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anxiety;mHealth;moderation;perceived stress;self-efficacy


Lance Rappaport



Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.


Background: Despite their potential to increase public accessibility for mental health resources, little prior research evaluated factors that may moderate the utility of e-mental health interventions. Research to identify moderators of e- mental health response would guide the development of interventions to meet the needs of presently underserved populations. Objective: The present study extended a North American open label trial of a smartphone-based mental health app (MindShift, Anxiety Canada) designed by psychologists and psychiatrists to increase public accessibility to evidence-based anxiety resources. Specifically, this study examined the role of perceived self- efficacy and helplessness to moderate individuals’ response to use of the MindShift app. Methods: Adults ages 18 to 74 (N = 154) in Canada and the USA reported on perceived self-efficacy and helplessness at a pre-treatment baseline assessment as well as after 8- and 16-weeks of using the app. Participants also reported on functional impairment, anxiety symptoms, and depressive symptoms at baseline and after 2-, 4-, 8-, 12-, and 16-weeks of app use. Results: Participant-reported functional impairment, anxiety symptoms, and depressive symptoms decreased over the 16 weeks that they used the app. Linear change over time in each outcome varied between participants but not as a function of participants’ baseline self-efficacy or helplessness. Self-efficacy increased over the 16-week study; helplessness decreased. Conclusions: Overall, the MindShift app may be a useful, scalable, self-guided resource to augment self-efficacy and helplessness in adults seeking help to manage anxiety and related distress.

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