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Brief Digital Interventions for Psychological Distress: An AI-Enhanced Response-Adaptive Randomized Clinical Trial.

Jill Newby1,2, Sunil Gupta3, Leonard Hoon3

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This summary is machine-generated.

Smartphone interventions for college student distress show promise. Physical activity and mindfulness apps were effective for severe distress, while physical activity and sleep hygiene apps helped mild distress.

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Area of Science:

  • Digital mental health
  • Clinical psychology
  • Behavioral science

Background:

  • College students frequently experience psychological distress.
  • Smartphone interventions offer a scalable approach to mental health support.
  • Effectiveness of app-based interventions across distress severity levels requires investigation.

Purpose of the Study:

  • To compare the efficacy of physical activity, mindfulness, and sleep hygiene smartphone interventions against an active control for reducing psychological distress in college students.
  • To evaluate intervention effectiveness across mild, moderate, and severe distress levels.

Main Methods:

  • An AI-enhanced response-adaptive randomized clinical trial involving 1282 college students with distress scores ≥20 on the Kessler Psychological Distress Scale.
  • Participants were assigned to 2-week self-guided app interventions (physical activity, mindfulness, sleep hygiene) or an ecological momentary assessment (EMA) control using a contextual multi-armed bandit algorithm.
  • Primary outcome was change in the 21-item Depression Anxiety Stress Scale (DASS-21) score from baseline to post-intervention (4 weeks).

Main Results:

  • For severe distress, physical activity and mindfulness interventions significantly reduced DASS-21 scores compared to the EMA control.
  • For mild distress, physical activity and sleep hygiene interventions significantly reduced DASS-21 scores compared to the EMA control.
  • No significant differences were observed among participants with moderate distress.

Conclusions:

  • Physical activity and mindfulness apps are effective for severe psychological distress in college students.
  • Physical activity and sleep hygiene apps are effective for mild psychological distress in college students.
  • AI-enhanced adaptive trials can efficiently evaluate digital mental health interventions, guiding personalized care.