Background User experience and engagement are critical elements of mental health apps’ abilities to support users. However, work examining the relationships among user experience, engagement, and popularity has been limited. Understanding how user experience relates to engagement with and popularity of mental health apps can demonstrate the relationship between subjective and objective measures of app use. In turn, this may inform efforts to develop more effective and appealing mental health apps and ensure that they reach wide audiences. Objective We aimed to examine the relationship among subjective measures of user experience, objective measures of popularity, and engagement in mental health apps. Methods We conducted a preregistered secondary data analysis in a sample of 56 mental health apps. To measure user experience, we used expert ratings on the Mobile App Rating Scale (MARS) and consumer ratings from the Apple App Store and Google Play. To measure engagement, we acquired estimates of monthly active users (MAU) and user retention. To measure app popularity, we used download count, total app revenue, and MAU again. Results MARS total score was moderately positively correlated with app-level revenue (Kendall rank [T]=0.30, P=.002), MAU (T=0.39, P<.001), and downloads (T=0.41, P<.001). However, the MARS total score and each of its subscales (Engagement, Functionality, Aesthetics, and Information) showed extremely small correlations with user retention 1, 7, and 30 days after downloading. Furthermore, the total MARS score only correlated with app store rating at T=0.12, which, at P=.20, did not meet our threshold for significance. Conclusions More popular mental health apps receive better ratings of user experience than less popular ones. However, user experience does not predict sustained engagement with mental health apps. Thus, mental health app developers and evaluators need to better understand user experience and engagement, as well as to define sustained engagement, what leads to it, and how to create products that achieve it. This understanding might be supported by better collaboration between industry and academic teams to advance a science of engagement.
Some ideas that we have feel mundane, but others are imbued with a sense of profundity. Here we tested the possibility that humans rely on feelings of insight in order to appraise their own ideas, the source of which is often hidden from conscious view. We began by investigating the recent finding that insight experiences predict objective problem solving performance. In Experiment 1, we measured insight experiences in real-time using a dynamometer, and found that impulsive feelings of insight (and their intensity) are strong predictors of accurate solutions to problems that typically involve implicit processing. In Experiment 2, we found that this insight-accuracy effect is also robust in a sensory identification task reminiscent of everyday life. In a third experiment, we presented participants with general knowledge ‘facts’ while eliciting insight experiences at the same time using anagrams. Participants reported greater perceived truth for facts accompanied by solved anagrams and particularly those that elicited insight experiences, even if the facts were false. Taken together, the results suggest that insight phenomenology usually contains useful information about the veracity of a solution, and that humans use this feeling heuristically to appraise new ideas. However, so-called Aha! moments can be overgeneralized, and bias truth judgments regarding a temporally coincident but otherwise irrelevant fact. We conclude by discussing potential side effects of relying on phenomenology to evaluate ideas, including false beliefs and dangerous ideologies.
Our basic beliefs about reality can be impossible to prove and yet we can feel a strong intuitive conviction about them, as exemplified by insights that imbue an idea with immediate certainty. Here we presented participants with worldview beliefs such as “people’s core qualities are fixed” and simultaneously elicited an aha moment. In the first experiment (N = 3000, which included a direct replication), participants rated worldview beliefs as truer when they solved anagrams and also experienced aha moments. A second experiment (N = 1564) showed that the worldview statement and the aha moment must be perceived simultaneously for this ‘insight misattribution’ effect to occur. These results demonstrate that artificially induced aha moments can make worldview beliefs seem truer, possibly because humans partially rely on feelings of insight to appraise an idea’s veracity. Feelings of insight are therefore not epiphenomenal and should be investigated for their effects on decisions, beliefs, and delusions.
Background People with obsessive-compulsive disorder (OCD) have faced unique challenges during the COVID-19 pandemic. Research from the first two months of the pandemic suggests that a small proportion of people with OCD experienced worsening in their OCD symptoms since the pandemic began, whereas the rest experienced either no change or an improvement in their symptoms. However, as society-level factors relating to the pandemic have evolved, the effects of the pandemic on people with OCD have likely changed as well, in complex and population-specific ways. Therefore, this study contributes to a growing body of knowledge on the impact of the COVID-19 pandemic on people and demonstrates how differences across studies might emerge when studying specific populations at specific timepoints. Objective This study aimed to assess how members of online OCD support communities felt the COVID-19 pandemic had affected their OCD symptoms, around 3 months after the pandemic began. Methods We recruited participants from online OCD support communities for our brief survey. Participants indicated how much they felt their OCD symptoms had changed since the pandemic began and how much they felt that having OCD was making it harder to deal with the pandemic. Results We collected survey data from June through August 2020 and received a total of 196 responses, some of which were partial responses. Among the nonmissing data, 65.9% (108/164) of the participants were from the United States and 90.5% (152/168) had been subjected to a stay-at-home order. In all, 92.9% (182/196) of the participants said they experienced worsening of their OCD symptoms since the pandemic began, although the extent to which their symptoms worsened differed across dimensions of OCD; notably, symmetry and completeness symptoms were less likely to have worsened than others. Moreover, 95.5% (171/179) of the participants felt that having OCD made it difficult to deal with the pandemic. Conclusions Our study of online OCD support community members found a much higher rate of OCD symptom worsening than did other studies on people with OCD conducted during the current COVID-19 pandemic. Factors such as quarantine length, location, overlapping society-level challenges, and differing measurement and sampling choices may help to explain this difference across studies.
Background: Depression is an illness with biological, psychological, and social underpinnings, which may include the interplay of inflammation, psychological traits, stress, social relationships, and cultural background. Aims: This work examines the prospective associations between social relationship quality and depressive symptoms, and between social relationship quality and inflammatory outcomes in two distinct cultures. Methods: Data were obtained from two longitudinal, prospective cohort studies: Midlife in the United States (MIDUS), and Midlife Development in Japan (MIDJA) between 2004 and 2010. One thousand three hundred and twenty-seven community-based adults were included in analyses, 1,054 from the United States and 273 from Tokyo, Japan. Depressive symptoms (measured by the CES-D Depression Scale) and inflammation (measured by blood sample concentrations of the inflammatory biomarkers interleukin-6 and C-reactive protein) were the outcomes. Social relationship quality was the predictor. Culture, trait independence and interdependence, and psychosocial stressors were examined as moderators of the link between social relationship quality and depressive symptoms. Results: Higher social relationship quality was associated with lower depressive symptoms in the United States (β = −6.15, p < .001), but not in Japan (β = −1.25, p = .390). Social relationship quality had no association with inflammation. Psychosocial stressors moderated the link between social relationship quality and depressive symptoms in both the United States (β = −0.39, p = .001) and Tokyo (β = −0.55, p = .001), such that social relationship quality acted as a buffer against depressive symptoms as psychosocial stress increased. Conclusion: Improving the perceived quality of social relationships appears to be a stronger target for depression interventions in the United States than in Tokyo, Japan.
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