Transdiagnostic Ecological Momentary Intervention for Improving Self-Esteem in Youth Exposed to Childhood Adversity

• DOI: 10.1001/jamapsychiatry.2023.4590
• Publication Date: 2023-11-29T11:34:39Z
• Authors: Ulrich Reininghaus; Maud Daemen; Mary Rose Postma; Anita Schick; Iris Hoes-van der...; Nele Volbragt; Dorien Nieman; Philippe Delespaul; Lieuwe de Haan; Marieke van der P...; Josefien Johanna ...; Mark van der Gaag; Ramon Lindauer; Jan R. Boehnke; Wolfgang Viechtbauer; David van den Berg; Claudi Bockting; Therese van Amels...
• Keywords: 150; 16. Peace & justice; 3. Good health; Original Investigation

Importance Targeting low self-esteem in youth exposed to childhood adversity is a promising strategy for preventing adult mental disorders. Ecological momentary interventions (EMIs) allow the delivery of youth-friendly, adaptive improving self-esteem, but robust trial-based evidence pending. Objective To examine efficacy SELFIE, novel transdiagnostic, blended EMI plus care as usual (CAU) compared with CAU only. Design, Setting, and Participants This was 2-arm, parallel-group, assessor-blinded, randomized clinical trial conducted from December 2018 2022. The study took place at Dutch secondary health services within general population included (aged 12-26 years) (Rosenberg Self-Esteem Scale [RSES] <26) adversity. Interventions A (3 face-to-face sessions, email contacts, app-based, EMI) or Main Outcomes Measures primary outcome RSES postintervention 6-month follow-up. Secondary outcomes positive negative schematic self-beliefs, affect, psychopathology, quality life, observer-rated symptoms, functioning. Results total 174 participants (mean [SD] age, 20.7 [3.1] years; 154 female [89%]) were intention-to-treat sample, who primarily emotional abuse neglect, verbal indirect bullying, and/or parental conflict. At postintervention, 153 (87.9%) and, follow-up, 140 (80.5%), provided data. was, on average, higher experimental condition (blended + CAU) than control across both follow-up (B = 2.32; 95% CI, 1.14-3.50; P < .001; Cohen d -type effect size [hereafter, ] 0.54). Small moderate sizes observed suggestive beneficial effects 3.85; 1.83-5.88; 0.53) −3.78; −6.59 −0.98; .008; −0.38) 1.58; 0.41-2.75; 0.38) −1.71; −2.93 −0.48; .006; −0.39) 0.29; 0.01-0.57; .04; 0.24), affect 0.23; 0.01-0.45; 0.20), −0.33; −0.59 −0.03, .01, −0.27), psychopathology −17.62; −33.03 −2.21; .03; −0.34), life 1.16; 0.18-2.13; .02; 0.33) No symptoms functioning observed. Conclusions Relevance demonstrated signaled several outcomes. Further work should focus implementing this routine public provision. Trial Registration Register Identifier: NL7129(NTR7475)