1 General Introduction 21 scientific or medical knowledge on their prospected users in their design [113, 114, 116]. The quality of online mental health information, including smartphone applications for mental health, currently varies greatly [106]. According to dr. Stephen Schueller, Executive Director of OneMind Psyberguide (a non-profit website that reviews mHealth apps “based on the app’s Credibility, User Experience, and Transparency of Privacy Practices”) only 3 to 5% of all mHealth apps are research based [114]. This puts at risk mental health patients who decide to use these notvalidated, potentially ineffective, and even harmful apps. Another concern is risks involving privacy and confidentiality. Data gathered from apps can be accessed by unauthorized individuals through digital theft or physical loss of the phone; or apps may have inadequate data protection, may not fully inform users as to what information is automatically gathered and returned to software developers, etcetera. Despite these security risks and other challenges of mHealth, the development and dissemination of mental health apps continue to proliferate and outpace both research and regulatory policies [113]. And patients, in search of ways to improve their mental health, are eager to pick them up and use them [116]. 2. Aims and outline of this dissertation The aim of this dissertation is twofold. First, to add to the understanding of alexithymia, especially with regard to borderline personality pathology as one of the main, most severe, and ubiquitous forms of psychopathology. This aim is addressed in part I and II. Second, to contribute to the advancement of treatment of alexithymia by using a transdisciplinary, scientist-practitioner approach to design a crossmodality, biosensor-informed wearable application, which can continuously support emotional awareness in daily life. This aim is addressed in part III. Each part corresponds to one of the three research questions of this thesis. The research questions addressed in this thesis are: 1. What are the characteristics of a comprehensive, transtheoretical account of the concept of alexithymia and its implications for patients and their treatment that can be learned from the evolution and development of the concept over time? 2. To what extent are alexithymia and low emotional awareness associated to borderline personality pathology? 3. Is it feasible to develop a biosensor-informed wearable app aimed to support training of emotional awareness in patients with borderline personality pathology by employing a design science paradigm?
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