Discovery of Health Apps Among Those With Mental Health Needs

A study published in Journal of Medical Internet Research (JMIR) by Stephen M Schueller, PhD and colleagues from Northwestern University, Chicago, IL, recruited participants from Northwestern University’s Center for Behavioral Intervention Technologies’ research registry of individuals with mental health needs. Participants (n=811) completed a survey asking about their use and interest in health and mental health apps. A total of 7 focus groups composed of local participants were conducted with 30 participants that collected more detailed information about their use and interest in health and mental health apps.

Results revealed that the most common sources that were indentified by participants in looking for mental health apps were social media (45.1%) as well through their own searches (42.7%). Common places people searched for apps were the app stores, Google searches, and Web forums such as Reddit. Some specific apps were suggested by their medical providers (24.6%), others indicated that a friend or family member helped them identify apps (36.9%). It appears that more informal sources of information are relied on more than formal of sources of information in identifying mental health apps.

The authors describe that “the results of our survey and focus group were largely consistent showing that, in general, content within apps (eg, aesthetics, features, and functionality) was the largest determinant to encourage people to download and use health apps. Although notions of credibility and issues of privacy and security were important, these aspects were often assumed to be present when “trusted sources” were involved in app development.” The survey data revealed one hesitation to adoption was uncertainty regarding the effectiveness of digital tools, “but the focus group participants did not seem to think that research evidence was extremely compelling.”

The study suggests that “future work should help promote standards related to the promotion of health apps to ensure that effective tools make their ways into the hands of consumers. Furthermore, our focus groups identified “trusted sources” as a strong influence of people’s decision to use tools, but the survey results participants rarely received information about apps from professional sources such as providers.”

Source: JMIR, Schueller, et al.

Barriers to eHealth in Psychiatry

Unlike other areas of medicine, technological solutions for mental health are not necessarily sought by consumers nor recommended by clinicians. A study of multidisciplinary professionals was conducted to identify and discuss the barriers to introducing eHealth technology-supported interventions within mental health.

Ten issues were identified that need to be addressed to improve mental health (using technology). They are ranked in order of importance.

Issue identified n (%)
Access to care 24 (36)
Integration and collaboration 15 (23)
Education and awareness 13 (20)
Mental health stigma 13 (20)
Data privacy 12 (18)
Trust 11 (17)
Understanding and assessment of mental health 11 (17)
Government and policy 10 (15)
Optimal design 9 (14)
Engagement 8 (12)

According to the authors, “Without a concerted effort to translate research into policy and practice to address the barriers described here, the adoption of technology into mental health care will inevitably be slowed. However, the greater failure will be to miss the potential, offered by technology, to address in a timely way major concerns of access, stigma, and engagement that stand as active barriers to participation in mental health care and the receipt of effective, evidence-based therapy by those most in need.”

Source: Journal of Medical Internet Research, 2/28/17





Text Messaging & Brain Waves

New research published in Epilepsy and Behavior shows that sending text messages on a smartphone can change the rhythm of brain waves.  People communicate increasingly via text messaging, though little is known on the neurological effects of smartphone use. A neurologist and director of the epilepsy monitoring unit and epilepsy center at the Mayo Clinic in Jacksonville, Florida found a unique EEG ‘texting rhythm’ in approximately 1 in 5 patients who were using their smartphone to text message while having their brain waves monitored.

eegAccording to the researchers, while the use of smartphones has drastically increased within the past few years, little is known about their influence on neurophysiological processes. Recently, we have observed more patients using personal electronic devices to communicate by text messaging during VEM. As a result, we have encountered a reproducible, stimulus-coupled, time-locked, 5–6-Hz, generalized, frontocentral-predominant, theta rhythm that occurs during active texting. The researchers define it as a texting rhythm (TR) evoked by the use of smartphones. “We found that a TR is a reproducible neurophysiological response to complex technology-specific communication. The visual–spatial–motor cortical processing during texting appears to generate an EEG signal that is unique to personal electronic devices. We hypothesize that a TR likely reflects a combination of increased attention coupled with a heightened affective influence while sending smartphone text messages. Whether the TR reflects a benign form of midline frontal theta or a biomarker with application in industry or health care will merit further investigation.”


IBM Watson Can Help You Improve Your Writing

toneanalyzerIBM’s Watson Tone Analyzer is a new service that can analyze text for the attitude and tone that underlie it. The tool could help anyone refine an email, marketing message, presentation or blog post before releasing it into the world said Rama Akkiraju, a distinguished engineer and master inventor for IBM Watson User Technologies.

The goal of Tone Analyzer is to help correct written communication by assessing writing on three primary dimensions. The first is emotional tone, where it focuses on cheerfulness, negative emotions, and anger. Social tone is the second metric it captures by assessing openness, agreeableness and conscientiousness. Finally, writing tone is the third dimension it evaluates in order to provide feedback on how analytical, confident, and tentative the writing is. When it analyzes a passage of text, Tone Analyzer’s results include an explanation of which words contributed to which tone; it also offers alternate word suggestions to refine the text and its tone accordingly.

According to Rama Akkiraju, Distinguished Engineer and Master Inventor at IBM Watson User Technologies, “to read a message and to judge the tone conveyed in the message comes naturally to humans. But, at times, the tone may be overlooked, undesired, or not conveyed well by the author. Can a computer detect the tones conveyed in a message accurately and automatically? Helping humans assess and refine tone in written communication is an interesting challenge in the Artificial Intelligence and Cognitive Sciences fields. At IBM Watson, we are beginning to answer this question.”

Tone Analyzer Scorecard includes Emotional Tone, Social Tone and Writing Style/Tone. For a more elaborate explanation of these ‘tones’ and to test out an analysis of your text, click on the link below for the IBM developer blog.

IBM Watson Tone Analyzer Link

IBM Announcement

Teens May Seek Health Information Online, Don’t Always Trust It



A study by Northwestern University Center on Media and Human Development of 1,156 adolescents (13-18) studied how teenagers learned about health. It is often assumed that adolescents are easily reached via social media, the researchers found that these efforts do not necessarily true and that often teenagers want to be more private and don’t want others to know what they’re searching about.

Teenagers reported that they primarily looked online for health information for school projects, and then for fitness and diet advice. A third sought information online when a health issue affected them, and a quarter did so to learn more about treating an illness or an injury. One in three teenagers said they changed their behavior because of what they had learned from online sites or apps.

Interestingly, when asked where they got most of their health information, 55 percent of the teenagers cited their parents. School health classes and medical providers also ranked higher than the Internet as preferred sources. Forty-one percent of teenagers searched online for “unhealthy” in formation, including drinking games and how to be anorexic or bulimic, the researchers found. Forty-three percent said they had seen pornography online.

Teen Tables












NY Times Well Blog

Teens, Health, and Technology A National Survey June 2015

Northwestern University Center on Media and Human Development






Putting Education Back In Educational Apps

PSNumerous apps are developed and available for children and many of them are marketed as “educational.” The question is…how do we know which of these thousands of apps will actually help children learn? A report published in Psychological Science in the Public Interest, a journal of the Association for Psychological Science, integrates research from scientific disciplines such as psychological science, linguistics, and neuroscience to assemble an evidence-based guide that parents, educators, and app designers can use to evaluate the quality of present and future “educational” apps.

According to the authors of the report, “The numbers tell the story. Apps are not just ubiquitous, but also big business: Over $10 billion was spent in the App Store in 2013. By 2015, revenue from apps is predicted to triple to $38 billion. Technology is rapidly changing the nature of adults’ day-to-day and even minute-to-minute experiences. We have not begun to understand the impact of the app explosion on our economy and society. The content of the report uses data from decades of research in the Science of Learning to illustrate how the development and evaluation of apps could embrace an evidence-based stance. Importantly, there are a number of theoretical positions on the ways in which children learn.

The researchers conclude that “educational” apps best support learning when they are:

“These four principles can help us distinguish apps that masquerade as educational from those most likely to engage children in an educationally meaningful experience,” the authors say. While not all of these principles are necessary, the more an app promotes these types of learning experiences, the greater the educational value of the app will likely be.

Free full text report

Are computer-based personality judgments are more accurate than those made by humans?

PNASAccording to a new study published in the Proceedings of the National of Sciences (PNAS), computer predictions based on a generic digital footprint (Facebook Likes) are more accurate (r = 0.56) than those made by the participants’ Facebook friends using a personality questionnaire (r = 0.49); (ii) computer models show higher interjudge agreement; and (iii) computer personality judgments have higher external validity when predicting life outcomes such as substance use, political attitudes, and physical health; for some outcomes, they even outperform the self-rated personality score.

The authors point out that “perceiving and judging other people’s personality traits is an essential component of social living. People use personality judgments to make day-to-day decisions and long-term plans in their personal and professional lives, such as whom to befriend, marry, trust, hire, or elect as president. The more accurate the judgment, the better the decision. Previous research has shown that people are fairly good at judging each other’s personalities; for example, even complete strangers can make valid personality judgments after watching a short video presenting a sample of behavior.”

This study compares the accuracy of personality judgment— a ubiquitous and important social-cognitive activity—between computer models and humans. Using several criteria, the researchers demonstrate that computers’ judgments of people’s personalities based on their digital footprints are more accurate and valid than judgments made by their close others or acquaintances (friends,family, spouse, colleagues, etc.). Our findings highlight that people’s personalities can be predicted automatically and without involving human social-cognitive skills.


Source: PNAS

Smartphone Apps to Manage Schizophrenia and Bipolar Disorder


Smartphone apps are being developed to address mental health issues such as support, reminders, monitoring of mood changes and even stress levels. Tools under development from startups, academic institutions, and research clinics aim to help people manage everything from severe depression to bipolar disorder and schizophrenia. A recent article in Wired magazine points out that “through the discreet and continuous recording of social and physical behavior, these apps can detect changes in mental well-being, deliver micro-interventions when and where needed, and give patients a new awareness of their own illnesses. In the long run, they may even diminish the stigma attached to mental health disorders.”

A Boston-based company Cogito was conducting a clinical trial of an app at the time of the Boston Marathon bombing. Their smartphone application continuously and passively monitors psychological health and well-being using built-in mobile sensors and survey questions. “The bombing offers a unique pre-and post-disaster dataset for understanding the longitudinal trajectories and risk factors for PTSD following trauma. Initial analyses of the data show that survey participation dropped by ~50% during the two weeks immediately after the Boston bombing, perhaps an early indication of the PTSD symptom of withdrawal. Of those that did respond, participants reported an average of ~14% increase in severity of attitudes and behaviors linked with depression and PTSD in the two weeks following the bombing than they did in the two weeks prior.”

A number of apps are being researched to monitor the symptoms of bipolar disorder and schizophrenia. The University of Michigan is working with a company to monitor individuals with rapid-cycling bipolar disorder. Although the possibilities are interesting, many of these ‘medical apps’ are untested and unregulated. Last year the FDA released a document for guidance on medical apps, however it focused mostly on apps that diagnose or turn a smartphone into an EEG. There are no guidelines for mental health apps as yet.


November 20, 2014



Nearly Half of Consumers Desperately Need Their Smartphones

smartphonesA survey by Bank of America states that 47 percent of U.S. consumers admit they wouldn’t last a day without their smartphone. Additionally, of those surveyed who use their phone for mobile banking, 31 percent said they log on at least once a day, while 82 percent access their accounts at least once a week or more. These findings are part of the inaugural Bank of America Trends in Consumer Mobility Report, “a study that explores broad mobile trends and banking behaviors among adult consumers across the country who own a smartphone and have an existing banking relationship. The survey found that mobile connectivity is so critical, the smartphone falls below only the Internet and personal hygiene when ranked by importance to people’s daily lives. Ninety-one percent say their mobile phone is very important, just as important as their car (91 percent) and deodorant (91 percent); and significantly more important than television (76 percent) and coffee (60 percent). The report also found that the youngest millennials ages 18-24 are most likely to view their mobile phones as very important (96 percent) — more so than deodorant (90 percent) and even their toothbrush (93 percent).”

So who own smartphones? The Pew Research Internet Project states that “As of January 2014, 90% of American adults have a cell phone. 58% have a smartphone.”

Here is the breakdown of their study.

























Sources: Bank of America Newsroom

Pew Research Internet project

Is it time to update physician’s social media guidelines?

s_cover_jcv082113According to an article in this month’s JAMA, organized medicine should change the medical profession guidelines on social media use that calls on doctors to separate their personal and professional online personas. The article suggests that “instead of focusing on professional and personal boundaries, physicians should zero in on the boundary between what is appropriate and what is not. When a physician asks, ‘Should I post this on social media?’ the answer does not depend on whether the content is professional or personal but instead depends on whether it is appropriate for a physician in a public space,” the authors said.

The separation of personal and professional personae was a recommendation first made by the American Medical Association in 2010. Other physician organizations followed suit with their own guidelines, each promoting the same personal-professional separation advice. In April, the American College of Physicians and the Federation of State Medical Boards released similar guidelines. According to the JAMA authors, “Separation of identities online is operationally impossible.” They argue that an online search for a social media page would connect both personal and professional pages. “Despite the increasing availability of paid services to monitor and control a person’s Web presence, no current technology exists to overcome fully this particular barrier.”

In addition, the argument highlights that “Professional identity constitutes and is constituted by personal identity, perhaps as one of the many ‘subidentities’ or roles individuals might have, such as a spouse, parent and so on. Separation therefore verges on nonsensical. The argument is also made that separation may be harmful and that depersonalized online interactions could lead patients to believe the doctor is hiding something. They also could lead to a physician’s inability to normalize a difficult situation or express empathy.

JAMA: Social Media and Physicians’ Online Identity Crisis