Table 1 Summary of Studies Included
| Study | App Name and Description | Control Condition | Len-gth (wks) |
N, % male | % with BPD | Study Inclusion Criteria | Outcomes | Drop-outc |
|---|---|---|---|---|---|---|---|---|
| Suicide and Self-Harm Applications | ||||||||
| [18] | TecTec.a Positive stimuli are paired with self, and self-harm related stimuli to aversive stimuli in a gamified format | Gamified format with stimuli pairing, but only with neutral stimuli (RCT) | 4 | 31, 19.3% | NR | Community adults with active NSSI |
• ↓ in all self-injurious thoughts and behaviors (SITB) except SI in app group vs. control • ↓ in self-cutting episodes (32–40%), suicide plans (21–59%), and suicidal behaviors (33–77%) | 24.4% (10) |
| [18] | 40, 26.0% | NR | 28.6% (16) | |||||
| [18] | 33, 41.1% | NR | 47.6% (30) | |||||
| [40] | BeyondNow. Personalized safety plan, including contacts and emergency services + Treatment as usual | None | ~ 10.42 | 36, 33.3% | 22.3% | Adults with elevated suicide risk in mental health treatment |
• ↓ severity and intensity of SI • ↑ suicide-related coping | 38.9% (14) |
| [47] | LifeApp’tite. Psychoeducation on suicidal thoughts; symptom monitoring; safety plan; digital hope kit; list of self-help skills + Treatment as usual | Treatment as usual in a specialized outpatient suicide prevention clinic (RCT) | ~ 9.4 | 60, 33.3% | NR | Adults referred to treatment or evaluation for to suicidal thoughts |
• ↓ in suicide risk in app group < control (only at trend level at 4-month follow up) • No between-group differences in depression | 56.7% (34) |
| [49] | BackUp.a Hope box (see VHB); coping cards; tools to recognize warning signs, use coping strategies, and reach out to others | None | 1 | 21, 23.9% | NR | Adults with suicidal thoughts as measured by BSS | • Non-significant ↓ in SI | 4.76% (1) |
| Emotion Regulation Applications | ||||||||
| [38] | RELAX. Tracks anger frequency, intensity, and cues; personalized anger management exercises + Anger management training group | Twice-weekly anger management training outpatient group alone (RCT) | 6 | 28, 100% | NR | Adult armed forces veterans with high levels of STAXI-measured anger |
• No differences between app group and control • ↓ anger severity and PTSD in both groups | 10.7% (3) |
| [41] | Headspace. Brief mindfulness meditation exercises + acute state hospital treatment. | None | 1 | 12, 83% | NR | Adults with schizophrenia or bipolar disorder and history of aggression or violence. | • No change in state or trait anger | 16.7% (2) |
| [45] | RELAX. See above + Anger management training group | None | 6 | 4 | NR | Adult armed forces veterans participating in anger management group. | • ↓ in anger, PTSD and depression symptoms at post-tx and 3-month follow-up | 25.0% (1) |
| [17] | EMOTEO. Provides guided mindfulness and distress tolerance exercises depending on stated level of tension + specialized BPD treatment | None | 24 | 16, 0% | 100% | Adult women with BPD in specialized treatment | • ↓ aversive tension | NR |
| Multipurpose (Suicide/Self-Harm, Impulsivity, & Emotion Regulation) Applications | ||||||||
| [7] | VHB. Repository of tools for distraction, relaxation, & stress-coping; fond memories; inspirational quotes + Treatment as usual | Printed materials about coping with suicidality + Treatment as usual (RCT) | 12 | 50, 62.1% | NR | Adult armed forces veterans in treatment with current/past-3-month SI |
• Stress coping in VHB > TAU group • No between-group differences in SI, reasons for living, suicide severity, and perceived stress | 13.8% (8) |
| [54] | DBT Coach. Suggests emotion-specific opposite action behaviors, tracks emotional intensity and urges to use substances + DBT | None | 2 | 22, 18.2% | 100% | Adults with BPD and SUD in current DBT treatment |
• ↓ in emotional intensity and urges to use substances • ↓ in depression and general distress | 0% (0) |
| [55] | DBT Coach. Same as above but expanded to include most DBT skills, tracks distress and urges to self-harm + DBT | None | 36 | 14, 25% | 100% | Adults with BPD and recent history of NSSI and/or suicide attempts | • ↑ app use predicted larger ↓ in NSSI, but not psychopathology, suicidal behavior, or skills use | 25% (4) |
| [67] | Ibobbly.a Psychoeducation on thoughts, strategies to defuse them and regulate emotions; action plans for value-based goals | Waitlist (RCT) | 6 | 31, 35.5% | NR | Indigenous Australian adults with past-2-week suicidal thoughts |
• No between-group differences in SI, impulsivity • ↓ in depression and distress in app group > waitlist | 6.45% (2) |