Mental and emotional health concerns among college students are prevalent and diverse in their symptom presentations. With increasing demands on counseling centers to provide efficient care and to address students with higher acuity or risk for harm, there has been an increased focus on identifying therapeutic targets that underlie a wide breadth of concerns to broaden the scope and impact of mental health services. Psychological inflexibility is one such target and refers to a combination of excessive avoidance of internal experiences coupled with a lack of actions that align with a person’s values. Interventions for psychological inflexibility aim to support people in reducing actions that are mostly about avoiding unwanted thoughts and feelings and actions that involve moving towards chosen values. Such interventions may produce changes in people’s actions in part through helping people notice and label the different roles their actions play in relation to thoughts, feelings, and personal values. However, the skill of noticing and labeling the purposes of one’s actions has not been studied in interventions for psychological inflexibility despite being discussed in theoretical writings. Training this skill may serve as a direct means of reducing psychological inflexibility and as a foundation for other interventions, thus it may be a relevant target in interventions for psychological inflexibility among college students. Given this, the present study developed and tested an intervention focused on noticing and labeling one’s actions as an intervention for psychological inflexibility in a college student sample, as delivered through web and app-based media. The study recruited 106 students with symptoms of depression and anxiety from a medium sized university in the Mountain West of the United States, and then randomly assigned them to either wait for eight weeks or receive a three-week online and app-based training for noticing and labeling avoidant and values-consistent actions. The results of the study indicated short-term effects on symptoms of depression and anxiety for participants who received the online and app-based training as compared with participants who were asked to wait, although both groups showed reductions in symptoms by the end of the study period. Participants did not report changes in the target skill of noticing and labeling their actions although the study did find larger reductions in psychological inflexibility among participants who received the training as compared with those asked to wait. Further, changes in psychological flexibility were related to changes in behavioral activity and life satisfaction, but not life quality. The results raise questions about the necessity of training the ability to notice and label one’s actions as a direct intervention mechanism for psychological inflexibility. The findings also suggest that changing inflexible patterns of behavior may be more important than the capacity to notice such changes. These results are further interpreted in relation to interventions for college student mental and emotional health.

The polycystic ovary syndrome (PCOS) affects women or people with female reproductive organs negatively, by irregular periods, difficulties in getting pregnant, and excessive hair growth. The symptoms can be eased by taking on habits of regular physical exercise and a balanced diet. Taking on new habits is however a challenging task. This thesis aims at harnessing the affordances (if any) that the design of gamification in a mobile application for women with PCOS could bring. The theoretical lens of self-determination theory has been used to underpin the design of gamification elements that can engage the users of an app. After creating designs and implementations in the app, evaluations were made with 29 participants through surveys and interviews. The results from the user evaluations show that participants’ thoughts on features and elements differed and that they were interested in them being designed in different ways. Designing an app that allows the user flexibility was desirable, and even viewed as motivational. Another take is that one should be careful in designing elements in a health app that uses comparing elements of gamification, since it can generate negative feelings such as anxiety. In the future, it would be interesting to include more features in the app and let users test it for a longer time to see if that would have a significant impact on the user engagement, and if habits could form for a better well-being. / Polycystiskt ovarialsyndrom (PCOS) påverkar kvinnor eller människor med kvinnliga reproduktiva organ negativt, genom oregelbunden mens, svårigheter i att bli gravid, och ökad hårväxt. Symptomen kan lindras genom regelbunden fysisk aktivitet och en balanserad kost. Att skaffa nya vanor är en utmaning. Det här examensarbetet har i syfte att se vilka möjligheter (om några) som en design av spelifiering i en mobilapp för kvinnor med PCOS kan ge. Linsen av självbestämmande teorin har använts för att stödja designen av spelifiering element som kan engagera app användare. Utvärderingar gjordes med 29 deltagare i form av enkäter samt intervjuer efter att ha skapat designer samt gjort implementationer i appen. Resultaten, baserade på deltagar utvärderingarna, visar på att användarnas tankar kring funktioner och element skilde sig åt samt att de var intresserade i olika designer för dessa. Att designa en app som erbjuder användaren flexibilitet var önskvärt, och sågs även som motiverande. En annan insikt är att designa delar av en hälsoapp som använder sig av spelifiering element där man jämför sig med andra bör ske med omsorg, då det kan medföra användaren med negativa känslor såsom ångest. Vidare vore det intressant att inkludera fler funktioner i appen och låta användare testa den en längre period för att se om det skulle ha en signifikant påverkan på användarnas engagemang, samt om vanor kunde skapas för ett bättre välbefinnande.