Ecological Momentary Assessment and Smartphone Application Intervention in Adolescents with Substance Use and Comorbid Severe Psychiatric Disorders: Study Protocol

Abstract

ContextSubstance use disorders (SUDs) are highly prevalent among inpatient adolescents with psychiatric disorders. In this population, substance use and other psychiatric outcomes can reinforce one another. Despite the need for integrated interventions in youths with dual diagnoses, few specific instruments are available. App-based technologies have shown promising results to help reduce substance use in adolescents, but their applicability in youths with associated severe psychiatric disorders is poorly documented. We aim to evaluate the feasibility of an ecological momentary assessment (EMA) intervention for all substance users, and of a smartphone application for cannabis users (Stop-Cannabis), for outpatient treatment after hospital discharge.Methods and analysisAll inpatient adolescents with psychiatric disorders hospitalized between 2016 and 2018 in a university hospital will be systematically screened for SUD and, if positive, will be assessed by an independent specialist addiction team. Participants with confirmed SUDs will be invited and helped to download an EMA app and, if required, the Stop-Cannabis app, the week preceding hospital discharge. Information about the acceptability and use of both apps and the validity of EMA data in comparison to clinical assessments will be assessed after 6 months and 1 year.DiscussionThis research has been designed to raise specific issues for consideration regarding the sequence between substance use, contextual factors, and other psychiatric symptoms among adolescents with comorbid severe psychiatric disorders. A better understanding of the mechanisms involved will inform the development of integrated treatment for dual disorders at that age.Ethics and disseminationThe study has already been approved and granted. Dissemination will include presentations at international congresses as well as publications in peer-reviewed journals.Trial registrationEuropean Clinical Trials Database: Number 2016-001999-30.

Mobile Phone Cognitive Bias Modification Research Platform for Substance Use Disorders: Protocol for a Feasibility Study (Preprint)

“…Also, there's potential to couple these bias modification tasks with other sensors in the smartphone, such that users will be prompted to engage in training tasks to help them with their symptoms if they are deemed to be in a highrisk locality. This is in-line with the recommendations of current research about the utility of momentary ecological analysis (14).…”

Research Review: What have we learned about adolescent substance use?

“…A meta-analysis revealed a small positive effect size for text messaging interventions for youth with substance use problems (Mason, Ola, Zaharakis, & Zhang, 2015), and a pilot study demonstrated the feasibility of using smartphones to provide recovery support for adolescents after discharge from residential treatment (Dennis, Scott, Funk, & Nicholson, 2015). Ongoing work is focused on combining ecological momentary assessment and smartphone application intervention in adolescents with substance use and cooccurring psychiatric disorders (Benarous et al, 2016).…”

Use of smartphones to prospectively evaluate predictors and outcomes of caregiver responses to pain in youth with chronic disease

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