Six-figure grant a vote of confidence for LU prof’s youth mental health app

This will come as a shock to no one, but middle school is hard.

Throw in the first year of high school and you have a three- or four-year stretch that for many is an often emotionally difficult, awkward, angst-filled journey through adolescent hell, a transition from the relative safety of elementary school to the more confident (sometimes) world of young adulthood.

Getting across that bridge with your emotional bearings intact is no small thing. And that’s where the studies of Lawrence University Associate Professor of Psychology Lori Hilt '97 and her psychology students come into play.

For the past two years, Hilt has been leading a study on adolescent rumination, focused on ages 12 to 15, and the study is about to be supersized thanks to a $368,196 three-year grant from the National Institutes of Health.

Adolescent rumination refers to a mindset in which someone can’t get beyond the negative things that are happening around them. Where most kids will process something bad that has happened, react to it and then move on, an adolescent struggling with rumination will dwell on the negative information, stew on it until it consumes them, unable to let go.

It’s often a precursor to depression or anxiety or other mental health battles that can track into adulthood.

Launching a study

Hilt and the students in her Child and Adolescent Research in Emotion (CARE) Lab set out to create a mobile app that would utilize mindfulness techniques designed to aid those 12- to 15-year-olds struggling with rumination, and then sought funding to study the use of the app. 

“We see technology just skyrocketing with kids, so why not harness that for good?” Hilt said.

The American Psychological Foundation agreed, awarding Hilt an $18,000 John and Polly Sparks Early Career Grant two years ago to launch a study that would involve 80 Fox Valley adolescents and their families.

Data from that study has been collected and follow-up visits with the families have been completed. Hilt and her team are in the process of analyzing what they have.

But now comes the much more robust grant from the National Institute of Mental Health, part of the National Institutes of Health, allowing  the study of the app to continue over the next three years, entailing more sophisticated research methods. It’s expected to involve an additional 150 kids and their families. A full-time project assistant will be hired, and 12 to 20 LU students could be working on the study at any given time.

“If the results come out as we hypothesize, if we find that the kids who use the app actually decrease their rumination and their levels of depression and anxiety remain lower, then I think we’d move forward with further developing of the app and maybe get it out publicly, make it available for more kids to use,” Hilt said.

The app is designed to talk young students through brief mindfulness exercises at various points during the day, most notably when they wake up in the morning, after school lets out and before they go to sleep. The exercises could last from three to 10 minutes, focusing on breathing techniques and other things to help clear or refocus the mind.

“It came out of some research I was doing right when I started at Lawrence in 2011,” Hilt said. “One of the first studies I looked at, in the lab, how can we change rumination?”

So, a lab study using 160 kids was conducted, focused on various avenues to combat rumination, from briefly distracting the student to using mindfulness techniques. Mindfulness came out the clear winner.

“If we know that doing this in the lab for just a few minutes was really helpful, what if we had a way for people to access this as an intervention?” Hilt said. “Obviously, we think it needs more repeated exposure to actually be helpful in the long run. So, we developed an app that would allow kids to access it repeatedly.”

A tech assist

Hilt and her psychology students knew where they wanted to go. But they lacked the technical know-how to create and develop an app.

Thus, they tapped a student in Lawrence’s mathematics-computer science department. Eduardo Elizondo ’16 set to work creating the app. 

“He was a freshman at the time,” Hilt said. “Now he’s at Facebook. He really helped develop the first version of the app, and it was kind of clunky. He was learning, we were learning. So then as he became more sophisticated and we got more pilot data, we refined the app. So, before he graduated, it kind of developed into the version we have now.”

Another computer science student, Simon Abbot ’20, has since picked up the ball, continuing the work started by Elizondo.

For the LU psychology students, the work on the rumination study is part of a wider education.

“Since all CARE lab members are undergraduates, we have opportunities at every step in the research process that are normally only available to graduate students,” said Caroline Swords ’19, a neuroscience and psychology major who has been heavily invested in the study and will continue working with it as a research associate after graduation.

The study is focused on practical tools that young people can use to navigate their mental and emotional journeys, she said. And, while the results aren’t in yet, seeing the study unfold over the past couple of years has been fascinating.

“I was drawn to the study because of the positive impact teaching mindfulness can have,” Swords said. “Since adolescence is a time when mental illnesses can first develop, it’s great to teach adolescents about mindfulness, which can act as a buffer and remain a lifelong skill.”  

For Hilt, providing any tools that can help a child adjust, cope and thrive is always worthwhile.

“I’ve really focused my career on studying that early adolescent window,” she said. “We know so many things develop then, including depression. We see pretty low levels, luckily, in childhood, but then in adolescence you see this huge spike that really stays throughout adulthood. So, I’ve really focused all my research on trying to understand what’s going on, how kids process emotions in that window shortly before we see this increase, and what can we do to try to prevent that from happening?”

Existing apps such as Headspace are already available to teach ways to redirect our thoughts or calm our anxieties. But those, and any studies that accompanied them, are primarily geared toward adults, Hilt said. 

“We’re one of the first to really look at it in kids.”

Note: Research tied to the new grant is supported by the National Institute of Mental Health of the National Institutes of Health. The content reported here is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health.