title: Self-monitoring practices, attitudes, and needs of individuals with bipolar disorder: implications for the design of technologies to manage mental health.
abstract: To understand self-monitoring strategies used independently of clinical treatment by individuals with bipolar disorder (BD), in order to recommend technology design principles to support mental health management.
  
  
  
  Participants with BD (N = 552) were recruited through the Depression and Bipolar Support Alliance, the International Bipolar Foundation, and WeSearchTogether.org to complete a survey of closed- and open-ended questions. In this study, we focus on descriptive results and qualitative analyses.
  
  
  
  Individuals reported primarily self-monitoring items related to their bipolar disorder (mood, sleep, finances, exercise, and social interactions), with an increasing trend towards the use of digital tracking methods observed. Most participants reported having positive experiences with technology-based tracking because it enables self-reflection and agency regarding health management and also enhances lines of communication with treatment teams. Reported challenges stem from poor usability or difficulty interpreting self-tracked data.
  
  
  
  Two major implications for technology-based self-monitoring emerged from our results. First, technologies can be designed to be more condition-oriented, intuitive, and proactive. Second, more automated forms of digital symptom tracking and intervention are desired, and our results suggest the feasibility of detecting and predicting emotional states from patterns of technology usage. However, we also uncovered tension points, namely that technology designed to support mental health can also be a disruptor.
  
  
  
  This study provides increased understanding of self-monitoring practices, attitudes, and needs of individuals with bipolar disorder. This knowledge bears implications for clinical researchers and practitioners seeking insight into how individuals independently self-manage their condition as well as for researchers designing monitoring technologies to support mental health management.
authors.affiliation: Information Science Department, Cornell University, Ithaca, NY, USA elm236@cornell.edu.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Murnane
authors.affiliation: Information Science Department, Cornell University, Ithaca, NY, USA.
authors.forename: Dan
authors.initials: D
authors.lastname: Cosley
authors.affiliation: Department of Communication, Cornell University, Ithaca, NY, USA.
authors.forename: Pamara
authors.initials: P
authors.lastname: Chang
authors.affiliation: Information Science Department, Cornell University, Ithaca, NY, USA.
authors.forename: Shion
authors.initials: S
authors.lastname: Guha
authors.affiliation: School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Ellen
authors.initials: E
authors.lastname: Frank
authors.affiliation: Information Science Department, Cornell University, Ithaca, NY, USA Department of Communication, Cornell University, Ithaca, NY, USA.
authors.forename: Geri
authors.initials: G
authors.lastname: Gay
authors.affiliation: Information Science Department, Cornell University, Ithaca, NY, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Matthews
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001294:Attitude to Health; D001714:Bipolar Disorder / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000706:statistics & numerical data*; D017060:Patient Satisfaction; D000073278:Self-Management / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D017216:Telemedicine / Q000295:instrumentation; D000076251:Wearable Electronic Devices; D055815:Young Adult
keywords: health information technology; informatics; self-management; telehealth