title: Smartphone-Based Psychotherapeutic Micro-Interventions to Improve Mood in a Real-World Setting.
abstract: BACKGROUND
  Using mobile communication technology as new personalized approach to treat mental disorders or to more generally improve quality of life is highly promising. Knowledge about intervention components that target key psychopathological processes in terms of transdiagnostic psychotherapy approaches is urgently needed. We explored the use of smartphone-based micro-interventions based on psychotherapeutic techniques, guided by short video-clips, to elicit mood changes.
  
  
  METHODS
  As part of a larger neurofeedback study, all subjects-after being randomly assigned to an experimental or control neurofeedback condition-underwent daily smartphone-based micro-interventions for 13 consecutive days. They were free to choose out of provided techniques, including viscerosensory attention, emotional imagery, facial expression, and contemplative repetition. Changes in mood were assessed in real world using the Multidimensional Mood State Questionnaire (scales: good-bad, GB; awake-tired, AT; and calm-nervous, CN).
  
  
  RESULTS
  Twenty-seven men participated on at least 11 days and were thus included in the analyses. Altogether, they underwent 335, generally well-tolerated, micro-intervention sessions, with viscerosensory attention (178 sessions, 53.13%) and contemplative repetition (68 sessions, 20.30%) being the most frequently applied techniques. Mixed models indicated that subjects showed better mood [GB: b = 0.464, 95%confidence interval (CI) [0.068, 0.860], t (613.3) = 2.298, p = 0.022] and became more awake [AT: b = 0.514, 95%CI [0.103, 0.925], t (612.4) = 2.456, p = 0.014] and calmer [CN: b = 0.685, 95%CI [0.360, 1.010], t (612.3) = 4.137, p < 0.001] from pre- to post-micro-intervention. These mood improvements from pre- to post-micro-intervention were associated with changes in mood from the 1st day until the last day with regard to GB mood (r = 0.614, 95%CI [0.297, 0.809], p < 0.001), but not AT mood (r = 0.279, 95%CI [-0.122, 0.602], p = 0.167) and CN mood (r = 0.277, 95%CI [0.124, 0.601], p = 0.170).
  
  
  CONCLUSIONS
  Our findings provide evidence for the applicability of smartphone-based micro-interventions eliciting short-term mood changes, based on techniques used in psychotherapeutic approaches, such as mindfulness-based psychotherapy, transcendental meditation, and other contemplative therapies. The results encourage exploring these techniques' capability to improve mood in randomized controlled studies and patients. Smartphone-based micro-interventions are promising to modify mood in real-world settings, complementing other psychotherapeutic interventions, in line with the precision medicine approach. The here presented data were collected within a randomized trial, registered at ClinicalTrials.gov (Identifier: NCT01921088) https://clinicaltrials.gov/ct2/show/NCT01921088.
authors: Division of Clinical Psychology and Epidemiology, Department of Psychology, University of BaselBasel, Switzerland; Faculty of Medicine, Ruhr-University BochumBochum, Germany.
authors: Gunther
authors: G
authors: Meinlschmidt
authors: Department of Brain and Cognitive Engineering, Korea University Seoul, South Korea.
authors: Jong-Hwan
authors: JH
authors: Lee
authors: Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel Basel, Switzerland.
authors: Esther
authors: E
authors: Stalujanis
authors: Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel Basel, Switzerland.
authors: Angelo
authors: A
authors: Belardi
authors: Department of Brain and Cognitive Engineering, Korea University Seoul, South Korea.
authors: Minkyung
authors: M
authors: Oh
authors: Department of Brain and Cognitive Engineering, Korea University Seoul, South Korea.
authors: Eun Kyung
authors: EK
authors: Jung
authors: Department of Brain and Cognitive Engineering, Korea University Seoul, South Korea.
authors: Hyun-Chul
authors: HC
authors: Kim
authors: Division of Clinical Psychology and Epidemiology, Department of Psychology, University of Basel Basel, Switzerland.
authors: Janine
authors: J
authors: Alfano
authors: Department of Radiology, Brigham and Women's Hospital, Harvard Medical SchoolBoston, MA, USA; Incheon St. Mary's Hospital, The Catholic University of KoreaIncheon, South Korea.
authors: Seung-Schik
authors: SS
authors: Yoo
authors: Division of Clinical Psychology and Psychiatry, Department of Psychology, University of Basel Basel, Switzerland.
authors: Marion
authors: M
authors: Tegethoff
keywords: Internet- and mobile-based intervention; behavioral intervention technology; ehealth; health information technology; information and communication technology; mental disorder; mhealth; wireless health