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Internet- and mobile technologies are increasingly used to deliver mental health care. E-Mental Health is promising for the prevention and treatment of mental disorders, in particular due to its wide population access, a low threshold, the active role of the client, lower costs compared to traditional care, and the possibility to integrate interventions in real-world settings. However, while E-Mental Health was shown to be an effective treatment tool, fewer studies investigated the prevention of mental health problems with E-Mental Health approaches. In a series of three studies, this dissertation examines internet- and mobile-based approaches for the early monitoring and supporting of mental health. First, a pilot study investigates the use of smartphone data as collected by daily self-reports and sensor information for the self-monitoring of bipolar disorder symptoms. It was found that some, but not all smartphone measurements predicted clinical symptoms of mania and depression, indicating that smartphones could be used as an earlywarning system for patients with bipolar disorder. Second, a randomized controlled trial evaluates the effectiveness of an internet-based intervention among persons with depression and sickness absence. The intervention was found to be effective in reducing depressive symptoms compared to a control group, suggesting that the internet can provide effective support for people with sickness absence due to depression. Third, a study protocol proposes to combine self-monitoring with a mobile intervention to support mental health in daily life. Supportive self-monitoring will be evaluated in a fully mobile randomized controlled trial among a sample of smartphone users with psychological distress. If supportive self-monitoring on the basis of a smartphone application is effective, it could be widely distributed to monitor and support mental health on a population level. Finally, the contribution of the presented studies to current research topics in E-Mental Health is discussed.
Due to increased life expectancy, a growing number of retirees are spending more and more time in retirement. Life satisfaction in later life therefore becomes an increasingly important societal issue. Good work ability and health are prerequisites for a self-determined transition to retirement, for example allowing for a continuation of gainful employment beyond retirement age. Such continued employment is one way of dealing with the consequences of a historically unique long retirement phase: a self-determined continued employment can have a positive effect on individual well-being, on societal level relieve the burden on the pension insurance system, and on meso-level provide companies with urgently needed human capital. The self-determination of life circumstances is postulated by Self-Determination Theory (SDT) as a basic psychological need with effects on individual well-being. This dissertation investigates work ability as a concept that supports workers, employers, and societies in the extension of working lives, and how work ability is related to the level of self-determination in the transition to retirement, and ultimately life satisfaction.
In the first study of this dissertation, the Work Ability Survey-R (WAS-R) was translated from English into German and then evaluated regarding its psychometric properties and construct validity. The WAS-R operationalizes work ability as the interplay of personal and organizational resources and thus allows companies to derive targeted interventions to maintain work ability.
In the second study, the WAS-R was examined together with the questionnaire Work-Related Behavior and Experience Pattern (Arbeitsbezogenes Verhaltens- und Erlebensmuster, AVEM) regarding its construct validity. A striking feature of this study was the high number of participants with the answering pattern indicating low work-related ambitions and protection. Persons with this pattern are in danger of entering the risk pattern for burnout in the future. The findings support the validity of the WAS-R.
In the third contribution, two studies examined the experience of control (i.e., autonomy) in the transition to retirement as a mediator between previous work ability, health, and financial well-being, and later life satisfaction in retirement. Control was found to partially mediate the relationship between work ability and later life satisfaction. Different mechanisms on later life satisfaction of work ability and health, and the subjective and objective financial situation were found.
This dissertation contributes to research on and practice with aging workers in two ways: (1) The German translation of the WAS-R is presented as a useful instrument for measuring work ability, assessing individual and organizational aspects and therefore enabling employers to make targeted interventions to maintain and improve work ability, and eventually enable control during later work life, the retirement transition and even old age. (2) This dissertation corroborates the importance of good work ability and health, even in old age, as well as control in these phases of life. Work ability is indirectly related to life satisfaction in the long period of retirement, mediated by a sense of control in the transition to retirement. This emphasizes the importance of the need for control as postulated by the SDT also in the transition to retirement.
