Optimizing Smartphone-Delivered Cognitive Behavioral Therapy for Body Dysmorphic Disorder Using Passive Smartphone Data: Initial Insights From an Open Pilot Trial
Optimizing Smartphone-Delivered Cognitive Behavioral Therapy for Body Dysmorphic Disorder Using Passive Smartphone Data: Initial Insights From an Open Pilot Trial
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DOI：
10.2196/16350
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发表时间：
2020-06-18
影响因子：
5
通讯作者：
Wilhelm, Sabine
中科院分区：
文献类型：
--
作者：
Weingarden, Hilary;Matic, Aleksandar;Wilhelm, Sabine
背景：智能手机提供的认知行为疗法（CBT）正变得越来越普遍，但对该主题的研究仍处于起步阶段。关于人们通常如何参与智能手机CBT或哪些参与和移动模式可以优化治疗，人们知之甚少。被动智能手机数据提供了一个独特的机会，以深入了解这些知识差距。目的：本研究旨在检查被动智能手机数据在智能手机CBT的身体畸形障碍（BDD），一种精神疾病的特点是专注于一个感知缺陷的身体外观的试点课程，以告知假设生成和后续的设计，更大的试验。方法：在全国范围内共招募了10名BDD初步诊断的成年人，并与可靠的评估者一起完成了远程医疗临床医生评估。在为期12周的智能手机CBT开放试点试验中，我们最初的特点是参与治疗的自然模式，并测试了如何参与和流动性模式在整个治疗对应于治疗respons.Results：大多数参与者的互动简短而频繁的智能手机提供的治疗。更频繁的应用程序使用（r=-0.57），而不是更长的使用时间（r=-0.084），与反应密切相关。GPS检测到的时间在家里，一个潜在的数字标记的回避，减少治疗和中度相关的BDD严重程度（r=0.49）。结论：在这个试点研究的样本是小的，因此，结果应被用来通知的假设和设计的后续试验。研究结果提供了初步证据，表明频繁（即使是短暂的）CBT技能的练习可以优化对智能手机CBT的反应，并且移动模式可以作为症状严重程度的有用的被动标记。这是第一批研究被动收集的传感器数据可能有助于理解和优化用户对智能手机CBT的反应的价值之一。通过进一步验证，结果可以为如何增强智能手机CBT设计提供信息。
Background: Smartphone-delivered cognitive behavioral therapy (CBT) is becoming more common, but research on the topic remains in its infancy. Little is known about how people typically engage with smartphone CBT or which engagement and mobility patterns may optimize treatment. Passive smartphone data offer a unique opportunity to gain insight into these knowledge gaps.Objective: This study aimed to examine passive smartphone data across a pilot course of smartphone CBT for body dysmorphic disorder (BDD), a psychiatric illness characterized by a preoccupation with a perceived defect in physical appearance, to inform hypothesis generation and the design of subsequent, larger trials.Methods: A total of 10 adults with primary diagnoses of BDD were recruited nationally and completed telehealth clinician assessments with a reliable evaluator. In a 12-week open pilot trial of smartphone CBT, we initially characterized natural patterns of engagement with the treatment and tested how engagement and mobility patterns across treatment corresponded with treatment response.Results: Most participants interacted briefly and frequently with smartphone-delivered treatment. More frequent app usage (r=-0.57), as opposed to greater usage duration (r=-0.084), correlated strongly with response. GPS-detected time at home, a potential digital marker of avoidance, decreased across treatment and correlated moderately with BDD severity (r=0.49).Conclusions: The sample was small in this pilot study; thus, results should be used to inform the hypotheses and design of subsequent trials. The results provide initial evidence that frequent (even if brief) practice of CBT skills may optimize response to smartphone CBT and that mobility patterns may serve as useful passive markers of symptom severity. This is one of the first studies to examine the value that passively collected sensor data may contribute to understanding and optimizing users' response to smartphone CBT. With further validation, the results can inform how to enhance smartphone CBT design.