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The Space Between: Bridging Emotion and Data in Mental Health Research
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences. WOMHER. (Clinical Psychiatry)ORCID iD: 0000-0002-7349-8765
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Description
Abstract [en]

Smartphone apps offer new opportunities to study mental health in real-world settings through a combination of passive sensor data and active self-report. This thesis explores how digital mental health research tools can be designed to collect meaningful, ecologically valid data while respecting user experience, motivation, and autonomy. Across four interrelated studies, I examine two app-based cohort studies targeting perinatal women (Mom2B) and young people (UPIC) in Sweden.

The first study presents the technical and ethical foundations of the Mom2B platform, including its integration of digital phenotyping methods. The second study applies machine learning techniques to self-reported data to assess the potential for early prediction of antenatal depression. The third study investigates user attitudes toward data sharing and task engagement, revealing the nuanced balance between research goals and participant comfort. The fourth study follows a user-centered design and usability testing process in the development of the UPIC app, highlighting how early user involvement can improve design, trust, and engagement.

Together, the findings demonstrate the importance of aligning technological possibilities with thoughtful, user-informed design. The thesis contributes to the growing field of digital mental health research by offering practical and ethical insights into the design and evaluation of emotion- and experience-aware research tools.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2025. , p. 73
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 2153
Keywords [en]
digital phenotyping, mhealth, user-centered design, perinatal mental health, youth mental health, app-based research, prediction, usability testing.
National Category
Human Computer Interaction Psychology
Research subject
Human-Computer Interaction; Psychology
Identifiers
URN: urn:nbn:se:uu:diva-554749ISBN: 978-91-513-2491-3 (print)OAI: oai:DiVA.org:uu-554749DiVA, id: diva2:1952555
Public defence
2025-06-11, H:son Holmdahl, Akademiska sjukhuset, Entrance 100, Uppsala, 12:00 (English)
Opponent
Supervisors
Part of project
Predicting postpartum depression with the Mom2B app: a large-scale Swedish study using artificial intelligence to improve mothers´ mental health, Swedish Research CouncilAvailable from: 2025-05-21 Created: 2025-04-15 Last updated: 2025-05-21
List of papers
1. Predicting perinatal health outcomes using smartphone-based digital phenotyping and machine learning in a prospective Swedish cohort (Mom2B): study protocol
Open this publication in new window or tab >>Predicting perinatal health outcomes using smartphone-based digital phenotyping and machine learning in a prospective Swedish cohort (Mom2B): study protocol
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2022 (English)In: BMJ Open, E-ISSN 2044-6055, Vol. 12, no 4, article id e059033Article in journal (Refereed) Published
Abstract [en]

Introduction: Perinatal complications, such as perinatal depression and preterm birth, are major causes of morbidity and mortality for the mother and the child. Prediction of high risk can allow for early delivery of existing interventions for prevention. This ongoing study aims to use digital phenotyping data from the Mom2B smartphone application to develop models to predict women at high risk for mental and somatic complications.

Methods and analysis: All Swedish-speaking women over 18 years, who are either pregnant or within 3 months postpartum are eligible to participate by downloading the Mom2B smartphone app. We aim to recruit at least 5000 participants with completed outcome measures. Throughout the pregnancy and within the first year postpartum, both active and passive data are collected via the app in an effort to establish a participant's digital phenotype. Active data collection consists of surveys related to participant background information, mental and physical health, lifestyle, and social circumstances, as well as voice recordings. Participants' general smartphone activity, geographical movement patterns, social media activity and cognitive patterns can be estimated through passive data collection from smartphone sensors and activity logs. The outcomes will be measured using surveys, such as the Edinburgh Postnatal Depression Scale, and through linkage to national registers, from where information on registered clinical diagnoses and received care, including prescribed medication, can be obtained. Advanced machine learning and deep learning techniques will be applied to these multimodal data in order to develop accurate algorithms for the prediction of perinatal depression and preterm birth. In this way, earlier intervention may be possible.

Ethics and dissemination: Ethical approval has been obtained from the Swedish Ethical Review Authority (dnr: 2019/01170, with amendments), and the project fully fulfils the General Data Protection Regulation (GDPR) requirements. All participants provide consent to participate and can withdraw their participation at any time. Results from this project will be disseminated in international peer-reviewed journals and presented in relevant conferences.

Place, publisher, year, edition, pages
BMJ Publishing Group LtdBMJ, 2022
Keywords
depression & mood disorders, mental health, maternal medicine, perinatology, preventive medicine, anxiety disorders
National Category
Gynaecology, Obstetrics and Reproductive Medicine Psychiatry
Identifiers
urn:nbn:se:uu:diva-474320 (URN)10.1136/bmjopen-2021-059033 (DOI)000788629100017 ()35477874 (PubMedID)
Funder
Swedish Research Council, 2020-01965Swedish Association of Local Authorities and RegionsThe Swedish Brain FoundationRegion Uppsala
Available from: 2022-05-18 Created: 2022-05-18 Last updated: 2025-04-15Bibliographically approved
2. Unimodal vs. Multimodal Prediction of Antenatal Depression from Smartphone-based Survey Data in a Longitudinal Study
Open this publication in new window or tab >>Unimodal vs. Multimodal Prediction of Antenatal Depression from Smartphone-based Survey Data in a Longitudinal Study
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2022 (English)In: ICMI '22: Proceedings of the 2022 International Conference on Multimodal Interaction / [ed] Raj Tumuluri; Nicu Sebe; Gopal Pingali; Dinesh Babu Jayagopi; Abhinav Dhall; Richa Singh; Lisa Anthony; Albert Ali Salah, Association for Computing Machinery (ACM), 2022, p. 455-467Conference paper, Published paper (Refereed)
Abstract [en]

Antenatal depression impacts 7-20% of women globally, and can have serious consequences for both the mother and the infant. Preventative interventions are effective, but are cost-efficient only among those at high risk. As such, being able to predict and identify those at risk is invaluable for reducing the burden of care and adverse consequences, as well as improving treatment outcomes. While several approaches have been proposed in the literature for the automatic prediction of depressive states, there is a scarcity of research on automatic prediction of perinatal depression. Moreover, while there exist some works on the automatic prediction of postpartum depression using data collected in clinical settings and applied the model to a smartphone application, to the best of our knowledge, no previous work has investigated the automatic prediction of late antenatal depression using data collected via a smartphone app in the first and second trimesters of pregnancy. This study utilizes data measuring various aspects of self-reported psychological, physiological and behavioral information, collected from 915 women in the first and second trimesters of pregnancy using a smartphone app designed for perinatal depression. By applying machine learning algorithms on these data, this paper explores the possibility of automatic early detection of antenatal depression (i.e., during week 36 to week 42 of pregnancy) in everyday life without the administration of healthcare professionals. We compare uni-modal and multi-modal models and identify predictive markers related to antenatal depression. With multi-modal approach the model reaches a BAC of 0.75, and an AUC of 0.82.

Place, publisher, year, edition, pages
Association for Computing Machinery (ACM), 2022
Keywords
Antenatal depression, multimodal markers, mobile surveys, longitudinal study, machine learning
National Category
Health Sciences Computer Systems Psychiatry
Identifiers
urn:nbn:se:uu:diva-488966 (URN)10.1145/3536221.3556605 (DOI)001074464500050 ()9781450393904 (ISBN)
Conference
24th ACM International Conference on Multimodal Interaction, Bangalore, Indien, November 7-11, 2022
Funder
Uppsala University
Available from: 2022-11-24 Created: 2022-11-24 Last updated: 2025-04-24Bibliographically approved
3. Exploring User Experiences of the Mom2B mHealth Research App During the Perinatal Period: Qualitative Study
Open this publication in new window or tab >>Exploring User Experiences of the Mom2B mHealth Research App During the Perinatal Period: Qualitative Study
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2024 (English)In: JMIR Formative Research, E-ISSN 2561-326X, Vol. 8, article id e53508Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Perinatal depression affects a significant number of women during pregnancy and after birth, and early identification is imperative for timely interventions and improved prognosis. Mobile apps offer the potential to overcome barriers to health care provision and facilitate clinical research. However, little is known about users' perceptions and acceptability of these apps, particularly digital phenotyping and ecological momentary assessment apps, a relatively novel category of apps and approach to data collection. Understanding user's concerns and the challenges they experience using the app will facilitate adoption and continued engagement.

OBJECTIVE: This qualitative study explores the experiences and attitudes of users of the Mom2B mobile health (mHealth) research app (Uppsala University) during the perinatal period. In particular, we aimed to determine the acceptability of the app and any concerns about providing data through a mobile app.

METHODS: Semistructured focus group interviews were conducted digitally in Swedish with 13 groups and a total of 41 participants. Participants had been active users of the Mom2B app for at least 6 weeks and included pregnant and postpartum women, both with and without depression symptomatology apparent in their last screening test. Interviews were recorded, transcribed verbatim, translated to English, and evaluated using inductive thematic analysis.

RESULTS: Four themes were elicited: acceptability of sharing data, motivators and incentives, barriers to task completion, and user experience. Participants also gave suggestions for the improvement of features and user experience.

CONCLUSIONS: The study findings suggest that app-based digital phenotyping is a feasible and acceptable method of conducting research and health care delivery among perinatal women. The Mom2B app was perceived as an efficient and practical tool that facilitates engagement in research as well as allows users to monitor their well-being and receive general and personalized information related to the perinatal period. However, this study also highlights the importance of trustworthiness, accessibility, and prompt technical issue resolution in the development of future research apps in cooperation with end users. The study contributes to the growing body of literature on the usability and acceptability of mobile apps for research and ecological momentary assessment and underscores the need for continued research in this area.

Place, publisher, year, edition, pages
JMIR Publications, 2024
Keywords
acceptability, app, behavioral data, clinical research, depression, depressive symptoms, digital phenotyping, interview, mHealth, mobile app, mobile health, mobile phone, monitor, perinatal, perinatal depression, postpartum, pregnant, qualitative, qualitative study, smartphone app, thematic analysis, usability, user, user experience, users, well-being, women
National Category
Science and Technology Studies Gynaecology, Obstetrics and Reproductive Medicine
Identifiers
urn:nbn:se:uu:diva-554627 (URN)10.2196/53508 (DOI)39115893 (PubMedID)2-s2.0-85202686190 (Scopus ID)
Funder
Region UppsalaSwedish Association of Local Authorities and RegionsSwedish Research Council, 2020-01965The Swedish Brain FoundationThe Swedish Medical AssociationStiftelsen Söderström - Königska sjukhemmet, SLS-940670Uppsala University
Available from: 2025-04-14 Created: 2025-04-14 Last updated: 2025-04-15Bibliographically approved
4. Developing a Mobile Research App for Youth Mental Health:: A User-Centered Design and Usability Evaluation
Open this publication in new window or tab >>Developing a Mobile Research App for Youth Mental Health:: A User-Centered Design and Usability Evaluation
(English)Manuscript (preprint) (Other academic)
National Category
Science and Technology Studies
Research subject
Human-Computer Interaction; Psychology
Identifiers
urn:nbn:se:uu:diva-554629 (URN)
Available from: 2025-04-14 Created: 2025-04-14 Last updated: 2025-04-15

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