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Symposia

Technology/Digital Health

Leveraging Novel Scientific Approaches and Digital Technologies to Bridge the Divide in Under Addressed Psychological Conditions

3 - (SYM 25) Preliminary Results from an Ongoing Micro-randomized Trial Testing a Just-in-time-adaptive Intervention for Problem Anger After Trauma

Friday, November 21, 2025
3:48 PM - 4:09 PM CST
Location: Bolden 2, Level 2
Keywords: Technology / Mobile Health, Vulnerable Populations, Anger / Irritability
Recommended Readings: Philippe, T. J., Sikder, N., Jackson, A., Koblanski, M. E., Liow, E., Pilarinos, A., & Vasarhelyi, K. (2022). Digital health interventions for delivery of mental health care: systematic and comprehensive meta-review. JMIR mental health, 9(5), e35159.,   Chung, J., & Teo, J. (2022). Mental health prediction using machine learning: taxonomy, applications, and challenges. Applied Computational Intelligence and Soft Computing, 2022(1), 9970363.,   van Genugten, C. R., Thong, M. S., Van Ballegooijen, W., Kleiboer, A. M., Spruijt-Metz, D., Smit, A. C., ... & Riper, H. (2025). Beyond the current state of just-in-time adaptive interventions in mental health: a qualitative systematic review. Frontiers in Digital Health, 7, 1460167.,   Larkin, M., Boden, Z. V., & Newton, E. (2015). On the brink of genuinely collaborative care: experience-based co-design in mental health. Qualitative health research, 25(11), 1463-1476.,  
Abstract Body

Background: Just-in-time-adaptive interventions (JITAIs) are a new type of digital mental health tool that leverages contextual and environmental information to deliver the right intervention components at the right time. JITAIs have the potential to bridge inequity in mental health access by providing evidence-based support in an individual's environment. This study reports preliminary findings from an ongoing micro-randomized trial (MRT) testing a new JITAI for problem anger after trauma.

Method: CBT-based components to manage problem anger were co-designed with individuals with lived experience of trauma and anger, alongside mental health experts, and then developed into a JITAI smartphone app. An ongoing MRT is investigating whether prompting users four times per day, for 30 days, to engage with the CBT-based components tailored to the in-the-moment anger state, as compared to no prompt, improves near-term anger intensity. Sample size of N = 65 was planned based on the primary aim comparison assuming 1:1 micro-randomization at each decision point.

Results: To date, 103 individuals completed screening, with 53 trauma-exposed adults with problem anger (Dimensions of Anger Reactions-5 [DAR-5]; ≥12) screened eligible and 50 enrolling to participate (Mage= 38.2; 80% women, 18% men, 2% non-binary; 32% non-white; 20% living in rural and regional areas; 68% probable posttraumatic stress disorder). Thirty-two participants have completed the 30 days and preliminary results show a significant reduction in mean DAR-5 scores: 5.59 (95% CI [4.13, 7.05]), t(31) = 7.82, p < .001, drm= 1.38. Participant-rated System Usability Scores of the JITAI was high (82.9/100). Qualitative data showed participants reported that they felt the JITAI increased their self-awareness of their anger and triggers, provided practical tools for anger management, used language and information that was validating of their anger experiences, and had some ability to personalize to their needs. Suggestions for improvement included the need to address some technical issues, provide more personalization, offer more novel content, and expand the range of features to cater to diverse user needs and situations.

Conclusions: The positive preliminary results, high usability scores, and qualitative feedback demonstrate the potential of CBT-based JITAIs to enhance the reach and impact of cognitive and behavioral therapies to underserved populations.