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Investigating ACT-based Active Intervention Elements in Smartphone-based Mental Health Applications to Reduce Anxiety Symptoms : A Meta-Analysis

Mardjo, R. (2025) Investigating ACT-based Active Intervention Elements in Smartphone-based Mental Health Applications to Reduce Anxiety Symptoms : A Meta-Analysis.

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Abstract:Background: Anxiety disorders are highly prevalent, yet access to treatment remains limited. Smartphone-based mental health applications, especially those grounded in evidence-based frameworks like Acceptance and Commitment Therapy (ACT), could help bridge this treatment gap. However, more research is needed to identify which ACT-based active intervention elements improve anxiety symptoms. Method: This meta-analysis reviewed 160 RCTs involving 35,504 participants, retrieved from PubMed, PsycINFO, and Web of Science. Studies included smartphone-based mental health apps and validated self-report anxiety measures (e.g., GAD-7). Univariable mixed-effect meta-regressions examined associations between five ACT elements cognitive defusion, values, acceptance, present-moment focus, and committed action and anxiety outcomes. Sensitivity analyses controlled for time, age, gender, comorbidity, clinical severity, adjunct treatments, and guidance. Results: Cognitive defusion (g = -0.22, p < .01), acceptance (g = -0.14, p < .05), and present-moment focus (g = -0.21, p < .001) were significantly associated with small reductions in anxiety symptoms. Values (g = -0.14, p > .05) and committed action (g = -0.14, p > .05) showed no significant effects. These findings remained consistent after adjusting for covariates. Conclusion: ACT-based elements addressing cognitive and emotional anxiety processes are most effective in smartphone-based mental health applications, highlighting the importance of targeting these mechanisms in app design.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
Link to this item:https://purl.utwente.nl/essays/107092
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