Mobile RDoC: Using Smartphones to Understand the Relationship Between Auditory Verbal Hallucinations and Need for Care

Dror Ben-Zeev; Benjamin Buck; Ayesha Chander; Rachel Brian; Weichen Wang; David Atkins; Carolyn J Brenner; Trevor Cohen; Andrew Campbell; Jeffrey Munson

doi:10.1093/schizbullopen/sgaa060

Mobile RDoC: Using Smartphones to Understand the Relationship Between Auditory Verbal Hallucinations and Need for Care

Schizophr Bull Open. 2020 Nov 9;1(1):sgaa060. doi: 10.1093/schizbullopen/sgaa060. eCollection 2020 Jan.

Authors

Affiliations

¹ Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA.
² Department of Computer Science, Dartmouth College, Hanover, NH.
³ Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA.

Abstract

Objective: Auditory verbal hallucinations (AVH) are common in multiple clinical populations but also occur in individuals who are otherwise considered healthy. Adopting the National Institute of Mental Health's Research Domain Criteria (RDoC) framework, the aim of the current study was to integrate a variety of measures to evaluate whether AVH experience varies across clinical and nonclinical individuals.

Methods: A total of 384 people with AVH from 41 US states participated in the study; 295 participants (77%) who received inpatient, outpatient, or combination treatments for AVH and 89 participants (23%) who never received care. Participants used a multi-modal smartphone data collection system to report on their AVH experiences and co-occurring psychological states multiple times daily, over 30 days. In parallel, smartphone sensors recorded their physical activity, geolocation, and calling and texting behavior continuously.

Results: The clinical sample experienced AVH more frequently than the nonclinical group and rated their AVH as significantly louder and more powerful. They experienced more co-occurring negative affect and were more socially withdrawn, spending significantly more time at home and significantly less time near other people. Participants with a history of inpatient care also rated their AVH as infused with significantly more negative content. The groups did not differ in their physical activity or use of their smartphones for digital communication.

Conclusion: Smartphone-assisted remote data collection revealed real-time/real-place phenomenological, affective, and behavioral differences between clinical and nonclinical samples of people who experience AVH. The study provided strong support for the application of RDoC-informed approaches in psychosis research.

Keywords: ecological momentary assessment; mobile health (mHealth); mobile phones; psychosis; schizophrenia; sensing.