{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,22]],"date-time":"2026-02-22T21:49:54Z","timestamp":1771796994149,"version":"3.50.1"},"reference-count":96,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"},{"start":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T00:00:00Z","timestamp":1746835200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/100000025","name":"U.S. Department of Health & Human Services | NIH | National Institute of Mental Health","doi-asserted-by":"publisher","award":["K01MH12043"],"award-info":[{"award-number":["K01MH12043"]}],"id":[{"id":"10.13039\/100000025","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006108","name":"U.S. Department of Health & Human Services | NIH | National Center for Advancing Translational Sciences","doi-asserted-by":"publisher","award":["UL1TR004419"],"award-info":[{"award-number":["UL1TR004419"]}],"id":[{"id":"10.13039\/100006108","id-type":"DOI","asserted-by":"publisher"}]},{"name":"The Friedman Brain Institute, The Ehrenkranz Laboratory for Human Resilience, The Gottesman Foundation"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["npj Digit. Med."],"DOI":"10.1038\/s41746-025-01669-0","type":"journal-article","created":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T15:16:37Z","timestamp":1746890197000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Digital measures of activity and motivation impact depression and anxiety in the real world"],"prefix":"10.1038","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6311-9947","authenticated-orcid":false,"given":"Jacqueline M.","family":"Beltr\u00e1n","sequence":"first","affiliation":[]},{"given":"Yael","family":"Jacob","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5105-6723","authenticated-orcid":false,"given":"Marishka M.","family":"Mehta","sequence":"additional","affiliation":[]},{"given":"Tasnim","family":"Hossain","sequence":"additional","affiliation":[]},{"given":"Abigail","family":"Adams","sequence":"additional","affiliation":[]},{"given":"Samantha","family":"Fontaine","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5362-7937","authenticated-orcid":false,"given":"John","family":"Torous","sequence":"additional","affiliation":[]},{"given":"Catherine","family":"McDonough","sequence":"additional","affiliation":[]},{"given":"Matthew","family":"Johnson","sequence":"additional","affiliation":[]},{"given":"Andrew D.","family":"Delgado","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6286-1242","authenticated-orcid":false,"given":"James W.","family":"Murrough","sequence":"additional","affiliation":[]},{"given":"Laurel S.","family":"Morris","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2025,5,10]]},"reference":[{"key":"1669_CR1","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1001\/jamapsychiatry.2017.4602","volume":"75","author":"DS Hasin","year":"2018","unstructured":"Hasin, D. S. et al. Epidemiology of adult DSM-5 major depressive disorder and its specifiers in the United States. JAMA Psychiatry 75, 336\u2013346 (2018).","journal-title":"JAMA Psychiatry"},{"key":"1669_CR2","doi-asserted-by":"publisher","first-page":"286","DOI":"10.1002\/da.23113","volume":"38","author":"S Saha","year":"2021","unstructured":"Saha, S. et al. Co-morbidity between mood and anxiety disorders: a systematic review and meta-analysis. Depress Anxiety 38, 286\u2013306 (2021).","journal-title":"Depress Anxiety"},{"key":"1669_CR3","doi-asserted-by":"publisher","first-page":"2201","DOI":"10.3389\/fpsyg.2018.02201","volume":"9","author":"Y Liu","year":"2018","unstructured":"Liu, Y., Zhao, J. & Guo, W. Emotional roles of mono-aminergic neurotransmitters in major depressive disorder and anxiety disorders. Front. Psychol. 9, 2201 (2018).","journal-title":"Front. Psychol."},{"key":"1669_CR4","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1192\/bjp.2024.19","volume":"224","author":"OV Ebrahimi","year":"2024","unstructured":"Ebrahimi, O. V. et al. Towards precision in the diagnostic profiling of patients: leveraging symptom dynamics as a clinical characterisation dimension in the assessment of major depressive disorder. Br. J. Psychiatry J. Ment. Sci. 224, 157\u2013163 (2024).","journal-title":"Br. J. Psychiatry J. Ment. Sci."},{"key":"1669_CR5","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1017\/S2045796015000189","volume":"24","author":"RC Kessler","year":"2015","unstructured":"Kessler, R. C. et al. Anxious and non-anxious major depressive disorder in the World Health Organization World Mental Health Surveys. Epidemiol. Psychiatr. Sci. 24, 210\u2013226 (2015).","journal-title":"Epidemiol. Psychiatr. Sci."},{"key":"1669_CR6","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1037\/0021-843X.104.1.3","volume":"104","author":"D Watson","year":"1995","unstructured":"Watson, D. et al. Testing a tripartite model: I. Evaluating the convergent and discriminant validity of anxiety and depression symptom scales. J. Abnorm. Psychol. 104, 3\u201314 (1995).","journal-title":"J. Abnorm. Psychol."},{"key":"1669_CR7","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1002\/da.22518","volume":"34","author":"NL Balderston","year":"2017","unstructured":"Balderston, N. L. et al. Anxiety patients show reduced working memory related dlPFC activation during safety and threat. Depress Anxiety 34, 25\u201336 (2017).","journal-title":"Depress Anxiety"},{"key":"1669_CR8","doi-asserted-by":"publisher","first-page":"1044","DOI":"10.1080\/02699931.2019.1710467","volume":"34","author":"R Gadassi Polack","year":"2020","unstructured":"Gadassi Polack, R., Tran, T. B. & Joormann, J. What has been is what will be\u2019? Autobiographical memory and prediction of future events in depression. Cognit. Emot. 34, 1044\u20131051 (2020).","journal-title":"Cognit. Emot."},{"key":"1669_CR9","doi-asserted-by":"publisher","first-page":"20","DOI":"10.3389\/fnint.2016.00020","volume":"10","author":"HY Khdour","year":"2016","unstructured":"Khdour, H. Y. et al. Generalized anxiety disorder and social anxiety disorder, but not panic anxiety disorder, are associated with higher sensitivity to learning from negative feedback: behavioral and computational investigation. Front. Integr. Neurosci. 10, 20 (2016).","journal-title":"Front. Integr. Neurosci."},{"key":"1669_CR10","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1016\/j.cpr.2018.06.008","volume":"69","author":"J LeMoult","year":"2019","unstructured":"LeMoult, J. & Gotlib, I. H. Depression: a cognitive perspective. Clin. Psychol. Rev. 69, 51\u201366 (2019).","journal-title":"Clin. Psychol. Rev."},{"key":"1669_CR11","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1038\/s41386-020-0771-3","volume":"46","author":"J-P Onnela","year":"2021","unstructured":"Onnela, J.-P. Opportunities and challenges in the collection and analysis of digital phenotyping data. Neuropsychopharmacology 46, 45\u201354 (2021).","journal-title":"Neuropsychopharmacology"},{"key":"1669_CR12","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1037\/abn0000884","volume":"133","author":"MD Nemesure","year":"2024","unstructured":"Nemesure, M. D. et al. Depressive symptoms as a heterogeneous and constantly evolving dynamical system: Idiographic depressive symptom networks of rapid symptom changes among persons with major depressive disorder. J. Psychopathol. Clin. Sci. 133, 155\u2013166 (2024).","journal-title":"J. Psychopathol. Clin. Sci."},{"key":"1669_CR13","doi-asserted-by":"publisher","first-page":"194","DOI":"10.1111\/acps.12987","volume":"139","author":"WA van Eeden","year":"2019","unstructured":"van Eeden, W. A., van Hemert, A. M., Carlier, I. V. E., Penninx, B. W. & Giltay, E. J. Severity, course trajectory, and within-person variability of individual symptoms in patients with major depressive disorder. Acta Psychiatr. Scand. 139, 194\u2013205 (2019).","journal-title":"Acta Psychiatr. Scand."},{"key":"1669_CR14","doi-asserted-by":"publisher","first-page":"e16","DOI":"10.2196\/mental.5165","volume":"3","author":"J Torous","year":"2016","unstructured":"Torous, J., Kiang, M. V., Lorme, J. & Onnela, J.-P. New tools for new research in psychiatry: a scalable and customizable platform to empower data driven smartphone research. JMIR Ment. Health 3, e16 (2016).","journal-title":"JMIR Ment. Health"},{"key":"1669_CR15","unstructured":"Mobile Fact Sheet. Pew Research Center https:\/\/www.pewresearch.org\/internet\/fact-sheet\/mobile\/ (2024)."},{"key":"1669_CR16","unstructured":"Poushter, J. Smartphone Ownership and Internet Usage Continues to Climb in Emerging Economies. Pew Research Center https:\/\/www.pewresearch.org\/global\/2016\/02\/22\/smartphone-ownership-and-internet-usage-continues-to-climb-in-emerging-economies\/ (2016)."},{"key":"1669_CR17","doi-asserted-by":"publisher","first-page":"05TR01","DOI":"10.1088\/1361-6579\/aabf64","volume":"39","author":"E Reinertsen","year":"2018","unstructured":"Reinertsen, E. & Clifford, G. D. A review of physiological and behavioral monitoring with digital sensors for neuropsychiatric illnesses. Physiol. Meas. 39, 05TR01 (2018).","journal-title":"Physiol. Meas."},{"key":"1669_CR18","doi-asserted-by":"publisher","first-page":"e40689","DOI":"10.2196\/40689","volume":"12","author":"A Choi","year":"2024","unstructured":"Choi, A., Ooi, A. & Lottridge, D. Digital phenotyping for stress, anxiety, and mild depression: systematic literature review. JMIR MHealth UHealth 12, e40689 (2024).","journal-title":"JMIR MHealth UHealth"},{"key":"1669_CR19","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/j.comppsych.2015.12.004","volume":"66","author":"G Fervaha","year":"2016","unstructured":"Fervaha, G., Foussias, G., Takeuchi, H., Agid, O. & Remington, G. Motivational deficits in major depressive disorder: cross-sectional and longitudinal relationships with functional impairment and subjective well-being. Compr. Psychiatry 66, 31\u201338 (2016).","journal-title":"Compr. Psychiatry"},{"key":"1669_CR20","doi-asserted-by":"publisher","first-page":"633","DOI":"10.1002\/da.23267","volume":"39","author":"R Bi","year":"2022","unstructured":"Bi, R., Dong, W., Zheng, Z., Li, S. & Zhang, D. Altered motivation of effortful decision-making for self and others in subthreshold depression. Depress Anxiety 39, 633\u2013645 (2022).","journal-title":"Depress Anxiety"},{"key":"1669_CR21","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1016\/j.biopsych.2016.12.010","volume":"81","author":"CJ Charpentier","year":"2017","unstructured":"Charpentier, C. J., Aylward, J., Roiser, J. P. & Robinson, O. J. Enhanced risk aversion, but not loss aversion, in unmedicated pathological anxiety. Biol. Psychiatry 81, 1014\u20131022 (2017).","journal-title":"Biol. Psychiatry"},{"key":"1669_CR22","doi-asserted-by":"publisher","first-page":"553","DOI":"10.1037\/a0028813","volume":"121","author":"MT Treadway","year":"2012","unstructured":"Treadway, M. T., Bossaller, N., Shelton, R. C. & Zald, D. H. Effort-based decision-making in major depressive disorder: a translational model of motivational Anhedonia. J. Abnorm. Psychol. 121, 553\u2013558 (2012).","journal-title":"J. Abnorm. Psychol."},{"key":"1669_CR23","doi-asserted-by":"publisher","first-page":"1106","DOI":"10.1016\/j.janxdis.2009.07.014","volume":"23","author":"HA Westra","year":"2009","unstructured":"Westra, H. A., Arkowitz, H. & Dozois, D. J. A. Adding a motivational interviewing pretreatment to cognitive behavioral therapy for generalized anxiety disorder: a preliminary randomized controlled trial. J. Anxiety Disord. 23, 1106\u20131117 (2009).","journal-title":"J. Anxiety Disord."},{"key":"1669_CR24","doi-asserted-by":"publisher","first-page":"1801","DOI":"10.1017\/S0033291722001611","volume":"52","author":"LS Morris","year":"2022","unstructured":"Morris, L. S., Grehl, M. M., Rutter, S. B., Mehta, M. & Westwater, M. L. On what motivates us: a detailed review of intrinsic v. extrinsic motivation. Psychol. Med. 52, 1801\u20131816 (2022).","journal-title":"Psychol. Med."},{"key":"1669_CR25","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1146\/annurev.clinpsy.3.022806.091415","volume":"4","author":"S Shiffman","year":"2008","unstructured":"Shiffman, S., Stone, A. A. & Hufford, M. R. Ecological momentary assessment. Annu. Rev. Clin. Psychol. 4, 1\u201332 (2008).","journal-title":"Annu. Rev. Clin. Psychol."},{"key":"1669_CR26","doi-asserted-by":"publisher","first-page":"2419","DOI":"10.1080\/13548506.2022.2159453","volume":"28","author":"FS Hussenoeder","year":"2023","unstructured":"Hussenoeder, F. S. et al. Physical activity and mental health: the connection between step count and depression, anxiety and quality of sleep. Psychol. Health Med. 28, 2419\u20132429 (2023).","journal-title":"Psychol. Health Med."},{"key":"1669_CR27","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1002\/wps.21188","volume":"23","author":"J Firth","year":"2024","unstructured":"Firth, J. et al. From \u201conline brains\u201d to \u201conline lives\u201d: understanding the individualized impacts of Internet use across psychological, cognitive and social dimensions. World Psychiatry 23, 176\u2013190 (2024).","journal-title":"World Psychiatry"},{"key":"1669_CR28","doi-asserted-by":"publisher","first-page":"432","DOI":"10.1038\/d41586-018-02109-8","volume":"554","author":"C Odgers","year":"2018","unstructured":"Odgers, C. Smartphones are bad for some teens, not all. Nature 554, 432\u2013434 (2018).","journal-title":"Nature"},{"key":"1669_CR29","doi-asserted-by":"crossref","first-page":"zmab015","DOI":"10.1093\/jcmc\/zmac015","volume":"27","author":"PM Valkenburg","year":"2022","unstructured":"Valkenburg, P. M., Beyens, I., Pouwels, J. L., van Driel, I. I. & Keijsers, L. Social media browsing and adolescent well-being: challenging the \u201cpassive social media use hypothesis\u201d. J. Comput. Mediat. Commun. 27, zmab015 (2022).","journal-title":"J. Comput. Mediat. Commun."},{"key":"1669_CR30","doi-asserted-by":"publisher","first-page":"9352","DOI":"10.3390\/ijerph19159352","volume":"19","author":"M Daniyal","year":"2022","unstructured":"Daniyal, M., Javaid, S. F., Hassan, A. & Khan, M. A. B. The relationship between cellphone usage on the physical and mental wellbeing of university students: a cross-sectional study. Int. J. Environ. Res. Public. Health 19, 9352 (2022).","journal-title":"Int. J. Environ. Res. Public. Health"},{"key":"1669_CR31","doi-asserted-by":"publisher","first-page":"53","DOI":"10.1016\/j.chb.2018.08.044","volume":"90","author":"C Fennell","year":"2019","unstructured":"Fennell, C., Barkley, J. E. & Lepp, A. The relationship between cell phone use, physical activity, and sedentary behavior in adults aged 18\u201380. Comput. Hum. Behav. 90, 53\u201359 (2019).","journal-title":"Comput. Hum. Behav."},{"key":"1669_CR32","doi-asserted-by":"publisher","first-page":"822","DOI":"10.1007\/s10826-018-01323-2","volume":"28","author":"X Yang","year":"2019","unstructured":"Yang, X., Zhou, Z., Liu, Q. & Fan, C. Mobile phone addiction and adolescents\u2019 anxiety and depression: the moderating role of mindfulness. J. Child Fam. Stud. 28, 822\u2013830 (2019).","journal-title":"J. Child Fam. Stud."},{"key":"1669_CR33","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1556\/2006.4.2015.028","volume":"4","author":"S-E Kim","year":"2015","unstructured":"Kim, S.-E., Kim, J.-W. & Jee, Y.-S. Relationship between smartphone addiction and physical activity in Chinese international students in Korea. J. Behav. Addict. 4, 200 (2015).","journal-title":"J. Behav. Addict."},{"key":"1669_CR34","doi-asserted-by":"publisher","DOI":"10.1186\/1479-5868-10-79","volume":"10","author":"A Lepp","year":"2013","unstructured":"Lepp, A., Barkley, J. E., Sanders, G. J., Rebold, M. & Gates, P. The relationship between cell phone use, physical and sedentary activity, and cardiorespiratory fitness in a sample of U.S. college students. Int. J. Behav. Nutr. Phys. Act. 10, 79 (2013).","journal-title":"Int. J. Behav. Nutr. Phys. Act."},{"key":"1669_CR35","doi-asserted-by":"publisher","unstructured":"Casillas, A. & Clark, L. A. The mini mood and anxiety symptom questionnaire (Mini-MASQ). https:\/\/doi.org\/10.1037\/e413792005-215 (2000).","DOI":"10.1037\/e413792005-215"},{"key":"1669_CR36","doi-asserted-by":"publisher","first-page":"64","DOI":"10.1016\/j.schres.2022.02.031","volume":"243","author":"T Ranjan","year":"2022","unstructured":"Ranjan, T., Melcher, J., Keshavan, M., Smith, M. & Torous, J. Longitudinal symptom changes and association with home time in people with schizophrenia: an observational digital phenotyping study. Schizophr. Res. 243, 64\u201369 (2022).","journal-title":"Schizophr. Res."},{"key":"1669_CR37","first-page":"24","volume":"18","author":"PD Harvey","year":"2021","unstructured":"Harvey, P. D. et al. Capturing clinical symptoms with ecological momentary assessment: convergence of momentary reports of psychotic and mood symptoms with diagnoses and standard clinical assessments. Innov. Clin. Neurosci. 18, 24\u201330 (2021).","journal-title":"Innov. Clin. Neurosci."},{"key":"1669_CR38","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1016\/j.jpsychires.2021.02.012","volume":"136","author":"SD Targum","year":"2021","unstructured":"Targum, S. D., Sauder, C., Evans, M., Saber, J. N. & Harvey, P. D. Ecological momentary assessment as a measurement tool in depression trials. J. Psychiatr. Res. 136, 256\u2013264 (2021).","journal-title":"J. Psychiatr. Res."},{"key":"1669_CR39","doi-asserted-by":"publisher","first-page":"272","DOI":"10.1002\/da.23133","volume":"38","author":"E Seidl","year":"2021","unstructured":"Seidl, E. et al. How current and past anxiety disorders affect daily life in adolescents and young adults from the general population\u2014An epidemiological study with ecological momentary assessment. Depress Anxiety 38, 272\u2013285 (2021).","journal-title":"Depress Anxiety"},{"key":"1669_CR40","doi-asserted-by":"publisher","first-page":"e30557","DOI":"10.2196\/30557","volume":"10","author":"A Vaidyam","year":"2022","unstructured":"Vaidyam, A., Halamka, J. & Torous, J. Enabling research and clinical use of patient-generated health data (the mindLAMP Platform): digital phenotyping study. JMIR MHealth UHealth 10, e30557 (2022).","journal-title":"JMIR MHealth UHealth"},{"key":"1669_CR41","volume":"29\u201330","author":"SE Jones","year":"2021","unstructured":"Jones, S. E. et al. A cross-diagnostic study of adherence to ecological momentary assessment: comparisons across study length and daily survey frequency find that early adherence is a potent predictor of study-long adherence. Pers. Med. Psychiatry 29\u201330, 100085 (2021).","journal-title":"Pers. Med. Psychiatry"},{"key":"1669_CR42","doi-asserted-by":"publisher","first-page":"413","DOI":"10.1016\/j.jad.2019.11.167","volume":"263","author":"J Torous","year":"2020","unstructured":"Torous, J., Lipschitz, J., Ng, M. & Firth, J. Dropout rates in clinical trials of smartphone apps for depressive symptoms: a systematic review and meta-analysis. J. Affect. Disord. 263, 413\u2013419 (2020).","journal-title":"J. Affect. Disord."},{"key":"1669_CR43","doi-asserted-by":"publisher","first-page":"116","DOI":"10.1136\/eb-2018-102891","volume":"21","author":"J Torous","year":"2018","unstructured":"Torous, J., Nicholas, J., Larsen, M. E., Firth, J. & Christensen, H. Clinical review of user engagement with mental health smartphone apps: evidence, theory and improvements. Evid. Based Ment. Health 21, 116\u2013119 (2018).","journal-title":"Evid. Based Ment. Health"},{"key":"1669_CR44","doi-asserted-by":"publisher","first-page":"642044","DOI":"10.3389\/fpsyg.2021.642044","volume":"12","author":"M Hall","year":"2021","unstructured":"Hall, M., Scherner, P. V., Kreidel, Y. & Rubel, J. A. A systematic review of momentary assessment designs for mood and anxiety symptoms. Front. Psychol. 12, 642044 (2021).","journal-title":"Front. Psychol."},{"key":"1669_CR45","doi-asserted-by":"publisher","first-page":"103033","DOI":"10.1016\/j.nepr.2021.103033","volume":"52","author":"MA Joseph","year":"2021","unstructured":"Joseph, M. A., Natarajan, J., Buckingham, J. & Al Noumani, M. Using digital badges to enhance nursing students\u2019 attendance and motivation. Nurse Educ. Pract. 52, 103033 (2021).","journal-title":"Nurse Educ. Pract."},{"key":"1669_CR46","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.3390\/brainsci11111454","volume":"11","author":"S Mouchabac","year":"2021","unstructured":"Mouchabac, S. et al. In search of digital dopamine: how apps can motivate depressed patients, a review and conceptual analysis. Brain Sci. 11, 1454 (2021).","journal-title":"Brain Sci."},{"key":"1669_CR47","doi-asserted-by":"publisher","first-page":"68","DOI":"10.1016\/j.neures.2012.02.010","volume":"73","author":"W Lee","year":"2012","unstructured":"Lee, W., Reeve, J., Xue, Y. & Xiong, J. Neural differences between intrinsic reasons for doing versus extrinsic reasons for doing: an fMRI study. Neurosci. Res. 73, 68\u201372 (2012).","journal-title":"Neurosci. Res."},{"key":"1669_CR48","doi-asserted-by":"publisher","first-page":"702","DOI":"10.1176\/appi.ajp.2008.08081201","volume":"166","author":"DA Pizzagalli","year":"2009","unstructured":"Pizzagalli, D. A. et al. Reduced caudate and nucleus accumbens response to rewards in unmedicated individuals with major depressive disorder. Am. J. Psychiatry 166, 702\u2013710 (2009).","journal-title":"Am. J. Psychiatry"},{"key":"1669_CR49","doi-asserted-by":"publisher","first-page":"639","DOI":"10.1016\/j.biopsych.2012.10.014","volume":"73","author":"E Vrieze","year":"2013","unstructured":"Vrieze, E. et al. Reduced reward learning predicts outcome in major depressive disorder. Biol. Psychiatry 73, 639\u2013645 (2013).","journal-title":"Biol. Psychiatry"},{"key":"1669_CR50","doi-asserted-by":"publisher","first-page":"874","DOI":"10.1016\/j.psychres.2014.08.056","volume":"220","author":"X Yang","year":"2014","unstructured":"Yang, X. et al. Motivational deficits in effort-based decision making in individuals with subsyndromal depression, first-episode and remitted depression patients. Psychiatry Res. 220, 874\u2013882 (2014).","journal-title":"Psychiatry Res."},{"key":"1669_CR51","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/2045-5380-1-11","volume":"1","author":"DJ Furman","year":"2011","unstructured":"Furman, D. J., Hamilton, J. P. & Gotlib, I. H. Frontostriatal functional connectivity in major depressive disorder. Biol. Mood Anxiety Disord. 1, 11 (2011).","journal-title":"Biol. Mood Anxiety Disord."},{"key":"1669_CR52","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1192\/bjo.2018.40","volume":"4","author":"A Mori","year":"2018","unstructured":"Mori, A. et al. Effects of behavioural activation on the neural circuit related to intrinsic motivation. BJPsych Open 4, 317\u2013323 (2018).","journal-title":"BJPsych Open"},{"key":"1669_CR53","doi-asserted-by":"publisher","first-page":"1295","DOI":"10.1080\/02699931.2014.976544","volume":"29","author":"A Winch","year":"2015","unstructured":"Winch, A., Moberly, N. J. & Dickson, J. M. Unique associations between anxiety, depression and motives for approach and avoidance goal pursuit. Cognit. Emot. 29, 1295\u20131305 (2015).","journal-title":"Cognit. Emot."},{"key":"1669_CR54","doi-asserted-by":"publisher","DOI":"10.1186\/s12888-016-0842-5","volume":"16","author":"Y Ling","year":"2016","unstructured":"Ling, Y. et al. Intrinsic and extrinsic goals as moderators of stress and depressive symptoms in Chinese undergraduate students: a multi-wave longitudinal study. BMC Psychiatry 16, 138 (2016).","journal-title":"BMC Psychiatry"},{"key":"1669_CR55","doi-asserted-by":"publisher","first-page":"8963","DOI":"10.1523\/JNEUROSCI.0858-20.2021","volume":"41","author":"B Chew","year":"2021","unstructured":"Chew, B., Blain, B., Dolan, R. J. & Rutledge, R. B. A Neurocomputational Model for Intrinsic Reward. J. Neurosci. 41, 8963\u20138971 (2021).","journal-title":"J. Neurosci."},{"key":"1669_CR56","doi-asserted-by":"publisher","first-page":"939","DOI":"10.3758\/s13415-017-0524-x","volume":"17","author":"W Lee","year":"2017","unstructured":"Lee, W. & Reeve, J. Identifying the neural substrates of intrinsic motivation during task performance. Cognit. Affect. Behav. Neurosci. 17, 939\u2013953 (2017).","journal-title":"Cognit. Affect. Behav. Neurosci."},{"key":"1669_CR57","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1007\/BF00992956","volume":"13","author":"J Reeve","year":"1989","unstructured":"Reeve, J. The interest-enjoyment distinction in intrinsic motivation. Motiv. Emot. 13, 83\u2013103 (1989).","journal-title":"Motiv. Emot."},{"key":"1669_CR58","first-page":"175","volume":"10","author":"R Rast","year":"2021","unstructured":"Rast, R., Coleman, J. T. & Simmers, C. S. The darkside of the like: the effects of social media addiction on digital and in-person communication. J. Soc. Media Soc. 10, 175\u2013201 (2021).","journal-title":"J. Soc. Media Soc."},{"key":"1669_CR59","first-page":"140","volume":"2","author":"AF Ward","year":"2017","unstructured":"Ward, A. F., Duke, K., Gneezy, A. & Bos, M. W. Brain drain: the mere presence of one\u2019s own smartphone reduces available cognitive capacity. J. Assoc. Consum. Res. 2, 140\u2013154 (2017).","journal-title":"J. Assoc. Consum. Res."},{"key":"1669_CR60","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1016\/j.jaac.2019.06.017","volume":"59","author":"AK Przybylski","year":"2020","unstructured":"Przybylski, A. K., Orben, A. & Weinstein, N. How much is too much? Examining the relationship between digital screen engagement and psychosocial functioning in a confirmatory cohort study. J. Am. Acad. Child Adolesc. Psychiatry 59, 1080\u20131088 (2020).","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"1669_CR61","doi-asserted-by":"publisher","first-page":"1312","DOI":"10.1080\/0144929X.2023.2209797","volume":"43","author":"Z Taylor","year":"2024","unstructured":"Taylor, Z., Yankouskaya, A. & Panourgia, C. Social media use, loneliness and psychological distress in emerging adults. Behav. Inf. Technol. 43, 1312\u20131325 (2024).","journal-title":"Behav. Inf. Technol."},{"key":"1669_CR62","doi-asserted-by":"publisher","first-page":"240","DOI":"10.1037\/cbs0000323","volume":"55","author":"JA Roberts","year":"2023","unstructured":"Roberts, J. A. & David, M. E. On the outside looking in: social media intensity, social connection, and user well-being: the moderating role of passive social media use. Can. J. Behav. Sci. Rev. Can. Sci. Comport. 55, 240\u2013252 (2023).","journal-title":"Can. J. Behav. Sci. Rev. Can. Sci. Comport."},{"key":"1669_CR63","doi-asserted-by":"publisher","first-page":"530","DOI":"10.1177\/14614448211065425","volume":"24","author":"PM Valkenburg","year":"2022","unstructured":"Valkenburg, P. M., van Driel, I. I. & Beyens, I. The associations of active and passive social media use with well-being: a critical scoping review. N. Media Soc. 24, 530\u2013549 (2022).","journal-title":"N. Media Soc."},{"key":"1669_CR64","doi-asserted-by":"publisher","DOI":"10.1038\/s41467-022-29296-3","volume":"13","author":"A Orben","year":"2022","unstructured":"Orben, A., Przybylski, A. K., Blakemore, S.-J. & Kievit, R. A. Windows of developmental sensitivity to social media. Nat. Commun. 13, 1649 (2022).","journal-title":"Nat. Commun."},{"key":"1669_CR65","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1177\/2167702621994549","volume":"9","author":"M Vuorre","year":"2021","unstructured":"Vuorre, M., Orben, A. & Przybylski, A. K. There is no evidence that associations between adolescents\u2019 digital technology engagement and mental health problems have increased. Clin. Psychol. Sci. 9, 823\u2013835 (2021).","journal-title":"Clin. Psychol. Sci."},{"key":"1669_CR66","doi-asserted-by":"publisher","first-page":"783","DOI":"10.1016\/S2352-4642(18)30278-5","volume":"2","author":"JJ Walsh","year":"2018","unstructured":"Walsh, J. J. et al. Associations between 24-hour movement behaviours and global cognition in a cross-sectional sample of US children. Lancet Child Adolesc. Health 2, 783\u2013791 (2018).","journal-title":"Lancet Child Adolesc. Health"},{"key":"1669_CR67","doi-asserted-by":"publisher","first-page":"655491","DOI":"10.3389\/fpubh.2021.655491","volume":"9","author":"MN Woessner","year":"2021","unstructured":"Woessner, M. N. et al. The evolution of technology and physical inactivity: the good, the bad, and the way forward. Front. Public Health 9, 655491 (2021).","journal-title":"Front. Public Health"},{"key":"1669_CR68","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyt.2021.660642","volume":"12","author":"W Br\u00fcchle","year":"2021","unstructured":"Br\u00fcchle, W. et al. Physical activity reduces clinical symptoms and restores neuroplasticity in major depression. Front. Psychiatry 12, 660642 (2021).","journal-title":"Front. Psychiatry"},{"key":"1669_CR69","doi-asserted-by":"publisher","first-page":"555","DOI":"10.1007\/s00406-018-0916-0","volume":"269","author":"V Buschert","year":"2019","unstructured":"Buschert, V. et al. Effects of physical activity on cognitive performance: a controlled clinical study in depressive patients. Eur. Arch. Psychiatry Clin. Neurosci. 269, 555\u2013563 (2019).","journal-title":"Eur. Arch. Psychiatry Clin. Neurosci."},{"key":"1669_CR70","doi-asserted-by":"publisher","first-page":"673","DOI":"10.1007\/s12529-022-10130-5","volume":"30","author":"D Mizrahi","year":"2023","unstructured":"Mizrahi, D. et al. The relationship between psychological distress and physical activity is non-linear and differs by domain: a cross-sectional study. Int. J. Behav. Med. 30, 673\u2013681 (2023).","journal-title":"Int. J. Behav. Med."},{"key":"1669_CR71","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-018-0923-x","volume":"20","author":"A Kandola","year":"2018","unstructured":"Kandola, A. et al. Moving to beat anxiety: epidemiology and therapeutic issues with physical activity for anxiety. Curr. Psychiatry Rep. 20, 63 (2018).","journal-title":"Curr. Psychiatry Rep."},{"key":"1669_CR72","doi-asserted-by":"publisher","first-page":"43","DOI":"10.1016\/j.janxdis.2017.09.005","volume":"52","author":"DM LeBouthillier","year":"2017","unstructured":"LeBouthillier, D. M. & Asmundson, G. J. G. The efficacy of aerobic exercise and resistance training as transdiagnostic interventions for anxiety-related disorders and constructs: a randomized controlled trial. J. Anxiety Disord. 52, 43\u201352 (2017).","journal-title":"J. Anxiety Disord."},{"key":"1669_CR73","doi-asserted-by":"publisher","DOI":"10.1038\/s41398-024-02922-y","volume":"14","author":"EJ Hird","year":"2024","unstructured":"Hird, E. J., Slanina-Davies, A., Lewis, G., Hamer, M. & Roiser, J. P. From movement to motivation: a proposed framework to understand the antidepressant effect of exercise. Transl. Psychiatry 14, 273 (2024).","journal-title":"Transl. Psychiatry"},{"key":"1669_CR74","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1002\/wps.20630","volume":"18","author":"L Boschloo","year":"2019","unstructured":"Boschloo, L. et al. The symptom-specific efficacy of antidepressant medication vs. cognitive behavioral therapy in the treatment of depression: results from an individual patient data meta-analysis. World Psychiatry18, 183\u2013191 (2019).","journal-title":"World Psychiatry"},{"key":"1669_CR75","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1159\/000486793","volume":"87","author":"E Bekhuis","year":"2018","unstructured":"Bekhuis, E. et al. Symptom-specific effects of psychotherapy versus combined therapy in the treatment of mild to moderate depression: a network approach. Psychother. Psychosom. 87, 121\u2013123 (2018).","journal-title":"Psychother. Psychosom."},{"key":"1669_CR76","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM- 5). (American Psychiatric Association, 2013).","DOI":"10.1176\/appi.books.9780890425596"},{"key":"1669_CR77","unstructured":"Intrinsic Motivation Inventory (IMI) \u2013 selfdeterminationtheory.org. https:\/\/selfdeterminationtheory.org\/intrinsic-motivation-inventory\/."},{"key":"1669_CR78","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1037\/a0015167","volume":"41","author":"MA Tremblay","year":"2009","unstructured":"Tremblay, M. A., Blanchard, C. M., Taylor, S., Pelletier, L. G. & Villeneuve, M. Work extrinsic and intrinsic motivation scale: Its value for organizational psychology research. Can. J. Behav. Sci. Rev. Can. Sci. Comport. 41, 213\u2013226 (2009).","journal-title":"Can. J. Behav. Sci. Rev. Can. Sci. Comport."},{"key":"1669_CR79","unstructured":"iOS - Health. Apple https:\/\/www.apple.com\/ios\/health\/."},{"key":"1669_CR80","doi-asserted-by":"publisher","DOI":"10.1136\/bmjment-2023-300718","volume":"26","author":"D Currey","year":"2023","unstructured":"Currey, D. & Torous, J. Increasing the value of digital phenotyping through reducing missingness: a retrospective review and analysis of prior studies. BMJ Ment. Health 26, e300718 (2023).","journal-title":"BMJ Ment. Health"},{"key":"1669_CR81","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.jcm.2016.02.012","volume":"15","author":"TK Koo","year":"2016","unstructured":"Koo, T. K. & Li, M. Y. A Guideline of Selecting and Reporting Intraclass Correlation Coefficients for Reliability Research. J. Chiropr. Med. 15, 155\u2013163 (2016).","journal-title":"J. Chiropr. Med."},{"key":"1669_CR82","unstructured":"Zero-Inflated and Two-Part Mixed Effects Models. https:\/\/drizopoulos.github.io\/GLMMadaptive\/articles\/ZeroInflated_and_TwoPart_Models.html."},{"key":"1669_CR83","unstructured":"Zero-Inflated Poisson Regression | R Data Analysis Examples. https:\/\/stats.oarc.ucla.edu\/r\/dae\/zip\/."},{"key":"1669_CR84","doi-asserted-by":"crossref","unstructured":"Chen, H., Cohen, P. & Chen, S. How Big is a Big Odds Ratio? Interpreting the Magnitudes of Odds Ratios in Epidemiological Studies. Commun. Stat. Simul. Comput. 39, 860\u2013864 (2010).","DOI":"10.1080\/03610911003650383"},{"key":"1669_CR85","doi-asserted-by":"publisher","first-page":"60","DOI":"10.3389\/fnbeh.2018.00060","volume":"12","author":"Y Jacob","year":"2018","unstructured":"Jacob, Y., Gilam, G., Lin, T., Raz, G. & Hendler, T. Anger modulates influence hierarchies within and between emotional reactivity and regulation networks. Front. Behav. Neurosci. 12, 60 (2018).","journal-title":"Front. Behav. Neurosci."},{"key":"1669_CR86","doi-asserted-by":"publisher","unstructured":"Jacob, Y., Or-Borichev, A., Jackont, G., Lubianiker, N. & Hendler, T. Network based fMRI neuro-feedback for emotion regulation; Proof-of-Concept. in 1250\u20131260. https:\/\/doi.org\/10.1007\/978-3-319-72150-7_101 (2018).","DOI":"10.1007\/978-3-319-72150-7_101"},{"key":"1669_CR87","doi-asserted-by":"publisher","DOI":"10.1038\/srep27444","volume":"6","author":"Y Jacob","year":"2016","unstructured":"Jacob, Y. et al. Dependency Network Analysis (DEPNA) reveals context related influence of brain network nodes. Sci. Rep. 6, 27444 (2016).","journal-title":"Sci. Rep."},{"key":"1669_CR88","doi-asserted-by":"publisher","first-page":"2546","DOI":"10.1002\/hbm.24543","volume":"40","author":"Y Jacob","year":"2019","unstructured":"Jacob, Y. et al. Network abnormalities among non-manifesting Parkinson disease related LRRK2 mutation carriers. Hum. Brain Mapp. 40, 2546\u20132555 (2019).","journal-title":"Hum. Brain Mapp."},{"key":"1669_CR89","doi-asserted-by":"publisher","first-page":"3154","DOI":"10.1093\/cercor\/bhy181","volume":"29","author":"Y Jacob","year":"2019","unstructured":"Jacob, Y., Shany, O., Goldin, P. R., Gross, J. J. & Hendler, T. Reappraisal of interpersonal criticism in social anxiety disorder: a brain network hierarchy perspective. Cereb. Cortex29, 3154\u20133167 (2019).","journal-title":"Cereb. Cortex"},{"key":"1669_CR90","doi-asserted-by":"publisher","first-page":"e15032","DOI":"10.1371\/journal.pone.0015032","volume":"5","author":"DY Kenett","year":"2010","unstructured":"Kenett, D. Y. et al. Dominating clasp of the financial sector revealed by partial correlation analysis of the stock market. PLOS ONE 5, e15032 (2010).","journal-title":"PLOS ONE"},{"key":"1669_CR91","doi-asserted-by":"publisher","first-page":"e23912","DOI":"10.1371\/journal.pone.0023912","volume":"6","author":"YN Kenett","year":"2011","unstructured":"Kenett, Y. N., Kenett, D. Y., Ben-Jacob, E. & Faust, M. Global and local features of semantic networks: evidence from the hebrew mental lexicon. PLOS ONE 6, e23912 (2011).","journal-title":"PLOS ONE"},{"key":"1669_CR92","doi-asserted-by":"publisher","DOI":"10.1063\/1.3543800","volume":"21","author":"A Madi","year":"2011","unstructured":"Madi, A. et al. Analyses of antigen dependency networks unveil immune system reorganization between birth and adulthood. Chaos Woodbury N. 21, 016109 (2011).","journal-title":"Chaos Woodbury N."},{"key":"1669_CR93","doi-asserted-by":"publisher","first-page":"e19378","DOI":"10.1371\/journal.pone.0019378","volume":"6","author":"DY Kenett","year":"2011","unstructured":"Kenett, D. Y. et al. Index cohesive force analysis reveals that the US market became prone to systemic collapses since 2002. PLoS ONE 6, e19378 (2011).","journal-title":"PLoS ONE"},{"key":"1669_CR94","doi-asserted-by":"crossref","unstructured":"Hagberg, A., Swart, P. J. & Schult, D. A. Exploring network structure, dynamics, and function using networkX. https:\/\/www.osti.gov\/biblio\/960616 (2008).","DOI":"10.25080\/TCWV9851"},{"key":"1669_CR95","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1037\/0022-3514.43.3.450","volume":"43","author":"RM Ryan","year":"1982","unstructured":"Ryan, R. M. Control and information in the intrapersonal sphere: an extension of cognitive evaluation theory. J. Pers. Soc. Psychol. 43, 450\u2013461 (1982).","journal-title":"J. Pers. Soc. Psychol."},{"key":"1669_CR96","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1037\/0022-3514.45.4.736","volume":"45","author":"RM Ryan","year":"1983","unstructured":"Ryan, R. M., Mims, V. & Koestner, R. Relation of reward contingency and interpersonal context to intrinsic motivation: a review and test using cognitive evaluation theory. J. Pers. Soc. Psychol. 45, 736\u2013750 (1983).","journal-title":"J. Pers. Soc. Psychol."}],"container-title":["npj Digital Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01669-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01669-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01669-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T16:03:47Z","timestamp":1746893027000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41746-025-01669-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,10]]},"references-count":96,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["1669"],"URL":"https:\/\/doi.org\/10.1038\/s41746-025-01669-0","relation":{},"ISSN":["2398-6352"],"issn-type":[{"value":"2398-6352","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,10]]},"assertion":[{"value":"12 August 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"24 April 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 May 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Murrough has provided consultation services for Allergan Pharmaceuticals (AbbVie), Biohaven Pharmaceuticals, Inc., Boehreinger Ingelheim Inc., Cliniclabs, Inc., Clexio Biosciences, Ltd., Compass Pathfinder, Plc., Engrail Therapeutics, Inc., Fortress Biotech, FSV7, Llc., Genentech, Impel Neuropharma, Janssen Pharmaceuticals, KetaMed, Inc., LivaNova, Plc., Merck & Co., Inc., Novartis, Otsuka Pharmaceutical, Ltd., Sage Therapeutics, WCG, and Xenon Pharmaceuticals, Inc. Torous serves as an editor for npj Digital Medicine.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"268"}}