This pilot study tested the efficacy of the My Disaster Recovery (MDR) website to decrease negative affect and increase coping self-efficacy. Fifty-six survivors of Hurricane Ike were recruited from a larger study being conducted at the University of Texas Medical Branch at the first anniversary of the storm. Restricted randomization was used to assign participants to the MDR website, an information-only website, or a usual care condition. Group × time interactions indicated that MDR reduced participant worry more than the other conditions. A similar trend was also identified for depression. Both websites were accessed a small to moderate amount and participants reported mixed satisfaction for both websites. Although the effect sizes for worry and depression were in the moderate to large range, small sample size and timing of the intervention qualify the findings. These preliminary findings encourage further evaluation of MDR with a larger, demographically diverse sample and indicate that the MDR website might be helpful in reducing worry and depression.

Rural survivors of sexual assault and domestic violence experience considerable difficulties accessing mental health services. Similarly, graduate psychology training programs located in rural locations have historically been limited in their ability to provide trainees with extensive exposure to specific client populations. With the advent of distal technologies-especially secure, encrypted videoconferencing capabilities-it is now possible to connect rural clients with specialized, mental health services provided by university-based training clinics. This article reviews mental health care needs and treatment barriers experienced by rural populations, and describes an innovative solution to begin to address these problems. Specifically, a partnership between a university-based mental health care clinic and 3 rural domestic violence/rape crisis centers is described, and preliminary treatment outcome data are presented. Training benefits reported by graduate student therapists and satisfaction ratings provided by crisis center staff and advocates are also presented and discussed.

Background The COVID-19 pandemic has significantly impacted mental health and well-being. Mobile mental health apps can be scalable and useful tools in large-scale disaster responses and are particularly promising for reaching vulnerable populations. COVID Coach is a free, evidence-informed mobile app designed specifically to provide tools and resources for addressing COVID-19–related stress. Objective The purpose of this study was to characterize the overall usage of COVID Coach, explore retention and return usage, and assess whether the app was reaching individuals who may benefit from mental health resources. Methods Anonymous usage data collected from COVID Coach between May 1, 2020, through October 31, 2020, were extracted and analyzed for this study. The sample included 49,287 unique user codes and 3,368,931 in-app events. Results Usage of interactive tools for coping and stress management comprised the majority of key app events (n=325,691, 70.4%), and the majority of app users tried a tool for managing stress (n=28,009, 58.8%). COVID Coach was utilized for ≤3 days by 80.9% (n=34,611) of the sample whose first day of app use occurred within the 6-month observation window. Usage of the key content in COVID Coach predicted returning to the app for a second day. Among those who tried at least one coping tool on their first day of app use, 57.2% (n=11,444) returned for a second visit; whereas only 46.3% (n=10,546) of those who did not try a tool returned (P<.001). Symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD) were prevalent among app users. For example, among app users who completed an anxiety assessment on their first day of app use (n=4870, 11.4% of users), 55.1% (n=2680) reported levels of anxiety that were moderate to severe, and 29.9% (n=1455) of scores fell into the severe symptom range. On average, those with moderate levels of depression on their first day of app use returned to the app for a greater number of days (mean 3.72 days) than those with minimal symptoms (mean 3.08 days; t1=3.01, P=.003). Individuals with significant PTSD symptoms on their first day of app use utilized the app for a significantly greater number of days (mean 3.79 days) than those with fewer symptoms (mean 3.13 days; t1=2.29, P=.02). Conclusions As the mental health impacts of the pandemic continue to be widespread and increasing, digital health resources, such as apps like COVID Coach, are a scalable way to provide evidence-informed tools and resources. Future research is needed to better understand for whom and under what conditions the app is most helpful and how to increase and sustain engagement.

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Although the topic of moral injury (MI) has been garnering increasing attention in recent years within military populations, research has rarely applied the concept to civilian contexts. Extant literature on distinct acts of perpetration or transgressions suggests similar emotional, cognitive, and behavioral patterns of distress associated with appraisals of wrongdoing. However, the absence of a psychometrically sound measure to detect and quantify pathological levels of distress associated with perpetrating harm against others has hindered additional research from being conducted on the topic. The current research presents the Perpetration‐Induced Distress Scale (PIDS) as a valid and reliable measurement of distress associated with MI within civilian contexts. Factor analytic techniques revealed a two‐factor solution characterized by perpetration‐induced distress related to maladaptive reactions to shame (seven items) and guilt/self‐blame (seven items). The PIDS demonstrated favorable temporal stability over a 1‐week period as well as excellent internal reliability. Further, the PIDS evidenced convergent validity with functional impairment, posttraumatic stress disorder, and existing scales of shame and guilt; associations were large (rs = 0.62–0.87). The development of the PIDS represents one of the first studies to measure MI within a civilian population and indicates evidence that additional research on the topic is warranted.