumination; anxiety; depression; mobile app; just-in-time adaptive interventions; youth mental health; adolescent; mobile phone",
abstract="Background: Repetitive negative thinking (RNT) is a key transdiagnostic mechanism underpinning depression and anxiety. Using ``just-in-time adaptive interventions'' via smartphones may disrupt RNT in real time, providing targeted and personalized intervention. Objective: This pilot randomized controlled trial evaluates the feasibility, acceptability, and preliminary clinical outcomes and mechanisms of Mello---a fully automated, personalized, transdiagnostic, and mechanistic smartphone intervention targeting RNT in young people with depression and anxiety. Methods: Participants with heightened depression, anxiety, and RNT were recruited via social media and randomized to receive Mello or a nonactive control over a 6-week intervention period. Assessments were completed via Zoom sessions at baseline and at 3 and 6 weeks after baseline. Results: The findings supported feasibility and acceptability, with high rates of recruitment (N=55), uptake (55/64, 86{\%} of eligible participants), and retention (52/55, 95{\%} at 6 weeks). Engagement was high, with 90{\%} (26/29) and 59{\%} (17/29) of the participants in the Mello condition still using the app during the third and sixth weeks, respectively. Greater reductions in depression (Cohen d=0.50), anxiety (Cohen d=0.61), and RNT (Cohen d=0.87) were observed for Mello users versus controls. Mediation analyses suggested that changes in depression and anxiety were accounted for by changes in RNT. Conclusions: The results indicate that mechanistic, targeted, and real-time technology-based solutions may provide scalable and effective interventions that advance the treatment of youth mental ill health. Trial Registration: Australian New Zealand Clinical Trials Registry ACTRN12621001701819; http://tinyurl.com/4d3jfj9f ",
issn="1438-8871",
doi="10.2196/47860",
url="https://www.jmir.org/2023/1/e47860",
url="https://doi.org/10.2196/47860",
url="http://www.ncbi.nlm.nih.gov/pubmed/38090786"
}