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Statistical Approaches in the Development of Digital Therapeutics
Published in Oleksandr Sverdlov, Joris van Dam, Digital Therapeutics, 2023
Oleksandr Sverdlov, Yevgen Ryeznik, Sergei Leonov, Valerii Fedorov
Many DTx products are complex interventions (Craig et al., 2008; Rodriguez et al., 2020) that contain several potentially interacting components contributing to the overall efficacy of the therapy. For example, in mental health, a mobile intervention for young people with recent-onset schizophrenia spectrum disorder utilizes social reinforcement theory to target the motivational system of the patient (Schlosser et al., 2018). By providing a supportive online environment for social interaction, motivational coaching, personalized goal-setting for health/wellness, social relationships, creativity, etc., the program aims at improving the subject's motivated behavior and other clinically relevant outcomes over time. Unlike pharmacological interventions, where the therapeutic effect is driven by drug exposure at the site of action, the mobile mental health intervention provides—in a highly individualized manner—new information that helps the subject to make changes in their thoughts and behaviors, to achieve consciousness and eventually improve their clinical outcome.
Imaging Dopamine Signaling in Addiction
Published in Hanna Pickard, Serge H. Ahmed, The Routledge Handbook of Philosophy and Science of Addiction, 2019
Diana Martinez, Felipe Castillo
The failure of cocaine use disorder subjects with low dopamine release to alter their behavior can be viewed as a reward system that is unable to shift between alternative sources of reward. In other words, subjects with low dopamine release tend to make more impulsive choices, and chose a smaller, immediate reward over a larger, delayed reward (Trifilieff and Martinez 2014). To an extent, motivation can be thought of as the inverse of impulsivity, as the ability to exert greater effort in order to obtain a more valuable reward. These findings in human studies are consistent with rodent studies of motivation, which demonstrate that motivated behavior can be modulated by dopamine signaling in the ventral striatum, where increasing D2 receptor signaling enhances motivation, whereas impaired D2 signaling lessens it (Salamone et al. 2007).
Psychotherapeutics
Published in R. Andrew Chambers, The 2 × 4 Model, 2017
As previously mentioned, successful recovery from addiction and dual diagnosis disorders must involve some degree of neuroplasticity—changes in brain circuitry are required to produce changes in mental experience and behavior. Growth out of pathological patterns of motivated behavior will require change and growth of new connectivity between neurons that support motivated behavior. At the same time, adaptation to new, healthier environments will also require neuroadaptative change. These themes from translational neuroscience can be understood and expressed to patients with the plant analogy. For the tree (their brains) to grow, which is necessary for their recovery, they need exposure to not one but several elements at the same time. This often includes sun (psychotherapies), water (medications) and nutritive soil (new experiences). It is up to the addiction psychiatrist and the 2 × 4 Model team to deliver the best combinations and balance of these elements, with psychotherapies and medications being directly provided in the clinic. But a host of experiential approaches and therapies, many of which are evidence based, should also be discussed, supported, and/or prescribed to patients in an individualized way, including any one or more of the following:
The use and impact of self-monitoring on substance use outcomes: A descriptive systematic review
Published in Substance Abuse, 2021
Julie C. Gass, Jennifer S. Funderburk, Robyn Shepardson, Jesse D. Kosiba, Lauren Rodriguez, Stephen A. Maisto
Consistent with SM theories, there are potential moderators of SM’s effectiveness. Specifically, consistent with Rachlin31 and Karoly and Kafner’s15 theories, SM functions by bringing substance use behaviors into awareness; thus, methodological differences including variability in assessment strategy (e.g., EMA, paper-and-pencil measures in the lab or clinic) and the length/type/intensity of monitoring (e.g., multiple assessments per day via prompts versus infrequent assessments) may contribute to mixed results.17,34 Additionally, whether participants were compensated for engaging in SM may play a role. There is evidence that intrinsically motivated behavior leads to longer sustained change than behavior that is extrinsically (e.g., by being paid) motivating,35 Finally, it is likely that participants who are more adherent to SM (i.e., complete more assessments) would see greater benefits of SM, as they are essentially more adherent to the treatment.
Commitment in Sport: The Role of Coaching Style and Autonomous versus Controlled Motivation
Published in Journal of Applied Sport Psychology, 2020
While certain features of multidimensional SCM commitment and SDT motivation share conceptual similarities, they ultimately represent distinct psychological variables. From a theoretical viewpoint, motivation is considered a global variable that energizes and directs behavior (Ryan & Deci, 2017). As a result, autonomous and controlled motivation are viewed as distal psychological variables influencing motivated behavior at the contextual level. This might explain why despite reporting significant associations between different forms of motivation (i.e., autonomous vs. controlled) and sport persistence, empirical research has found the amount of variance explained to be modest/moderate. On the other hand, sport commitment is regarded as a psychological state that binds athletes to a specific commitment target (e.g., club, team, sporting activity). Therefore, enthusiastic and constrained commitment are considered proximal psychological variables that have a direct, immediate influence on motivated behavior (Boiché & Sarrazin, 2009). Jackson, Gucciardi, Hodge, and Dimmock (2017) summarized this distinction by asserting that an athlete may exhibit motivation “for” one’s sport and commitment “to” one’s sport.
Optimism and the Experience of Pain: A Systematic Review
Published in Behavioral Medicine, 2019
Johanna Basten-Günther, Madelon Peters, Stefan Lautenbacher
As stated in the fear-avoidance model of musculoskeletal pain,5 chronic pain can be a result of a dysfunctional psychological reaction to an acute pain experience. People who tend to engage in catastrophizing thoughts concerning their pain are likely to get caught in a vicious circle of fear of pain, avoidance and hypervigilance, disuse and disability, and in turn increased pain. Optimism seems to protect against the development of this vicious circle leading to chronic pain in that it stops catastrophizing and hypervigilance to negative information, as will be described. Originally defined by Scheier and Carver as “generalized positive outcome expectancies”6 in the context of their theory of self-regulation,7 optimism describes the tendency of individuals to expect positive things to happen to them in the future. As optimists subjectively evaluate the probability of success higher, they are more likely to engage and persist in goal-directed efforts (as opposed to the “why-bother”-attitude of pessimists),8 which in turn increases their chance to effectively cope with stressors.9 This is in line with traditional expectancy x value-theories of motivation,10 which emphasize the role of expectations in motivation and motivated behavior.