Mobile Cognitive Behavior Therapy Targeting Anxiety Disorders

Not Applicable

Completed

Interventions: Behavioral: Maya mobile app
Behavioral: Gain Framed
Behavioral: Social Support
Behavioral: Loss Framed

Brief Summary: This study aims to examine different ways of motivating people to make use of Maya, a mobile cognitive behavior therapy (CBT) program for adolescents and young adults experiencing anxiety symptoms, and to assess whether social supports are as efficacious, or more efficacious, than other non-monetary incentives. Subjects will use the Maya app for at least 20 minutes per day, 2 days per week, for 6 weeks. Assessments will include a weekly check in with a member of the research team, questionnaires, and an optional magnetic resonance imaging (MRI) recording.

Detailed Description: There is a growing need for easily accessed anxiety treatments designed for young adults. Mobile app-based interventions can be disseminated more broadly than traditional psychosocial interventions and may be particularly appealing to this age group, which uses mobile devices frequently. Mobile apps can also collect real-time data about patient symptom severity and provide tailored, in-the-moment coping strategies.

This study aims to examine different ways of motivating people to make use of Maya, a mobile cognitive behavior therapy (CBT) app for adolescents and young adults experiencing anxiety symptoms, and to assess whether social supports are as efficacious, or more efficacious, than other non-monetary incentives. Young adults with anxiety will be randomized to one of three conditions: a social support condition, a gain-framed condition in which participants can earn "points" for completing their assigned sessions, and a loss-framed condition in which participants lose "points" for failing to complete their assigned sessions. Subjects will use the Maya app for at least 20 minutes per day, 2 days per week, for 6 weeks and will complete assessments at baseline, week 3, week 6 (end of treatment), and a follow-up assessment at week 12. Subjects may also choose to complete an optional magnetic resonance imaging (MRI) recording at the baseline and end of treatment (week 6).

Recruitment & Eligibility

Inclusion Criteria

Between the ages of 18 and 25
Primary diagnosis of an anxiety disorder, as determined by a score of 4 on the Clinical Severity Rating from the Anxiety Disorders Interview Schedule (ADIS)

Exclusion Criteria

Arm && Interventions

Group	Intervention	Description
Gain Framed	Maya mobile app	Participants receive treatment with the Maya app in conjunction with gain-framed incentives for 6 weeks.
Gain Framed	Gain Framed	Participants receive treatment with the Maya app in conjunction with gain-framed incentives for 6 weeks.
Social Support	Social Support	Participants receive treatment with the Maya app in conjunction with social support incentives for 6 weeks.
Social Support	Maya mobile app	Participants receive treatment with the Maya app in conjunction with social support incentives for 6 weeks.
Loss Framed	Maya mobile app	Participants receive treatment with the Maya app in conjunction with loss-framed incentives for 6 weeks.
Loss Framed	Loss Framed	Participants receive treatment with the Maya app in conjunction with loss-framed incentives for 6 weeks.

Primary Outcome Measures

Name	Time	Method
Change in Anxious Symptoms From Baseline to End of Treatment (Week 6)	Baseline to week 6 (end of intervention)	Change in anxiety between the three incentive conditions will be measured using the the Leibowitz Social Anxiety Scale (LSAS). The LSAS is a 24-item scale measuring fear and avoidance across social situations with a total score range of 0-144. Higher scores, defined by a total score range of 50-95 or greater, indicate greater fear and avoidance severity and lower scores, defined by a total score range of 0-49, indicate mild to no fear or avoidance.

Secondary Outcome Measures

Name	Time	Method
Mean Number of Sessions Completed	End of intervention (week 6)	Mean number of sessions completed in the mobile app over the course of treatment. A greater number of sessions completed over the course of treatment will indicate greater engagement.
Mean Rating Score on the Mobile Application Rating Scale	End of intervention (week 6)	The mean rating score is a average of four rating sub-scales (engagement, functionality, aesthetics, quality of information) on the uMARS throughout the intervention (average of week 1, 3, and 6) for each participant. The Mobile Application Rating Scale (uMARS) is a 26-item measure of mobile application engagement, functionality, aesthetics, quality of information, and perceived impact. The mean rating score has a total range of 1-5, with higher total scores, defined by a mean score of 4 or greater, indicating greater application feasibility and lower scores, defined by a mean score of 3 or lower, indicating poorer application feasibility.