Accepted for/Published in: JMIR Formative Research
Date Submitted: Dec 23, 2020
Date Accepted: Nov 23, 2021
Promoting recovery from nonsuicidal self-injury: A small-scale randomized controlled trial of a mobile peer support application
ABSTRACT
Background:
Nonsuicidal self-injury (NSSI) is a widespread behavior among adolescents and young adults. While many individuals who self-injure do not seek treatment, there is evidence for online help-seeking through online communities and mobile peer support networks. However, few studies have rigorously tested the efficacy of such platforms on outcomes relevant for NSSI recovery.
Objective:
The objectives of this small-scale pre-registered randomized controlled trial were to provide preliminary insight into the shorter- and longer-term efficacy of the use of a peer support application, TalkLife, in reducing NSSI frequency and urges and increasing readiness to change. We additionally explored contact with informal support, interest in therapy, and attitudes towards professional help-seeking.
Methods:
Individuals between 16 and 25 years old with current (within 3 months) and chronic (> 6 episodes in past year) NSSI history were eligible to participate in this study. After baseline, the intervention group was instructed to use the app actively (e.g., post or comment at least three times per week), and the control group received weekly psychoeducational materials through email, for eight weeks. Follow-up was assessed at 1 month and 2 months. Linear mixed modeling was used to evaluate condition and timepoint effects for primary outcomes of NSSI frequency and urges, readiness to change, contact with informal support, interest in therapy, and attitudes towards professional help-seeking.
Results:
One-hundred thirty-one participants were included in analysis. We evidenced a significant effect of condition on NSSI frequency such that participants using the peer support app injured less over the course of the study (M=1.30, SE=.18) when compared to participants in the control condition (M=1.62, S¬E=.18, P=.02, η²=.02). We also evidenced a significant condition effect of readiness to change such that treatment participants reported greater confidence in their ability to change their NSSI behavior (M=6.28, SE=.41), when compared to control participants (M=5.67, SE=.41, P=.04, η²=.02). No significant differences were observed for contact with informal support, interest in therapy, or attitudes towards professional help-seeking.
Conclusions:
Use of the peer support app was related to less NSSI frequency and greater confidence in one’s ability to change NSSI over the course of the study period, but no effects on NSSI urges, contact informal support, interest in therapy, or attitudes towards professional help-seeking were observed. Findings provide preliminary support for considering the use of mobile peer support apps as a supplement to NSSI intervention and point to the need for larger scale trials. Clinical Trial: https://osf.io/3uay9
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