Using Mobile Applications for SAD

Internet Self-Help for University Students

Q1. The claim of the researchers is causal in nature, based upon the fact that the study attempts to determine the efficacy of using Internet? and mobile?based interventions (IMIs) to reduce social anxiety disorder with an experimental design (Kählke et al., 2019).

Q2. The design was experimental, given that a randomized control and experimental intervention group was used (Kählke et al., 2019).

Q3. The hypothesis was that in university students diagnosed with SAD, using IMI would reduce symptoms as measured 10 weeks posttreatment on the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS).

Q4. The primary conceptual independent variable (the one which resulted from the manipulation of the researchers) was social anxiety symptoms as operationalized by a premeasured diagnosis.

Q5. The primary conceptual dependent variable was the reduction of social anxiety symptoms, measurement based upon independently validated scales.

Q6. All participants (n=200) were university students over the age of 18 which met DSM?IV Axis I Disorders for SAD, with exclusions made for individuals with suicidal symptoms or diagnosis of bipolar disorder, psychosis, or other severe mental disorders.

Q7. Participants in the experimental group received a cognitive behavioral intervention consisting of 9 hourly text-based sessions involving exercises, diaries, and homework outside of the classes (Kählke et al., 2019). All students within the experimental group received the same intervention, while the control group was merely placed upon a wait list for treatment.

Q8. The main results indicated that students in the experimental group self-reported a reduction in symptoms, compared with those of the experimental group, and also improvements upon other self-reported assessments scales, including depression, anxiety, quality of life, and other secondary symptoms associated with social anxiety.

Q9. The hypothesis that using a purely Internet-based intervention to reduce clinical social anxiety in university students and associated mental health issues like depression was supported.

Q10. Reliability was assessed using the Reliable Change Index of Jacobson and Truax and reduction in symptoms posttreatment.

Q11. Overall, the variable shows strong construct validity, given that all participants were assessed with independent, widely validated scales for social anxiety as well as met DSM criteria, and participants were assigned to randomized control groups. The CBT intervention has been widely used to treat SAD before, and was specifically designed to tackle the disorder. Individuals likely to have other comorbidities were excluded from the study. The study also attempted to exclude potentially confounding variables by focusing on a relatively narrow population from the same age group and social circumstances.

Q12. The study has moderately strong external validity. On one hand, it is likely that any intervention to help an individual with social anxiety is better than none, and CBT techniques have been widely and empirically validated outside of the study. On the other hand, the population was relatively homogeneous which might not be reflected in a larger population even of university students.

Q13. Covariance is not likely reflected in the study, given the high degree of randomization in assigning different students to the experimental and control groups, and the attempt to reduce confounding variables in relation to mental health.

Q14. The study establishes temporal precedence given the lengthy duration of the study (10 weeks), with pre-intervention and post-intervention testing of both groups.

Q15. The study makes clear the researchers’ efforts to reduce the third variable problem by eliminating subjects with comorbidities for other psychological disorders, as well as individuals on mood-stabilizing medications.

Q16. The conclusions of the study do match the research methods, given the relatively limited focus upon a single disorder (SAD), population (college students), and it has a purely quantitative design, both in treatment and results testing.

Q17. To improve external validity, testing a wider population of college students from a diverse range of universities might be helpful, given 200 participants is a relatively small number. Also, expanding testing to include students with potential comorbidities (given that social anxiety can often coexist with clinical anxiety and depression) might give a clearer portrait of its wider utility, even if more confounding variables were included.

Three Studies

Other studies have similarly supported the use of internet-based interventions for the difficulties that many university students experience. An earlier study of 102 university students with the same disorder (social anxiety) with a similar CBT approach was found to reduce symptoms (McCall et al., 2018). One study by Küchler (et al., 2020) of 387 college students from 15+ cooperating universities in Germany, Austria, and Switzerland exhibiting low to moderate levels of mindfulness found that an internet-based intervention increased mindfulness and resilience. Internet and mobile applications have also been found to help patients with major depressive disorder, which can be comorbid with SAD, as noted in a study of 269 outpatients (Kenter et al., 2016).

As noted by the researchers, SAD as well as other mental health conditions associated with SAD such as depression and anxiety, can make individuals resistant to seeking treatment. Although studies have been small, the greater willingness of afflicted individuals to seek help online and evidence-based support for their efficacy suggests hope in the future that Internet and mobile treatments can be first or even holistic steps to improving the quality of life of patients and treating severe mental illness.