Effects of a Novel, Transdiagnostic, Hybrid Ecological Momentary Intervention for Improving Resilience in Youth (EMIcompass): Protocol for an Exploratory Randomized Controlled Trial

Schick, Anita; Paetzold, Isabell; Rauschenberg, Christian; Hirjak, Dušan; Banaschewski, Tobias; Meyer‐Lindenberg, Andreas; Boehnke, Jan R.; Boecking, Benjamin; Reininghaus, Ulrich

doi:10.2196/27462

Cited by 15 publications

(16 citation statements)

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“…To this end, they identified healthy relatives with high PRS for psychosis and compared this sample to riskmatched cases showing that the resilience score increases in unaffected individuals as their PRS increases. The specific role of buffering or protective factors in pathways to psychosis such as a polygenic resilience score for schizophrenia or a resilience-enhancing social environment (Gayer-Anderson & Morgan, 2013), and their impact on targetable mechanisms needs to be elucidated further as a basis for improving prevention (Rauschenberg et al, 2021a(Rauschenberg et al, , 2021bReininghaus et al, 2016a), treatment (Schick et al, 2021;van Aubel et al, 2020) and, ultimately, outcomes of psychosis.…”

Section: Comparison With Previous Researchmentioning

confidence: 99%

Polygenic risk, familial liability and stress reactivity in psychosis: an experience sampling study

et al. 2022

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Background There is evidence for a polygenic contribution to psychosis. One targetable mechanism through which polygenic variation may impact on individuals and interact with the social environment is stress sensitization, characterized by elevated reactivity to minor stressors in daily life. The current study aimed to investigate whether stress reactivity is modified by polygenic risk score for schizophrenia (PRS) in cases with enduring non-affective psychotic disorder, first-degree relatives of cases, and controls. Methods We used the experience sampling method to assess minor stressors, negative affect, positive affect and psychotic experiences in 96 cases, 79 first-degree relatives, i.e. siblings, and 73 controls at wave 3 of the Dutch Genetic Risk and Outcome of Psychosis (GROUP) study. Genome-wide data were collected at baseline to calculate PRS. Results We found that associations of momentary stress with psychotic experiences, but not with negative and positive affect, were modified by PRS and group (all pFWE<0.001). In contrast to our hypotheses, siblings with high PRS reported less intense psychotic experiences in response to momentary stress compared to siblings with low PRS. No differences in magnitude of these associations were observed in cases with high v. low level of PRS. By contrast, controls with high PRS showed more intense psychotic experiences in response to stress compared to those with low PRS. Conclusions This tentatively suggests that polygenic risk may operate in different ways than previously assumed and amplify reactivity to stress in unaffected individuals but operate as a resilience factor in relatives by attenuating their stress reactivity.

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Section: Comparison With Previous Researchmentioning

confidence: 99%

Polygenic risk, familial liability and stress reactivity in psychosis: an experience sampling study

et al. 2022

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“…Observer ratings were performed by blinded assessors. The sample size was based on a power simulation for the primary outcome of the trial [ 56 ]. The RCT was conducted between August 2019 and September 2021.…”

Section: Methodsmentioning

confidence: 99%

“…Appointments were held in person or via video calls (owing to the COVID-19 pandemic). Further details on study procedures are described in the study protocol [ 56 ].…”

Section: Methodsmentioning

confidence: 99%

“…All participants (including caregivers for minors) provided informed consent and were reimbursed for their time and travel expenses. Further details on inclusion and exclusion criteria are provided in the study protocol [ 56 ].…”

Section: Methodsmentioning

confidence: 99%

“…In line with a modified version of the clinical staging model [12,56], the EMIcompass study recruited young individuals aged 14 to 25 with current psychological distress, Clinical High At-Risk Mental State (CHARMS), or a first treated episode of severe mental disorder (for a detailed description of the modified criteria, see Multimedia Appendix 3 [12,56,[59][60][61][62][63][64]; age range based on suggestions of the youth mental health reform and local regulations [65]). Participants were recruited from mental health services at the Central Institute of Mental Health, Mannheim, Germany, via local registries and advertisements on the institute's webpage and social media.…”

Section: Participantsmentioning

confidence: 99%

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A Hybrid Ecological Momentary Compassion–Focused Intervention for Enhancing Resilience in Help-Seeking Young People: Prospective Study of Baseline Characteristics in the EMIcompass Trial

Paetzold¹,

Schick²,

Rauschenberg³

et al. 2022

JMIR Form Res

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Background Young people are a target population for mental health–related early intervention and prevention. Although evidence for early intervention is promising, availability of and access to youth mental health services remain limited. Therefore, the development of an evidence-based hybrid intervention is urgently needed. Objective This study aimed to present a manual for a hybrid intervention, combining an ecological momentary intervention and face-to-face sessions aimed for enhancing resilience in help-seeking young people based on compassion-focused interventions, and explore whether participants’ baseline characteristics are associated with putative mechanisms and outcomes of the EMIcompass intervention. Specifically, we aimed to explore initial signals as to whether participants’ sociodemographic, clinical, and functional characteristics at baseline are associated with putative mechanisms (ie, change in self-compassion, change in emotion regulation, working alliance, training frequency); and whether participants’ sociodemographic, clinical, and functional characteristics, self-compassion, and emotion regulation at baseline are associated with clinical outcomes (ie, psychological distress and general psychopathology at postintervention and 4-week follow-ups) in the experimental condition and obtain first parameter estimates. Methods We recruited young people aged 14 to 25 years, with psychological distress, Clinical High At-Risk Mental State, or first episodes of severe mental disorder for an exploratory randomized controlled trial with assessments at baseline and postintervention and 4-week follow-ups. A structured manual was developed and optimized based on a pilot study’s manual, a scoping review of existing literature and manuals, exchange with experts, the team’s clinical experience of working with compassion-focused interventions, and the principles of ecological momentary interventions. This analysis focuses on the experimental condition receiving the EMIcompass intervention. Results A total of 46 young individuals were randomized to the experimental condition. There was evidence for initial signals of effects of age (B=0.11, 95% CI 0.00-0.22), general psychopathology (B=0.08, 95% CI −0.01 to 0.16), and clinical stage (B=1.50, 95% CI 0.06-2.93) on change in momentary self-compassion and change in emotion regulation from baseline to postintervention assessments. There was no evidence for associations of other baseline characteristics (eg, gender, minority status, and level of functioning) and putative mechanisms (eg, overall self-compassion, working alliance, and training frequency). In addition, except for an initial signal for an association of momentary self-compassion at baseline and psychological distress (B=−2.83, 95% CI −5.66 to 0.00), we found no evidence that baseline characteristics related to clinical outcomes. Conclusions The findings indicated the reach of participants by the intervention largely independent of sociodemographic, clinical, and functional baseline characteristics. The findings need to be confirmed in a definitive trial. Trial Registration German Clinical Trials Register NDRKS00017265; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017265 International Registered Report Identifier (IRRID) RR2-10.2196/27462

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Negative life events and stress sensitivity in youth’s daily life: an ecological momentary assessment study

Rauschenberg

Schulte-Strathaus

et al. 2022

Soc Psychiatry Psychiatr Epidemiol

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Purpose Negative life events (LEs) are associated with mental health problems in youth. However, little is known about underlying mechanisms. The aim of the study was to investigate whether exposure to LEs modifies stress sensitivity in youth’s daily life. Methods Ecological Momentary Assessment (EMA) was used to assess stress sensitivity (i.e., association of momentary stress with (i) negative affect and (ii) psychotic experiences) in 99 adolescents and young adults (42 service users, 17 siblings, and 40 controls; Mage 15 years). Before EMA, exposure to LEs (e.g., intrusive threats, experience of loss, serious illness) was assessed. Results Lifetime as well as previous-year exposure to LEs modified stress sensitivity in service users: they experienced more intense negative affect and psychotic experiences in response to stress when high vs. low exposure levels were compared. In contrast, controls showed no differences in stress sensitivity by exposure levels. Looking at specific types of LEs, controls showed less intense negative affect in response to stress when high vs. low exposure levels to threatening events during the last year, but not lifetime exposure, were compared. In siblings, no evidence was found that LEs modified stress sensitivity. Conclusion Stress sensitivity may constitute a putative risk mechanism linking LEs and mental health in help-seeking youth, while unfavourable effects of LEs on stress sensitivity may attenuate over time or do not occur in controls and siblings. Targeting individuals’ sensitivity to stress in daily life using novel digital interventions may be a promising approach towards improving youth mental health.

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Effects of a Novel, Transdiagnostic, Hybrid Ecological Momentary Intervention for Improving Resilience in Youth (EMIcompass): Protocol for an Exploratory Randomized Controlled Trial

Cited by 15 publications

References 117 publications

Polygenic risk, familial liability and stress reactivity in psychosis: an experience sampling study

Polygenic risk, familial liability and stress reactivity in psychosis: an experience sampling study

A Hybrid Ecological Momentary Compassion–Focused Intervention for Enhancing Resilience in Help-Seeking Young People: Prospective Study of Baseline Characteristics in the EMIcompass Trial

Negative life events and stress sensitivity in youth’s daily life: an ecological momentary assessment study

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