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Cited by 43Mental Health Research TopicsDigital Mental Health InterventionsPsychotherapy Techniques and Applications

The use of digitally assessed stress levels to model change processes in CBT -A feasibility study on seven case examples

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Hehlmann, Miriam I., Schwartz, Brian, Lutz, Teresa, Gómez Penedo, Juan Martín, Rubel, Julian A., Lutz, Wolfgang·2021·Frontiers in Psychiatry
DOI 10.3389/fpsyt.2021.613085PMC PMC7985334
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Abstract

In psychotherapy research, the measurement of treatment processes and outcome are predominantly based on self-reports. However, given new technological developments, other potential sources can be considered to improve measurements. In a feasibility study, we examined whether Ecological Momentary Assessments (EMA) using digital phenotyping (stress level) can be a valuable tool to investigate change processes during cognitive behavioral therapy (CBT). Seven outpatients undergoing psychological treatment were assessed using EMA. Continuous stress levels (heart rate variability) were assessed via fitness trackers (Garmin) every 3 min over a 2-week time period (6,720 measurements per patient). Time-varying change point autoregressive (TVCP-AR) models were employed to detect both gradual and abrupt changes in stress levels. Results for seven case examples indicate differential patterns of change processes in stress. More precisely, inertia of stress level changed gradually over time in one of the participants, whereas the other participants showed both gradual and abrupt changes. This feasibility study demonstrates that intensive longitudinal assessments enriched by digitally assessed stress levels have the potential to investigate intra- and interindividual differences in treatment change processes and their relations to treatment outcome. Further, implementation issues and implications for future research and developments using digital phenotyping are discussed.

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  • More recent developments in data-informed psychotherapy deal with tools from e-mental health apps and intensive longitudinal assessments, which can also be used to create, improve and customize CF.

    “More recent developments in data-informed psychotherapy deal with tools from e-mental health apps and intensive longitudinal assessments, which can also be used to create, improve and customize CF (Hehlmann et al., 2021).”

    From Data-Informed Case Formulation with the Trier Treatment Navigator (2022) · cites this paper as Hehlmann et al., 2021

    The Introduction describes intensive repeated assessments using mobile devices, and the Limitations and Conclusion section says digitally assessed information might help therapists adapt treatment to individual patients. The paper does not say these tools can create, improve, or customize CF specifically; it discusses treatment monitoring and adaptation instead. No page numbers are available in our copy. (LLM, conf=0.86)

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Cited by

Sorted by citations

Authors
Hehlmann, M. I., Schwartz, B., Lutz, T., Gómez Penedo, J. M., Rubel, J. A., & Lutz, W.
Affiliations
  • Universität Trier (DE)
  • Justus-Liebig-Universität Gießen (DE)
Corresponding author
Hehlmann, Miriam I.
ORCID
Venue
Frontiers in Psychiatry
Publisher
Frontiers Media SA
Published
2021-03-09
Volume
12
Pages
613085-613085
ISSN
1664-0640 (ISSN-L)
DOI
10.3389/fpsyt.2021.613085
PMC
PMC7985334
OpenAlex
W3134372219
Cited by
43
References
17
Citations by year
2026: 3 · 2025: 11 · 2024: 8 · 2023: 9 · 2022: 4 · 2021: 8
FWCI
5.32
Type
journal article
Language
en
Open access
Licence
Locations
  • Frontiers in Psychiatry (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • CONICET Digital (CONICET) (submittedVersion, cc-by)
  • Greater South Information System
Funders
Deutsche Forschungsgemeinschaft (LU 660-10/1, LU 660/8–1 and LU 660/10–1, 660/10-1, LU 660/8‐1)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
  • Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
  • Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
Keywords
cognitive behavioral therapy, digital phenotyping, ecological momentary assessment, heart rate variability, wearable activity trackers, stress levels, intensive longitudinal data, treatment outcomes, individual differences

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