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Are mental health apps actually effective?

Despite their claims of treating mental illness, a new study found that these apps are ineffective

A new study found that mental health apps do not live up to their claims of treating mental health disorders. Many app users and psychologists agree that mental health apps are not effective as a sole treatment method.

 The study, conducted by researchers at the University of Wisconsin-Madison and led by Dr. Simon B. Goldberg, a professor in the Department of Counseling Psychology, “failed to find convincing evidence” that mental health smartphone apps effectively treat symptoms of mental illness. 

The research was a meta-analysis of existing studies: of 145 controlled trials, researchers attempted to find an overall consensus on the actual efficacy of mental health apps, ultimately discovering contradictory and inconsistent results.

Apps based on cognitive behavioural therapy, meditation, and smoking cessation that were designed to treat all types of mental health disorders were included in the studies researched. 

 The Concordian spoke with Casey Dillon, a communications director that has first-hand experience with mental health apps. Dillon has struggled with anxiety and depression for over 15 years, and she downloaded the CBT Thought Diary app after her therapist recommended it. 

Although skeptical and resistant at first, Dillon began using the app with the hopes of finding a new and more effective stress management tool. 

 “I’ve tried different medications, I’ve tried different therapists, I’ve tried paper journals and mood trackers,” Dillon said. “I’m always looking for something that works.”

Dillon used the app consistently for approximately one month, but her interest in the app slowly started to fade as time progressed. After another six months of occasional use, Dillon deleted the app. “It’s hard to stay consistent and have the time to write out your feelings every day,” Dillon said.  

 The CBT Thought Diary app encourages users to identify their emotions and type out their feelings throughout the day. The app’s concept, which is based on cognitive behavioural therapy, was helpful for Dillon to a certain degree. 

“Seeing your thoughts and your feelings in writing almost minimizes your problem. Now I can see it and think about it more objectively,” she said. “But at the same time, I spent more time thinking about what was upsetting me, which made me more upset.”

  Psychotherapist and counsellor Caroline Crotty acknowledged that cognitive behavioural therapy apps “may reinforce negative outlooks or viewpoints.” 

Crotty said therapists are important in intervening and assuring their clients are on the right track, something an app doesn’t do adequately. “There’s no one to challenge them about their feelings and saying hang on a second, you need to re-think that,” she added.

 After trying multiple mental health apps, Dillon concluded that apps could not replace therapy and the human connections that come with it. 

“Once you find a therapist you are compatible with, there’s nothing like a neutral person I can talk and vent to,” Dillon said. “I think these apps are a great supplement, but not more than that.”

 Crotty said that “apps work very well alongside talking therapies.” Crotty said she recommends the apps because they are easy to use and accessible. 

“You don’t have to leave home, you don’t have to worry about commuting or parking difficulties, there is no traffic, and unlike a therapist, it is there whenever you need it,” Crotty said. 

She adds that therapists aren’t with their clients every day, which is where the app becomes helpful, “I definitely recommend them to people. I think they are a brilliant way of keeping track of day-to-day feelings and emotions.”

 Although the study did not find “convincing evidence” of apps treating mental health disorders, mental health apps can help alleviate symptoms of anxiety, depression, stress and smoking/drinking. Despite the improvement of symptoms, the study notes that mental health apps rarely outperform traditional treatment methods. 

 Crotty said she believes mental health apps will become more effective as they evolve. According to Crotty, software developers are working on integrating artificial intelligence into the apps. 

“The human touch will always be important, but I do think apps will play an absolutely huge role in the provision of healthcare and emotional support going forward,” Crotty said.

 

Photo by: Cassidy Dora

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Concordia researchers study bilingualism and language development in toddlers

“The earlier you’re exposed to a language, there are some parts of the language that are going to be easier to learn,” said Krista Byers-Heinlein, Concordia professor and Research Chair in Bilingualism. 

A joint study by Concordia and Princeton universities aims at understanding how bilingual toddlers learn two languages in the context of language switching.

“Some bilingual people might switch back and forth between their languages more often, while others don’t tend to do that and we don’t have any information as of right now [whether] that is going to matter or not for development,” said Krista Byers-Heinlein, the Concordia professor working on this study.

Byers-Heinlein, associate professor in the Department of Psychology and the Concordia University Research Chair in Bilingualism, and Casey Lew-Williams, associate professor in Princeton’s Department of Psychology are in charge of the research.

Byers-Heinlein said the research is important because in Canadian cities like Montreal, Vancouver and Toronto, about 25 per cent of kids grow up in bilingual homes.

The study will be unique in several ways. They will be “following the kids longitudinally for three years to look at their development over time,” said Byers-Heinlein.

The toddlers will be wearing small digital recorders which will catch their home language environment. Through this, researchers can measure their language outcome. It will also contribute to an eye-tracking experiment that will be done periodically in their labs, which will observe word comprehension and language processing.

“With carefully designed stimuli, we can look at the earliest responses to language – [for example] how they look into different types of language sounds in each of their languages,” said Byers-Heinlein.

Byers-Heinlein said evidence shows children can only learn language on a deep level through interaction. Children must be able to interact with people in order to learn a new language, rather than just watching YouTube videos.

“The earlier you’re exposed to a language, there are some parts of the language that are going to be easier to learn,” added Byers-Heinlein.

With the partnership between Concordia and Princeton, the researchers will be able to study two bilingual communities, which is rare in most bilingual studies.They will observe the French-English bilingualism in Montreal, and the English-Spanish bilingualism in New Jersey.

Byers-Heinlein explained this creates an interesting layer in their research because in the United States, Spanish is not an official language.

Unofficial languages are usually synonymous with heritage languages, which are spoken at home or by community members only. It’s been noted those languages are at a greater risk, like Spanish in the United States, since children are generally more inclined to gravitate toward the languages their friends are speaking, and the official language of the city. They become more reluctant toward their heritage tongue. However, Byers-Heinlein explained the same cannot be said about Montreal where English and French are commonly spoken in the city and taught at school.

“We’re interested to see how those differences, as well as cultural differences, impact what’s going on in the home, and ultimately how children grow up learning their languages,” said Byers-Heinlein.

Studying different communities will also give researchers an opportunity to explore the socio-economic aspect of bilingualism. In some areas like New Jersey, bilingualism is synonymous with immigration. Oftentimes, those families come from a lower socio-economic status, said Byers-Heinlein. In Montreal, bilingualism is more common, and is not segregated in immigrant communities.

“We know that kids from lower socio-economic backgrounds, their language development tends to be a little bit behind than other kids, probably just because they’re not having the same opportunities towards interaction with their parents that are often working multiple jobs,” said Byers-Heinlein.

The researchers are currently in the planning stages of the study. Over the next couple of months they will start looking for families who are interested in participating in the research. Those who are interested in the study can learn more about it here, or sign up on the website. The team plans to keep in touch with the families every two months, and will invite them to the lab every year.

“Children can learn certain languages at a certain rate,” said Byers-Heinelin. “If you’re dividing that learning between two languages, versus a kid who is concentrating on one language, you’re going to see some differences in [learning and development]. Sometimes we might observe differences between monolinguals and bilinguals and say ‘oh wow that bilingual kid is way behind.’ Well, she’s not behind, she’s learning twice as much.”

 

Feature graphic by Victoria Blair

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Studying the worldwide phenomenon of vaping and its dangers

In a puff of smoke, vaping has become a worldwide phenomenon. As more dimly-lit electronic cigarette stores set up shop across Montreal, Concordia University Health and Exercise Science masters students, Tasfia Tasbih and Florent Larue, aim to demystify the consequences of using e-cigarettes.

“People have the notion that [an e-cigarette] is really safe and that it’s not harmful like a regular cigarette, but it actually is,” Tasbih said. “Any amount of nicotine consumed is harmful. Smokers may not feel the impact today, but what I have found is that these products will gradually drag you toward addiction and different negative physiological responses.”

Some users misguidedly believe that vaping is more effective than conventional treatments to stop smoking altogether. However, there is no evidence of its harmlessness. The World Health Organization has consistently called for a regulation of e-cigarettes because of the lack of literature, and this past June, San Francisco became the first U.S. city to ban the sale and distribution of e-cigarettes.

According to Tasbih and Larue, e-cigarettes are often promoted as being healthier because companies deceptively claim that they do not contain nicotine.

“More and more people are nowadays choosing electronic cigarettes to reduce their combustible cigarette consumption, unaware of the lack of knowledge we have about this device,” Larue said.

What makes e-cigarettes so appealing is that, unlike a traditional cigarette, as battery-powered vaporizers, they are more easily concealed than their tobacco-rolled counterpart. In 2018, the value of e-cigarettes was estimated at $15 billion worldwide, and their popularity continues to grow. In an attempt to attract more clients, companies have produced vapes in a variety of colours, sizes and designs, allowing users to customize their experience.

E-cigarette companies have also received backlash for developing different fruity flavours for vape juice, also referred to as “e-juice” or “e-liquid.” This juice is the fluid used in vaporizers to create vapour and varies in nicotine levels. Flavours available include peppermint, strawberry and raspberry, which are especially popular among younger clients.

While researchers have shown that using e-cigarettes leads to reduced respiratory function, Tasbih and Larue hope to take their work a step further. Over the course of their three-year project, the two graduate students will study how to approach smoking cessation treatment, as well as the impacts of e-cigarette consumption, according to sex differences.

For Larue, the research project is a way for he and his colleagues to confirm the impact of e-cigarettes on the autonomic nervous system’s stress response.

The research team, supervised by Dr. Simon Bacon, has already begun recruiting participants. Throughout the project, Tasbih and Larue plan to study 120 participants between the ages of 18 and 45 who don’t have chronic diseases. Ninety will be either e-cigarette or traditional cigarette smokers, and the remaining ones will be non-smokers.

Yet, conducting the pioneering study has presented its fair share of challenges. Although there are many ways to measure the autonomic nervous system, they are not easily feasible. Over the course of their work, Larue admits that he and his colleagues sometimes struggled to obtain a good signal to perform impedance cardiography assessments.

“One of the many [challenges] is to screen people with no smoking history and no underlying disease, to make sure that the effects we will see aren’t linked to something other than e-cig smoking,” Larue said. “We also have to be precise in our measurements since physiological changes observed can be small, but when lasting for years, they could still become meaningful or harmful.”

 

Photo by Britanny Clarke

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Stress levels rise with screen-addiction

While one hand is holding a phone, the other is distractedly tapping on the computer keyboard – and perhaps the television is on in the background. This scene is one that we have now become obliviously acclimated to. Screens are everywhere. How often do we truly stop to recognize the impact they have on our mental health?

A recent study published in the Journal of Medical Internet Research, led by neuroscientist Najmeh Khalili-Mahani, is taking a different approach in trying to understand the relationship between screen time and stress. Most studies previously conducted look at the effects of screen time with a focus on online gaming and gambling, TV, or internet addiction. The relationship to specific types of mental disorders, such as that between depression and social networking, has become a common conversation. Khalili-Mahani’s study uses a holistic approach to analyze the interrelation between different technologies used by the same person.

“It’s a post-modern study, the relation between everything, as opposed to cause and effect between one and the other,” said Khalili-Mahani, who is also an affiliate assistant professor in the Department of Design and Computation Arts at Concordia. “We wanted to understand how the same person is using television and a smartphone. We are showing these interrelations between these technologies and this is allowing us to somehow zoom in on devices or on usages that are most likely to be associated with mental health or physical difficulties.”

The results reveal that all the different aspects of stress, such as financial or relationship difficulties, seem to be higher in individuals also suffering from screen addiction.

Moreover, the study shows that age and gender are key factors. Unsurprisingly, the effect on adults using social networks is not as significant as the younger generations or even women, said Khalili-Mahani.

“Everybody uses technology for finding information or working,” said Khalili-Mahani. “About 30 per cent of the population seems to be addicted to screens, in the sense that they are spending more than 8 hours of their daily time on the internet. Twenty per cent are also stressed and it’s those individuals who are both screen-addicted and stressed that have a significantly higher level of emotional stress.”

The study looks into individuals who already struggled with anxiety – whether emotionally or physically – and their relationship with these screens for various activities, such as relaxing, entertaining, and social networking. Computers, televisions, smartphones, all screens may serve as a coping mechanism for people who already suffer or are actively developing mental health disorders; and this is what needs to be unpacked, according to Khalili-Mahani.

As mental health is still a considerably social taboo topic, people do not necessarily associate the simple use of screens for consuming news, or work-related activities, with screen addiction. Khalili-Mahani pointed out the fact that there is a sense of social guilt when it comes to using technology, which arguably impedes the conversation surrounding screen addiction and stress. Yet, everyone is using technology, one way or another. According to Statistics Canada, the percentage of the population [using technology] is above 90 per cent in most provinces, no matter what category of addiction or stress groups they fit into.

Paradoxically, the goal of the research is not to find a solution to withdraw screen-addicted individuals from technology, but rather to develop information and communication technology, using screens for health care prevention. This could be quite a controversial approach, as some social movements are calling for technology’s total disengagement, such as quitting Facebook. Indeed, the abrupt rise of technology confronts us with a lack of comprehension, which can lead to demonization and even disdain. The more stressed or anxious someone is feeling, the greater the opportunity for escaping reality via the internet.

But finding a solution within the problem makes sense. Individuals suffering from both screen-addiction and intense levels of stress could find a familiar comfort as they are undeniably more drawn to these technologies, argued Khalili-Mahani. Using screen technologies to reach out to highly-stressed individuals and help with mental health diseases, such as depression or suicidal tendencies, are still under development. Nonetheless, it is a great step towards positively adapting rather than passively losing our inner personal battles with technology.

 

Photos by Laurence B.D.

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