Browsing by Author "Ben-Zeev, Dror"
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- ItemComparing retrospective reports to real-time/real-place mobile assessments in individuals with schizophrenia and a nonclinical comparison group.(2012-04-20) Ben-Zeev, Dror; McHugo, Gregory J; Xie, Haiyi; Dobbins, Katy; Young, Michael ARetrospective reports are often used as the primary source of information for important diagnostic decisions treatment and clinical research Whether such reports accurately represent individuals past experiences in the context of a serious mental illness such as schizophrenia is unclear In the current study 24 individuals with schizophrenia and 26 nonclinical participants used a mobile device to complete multiple real time real place assessments daily over 7 consecutive days At the end of the week participants were also asked to provide a retrospective report summarizing the same period Comparison of the data captured by the 2 methods showed that participants from both groups retrospectively overestimated the intensity of negative and positive daily experiences In the clinical group overestimations for affect were greater than for psychotic symptoms which were relatively comparable to their retrospective reports In both samples retrospective reports were more closely associated with the week s average than the most intense or most recent ratings captured with a mobile device Multilevel modeling revealed that much of the variability in weekly assessments was not explained by between person differences and could not be captured by a single retrospective estimate Based on the findings of this study clinicians and researchers should be aware that while retrospective summary reports of the severity of certain symptoms compare relatively well with average momentary ratings they are limited in their ability to capture variability in one s affective or psychotic experiences over time
- ItemDevelopment and usability testing of FOCUS: a smartphone system for self-management of schizophrenia.(2013-12-10) Ben-Zeev, Dror; Kaiser, Susan M; Brenner, Christopher J; Begale, Mark; Duffecy, Jennifer; Mohr, David COBJECTIVE Mobile Health mHealth approaches can support the rehabilitation of individuals with psychiatric conditions In the current article we describe the development of a smartphone illness self management system for people with schizophrenia METHODS The research was conducted with consumers and practitioners at a community based rehabilitation agency Stage 1 904 individuals with schizophrenia or schizoaffective disorder completed a survey reporting on their current use of mobile devices and interest in mHealth services Eight practitioners completed a survey examining their attitudes and expectations from an mHealth intervention and identified needs and potential obstacles Stage 2 A multidisciplinary team incorporated consumer and practitioner input and employed design principles for the development of e resources for people with schizophrenia to produce an mHealth intervention Stage 3 12 consumers participated in laboratory usability sessions They performed tasks involved in operating the new system and provided think aloud commentary and post session usability ratings RESULTS 570 63 of survey respondents reported owning a mobile device and many expressed interest in receiving mHealth services Most practitioners believed that consumers could learn to use and would benefit from an mHealth intervention In response we developed a smartphone system that targets medication adherence mood regulation sleep social functioning and coping with symptoms Usability testing revealed several design vulnerabilities and the system was adapted to address consumer needs and preferences accordingly CONCLUSIONS AND IMPLICATIONS FOR PRACTICE Through a comprehensive development process we produced an mHealth illness self management intervention that is likely to be used successfully and is ready for deployment and systemic evaluation in real world conditions
- ItemFeasibility, acceptability, and preliminary efficacy of a smartphone intervention for schizophrenia.(2014-10-11) Ben-Zeev, Dror; Brenner, Christopher J; Begale, Mark; Duffecy, Jennifer; Mohr, David C; Mueser, Kim TThe FOCUS smartphone intervention was developed to provide automated real time real place illness management support to individuals with schizophrenia The system was specifically designed to be usable by people with psychotic disorders who may have cognitive impairment psychotic symptoms negative symptoms and or low reading levels FOCUS offers users both prescheduled and on demand resources to facilitate symptom management mood regulation medication adherence social functioning and improved sleep In this study 33 individuals with schizophrenia or schizoaffective disorder used FOCUS over a 1 month period in their own environments Participants were able to learn how to use the intervention independently and all but one participant completed the trial successfully and returned the smartphones intact Completers used the system on 86 5 of days they had the device an average of 5 2 times a day Approximately 62 of use of the FOCUS intervention was initiated by the participants and 38 of use was in response to automated prompts Baseline levels of cognitive functioning negative symptoms persecutory ideation and reading level were not related to participants use of the intervention Approximately 90 of participants rated the intervention as highly acceptable and usable Paired samples t tests found significant reductions in psychotic symptoms depression and general psychopathology after 1 month of FOCUS use This study demonstrated the feasibility acceptability and preliminary efficacy of the FOCUS intervention for schizophrenia and introduces a new treatment model which has promise for extending the reach of evidence based care beyond the confines of a physical clinic using widely available technologies
- ItemLife with FOCUS: A qualitative evaluation of the impact of a smartphone intervention on people with serious mental illness.(0000-00-00) Jonathan, Geneva; Carpenter-Song, Elizabeth A; Brian, Rachel M; Ben-Zeev, DrorOBJECTIVE A growing body of literature indicates that mobile health mHealth interventions that utilize smartphones for illness management are feasible acceptable and clinically promising In this study we examine how individuals with serious mental illness use a mHealth intervention FOCUS to self manage their illnesses Additionally we explored participant perceptions of the intervention s impact on their subjective illness experience METHOD We analyzed qualitative data from 30 individuals with serious mental illness who participated in 1 of 2 community based 3 month trials of FOCUS In Study 1 weekly calls were conducted by a mHealth specialist to facilitate and enhance intervention use In Study 2 researchers conducted qualitative interviews to gather detailed perspectives of intervention use Data were sampled from the weekly call notes and qualitative interviews and analyzed using a thematic and collaborative approach RESULTS Thematic analyses revealed 6 recurring themes Three themes emerged in regard to participants ongoing daily use of FOCUS back up support symptom management and self awareness Another 3 themes emerged related to the intervention s impact on participants recovery processes acceptance of symptoms motivation and supporting positive outlook CONCLUSIONS AND IMPLICATIONS FOR PRACTICE This qualitative study offers insight into how individuals with serious mental illness made use of a mHealth intervention designed to support illness self management Our findings suggest that individuals may benefit differently from mHealth interventions depending on where they are in the recovery process As mHealth interventions become increasingly popular in clinical settings it is important to understand consumers short term and long term benefits from these interventions PsycINFO Database Record c 2018 APA all rights reserved
- ItemmHealth for dual diagnosis: considering long-term implementation.(2014-11-13) Ben-Zeev, Dror
- ItemMobile Assessment and Treatment for Schizophrenia (MATS): a pilot trial of an interactive text-messaging intervention for medication adherence, socialization, and auditory hallucinations.(2012-04-20) Granholm, Eric; Ben-Zeev, Dror; Link, Peter C; Bradshaw, Kristen R; Holden, Jason LMobile Assessment and Treatment for Schizophrenia MATS employs ambulatory monitoring methods and cognitive behavioral therapy interventions to assess and improve outcomes in consumers with schizophrenia through mobile phone text messaging Three MATS interventions were developed to target medication adherence socialization and auditory hallucinations Participants received up to 840 text messages over a 12 week intervention period Fifty five consumers with schizophrenia or schizoaffective disorder were enrolled but 13 consumers with more severe negative symptoms lower functioning and lower premorbid IQ did not complete the intervention despite repeated prompting and training For completers the average valid response rate for 216 outcome assessment questions over the 12 week period was 86 and 86 of phones were returned undamaged Medication adherence improved significantly but only for individuals who were living independently Number of social interactions increased significantly and a significant reduction in severity of hallucinations was found In addition the probability of endorsing attitudes that could interfere with improvement in these outcomes was also significantly reduced in MATS Lab based assessments of more general symptoms and functioning did not change significantly This pilot study demonstrated that low intensity text messaging interventions like MATS are feasible and effective interventions to improve several important outcomes especially for higher functioning consumers with schizophrenia
- ItemMobile health (mHealth) for mental health in Asia: objectives, strategies, and limitations.(2014-07-21) Brian, Rachel M; Ben-Zeev, DrorMobile technologies are transforming the way in which we interact with one another access resources find information and conduct business around the world Harnessing the capabilities of mobile technologies to support health care initiatives worldwide has developed into a new interdisciplinary field called mobile health mHealth In the current paper we review the penetration of mobile technology in Asia and consider the integration of mobile technologies into the study diagnoses and treatment of mental disorders in the region We outline how mHealth programs could improve mental health literacy provide greater access to mental health services extend community based outreach and engagement support self management of illness and regulate medication distribution We end with a consideration of the potential barriers and limitations of mHealth for mental health including funding language and literacy barriers power supply considerations data security and privacy issues
- ItemMobile Health (mHealth) Versus Clinic-Based Group Intervention for People With Serious Mental Illness: A Randomized Controlled Trial.(0000-00-00) Ben-Zeev, Dror; Brian, Rachel M; Jonathan, Geneva; Razzano, Lisa; Pashka, Nicole; Carpenter-Song, Elizabeth; Drake, Robert E; Scherer, Emily AOBJECTIVE mHealth approaches that use mobile phones to deliver interventions can help improve access to care for people with serious mental illness The goal was to evaluate how mHealth performs against more traditional treatment METHODS A three month randomized controlled trial was conducted of a smartphone delivered intervention FOCUS versus a clinic based group intervention Wellness Recovery Action Plan WRAP Participants were 163 clients mostly from racial minority groups and with long term serious mental illness schizophrenia or schizoaffective disorder 49 bipolar disorder 28 and major depressive disorder 23 Outcomes were engagement throughout the intervention satisfaction posttreatment three months and improvement in clinical symptoms recovery and quality of life assessed at baseline posttreatment and six months RESULTS Participants assigned to FOCUS were more likely than those assigned to WRAP to commence treatment 90 versus 58 and remain fully engaged in eight weeks of care 56 versus 40 Satisfaction ratings were comparably high for both interventions Participants in both groups improved significantly and did not differ in clinical outcomes including general psychopathology and depression Significant improvements in recovery were seen for the WRAP group posttreatment and significant improvements in recovery and quality of life were seen for the FOCUS group at six months CONCLUSIONS Both interventions produced significant gains among clients with serious and persistent mental illnesses who were mostly from racial minority groups The mHealth intervention showed superior patient engagement and produced patient satisfaction and clinical and recovery outcomes that were comparable to those from a widely used clinic based group intervention for illness management
- ItemMobile interventions for severe mental illness: design and preliminary data from three approaches.(2010-10-05) Depp, Colin A; Mausbach, Brent; Granholm, Eric; Cardenas, Veronica; Ben-Zeev, Dror; Patterson, Thomas L; Lebowitz, Barry D; Jeste, Dilip VMobile devices can be used to deliver psychosocial interventions yet there is little prior application in severe mental illness We provide the rationale design and preliminary data from 3 ongoing clinical trials of mobile interventions developed for bipolar disorder or schizophrenia Project 1 used a personal digital assistant to prompt engagement in personalized self management behaviors based on real time data Project 2 employed experience sampling through text messages to facilitate case management Project 3 was built on group functional skills training for schizophrenia by incorporating between session mobile phone contacts with therapists Preliminary findings were of minimal participant attrition and no broken devices yet several operational and technical barriers needed to be addressed Adherence was similar to that reported in nonpsychiatric populations with high participant satisfaction Therefore mobile devices seem feasible and acceptable in augmenting psychosocial interventions for severe mental illness with future research in establishing efficacy cost effectiveness and ethical and safety protocols
- ItemMobile technologies among people with serious mental illness: opportunities for future services.(2013-06-14) Ben-Zeev, Dror; Davis, Kristin E; Kaiser, Susan; Krzsos, Izabela; Drake, Robert ESeveral national bodies have proposed using mobile technology to improve mental health services But rates of current use and interest in using technology to enhance services among individuals with serious mental illness are uncertain The authors surveyed 1 592 individuals with serious mental illness regarding their use of mobile devices and interest in using mobile technologies to enhance mental health services Seventy two percent of survey respondents reported currently owning a mobile device a rate approximately 12 lower than the general adult population The most common uses were for talking followed by texting and internet activities Both mobile device users and nonusers expressed interest in future mobile services
- ItemMobile technologies in the study, assessment, and treatment of schizophrenia.(2012-04-20) Ben-Zeev, Dror
- ItemPredictors of Self-Stigma in Schizophrenia: New Insights Using Mobile Technologies.(2013-03-05) Ben-Zeev, Dror; Frounfelker, Rochelle; Morris, Scott B; Corrigan, Patrick WOBJECTIVE Self stigma has significant negative impact on the recovery of individuals with severe mental illness but its varying course is not well understood Individual levels of self stigma may vary over time and fluctuate in response to both external contextual i e location activity social company and internal i e psychiatric symptoms mood factors The aim of this study was to examine the relationship between self stigmatizing beliefs and these factors as they occur in the daily life of individuals with schizophrenia METHODS Mobile technologies were used to longitudinally track momentary levels of self stigma psychotic symptoms negative affect positive affect activity and immediate social and physical environment in twenty four individuals with schizophrenia multiple times daily over a one week period RESULTS Multilevel modeling showed that participants current activity was associated with changes in self stigma 2 10 53 p Under0 05 but immediate location and social company were not Time lagged analyses found that increases in negative affect 0 11 pUnder0 01 and psychotic symptom severity 0 16 pUnder0 01 predicted increases in the intensity of self stigmatizing beliefs Psychotic symptoms were found to be both an antecedent and a consequence 0 08 pUnder0 01 of increased self stigma CONCLUSIONS Our findings support a framework for understanding self stigma as an experience that changes based on alterations in internal states and external circumstances Mobile technologies are an effective methodology to study self stigma and have potential to be used to deliver clinical interventions
- ItemReal-time electronic ambulatory monitoring of substance use and symptom expression in schizophrenia.(2011-02-07) Swendsen, Joel; Ben-Zeev, Dror; Granholm, EricOBJECTIVE Despite evidence demonstrating elevated comorbidity between schizophrenia and substance use disorders the underlying mechanisms of association remain poorly understood The brief time intervals that characterize interactions between substance use and psychotic symptoms in daily life are inaccessible to standard research protocols The authors used electronic personal digital assistants PDAs to examine the temporal association of diverse forms of substance use with psychotic symptoms and psychological states in natural contexts METHOD Of 199 community dwelling individuals with schizophrenia or schizoaffective disorder who were contacted to participate in the study 92 accepted and 73 completed the study The 145 participants who completed the study provided reports of substance use psychotic symptoms mood and event negativity multiple times per day over 7 consecutive days through PDAs RESULTS Participants responded to 72 of the electronic interviews N 2 737 across daily life contexts Strong within day prospective associations were observed in both directions between substance use and negative psychological states or psychotic symptoms but considerable variation was observed by substance type Consistent with the notion of self medication alcohol use was most likely to follow increases in anxious mood or psychotic symptoms Cannabis and other illicit substances demonstrating more complex patterns were more likely to follow certain psychological states but were also associated with the later onset of psychotic symptoms CONCLUSIONS The dynamic interplay of substance use and psychotic symptoms is in many cases consistent with both causal and self medication mechanisms and these patterns of association should be considered in the design of treatment and prevention strategies
- ItemRemote "hovering" with individuals with psychotic disorders and substance use: feasibility, engagement, and therapeutic alliance with a text-messaging mobile interventionist.(2014-11-13) Ben-Zeev, Dror; Kaiser, Susan M; Krzos, IzabelaPeople with serious mental illnesses and substance abuse problems i e dual diagnosis constitute a particularly challenging and costly clinical group This study evaluated the feasibility and acceptability of a novel model of care in which a mobile interventionist used mobile phone text messaging to remotely monitor and provide daily support to individuals with psychotic disorders and substance use
- ItemStrategies for mHealth research: lessons from 3 mobile intervention studies.(2015-02-25) Ben-Zeev, Dror; Schueller, Stephen M; Begale, Mark; Duffecy, Jennifer; Kane, John M; Mohr, David CThe capacity of Mobile Health mHealth technologies to propel healthcare forward is directly linked to the quality of mobile interventions developed through careful mHealth research mHealth research entails several unique characteristics including collaboration with technologists at all phases of a project reliance on regional telecommunication infrastructure and commercial mobile service providers and deployment and evaluation of interventions in the wild with participants using mobile tools in uncontrolled environments In the current paper we summarize the lessons our multi institutional multi disciplinary team has learned conducting a range of mHealth projects using mobile phones with diverse clinical populations First we describe three ongoing projects that we draw from to illustrate throughout the paper We then provide an example for multidisciplinary teamwork and conceptual mHealth intervention development that we found to be particularly useful Finally we discuss mHealth research challenges i e evolving technology mobile phone selection user characteristics the deployment environment and mHealth system bugs and glitches and provide recommendations for identifying and resolving barriers or preventing their occurrence altogether