Health Systems

, Volume 6, Issue 2, pp 122–129 | Cite as

Preliminary evidence for the use and efficacy of mobile health applications in managing posttraumatic stress disorder symptoms

  • Stefanie M Keen
  • Nicholas RobertsEmail author
Original Article


Mobile health applications like PTSD Coach are emerging as tools to help individuals manage post traumatic stress disorder (PTSD) symptoms. However, these applications will not be effective if people do not use them. Using PTSD Coach as the focal application, we address two interrelated questions: (1) what are the primary determinants of PTSD Coach use? and (2) is PTSD Coach use related to changes in PTSD symptomatology? Building on the Unified Theory of Acceptance and Use of Technology, we develop and test a research model that addresses these questions. Our results show that performance expectancy and social influence are positively related to PTSD Coach use; however, effort expectancy and facilitating conditions are not related to PTSD Coach use. We also found that PTSD Coach use is positively related to improvements in PTSD symptomatology. Our results provide preliminary evidence for the use and efficacy of mobile health applications in managing PTSD symptoms.


mobile health application health IT PTSD Coach PTSD symptomatology 



The authors are thankful for financial support from the Office of Sponsored Awards and Research Support at University of South Carolina Upstate. The views expressed in this manuscript are those of the authors and do not reflect the official policy or position of the Department of Veterans Affairs, Department of Defense, or the United States Government.


  1. Ajzen I (1991) The theory of planned behavior. Organizational Behavior and Human Decision Processes 50(2), 179–211.CrossRefGoogle Scholar
  2. Andersson G and Cuijpers P (2009) Internet-based and other computerized psychological treatments for adult depression: a meta-analysis. Cognitive Behaviour Therapy 38(4), 196–205.CrossRefGoogle Scholar
  3. American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders (4th edn.). Washington, DC: American Psychiatric Association.Google Scholar
  4. Baird A, Raghu TS, North F and Edwards F (2014) When traditionally inseparable services are separated by technology: the case of patient portal features offered by primary care providers. Health Systems 3(2), 143–158.CrossRefGoogle Scholar
  5. Ben-Zeev D, Kaiser SM, Brenner CJ, Begale M, Duffecy J and Mohr DC (2013) Development and usability testing of FOCUS: a smartphone system for self-management of schizophrenia. Psychiatric Rehabilitation Journal 36(4), 289–296.CrossRefGoogle Scholar
  6. Bhattacherjee A (2001) Understanding information systems continuance: an expectation-confirmation model. MIS Quarterly 25(3), 351–370.CrossRefGoogle Scholar
  7. Bush NE, Ouellette G and Kinn J (2014) Utility of the T2 mood tracker mobile application among army warrior transition unit service members. Military Medicine 179(12), 1453–1457.CrossRefGoogle Scholar
  8. Carlson EB (2001) Psychometric study of a brief screen for PTSD: Assessing the impact of multiple traumatic events. Assessment 8(4), 431–441.CrossRefGoogle Scholar
  9. Cheung GW and Rensvold RB (2002) Evaluating goodness-of-fit indexes for testing measurement invariance. Structural Equation Modeling 9(2), 233–255.CrossRefGoogle Scholar
  10. Clark AA and Owens GP (2012) Attachment, personality characteristics, and posttraumatic stress disorder in U.S. veterans of Iraq and Afghanistan. Journal of Traumatic Stress 25(6), 657–664.CrossRefGoogle Scholar
  11. Davis FD, Bagozzi RP and Warshaw PR (1989) User acceptance of computer technology: a comparison of two theoretical models. Management Science 35(8), 982–1003.CrossRefGoogle Scholar
  12. Finkelhor D, Ormrod RK and Turne HA (2007) Poly-victimization: A neglected component in child victimization. Child Abuse & Neglect 31(1), 7–26.CrossRefGoogle Scholar
  13. Fishbein M and Ajzen I (1975) Belief, Attitude, Intention, and Behavior: An Introduction to Theory and Research. Addison-Wesley Publishing Company, Reading, MA.Google Scholar
  14. Frueh BC, Monnier J, Yim E, Grubaugh AL, Hamner MB and Knapp RG (2007) A randomized study of telepsychiatry for posttraumatic stress disorder. Journal of Telemedicine & Telecare 13(3), 142–147.CrossRefGoogle Scholar
  15. Gould RA, Otto MW and Pollack MH (1995) A meta-analysis of treatment outcome for panic disorder. Clinical Psychology Review 15(8), 819–844.CrossRefGoogle Scholar
  16. Gray MJ, Litz BT, Hsu JL and Lombardo TW (2004) Psychometric properties of the life events checklist. Assessment 11(4), 330–341.CrossRefGoogle Scholar
  17. Harvey A, Bryant R and Tarrier N (2003) Cognitive behaviour therapy for posttraumatic stress disorder. Clinical Psychology Review 23(3), 501–522.CrossRefGoogle Scholar
  18. Hirai M and Clum GA (2005) An Internet-based self-change program for traumatic event related fear, distress, and maladaptive coping. Journal of Traumatic Stress 18(6), 631–636.CrossRefGoogle Scholar
  19. Kessler RC, Sonnega A, Bromet E, Hughes M and Nelson CB (1995) Posttraumatic stress disorder in the national comorbidity survey. Archives of General Psychiatry 52(12), 1048–1060.CrossRefGoogle Scholar
  20. King WR and He J (2006) A meta-analysis of the technology acceptance model. Information & Management 43(6), 740–755.CrossRefGoogle Scholar
  21. Kuhn E et al (2014) Preliminary evaluation of PTSD Coach, a smartphone app for post-traumatic stress symptoms. Military Medicine 179(1), 12–18.CrossRefGoogle Scholar
  22. Litz BT, Engel CC, Bryant RA and Papa A (2007) A randomized, controlled proof-of-concept trial of an internet-based, therapist-assisted self-management treatment for posttraumatic stress disorder. American Journal of Psychiatry 164, 1676–1684.CrossRefGoogle Scholar
  23. Litz BT, Williams L, Wang J, Bryant R and Engel CC (2004) A therapist-assisted internet self-help program for traumatic stress. Professional Psychology, Research and Practice 35(6), 628–634.CrossRefGoogle Scholar
  24. Luxton DD, Hansen RN and Stanfill K (2014) Mobile app self-care versus in-office care for stress reduction: a cost minimization analysis. Journal of Telemedicine & Telecare 20(8), 431–435.CrossRefGoogle Scholar
  25. Meis LA, Erbes CR, Polusny MA and Compton JS (2010) Intimate relationships among returning soldiers: the mediating and moderating roles of negative emotionality, PTSD symptoms, and alcohol problems. Journal of Traumatic Stress 23(5), 564–572.CrossRefGoogle Scholar
  26. Moore GC and Benbasat I (1991) Development of an instrument to measure the perceptions of adopting an information technology innovation. Information Systems Research 2(3), 192–222.CrossRefGoogle Scholar
  27. Paul RJ, Ezz I and Kuljis J (2012) Healthcare information systems: a patient-user perspective. Health Systems 1(2), 85–95.CrossRefGoogle Scholar
  28. Podsakoff PM, MacKenzie SB, Lee J-Y and Podsakoff NP (2003) Common method biases in behavioral research: a critical review of the literature and recommended remedies. Journal of Applied Psychology 88(5), 879–903.CrossRefGoogle Scholar
  29. Ruggiero KJ, Resnick HS, Acierno R, Coffey SF, Carpenter MJ and Ruscio AMS (2006) Internet-based intervention for mental health and substance use problems in disaster-affected populations: a pilot feasibility study. Behaviour Research and Therapy 37(2), 190–205.CrossRefGoogle Scholar
  30. Rusch N, Angermeyer MC and Corrigan PW (2005) Mental illness stigma: concepts, consequences, and initiatives to reduce stigma. European Psychiatry 20(8), 529–539.CrossRefGoogle Scholar
  31. Sayer NA, Spoont M, Murdoch M, Parker LE, Hintz S and Rosenheck R (2011) A qualitative study of U.S. Veterans’ reasons for seeking department of veterans affairs disability benefits for posttraumatic stress disorder. Journal of Traumatic Stress 24(6), 699–707.CrossRefGoogle Scholar
  32. Thompson RL, Higgins CA and Howell JM (1991) Personal computing: toward a conceptual model of utilization. MIS Quarterly 15(1), 125–143.CrossRefGoogle Scholar
  33. Triandis HC (1971) Attitude and Attitude Change. John Wiley and Sons, New York.Google Scholar
  34. Tuerk PW, Yoder M, Ruggiero KJ, Gros DF and Acierno R (2010) A pilot study of prolonged exposure therapy for posttraumatic stress disorder delivered via telehealth technology. Journal of Traumatic Stress 23(1), 116–123.Google Scholar
  35. Venkatesh V and Bala H (2008) Technology acceptance model 3 and a research agenda on interventions. Decision Sciences 39(2), 273–315.CrossRefGoogle Scholar
  36. Venkatesh V and Davis FD (2000) A theoretical extension of the technology acceptance model: four longitudinal field studies. Management Science 46(2), 186–204.CrossRefGoogle Scholar
  37. Venkatesh V, Morris MG, Davis GB and Davis FD (2003) User acceptance of information technology: toward a unified view. MIS Quarterly 27(3), 425–478.Google Scholar
  38. Weathers FW, Litz BT, Herman DS, Huska JA and Keane TM (1993) The PTSD Checklist: Reliability, Validity, and Diagnostic Utility. Paper presented at the 9th Annual Meeting of the International Society for Traumatic Stress Studies, San Antonio, TX.Google Scholar
  39. Weeger A and Gewald H (2015) Acceptance and use of electronic medical records: an exploratory study of hospital physicians’ salient beliefs about HIT systems. Health Systems 4(1), 64–81.CrossRefGoogle Scholar

Copyright information

© The OR Society 2016

Authors and Affiliations

  1. 1.Department of Psychology, University of South Carolina UpstateSpartanburgU.S.A.
  2. 2.Department of Computer Information Systems, College of Business, Colorado State UniversityFort CollinsU.S.A.

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