The Digital Marshmallow Test (DMT) is a mobile app that hopes to advance the science in identifying, understanding and, eventually, helping individuals who sometimes have difficulty regulating their behavior or act impulsively in certain situations.
**Available on iOS and Android
The DMT is a collaborative effort between Northwell Health, the Feinstein Institute for Medical Research, Cornell Tech, and Sage Bionetworks.
Powered by Apple’s ResearchKit(™) and Android’s ResearchStack(™) application development frameworks, the DMT uses the smartphone to understand individuals who have trouble controlling their impulses, particularly with regard to unhealthy behaviors, such as overeating or drinking alcohol, in order to help them regain control when they need it most. The app consists of surveys and game-like tasks to understand how individuals regulate their behavior in different settings and at different times of the day. In addition to the versions developed for the general public, there will also be a version of the DMT app intended for researchers to implement into their own research studies.
The ultimate goal is that the DMT will eventually lead to non-invasive mobile interventions to identify and help those at greatest risk for impulsive responding and enhance temptation resilience before serious problems can occur. Support for this research was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.
We are developing the DMT using both the Apple ResearchKit and Android ResearchStack application frameworks.
We recruit individuals who enrolled in a large genetic study, conduct a neurocognitive and psychological assessent in our laboratory, and have participants use the DMT for 21-days, completing an extended version of the application. This validation study is limited to those who have already participated in the large genetic study.
We plan on reducing the number of tests and streamline the application for use in the general population. During this phase we will provide individuals with feedback on their scores, based on the validation study, by age and help them understand situations and times when they are most and least impulsive.
Using this version, we will also create an open research version of the application for any researcher to use through a means to locally store data.
Our study is designed to help understand why, how, and when people are most likely to act on short-term temptations despite long-term consequences or loss of potential gains. This refers to problems regulating one’s behavior or acting against one’s intentions. Across studies, more impulsive individuals are significantly more likely to suffer from obesity, Type II Diabetes, substance abuse, ADHD, gambling problems, binge eating, self-mutilation, and suicidal behaviors, and other problems. Despite the overwhelming research on the impact of impulsivity on mental and physical health outcomes, it has been largely ignored as a target of assessment and intervention in its own right.
The obesity epidemic is an example. Across age groups, individuals high in impulsivity are significantly more likely to be obese because they have less control resisting temptation when unhealthy food is available, have more sensitivity to short-term reward, and continue to eat past satiation. Those scoring higher on measures of impulsivity are also less responsive to weight-based behavior change interventions. So not only does impulsivity predict obesity, but when people high in impulsivity want to change, they are more likely to fail, creating a negative feedback of failure, shame, and low efficacy. Perhaps the most effective interventions are those that target impulsivity by removing temptation through increasing health food choices and decreasing unhealthy ones. Similarly, studies have revealed that assessing impulsivity and intervening using self-regulation interventions can help people maintain long-term weight loss and reduce impulsive eating. Our goal is to help people recognize their patterns and become more intentional in all their behaviors. This study is one step in that direction.
PFrederick Muench, PhD, is an Associate Professor at the Feinstein Institute of Medical Research and the Director of Digital Health Interventions in Psychiatry at Northwell Health. He is the Northwell PI on the project. You can contact him at firstname.lastname@example.org.
Deborah Estrin, PhD, is Professor of Computer Science and Associate Dean at Cornell Tech in New York City and a Professor of Public Health at Weill Cornell Medicine. She is founder of the Health Tech Hub and directs the Small Data Lab at Cornell Tech. She is the Cornell Tech PI on the project.
JP Pollak is a Senior-Researcher in Residence at Cornell Tech and a visiting fellow at Weill Cornell Medicine. He is also the founder and CTO of Wellcoin, a program for rewarding healthy behavior. JP is a Cornell Tech co-investigator on the project.
Hongyi Wen is a first-year Information Science PhD student at Cornell Tech, working on health related projects that leverages personal digital traces. He is a Cornell Tech co-investigator on this project.
Rachel P. Vitale, B.A. is a Research Coordinator at the Center for Addiction Services and Personalized Interventions Research (CASPIR) working closely on the Adaptive Interventions (AI) study. She is the Research Coordinator on this project.
Zhaoxin Wu is the Mobile Application Developer at CASPIR working on SMS messaging platform integration and backend maintenance. She is the Project Coordinator on this project.
The Feinstein Institute for Medical Research is the research arm of Northwell Health, the largest healthcare provider in New York State. Home to 50 research laboratories and clinical research throughout dozens of hospitals and outpatient facilities, the 2,000 researchers and staff of the Feinstein Institute are making breakthroughs in molecular medicine, genetics, oncology, brain research, mental health, autoimmunity, and bioelectronic medicine–a new field of science that has the potential to revolutionize medicine. For more information about how we empower imagination and pioneer discovery, visit www.feinsteinInstitute.org.
Sage Bionetworks is a nonprofit biomedical research organization, founded in 2009, with a vision to promote innovations in personalized medicine by enabling a community-based approach to scientific inquiries and discoveries. Sage Bionetworks strives to activate patients and to incentivize scientists, encourage funders and researchers to work in fundamentally new ways in order to shape research, and accelerate access to knowledge and transform human health. It is located on the campus of the Fred Hutchinson Cancer Research Center in Seattle, Washington and is supported through a portfolio of philanthropic donations, competitive research grants, and commercial partnerships. Sage Bionetworks is the developer of Bridge Server, a system for securely acquiring data from mobile health applications, and Synapse, a system supporting collaborative data-driven research in biomedicine. More information is available at www.sagebase.org.
Cornell Tech develops pioneering leaders and technologies for the digital age. Cornell Tech brings together faculty, business leaders, tech entrepreneurs, and students in a catalytic environment to produce visionary results grounded in significant needs that will reinvent the way we live in the digital age. Cornell Tech’s temporary campus has been up and running at Google’s Chelsea building since 2012, with a growing world-class faculty, and about 150 master’s and Ph.D. students who collaborate extensively with tech-oriented companies and organizations and pursue their own start-ups. Construction is underway on Cornell Tech’s campus on Roosevelt Island, with a first phase due to open in 2017. When fully completed, the campus will include 2 million square feet of state-of-the-art buildings, over 2 acres of open space, and will be home to more than 2,000 graduate students and hundreds of faculty and staff.