Date of Award

9-7-2023

Author's School

Graduate School of Arts and Sciences

Author's Department

Psychology

Degree Name

Doctor of Philosophy (PhD)

Degree Type

Dissertation

Abstract

Mobile health applications (mHealth) may serve to augment or improve outcomes among individuals receiving psychotherapy or medication-based treatment. For others lacking access to mental healthcare, mHealth may serve as a sole source of intervention. Although thousands of mental health apps exist, the vast majority lack empirical evidence regarding effectiveness or validity. mHealth apps hold the potential to extend access to those in need of services, and empirical investigations may serve to identify apps with evidenced clinical utility. The present study examines the DARE app which utilizes empirically-supported treatment principles for symptoms of anxiety and panic. Ten participants diagnosed with social anxiety disorder used DARE for 30 days while completing four daily surveys via ecological momentary assessment. Dynamic structural equation modeling was utilized to examine idiographic models for each of the participants. Predictive pathways for momentary effects of DARE app use on EMA measures of social anxiety, general anxiety, depression, and positive affect were investigated. Additionally, the predictive pathway for gradual effect of time in the study on EMA social anxiety symptoms was examined. Multilevel models were also examined for variance between individuals. Results from the idiographic models suggested minimal prediction between DARE app use and EMA measures at the next hour. Significant pathways in these models suggested worsened anxious and affective symptoms after DARE use. By contrast, nearly half of participants evidenced improvements in general anxiety and positive affect as their time in the study increased; however, time was not significantly predictive of social anxiety or depression for most participants. Results from multilevel models suggested that social anxiety was unstable for participants and that social anxiety tended to decrease as the day progressed, but neither app use nor time in the study predicted social anxiety. Altogether, these results suggest that the DARE app may not be suitable for improving anxiety and affect during the hour after use. Additionally, the DARE app may not be particularly effective for intervention of social anxiety. Although results indicate gradual improvement in general anxiety symptoms and positive affect for several participants, various study limitations, including limited sample size, suggest that caution with interpretation is warranted.

Language

English (en)

Chair and Committee

Renee Thompson

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