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Both mindfulness and mentalization represent psychological constructs with the potential to mitigate the negative impact of interpersonal stressors.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aims to assess the feasibility and acceptability of an automated mindfulness- and mentalization-based ecological momentary intervention for common mental health problems as delivered via a mobile phone app.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n The design was a parallel-group pilot randomized controlled trial with 1:1 allocation ratio and exploratory framework. Recruitment of participants experiencing common mental health issues was internet-based from a university setting. Eligible participants were randomly allocated to fully automated mindfulness- or mentalization-based ecological momentary interventions via computer-generated randomization. Participants were blind to the alternative intervention options. Outcomes were self-assessed through questionnaires after 4 weeks. Primary outcomes were feasibility (recruitment, retention, and adherence) and acceptability (satisfaction ratings and qualitative feedback). Secondary outcomes included changes in depression (Patient Health Questionnaire-9 [PHQ-9]) and anxiety (Generalized Anxiety Disorder Questionnaire-7 [GAD-7]) scores.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 84 participants were randomized (42 to each group). The interventions demonstrated good feasibility with an 89.2% retention rate and a mean adherence of 87.69% (SD 11.3%) across both groups. Acceptability ratings were positive, with favorable scores for ease of engagement (mean 5.20, SD 1.6), overall enjoyment (mean 5.15, SD 1.2), and likelihood of recommending the app (mean 5.11, SD 1.6) on a 7-point scale. For primary outcomes, both groups showed significant within-group reductions in PHQ-9 and GAD-7 scores, with moderate to large effect sizes (Cohen\n d<\/jats:italic>\n =\u22120.68 to \u22120.81), with no significant difference between groups. Both treatments demonstrated clinically significant change, with (44%) participants in both groups no longer meeting caseness criteria for anxiety and depression. Mindfulness performed better on improving assertiveness and perceived support compared to mentalization in the ecological momentary assessment data. One unintended harm was reported in the mindfulness arm, whereas none was reported in the mentalization arm.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n This pilot trial suggests that both mindfulness- and mentalization-based ecological momentary interventions are feasible and acceptable for individuals with common mental health problems and warrant further evaluation.<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/79296","type":"journal-article","created":{"date-parts":[[2025,9,30]],"date-time":"2025-09-30T20:51:26Z","timestamp":1759265486000},"page":"e79296-e79296","source":"Crossref","is-referenced-by-count":1,"title":["Smartphone-Based Mindfulness and Mentalization Ecological Momentary Interventions for Common Mental Health Problems: Pilot Randomized Controlled Trial"],"prefix":"10.2196","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7316-3041","authenticated-orcid":false,"given":"Ciar\u00e1n","family":"O'Driscoll","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-1930-2177","authenticated-orcid":false,"given":"Sarah","family":"O'Reilly","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5925-0923","authenticated-orcid":false,"given":"Agata Julita","family":"Jaremba","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6834-7727","authenticated-orcid":false,"given":"Tobias","family":"Nolte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3362-5691","authenticated-orcid":false,"given":"Madiha","family":"Shaikh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,9,30]]},"reference":[{"issue":"12","key":"R1","doi-asserted-by":"publisher","DOI":"10.3390\/brainsci11121633","article-title":"Biological, psychological, and social determinants of depression: a review of recent literature","volume":"11","author":"Remes","journal-title":"Brain Sci"},{"issue":"6","key":"R2","doi-asserted-by":"publisher","first-page":"653","DOI":"10.1007\/s40273-021-01019-4","article-title":"The economic burden of adults with major depressive disorder in the United States (2010 and 2018)","volume":"39","author":"Greenberg","journal-title":"Pharmacoeconomics"},{"issue":"4","key":"R3","doi-asserted-by":"publisher","first-page":"455","DOI":"10.1111\/jcpp.12937","article-title":"Annual research review: expanding mental health services through novel models of intervention delivery","volume":"60","author":"Kazdin","journal-title":"J Child Psychol Psychiatry"},{"issue":"10","key":"R4","doi-asserted-by":"publisher","DOI":"10.2196\/20631","article-title":"Digital micro interventions for behavioral and mental health gains: core components and conceptualization of digital micro intervention care","volume":"22","author":"Baumel","journal-title":"J Med Internet Res"},{"key":"R5","doi-asserted-by":"publisher","DOI":"10.2196\/49857","article-title":"An ecological mobile momentary intervention to support dynamic goal pursuit: feasibility and acceptability study","volume":"8","author":"O\u2019Driscoll","journal-title":"JMIR Form Res"},{"key":"R6","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2020.00275","article-title":"Positive psychological micro-interventions to improve the work\u2013family interface: use your resources and count your blessings","volume":"11","author":"Peeters","journal-title":"Front Psychol"},{"issue":"6","key":"R7","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1002\/da.22649","article-title":"Ecological momentary interventions for depression and anxiety","volume":"34","author":"Schueller","journal-title":"Depress Anxiety"},{"key":"R8","doi-asserted-by":"publisher","DOI":"10.2196\/51125","article-title":"Selecting an ecological momentary assessment platform: tutorial for researchers","volume":"26","author":"Henry","journal-title":"J Med Internet Res"},{"issue":"2","key":"R9","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1002\/wps.21299","article-title":"The evolving field of digital mental health: current evidence and implementation issues for smartphone apps, generative artificial intelligence, and virtual reality","volume":"24","author":"Torous","journal-title":"World Psychiatry"},{"issue":"1","key":"R10","doi-asserted-by":"publisher","first-page":"37","DOI":"10.1177\/2167702618772296","article-title":"The future of intervention science: process-based therapy","volume":"7","author":"Hofmann","journal-title":"Clin Psychol Sci"},{"key":"R11","unstructured":"Beck AT . 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