Date of Award


Degree Type


Degree Name

Doctor of Philosophy (PhD)




National trends indicate that mental health concerns, particularly rates of depression, continue to rise on college campuses; however, treatment utilization remains low. Technology-based mental health interventions, such as mental health apps (MHapps), are a promising means of overcoming treatment barriers. MHapps are effective in improving psychological outcomes, but low rates of adherence are a noted limitation. The current study explored patterns of adherence to a MHapp, investigated the bidirectional relation between adherence and depression, and identified motivational predictors of adherence rates. Undergraduate students (N= 66) reporting clinically-elevated depressive symptoms completed a three-month trial using Headspace, a mindfulness MHapp. Patterns of Headspace use revealed subsets of students who never initiated Headspace use or discontinued within the first month, and adherence declined markedly by the end of the second month. Further, depressive symptoms at the end of the first month predicted fewer minutes of Headspace completed during the second month. Connections were not found between depression and adherence for metrics of module completion, mental health practice, or depression practice. Finally, motivational factors of perceived and expected benefit, self-regulation, and behavioral intention predicted increases in the completion of depression content. The implications of these results for clinicians, college administrations, and users of MHapps are discussed, as well as directions for future research.

Creative Commons License

Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.