Evaluating the effects of a self-help mobile phone application on worry and rumination experienced by young adults: A randomised controlled trial. (Preprint)

Abstract

Delivery of preventative interventions via mobile phone applications offers an effective and accessible way to address the global priority of improving the mental health of adolescents and young adults. A proven risk factor for anxiety and depression is elevated worry and rumination, also known as repetitive negative thinking (RNT).

This was a prevention mechanism trial testing whether an RNT-targeting self-help mobile phone application (MyMoodCoach) reduces worry and rumination in young adults residing in the United Kingdom. A secondary objective was to test whether the app reduces symptoms of anxiety and depression and improves well-being.

A web-based, single-blind, two-arm parallel-group Randomised Controlled Trial (RCT) was conducted with N=236 people aged between 16 and 24 who self-reported high levels of worry or rumination. Eligible participants were randomised to an active intervention group (usual practice, plus up to 6 weeks of using the RNT-targeting mobile app, n=119) or a waitlist control group (usual practice with no access to the app until after six weeks, n =117). The primary outcome was changes in worry and rumination six weeks after randomisation. Secondary outcomes included changes in well-being and symptoms of anxiety and depression after six weeks and changes on all measures after 12 weeks.

Participants randomly allocated to use the RNT-targeting self-help app showed significantly lower levels of rumination (mean difference -2.92, 95% CI [-5.57, -.28], P =.031, ηp2 = .02) and worry (mean difference -3.97; 95% CI [-6.21, -1.73], P <.001, ηp2 = .06) at six-week follow-up, relative to the waitlist control. Similar differences were observed for wellbeing (P <.001), anxiety (P = .03) and depression (P = .04). The waitlist control group also showed improvement when given access to the app after six weeks. Improvements observed in the intervention group after 6 weeks of using the app were maintained at the 12-week follow-up point.

The MyMoodCoach app had a significant positive effect on worry and rumination, well-being, anxiety, and depression in young adults, relative to waitlist controls, providing proof-of-principle that an unguided self-help app can effectively reduce repetitive negative thinking. This app therefore has potential for prevention of anxiety and depression although longer-term effects on incidence need to be directly evaluated.

ClinicalTrials.gov, NCT04950257. Registered 6 July 2021 – Retrospectively registered (shortly after start of recruitment), https://www.clinicaltrials.gov/ct2/show/NCT04950257

RR2-10.1186/s12888-021-03536-0