Preliminary Research and Summation
I'm considering two primary problem spaces/ideas, so I'll split this post between the two.
PROBLEM AREA I: anxiety in younger people seems to be occurring at an extremely high rate recently. a lot of noise has been made about this in the media, but I have also noticed corresponding anecdotal data among friends.
-what does "anxiety" mean? what's the current medical community's definition, discovery, diagnosis and treatment process? what research exists around anxiety and what does it conclude?
Contemporary scientists are attempting to root anxiety in physical sources, such as the brain regions and neurochemicals that process fear regulation--but these don't explain what anxious people are feeling or how they express those feelings inside their own cultural understanding. Each culture and time period understands a group of symptoms in its own way, making historical background and incidence of anxiety difficult to define.
Fear occurs as a result of perceived imminent threat whereas anxiety is a state of anticipation about perceived future threats. (Craske and Stein, 2016) Some fear is healthy, but what defines abnormal or dysfunctional anxiety? The DSM-V defines several subcategories of anxiety, including "panic disorder (with or without agoraphobia), agoraphobia with-out panic, specific phobias, social phobias, obsessive-compulsive disorders, post-traumatic stress disorders, acute stress disorders, and generalized anxiety disorders and several others." (Horwitz, 2013) "Anxiety disorders are common and disabling conditions that mostly begin during childhood, adolescence, and early adulthood. They differ from developmentally normative or stress-induced transient anxiety by being marked (ie, out of proportion to the actual threat present) and persistent, and by impairing daily functioning. Most anxiety disorders affect almost twice as many women as men. They often co-occur with major depression, alcohol and other substance-use disorders, and personality disorders." (Craske and Stein)
For treatment, most American physicians follow the biomedical model and prescribe antianxiety pharmaceuticals, in 2008 more than 50 million prescriptions for specifically anti-anxiety medications and more than 150 million for antidepressants, many of which were used for anxiety-related conditions. Moreover, usage rates of drug treatments are growing exponentially while those of nonmedical therapies are declining.
-what are "younger" people? why are we not seeing a similar spike in anxiety in the older segments of the population?
Because onset of many of the anxiety disorders is in childhood and adolescence and predicts later psychopathology, identification of people at risk and interventions at young ages are important treatment considerations. (Craske and Stein) If older adults have an anxiety disorder, they have most likely already been diagnosed, or have developed coping mechanisms on their own, and thus don't add to the statistic of those being (newly) diagnosed. Worldwide, women are twice as likely as men are to have an anxiety disorder; adults aged 55 years or older are 20% less likely to have an anxiety disorder than are those aged 35-54 years. Notably, prevalence estimates for anxiety disorders vary across countries, with 12 month prevalence ranging from 2·4% in Italy to 29·8% in Mexico. Controlling for variations in characterisation and methods, prevalence in the USA and European countries tends to be higher than that in other areas of the world. Although no data exist for prevalence of anxiety disorders across generations, some evidence suggests increasing endorsement of anxiety symptoms,15which could reflect increased exposure to threat-relevant information (eg, via the internet) or improved methods of detection.
-is this exclusively an American problem or is it consistent in other countries and cultures?
According to Craske and Stein, anxiety disorders have a much higher incidence in Asian and Western cultures, in developed countries. Unfortunately, there is no research as to what's causing that, and it may be caused by mental health being deprioritized in developing countries and thus insufficient diagnosis and reporting of a similar occurrence of anxiety, or it may genuinely be due to cultural differences and practices.
-once we figure out what anxiety is, who it affects, and how it displays itself, can we do anything about it through the lens of UI/UX? how might UI/UX approaches or the specific advantages of that medium (define those too!) address or alleviate specific problems of anxiety?
"[Anxiety] is strangely treatable when caught very early. This most human aspect of the human condition may not be, and probably should not be, eliminated altogether. However, it can be modified like inflammation, to more acceptable levels. Psychological treatments have demonstrated good efficacy with around two‐thirds of patients responding to treatment. However, treatment itself can be interpreted as a threat, and for this reason young people with anxiety disorders are among the least likely to seek appropriate help. Their families also can be fearful of treatments unless the parents are able to supervise them closely, which does not endear them to their treating clinician." (Nunn) Cognitive behavioral therapy (CBT) has an extremely strong track record of efficacy; can its methods and strengths be translated to UI/UX contexts?
UI/UX strengths that fit in with anxiety treatments: snackable, easily accessible, available on demand, private;
the “always-carried” and “always-on” nature of smartphones creates an opportunity to deliver CBT interventions to children in natural settings during their everyday lives, an approach referred to as “ecological momentary intervention” (Pramana).
UI/UX weaknesses for delivering anxiety treatment methodologies: This needs research.
Physical feedback coping mechanisms: hand-on-stomach breathing, 4 concepts/wave, autogenic training/guided meditation, "just because," (Quick, ch. 3), alternate thinking (Quick ch. 5)
-what populations is this directed toward? what populations will this not work for?
do i need to consider things like disability accessibility and non-neurotypical users?
-additional places to research: Headspace app, computer in campus counseling center that walks you through anxiety treatments in a tech delivered format
Sources:
Craske, M. G., & Stein, M. B. (2016). "Anxiety." The Lancet, 388(10063), 3048-3059. doi:http://dx.doi.org.aurarialibrary.idm.oclc.org/10.1016/S0140-6736(16)30381-6
Hofmann, Stefan G., ed. Psychobiological Approaches for Anxiety Disorders : Treatment Combination Strategies. Somerset: John Wiley & Sons, Incorporated, 2012. https://ebookcentral.proquest.com/lib/cudenver/detail.action?docID=882726#
Horwitz, Allan V. Anxiety : A Short History. Baltimore : Johns Hopkins University Press. 2013.
Pramana, Gede et al. “Using Mobile Health Gamification to Facilitate Cognitive Behavioral Therapy Skills Practice in Child Anxiety Treatment: Open Clinical Trial.” Ed. Gunther Eysenbach. JMIR Serious Games 6.2 (2018): e9. PMC. Web. 14 Oct. 2018.
*This one is really helpful!! It's a study of the exact subject I'm looking at! (Specific to children though.)
Quick, Ellen K. Solution Focused Anxiety Management: A Treatment and Training Manual. Academic Press. https://doi.org/10.1016/B978-0-12-394421-4.00003-6.
PROBLEM AREA II: designers bombarding the public with "awareness" campaigns without actionable steps
-what's an awareness campaign? what is it good for? what is it no good for?
"The term "information deficit model" was introduced in the 1980s to describe a widely held belief about science communication—that much of the public’s skepticism about science and new technology was rooted, quite simply, in a lack of knowledge. And that if the public only knew more, they would be more likely to embrace scientific information... Because abundant research shows that people who are simply given more information are unlikely to change their beliefs or behavior, it’s time for activists and organizations seeking to drive change in the public interest to move beyond just raising awareness. It wastes a lot of time and money for important causes that can’t afford to sacrifice either. Instead, social change activists need to use behavioral science to craft campaigns that use messaging and concrete calls to action that get people to change how they feel, think, or act, and as a result create long-lasting change." (SSIR)
-do we have any research or quantitative measurements of its impact or lack thereof? (e.g. number of campaigns seen in a day by average user of x social media site; stuff wasted by campaign--trees, electricity, research time; change initiated from seeing campaign, short term and long; percent of users tired of seeing these, or who ignored or "hid" them; number of google search results for "awareness")
"Public relations texts frequently cite awareness, attitude, and action objectives. Marketing students learn that awareness precedes action. And many of the foremost public relations and advertising agencies still report results to clients in the form of impressions—the number of people who were exposed to the message." (SSIR)
-what could those action steps be, and where might we find resources to create them?
Most causes for which the awareness campaigns are made need donations and volunteers, and know that they need those things but aren't quite sure how to engage people to that point (Philanthropy News Digest). There must be something in between? Or people can somehow come back to the issue later, and engage at the level they're comfortable with? I think there's probably a way to leverage tech to make these interactions more portable and remind people of worthy causes they're interested in, but not in the annoying/offputting way of ads or popups.
-who is the audience for a potential solution? is it designers, or is it the public at large?
This would be aimed more at designers, or perhaps at organizers and decision-makers at charities.
-what can be done about it through the medium of design? do we end up creating awareness of awareness? would a website giving designers strategies to come up with action steps help fix the problem?
That Stanford Social Innovation Review website is already out there. The biggest reason I, personally, have become disengaged with "awareness" campaigns is from taking a human-centered design and prototyping course at inworks, which was centered around taking stabs at problems and quickly building prototypes to test their workability and application. Perhaps a more helpful approach than "stop making awareness campaigns" would be something similar that focused on positive small goals and a different mindset.
Summation: I don't think this would work well for a thesis project; the deliverable isn't much, no measurable anything anywhere, and significantly less research to draw from.
... But I'll probably do it for a personal project at some point later because I'm still salty about the slew of dumb awareness campaigns in the world.
Sources:
Stanford Social Innovation Review (SSIR), "Stop Raising Awareness Already" https://ssir.org/articles/entry/stop_raising_awareness_already
Philanthropy News Digest, "5 Mistakes You're Making with your Awareness Campaigns"
https://philanthropynewsdigest.org/columns/the-sustainable-nonprofit/5-mistakes-you-re-making-with-your-awareness-campaigns
PSA Corp https://psacorp.com/pgs/lgcy/t-creating-a-successful-awareness-campaign.aspx
PROBLEM AREA I: anxiety in younger people seems to be occurring at an extremely high rate recently. a lot of noise has been made about this in the media, but I have also noticed corresponding anecdotal data among friends.
-what does "anxiety" mean? what's the current medical community's definition, discovery, diagnosis and treatment process? what research exists around anxiety and what does it conclude?
Contemporary scientists are attempting to root anxiety in physical sources, such as the brain regions and neurochemicals that process fear regulation--but these don't explain what anxious people are feeling or how they express those feelings inside their own cultural understanding. Each culture and time period understands a group of symptoms in its own way, making historical background and incidence of anxiety difficult to define.
Fear occurs as a result of perceived imminent threat whereas anxiety is a state of anticipation about perceived future threats. (Craske and Stein, 2016) Some fear is healthy, but what defines abnormal or dysfunctional anxiety? The DSM-V defines several subcategories of anxiety, including "panic disorder (with or without agoraphobia), agoraphobia with-out panic, specific phobias, social phobias, obsessive-compulsive disorders, post-traumatic stress disorders, acute stress disorders, and generalized anxiety disorders and several others." (Horwitz, 2013) "Anxiety disorders are common and disabling conditions that mostly begin during childhood, adolescence, and early adulthood. They differ from developmentally normative or stress-induced transient anxiety by being marked (ie, out of proportion to the actual threat present) and persistent, and by impairing daily functioning. Most anxiety disorders affect almost twice as many women as men. They often co-occur with major depression, alcohol and other substance-use disorders, and personality disorders." (Craske and Stein)
For treatment, most American physicians follow the biomedical model and prescribe antianxiety pharmaceuticals, in 2008 more than 50 million prescriptions for specifically anti-anxiety medications and more than 150 million for antidepressants, many of which were used for anxiety-related conditions. Moreover, usage rates of drug treatments are growing exponentially while those of nonmedical therapies are declining.
-what are "younger" people? why are we not seeing a similar spike in anxiety in the older segments of the population?
Because onset of many of the anxiety disorders is in childhood and adolescence and predicts later psychopathology, identification of people at risk and interventions at young ages are important treatment considerations. (Craske and Stein) If older adults have an anxiety disorder, they have most likely already been diagnosed, or have developed coping mechanisms on their own, and thus don't add to the statistic of those being (newly) diagnosed. Worldwide, women are twice as likely as men are to have an anxiety disorder; adults aged 55 years or older are 20% less likely to have an anxiety disorder than are those aged 35-54 years. Notably, prevalence estimates for anxiety disorders vary across countries, with 12 month prevalence ranging from 2·4% in Italy to 29·8% in Mexico. Controlling for variations in characterisation and methods, prevalence in the USA and European countries tends to be higher than that in other areas of the world. Although no data exist for prevalence of anxiety disorders across generations, some evidence suggests increasing endorsement of anxiety symptoms,15which could reflect increased exposure to threat-relevant information (eg, via the internet) or improved methods of detection.
-is this exclusively an American problem or is it consistent in other countries and cultures?
According to Craske and Stein, anxiety disorders have a much higher incidence in Asian and Western cultures, in developed countries. Unfortunately, there is no research as to what's causing that, and it may be caused by mental health being deprioritized in developing countries and thus insufficient diagnosis and reporting of a similar occurrence of anxiety, or it may genuinely be due to cultural differences and practices.
-once we figure out what anxiety is, who it affects, and how it displays itself, can we do anything about it through the lens of UI/UX? how might UI/UX approaches or the specific advantages of that medium (define those too!) address or alleviate specific problems of anxiety?
"[Anxiety] is strangely treatable when caught very early. This most human aspect of the human condition may not be, and probably should not be, eliminated altogether. However, it can be modified like inflammation, to more acceptable levels. Psychological treatments have demonstrated good efficacy with around two‐thirds of patients responding to treatment. However, treatment itself can be interpreted as a threat, and for this reason young people with anxiety disorders are among the least likely to seek appropriate help. Their families also can be fearful of treatments unless the parents are able to supervise them closely, which does not endear them to their treating clinician." (Nunn) Cognitive behavioral therapy (CBT) has an extremely strong track record of efficacy; can its methods and strengths be translated to UI/UX contexts?
UI/UX strengths that fit in with anxiety treatments: snackable, easily accessible, available on demand, private;
the “always-carried” and “always-on” nature of smartphones creates an opportunity to deliver CBT interventions to children in natural settings during their everyday lives, an approach referred to as “ecological momentary intervention” (Pramana).
UI/UX weaknesses for delivering anxiety treatment methodologies: This needs research.
Physical feedback coping mechanisms: hand-on-stomach breathing, 4 concepts/wave, autogenic training/guided meditation, "just because," (Quick, ch. 3), alternate thinking (Quick ch. 5)
-what populations is this directed toward? what populations will this not work for?
do i need to consider things like disability accessibility and non-neurotypical users?
-additional places to research: Headspace app, computer in campus counseling center that walks you through anxiety treatments in a tech delivered format
Sources:
Craske, M. G., & Stein, M. B. (2016). "Anxiety." The Lancet, 388(10063), 3048-3059. doi:http://dx.doi.org.aurarialibrary.idm.oclc.org/10.1016/S0140-6736(16)30381-6
Hofmann, Stefan G., ed. Psychobiological Approaches for Anxiety Disorders : Treatment Combination Strategies. Somerset: John Wiley & Sons, Incorporated, 2012. https://ebookcentral.proquest.com/lib/cudenver/detail.action?docID=882726#
Horwitz, Allan V. Anxiety : A Short History. Baltimore : Johns Hopkins University Press. 2013.
Pramana, Gede et al. “Using Mobile Health Gamification to Facilitate Cognitive Behavioral Therapy Skills Practice in Child Anxiety Treatment: Open Clinical Trial.” Ed. Gunther Eysenbach. JMIR Serious Games 6.2 (2018): e9. PMC. Web. 14 Oct. 2018.
*This one is really helpful!! It's a study of the exact subject I'm looking at! (Specific to children though.)
Quick, Ellen K. Solution Focused Anxiety Management: A Treatment and Training Manual. Academic Press. https://doi.org/10.1016/B978-0-12-394421-4.00003-6.
(http://www.sciencedirect.com/science/article/pii/B9780123944214000036)
Forums, in which to find more direct user statements:
https://www.reddit.com/r/anxiety
https://www.beyondblue.org.au/get-support/online-forums/anxiety
https://www.mentalhealthforum.net/forum/forum365.html
Dialectical Behavioral Therapy https://www.psychologytoday.com/us/blog/hope-eating-disorder-recovery/201609/what-is-dbt
Eye Movement Desensitization and Reprocessing Therapy https://www.psychologytoday.com/us/therapy-types/eye-movement-desensitization-and-reprocessing-therapy
Psychodynamic Therapy https://www.psychologytoday.com/us/blog/psychologically-minded/201311/psychodynamic-therapy-101 (v good interview)
The Efficacy of Psychodynamic Therapy https://www.apa.org/pubs/journals/releases/amp-65-2-98.pdf (scholarly paper in the APA publication)
Christoph Schneider, Markus Weinmann, Jan van Brocke, "Digital Nudging: Guiding Online User Choices through Interface Design," Communications of the ACM, July 2018, Vol. 61 No. 7, Pages 67-73. https://cacm.acm.org/magazines/2018/7/229029-digital-nudging/fulltext
Other management strategies/self-calming techniques:
https://www.reddit.com/r/Anxiety/comments/9u3sbo/if_you_are_in_a_high_anxiety_state_all_day_what/
https://www.reddit.com/r/Anxiety/wiki/onlineresources
Forums, in which to find more direct user statements:
https://www.reddit.com/r/anxiety
https://www.beyondblue.org.au/get-support/online-forums/anxiety
https://www.mentalhealthforum.net/forum/forum365.html
Dialectical Behavioral Therapy https://www.psychologytoday.com/us/blog/hope-eating-disorder-recovery/201609/what-is-dbt
Eye Movement Desensitization and Reprocessing Therapy https://www.psychologytoday.com/us/therapy-types/eye-movement-desensitization-and-reprocessing-therapy
Psychodynamic Therapy https://www.psychologytoday.com/us/blog/psychologically-minded/201311/psychodynamic-therapy-101 (v good interview)
The Efficacy of Psychodynamic Therapy https://www.apa.org/pubs/journals/releases/amp-65-2-98.pdf (scholarly paper in the APA publication)
Christoph Schneider, Markus Weinmann, Jan van Brocke, "Digital Nudging: Guiding Online User Choices through Interface Design," Communications of the ACM, July 2018, Vol. 61 No. 7, Pages 67-73. https://cacm.acm.org/magazines/2018/7/229029-digital-nudging/fulltext
Other management strategies/self-calming techniques:
https://www.reddit.com/r/Anxiety/comments/9u3sbo/if_you_are_in_a_high_anxiety_state_all_day_what/
https://www.reddit.com/r/Anxiety/wiki/onlineresources
PROBLEM AREA II: designers bombarding the public with "awareness" campaigns without actionable steps
-what's an awareness campaign? what is it good for? what is it no good for?
"The term "information deficit model" was introduced in the 1980s to describe a widely held belief about science communication—that much of the public’s skepticism about science and new technology was rooted, quite simply, in a lack of knowledge. And that if the public only knew more, they would be more likely to embrace scientific information... Because abundant research shows that people who are simply given more information are unlikely to change their beliefs or behavior, it’s time for activists and organizations seeking to drive change in the public interest to move beyond just raising awareness. It wastes a lot of time and money for important causes that can’t afford to sacrifice either. Instead, social change activists need to use behavioral science to craft campaigns that use messaging and concrete calls to action that get people to change how they feel, think, or act, and as a result create long-lasting change." (SSIR)
-do we have any research or quantitative measurements of its impact or lack thereof? (e.g. number of campaigns seen in a day by average user of x social media site; stuff wasted by campaign--trees, electricity, research time; change initiated from seeing campaign, short term and long; percent of users tired of seeing these, or who ignored or "hid" them; number of google search results for "awareness")
"Public relations texts frequently cite awareness, attitude, and action objectives. Marketing students learn that awareness precedes action. And many of the foremost public relations and advertising agencies still report results to clients in the form of impressions—the number of people who were exposed to the message." (SSIR)
-what could those action steps be, and where might we find resources to create them?
Most causes for which the awareness campaigns are made need donations and volunteers, and know that they need those things but aren't quite sure how to engage people to that point (Philanthropy News Digest). There must be something in between? Or people can somehow come back to the issue later, and engage at the level they're comfortable with? I think there's probably a way to leverage tech to make these interactions more portable and remind people of worthy causes they're interested in, but not in the annoying/offputting way of ads or popups.
-who is the audience for a potential solution? is it designers, or is it the public at large?
This would be aimed more at designers, or perhaps at organizers and decision-makers at charities.
-what can be done about it through the medium of design? do we end up creating awareness of awareness? would a website giving designers strategies to come up with action steps help fix the problem?
That Stanford Social Innovation Review website is already out there. The biggest reason I, personally, have become disengaged with "awareness" campaigns is from taking a human-centered design and prototyping course at inworks, which was centered around taking stabs at problems and quickly building prototypes to test their workability and application. Perhaps a more helpful approach than "stop making awareness campaigns" would be something similar that focused on positive small goals and a different mindset.
Summation: I don't think this would work well for a thesis project; the deliverable isn't much, no measurable anything anywhere, and significantly less research to draw from.
... But I'll probably do it for a personal project at some point later because I'm still salty about the slew of dumb awareness campaigns in the world.
Sources:
Stanford Social Innovation Review (SSIR), "Stop Raising Awareness Already" https://ssir.org/articles/entry/stop_raising_awareness_already
Philanthropy News Digest, "5 Mistakes You're Making with your Awareness Campaigns"
https://philanthropynewsdigest.org/columns/the-sustainable-nonprofit/5-mistakes-you-re-making-with-your-awareness-campaigns
PSA Corp https://psacorp.com/pgs/lgcy/t-creating-a-successful-awareness-campaign.aspx
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