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4 Publications visible to you, out of a total of 4
Investigating two mobile just-in-time adaptive interventions to foster psychological resilience: research protocol of the DynaM-INT study

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Abstract Background Stress-related disorders such as anxiety and depression are highly prevalent and cause a tremendous burden for affected individuals and society. In order to improve prevention …individuals and society. In order to improve prevention strategies, knowledge regarding resilience mechanisms and ways to boost them is highly needed. In the Dynamic Modelling of Resilience – interventional multicenter study (DynaM-INT), we will conduct a large-scale feasibility and preliminary efficacy test for two mobile- and wearable-based just-in-time adaptive interventions (JITAIs), designed to target putative resilience mechanisms. Deep participant phenotyping at baseline serves to identify individual predictors for intervention success in terms of target engagement and stress resilience. Methods DynaM-INT aims to recruit N  = 250 healthy but vulnerable young adults in the transition phase between adolescence and adulthood (18–27 years) across five research sites (Berlin, Mainz, Nijmegen, Tel Aviv, and Warsaw). Participants are included if they report at least three negative burdensome past life events and show increased levels of internalizing symptoms while not being affected by any major mental disorder. Participants are characterized in a multimodal baseline phase, which includes neuropsychological tests, neuroimaging, bio-samples, sociodemographic and psychological questionnaires, a video-recorded interview, as well as ecological momentary assessments (EMA) and ecological physiological assessments (EPA). Subsequently, participants are randomly assigned to one of two ecological momentary interventions (EMIs), targeting either positive cognitive reappraisal or reward sensitivity. During the following intervention phase, participants' stress responses are tracked using EMA and EPA, and JITAIs are triggered if an individually calibrated stress threshold is crossed. In a three-month-long follow-up phase, parts of the baseline characterization phase are repeated. Throughout the entire study, stressor exposure and mental health are regularly monitored to calculate stressor reactivity as a proxy for outcome resilience. The online monitoring questionnaires and the repetition of the baseline questionnaires also serve to assess target engagement. Discussion The DynaM-INT study intends to advance the field of resilience research by feasibility-testing two new mechanistically targeted JITAIs that aim at increasing individual stress resilience and identifying predictors for successful intervention response. Determining these predictors is an important step toward future randomized controlled trials to establish the efficacy of these interventions.

Authors: S. A. Bögemann, A. Riepenhausen, L. M. C. Puhlmann, S. Bar, E. J. C. Hermsen, J. Mituniewicz, Z. C. Reppmann, A. Uściƚko, J. M. C. van Leeuwen, C. Wackerhagen, K. S. L. Yuen, M. Zerban, J. Weermeijer, M. A. Marciniak, N. Mor, A. van Kraaij, G. Köber, S. Pooseh, P. Koval, A. Arias-Vásquez, H. Binder, W. De Raedt, B. Kleim, I. Myin-Germeys, K. Roelofs, J. Timmer, O. Tüscher, T. Hendler, D. Kobylińska, I. M. Veer, R. Kalisch, E. J. Hermans, H. Walter

Date Published: 1st Dec 2023

Publication Type: Journal

Dynamic Modelling of Mental Resilience in Young Adults: Protocol for a Longitudinal Observational Study (DynaM-OBS)

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Background Stress-related mental disorders are highly prevalent and pose a substantial burden on individuals and society. Improving strategies for the prevention and treatment of mental disorders …prevention and treatment of mental disorders requires a better understanding of their risk and resilience factors. This multicenter study aims to contribute to this endeavor by investigating psychological resilience in healthy but susceptible young adults over 9 months. Resilience is conceptualized in this study as the maintenance of mental health or quick recovery from mental health perturbations upon exposure to stressors, assessed longitudinally via frequent monitoring of stressors and mental health. Objective This study aims to investigate the factors predicting mental resilience and adaptive processes and mechanisms contributing to mental resilience and to provide a methodological and evidence-based framework for later intervention studies. Methods In a multicenter setting, across 5 research sites, a sample with a total target size of 250 young male and female adults was assessed longitudinally over 9 months. Participants were included if they reported at least 3 past stressful life events and an elevated level of (internalizing) mental health problems but were not presently affected by any mental disorder other than mild depression. At baseline, sociodemographic, psychological, neuropsychological, structural, and functional brain imaging; salivary cortisol and α-amylase levels; and cardiovascular data were acquired. In a 6-month longitudinal phase 1, stressor exposure, mental health problems, and perceived positive appraisal were monitored biweekly in a web-based environment, while ecological momentary assessments and ecological physiological assessments took place once per month for 1 week, using mobile phones and wristbands. In a subsequent 3-month longitudinal phase 2, web-based monitoring was reduced to once a month, and psychological resilience and risk factors were assessed again at the end of the 9-month period. In addition, samples for genetic, epigenetic, and microbiome analyses were collected at baseline and at months 3 and 6. As an approximation of resilience, an individual stressor reactivity score will be calculated. Using regularized regression methods, network modeling, ordinary differential equations, landmarking methods, and neural net–based methods for imputation and dimension reduction, we will identify the predictors and mechanisms of stressor reactivity and thus be able to identify resilience factors and mechanisms that facilitate adaptation to stressors. Results Participant inclusion began in October 2020, and data acquisition was completed in June 2022. A total of 249 participants were assessed at baseline, 209 finished longitudinal phase 1, and 153 finished longitudinal phase 2. Conclusions The Dynamic Modelling of Resilience–Observational Study provides a methodological framework and data set to identify predictors and mechanisms of mental resilience, which are intended to serve as an empirical foundation for future intervention studies. International Registered Report Identifier (IRRID) DERR1-10.2196/39817

Authors: Carolin Wackerhagen, Ilya M Veer, Judith M C van Leeuwen, Zala Reppmann, Antje Riepenhausen, Sophie A Bögemann, Netali Mor, Lara M C Puhlmann, Aleksandra Uściƚko, Matthias Zerban, Julian Mituniewicz, Avigail Lerner, Kenneth S L Yuen, Göran Köber, Marta A Marciniak, Shakoor Pooseh, Jeroen Weermeijer, Alejandro Arias-Vásquez, Harald Binder, Walter de Raedt, Birgit Kleim, Inez Myin-Germeys, Karin Roelofs, Jens Timmer, Oliver Tüscher, Talma Hendler, Dorota Kobylińska, Erno J Hermans, Raffael Kalisch, Henrik Walter

Date Published: 2023

Publication Type: Journal

Psychological Resilience Factors and Their Association With Weekly Stressor Reactivity During the COVID-19 Outbreak in Europe: Prospective Longitudinal Study

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Background Cross-sectional relationships between psychosocial resilience factors (RFs) and resilience, operationalized as the outcome of low mental health reactivity to stressor exposure (low “stressor …activity to stressor exposure (low “stressor reactivity” [SR]), were reported during the first wave of the COVID-19 pandemic in 2020. Objective Extending these findings, we here examined prospective relationships and weekly dynamics between the same RFs and SR in a longitudinal sample during the aftermath of the first wave in several European countries. Methods Over 5 weeks of app-based assessments, participants reported weekly stressor exposure, mental health problems, RFs, and demographic data in 1 of 6 different languages. As (partly) preregistered, hypotheses were tested cross-sectionally at baseline (N=558), and longitudinally (n=200), using mixed effects models and mediation analyses. Results RFs at baseline, including positive appraisal style (PAS), optimism (OPT), general self-efficacy (GSE), perceived good stress recovery (REC), and perceived social support (PSS), were negatively associated with SR scores, not only cross-sectionally (baseline SR scores; all P<.001) but also prospectively (average SR scores across subsequent weeks; positive appraisal (PA), P=.008; OPT, P<.001; GSE, P=.01; REC, P<.001; and PSS, P=.002). In both associations, PAS mediated the effects of PSS on SR (cross-sectionally: 95% CI –0.064 to –0.013; prospectively: 95% CI –0.074 to –0.0008). In the analyses of weekly RF-SR dynamics, the RFs PA of stressors generally and specifically related to the COVID-19 pandemic, and GSE were negatively associated with SR in a contemporaneous fashion (PA, P<.001; PAC,P=.03; and GSE, P<.001), but not in a lagged fashion (PA, P=.36; PAC, P=.52; and GSE, P=.06). Conclusions We identified psychological RFs that prospectively predict resilience and cofluctuate with weekly SR within individuals. These prospective results endorse that the previously reported RF-SR associations do not exclusively reflect mood congruency or other temporal bias effects. We further confirm the important role of PA in resilience.

Authors: Sophie A Bögemann, Lara M C Puhlmann, Carolin Wackerhagen, Matthias Zerban, Antje Riepenhausen, Göran Köber, Kenneth S L Yuen, Shakoor Pooseh, Marta A Marciniak, Zala Reppmann, Aleksandra Uściƚko, Jeroen Weermeijer, Dionne B Lenferink, Julian Mituniewicz, Natalia Robak, Nina C Donner, Merijn Mestdagh, Stijn Verdonck, Rolf van Dick, Birgit Kleim, Klaus Lieb, Judith M C van Leeuwen, Dorota Kobylińska, Inez Myin-Germeys, Henrik Walter, Oliver Tüscher, Erno J Hermans, Ilya M Veer, Raffael Kalisch

Date Published: 2023

Publication Type: Journal

Psycho-social factors associated with mental resilience in the Corona lockdown

Abstract (Expand)

Abstract The SARS-CoV-2 pandemic is not only a threat to physical health but is also having severe impacts on mental health. Although increases in stress-related symptomatology and other adverse …-related symptomatology and other adverse psycho-social outcomes, as well as their most important risk factors have been described, hardly anything is known about potential protective factors. Resilience refers to the maintenance of mental health despite adversity. To gain mechanistic insights about the relationship between described psycho-social resilience factors and resilience specifically in the current crisis, we assessed resilience factors, exposure to Corona crisis-specific and general stressors, as well as internalizing symptoms in a cross-sectional online survey conducted in 24 languages during the most intense phase of the lockdown in Europe (22 March to 19 April) in a convenience sample of N  = 15,970 adults. Resilience, as an outcome, was conceptualized as good mental health despite stressor exposure and measured as the inverse residual between actual and predicted symptom total score. Preregistered hypotheses (osf.io/r6btn) were tested with multiple regression models and mediation analyses. Results confirmed our primary hypothesis that positive appraisal style (PAS) is positively associated with resilience ( p  < 0.0001). The resilience factor PAS also partly mediated the positive association between perceived social support and resilience, and its association with resilience was in turn partly mediated by the ability to easily recover from stress (both p  < 0.0001). In comparison with other resilience factors, good stress response recovery and positive appraisal specifically of the consequences of the Corona crisis were the strongest factors. Preregistered exploratory subgroup analyses (osf.io/thka9) showed that all tested resilience factors generalize across major socio-demographic categories. This research identifies modifiable protective factors that can be targeted by public mental health efforts in this and in future pandemics.

Authors: Ilya M. Veer, Antje Riepenhausen, Matthias Zerban, Carolin Wackerhagen, Lara M. C. Puhlmann, Haakon Engen, Göran Köber, Sophie A. Bögemann, Jeroen Weermeijer, Aleksandra Uściłko, Netali Mor, Marta A. Marciniak, Adrian Dahl Askelund, Abbas Al-Kamel, Sarah Ayash, Giulia Barsuola, Vaida Bartkute-Norkuniene, Simone Battaglia, Yaryna Bobko, Sven Bölte, Paolo Cardone, Edita Chvojková, Kaja Damnjanović, Joana De Calheiros Velozo, Lena de Thurah, Yacila I. Deza-Araujo, Annika Dimitrov, Kinga Farkas, Clémence Feller, Mary Gazea, Donya Gilan, Vedrana Gnjidić, Michal Hajduk, Anu P. Hiekkaranta, Live S. Hofgaard, Laura Ilen, Zuzana Kasanova, Mohsen Khanpour, Bobo Hi Po Lau, Dionne B. Lenferink, Thomas B. Lindhardt, Dávid Á. Magas, Julian Mituniewicz, Laura Moreno-López, Sofiia Muzychka, Maria Ntafouli, Aet O’Leary, Ilenia Paparella, Nele Põldver, Aki Rintala, Natalia Robak, Anna M. Rosická, Espen Røysamb, Siavash Sadeghi, Maude Schneider, Roma Siugzdaite, Mirta Stantić, Ana Teixeira, Ana Todorovic, Wendy W. N. Wan, Rolf van Dick, Klaus Lieb, Birgit Kleim, Erno J. Hermans, Dorota Kobylińska, Talma Hendler, Harald Binder, Inez Myin-Germeys, Judith M. C. van Leeuwen, Oliver Tüscher, Kenneth S. L. Yuen, Henrik Walter, Raffael Kalisch

Date Published: 1st Jun 2021

Publication Type: Journal

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