Mobile Assessments of Mood, Cognition, Smartphone-Based Sensor Activity, and Variability in Craving and Substance Use in Patients With Substance Use Disorders in Norway: Prospective Observational Feasibility Study

Anders Dahlen Forsmo Lauvsnes; Tor Ivar Hansen; Sebastian Øiungen Ankill; Sang Won Bae; Rolf W Gråwe; Taylor A Braund; Mark Larsen; Mette Langaas

doi:10.2196/45254

Mobile Assessments of Mood, Cognition, Smartphone-Based Sensor Activity, and Variability in Craving and Substance Use in Patients With Substance Use Disorders in Norway: Prospective Observational Feasibility Study

JMIR Form Res. 2023 Jun 23:7:e45254. doi: 10.2196/45254.

Authors

Anders Dahlen Forsmo Lauvsnes^{1

2}, Tor Ivar Hansen³, Sebastian Øiungen Ankill^{1

4}, Sang Won Bae⁵, Rolf W Gråwe^{1

6}, Taylor A Braund^{7

8}, Mark Larsen^{7

8}, Mette Langaas⁴

Affiliations

¹ Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
² Clinic of Substance Use and Addiction Medicine, St Olavs University Hospital, Trondheim, Norway.
³ Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
⁴ Department of Mathematical Sciences, Faculty of Information Technology and Electrical Engineering, Norwegian University of Science and Technology, Trondheim, Norway.
⁵ Human-Computer Interaction and Human-Centered AI Systems Lab, AI for Healthcare Lab, School of Systems and Enterprises, Stevens Institute of Technology, Hoboken, NJ, United States.
⁶ Department of Research and Development, Division of Psychiatry, St Olavs University Hospital, Trondheim, Norway.
⁷ Black Dog Institute, Sydney, Australia.
⁸ Faculty of Medicine and Health, University of New South Wales, Sydney, Australia.

PMID: 37351934
PMCID: PMC10337471
DOI: 10.2196/45254

Abstract

Background: Patients with substance use disorders (SUDs) are at increased risk for symptom deterioration following treatment, with up to 60% resuming substance use within the first year posttreatment. Substance use craving together with cognitive and mental health variables play important roles in the understanding of the trajectories from abstinence to substance use.

Objective: This prospective observational feasibility study aims to improve our understanding of specific profiles of variables explaining SUD symptom deterioration, in particular, how individual variability in mental health, cognitive functioning, and smartphone use is associated with craving and substance use in a young adult clinical population.

Methods: In this pilot study, 26 patients with SUDs were included at about 2 weeks prior to discharge from inpatient SUD treatment from 3 different treatment facilities in Norway. Patients underwent baseline neuropsychological and mental health assessments; they were equipped with smartwatches and they downloaded an app for mobile sensor data collection in their smartphones. Every 2 days for up to 8 weeks, the patients were administered mobile ecological momentary assessments (EMAs) to evaluate substance use, craving, mental health, cognition, and a mobile Go/NoGo performance task. Repeated EMAs as well as the smartphone's battery use data were averaged across all days per individual and used as candidate input variables together with the baseline measures in models of craving intensity and the occurrence of any substance use episodes.

Results: A total of 455 momentary assessments were completed out of a potential maximum of 728 assessments. Using EMA and baseline data as candidate input variables and craving and substance use as responses, model selection identified mean craving intensity as the most important predictor of having one or more substance use episodes and with variabilities in self-reported impulsivity, mental health, and battery use as significant explanatory variables of craving intensity.

Conclusions: This prospective observational feasibility study adds novelty by collecting high-intensity data for a considerable period of time, including mental health data, mobile cognitive assessments, and mobile sensor data. Our study also contributes to our knowledge about a clinical population with the most severe SUD presentations in a vulnerable period during and after discharge from inpatient treatment. We confirmed the importance of variability in cognitive function and mood in explaining variability in craving and that smartphone usage may possibly add to this understanding. Further, we found that craving intensity is an important explanatory variable in understanding substance use episodes.

Keywords: clinical inference; decision support; ecological momentary assessment; executive functioning; mental health; mobile phone; mobile sensor; mood; neurocognitive functioning; pilot study; sensor; smartphone use; substance use; substance use disorder.

©Anders Dahlen Forsmo Lauvsnes, Tor Ivar Hansen, Sebastian Øiungen Ankill, Sang Won Bae, Rolf W Gråwe, Taylor A Braund, Mark Larsen, Mette Langaas. Originally published in JMIR Formative Research (https://formative.jmir.org), 23.06.2023.