Society for Ambulatory Assessment

First quarter 2016 (January to March)

Aardoom, Jiska J.; Dingemans, Alexandra E.; van Furth, Eric F. (2016): E-Health Interventions for Eating Disorders: Emerging Findings, Issues, and Opportunities. In: Current psychiatry reports 18 (4), S. 42. DOI: 10.1007/s11920-016-0673-6.

This study aimed to review the emerging findings regarding E-health interventions for eating disorders and to critically discuss emerging issues as well as challenges for future research. Internet-based cognitive behavioral therapy and guided self-help have demonstrated promising results in terms of reducing eating disorder psychopathology. Emerging findings also suggest that E-health interventions reach an underserved population and improve access to care. The use of smartphone applications is becoming increasingly popular and has much potential although their clinical utility and effectiveness is presently unknown and requires investigation. Important challenges include the diagnostic process in E-health interventions, the optimization of E-health within existing health care models, and the investigation and implementation of blended care. More high-quality research is needed to bring the field forward and to determine the place for E-health in our health care service delivery systems.

Abdullah, S.; Matthews, M.; Frank, E.; Doherty, G.; Gay, G.; Choudhury, T. (2016): Automatic Detection of Social Rhythms in Bipolar Disorder. In: Journal of the American Medical Informatics Association : JAMIA. DOI: 10.1093/jamia/ocv200.

OBJECTIVE: To evaluate the feasibility of automatically assessing the Social Rhythm Metric (SRM), a clinically-validated marker of stability and rhythmicity for individuals with bipolar disorder (BD), using passively-sensed data from smartphones. METHODS: Seven patients with BD used smartphones for 4 weeks passively collecting sensor data including accelerometer, microphone, location, and communication information to infer behavioral and contextual patterns. Participants also completed SRM entries using a smartphone app. RESULTS: We found that automated sensing can be used to infer the SRM score. Using location, distance traveled, conversation frequency, and non-stationary duration as inputs, our generalized model achieves root-mean-square-error of 1.40, a reasonable performance given the range of SRM score (0-7). Personalized models further improve performance with mean root-mean-square-error of 0.92 across users. Classifiers using sensor streams can predict stable (SRM score >/=3.5) and unstable (SRM score <3.5) states with high accuracy (precision: 0.85 and recall: 0.86). CONCLUSIONS: Automatic smartphone sensing is a feasible approach for inferring rhythmicity, a key marker of wellbeing for individuals with BD.

Alshurafa, N.; Sideris, C.; Pourhomayoun, M.; Kalantarian, H.; Sarrafzadeh, M.; Eastwood, J. A. (2016): Remote Health Monitoring Outcome Success Prediction using Baseline and First Month Intervention Data. In: IEEE journal of biomedical and health informatics. DOI: 10.1109/JBHI.2016.2518673.

Remote health monitoring (RHM) systems are becoming more widely adopted by clinicians and hospitals to remotely monitor and communicate with patients while optimizing clinician time, decreasing hospital costs, and improving quality of care. In the Women’s Heart Health Study (WHHS) we developed Wanda-CVD, where participants received healthy lifestyle education followed by six months of technology support and reinforcement. Wanda-CVD is a smartphone-based RHM system designed to assist participants in reducing identified cardiovascular disease (CVD) risk factors through wireless coaching using feedback and prompts as social support. Many participants benefitted from this RHM system. In response to the variance in participants’ success we developed a framework to identify classification schemes that predicted successful and unsuccessful participants. We analyzed both contextual baseline features and data from the first month of intervention such as activity, blood pressure and questionnaire responses transmitted through the smartphone. A prediction tool can aid clinicians and scientists in identifying participants who may optimally benefit from the RHM system. Targeting therapies could potentially save healthcare costs, clinician and participant time and resources. Our classification scheme yields RHM outcome success predictions with an F-measure of 91.9%, and identifies behaviors during the first month of intervention that help determine outcome success. We also show an improvement in prediction by using intervention-based smartphone data. Results from the WHHS study demonstrates that factors such as the variation in first month intervention response to the consumption of nuts, beans and seeds in the diet help predict patient RHM protocol outcome success in a group of young Black women ages 25-45.

Am Hickey; Freedson, P. S. (2016): Utility of Consumer Physical Activity Trackers as an Intervention Tool in Cardiovascular Disease Prevention and Treatment. In: Progress in cardiovascular diseases. DOI: 10.1016/j.pcad.2016.02.006.

Consumer activity trackers have grown in popularity over the last few years. These devices are typically worn on the hip or wrist and provide the user with information about physical activity measures such as steps taken, energy expenditure, and time spent in moderate to vigorous physical activity. The consumer may also use the computer interface (e.g. device websites, smartphone applications) to monitor and track achievement of PA goals and compete with other users. This review will describe some of the most popular consumer devices and discuss the user feedback tools. We will also present the limited evidence available about the accuracy of these devices and highlight how they have been used in cardiovascular disease management. We conclude with some recommendations for future research, focusing on how consumer devices might be used to assess effectiveness of various cardiovascular treatments.

Anastasiou, A.; Giokas, K.; Koutsouris, D. (2015): Monitoring of compliance on an individual treatment through mobile innovations. In: Conference proceedings : … Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference 2015, S. 7320–7323. DOI: 10.1109/EMBC.2015.7320082.

The present work examines the potential of smartphone usage for offering health services to elderly patients. The purpose of this work is the design, development, and implementation of a telemedicine application. This application aims to improve the monitoring mode and increase patient adherence to the instructions assigned by the medical staff. It consists of three parts: the doctor’s application (Web Application), the patient’s application (Android Application) and the Web Server of the platform, where the database is stored necessary for the smooth operation of the platform. Also the Web Server hosts the doctor’s Web Application. The Web Application is based on web front-end technologies, providing the medical personnel with a variety of features and useful actions. These actions and capabilities are mainly relevant to the assignment of instructions to patients and the monitoring of their health progress. The Android Application has been implemented and validated for the Android-based mobile devices operating system and consists of a handy and user-friendly environment, equipped with the right tools so that the patient has the ability to update the system on the progress of his/her health by storing the appropriate measurements. Both applications also provide customization capabilities in regards to the patients’ and doctors’ profile.

Anderson, S. M.; Riehle, T. H.; Lichter, P. A.; Brown, A. W.; Panescu, D. (2015): Smartphone-based system to improve transportation access for the cognitively impaired. In: Conference proceedings : … Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference 2015, S. 7760–7763. DOI: 10.1109/EMBC.2015.7320191.

This project developed and evaluated a smartphone-based system to improve mobility and transportation access for the cognitively impaired. The proposed system is intended to allow the cognitively impaired to use public transportation systems, community transportation and dedicated transportation services for the disabled with greater ease and safety. Individuals with cognitive disabilities are often unable to operate an automobile, or may require a prolonged recovery period before resuming driving. Public transportation systems represent a significant means to allow these individuals to maintain independence. Yet public transportation systems can pose significant challenges to individuals with cognitive impairment. The goal of this project is to develop a system to reduce these barriers via a technological solution consisting of components developed both for the cognitively impaired user and their caregiver or family member. The first component consists of a cognitive prosthetic device featuring traditional memory cueing and reminders as well as custom location-based transportation specific functions. This cognitive mobility assistant will leverage the computing power and GPS location determination capabilities of inexpensive, powerful smart phones. The second component consists of a management application which offers caregivers the ability to configure and program the reminder and transit functions remotely via the Internet. Following completion of the prototype system a pilot human test was performed with cognitively disabled individuals and family members or caregivers to assess the usability and acceptability of both system components.

Anglada-Martinez, Helena; Rovira-Illamola, Marina; Martin-Conde, Maite; Sotoca-Momblona, Jose Miguel; Codina-Jane, Carles (2016): mHealth intervention to improve medication management in chronically ill patients: analysis of the recruitment process. In: Postgraduate medicine, S. 1–5. DOI: 10.1080/00325481.2016.1170580.

OBJECTIVES: Mobile phones have been rapidly adopted by the general population and are now a promising technology with considerable potential in health care. However, refusal rates of 24%-75% have been reported in telemedicine studies. We aimed to report the challenges faced when recruiting patients to use Android and iOS smartphone applications aimed at improving medication management and communication between patients and healthcare professionals. METHODS: The patients invited to participate had heart failure and/or hypertension and/or dyslipidemia. After reaching the number of participants required for inclusion, the recruitment process was analyzed, and the study team determined the reasons for refusal. RESULTS: Of the 448 potential participants who were invited to participate, 210 responded. Of these, 37.1% did not use a smartphone, 2.9% owned a mobile phone that was neither iOS nor Android, and 28.6% were smartphone users who refused to participate. In this case, the most common motive was that patients considered their routine healthcare sufficient and had no trouble remembering to take their medicines (81.7%). The final study sample comprised 48 patients. The mean age of the patients enrolled was significantly lower than that of participants who were not included (59.9 +/- 10.6 vs. 66.8 +/- 11.4 years, respectively; p=0.00). CONCLUSION: We found age to be an important barrier to smartphone use in healthcare. Among smartphone users, good adherence and sufficient routine healthcare were the most common reasons for refusal to participate. Thus, this type of intervention could enhance participation for poor adherers or caregivers. Implementing educational initiatives could play a key role in improving patient perceptions of technology.

Ashar, Yoni K.; Andrews-Hanna, Jessica R.; Yarkoni, Tal; Sills, Jenifer; Halifax, Joan; Dimidjian, Sona; Wager, Tor D. (2016): Effects of Compassion Meditation on a Psychological Model of Charitable Donation. In: Emotion (Washington, D.C.). DOI: 10.1037/emo0000119.

Compassion is critical for societal wellbeing. Yet, it remains unclear how specific thoughts and feelings motivate compassionate behavior, and we lack a scientific understanding of how to effectively cultivate compassion. Here, we conducted 2 studies designed to a) develop a psychological model predicting compassionate behavior, and b) test this model as a mediator of a Compassion Meditation (CM) intervention and identify the “active ingredients” of CM. In Study 1, we developed a model predicting compassionate behavior, operationalized as real-money charitable donation, from a linear combination of self-reported tenderness, personal distress, perceived blamelessness, and perceived instrumental value of helping with high cross-validated accuracy, r = .67, p < .0001. Perceived similarity to suffering others did not predict charitable donation when controlling for other feelings and attributions. In Study 2, a randomized controlled trial, we tested the Study 1 model as a mediator of CM and investigated active ingredients. We compared a smartphone-based CM program to 2 conditions-placebo oxytocin and a Familiarity intervention-to control for expectancy effects, demand characteristics, and familiarity effects. Relative to control conditions, CM increased charitable donations, and changes in the Study 1 model of feelings and attributions mediated this effect (pab = .002). The Familiarity intervention led to decreases in primary outcomes, while placebo oxytocin had no significant effects on primary outcomes. Overall, this work contributes a quantitative model of compassionate behavior, and informs our understanding of the change processes and intervention components of CM.

Austin, Christopher; Kusumoto, Fred (2016): The application of Big Data in medicine: current implications and future directions. In: Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing. DOI: 10.1007/s10840-016-0104-y.

Since the mid 1980s, the world has experienced an unprecedented explosion in the capacity to produce, store, and communicate data, primarily in digital formats. Simultaneously, access to computing technologies in the form of the personal PC, smartphone, and other handheld devices has mirrored this growth. With these enhanced capabilities of data storage and rapid computation as well as real-time delivery of information via the internet, the average daily consumption of data by an individual has grown exponentially. Unbeknownst to many, Big Data has silently crept into our daily routines and, with continued development of cheap data storage and availability of smart devices both regionally and in developing countries, the influence of Big Data will continue to grow. This influence has also carried over to healthcare. This paper will provide an overview of Big Data, its benefits, potential pitfalls, and the projected impact on the future of medicine in general and cardiology in particular.

Bajpai, Anurag; Jilla, Vivek; Tiwari, Vijay N.; Venkatesan, Shankar M.; Narayanan, Rangavittal (2015): Quantifiable fitness tracking using wearable devices. In: Conference proceedings : … Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference 2015, S. 1633–1637. DOI: 10.1109/EMBC.2015.7318688.

Monitoring health and fitness is emerging as an important benefit that smartphone users could expect from their mobile devices today. Rule of thumb calorie tracking and recommendation based on selective activity monitoring is widely available today, as both on-device and server based solutions. What is surprisingly not available to the users is a simple application geared towards quantitative fitness tracking. Such an application potentially can be a direct indicator of one’s cardio-vascular performance and associated long term health risks. Since wearable devices with various inbuilt sensors like accelerometer, gyroscope, SPO2 and heart rate are increasingly becoming available, it is vital that the enormous data coming from these sensors be used to perform analytics to uncover hidden health and fitness associated facts. A continuous estimation of fitness level employing these wearable devices can potentially help users in setting personalized short and long-term exercise goals leading to positive impact on one’s overall health. The present work describes a step in this direction. This work involves an unobtrusive method to track an individual’s physical activity seamlessly, estimate calorie consumption during a day by mapping the activity to the calories spent and assess fitness level using heart rate data from wearable sensors. We employ a heart rate based parameter called Endurance to quantitatively estimate cardio-respiratory fitness of a person. This opens up avenues for personalization and adaptiveness by dynamically using individual’s personal fitness data towards building robust modeling based on analytical principles.

Bakker, D.; Kazantzis, N.; Rickwood, D.; Rickard, N. (2016): Mental Health Smartphone Apps: Review and Evidence-Based Recommendations for Future Developments. In: JMIR mental health 3 (1), S. e7. DOI: 10.2196/mental.4984.

BACKGROUND: The number of mental health apps (MHapps) developed and now available to smartphone users has increased in recent years. MHapps and other technology-based solutions have the potential to play an important part in the future of mental health care; however, there is no single guide for the development of evidence-based MHapps. Many currently available MHapps lack features that would greatly improve their functionality, or include features that are not optimized. Furthermore, MHapp developers rarely conduct or publish trial-based experimental validation of their apps. Indeed, a previous systematic review revealed a complete lack of trial-based evidence for many of the hundreds of MHapps available. OBJECTIVE: To guide future MHapp development, a set of clear, practical, evidence-based recommendations is presented for MHapp developers to create better, more rigorous apps. METHODS: A literature review was conducted, scrutinizing research across diverse fields, including mental health interventions, preventative health, mobile health, and mobile app design. RESULTS: Sixteen recommendations were formulated. Evidence for each recommendation is discussed, and guidance on how these recommendations might be integrated into the overall design of an MHapp is offered. Each recommendation is rated on the basis of the strength of associated evidence. It is important to design an MHapp using a behavioral plan and interactive framework that encourages the user to engage with the app; thus, it may not be possible to incorporate all 16 recommendations into a single MHapp. CONCLUSIONS: Randomized controlled trials are required to validate future MHapps and the principles upon which they are designed, and to further investigate the recommendations presented in this review. Effective MHapps are required to help prevent mental health problems and to ease the burden on health systems.

Bardus, M.; van Beurden, S. B.; Smith, JR; Abraham, C. (2016): A review and content analysis of engagement, functionality, aesthetics, information quality, and change techniques in the most popular commercial apps for weight management. In: The international journal of behavioral nutrition and physical activity 13 (1), S. 35. DOI: 10.1186/s12966-016-0359-9.

BACKGROUND: There are thousands of apps promoting dietary improvement, increased physical activity (PA) and weight management. Despite a growing number of reviews in this area, popular apps have not been comprehensively analysed in terms of features related to engagement, functionality, aesthetics, information quality, and content, including the types of change techniques employed. METHODS: The databases containing information about all Health and Fitness apps on GP and iTunes (7,954 and 25,491 apps) were downloaded in April 2015. Database filters were applied to select the most popular apps available in both stores. Two researchers screened the descriptions selecting only weight management apps. Features, app quality and content were independently assessed using the Mobile App Rating Scale (MARS) and previously-defined categories of techniques relevant to behaviour change. Inter-coder reliabilities were calculated, and correlations between features explored. RESULTS: Of the 23 popular apps included in the review 16 were free (70 %), 15 (65 %) addressed weight control, diet and PA combined; 19 (83 %) allowed behavioural tracking. On 5-point MARS scales, apps were of average quality (Md = 3.2, IQR = 1.4); “functionality” (Md = 4.0, IQR = 1.1) was the highest and “information quality” (Md = 2.0, IQR = 1.1) was the lowest domain. On average, 10 techniques were identified per app (range: 1-17) and of the 34 categories applied, goal setting and self-monitoring techniques were most frequently identified. App quality was positively correlated with number of techniques included (rho = .58, p < .01) and number of “technical” features (rho = .48, p < .05), which was also associated with the number of techniques included (rho = .61, p < .01). Apps that provided tracking used significantly more techniques than those that did not. Apps with automated tracking scored significantly higher in engagement, aesthetics, and overall MARS scores. Those that used change techniques previously associated with effectiveness (i.e., goal setting, self-monitoring and feedback) also had better “information quality”. CONCLUSIONS: Popular apps assessed have overall moderate quality and include behavioural tracking features and a range of change techniques associated with behaviour change. These apps may influence behaviour, although more attention to information quality and evidence-based content are warranted to improve their quality.

Beiwinkel, T.; Kindermann, S.; Maier, A.; Kerl, C.; Moock, J.; Barbian, G.; Rossler, W. (2016): Using Smartphones to Monitor Bipolar Disorder Symptoms: A Pilot Study. In: JMIR mental health 3 (1), S. e2. DOI: 10.2196/mental.4560.

BACKGROUND: Relapse prevention in bipolar disorder can be improved by monitoring symptoms in patients’ daily life. Smartphone apps are easy-to-use, low-cost tools that can be used to assess this information. To date, few studies have examined the usefulness of smartphone data for monitoring symptoms in bipolar disorder. OBJECTIVE: We present results from a pilot test of a smartphone-based monitoring system, Social Information Monitoring for Patients with Bipolar Affective Disorder (SIMBA), that tracked daily mood, physical activity, and social communication in 13 patients. The objective of this study was to investigate whether smartphone measurements predicted clinical symptoms levels and clinical symptom change. The hypotheses that smartphone measurements are (1) negatively related to clinical depressive symptoms and (2) positively related to clinical manic symptoms were tested. METHODS: Clinical rating scales were administered to assess clinical depressive and manic symptoms. Patients used a smartphone with the monitoring app for up to 12 months. Random-coefficient multilevel models were computed to analyze the relationship between smartphone data and externally rated manic and depressive symptoms. Overall clinical symptom levels and clinical symptom changes were predicted by separating between-patient and within-patient effects. Using established clinical thresholds from the literature, marginal effect plots displayed clinical relevance of smartphone data. RESULTS: Overall symptom levels and change in clinical symptoms were related to smartphone measures. Higher overall levels of clinical depressive symptoms were predicted by lower self-reported mood measured by the smartphone (beta=-.56, P<.001). An increase in clinical depressive symptoms was predicted by a decline in social communication (ie, outgoing text messages: beta=-.28, P<.001) and a decline in physical activity as measured by the smartphone (ie, cell tower movements: beta=-.11, P=.03). Higher overall levels of clinical manic symptoms were predicted by lower physical activity on the smartphone (ie, distance travelled: beta=-.37, P<.001), and higher social communication (beta=.48, P=.03). An increase in clinical manic symptoms was predicted by a decrease in physical activity on the smartphone (beta=-.17, P<.001). CONCLUSIONS: Clinical symptoms were related to some objective and subjective smartphone measurements, but not all smartphone measures predicted the occurrence of bipolar symptoms above clinical thresholds. Thus, smartphones have the potential to monitor bipolar disorder symptoms in patients’ daily life. Further validation of monitoring tools in a larger sample is needed. Conclusions are limited by the low prevalence of manic and depressive symptoms in the study sample. TRIAL REGISTRATION: International Standard Randomized Controlled Trial Number (ISRCTN): 05663421; (Archived by WebCite at

Bhavnani, S. P.; Narula, J.; Sengupta, P. P. (2016): Mobile technology and the digitization of healthcare. In: European heart journal. DOI: 10.1093/eurheartj/ehv770.

The convergence of science and technology in our dynamic digital era has resulted in the development of innovative digital health devices that allow easy and accurate characterization in health and disease. Technological advancements and the miniaturization of diagnostic instruments to modern smartphone-connected and mobile health (mHealth) devices such as the iECG, handheld ultrasound, and lab-on-a-chip technologies have led to increasing enthusiasm for patient care with promises to decrease healthcare costs and to improve outcomes. This ‘hype’ for mHealth has recently intersected with the ‘real world’ and is providing important insights into how patients and practitioners are utilizing digital health technologies. It is also raising important questions regarding the evidence supporting widespread device use. In this state-of-the-art review, we assess the current literature of mHealth and aim to provide a framework for the advances in mHealth by understanding the various device, patient, and clinical factors as they relate to digital health from device designs and patient engagement, to clinical workflow and device regulation. We also outline new strategies for generation and analysis of mHealth data at the individual and population-based levels.

Bissing-Olson, Megan J.; Fielding, Kelly S.; Iyer, Aarti (2016): Experiences of pride, not guilt, predict pro-environmental behavior when pro-environmental descriptive norms are more positive. In: Journal of Environmental Psychology 45, S. 145–153. DOI: 10.1016/j.jenvp.2016.01.001.

Emotions can greatly influence behavior, yet research on links between incidental emotions and pro-environmental behavior is limited. The present study uses an experience sampling design to examine how pride and guilt relate to daily pro-environmental behavior. Ninety-six university students recorded their engagement in specific pro-environmental behaviors, and their feelings of pride and guilt about these behaviors, at four time points each day for three consecutive days. Results showed that pro-environmental behavior during a 2.5-h time period was positively related to pride, and negatively related to guilt, during that same time period. Pride about environmental behavior was positively related to subsequent engagement in pro-environmental behavior (i.e., during the following 2.5-h time period), but only for people who perceived more positive pro-environmental descriptive norms. Guilt was not related to subsequent pro-environmental behavior. We discuss implications for further research on the complex associations between daily experiences of moral emotions and pro-environmental behavior.

Bjorling, Elin A.; Singh, Narayan (2016): Exploring Temporal Patterns of Stress in Adolescent Girls with Headache. In: Stress and health : journal of the International Society for the Investigation of Stress. DOI: 10.1002/smi.2675.

As part of a larger study on perceived stress and headaches in 2009, momentary perceived stress, head pain levels and stress-related symptom data were collected. This paper explores a temporal analysis of the patterns of stress, as well as an analysis of momentary and retrospective stress-related symptoms compared by level of headache activity. Adolescent girls (N = 31) ages 14-18 were randomly cued by electronic diaries 7 times per day over a 21-day period responding to momentary questions about level of head pain, perceived stress and stress-related symptoms. Multivariate general linear modelling was used to determine significant differences among headache groups in relation to temporal patterns of stress. Significant headache group differences were found on retrospective and momentary stress-related symptom measures. A total of 2841 diary responses captured stress levels, head pain and related symptoms. The chronic headache (CH) group reported the highest levels of hourly and daily stress, followed by the moderate headache (MH) and low headache (LH) groups. Patterns of stress for the three headache groups were statistically distinct, illustrating increased stress in girls with more frequent head pain. This evidence suggests that because of increased stress, girls with recurrent head pain are likely a vulnerable population who may benefit from stress-reducing interventions. Copyright (c) 2016 John Wiley & Sons, Ltd.

Black, Anne C.; Cooney, Ned L.; Justice, Amy C.; Fiellin, Lynn E.; Pietrzak, Robert H.; Lazar, Christina M.; Rosen, Marc I. (2016): Momentary assessment of PTSD symptoms and sexual risk behavior in male OEF/OIF/OND Veterans. In: Journal of affective disorders 190, S. 424–428. DOI: 10.1016/j.jad.2015.10.039.

Background: Post-traumatic stress disorder (PTSD) in Veterans is associated with increased sexual risk behaviors, but the nature of this association is not well understood. Typical PTSD measurement deriving a summary estimate of symptom severity over a period of time precludes inferences about symptom variability, and whether momentary changes in symptom severity predict risk behavior. Methods: We assessed the feasibility of measuring daily PTSD symptoms, substance use, and high-risk sexual behavior in Veterans using ecological momentary assessment (EMA). Feasibility indicators were survey completion, PTSD symptom variability, and variability in rates of substance use and sexual risk behavior. Nine male Veterans completed web-based questionnaires by cell phone three times per day for 28 days. Results: Median within-day survey completion rates maintained near 90%, and PTSD symptoms showed high within-person variability, ranging up to 59 points on the 80-point scale. Six Veterans reported alcohol or substance use, and substance users reported use of more than one drug. Eight Veterans reported 1 to 28 high-risk sexual events. Heightened PTSD-related negative affect and externalizing behaviors preceded high-risk sexual events. Greater PTSD symptom instability was associated with having multiple sexual partners in the 28-day period. Limitations: These results are preliminary, given this small sample size, and multiple comparisons, and should be verified with larger Veteran samples. Conclusions: Results support the feasibility and utility of using of EMA to better understand the relationship between PTSD symptoms and sexual risk behavior in Veterans. Specific antecedent-risk behavior patterns provide promise for focused clinical interventions.

Blake, Grant A.; Ferguson, Stuart G.; Palmer, Matthew A.; Shiffman, Saul (2016): Development and psychometric properties of the Smoking Restraint Questionnaire. In: Psychology of Addictive Behaviors 30 (2), S. 238–245. DOI: 10.1037/adb0000134.

Restraint is a component of self-control that focuses on the deliberate reduction of an undesired behavior and is theorized to play a role in smoking reduction and cessation. However, there exists no instrument to assess smoking restraint. This research aimed to develop the Smoking Restraint Questionnaire (SRQ) to meet this need. Participants were 406 smokers (48% female; 52.2% nondaily) with a mean age of 38.83 years (SD = 12.05). They completed a baseline questionnaire designed to assess smoking restraint. They also completed 21 days of ecological momentary assessment (EMA), during which they recorded each cigarette smoked and answered questions related to planned restraint every morning, and restraint attempts every evening. The 4-item questionnaire of smoking restraint was found to fit a single factor (root mean square error of approximation = .038, comparative fit index = .99, Tucker-Lewis index = .99), and the resulting composite was reliable (composite reliability = 0.74). The questionnaire contains items that assess the setting of weekly restraint goals and attempts at not lighting up when tempted to smoke. Participant SRQ scores positively correlated with EMA data on plans to restrain (p < .001) and frequency of restraint attempts (p < .001). These correlations suggest that the SRQ has good predictive validity in relation to the intention and behaviors of smoking reduction. The SRQ is promising as a measure of smoking restraint and may enable further research and insights into smoking reduction and cessation.

Boh, B.; Lemmens, L. H.; Jansen, A.; Nederkoorn, C.; Kerkhofs, V.; Spanakis, G. et al. (2016): An Ecological Momentary Intervention for weight loss and healthy eating via smartphone and Internet: study protocol for a randomised controlled trial. In: Trials 17 (1), S. 154. DOI: 10.1186/s13063-016-1280-x.

BACKGROUND: Long-term weight loss maintenance is difficult to achieve. Effectiveness of obesity interventions could be increased by providing extended treatment, and by focusing on person-environment interactions. Ecological Momentary Intervention (EMI) can account for these two factors by allowing an indefinite extension of a treatment protocol in everyday life. EMI relies on observations in daily life to intervene by providing appropriate in-the-moment treatment. The Think Slim intervention is an EMI based on the principles of cognitive behavioural therapy (CBT), and its effectiveness will be investigated in the current study. METHODS: A randomised controlled trial (RCT) will be conducted. At least 134 overweight adults (body mass index (BMI) above 25 kg/m(2)) will be randomly assigned to an 8-week immediate intervention group (Diet + Think Slim intervention, n = 67) or to an 8-week diet-only control group (followed by the Think Slim intervention, n = 67). The Think Slim intervention consists of (1) an app-based EMI that estimates and intervenes when people are likely to overeat, based on Ecological Momentary Assessment data, and (2) ten online computerised CBT sessions which work in conjunction with an EMI module in the app. The primary outcome is BMI. Secondary outcomes include (1) scores on self-report questionnaires for dysfunctional thinking, eating styles, eating disorder pathology, general psychological symptomatology, and self-esteem, and (2) eating patterns, investigated via network analysis. Primary and secondary outcomes will be obtained at pre- and post-intervention measurements, and at 3- and 12-month follow-up measurements. DISCUSSION: This is the first EMI aimed at treating obesity via a cognitive approach, provided via a smartphone app and the Internet, in the context of an RCT. TRIAL REGISTRATION: This trial has been registered at the Netherlands Trial Register, part of the Dutch Cochrane Centre ( NTR5473 ; registration date: 26 October 2015).

Bose, P.; Goadsby, P. J. (2016): The migraine postdrome. In: Current opinion in neurology. DOI: 10.1097/WCO.0000000000000310.

PURPOSE OF REVIEW: Migraine is a common, disabling neurological disorder that affects up to 12% of the world population. Its pathophysiology is incompletely described. Of the various phases of migraine, the migraine postdrome is the least studied and hence the least understood. RECENT FINDINGS: Electronic diary studies show patients are left disabled with non-headache symptoms in the migraine postdrome. Hence, the importance of understanding the phase better and ensuring that more effective treatments become available in the future to cut down the morbidity associated with this phase. SUMMARY: The disability related to migraine is not limited to the headache phase and pans out to include the postdrome phase. The migraine postdrome needs to be studied more as this may improve our overall understanding of migraine mechanisms and also treat the concurrent symptoms better.

Bosman, Renske C.; Jung, Sophie E.; Miloserdov, Kristina; Schoevers, Robert A.; Aan Het Rot, Marije (2016): Daily symptom ratings for studying premenstrual dysphoric disorder: A review. In: Journal of affective disorders 189, S. 43–53. DOI: 10.1016/j.jad.2015.08.063.

Background: To review how daily symptom ratings have been used in research into premenstrual dysphoric disorder (PMDD), and to discuss opportunities for the future. Methods: PsycINFO and Medline were systematically searched, resulting in the inclusion of 75 studies in which (1) participants met the diagnostic criteria for late luteal phase dysphoric disorder (LLPDD) or PMDD and (2) diaries were used to study LLPDD/PMDD. Results: To date, diaries have been used to gain insight into the aetiology and phenomenology of PMDD, to examine associated biological factors, and to assess treatment efficacy. We found low consistency among the diaries used, and often only part of the menstrual cycle was analysed instead of the whole menstrual cycle. We also observed that there was substantial variability in diagnostic procedures and criteria. Limitations: This review excluded diary studies conducted in women with premenstrual syndrome, women seeking help for premenstrual complaints without a clear diagnosis, and women without premenstrual complaints. Conclusions: Prospective daily ratings of symptoms and related variables provide a valuable and important tool in the study of PMDD. This paper addresses some options for improving the use of diaries and proposes the use of experience sampling and ecological momentary assessment to investigate within-person variability in symptoms in more detail.

Brazeau, Anne-Sophie; Beaudoin, Nadia; Bélisle, Virginie; Messier, Virginie; Karelis, Antony D.; Rabasa-Lhoret, Rémi (2016): Validation and reliability of two activity monitors for energy expenditure assessment. In: Journal of Science and Medicine in Sport 19 (1), S. 46–50. DOI: 10.1016/j.jsams.2014.11.001.

Objectives: This study explores the reliability and validity of the SenseWear Armband (SWA) and Actical (ACT) for free-living total energy expenditure, and energy expenditure during rest and light-to-moderate exercises (walking, ergocycling). Design: Participants wore the 2 devices during 7 days (free-living) and then participated to 3 days of testing in our laboratory. Methods: SWA and ACT estimates of total energy expenditure was compared to the doubly labeled water technique (7 days), and energy expenditure during rest (60 min), treadmill (45 min; intensities ∼22% to ∼41% VO2peak) and ergocycling (45 min; ∼50% VO2peak) were compared to indirect calorimetry over the following 3 days. Paired T-tests and intra-class correlation coefficient (ICC) with 95% confidence interval (CI95) were computed. Results: Twenty adults were recruited (BMI 23.1 ± 2.3 kg/m²). Compared to doubly labelled water, SWA overestimated energy expenditure by 94 kcal/d (±319; P = 0.2) and ACT underestimated by −244 kcal/d (±258; P = 0.001). Energy expenditure during rest (SWA 210 ± 116, ACT 124 ± 133 kcal/d; p < 0.05) and treadmill (according on intensity: SWA 54 ± 46 to 67 ± 38, ACT 68 ± 25 to 84 ± 40 kcal; p < 0.05) were overestimated and underestimated during ergocycling (SWA −93 ± 65, ACT −269 ± 111 kcal; p < 0.05) compared to indirect calorimetry. High ICC were observed at rest (SWA 0.994 CI₉₅ 0.987–0.997; ACT 0.998 CI₉₅ 0.996–0.999) and during ergocycling (SWA 0.941 CI₉₅ 0.873–0.975; ACT 0.854 CI₉₅ 0.687–0.939). Conclusion: Acceptable estimation of total energy expenditure was observed with the SWA. Both devices were reliable but not accurate for energy expenditure’s estimations during rest and for specific exercises.

Broen, Martijn P. G.; Marsman, Vera A. M.; Kuijf, Mark L.; van Oostenbrugge, Robert J.; van Os, Jim; Leentjens, Albert F. G. (2016): Unraveling the Relationship between Motor Symptoms, Affective States and Contextual Factors in Parkinson’s Disease: A Feasibility Study of the Experience Sampling Method. In: PloS one 11 (3), S. e0151195. DOI: 10.1371/journal.pone.0151195.

BACKGROUND: In Parkinson’s disease (PD), the complex relationship between motor symptoms, affective states, and contextual factors remains to be elucidated. The Experience Sampling Method provides (ESM) a novel approach to this issue. Using a mobile device with a special purpose application (app), motor symptoms, affective states and contextual factors are assessed repeatedly at random moments in the flow of daily life, yielding an intensive time series of symptoms and experience. The aim of this study was to study the feasibility of this method. METHOD: We studied the feasibility of a five-day period of ESM in PD and its ability to objectify diurnal fluctuations in motor symptom severity and their relation with affect and contextual factors in five PD patients with motor fluctuations. RESULTS: Participants achieved a high compliance, with 84% of assessment moments completed without disturbance of daily activities. The utility of the device was rated 8 on a 10-point scale. We were able to capture extensive diurnal fluctuations that were not revealed by routine clinical assessment. In addition, we were able to detect clinically relevant associations between motor symptoms, emotional fluctuations and contextual factors at an intra-individual level. CONCLUSIONS: ESM represents a viable and novel approach to elucidate relationships between motor symptoms, affective states and contextual factors at the level of individual subjects. ESM holds promise for clinical practice and scientific research.

Buckner, J. D.; Langdon, K. J.; Jeffries, E. R.; Zvolensky, M. J. (2016): Socially anxious smokers experience greater negative affect and withdrawal during self-quit attempts. In: Addictive behaviors 55, S. 46–49. DOI: 10.1016/j.addbeh.2016.01.004.

Despite evidence of a strong and consistent relation between smoking and elevated social anxiety, strikingly little empirical work has identified mechanisms underlying the smoking-social anxiety link. Persons with elevated social anxiety may rely on smoking to cope with more severe nicotine withdrawal and post-quit negative mood states; yet, no known studies have investigated the relation of social anxiety to withdrawal severity. The current study examined the relation of social anxiety to post-quit nicotine withdrawal severity among 51 (33.3% female, Mage=34.6) community-recruited smokers during the first two weeks following an unaided (i.e., no treatment) cessation attempt. Ecological momentary assessment was used to collect multiple daily ratings of withdrawal and negative mood states. Baseline social anxiety was related to increases in negative affect during the monitoring period and remained significantly related to post-quit withdrawal after controlling for negative affect, gender, lapses, and substance use. Persons with elevated social anxiety experience more severe post-quit withdrawal symptoms and increases in negative affect during a cessation attempt and may therefore benefit from intervention and treatment strategies geared toward helping them learn to cope with withdrawal and negative affect to improve cessation rates among these vulnerable smokers.

Buman, M. P.; Hu, F.; Newman, E.; Smeaton, A. F.; Epstein (2016): Behavioral Periodicity Detection from 24 h Wrist Accelerometry and Associations with Cardiometabolic Risk and Health-Related Quality of Life. In: BioMed research international 2016, S. 4856506. DOI: 10.1155/2016/4856506.

Periodicities (repeating patterns) are observed in many human behaviors. Their strength may capture untapped patterns that incorporate sleep, sedentary, and active behaviors into a single metric indicative of better health. We present a framework to detect periodicities from longitudinal wrist-worn accelerometry data. GENEActiv accelerometer data were collected from 20 participants (17 men, 3 women, aged 35-65) continuously for 64.4 +/- 26.2 (range: 13.9 to 102.0) consecutive days. Cardiometabolic risk biomarkers and health-related quality of life metrics were assessed at baseline. Periodograms were constructed to determine patterns emergent from the accelerometer data. Periodicity strength was calculated using circular autocorrelations for time-lagged windows. The most notable periodicity was at 24 h, indicating a circadian rest-activity cycle; however, its strength varied significantly across participants. Periodicity strength was most consistently associated with LDL-cholesterol (r’s = 0.40-0.79, P’s < 0.05) and triglycerides (r’s = 0.68-0.86, P’s < 0.05) but also associated with hs-CRP and health-related quality of life, even after adjusting for demographics and self-rated physical activity and insomnia symptoms. Our framework demonstrates a new method for characterizing behavior patterns longitudinally which captures relationships between 24 h accelerometry data and health outcomes.

Burgi, R.; Tomatis, L.; Murer, K.; Bruin, E. D. de (2016): Spatial physical activity patterns among primary school children living in neighbourhoods of varying socioeconomic status: a cross-sectional study using accelerometry and Global Positioning System. In: BMC public health 16 (1), S. 282. DOI: 10.1186/s12889-016-2954-8.

BACKGROUND: Neighbourhood socioeconomic status (SES) has been shown to be related to health status and overweight independent of individual SES. However, results about the association between neighbourhood SES and physical activity among children are ambiguous. Particularly, it is unknown how socioeconomic factors influence the spatial context of children’s moderate-vigorous physical activity (MVPA) and sedentary behaviour (SB). This study aimed to investigate by means of Global Positioning System (GPS) and accelerometry whether locations where children engage in MVPA and SB differ by neighbourhood SES. METHODS: Participants included 83 children aged 7-9 from nine public schools located in a low- and high-SES area in Zurich, Switzerland. Children wore an accelerometer and GPS sensor for seven consecutive days. Time-matched accelerometer and GPS data was mapped with a geographic information system and each data point assigned to one of eight activity settings. The amount and proportion of MVPA and SB were calculated for every setting. To investigate differences between the two SES groups, multilevel analyses accounting for the hierarchical structure of the data were conducted. RESULTS: Both SES groups achieved most minutes in MVPA at own school, on streets and at home and recorded the highest proportions of MVPA in recreational facilities, streets and other schools. The highest amounts and proportions of SB were found at home and own school. High-SES children accumulated significantly more minutes in MVPA and SB in parks, sport facilities, other schools and streets, while the low-SES group spent more time in both activities in other places. When taking the total time spent in a setting into account and using the proportion of MVPA or SB, the only differences between the two groups were found at other schools and outside, where the high-SES children showed a significantly higher activity level (p-values <0.001). CONCLUSIONS: Several differences in the spatial activity pattern between children from low- and high-SES neighbourhoods were found, independent of their individual SES. The findings seem to highlight the importance of providing safe streets and access to appropriate types of recreational facilities to reach recommended PA levels. Further policies to reduce SB within home and school environment are needed.

Busby Grant, Janie; Walsh, Erin (2016): Exploring the use of experience sampling to assess episodic thought. In: Applied Cognitive Psychology. DOI: 10.1002/acp.3215.

Summary Mental time travel is the ability to mentally relive events in one’s own past (episodic recall) and pre‐live potential personal future events (episodic foresight). Recent research has used experience sampling to reveal when and how often we think about the past and future in everyday life; however, it remains unclear how much of thought is episodic, involving the sense of self that underpins mental time travel. In this study, we investigate the use of experience sampling to assess the frequency of episodic past and future thought in everyday life. Participants (n = 214) were exposed to 20 short message service prompts over 1 or 2 days. Half of thoughts were sited in the present; of the remainder, future‐oriented thoughts were more frequent than past‐oriented thoughts. Participants reported 20% of thoughts as episodic. This study suggests that experience sampling methodology can provide a means of assessing episodic thought during everyday activities.Copyright © 2016 John Wiley & Sons, Ltd.

Calkins, Anne M.; Gudin, Jeff; Gidal, Barry; Jaros, Mark J.; Kim, Richard; Shang, Gwendoline (2016): Impact of Data Imputation Methodology on Pain Assessment over 24 Hours in a Randomized, Placebo-Controlled Study of Gabapentin Enacarbil in Patients with Neuropathic Pain Associated with Postherpetic Neuralgia. In: Pain medicine (Malden, Mass.). DOI: 10.1093/pm/pnv072.

OBJECTIVE: To assess the impact of gabapentin enacarbil on primary and secondary pain endpoints using three data imputation methodologies in a randomized phase II study of adult patients with postherpetic neuralgia. METHODS: The primary endpoint was change from baseline to end of maintenance treatment in mean 24-hour average pain intensity score. Secondary endpoints (daytime/nighttime average pain intensity score, daytime/nighttime current pain intensity score, and daytime/nighttime worst pain intensity score) were based on daily electronic diary assessments. Comparisons of each gabapentin enacarbil dose with placebo were performed using three different statistical methodologies: last observation carried forward, baseline observation carried forward, and mixed-effect model for repeated measures. RESULTS: Of the 376 randomized patients, 371 were in the intent-to-treat population (gabapentin enacarbil 1,200 mg, 107; 2,400 mg, 82; 3,600 mg, 87; placebo, 95). For mean 24-hour average pain intensity score, there were statistically significant improvements from baseline to end of maintenance treatment for all gabapentin enacarbil groups vs placebo using the three analysis methods. Significant improvements were also observed for all secondary endpoints with gabapentin enacarbil 1,200 mg using the three analysis methods. Most secondary endpoints also showed improvements following treatment with gabapentin enacarbil 2,400 mg or 3,600 mg compared with placebo. CONCLUSIONS: Gabapentin enacarbil (1,200 mg, 2,400 mg, and 3,600 mg) was effective and well tolerated in patients with postherpetic neuralgia compared with placebo, as confirmed by three different and robust statistical methodologies.

Cardeña, Etzel; Marcusson-Clavertz, David (2016): The relation of hypnotizability and dissociation to everyday mentation: An experience-sampling study. In: Psychology of Consciousness: Theory, Research, and Practice 3 (1), S. 61–79. DOI: 10.1037/cns0000080.

Research has found that individuals varying in hypnotizability and dissociation respond differently to questionnaires and procedures geared to affect their state of consciousness, but their stream of consciousness in everyday life has not been investigated. We evaluated the everyday mentation of students (N = 46) in a 2 (High vs. Low Hypnotizability) × 2 (High vs. Low Dissociative) design through experience sampling with personal digital assistants (PDAs). The PDAs prompted volunteers randomly 8 times per day during 5 days and included questions about attention, type of mental activity, and mood, among others, which resulted in 5 factors: focus/absorption, daydreaming, negative affect, control/awareness, and detachment. High control/awareness correlated with high focus/absorption, low negative affect, and low detachment. Detachment correlated also with daydreaming. As predicted, high dissociatives reported less control but more detachment and negative affect than low dissociatives. High hypnotizables (Highs) did not report more focus/absorption than low hypnotizables (Lows) but endorsed more daydreaming and negative affect. Highs reported more thoughts than Lows, and Lows reported more sensory impressions than Highs. Hypnotizability and dissociation also interacted: Low dissociatives/Lows reported less daydreaming than the others, and high dissociatives/Lows experienced less control than the other 3 groups combined. Participants reported less control/awareness during daydreaming, with high dissociatives/Highs showing a larger decrement than the others. Most mentations referred to thoughts or sensory impressions; the former were characterized by more negative affect than the latter. In general, individuals felt more dysphoric when their mentation was more detached or less focused or controlled than usual.

Chen, J.; Bauman, A.; Allman-Farinelli, M. (2016): A Study to Determine the Most Popular Lifestyle Smartphone Applications and Willingness of the Public to Share Their Personal Data for Health Research. In: Telemedicine journal and e-health : the official journal of the American Telemedicine Association. DOI: 10.1089/tmj.2015.0159.

INTRODUCTION: Smartphone lifestyle applications (apps) and wearable fitness-tracking devices collect a wealth of data that could provide research insights to support prevention and treatment of obesity and chronic diseases. The aim of this study was to pilot a survey to explore patterns of behavioral tracking using smartphone lifestyle apps and individuals’ willingness to share their app-generated data. METHODS: A cross-sectional Web-based survey was conducted within a university setting. The 35-item survey asked participants about their self-tracking patterns; use of lifestyle apps and wearable devices; how their self-tracked health data could be useful to them; and any restrictions they would impose on sharing personal data. Responses were tabulated and analyzed for trends. RESULTS: The survey was completed by 101 participants. On average, 3.1 (standard deviation [SD] +/-1.9) health and fitness apps were installed by current app users (n = 85), with MyFitnessPal, MapMyRun, Nike+, and Fitbit being most popular. Most participants were willing to share their personal health data for research (77%). Those who did not normally share their health-tracking data were more likely than sharers to be concerned about privacy (odds ratio [OR] = 5.93; 95% confidence interval [95% CI] = 2.09-16.78), as were those not identifying with the quantified-self movement compared with those who were (OR = 5.04; 95% CI = 1.64-15.50). DISCUSSION: Participants were generally willing to share personal data, thus increasing the potential for these data to inform public health research and for use in targeted personalized program and intervention development. CONCLUSIONS: Opportunities for partnerships between researchers and commercial app developers or industry could improve public health research and practice.

Chin, TanChyuan; Rickard, Nikki S.; Vella-Brodrick, Dianne A. (2016): Development and feasibility of a mobile experience sampling application for tracking program implementation in youth well-being programs. In: Psychology of well-being 6, S. 1. DOI: 10.1186/s13612-016-0038-2.

Well-being program evaluations mostly focus on identifying effective outcomes rather than measuring the actual extent to which program participants may apply learned skills in subsequent everyday lives. This study examined the feasibility of using a newly developed mobile experience sampling app called Wuzzup to study program implementation in young people participating in well-being programs. Ninety-six participants (60 females; 36 males) between the ages of 13 and 15 years (M = 13.87, SD = 0.71) were recruited to respond to two random prompts each day, for 7 days, at each of the three data collection time-points. Responses from 69 participants (72 % of initial sample) that met study criteria were retained for analysis. The average response rate was 92.89 %, with an average of 85.92 s to complete each ESM survey. Significant associations between first and second halves of the ESM week, and their respective positive affect and negative affect survey responses, demonstrate internal reliability and construct validity of the Wuzzup app to capture momentary affect and activation states of young people. This study also demonstrated the feasibility and practical utility of the Wuzzup app to profile and track an individual’s learning over time.

Chun, Charlotte A. (2016): The expression of posttraumatic stress symptoms in daily life: A review of experience sampling methodology and daily diary studies. In: Journal of Psychopathology and Behavioral Assessment. DOI: 10.1007/s10862-016-9540-3.

This review examined the assessment of posttraumatic stress symptoms (PTSS) in daily life using experience sampling methodology (ESM)/ecological momentary assessment (EMA) and daily diary studies in adult samples. Fifteen peer-reviewed studies were identified and categorized into areas of total PTSD/multiple PTSS (studies including three or more symptom clusters), intrusive memories, and mood and anxiety symptoms. Overall, ESM and the daily diary method proved feasible for assessing the real-world expression of PTSS, resulted in minimal reactivity, and offered a number of advantages over classical assessment. Even within the two measurement types of ESM and daily diary, there was great variability in study design and analysis. The benefits and limitations of the different approaches are discussed. Different themes in content emerged as well, such as coping strategies and affective instability throughout the course of a day. Gaps in our current understanding are highlighted and suggestions for methodology and future areas of research are proposed.

Connor, Siobhan O.; McCaffrey, Noel; Whyte, Enda; Moran, Kieran (2016): The novel use of a SenseCam and accelerometer to validate training load and training information in a self-recall training diary. In: Journal of sports sciences 34 (4), S. 303–310. DOI: 10.1080/02640414.2015.1050600.

Self-recall training diaries are a frequently used tool to quantify training load and training information. While accelerometers are predominantly used to validate training diaries, they are unable to validate contextual training information. Thus this study aimed to examine the novel use of data fusion from a wearable camera device (SenseCam) and accelerometer to validate a self-recall training diary. Thirty participants filled in a training diary for 1 day while simultaneously wearing a SenseCam and accelerometer. The training diary was validated using Bland–Altman plots, Spearman’s rank-order correlation, percentage agreement and κ measure of agreement between the diary and the SenseCam and accelerometer. The results demonstrated overall agreement, and no bias, between the training diary and the accelerometer for training intensity, and the SenseCam for duration of activity and travel time. A positive correlation was found for duration (r = 0.82, P < 0.001) and intensity (r = 0.67, P < 0.001). Hundred per cent agreement was found between the SenseCam and training diary for activity, training surface and footwear (κ = 1, P < 0.0001), with a lower agreement noted for sports played (97.3%, κ = 0.91, P < 0.0001). The self-recall training diary was found to be a valid measure of capturing training load and training information using the combined wearable camera device and accelerometer.

Cook, Paul F.; McElwain, Catherine J.; Bradley-Springer, Lucy A. (2016): Brief report on ecological momentary assessment: everyday states predict HIV prevention behaviors. In: BMC research notes 9 (1), S. 9. DOI: 10.1186/s13104-015-1814-4.

BACKGROUND: Prevention behaviors help persons living with HIV (PLWH) to avoid transmitting HIV, and psychological variables have been found to predict HIV prevention behaviors. These variables have typically been measured using retrospective questionnaires about average psychological states over a period of time, which are likely to be biased by selective recall and interpretation. Measuring the same variables as momentary states, in the day-to-day context where they actually occur, may reveal different relationships to behavior. FINDINGS: 21 PLWH completed daily surveys about momentary states and prevention behaviors. Brief, validated measures were used to assess control beliefs, mood, stress, coping, social support, stigma, knowledge, and motivation. We used multilevel models to predict prevention behaviors from momentary states the previous day, while controlling for the effect of multiple observations from the same person over time. Participants reported a moderate overall level of HIV prevention behaviors during the 6-month study. Although lapses in prevention were infrequent, there was room for improvement. Control beliefs, mood, and motivation had significant prospective effects on HIV prevention behaviors, rs = 0.07-0.21. Stress and coping had effects approaching significance. CONCLUSIONS: Some momentary states predicted prevention behaviors, providing partial support for the motivational model. This finding supports past research showing effects of momentary states on behavior, and advances the science by testing multiple predictors. High within-sample diversity strengthened generalizability, but the overall sample size was small and the findings require replication. Future research should continue to examine the everyday experiences of PLWH as influences on their behavior.

Cordier, Reinie; Brown, Nicole; Chen, Yu-Wei; Wilkes-Gillan, Sarah; Falkmer, Torbjorn (2016): Piloting the use of experience sampling method to investigate the everyday social experiences of children with Asperger syndrome/high functioning autism. In: Developmental Neurorehabilitation 19 (2), S. 103–110. DOI: 10.1037/t15178-000.

Objective: This pilot study explored the nature and quality of social experiences of children with Asperger Syndrome/High Functioning Autism (AS/HFA) through experience sampling method (ESM) while participating in everyday activities. Methods: ESM was used to identify the contexts and content of daily life experiences. Six children with AS/HFA (aged 8–12) wore an iPod Touch on seven consecutive days, while being signalled to complete a short survey. Results: Participants were in the company of others 88.3% of their waking time, spent 69.0% of their time with family and 3.8% with friends, but only conversed with others 26.8% of the time. Participants had more positive experiences and emotions when they were with friends compared with other company. Participating in leisure activities was associated with enjoyment, interest in the occasion, and having positive emotions. Conclusions: ESM was found to be helpful in identifying the nature and quality of social experiences of children with AS/HFA from their perspective.

Coughlin, S. S.; Whitehead, M.; Sheats, J. Q.; Mastromonico, J.; Hardy, D.; Smith, S. A. (2015): Smartphone Applications for Promoting Healthy Diet and Nutrition: A Literature Review. In: Jacobs journal of food and nutrition 2 (3), S. 21.

BACKGROUND: Rapid developments in technology have encouraged the use of smartphones in health promotion research and practice. Although many applications (apps) relating to diet and nutrition are available from major smartphone platforms, relatively few have been tested in research studies in order to determine their effectiveness in promoting health. METHODS: In this article, we summarize data on the use of smartphone applications for promoting healthy diet and nutrition based upon bibliographic searches in PubMed and CINAHL with relevant search terms pertaining to diet, nutrition, and weight loss through August 2015. RESULTS: A total of 193 articles were identified in the bibliographic searches. By screening abstracts or full-text articles, a total of three relevant qualitative studies and 9 randomized controlled trials were identified. In qualitative studies, participants preferred applications that were quick and easy to administer, and those that increase awareness of food intake and weight management. In randomized trials, the use of smartphone apps was associated with better dietary compliance for lower calorie, low fat, and high fiber foods, and higher physical activity levels (p=0.01-0.02) which resulted in more weight loss (p=0.042-<0.0001). DISCUSSION: Future studies should utilize randomized controlled trial research designs, larger sample sizes, and longer study periods to better establish the diet and nutrition intervention capabilities of smartphones. There is a need for culturally appropriate, tailored health messages to increase knowledge and awareness of health behaviors such as healthy eating. Smartphone apps are likely to be a useful and low-cost intervention for improving diet and nutrition and addressing obesity in the general population. Participants prefer applications that are quick and easy to administer and those that increase awareness of food intake and weight management.

Coulon, Sandra M.; Monroe, Courtney M.; West, Delia S. (2016): A Systematic, Multi-domain Review of Mobile Smartphone Apps for Evidence-Based Stress Management. In: American journal of preventive medicine. DOI: 10.1016/j.amepre.2016.01.026.

CONTEX: Chronic stress presents a growing, pervasive burden in healthcare, and mobile smartphone applications (apps) have the potential to deliver evidence-based stress management strategies. This review identified and evaluated stress management apps across domains of (1) evidence-based content; (2) transparency in app development; and (3) functionality of the app interface. EVIDENCE ACQUISITION: The iOS App Store was systematically searched. Apps with descriptions indicating that they targeted the intended audience and included evidence-related terminology, at least one evidence-based stress management strategy, and behavior change components were downloaded and evaluated by two independent raters across the three domains of evidence-based content, transparency, and functionality. EVIDENCE SYNTHESIS: A total of 902 apps were identified based on 21 searches. Of these, 60 met study criteria and were downloaded and evaluated between April and June 2015. Twenty (33%) ultimately did not deliver an evidence-based strategy. Of the delivered strategies, the most common were mindfulness and meditation (73%) and diaphragmatic breathing (25%). On average, apps addressed half of the transparency criteria, and nearly all (85%) were acceptable across usability criteria. A total of 32 apps included both evidence-based content and exhibited no problems with usability or functionality; apps affiliated with a non-profit, research-engaged institution comprised 31% of these. CONCLUSIONS: This review evaluated 60 iOS apps for stress management across domains of evidence-based content, transparency, and functionality; these apps have the potential to effectively supplement medical care. Findings further indicate that a comprehensive, multi-domain approach can distinguish apps that use evidence-based strategies from those that do not.

Cuba, Gyllensten I.; Bonomi, A. G.; Goode, K. M.; Reiter, H.; Habetha, J.; Amft, O.; Cleland, J. G. (2016): Early Indication of Decompensated Heart Failure in Patients on Home-Telemonitoring: A Comparison of Prediction Algorithms Based on Daily Weight and Noninvasive Transthoracic Bio-impedance. In: JMIR medical informatics 4 (1), S. e3. DOI: 10.2196/medinform.4842.

BACKGROUND: Heart Failure (HF) is a common reason for hospitalization. Admissions might be prevented by early detection of and intervention for decompensation. Conventionally, changes in weight, a possible measure of fluid accumulation, have been used to detect deterioration. Transthoracic impedance may be a more sensitive and accurate measure of fluid accumulation. OBJECTIVE: In this study, we review previously proposed predictive algorithms using body weight and noninvasive transthoracic bio-impedance (NITTI) to predict HF decompensations. METHODS: We monitored 91 patients with chronic HF for an average of 10 months using a weight scale and a wearable bio-impedance vest. Three algorithms were tested using either simple rule-of-thumb differences (RoT), moving averages (MACD), or cumulative sums (CUSUM). RESULTS: Algorithms using NITTI in the 2 weeks preceding decompensation predicted events (P<.001); however, using weight alone did not. Cross-validation showed that NITTI improved sensitivity of all algorithms tested and that trend algorithms provided the best performance for either measurement (Weight-MACD: 33%, NITTI-CUSUM: 60%) in contrast to the simpler rules-of-thumb (Weight-RoT: 20%, NITTI-RoT: 33%) as proposed in HF guidelines. CONCLUSIONS: NITTI measurements decrease before decompensations, and combined with trend algorithms, improve the detection of HF decompensation over current guideline rules; however, many alerts are not associated with clinically overt decompensation.

Cuesta-Vargas, Antonio I.; Roldan-Jimenez, Cristina (2016): Validity and reliability of arm abduction angle measured on smartphone: a cross-sectional study. In: BMC musculoskeletal disorders 17 (1), S. 93. DOI: 10.1186/s12891-016-0957-3.

BACKGROUND: Measuring range of movement is important in clinical shoulder assessment. Over the years, different techniques have been used to analyze upper limbs mobility. Smartphone image-based goniometer offers a noninvasive easy-to-use method of measuring arm abduction angle. However, the validity of this method has not been previously established. The purpose of this study was to investigate the validity and reliability of an Internet and image-based app (mROM) regarding arm abduction angle in both healthy subjects and patients suffering from shoulder damage. METHODS: Twenty three subjects with shoulder pathology (14 female, 9 male) and 14 healthy subjects (8 female, 6 male) were examined (37 shoulders). mROM app was used to measure arm abduction angle. Two examiners measured 37 shoulders on 3 separate occasions over 2 days: 2 measurements on the first day and a third one the following day. Descriptive statistics were calculated for descriptive and anthropometric variables, as well as for the first measure of arm abduction angle by photographs and inertial sensors. Reliability was investigated by intraclass correlation coefficients and p values, and validity by Pearson correlation and P. RESULTS: Intra-rater and inter-rater reliability were high (intraclass correlation coefficients 0.998 and 0.984 respectively) for the total sample, although, for the healthy group, intrareliability was lower and interreliability was no reliable. Measurements from photographs and intertial sensors were highly correlated (Pearson r = 0.964) for the total sample. However, it was no significant for the healthy group. CONCLUSION: Smartphone photographs are a reliable and valid method to measure arm abduction angle, supporting the use of photography obtained through app for measuring joint ROM. This method provides a convenient and precise tool in assessment of arm motion.

Culbert, K. M.; Lavender, J. M.; Crosby, R. D.; Wonderlich, S. A.; Engel, S. G.; Peterson, C. B. et al. (2016): Associations between negative affect and binge/purge behaviors in women with anorexia nervosa: Considering the role of negative urgency. In: Comprehensive psychiatry 66, S. 104–112. DOI: 10.1016/j.comppsych.2016.01.010.

OBJECTIVE: Evidence implicates negative affect in the occurrence of binge/purge behaviors, although the extent to which theoretically relevant individual difference variables may impact this association remains unclear. Negative urgency, the dispositional tendency to engage in rash action when experiencing negative affect, is a unique facet of impulsivity that may play a key role. Moreover, it was hypothesized that women with anorexia nervosa (AN) who are higher on measures of negative urgency, relative to those lower on negative urgency, would exhibit: 1) greater binge eating and purging frequencies on high negative affect days, and 2) a greater change in negative affect prior to and following binge eating and purging episodes. METHOD: Women with AN (n=82) completed a self-report measure of negative urgency and a 2-week ecological momentary assessment protocol in which they recorded binge eating, purging, and negative affect ratings. RESULTS: Women with higher levels of negative urgency exhibited a greater frequency of binge eating and purging; however, in comparison to women low on negative urgency, they: 1) were more likely to binge eat on days corresponding with low-to-moderate negative affect (similar rates of binge eating were observed on high negative affect days), and 2) displayed substantially elevated levels of negative affect across time, and thus, smaller degrees of change in negative affect prior to and following binge eating and purging episodes. DISCUSSION: Negative urgency underlies individual differences in the daily experience of negative affect. Women with AN who are high on negative urgency may have an increased propensity for binge eating and purging via a relatively persistent and heightened state of negative emotions.

Darby, A.; Strum, M. W.; Holmes, E.; Gatwood, J. (2016): A Review of Nutritional Tracking Mobile Applications for Diabetes Patient Use. In: Diabetes technology & therapeutics 18 (3), S. 200–212. DOI: 10.1089/dia.2015.0299.

Diabetes, a prevalent disease in the United States, is greatly impacted by lifestyle choices, notably nutrition. The goal of this research was to determine which of the nutritional tracking applications (apps) available for Apple (Cupertino, CA) iOS, Android((R)) (Google, Mountain View, CA), and Windows (Microsoft, Redmond, WA) platforms should be a first recommendation to diabetes patients searching for a smartphone app to aid in dietary logging and, for some apps, other varying lifestyle and health data. This project did so by identifying the smartphone apps available on the iTunes((R)) (Apple), Google Play, and Microsoft stores that have nutritional tracking capabilities and are of potential benefit to a patient with diabetes based on certain criteria. Each of the individual apps was then evaluated to determine which would be of most benefit to a diabetes patient. The apps were assessed based on several parameters, such as their food databases, logging options, additional tracking options, interoperability with other devices and apps, and diabetes-specific resources. This information was then compiled and evaluated to determine which apps would be of most benefit for diabetes patients. This research provides valuable information for both patients and healthcare providers because the results of this study can be used as a reference for practitioners wishing to make app recommendations for diabetes patients who are implementing lifestyle change as an aspect of therapy.

Davidson, C. L.; Anestis, M. D.; Gutierrez, P. M. (2016): Ecological Momentary Assessment is a Neglected Methodology in Suicidology. In: Archives of suicide research : official journal of the International Academy for Suicide Research, S. 1–11. DOI: 10.1080/13811118.2015.1004482.

Ecological momentary assessment (EMA) is a group of research methods that collect data frequently, in many contexts, and in real-world settings. EMA has been fairly neglected in suicidology. The current article provides an overview of EMA for suicidologists including definitions, data collection considerations, and different sampling strategies. Next, the benefits of EMA in suicidology (i.e., reduced recall bias, accurate tracking of fluctuating variables, testing assumptions of theories, use in interventions), participant safety considerations, and examples of published research that investigate self-directed violence variables using EMA are discussed. The article concludes with a summary and suggested directions for EMA research in suicidology with the particular aim to spur the increased use of this methodology among suicidologists.

Depp, C. A.; Moore, R. C.; Perivoliotis, D.; Holden, J. L.; Swendsen, J.; Granholm, E. L. (2016): Social behavior, interaction appraisals, and suicidal ideation in schizophrenia: The dangers of being alone. In: Schizophrenia research 172 (1-3), S. 195–200. DOI: 10.1016/j.schres.2016.02.028.

Despite the increasing attention to social appraisals in suicide risk, the interpersonal correlates of suicidal thoughts and behavior in schizophrenia are not well understood. Ecological momentary assessment could reveal whether dysfunctional social appraisals and behavior are evident in people with schizophrenia with suicidal ideation. A total of 93 outpatients with diagnoses of schizophrenia with (n=18, 19%) and without (N=75; 81%) suicidal ideation participated in one week of intensive daily monitoring via mobile devices, generating real-time reports on the quantity of social interactions and appraisals about them, as well as information concerning concurrent affect and symptoms. The presence of suicidal ideation was not associated with the quantity of social interactions or time spent alone, but it was associated with the anticipation of being alone as well as greater negative and lower positive affect when alone. Despite this aversive experience of being alone, people with suicidal ideation reported negative appraisals about the value of recent and potential social interactions. These findings suggest that suicidal ideation in schizophrenia may not be associated with the quantity of social interactions, but with negative expectations about the quality of social interactions coupled with an aversive experience of being alone. Cognitive therapy interventions that address negative expectations and pleasure about social interactions, especially when alone, may reduce suicidal ideation.

Depp, Colin A.; Moore, Raeanne C.; Dev, Sheena I.; Mausbach, Brent T.; Eyler, Lisa T.; Granholm, Eric L. (2016): The temporal course and clinical correlates of subjective impulsivity in bipolar disorder as revealed through ecological momentary assessment. In: Journal of affective disorders 193, S. 145–150. DOI: 10.1016/j.jad.2015.12.016.

BACKGROUND: Impulsivity is frequently linked with bipolar disorder and is associated with mania and negative outcomes. The temporal dynamics of subjective impulsivity are unclear, in particular whether impulsivity precedes or follows changes in positive or negative affect. METHODS: A total of 41 outpatients with bipolar disorder (I or II) were provided with mobile devices for 11 weeks and completed twice-daily surveys about affective states and subjective impulsivity. We examined the association between aggregate subjective impulsivity with baseline global cognitive function, suicide risk ratings, and medication adherence, as well as concurrent and lagged associations with momentary positive and negative affect ratings. RESULTS: A total of 2902 ratings were available across study subjects. Higher aggregate mean ratings of impulsivity were associated with worse baseline global cognitive function, prior suicide attempts, and self-reported problems with medication adherence, as well as more severe manic (but not depressive) symptoms. Time-lagged models indicated that greater negative affect, but not positive affect, predicted subsequent increases in subjective impulsivity, which, in turn, predicted diminished positive affect. LIMITATIONS: Other measures of impulsivity with which to validate subjective ratings were unavailable and the sample was restricted to generally clinically stable outpatients. CONCLUSIONS: Subjective impulsivity as measured by daily monitoring was associated with worse cognitive function and self-rated medication adherence, and higher suicide risk ratings. Impulsivity may be a maladaptive strategy to regulate negative affect in bipolar disorder.

Droit-Volet, S.; Wearden, J. (2016): Passage of Time Judgments Are Not Duration Judgments: Evidence from a Study Using Experience Sampling Methodology. In: Frontiers in psychology 7, S. 176. DOI: 10.3389/fpsyg.2016.00176.

This study examined relations between passage of time judgments and duration judgments (DJs) in everyday life, in young and elderly people, with an Experience Sampling Method. The DJs were assessed by verbal estimation and interval production measures. The results showed no difference between young and elderly people in judgments of rate of passage of time, a result contrary to the conventional idea that time passes more quickly as we get older. There were also no significant relation between the judgment of passage of time and the judgments of durations. In addition, the significant predictors of individual differences in the judgment of passage of time (emotion states and focus of attention on the current activity) were not predictors of judgment of durations. In sum, passages of time judgments are not related to DJs.

Dunkl, A.; Jimenez, P. (2016): Using smartphone-based applications (apps) in workplace health promotion: The opinion of German and Austrian leaders. In: Health informatics journal. DOI: 10.1177/1460458215623077.

Reaching the actual target group for a web-based health promotion project turns out to be a difficult task. In this article, individual and organizational factors which can influence the decision of using apps in workplace health promotion are analyzed. Furthermore, we analyzed the opinion about feedback possibilities of apps in workplace health promotion. A study with 438 leaders was conducted, as leaders can be seen as a key factor in the success of health promotion projects. The results showed that younger leaders and leaders with a more positive attitude toward workplace health promotion are more likely to use an app. Furthermore, leaders with a positive attitude are more interested in expert-feedback than in instant feedback received from an app.

Dunton, Genevieve; Dzubur, Eldin; Li, Marilyn; Huh, Jimi; Intille, Stephen; McConnell, Rob (2016): Momentary assessment of psychosocial stressors, context, and asthma symptoms in Hispanic adolescents. In: Behavior Modification 40 (1-2), S. 257–280. DOI: 10.1177/0145445515608145.

The current study used a novel real-time data capture strategy, ecological momentary assessment (EMA), to examine whether within-day variability in stress and context leads to exacerbations in asthma symptomatology in the everyday lives of ethnic minority adolescents. Low-income Hispanic adolescents (N = 20; 7th-12th grade; 54% male) with chronic asthma completed 7 days of EMA on smartphones, with an average of five assessments per day during non-school time. EMA surveys queried about where (e.g., home, outdoors) and with whom (e.g., alone, with friends) participants were at the time of the prompt. EMA surveys also assessed over the past few hours whether participants had experienced specific stressors (e.g., being teased, arguing with anyone), asthma symptoms (e.g., wheezing, coughing), or used an asthma inhaler. Multilevel models tested the independent relations of specific stressors and context to subsequent asthma symptoms adjusting for age, gender, and chronological day in the study. Being outdoors, experiencing disagreements with parents, teasing, and arguing were associated with more severe self-reported asthma symptoms in the next few hours (ps < .05). Being alone and having too much to do were unrelated to the experience of subsequent self-reported asthma symptoms. Using a novel real-time data capture strategy, results provide preliminary evidence that being outdoors and experiencing social stressors may induce asthma symptoms in low-income Hispanic children and adolescents with chronic asthma. The results of this preliminary study can serve as a basis for larger epidemiological and intervention studies.

Ellison, Jo M.; Wonderlich, Stephen A.; Engel, Scott G. (2016): Application of modern technology in eating disorder assessment and intervention. In: B. Timothy Walsh, Evelyn Attia, Deborah R. Glasofer, Robyn Sysko, B. Timothy (Ed) Walsh, Evelyn (Ed) Attia et al. (Hg.): Handbook of assessment and treatment of eating disorders. Arlington, VA, US: American Psychiatric Publishing, Inc, S. 231–255.

The purpose of this chapter is to provide clinicians with information about the practical application of technology in both the assessment and treatment of eating disorders. Several areas of recent technological development and empirical study fall under this large umbrella; however, our focus in this chapter is on those areas most relevant to clinical practice with individuals with eating disorders. We discuss ecological momentary assessment (EMA) in terms of its use in the scientific study of these conditions and as a possible clinical tool for data collection. We review ecological momentary intervention (EMI), another portable strategy that has emerged in conjunction with EMA and that can be useful in delivering interventions to individuals as they go about daily routines. We then discuss the utility and effectiveness of Web-based and telemedicine treatments. Finally, we offer a practical examination of how clinicians can integrate portable technology into practice.

Engel, S. G.; Crosby, R. D.; Thomas, G.; Bond, D.; Lavender, J. M.; Mason, T. et al. (2016): Ecological Momentary Assessment in Eating Disorder and Obesity Research: a Review of the Recent Literature. In: Current psychiatry reports 18 (4), S. 37. DOI: 10.1007/s11920-016-0672-7.

Our current understanding of the etiology and maintenance of eating disorders and obesity continues to be far from complete. Similarly, our understanding of determinants of both successful and unsuccessful weight loss surgery is also quite limited. While a number of research methodologies have been applied to these areas, one methodology that has recently seen a rise in popularity is the use of ecological momentary assessment (EMA). EMA allows one to study a variety of variables of interest in the natural environment. The study of eating disorders, obesity, and bariatric surgery has all been conducted using EMA recently. The current study is a review of these areas and summarizes the recent literature (past 3 years) in eating disorders, obesity, and bariatric surgery using EMA methodology.

Exelmans, Liese; van Den Bulck, Jan (2016): Bedtime mobile phone use and sleep in adults. In: Social Science & Medicine 148, S. 93–101. DOI: 10.1016/j.socscimed.2015.11.037.

Background: The few studies that have investigated the relationship between mobile phone use and sleep have mainly been conducted among children and adolescents. In adults, very little is known about mobile phone usage in bed our after lights out. This cross-sectional study set out to examine the association between bedtime mobile phone use and sleep among adults. Methods: A sample of 844 Flemish adults (18–94 years old) participated in a survey about electronic media use and sleep habits. Self-reported sleep quality, daytime fatigue and insomnia were measured using the Pittsburgh Sleep Quality Index (PSQI), the Fatigue Assessment Scale (FAS) and the Bergen Insomnia Scale (BIS), respectively. Data were analyzed using hierarchical and multinomial regression analyses. Results: Half of the respondents owned a smartphone, and six out of ten took their mobile phone with them to the bedroom. Sending/receiving text messages and/or phone calls after lights out significantly predicted respondents’ scores on the PSQI, particularly longer sleep latency, worse sleep efficiency, more sleep disturbance and more daytime dysfunction. Bedtime mobile phone use predicted respondents’ later self-reported rise time, higher insomnia score and increased fatigue. Age significantly moderated the relationship between bedtime mobile phone use and fatigue, rise time, and sleep duration. An increase in bedtime mobile phone use was associated with more fatigue and later rise times among younger respondents (≤ 41.5 years old and ≤ 40.8 years old respectively); but it was related to an earlier rise time and shorter sleep duration among older respondents (≥ 60.15 years old and ≥ 66.4 years old respectively). Conclusion: Findings suggest that bedtime mobile phone use is negatively related to sleep outcomes in adults, too. It warrants continued scholarly attention as the functionalities of mobile phones evolve rapidly and exponentially.

Faedda, Gianni L.; Ohashi, Kyoko; Hernandez, Mariely; McGreenery, Cynthia E.; Grant, Marie C.; Baroni, Argelinda et al. (2016): Actigraph measures discriminate pediatric bipolar disorder from attention-deficit/hyperactivity disorder and typically developing controls. In: Journal of child psychology and psychiatry, and allied disciplines. DOI: 10.1111/jcpp.12520.

BACKGROUND: Distinguishing pediatric bipolar disorder (BD) from attention-deficit hyperactivity disorder (ADHD) can be challenging. Hyperactivity is a core feature of both disorders, but severely disturbed sleep and circadian dysregulation are more characteristic of BD, at least in adults. We tested the hypothesis that objective measures of activity, sleep, and circadian rhythms would help differentiate pediatric subjects with BD from ADHD and typically developing controls. METHODS: Unmedicated youths (N = 155, 97 males, age 5-18) were diagnosed using DSM-IV criteria with Kiddie-SADS PL/E. BD youths (n = 48) were compared to typically developing controls (n = 42) and children with ADHD (n = 44) or ADHD plus comorbid depressive disorders (n = 21). Three-to-five days of minute-to-minute belt-worn actigraph data (Ambulatory Monitoring Inc.), collected during the school week, were processed to yield 28 metrics per subject, and assessed for group differences with analysis of covariance. Cross-validated machine learning algorithms were used to determine the predictive accuracy of a four-parameter model, with measures reflecting sleep, hyperactivity, and circadian dysregulation, plus Indic’s bipolar vulnerability index (VI). RESULTS: There were prominent group differences in several activity measures, notably mean 5 lowest hours of activity, skewness of diurnal activity, relative circadian amplitude, and VI. A predictive support vector machine model discriminated bipolar from non-bipolar with mean accuracy of 83.1 +/- 5.4%, ROC area of 0.781 +/- 0.071, kappa of 0.587 +/- 0.136, specificity of 91.7 +/- 5.3%, and sensitivity of 64.4 +/- 13.6%. CONCLUSIONS: Objective measures of sleep, circadian rhythmicity, and hyperactivity were abnormal in BD. Wearable sensor technology may provide bio-behavioral markers that can help differentiate children with BD from ADHD and healthy controls.

Ferguson, S. G.; Shiffman, S.; Dunbar, M.; Schuz, N. (2016): Higher stimulus control is associated with less cigarette intake in daily smokers. In: Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors 30 (2), S. 229–237. DOI: 10.1037/adb0000149.

It is well established that environmental stimuli influence smoking in light, and to a lesser degree, heavy smokers. A 2-factor model of dependence suggests that the influence of stimulus control is masked among heavier smokers who primarily smoke for nicotine maintenance. The current study aimed to assess the influence of stimulus control across a range of moderate to heavy daily smokers. Furthermore, as local tobacco control policies may change the role of stimulus control, the study aimed to replicate previous U.S. findings on stimulus control in an Australian setting marked by strong tobacco control policies. In 2 Ecological Momentary Assessment studies, 420 participants monitored antecedents of smoking and nonsmoking situations. In a set of idiographic logistic regression analyses, situational antecedents were used to predict smoking occasions within each individual’s data. Linear regression analysis was used to test for the association between stimulus control and smoking rate, and to test for differences between the 2 samples. Daily smokers’ smoking was under considerable stimulus control, which was weaker at higher smoking rates. Overall, there was greater stimulus control in the Australian sample. Daily smokers also experience a degree of stimulus control, which is less influential in heavier smokers.

Fischer, Susanne; Doerr, Johanna M.; Strahler, Jana; Mewes, Ricarda; Thieme, Kati; Nater, Urs M. (2016): Stress exacerbates pain in the everyday lives of women with fibromyalgia syndrome—the role of cortisol and alpha-amylase. In: Psychoneuroendocrinology 63, S. 68–77. DOI: 10.1016/j.psyneuen.2015.09.018.

Objective: Although fibromyalgia syndrome (FMS) is a chronic condition, its cardinal symptom pain is known to fluctuate over the day. Stress has often been claimed to exacerbate pain; however, there is barely any evidence on whether or not this is true on a day-to-day basis (and, alternatively, on whether pain leads to increased stress levels). Using an ecologically valid measurement design, we tested whether and how stress and pain are intertwined in participants with FMS. We additionally examined the role of the two major stress-responsive systems, the hypothalamic-pituitary-adrenal axis and the autonomic nervous system, as potential mediators of this relationship. Methods: An ambulatory assessment study was conducted over the course of 14 days. On each day, 32 females with FMS provided six diary entries on momentary stress and pain levels. Saliva samples were collected at the same time points to determine cortisol and alpha-amylase as indicators of stress-responsive systems. Results: Higher stress at a given measurement time point was associated with higher reported pain levels at the subsequent time point (UC = 1.47, p < 0.001), but not vice versa (UC < 0.01, p = 0.179). The stress-pain relationship was neither mediated by momentary cortisol nor by alpha-amylase; however, momentary cortisol was independently associated with momentary pain (UC = 0.27, p = 0.009). Conclusion: Stress seems to be a powerful exacerbating factor for pain as experienced by patients with FMS in their everyday lives. Cortisol may be involved in the diurnal fluctuation of pain levels in patients with FMS. Future studies should identify relevant daily stressors in persons with FMS and scrutinize the mechanisms underlying the cortisol-pain relationship.

Franklin, Michael S.; Smallwood, Jonathan; Zedelius, Claire M.; Broadway, James M.; Schooler, Jonathan W. (2016): Unaware yet reliant on attention: Experience sampling reveals that mind-wandering impedes implicit learning. In: Psychonomic Bulletin & Review 23 (1), S. 223–229. DOI: 10.3758/s13423-015-0885-5.

Although implicit learning has been widely studied, controversy remains regarding its reliance on attentional resources. A central issue in this controversy is the question of how best to manipulate attention. The usual approach of comparing implicit learning in a serial reaction time (SRT) task under single- versus dual-task conditions is known to be problematic, because the secondary task may not only divert attention away from the primary task, but also interfere with the implicit-learning process itself. To address this confound, in the present study we used an experience-sampling instead of a dual-task approach. We assessed lapses of attention (mind-wandering) with experience-sampling thought probes during a standard implicit-learning SRT task. The results revealed a significant negative correlation between mind-wandering and implicit learning. Thus, greater task focus was associated with improved implicit sequence learning. This result suggests that, at least in the context of this SRT task, optimal implicit learning relies on attention.

Gidlow, Christopher J.; Randall, Jason; Gillman, Jamie; Silk, Steven; Jones, Marc V. (2016): Hair cortisol and self-reported stress in healthy, working adults. In: Psychoneuroendocrinology 63, S. 163–169. DOI: 10.1016/j.psyneuen.2015.09.022.

Chronic stress can be important in the pathology of chronic disease. Hair cortisol concentrations (HCC) are proposed to reflect long term cortisol secretion from exposure to stress. To date, inconsistencies in the relationship between HCC and self-reported stress have been attributed to variation and limitations of perceived stress measurement. We report data from employees of two large public sector worksites (n = 132). Socio-demographic, health, lifestyle, perceived stress scale (PSS), and work-related effort reward imbalance (ERI) were collected at baseline. Participants were asked to respond to mobile text messages every two days, asking them to report current stress levels (Ecological momentary assessment, EMA), and mean stress was determined overall, during work hours, and out of work hours. At 12 weeks, the appraisal of stressful life events scale (ALES) was completed and 3cm scalp hair samples were taken, from which HCC was determined (to reflect cortisol secretion over the past 12 weeks). Mean response rate to EMA was 81.9 ± 14.9%. Associations between HCC and the various self-reported stress measures (adjusted for use of hair dye) were weak (all < .3). We observed significant associations with HCC for EMA measured stress responses received out of work hours (ρ = .196, p = .013) and ALES Loss subscale (ρ = .241, p = .003), and two individual items from ERI (relating to future work situation). In regression analysis adjusting for other possible confounders, only the HCC-ALES Loss association remained significant (p = .011). Overall, our study confirms that EMA provides a useful measurement tool that can gather perceived stress measures in real-time. But, there was no relationship between self-reported stress collected in this way, and HCC. The modest association between HCC and stress appraisal does however, provide some evidence for the role of cognitive processes in chronic stress.

Glaros, A. G.; Marszalek, J. M.; Williams, K. B. (2016): Longitudinal Multilevel Modeling of Facial Pain, Muscle Tension, and Stress. In: Journal of dental research 95 (4), S. 416–422. DOI: 10.1177/0022034515625216.

The role of masticatory muscle activation on pain in temporomandibular muscle and joint disorders (TMJD) is controversial. This single-group, prospective panel study examined the relationships among masticatory muscle tension, emotional distress, and TMJD pain in a sample of 7,023 observations obtained from 171 individuals using longitudinal multilevel modeling. Three main hypotheses were tested. The first posited that emotional distress and muscle tension directly influenced pain (hypothesis 1a: Distress –> TMJD Pain; hypothesis 1b: Muscle Tension –> TMJD Pain). The second posited that emotional distress directly influenced muscle tension (Distress –> Muscle Tension), and the third posited that the effect of emotional distress on pain was mediated by muscle tension (Distress –> Muscle Tension –> TMJD pain). We also examined the fit of the data to possible alternative models. All the data used in this study were collected via an experience sampling methodology. The fit of the preferred models was better than that of the alternative models, with the preferred models explaining large proportions of the data, especially for level 2 variance (hypothesis 1a = 41% variance; hypothesis 1b = 69% variance; hypothesis 2 = 48% variance). In the mediation model, the addition of muscle tension to the model reduced the impact of emotional distress. The findings support a causal role for masticatory muscle tension in TMJD pain. Clinically, the results suggest that addressing tension and other oral parafunctions in those diagnosed with TMJDs should be an important part of the conservative, noninvasive care of individuals diagnosed with the myofascial pain or arthralgia of TMJD.

Goodwin, John; Cummins, John; Behan, Laura; O’Brien, Sinead M. (2016): Development of a mental health smartphone app: perspectives of mental health service users. In: Journal of mental health (Abingdon, England), S. 1–7. DOI: 10.3109/09638237.2015.1124392.

BACKGROUND: Current mental health policy emphasises the importance of service user involvement in the delivery of care. Information Technology can have an effect on quality and efficiency of care. AIMS: The aim of this study is to gain the viewpoint of service users from a local mental health service in developing a mental health app. METHOD: A qualitative descriptive approach was used. Eight volunteers aged 18-49 years were interviewed with the aid of a semi-structured questionnaire. RESULTS: Interviewees defined a good app by its ease of use. Common themes included availability of contact information, identifying triggers, the ability to rate mood/anxiety levels on a scale, guided relaxation techniques, and the option to personalise the app. The researchers will aim to produce an app that is easily accessible, highly personalisable and will include functions highlighted as important (i.e. contact information, etc.). CONCLUSIONS: This research will assist in the development of an easy-to-use app that could increase access to services, and allow service users to take an active role in their care. In previous studies, apps were developed without the involvement of service users. This study recognises the important role of service users in this area.

Gould, Todd D.; Hashimoto, Ryota; Schulze, Thomas G. (2016): Going longitudinal in biological psychiatric research: All things considered. In: Neuroscience Research 102, S. 1–3. DOI: 10.1016/j.neures.2015.12.012.

The editorial discusses the current issue of Neuroscience Research. The issue review longitudinal studies for the major psychiatric illnesses, SZ, BD, and MDD, arguing for the general importance of such studies, and specific significance to nosology, treatment, and neurobiology. Another paper take a practical approach, arguing for in-field, ambulatory assessment as a means revolutionize the long-term gathering of data, and incorporation findings with genetic investigations. Next article discuss the reality that an information technology structure is required to incorporate such large volumes of data, often originating from multiple centers simultaneously. Some article discuss the approach of multi-modal imaging, address a specific factor that may play a role in psychiatric disease progression, fatty acid binding proteins, the importance of epigenetic factors in the progression of illness and discuss the role of model animals in longitudinal studies of psychiatric illness.

Green, Kimberly T.; Dennis, Paul A.; Neal, Lydia C.; Hobkirk, Andrea L.; Hicks, Terrell A.; Watkins, Lana L. et al. (2016): Exploring the relationship between posttraumatic stress disorder symptoms and momentary heart rate variability. In: Journal of psychosomatic research 82, S. 31–34. DOI: 10.1016/j.jpsychores.2016.01.003.

OBJECTIVE: Exposure to trauma-related cues has been associated with a prolonged decrease in heart rate variability (HRV) under laboratory conditions, however the relationship between PTSD symptoms and HRV has not been evaluated during everyday life. The present study sought to determine whether Posttraumatic Stress Disorder (PTSD) symptoms reported during everyday life were related to reduced HRV. METHODOLOGY: Eighty-three young adults with PTSD underwent 24-hour Holter monitoring, during which PTSD symptoms were measured using ecological momentary assessment (EMA). Multilevel modeling was used to examine the association between PTSD symptom severity and low frequency (LF) and high frequency (HF) HRV. RESULTS: PTSD symptoms were associated with reductions in LF HRV, independently of age and activity level. There was no significant association between PTSD symptom levels and HF HRV. CONCLUSIONS: These results indicate that an association between momentary PTSD symptom severity and reduced LF HRV is significant and observable in young adults with PTSD. Findings highlight the need for cardiovascular screening in young adults with PTSD and early interventions that target physiological reactivity in PTSD.

Guidetti, L.; Placentino, U.; Baldari, C. (2016): Reliability and Criterion Validity of the Smartphone Inclinometer Application to Quantify Cervical Spine Mobility. In: Clinical spine surgery. DOI: 10.1097/BSD.0000000000000364.

STUDY DESIGN: In this observational study, we compare fluid inclinometer and smartphone measures to analyze active cervical range of motion (ACROM) in healthy individuals. OBJECTIVE: The purpose of this study was to investigate the reliability and the criterion validity of a smartphone application to analyze head movements. SUMMARY OF BACKGROUND DATA: Recent studies on the reliability and the validity of customized smartphone applications to measure ACROM show good results for frontal and lateral planes’ movement analysis, but poor results for the transverse plane. This can be due to the surrounding magnetic fields that affect the compass application used during head rotation valuation. METHODS: Twenty-three individuals were asked to perform neck maximal (end-range) movements (frontal flex-extension and left-right side flexion in the sitting position, left-right rotation in the prone position). Two separate examiners took all ACROM measures and were assigned to each device (iPhone 5c and the inclinometer) contemporary for each individual. RESULTS: All measurements were taken twice to assess the intraobserver reliability. Interobserver and intraobserver reliabilities were evaluated using the intraclass correlation coefficient (ICC). The criterion validity between the 2 instruments was also assessed in terms of the ICC. The procedures used in this investigation for measuring ACROM yielded good validity (Pearson r>/=0.99 and ICC>/=0.99) between the 2 instruments for all movements. The Bland and Altman’s 95% LoA ranged from -1.8 to 1.15 degrees. Percentage error values ranged from 1% to 3%. The intrarater and the interrater reliabilities were good (ICC>/=0.9) for both instruments in all movements including the rotation movements (ICC>0.95). The minimal detectable change (MDC95) ranged from 4 to 8 degrees. CONCLUSIONS: This study confirms that the tested smartphone is valid and reliable to measure ACROM on the frontal and the sagittal planes; furthermore, it also demonstrates its usefulness for rotation movement analysis, using the inclinometric application.

He, F.; Hensel, D. J.; Harezlak, J.; Fortenberry, J. D. (2016): Condom Use as a Function of Number of Coital Events in New Relationships. In: Sexually transmitted diseases 43 (2), S. 67–70. DOI: 10.1097/OLQ.0000000000000390.

STUDY OBJECTIVE: To assess condom use as a function of number of coital events in newly formed sexual relationships. METHODS: Participants who reported at least one new partner during the 12-week study interval (n = 115; ages 18-29 years; 48% women; 90% African American) completed weekly sexually transmitted infections testing and 3 times daily electronic diary collection assessing individual and partner-specific affect, daily activities, sexual behavior, and condom use. We analyzed event-level condom use percentage and participant-level behavior response effects. generalized additive mixed models were used to estimate condom use probability accounting for within-partner and within-participant correlations via random effects. RESULTS: The average condom use probability at the first coital event in new relationships was 55% for men and 36% for women. Analyses showed that smooth shapes of estimated condom use probabilities were similar for both sexes and were fitted using generalized additive mixed models. Relatively higher condom use percentage was followed by a sharp decline during the first 9 coital events decreasing to 16% for men and 8% for women. More rapid decline in condom use among women was highly associated with higher levels of relationship and sexual satisfaction. CONCLUSIONS: The likelihood of condom use declines sharply for both men and women after the early accrual experience with a partner. Relationship and sexual satisfaction also influence declines in condom use, especially among women.

Heldberg, Beeke E.; Kautz, Thomas; Leutheuser, Heike; Hopfengartner, Rudiger; Kasper, Burkhard S.; Eskofier, Bjoern M. (2015): Using wearable sensors for semiology-independent seizure detection – towards ambulatory monitoring of epilepsy. In: Conference proceedings : … Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference 2015, S. 5593–5596. DOI: 10.1109/EMBC.2015.7319660.

Epilepsy is a disease of the central nervous system. Nearly 70% of people with epilepsy respond to a proper treatment, but for a successful therapy of epilepsy, physicians need to know if and when seizures occur. The gold standard diagnosis tool video-electroencephalography (vEEG) requires patients to stay at hospital for several days. A wearable sensor system, e.g. a wristband, serving as diagnostic tool or event monitor, would allow unobtrusive ambulatory long-term monitoring while reducing costs. Previous studies showed that seizures with motor symptoms such as generalized tonic-clonic seizures can be detected by measuring the electrodermal activity (EDA) and motion measuring acceleration (ACC). In this study, EDA and ACC from 8 patients were analyzed. In extension to previous studies, different types of seizures, including seizures without motor activity, were taken into account. A hierarchical classification approach was implemented in order to detect different types of epileptic seizures using data from wearable sensors. Using a k-nearest neighbor (kNN) classifier an overall sensitivity of 89.1% and an overall specificity of 93.1% were achieved, for seizures without motor activity the sensitivity was 97.1% and the specificity was 92.9%. The presented method is a first step towards a reliable ambulatory monitoring system for epileptic seizures with and without motor activity.

Hepp, Johanna; Carpenter, Ryan W.; Lane, Sean P.; Trull, Timothy J. (2016): Momentary Symptoms of Borderline Personality Disorder as a Product of Trait Personality and Social Context. In: Personality Disorders: Theory, Research, and Treatment. DOI: 10.1037/per0000175.

Past studies identify Five Factor Model (FFM) domains that are characteristic of borderline personality disorder (BPD), including those associated with specific BPD symptoms, at a between-person level. The present study replicated these between-person associations and extended past research by assessing whether the FFM explains within-person variance in the manifestation of momentary BPD symptoms in the presence or absence of close social contact (CSC). We measured CSC and the BPD core symptoms negative affectivity, impulsivity, and interpersonal problems in 74 BPD patients and in a clinical control group of 40 depressed patients over the course of 28 days, 6 times a day. The FFM domains showed specificity in predicting momentary BPD symptoms and interacted with CSC in doing so. In particular, for BPD individuals only, momentary impulsivity and interpersonal problems were associated with higher neuroticism and extraversion and lower agreeableness, and these associations were especially strong in situations involving CSC. Negative affectivity was predicted by neuroticism for both groups of individuals, and this association was generally unaffected by CSC. Overall, experiencing CSC was positively associated with momentary BPD symptoms. Thus, both the FFM and CSC were associated with BPD patients’ experience of symptoms in everyday life. Furthermore, specific FFM trait domains were particularly impactful in contexts where BPD symptoms are more likely to be manifested, providing further evidence that person-by-situation interactions are important for understanding BPD symptoms in the moment.

Hoffmann, Ferdinand; Banzhaf, Christian; Kanske, Philipp; Bermpohl, Felix; Singer, Tania (2016): Where the depressed mind wanders: Self-generated thought patterns as assessed through experience sampling as a state marker of depression. In: Journal of affective disorders 198, S. 127–134. DOI: 10.1016/j.jad.2016.03.005.

BACKGROUND: Self-generated thoughts (SGTs), such as during mind wandering, occupy much of our waking life. Individuals with Major Depressive Disorder (MDD) are less in the “here and now” and prone to rumination. Few studies have looked at SGTs in depression using experience sampling methods and no study has so far investigated the specific contents of depressive SGTs and how they vary from one time point to another. METHODS: MDD patients (n=25) and matched healthy controls (n=26) performed an established mind wandering task, involving non-demanding number discriminations. Intermittent probe questions ask for participants’ current SGTs, that is, how off-task the thoughts are, how positive or negative, self- or other-related, and past- or future-oriented. RESULTS: Multi-level modelling revealed that MDD patients engaged in more mind wandering than healthy controls. Their SGTs were predominantly negative and less positive, more self-related and past-oriented. Strongest predictor of depressive SGT was the decreased positive valence of thoughts. MDD patients’ future and past-oriented thoughts were particularly more negative compared to healthy controls. Within MDD patients, the less positively valenced thoughts they had and the less variable these thoughts were, the more depressive symptoms they showed. LIMITATION: No other measures of rumination and worry were used. CONCLUSION: MDD patients show a very specific SGT pattern, possibly reflecting ruminative and anxious thoughts. This SGT pattern in depression might represent a useful state marker and even constitute an etiological factor of this debilitating disease, considering the importance of current SGT on and individual’s cognitive processes and affective states.

Houben, Marlies; Bohus, Martin; Santangelo, Philip S.; Ebner-Priemer, Ulrich; Trull, Timothy J.; Kuppens, Peter (2016): The specificity of emotional switching in borderline personality disorder in comparison to other clinical groups. In: Personality disorders 7 (2), S. 198–204. DOI: 10.1037/per0000172.

In an attempt to better understand the nature of emotion dysregulation in the daily lives of persons with a borderline personality disorder (BPD), Houben et al. (2016) recently identified emotional switching, which refers to the tendency to make large changes between positive and negative emotional states over time, as a possible defining characteristic of the emotion dynamics observed in BPD. The goal of this study was to examine the specificity of these previous findings in 2 samples by comparing BPD patients (N = 43 in sample 1; N = 81 in sample 2) to patients with bulimia nervosa (N = 20), posttraumatic stress disorder (N = 28), or healthy controls (N = 28) in sample 1, and to patients with depressive disorder (N = 50) in sample 2, with respect to measures of emotional switching. Analyses of these 2 experience sampling datasets revealed that contrary to expectations, BPD patients did not differ from the clinical groups regarding their mere tendency to switch between positive and negative emotional states on consecutive moments over time and regarding the magnitude of such changes between positive and negative emotional states over time. However, all clinical groups did differ from healthy controls regarding all switch measures in dataset 1. These results indicate that emotional switching, similar to other more traditional indicators of overall changes in emotional intensity in daily life, might reflect a feature of emotional responding characterizing a range of disorders with mood disturbances. (PsycINFO Database Record

Houben, Marlies; Vansteelandt, Kristof; Claes, Laurence; Sienaert, Pascal; Berens, Ann; Sleuwaegen, Ellen; Kuppens, Peter (2016): Emotional switching in borderline personality disorder: A daily life study. In: Personality Disorders: Theory, Research, and Treatment 7 (1), S. 50–60. DOI: 10.1037/per0000126.

Despite large efforts to understand emotional instability in borderline personality disorder (BPD), it is still unclear exactly how this is manifested in the daily lives of people suffering from the disorder. Building on theoretical and clinical observations of BPD, we propose that the emotional instability in BPD particularly consists of the occurrence of strong changes between positive and negative emotional states from 1 moment to the next, labeled emotional switching. We tested this proposal by means of an experience sampling study in which 30 BPD patients and 28 healthy controls reported in their daily lives the level of pleasantness/unpleasantness of their emotional states 10 times a day for 8 consecutive days using handheld palmtops. Results showed that although BPD patients did not differ from healthy controls regarding their overall tendency to switch from a positive to a negative emotional state or vice versa, the size of such changes between positive and negative states was found to be significantly larger in BPD patients. In contrast, the magnitude of emotional changes that remained within the negative emotional range or positive emotional range was not particularly larger for BPD patients compared with healthy participants. These findings imply that the emotional instability in BPD is particularly characterized by larger changes from positive to negative states and vice versa, rather than overall larger changes in intensity, providing insight into possible processes underlying emotion dysfunction in BPD.

Howells, Annika; Ivtzan, Itai; Eiroa-Orosa, Francisco Jose (2016): Putting the ‘app’ in happiness: A randomised controlled trial of a smartphone-based mindfulness intervention to enhance wellbeing. In: Journal of Happiness Studies 17 (1), S. 163–185. DOI: 10.1007/s10902-014-9589-1.

Smartphones are revolutionizing approaches to wellbeing investment. Those seeking greater happiness can engage with thousands of downloadable self-help applications instantly, yet their effectiveness remains largely unknown. This investigation explored the viability of delivering a positive psychological intervention in application format to authentic happiness seekers. A smartphone-based randomized-controlled trial was conducted with a diverse self-selecting pool, randomly assigned to engage with an empirically supported mindfulness intervention (n = 57) or a control intervention (n = 64) for 10 days. The study explored smartphone methodology, the importance of empirically based content for wellbeing enhancement and the extent to which user experience related to wellbeing gains. Results of repeated measures ANOVAs showed statistically significant increases in positive affect with a medium effect size and reduced depressive symptoms with a small effect size, although no statistically significant differences in satisfaction with life, flourishing or negative affect were found. No statistically significant gains were observed in the control condition. Ratings of task enjoyment were positively correlated (Pearson’s r) with positive affect increase. Findings support the viability of smartphone-based interventions to significantly enhance elements of wellbeing, underscoring the importance of application content and the role of person-activity fit. This investigation presents implications for happiness seeking strategies in the real world whilst showcasing a dynamic method of intervention delivery that can benefit future research and practice. If the greatest mission of positive psychology is to enhance global flourishing, the potential of smartphone-based interventions may play a vital role.

Huh, J.; Cerrada, C. J.; Kirkpatrick, M. G.; Dunton, G.; Am Leventhal (2016): Social contexts of momentary craving to smoke among Korean American emerging adults. In: Addictive behaviors 56, S. 23–29. DOI: 10.1016/j.addbeh.2016.01.006.

INTRODUCTION: Korean American emerging adult (KAEA) smokers represent a culturally and developmentally unique population constituted of primarily light, intermittent smokers. Sociocultural contexts might play an important role in contributing to instances of acute cigarette craving and motivation to smoke in this population; yet, research testing such hypotheses is scant. The current study tests whether and how social contexts are associated with the craving among KAEA smokers. METHODS: Seventy-eight daily KAEA smokers, who smoke 4+ cigs/day, participated in a 7-day ecological momentary assessment (EMA), in which participants responded to both signal-contingent (random) and event-contingent (smoking) prompts to answer surveys on their mobile phones (prompt-level n=1377; 603 random +774 smoking prompts). Nicotine dependence was measured at baseline; cigarette craving, negative affect, presence of others smoking, social contexts were measured with EMA. RESULTS: Modeling of within-participant variation and covariation showed that being with Korean friends (vs. alone) was associated with increased levels of momentary craving. This association between Korean friends and craving disappeared when adjusted for presence of others smoking, which was a strong predictor of momentary craving. The positive association between Korean friends and craving was amplified immediately prior to smoking (vs. non-smoking random) instances. CONCLUSIONS: Being with Korean friends might serve as a culturally-specific salient smoking cue, which might have been learned throughout their smoking history. Our data also showed that increased craving associated with Korean friends may represent social settings that primarily involve cigarette smoking. Given our findings on cigarette use among KAEA’s social network, addressing cigarette use as a group behavior might be a fruitful intervention strategy.

Huh, Jimi; Leventhal, Adam M. (2016): Intraindividual covariation between e-cigarette and combustible cigarette use in Korean American emerging adults. In: Psychology of Addictive Behaviors 30 (2), S. 246–251. DOI: 10.1037/adb0000141.

Critical gaps exist in understanding the patterns and correlates of dual use of electronic cigarettes (ECs) and combustible cigarettes (CCs), particularly in ethnic minority populations. In this study, we assessed CC and EC use in the naturalistic environment using ecological momentary assessment (EMA). We hypothesized that within-subject variation in EC use (yes/no each day) would be inversely associated with within-subject variation in number of CCs consumed and craving during that same day. We also examined gender and nicotine dependence as moderators of the EC-CC and EC-craving covariations. Korean American emerging adult (KAEA; 18–25 years old) smokers (N = 78) completed 7 days of EMA. Participants completed EMA surveys throughout the day, which assessed CC craving, and end-of-day surveys, which assessed EC use and the number of CCs smoked that day. Generalized linear mixed models were used to predict day-level EC use, with number of CCs smoked and craving during that same day, gender, and nicotine dependence as predictors (n = 501). We found that within-subject variation in CC use was not associated with same-day EC use; neither was within-subject variation in craving (ps > .27). Gender moderated the relationship between craving and EC use on a given day (p = .03); only for females, on the days with higher craving, the likelihood of their EC use that day was significantly heightened. This study does not suggest that EC use is linked with lower CC smoking quantity, at least at the day level and among KAEA smokers. CC craving may play a role in dual EC-CC use for KAEA female smokers.

Huhn, Andrew S.; Harris, Jonathan; Cleveland, H. Harrington; Lydon, David M.; Stankoski, Dean; Cleveland, Michael J. et al. (2016): Ecological momentary assessment of affect and craving in patients in treatment for prescription opioid dependence. In: Brain research bulletin. DOI: 10.1016/j.brainresbull.2016.01.012.

Low positive affect (PA) is likely to contribute to risk of relapse; however, it has received relatively little attention in clinical research. This study examined the associations among positive affect, negative affect (NA), and craving in medically withdrawn patients using ecological momentary assessment (EMA). Participants (n=73) provided reports of their PA, NA, and craving 4 times a day for an average of 10.47 (SD=3.80) days. Person- and day-level associations between PA, NA, and craving were examined using multilevel models. A significant interaction emerged between person- and day-level PA such that PA on the day level was negatively associated with craving for individuals experiencing low mean PA throughout the study. No significant interaction emerged between person- and day-level NA. The main effects for both person- and day-level NA were significant. Individuals experiencing high NA throughout the study experienced higher craving overall and on days when NA was higher than usual, craving was also higher. Results suggest that high person- and day-level NA may directly contribute to the risk for relapse via increased craving, whereas low day- level PA may contribute to risk for relapse among individuals exhibiting low person-level PA via increased craving on days with lower than average levels of PA for those individuals. Given that there is a paucity of research relating low PA to craving, continued investigation into how and when low PA creates risk for relapse is warranted.

Hunter, Emily M.; Wu, Cindy (2016): Give me a better break: Choosing workday break activities to maximize resource recovery. In: Journal of Applied Psychology 101 (2), S. 302–311. DOI: 10.1037/apl0000045.

Surprisingly little research investigates employee breaks at work, and even less research provides prescriptive suggestions for better workday breaks in terms of when, where, and how break activities are most beneficial. Based on the effort–recovery model and using experience sampling methodology, we examined the characteristics of employee workday breaks with 95 employees across 5 workdays. In addition, we examined resources as a mediator between break characteristics and well-being. Multilevel analysis results indicated that activities that were preferred and earlier in the work shift related to more resource recovery following the break. We also found that resources mediated the influence of preferred break activities and time of break on health symptoms and that resource recovery benefited person-level outcomes of emotional exhaustion, job satisfaction, and organizational citizenship behavior. Finally, break length interacted with the number of breaks per day such that longer breaks and frequent short breaks were associated with more resources than infrequent short breaks.

Hurlburt, Russell T.; Alderson-Day, Ben; Kuhn, Simone; Fernyhough, Charles (2016): Exploring the Ecological Validity of Thinking on Demand: Neural Correlates of Elicited vs. Spontaneously Occurring Inner Speech. In: PloS one 11 (2), S. e0147932. DOI: 10.1371/journal.pone.0147932.

Psychology and cognitive neuroscience often use standardized tasks to elicit particular experiences. We explore whether elicited experiences are similar to spontaneous experiences. In an MRI scanner, five participants performed tasks designed to elicit inner speech (covertly repeating experimenter-supplied words), inner seeing, inner hearing, feeling, and sensing. Then, in their natural environments, participants were trained in four days of random-beep-triggered Descriptive Experience Sampling (DES). They subsequently returned to the scanner for nine 25-min resting-state sessions; during each they received four DES beeps and described those moments (9 x 4 = 36 moments per participant) of spontaneously occurring experience. Enough of those moments included spontaneous inner speech to allow us to compare brain activation during spontaneous inner speech with what we had found in task-elicited inner speech. ROI analysis was used to compare activation in two relevant areas (Heschl’s gyrus and left inferior frontal gyrus). Task-elicited inner speech was associated with decreased activation in Heschl’s gyrus and increased activation in left inferior frontal gyrus. However, spontaneous inner speech had the opposite effect in Heschl’s gyrus and no significant effect in left inferior frontal gyrus. This study demonstrates how spontaneous phenomena can be investigated in MRI and calls into question the assumption that task-created phenomena are often neurophysiologically and psychologically similar to spontaneously occurring phenomena.

Ifejika, Nneka Lotea; Noser, Elizabeth Anne; Grotta, James C.; Savitz, Sean I. (2016): Swipe out Stroke: Feasibility and efficacy of using a smart-phone based mobile application to improve compliance with weight loss in obese minority stroke patients and their carers. In: International journal of stroke : official journal of the International Stroke Society. DOI: 10.1177/1747493016631557.

RATIONALE: Swipe out Stroke (SOS) examines the use of a smartphone-based mobile application to reduce obesity in high-risk minority stroke patients. At record-high levels in the United States, obesity disproportionately affects minorities and is highly correlated with cerebrovascular disease. Unfortunately, structured weight loss programs are expensive, and compliance significantly decreases upon program completion. Mobile health (mHealth) technology is an innovative, cost-effective way to bridge this gap. Minorities spend over 4.5 billion dollars annually on consumer electronics, making studies that utilize mHealth applications ideal for health promotion and disease prevention. AIMS AND DESIGN: SOS is a prospective, randomized-controlled trial with open blinded endpoint comparing an mHealth based dietary intervention to usual care to facilitate weight reduction. Ischemic and hemorrhagic stroke survivors and their carers are recruited from the acute care service of a Houston-based comprehensive stroke center. A neurorehabilitation physician or vascular neurologist meets with participants during the index hospitalization, a baseline clinic visit, followed by visits at 1, 3, and 6 month intervals. The SOS Team focuses on feasible modifications to the Southern dietary pattern (fried foods, fatty foods, added fats, eggs, processed meats, such as bacon and ham, organ meats (e.g., liver), and sweetened drinks) and caloric restriction to facilitate a 5% reduction in total body weight. Practical barriers to adherence are addressed, such as access to transportation, financial limitations, and depression. STUDY OUTCOMES: The primary dependent measure is a reduction of total body weight. Secondary outcomes include systolic blood pressure, hemoglobin A1c, low-density lipoprotein, triglycerides, and Factor VIII. CONCLUSION: SOS will determine whether a Phase III effectiveness trial of a smartphone-based mobile application to address obesity-related health disparities is warranted throughout the Southeastern United States (Stroke Belt).

Inada, S.; Yoshiuchi, K.; Iizuka, Y.; Ohashi, K.; Kikuchi, H.; Yamamoto, Y. et al. (2016): Pilot Study for the Development of a Self-Care System for Type 2 Diabetes Patients Using a Personal Digital Assistant (PDA). In: International journal of behavioral medicine. DOI: 10.1007/s12529-016-9535-1.

PURPOSE: The primary objective of the present pilot study was to investigate the feasibility and acceptability of the newly developed self-care system using personal digital assistance in patients with type 2 diabetes. The secondary objective was to investigate changes in daily calorie intake, body weight, and hemoglobin A1c after using the system for 6 months. METHOD: The participants were nine outpatients with type 2 diabetes, aged 34-72 and living in Tokyo or surrounding prefectures. They were instructed to use the electronic food diary and to review the graphs of the total energy intake to control food intake under their own target value for 6 months. After they completed the study, the feasibility indicated by adherence rate for food recording and acceptability of the system rated with 6-point Likert scale from 1 (worst) to 6 (best) by the participants were investigated. RESULTS: Seven participants out of nine completed the study protocol. The median adherence rate for food recording was 80.6 %. Regarding the acceptability, six patients rated 6 for desire to use the system while one rated 5. In addition, regarding improvement in self-care for diabetes, the median score was 5. Daily calorie intake, body weight, and HbA1c, however, did not change significantly over the 6-month period. CONCLUSION: The newly developed self-care system might be feasible and acceptable in diabetes patients, which could be applied as an ecological momentary intervention tool, although there was some room to refine it to raise adherence.

Inauen, Jennifer; Shrout, Patrick E.; Bolger, Niall; Stadler, Gertraud; Scholz, Urte (2016): Mind the Gap? An Intensive Longitudinal Study of Between-Person and Within-Person Intention-Behavior Relations. In: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine. DOI: 10.1007/s12160-016-9776-x.

BACKGROUND: Despite their good intentions, people often do not eat healthily. This is known as the intention-behavior gap. Although the intention-behavior relationship is theorized as a within-person process, most evidence is based on between-person differences. PURPOSE: The purpose of the present study is to investigate the within-person intention-behavior association for unhealthy snack consumption. METHODS: Young adults (N = 45) participated in an intensive longitudinal study. They reported intentions and snack consumption five times daily for 7 days (n = 1068 observations analyzed). RESULTS: A within-person unit difference in intentions was associated with a halving of the number of unhealthy snacks consumed in the following 3 h (CI95 27-70 %). Between-person differences in average intentions did not predict unhealthy snack consumption. CONCLUSIONS: Consistent with theory, the intention-behavior relation for healthy eating is best understood as a within-person process. Interventions to reduce unhealthy snacking should target times of day when intentions are weakest.

Jamwal, Nisha Rani; Kumar, Senthil P. (2016): Smarter palliative care for cancer: Use of smartphone applications. In: Indian journal of palliative care 22 (1), S. 108–110. DOI: 10.4103/0973-1075.173950.

Smartphones are technologically advanced mobile phone devices which use software similar to computer-based devices as a user-friendly interface. This review article is aimed to inform the palliative care professionals, cancer patients and their caregivers about the role of smartphone applications (apps) in the delivery of palliative care services, through a brief review of existing literature on the development, feasibility, analysis, and effectiveness of such apps. There is a dearth need for sincere palliative care clinicians to work together with software professionals to develop the suitable smartphone apps in accordance with the family/caregivers’ necessities and patients’ biopsychosocial characteristics that influence the technology driven evidence informed palliative cancer care.

Janssen, X.; Basterfield, L.; Parkinson, K. N.; Pearce, M.; Reilly, J. K.; Adamson, A. J.; Reilly, J. J. (2015): Determinants of changes in sedentary time and breaks in sedentary time among 9 and 12 year old children. In: Preventive medicine reports 2, S. 880–885. DOI: 10.1016/j.pmedr.2015.10.007.

The current study aimed to identify the determinants of objectively measured changes in sedentary time and sedentary fragmentation from age 9- to age 12 years. Data were collected as part of the Gateshead Millennium Birth Cohort study from September 2008 to August 2009 and from January 2012 to November 2012. Participants were 9.3 (+/- 0.4) years at baseline (n = 508) and 12.5 (+/- 0.3) years at follow-up (n = 427). Sedentary behaviour was measured using an ActiGraph GT1M accelerometer. Twenty potential determinants were measured, within a socio-ecological model, and tested for their association with changes in sedentary time and the extent to which sedentary behaviour is prolonged or interrupted (fragmentation index). Univariate and multivariate linear regression analyses were conducted. Measurements taken during winter and a greater decrease in moderate-to-vigorous intensity physical activity (MVPA) over time were associated with larger increases in sedentary time (seasonality beta: – 3.03; 95% CI: – 4.52, – 1.54; and change in MVPA beta: – 1.68; 95% CI: – 1.94, – 1.41). Attendance at sport clubs was associated with smaller increases in sedentary time (- 1.99; – 3.44, – 0.54). Girls showed larger decreases in fragmentation index (- 0.52; – 1.01, – 0.02). Interventions aimed at decreasing the decline in MVPA and increasing/maintaining sport club attendance may prevent the rise in sedentary time as children grow older. In addition, winter could be targeted to prevent an increase in sedentary time and reduction in sedentary fragmentation during this season.

Jazaieri, Hooria; Lee, Ihno A.; McGonigal, Kelly; Jinpa, Thupten; Doty, James R.; Gross, James J.; Goldin, Philippe R. (2016): A wandering mind is a less caring mind: Daily experience sampling during compassion meditation training. In: The Journal of Positive Psychology 11 (1), S. 37–50. DOI: 10.1080/17439760.2015.1025418.

Mind wandering, or the tendency for attention to drift to task-irrelevant thoughts, has been associated with worse intra- and inter-personal functioning. Utilizing daily experience sampling with 51 adults during 9-weeks of a compassion meditation program, we examined effects on mind wandering (to neutral, pleasant, and unpleasant topics) and caring behaviors for oneself and others. Results indicated that compassion meditation decreased mind wandering to neutral topics and increased caring behaviors towards oneself. When collapsing across topics, mind wandering did not serve as an intermediary between the frequency of compassion meditation practice and caring behaviors, though mind wandering to pleasant and unpleasant topics was linked to both variables. A path analysis revealed that greater frequency of compassion meditation practice was related to reductions in mind wandering to unpleasant topics and increases in mind wandering to pleasant topics, both of which were related to increases in caring behaviors for oneself and others.

Jiang, Da; Fung, Helene H.; Sims, Tamara; Tsai, Jeanne L.; Zhang, Fan (2016): Limited time perspective increases the value of calm. In: Emotion 16 (1), S. 52–62. DOI: 10.1037/emo0000094.

Previous findings indirectly suggest that the more people perceive their time in life as limited, the more they value calm. No study, however, has directly tested this hypothesis. To this end, using a combination of survey, experience sampling, and experimental methods, we examined the relationship between future time perspective and the affective states that people ideally want to feel (i.e., their “ideal affect”). In Study 1, the more people reported a limited time perspective, the more they wanted to feel calm and experience other low-arousal positive states. In Study 2, participants were randomly assigned to a limited time or an expanded time condition. Participants in the limited time condition reported valuing calm and other low arousal positive states more than those in the expanded time condition. We discuss the implications of these findings for broadening our understanding of the factors that shape how people ideally want to feel, and their consequences for decision making.

Jinhyuk, Kim; Nakamura, Toru; Kikuchi, Hiroe; Yamamoto, Yoshiharu (2015): Psychobehavioral validity of self-reported symptoms based on spontaneous physical activity. In: Conference proceedings : … Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference 2015, S. 4021–4024. DOI: 10.1109/EMBC.2015.7319276.

A limitation of self-reports is the presence of recall biases including retrospective distortions of the respondents’ experiences. To overcome this concern, ecological momentary assessment (EMA) and day reconstruction method (DRM) have recently been developed. Very recently, we reported the psychobehavioral validity of within-individual temporal variations in momentary depressive mood recorded with EMA by examining co-variant properties with spontaneous physical activity as the external criteria. However, the validity of DRM in this context has not been objectively examined yet. Therefore, in this study, we examined the psychobehavioral validity of DRM by examining temporal associations with spontaneous physical activity and then showed the difference from EMA. Twenty-two healthy undergraduates wore a watch-type computer for two consecutive days and recorded self-reported symptoms (fatigue, depressive mood, and anxious mood) by EMA. They also recorded the symptoms afterward according to the series of behavioral episodes they reconstructed (DRM) about the same days. Physical activity was also obtained using an actigraph built into the watch-type computer. Multilevel analysis showed the significant association between depressive mood recorded with EMA and local statistics (mean activity levels calculated from 60min data length) of physical activity around EMA recordings. However, depressive mood recorded with DRM had no significant association with physical activity. As for fatigue and anxious mood, none of the methods showed significant associations with the local statistics of physical activity. These results imply that depressive mood recorded with EMA would include psychobehavioral information which cannot be captured with DRM.

Kalafatakis, K.; Russell, G. M.; Harmer, C. J.; Munafo; Marchant, N.; Wilson, A. et al. (2016): Effects of the pattern of glucocorticoid replacement on neural processing, emotional reactivity and well-being in healthy male individuals: study protocol for a randomised controlled trial. In: Trials 17 (1), S. 44. DOI: 10.1186/s13063-016-1159-x.

BACKGROUND: Deviation from the physiological glucocorticoid dynamics (circadian and underlying ultradian rhythmicity) is a common characteristic of various neuropsychiatric and endocrine disorders as well as glucocorticoid-based therapeutics. These states may be accompanied by neuropsychiatric symptomatology, suggesting continuous dynamic glucocorticoid equilibrium is essential for brain homeostasis. METHODS/DESIGN: The study consists of two parts. The preliminary stage of the study aims to validate (technically and pharmacologically) and optimise three different patterns of systemic cortisol administration in man. These patterns are based on the combinatory administration of metyrapone, to suppress endogenous cortisol production, and concurrent hydrocortisone replacement. The second, subsequent, core part of the study is a randomised, double-blinded, placebo-controlled, crossover study, where participants (healthy male individuals aged 18-60 years) will undergo all three hydrocortisone replacement schemes. During these infusion regimes, we plan a number of neurobehavioural tests and imaging of the brain to assess neural processing, emotional reactivity and perception, mood and self-perceived well-being. The psychological tests include: ecological momentary assessment, P1vital Oxford Emotional Test Battery and Emotional Potentiated Startle Test, Leeds Sleep Evaluation Questionnaire and the visual working memory task (n-back). The neuroimaging protocol combines magnetic resonance sequences that capture data related to the functional and perfusion status of the brain. DISCUSSION: Results of this clinical trial are designed to evaluate the impact (with possible mechanistic insights) of different patterns of daily glucocorticoid dynamics on neural processing and reactivity related to emotional perception and mood. This evidence should contribute to the optimisation of the clinical application of glucocorticoid-based therapeutics. TRIAL REGISTRATION: UK Clinical Research Network, IRAS Ref: 106181, UKCRN-ID-15236 (23 October 2013).

Khobragade, Nivedita; Graupe, Daniel; Tuninetti, Daniela (2015): Towards fully automated closed-loop Deep Brain Stimulation in Parkinson’s disease patients: A LAMSTAR-based tremor predictor. In: Conference proceedings : … Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference 2015, S. 2616–2619. DOI: 10.1109/EMBC.2015.7318928.

This paper describes the application of the LAMSTAR (LArge Memory STorage and Retrieval) neural network for prediction of onset of tremor in Parkinson’s disease (PD) patients to allow for on-off adaptive control of Deep Brain Stimulation (DBS). Currently, the therapeutic treatment of PD by DBS is an open-loop system where continuous stimulation is applied to a target area in the brain. This work demonstrates a fully automated closed-loop DBS system so that stimulation can be applied on-demand only when needed to treat PD symptoms. The proposed LAMSTAR network uses spectral, entropy and recurrence rate parameters for prediction of the advent of tremor after the DBS stimulation is switched off. These parameters are extracted from non-invasively collected surface electromyography and accelerometry signals. The LAMSTAR network has useful characteristics, such as fast retrieval of patterns and ability to handle large amount of data of different types, which make it attractive for medical applications. Out of 21 trials blue from one subject, the average ratio of delay in prediction of tremor to the actual delay in observed tremor from the time stimulation was switched off achieved by the proposed LAMSTAR network is 0.77. Moreover, sensitivity of 100% and overall performance better than previously proposed Back Propagation neural networks is obtained.

Kim, C. H.; Chung, C. K.; Choi, Y.; Shin, H.; Woo, J. W.; Kim, S. M.; Lee, H. J. (2016): The usefulness of a mobile device-based system for patient-reported outcomes in a spine outpatient clinic. In: The spine journal : official journal of the North American Spine Society. DOI: 10.1016/j.spinee.2016.02.048.

BACKGROUND: Context Patient reported outcomes (PRO) are typically collected using a paper form, but this format is cumbersome to incorporate into outpatient clinic visits as well as in research. Therefore, we developed a mobile device-based system (mobile system) for spinal PRO. We hypothesized that this system may improve the quality of care in an outpatient clinic. PURPOSE: To analyze the patient-reported efficacy of a mobile system through a survey of patients’ responses compared to a paper system. STUDY DESIGN/SETTING: Prospective observational study PATIENT SAMPLE: Surveys were conducted for 103 patients who had experience using both the paper and electronic systems in the outpatient clinic. OUTCOME MEASURES: Patient-reported positive response score (PRS) METHODS: The survey included the characteristics of the patients (sex, age, use of smartphone, familiarity with smartphone applications, proficiency of typing with mobile device, site of pain and education level) and eight questions in four domains: 1) efficacy in the waiting room, 2) efficacy during the clinic visit, 3) overall satisfaction and 4) opinion about the use of this system. The response to each question was scored from 1-5 (1, negative; 5, positive response). The patient-reported PRS was calculated by adding the scores of the 8 questions and converting the total range to 0 to 100 (60, neutral). RESULTS: The mean PRS of the 8 questions was 79.8 (95% CI, 76.7-83.9). The mean PRS was 78.9 (75.6-82.2) at the waiting room and was 80.5 (77.1-83.9) during the clinic. The PRS for overall satisfaction and use of this system were 83.3 (79.6-87.0) and 77.1 (71.9-82.3), respectively. The use of smartphones and the proficiency of typing were independently significant predictors of PRS with an R2 value of 0.325. CONCLUSIONS: The mobile device-based system improved the patient-reported efficacy in spine outpatient clinics. However, various factors such as the use of smartphones need to be considered when developing and applying mobile systems.

Kim, Jinhyuk; Nakamura, Toru; Yamamoto, Yoshiharu (2016): A momentary biomarker for depressive mood. In: In silico pharmacology 4 (1), S. 4. DOI: 10.1186/s40203-016-0017-6.

Many biomarkers from genetic, neuroimaging, and biological/biochemical measures have been recently developed in order to make a shift toward the objective evaluation of psychiatric disorders. However, they have so far been less successful in capturing dynamical changes or transitions in pathological states, such as those occurring during the course of clinical treatments or pathogenic processes of disorders. A momentary biomarker is now required for objective monitoring of such dynamical changes. The development of ecological momentary assessment (EMA) allows the assessment of dynamical aspects of diurnal/daily clinical conditions and subjective symptoms. Furthermore, a variety of validation studies on momentary symptoms assessed by EMA using behavioral/physiological/biochemical measures have demonstrated the possibility of evaluating momentary symptoms from such external objective measures. In this review, we introduce physical activity as a candidate biobehavioral biomarker for psychiatric disorders. We also mention its potential as a momentary biomarker for depressive mood. Finally, we address the continuous monitoring of the pathogenic processes and pathological states of depressive disorders based on physical activity, as well as its application in pharmacological animal studies.

Kim, Youngwon; Crouter, Scott E.; Lee, Jung-Min; Dixon, Phillip M.; Gaesser, Glenn A.; Welk, Gregory J. (2016): Comparisons of prediction equations for estimating energy expenditure in youth. In: Journal of Science and Medicine in Sport 19 (1), S. 35–40. DOI: 10.1016/j.jsams.2014.10.002.

Objectives: The purpose of this study was to compare the validity of Actigraph 2-regression models (2RM) and 1-regression models (1RM) for estimation of EE in children. Design: The study used a cross-sectional design with criterion estimates from a metabolic cart. Methods: A total of 59 children (7–13 yrs) performed 12 activities (randomly selected from a set of 24 activities) for 5 min each, while being concurrently measured with an Actigraph GT3X and indirect calorimetry. METRMR (MET considering one’s resting metabolic rate) for the GT3X was estimated applying 2RM with vector magnitude (VM2RM) and vertical axis (VA2RM), and four standard 1RMs. The validity of the 2RMs and 1RMs was evaluated using 95% equivalence testing and mean absolute percent error (MAPE). Results: For the group-level comparison, equivalence testing revealed that the 90% confidence intervals for all 2RMs and 1RMs were outside of the equivalence zone (range: 3.63, 4.43) for indirect calorimetry. When comparing the individual activities, VM2RM produced smaller MAPEs (range: 14.5–45.3%) than VA2RM (range, 15.5–58.1%) and 1RMs (range, 14.5–75.1%) for most of the light and moderate activities. Conclusions: None of the 2RMs and 1RMs were equivalent to indirect calorimetry. The 2RMs showed smaller individual-level errors than the 1RMs.

Kircanski, Katharina; Thompson, Renee J.; Sorenson, James; Sherdell, Lindsey; Gotlib, Ian H. (2015): Rumination and Worry in Daily Life: Examining the Naturalistic Validity of Theoretical Constructs. In: Clinical psychological science : a journal of the Association for Psychological Science 3 (6), S. 926–939. DOI: 10.1177/2167702614566603.

Rumination and worry, two forms of perseverative thinking, hold promise as core processes that transect depressive and anxiety disorders. Whereas previous studies have been limited to the laboratory or to single diagnoses, we used experience sampling methods to assess and validate rumination and worry as transdiagnostic phenomena in the daily lives of individuals diagnosed with Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), and co-occurring MDD-GAD. Clinical and healthy control participants carried a hand-held electronic device for one week. Eight times per day they reported on their current levels of rumination and worry and their theoretically postulated features: thought unpleasantness, repetitiveness, abstractness, uncontrollability, temporal orientation, and content, and overall senses of certainty and control. Both rumination and worry emerged as transdiagnostic processes that cut across MDD, GAD, and MDD-GAD. Furthermore, most psychological theories concerning rumination and worry strongly mapped onto participants’ reports, providing the first naturalistic validation of these constructs.

Kordy, H.; Wolf, M.; Aulich, K.; Burgy, M.; Hegerl, U.; Husing, J. et al. (2016): Internet-Delivered Disease Management for Recurrent Depression: A Multicenter Randomized Controlled Trial. In: Psychotherapy and psychosomatics 85 (2), S. 91–98. DOI: 10.1159/000441951.

BACKGROUND: Strategies to improve the life of patients suffering from recurrent major depression have a high relevance. This study examined the efficacy of 2 Internet-delivered augmentation strategies that aim to prolong symptom-free intervals. METHODS: Efficacy was tested in a 3-arm, multicenter, open-label, evaluator-blind, randomized controlled trial. Upon discharge from inpatient mental health care, 232 adults with 3 or more major depressive episodes were randomized to 1 of 2 intervention groups (SUMMIT or SUMMIT-PERSON) or to treatment as usual (TAU) alone. Over 12 months, participants in both intervention arms received, in addition to TAU, intense monitoring via e-mail or a smartphone, including signaling of upcoming crises, assistance with personal crisis management, and facilitation of early intervention. SUMMIT-PERSON additionally offered regular expert chats. The primary outcome was ‘well weeks’, i.e. weeks with at most mild symptoms assessed by the Longitudinal Interval Follow-Up Evaluation, during 24 months after the index treatment. RESULTS: SUMMIT compared to TAU reduced the time with an unwell status (OR 0.48; 95% CI 0.23-0.98) through faster transitions from unwell to well (OR 1.44; 95% CI 0.83-2.50) and slower transitions from well to unwell (OR 0.69; 95% CI 0.44-1.09). Contrary to the hypothesis, SUMMIT-PERSON was not superior to either SUMMIT (OR 0.77; 95% CI 0.38-1.56) or TAU (OR 0.62; 95% CI 0.31-1.24). The efficacy of SUMMIT was strongest 8 months after the intervention. CONCLUSIONS: The fully automated Internet-delivered augmentation strategy SUMMIT has the potential to improve TAU by reducing the lifelong burden of patients with recurrent depression. The fact that the effects wear off suggests a time-unlimited extension.

Kuhn, E.; Weiss, B. J.; Taylor, K. L.; Hoffman, J. E.; Ramsey, K. M.; Manber, R. et al. (2015): CBT-I Coach: A Description and Clinician Perceptions of a Mobile App for Cognitive Behavioral Therapy for Insomnia. In: Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine.

STUDY OBJECTIVES: This paper describes CBT-I Coach, a patient-facing smartphone app designed to enhance cognitive behavioral therapy for insomnia (CBT-I). It presents findings of two surveys of U.S. Department of Veterans Affairs (VA) CBT-I trained clinicians regarding their perceptions of CBT-I Coach before it was released (N = 138) and use of it two years after it was released (N = 176). METHODS: VA-trained CBT-I clinicians completed web-based surveys before and two years after CBT-I Coach was publicly released. RESULTS: Prior to CBT-I Coach release, clinicians reported that it was moderately to very likely that the app could improve care and a majority (87.0%) intended to use it if it were available. Intention to use the app was predicted by smartphone ownership (beta = 0.116, p < 0.05) and perceptions of relative advantage to existing CBT-I practices (beta = 0.286, p < 0.01), compatibility with their own needs and values (beta = 0.307, p < 0.01), and expectations about the complexity of the app (beta = 0.245, p < 0.05). Two years after CBT-I Coach became available, 59.9% of participants reported using it with patients and had favorable impressions of its impact on homework adherence and outcomes. CONCLUSIONS: Findings suggest that before release, CBT-I Coach was perceived to have potential to enhance CBT-I and address common adherence issues and clinicians would use it. These results are reinforced by findings two years after it was released suggesting robust uptake and favorable perceptions of its value.

La DiCarlo; Weinstein, R. L.; Morimoto, C. B.; Savage, G. M.; Moon, G. L.; Au-Yeung, K.; Kim, Y. A. (2016): Patient-Centered Home Care Using Digital Medicine and Telemetric Data for Hypertension: Feasibility and Acceptability of Objective Ambulatory Assessment. In: Journal of clinical hypertension (Greenwich, Conn.). DOI: 10.1111/jch.12787.

Objective information that can be passively obtained in an ambulatory setting could be potentially useful for determining appropriate care in blood pressure (BP) management. This study utilized digital medicine (DM) prototypes and telemetric data acquisition to directly confirm medication use and to assess habits of daily living in a hypertensive population. Thirty-seven patients (23 men age 62+/-9 years) used the system for 6 weeks. DM prototypes consisted of valsartan 80 mg or 160 mg placed in a gelatin hemicapsule with an excipient tablet as a “stopper,” with a poppy seed-sized ingestible sensor (IS) made of foodstuff on its external surface and capable of creating a biogalvanic current on ingestion to alert a wearable sensor (WS) that was worn on the torso. Passive data collection included IS ingestion dates and times, daily step count, BP, and weight. Automatic short message service (SMS) reminders were sent whenever BP or weight values were not received. Passive detection of DM ingestion was 98% when compared with directly observed dosing. Mean taking and timing adherence rates were 90% and 83%, respectively, and the average step count at a pace of >/=60 steps per minute was 2.0+/-1.5 h/d. An automatic SMS was sent and 100% confirmed for 251 BP and 14 weight values that were not received. Mild and transient WS-related skin irritation was the most common device-related adverse event. There were no serious or unanticipated adverse events. Ninety percent of patients did not mind swallowing a DM capsule, and 75% had a positive overall experience with the system. Ambulatory evaluation of medication adherence and habits of daily living appear to be feasible and acceptable using DM and passive acquisition of telemetric data.

Lanaj, Klodiana; Johnson, Russell E.; Lee, Stephanie M. (2016): Benefits of transformational behaviors for leaders: A daily investigation of leader behaviors and need fulfillment. In: Journal of Applied Psychology 101 (2), S. 237–251. DOI: 10.1037/apl0000052.

Although a large body of work has examined the benefits of transformational leadership, this work has predominantly focused on recipients of such behaviors. Recent research and theory, however, suggest that there are also benefits for those performing behaviors reflective of transformational leadership. Across 2 experience-sampling studies, we investigate the effects of such behaviors on actors’ daily affective states. Drawing from affective events theory and self-determination theory we hypothesize and find that engaging in behaviors reflective of transformational leadership is associated with improvement in actors’ daily affect, more so than engaging in behaviors reflective of transactional, consideration, initiating structure, and participative leadership. Behaviors reflective of transformational leadership improved actors’ affect in part by fulfilling their daily needs. Furthermore, extraversion and neuroticism moderated these effects such that extraverts benefitted less whereas neurotics benefitted more from these behaviors in terms of affective changes. We consider the theoretical and practical implications of these findings and offer directions for future research.

Langguth, N.; Schmid, J.; Gawrilow, C.; Stadler, G. (2016): Within-Person Link between Depressed Affect and Moderate-to-Vigorous Physical Activity in Adolescence: An Intensive Longitudinal Approach. In: Applied psychology. Health and well-being 8 (1), S. 44–63. DOI: 10.1111/aphw.12061.

BACKGROUND: During adolescence, young women and men frequently show low physical activity and elevated depressed affect. This study aimed to examine the within-person link between moderate-to-vigorous physical activity (MVPA) and depressed affect in everyday life. METHODS: Within an intensive longitudinal approach, adolescents (N = 72; 37% young women; M age = 17.36 years; age range: 12-26 years; mid-90% age range: 13-22 years) wore accelerometers to assess their daily MVPA and reported next-morning and same-evening depressed affect in diaries over eight consecutive days. The within-person link between MVPA and depressed affect on the next morning (time-lagged prediction) and the same evening (same-day link) was analyzed with mixed-effects models. RESULTS: More-than-usual MVPA significantly predicted less next-morning depressed affect on weekdays in young women, to the extent that a 60-min increase in MVPA over the person mean significantly predicted 50 per cent lower next-morning depressed affect. CONCLUSIONS: This study encourages the development of individually tailored physical activity interventions that could help adolescents enhance their daily amount of unstructured, self-initiated MVPA to reduce depressed affect. This approach may be particularly suitable for young women who have the highest risk for an inactive lifestyle and elevated depressed affect.

Lee, N. C.; Voss, C.; Frazer, A. D.; Hirsch, J. A.; McKay, H. A.; Winters, M. (2016): Does Activity Space Size Influence Physical Activity Levels of Adolescents? – A GPS study of an urban environment. In: Preventive medicine reports 3, S. 75–78. DOI: 10.1016/j.pmedr.2015.12.002.

BACKGROUND: Physical activity (PA) is closely linked with child and youth health, and active travel may be a solution to enhancing PA levels. Activity spaces depict the geographic coverage of one’s travel. Little is known about activity spaces and PA in adolescents. OBJECTIVE: To explore the relation between adolescent travel (using a spatial measure of activity space size) and daily moderate-to-vigorous PA (MVPA), with a focus on school days. METHODS: In Fall 2012, we used Global Positioning Systems to manually identify trips and generate activity spaces for each person-day; quantified by area for 39 students (13.8+/-0.6 years, 38% female) attending high school in urban Downtown Vancouver, Canada. We assessed the association between activity space area and MVPA using multi-level regression. We calculated total, school-day and trip-based MVPA for each valid person-day (accelerometry; >/= 600 min wear time). RESULTS: On school days, students accrued 68.2 min/day (95% CI 60.4-76.0) of MVPA. Daily activity spaces averaged 2.2 km2 (95% CI 1.3-3.0). There was no association between activity space size and school-day MVPA. Students accrued 21.8 min/day (95% CI 19.2-24.4) of MVPA during school hours, 19.4 min/day (95% CI 15.1-23.7) during travel, and 28.3 min/day (95% CI 22.3-34.3) elsewhere. CONCLUSION: School and school travel are important sources of PA in Vancouver adolescents, irrespective of activity space area covered.

Leong, J. Y.; Wong, J. E. (2016): Accuracy of three Android-based pedometer applications in laboratory and free-living settings. In: Journal of sports sciences, S. 1–8. DOI: 10.1080/02640414.2016.1154592.

This study examines the accuracy of three popular, free Android-based pedometer applications (apps), namely, Runtastic (RT), Pacer Works (PW), and Tayutau (TY) in laboratory and free-living settings. Forty-eight adults (22.5 +/- 1.4 years) completed 3-min bouts of treadmill walking at five incremental speeds while carrying a test smartphone installed with the three apps. Experiment was repeated thrice, with the smartphone placed either in the pants pockets, at waist level, or secured to the left arm by an armband. The actual step count was manually counted by a tally counter. In the free-living setting, each of the 44 participants (21.9 +/- 1.6 years) carried a smartphone with installed apps and a reference pedometer (Yamax Digi-Walker CW700) for 7 consecutive days. Results showed that TY produced the lowest mean absolute percent error (APE 6.7%) and was the only app with acceptable accuracy in counting steps in a laboratory setting. RT consistently underestimated steps with APE of 16.8% in the laboratory. PW significantly underestimated steps when the smartphone was secured to the arm, but overestimated under other conditions (APE 19.7%). TY was the most accurate app in counting steps in a laboratory setting with the lowest APE of 6.7%. In the free-living setting, the APE relative to the reference pedometer was 16.6%, 18.0%, and 16.8% for RT, PW, and TY, respectively. None of the three apps counted steps accurately in the free-living setting.

Liao, Y.; Shonkoff, E. T.; Dunton, G. F. (2015): The Acute Relationships Between Affect, Physical Feeling States, and Physical Activity in Daily Life: A Review of Current Evidence. In: Frontiers in psychology 6, S. 1975. DOI: 10.3389/fpsyg.2015.01975.

Until recently, most studies investigating the acute relationships between affective and physical feeling states and physical activity were conducted in controlled laboratory settings, whose results might not translate well to everyday life. This review was among the first attempts to synthesize current evidence on the acute (e.g., within a few hours) relationships between affective and physical feeling states and physical activity from studies conducted in free-living, naturalistic settings in non-clinical populations. A systematic literature search yielded 14 eligible studies for review. Six studies tested the relationship between affective states and subsequent physical activity; findings from these studies suggest that positive affective states were positively associated with physical activity over the next few hours while negative affective states had no significant association. Twelve studies tested affective states after physical activity and yielded consistent evidence for physical activity predicting higher positive affect over the next few hours. Further, there was some evidence that physical activity was followed by a higher level of energetic feelings in the next few hours. The evidence for physical activity reducing negative affect in the next few hours was inconsistent and inconclusive. Future research in this area should consider recruiting more representative study participants, utilizing higher methodological standards for assessment (i.e., electronic devices combined with accelerometry), reporting patterns of missing data, and investigating pertinent moderators and mediators (e.g., social and physical context, intensity, psychological variables). Knowledge gained from this topic could offer valuable insights for promoting daily physical activity adoption and maintenance in non-clinical populations.

Linas, B. S.; Genz, A.; Westergaard, R. P.; Chang, L. W.; Bollinger, R. C.; Latkin, C.; Kirk, G. D. (2016): Ecological Momentary Assessment of Illicit Drug Use Compared to Biological and Self-Reported Methods. In: JMIR mHealth and uHealth 4 (1), S. e27. DOI: 10.2196/mhealth.4470.

BACKGROUND: The use of mHealth methods for capturing illicit drug use and associated behaviors have become more widely used in research settings, yet there is little research as to how valid these methods are compared to known measures of capturing and quantifying drug use. OBJECTIVE: We examined the concordance of ecological momentary assessment (EMA) of drug use to previously validated biological and audio-computer assisted self-interview (ACASI) methods. METHODS: The Exposure Assessment in Current Time (EXACT) study utilized EMA methods to assess drug use in real-time in participants’ natural environments. Utilizing mobile devices, participants self-reported each time they used heroin or cocaine over a 4-week period. Each week, PharmChek sweat patch samples were collected for measurement of heroin and cocaine and participants answered an ACASI-based questionnaire to report behaviors and drug using events during the prior week. Reports of cocaine and heroin use captured through EMA were compared to weekly biological or self-report measures through percent agreement and concordance correlation coefficients to account for repeated measures. Correlates of discordance were obtained from logistic regression models. RESULTS: A total of 109 participants were a median of 48.5 years old, 90% African American, and 52% male. During 436 person-weeks of observation, we recorded 212 (49%) cocaine and 103 (24%) heroin sweat patches, 192 (44%) cocaine and 161 (37%) heroin ACASI surveys, and 163 (37%) cocaine and 145 (33%) heroin EMA reports. The percent agreement between EMA and sweat patch methods was 70% for cocaine use and 72% for heroin use, while the percent agreement between EMA and ACASI methods was 77% for cocaine use and 79% for heroin use. Misreporting of drug use by EMA compared to sweat patch and ACASI methods were different by illicit drug type. CONCLUSIONS: Our work demonstrates moderate to good agreement of EMA to biological and standard self-report methods in capturing illicit drug use. Limitations occur with each method and accuracy may differ by type of illicit drugs used.

Madhushri, P.; Ahmed, B.; Penzel, T.; Jovanov, E. (2015): Periodic leg movement (PLM) monitoring using a distributed body sensor network. In: Conference proceedings : … Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference 2015, S. 1837–1840. DOI: 10.1109/EMBC.2015.7318738.

Wireless sensors networks represent the architecture of choice for distributed monitoring due to the ease of deployment and configuration. We developed a distributed sleep monitoring system which combines wireless inertial sensors SP-10C by Sensoplex controlled by a custom smartphone application as an extension of the polysomnographic (PSG) monitor SOMNOscreen plus from Somnomedics. While existing activity monitors are wired to the SOMNOscreen, our system allows the use of wireless inertial sensors to improve user’s comfort during sleep. The system is intended for monitoring of periodic leg movements (PLM) and user’s activity during sleep. Wireless sensors are placed on ankle and toes of the foot in a customized sock. An Android app communicates with wireless sensors over Bluetooth Smart (BTS) link and streams 3D accelerometer values, 4D unit quaternion values and timestamps. In this paper we present a novel method of synchronization of data streams from PSG and inertial sensors, and original method of detection of PLM events. The system was tested using five experiments of simulated PLM, and achieved 96.51% of PLM detection accuracy.

Maher, Carol; Lewis, Lucy; Katzmarzyk, Peter T.; Dumuid, Dot; Cassidy, Leah; Olds, Tim (2016): The associations between physical activity, sedentary behaviour and academic performance. In: Journal of science and medicine in sport / Sports Medicine Australia. DOI: 10.1016/j.jsams.2016.02.010.

OBJECTIVES: To examine the relationships between children’s moderate-to-vigorous physical activity (MVPA), sedentary behaviours, and academic performance. DESIGN: This study investigated cross-sectional relationships between children’s accelerometer-measured physical activity and sedentary behaviour patterns, and academic performance using a standardised, nationally-administered academic assessment. METHODS: A total of 285 Australian children aged 9-11 years from randomly selected schools undertook 7-day 24h accelerometry to objectively determine their MVPA and sedentary behaviour. In the same year, they completed nationally-administered standardised academic testing (National Assessment Program-Literacy and Numeracy; NAPLAN). BMI was measured, and socio-demographic variables were collected in a parent-reported survey. Relationships between MVPA, sedentary behaviour and academic performance across five domains were examined using Generalised Linear Mixed Models, adjusted for a wide variety of socio-demographic variables. RESULTS: Higher academic performance was strongly and consistently related to higher sedentary time, with significant relationships seen across all five academic domains (range F=4.13, p=0.04 through to F=18.65, p=<0.01). In contrast, higher academic performance was only related to higher MVPA in two academic domains (writing F=5.28, p=0.02, and numeracy F=6.28, p=0.01) and was not related to language, reading and spelling performance. CONCLUSIONS: Findings highlight that sedentary behaviour can have positive relationships with non-physical outcomes. Positive relationships between MVPA and literacy and numeracy, as well as the well documented benefits for MVPA on physical and social health, suggest that it holds an important place in children’s lives, both in and outside of school.

Marcusson-Clavertz, David; Cardeña, Etzel; Terhune, Devin Blair (2016): Daydreaming style moderates the relation between working memory and mind wandering: Integrating two hypotheses. In: Journal of Experimental Psychology: Learning, Memory, and Cognition 42 (3), S. 451–464. DOI: 10.1037/xlm0000180.

Mind wandering—mentation unrelated to one’s current activity and surroundings—is a ubiquitous phenomenon, but seemingly competing ideas have been proposed regarding its relation to executive cognitive processes. The control-failure hypothesis postulates that executive processes prevent mind wandering, whereas the global availability hypothesis proposes that mind wandering requires executive resources, and thus an excess of such resources enables mind wandering. Here, we examined whether these hypotheses could be reconciled by considering the moderating influence of daydreaming style. We expected that executive resources would be positively related to mind wandering in those who typically experience positive mind wandering mentation, but negatively related in those who typically experience negative mentation. One hundred eleven participants reported mind wandering over 4 days using experience sampling and completed the sustained attention to response task (SART), the symmetry span task, and the Stroop task. There was a significant interaction between working memory and negative, but not positive, daydreaming style on mind wandering: Working memory related positively to mind wandering in those with a low negative style, but negatively in those with a high negative style. In contrast, poor Stroop performance significantly predicted increased mind wandering, but only in those with a low positive style. SART responses did not predict mind wandering although the relation was suggestively enhanced as the difficulty of daily life activities increased, indicating that the SART is more generalizable to high-demanding than low-demanding activities. These results suggest that the content and context of mind wandering episodes play important roles in the relation between executive processes and mind wandering.

Markevych, I.; Smith, M. P.; Jochner, S.; Standl, M.; Bruske, I.; Berg, A. von et al. (2016): Neighbourhood and physical activity in German adolescents: GINIplus and LISAplus. In: Environmental research 147, S. 284–293. DOI: 10.1016/j.envres.2016.02.023.

INTRODUCTION: Impact of neighbourhood on physical activity (PA) is under-investigated in European adolescents, and few studies have used objective data on both exposures and outcomes. Therefore we investigated the association between objectively measured neighbourhood characteristics and PA in 15-year-old German adolescents. METHODS: Study populations comprised of 688 adolescents residing in the urban Munich area and 504 from the rural Wesel area from the GINIplus and LISAplus birth cohorts. Neighbourhood was defined as a circular 500-m buffer around the residence. Greenness was calculated 1) as the mean Normalized Difference Vegetation Index (NDVI), and 2) as percent tree cover. Neighbourhood green spaces and sport and leisure facilities were defined as present or absent in a neighbourhood (data only available for Munich). Data on PA were collected from one-week triaxial accelerometry (hip-worn ActiGraph GT3X). Minutes of PA were classified into moderate-to-vigorous (MVPA), light and sedentary using Romanzini’s et al. triaxial cutoffs, and averaged over the recording period. Activity diaries were used for differentiation between school and leisure (total minus school) PA. Area-specific associations were assessed by adjusted negative binomial regressions. RESULTS: In the Wesel area, residing in a neighbourhood with higher NDVI was associated with 9% more leisure MVPA among females and with 8% more leisure MVPA in rural dwellers. In the Munich area, residing in a neighbourhood with sport facilities was associated with 9% more leisure MVPA. The latter association was only significant in urban dwellers while neighbourhood leisure facilities increased MVPA in rural dwellers. Estimates were very similar when total MVPA was considered rather than solely leisure. CONCLUSION: There is indication that neighbourhood features could be associated with MVPA in German adolescents. However, different features seem to be important across sexes and in rural/urban settings, which need to be specifically addressed in future studies.

Martino, Steven C.; Kovalchik, Stephanie A.; Collins, Rebecca L.; Becker, Kirsten M.; Shadel, William G.; D’Amico, Elizabeth J. (2016): Ecological momentary assessment of the association between exposure to alcohol advertising and early adolescents’ beliefs about alcohol. In: Journal of Adolescent Health 58 (1), S. 85–91. DOI: 10.1016/j.jadohealth.2015.08.010.

Purpose: To evaluate the momentary association between exposure to alcohol advertising and middle-school students’ beliefs about alcohol in real-world settings and to explore racial/ethnic differences in this association. Methods: Middle-school students (N = 588) carried handheld data collection devices for 14 days, recording their exposures to all forms of alcohol advertising during the assessment period. Students also responded to three investigator-initiated control prompts (programmed to occur randomly) on each day of the assessment period. After each exposure to advertising and at each control prompt, students reported their beliefs about alcohol. Mixed-effects regression models compared students’ beliefs about alcohol between moments of exposure to alcohol advertising and control prompts. Results: Students perceived the typical person their age who drinks alcohol (prototype perceptions) more favorably and perceived alcohol use as more normative at times of exposure to alcohol advertising than at times of nonexposure (i.e., at control prompts). Exposure to alcohol advertising was not associated with shifts in the perceived norms of black and Hispanic students, however, and the association between exposure and prototype perceptions was stronger among non-Hispanic students than among Hispanic students. Conclusions: Exposure to alcohol advertising is associated with acute shifts in adolescents’ perceptions of the typical person that drinks alcohol and the normativeness of drinking. These associations are both statistically and substantively meaningful.

McCabe, Kira O.; Fleeson, William (2016): Are traits useful? Explaining trait manifestations as tools in the pursuit of goals. In: Journal of Personality and Social Psychology 110 (2), S. 287–301. DOI: 10.1037/a0039490.

Traits and motivation mainly have been treated separately for almost a century. The purpose of these studies is to test the proposal that traits and motivation are intricately linked. Specifically, that 1 explanation for traits, at least in terms of their descriptiveness of what people actually do, is the goals people pursue. Study 1 used experience-sampling methodology to show that almost half the variance in extraversion and conscientiousness manifestation was explained by goal pursuit differences. Both why people enacted more of extraversion and/or conscientiousness than others, and why people enacted extraversion and/or conscientiousness at any given moment were explained by the goals people were pursuing at those moments. Study 2 used experimental methodology to show that extraversion and conscientiousness enactment was in fact caused by the goal pursuit. Study 3 employed observer ratings to show that the goal-dependent enactments of traits were observer-verified actual behaviors. In all 3 studies, different goals affected different traits discriminatively. Thus, these findings provided strong evidence for 1 explanation of traits, that they are useful for accomplishing goals. These findings provided 1 answer to long-standing questions about the conceptual relations between traits and motivation. And these findings clarified the meaning and nature of extraversion and conscientiousness by revealing part of what these traits are for.

Mehta, Clare M.; Walls, Courtney; Scherer, Emily A.; Feldman, Henry A.; Shrier, Lydia A. (2016): Daily affect and intimacy in emerging adult couples. In: Journal of Adult Development. DOI: 10.1007/s10804-016-9226-9.

We investigated individual- and couple-level associations between daily intimacy and affective states (N = 2211 observations) in 20 heterosexual emerging adult couples (age 18–25 years, M = 23) who had been in a sexual relationship with one another for at least 3 weeks (M = 12 months). Individual analyses revealed that emerging adults’ feelings of intimacy varied from day to day and that there were no gender differences in daily intimacy. Affect and intimacy were positively associated within day for women, but not for men. Time-lagged individual-level analyses revealed that prior-day positive or negative affect did not predict present-day intimacy for men or women. However, prior-day intimacy positively predicted present-day positive affect in men and negatively predicted present-day negative affect in women. Time-lagged couple-level analyses revealed that men’s prior-day positive affect positively predicted their female partner’s present-day intimacy. Women’s prior-day intimacy negatively predicted their male partner’s present-day negative affect. Implications of the day-to-day associations of intimacy with positive and negative affect within emerging adult couples are discussed.

Mill, Aire; Realo, Anu; Allik, Juri (2015): Retrospective Ratings of Emotions: the Effects of Age, Daily Tiredness, and Personality. In: Frontiers in psychology 6, S. 2020. DOI: 10.3389/fpsyg.2015.02020.

Remembering the emotions we have experienced in the past is the core of one’s unique life-experience. However, there are many factors, both at the state and trait level that can affect the way past feelings are seen. The main aim of the current study was to examine the impact of individual differences on systematic biases in retrospective ratings compared to the momentary experience of basic emotions such as sadness, fear, happiness, and anger. To this end, an experience sampling study across 2 weeks was conducted using a younger and an older age-group; the experience of momentary emotions was assessed on 7 randomly determined occasions per day, the retrospective ratings being collected at the end of each day about that day, as well as at the end of the study about the previous 2 weeks. The results indicated that age and daily tiredness have significant effects on retrospective emotion ratings over a 1-day period (state level), enhancing the retrospective ratings of negative emotions and decreasing the ratings of felt happiness. Whereas personality traits influence the more long-term emotion experience (trait level), with all Big Five personality traits having selective impact on retrospective emotion ratings of fear, sadness, happiness, and anger. Findings provide further evidence about the systematic biases in retrospective emotion ratings, suggesting that, although retrospective ratings are based on momentary experience, daily tiredness and personality traits systematically influence the way in which past feelings are seen.

Miner, Adam; Kuhn, Eric; Hoffman, Julia E.; Owen, Jason E.; Ruzek, Josef I.; Taylor, C. Barr (2016): Feasibility, Acceptability, and Potential Efficacy of the PTSD Coach App: A Pilot Randomized Controlled Trial With Community Trauma Survivors. In: Psychological Trauma: Theory, Research, Practice, and Policy. DOI: 10.1037/tra0000092.

Objective: Posttraumatic stress disorder (PTSD) is a major public health concern. Although effective treatments exist, affected individuals face many barriers to receiving traditional care. Smartphones are carried by nearly 2 thirds of the U.S. population, offering a promising new option to overcome many of these barriers by delivering self-help interventions through applications (apps). As there is limited research on apps for trauma survivors with PTSD symptoms, we conducted a pilot feasibility, acceptability, and potential efficacy trial of PTSD Coach, a self-management smartphone app for PTSD. Method: A community sample of trauma survivors with PTSD symptoms (N = 49) were randomized to 1 month using PTSD Coach or a waitlist condition. Self-report assessments were completed at baseline, postcondition, and 1-month follow-up. Following the postcondition assessment, waitlist participants were crossed-over to receive PTSD Coach. Results: Participants reported using the app several times per week, throughout the day across multiple contexts, and endorsed few barriers to use. Participants also reported that PTSD Coach components were moderately helpful and that they had learned tools and skills from the app to manage their symptoms. Between conditions effect size estimates were modest (d = −0.25 to −0.33) for PTSD symptom improvement, but not statistically significant. Conclusions: Findings suggest that PTSD Coach is a feasible and acceptable intervention. Findings regarding efficacy are less clear as the study suffered from low statistical power; however, effect size estimates, patterns of within group findings, and secondary analyses suggest that further development and research on PTSD Coach is warranted.

Miranda, Robert, JR.; MacKillop, James; Treloar, Hayley; Blanchard, Alexander; Tidey, Jennifer W.; Swift, Robert M. et al. (2016): Biobehavioral mechanisms of topiramate’s effects on alcohol use: An investigation pairing laboratory and ecological momentary assessments. In: Addiction Biology 21 (1), S. 171–182. DOI: 10.1111/adb.12192.

Topiramate reduces drinking, but little is known about the mechanisms that precipitate this effect. This double‐blind randomized placebo‐controlled study assessed the putative mechanisms by which topiramate reduces alcohol use among 96 adult non‐treatment‐seeking heavy drinkers in a laboratory‐based alcohol cue reactivity assessment and in the natural environment using ecological momentary assessment methods. Topiramate reduced the quantity of alcohol heavy drinkers consumed on drinking days and reduced craving while participants were drinking but did not affect craving outside of drinking episodes in either the laboratory or in the natural environment. Topiramate did not alter the stimulant or sedative effects of alcohol ingestion during the ascending limb of the blood alcohol curve. A direct test of putative mechanisms of action using multilevel structural equation mediation models showed that topiramate reduced drinking indirectly by blunting alcohol‐induced craving. These findings provide the first real‐time prospective evidence that topiramate reduces drinking by reducing alcohol’s priming effects on craving and highlight the importance of craving as an important treatment target of pharmacotherapy for alcoholism.

Mocking, R. J.; Figueroa, C. A.; Rive, M. M.; Geugies, H.; Servaas, M. N.; Assies, J. et al. (2016): Vulnerability for new episodes in recurrent major depressive disorder: protocol for the longitudinal DELTA-neuroimaging cohort study. In: BMJ open 6 (3), S. e009510. DOI: 10.1136/bmjopen-2015-009510.

INTRODUCTION: Major depressive disorder (MDD) is widely prevalent and severely disabling, mainly due to its recurrent nature. A better understanding of the mechanisms underlying MDD-recurrence may help to identify high-risk patients and to improve the preventive treatment they need. MDD-recurrence has been considered from various levels of perspective including symptomatology, affective neuropsychology, brain circuitry and endocrinology/metabolism. However, MDD-recurrence understanding is limited, because these perspectives have been studied mainly in isolation, cross-sectionally in depressed patients. Therefore, we aim at improving MDD-recurrence understanding by studying these four selected perspectives in combination and prospectively during remission. METHODS AND ANALYSIS: In a cohort design, we will include 60 remitted, unipolar, unmedicated, recurrent MDD-participants (35-65 years) with >/=2 MDD-episodes. At baseline, we will compare the MDD-participants with 40 matched controls. Subsequently, we will follow-up the MDD-participants for 2.5 years while monitoring recurrences. We will invite participants with a recurrence to repeat baseline measurements, together with matched remitted MDD-participants. Measurements include questionnaires, sad mood-induction, lifestyle/diet, 3 T structural (T1-weighted and diffusion tensor imaging) and blood-oxygen-level-dependent functional MRI (fMRI) and MR-spectroscopy. fMRI focusses on resting state, reward/aversive-related learning and emotion regulation. With affective neuropsychological tasks we will test emotional processing. Moreover, we will assess endocrinology (salivary hypothalamic-pituitary-adrenal-axis cortisol and dehydroepiandrosterone-sulfate) and metabolism (metabolomics including polyunsaturated fatty acids), and store blood for, for example, inflammation analyses, genomics and proteomics. Finally, we will perform repeated momentary daily assessments using experience sampling methods at baseline. We will integrate measures to test: (1) differences between MDD-participants and controls; (2) associations of baseline measures with retro/prospective recurrence-rates; and (3) repeated measures changes during follow-up recurrence. This data set will allow us to study different predictors of recurrence in combination. ETHICS AND DISSEMINATION: The local ethics committee approved this study (AMC-METC-Nr.:11/050). We will submit results for publication in peer-reviewed journals and presentation at (inter)national scientific meetings. TRIAL REGISTRATION NUMBER: NTR3768.

O’Leary, K.; Small, B. J.; Panaite, V.; Bylsma, L. M.; Rottenberg, J. (2016): Sleep quality in healthy and mood-disordered persons predicts daily life emotional reactivity. In: Cognition & emotion, S. 1–9. DOI: 10.1080/02699931.2015.1126554.

Disordered sleep has been linked to impaired emotional functioning in healthy and depressed individuals. Little is known, however, about how chronic sleep problems influence emotional reactivity in everyday life. Participants with major or minor unipolar depressive disorder (n = 60) and healthy controls (n = 35) reported on sleep and emotional responses to daily life events using a computerised Experience Sampling Method. We examined whether impaired sleep quality influenced emotional reactivity to daily events, and if this relationship was altered by unipolar mood disorders. Among healthy individuals, sleep difficulties were associated with enhanced negative affect (NA) to unpleasant events and a dulled response to neutral events. However, among mood-disordered persons, sleep difficulties were associated with higher NA across all types of everyday life events. Impaired sleep quality differentially affects daily life emotional reactions as a function of depression.

Oppenheimer, C. W.; Ladouceur, C. D.; Waller, J. M.; Ryan, N. D.; Allen, K. B.; Sheeber, L. et al. (2016): Emotion Socialization in Anxious Youth: Parenting Buffers Emotional Reactivity to Peer Negative Events. In: Journal of abnormal child psychology. DOI: 10.1007/s10802-015-0125-5.

Anxious youth exhibit heightened emotional reactivity, particularly to social-evaluative threat, such as peer evaluation and feedback, compared to non-anxious youth. Moreover, normative developmental changes during the transition into adolescence may exacerbate emotional reactivity to peer negative events, particularly for anxious youth. Therefore, it is important to investigate factors that may buffer emotional reactivity within peer contexts among anxious youth. The current study examined the role of parenting behaviors in child emotional reactivity to peer and non-peer negative events among 86 anxious youth in middle childhood to adolescence (Mean age = 11.29, 54 % girls). Parenting behavior and affect was observed during a social-evaluative laboratory speech task for youth, and ecological momentary assessment (EMA) methods were used to examine youth emotional reactivity to typical daily negative events within peer and non-peer contexts. Results showed that parent positive behaviors, and low levels of parent anxious affect, during the stressful laboratory task for youth buffered youth negative emotional reactivity to real-world negative peer events, but not non-peer events. Findings inform our understanding of parenting influences on anxious youth’s emotional reactivity to developmentally salient negative events during the transition into adolescence.

Padhye, Nikhil S.; Jing, Wang (2015): Pattern of active and inactive sequences of diabetes self-monitoring in mobile phone and paper diary users. In: Conference proceedings : … Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference 2015, S. 7630–7633. DOI: 10.1109/EMBC.2015.7320159.

In a pilot randomized controlled trial involving overweight or obese participants with type 2 diabetes, we find that smartphone users have sharply higher adherence to self-monitoring of diet, physical activity, blood glucose, and body weight, as compared to paper diary users. By characterizing the pattern of adherence with the probability of continuation of active and inactive sequences of self-monitoring, we find that smartphone users have longer active sequences of self-monitoring of all four behaviors that were being monitored. Smartphone users are also quicker to resume self-monitoring of diet and physical activity after a lapse in self-monitoring, whereas paper diary users have shorter inactive sequences for monitoring blood glucose and body weight. The findings are informative for data collection methodology in this burgeoning area of research.

Papp, Lauren M.; Blumenstock, Shari M. (2016): Momentary affect and risky behavior correlates of prescription drug misuse among young adult dating couples: An experience sampling study. In: Addictive behaviors 53, S. 161–167. DOI: 10.1016/j.addbeh.2015.10.016.

Although published research based on retrospective survey designs has established prescription drug misuse as a serious health issue for individuals and society, misuse behavior has not been investigated as it occurs in daily life and important relationships. To address this gap, young adult romantic couples were recruited from the community to participate in an experience sampling study. Participants were identified through phone screen procedures as having engaged in recent prescription drug misuse behavior. Participants (n =46 couples) completed electronic diary reports throughout the day for 10days, tapping momentary affect, sexual experiences, prescription drug misuse, and alcohol and other drug use. Dyadic multilevel modeling revealed a more consistent pattern of associations between prescription drug misuse and problematic affective and behavioral outcomes for female partners than male partners. Specifically, during epochs of females’ prescription drug misuse, they experienced relatively higher levels of negative affect and sexual regret. Also, females who misused prescriptions more during the study period evidenced lower levels of sexual enjoyment and engaged in more unprotected sex, alcohol use, and heavy alcohol use in daily life. Males’ in-the-moment prescription drug misuse was not associated with their concurrent outcomes, though males with relatively more misuse across the reporting period were more likely to engage in heavy drinking. Couples’ time together emerged as a moderator of prescription drug misuse in daily life: Females who spent relatively more time with their partner across the study were less likely to engage in misuse, and proportion of time spent together moderated several of the momentary misuse-outcome linkages. This study supports the use of ecologically-valid sampling methods for characterizing young adults’ prescription drug misuse in daily life and relationship contexts.

Park, J. W.; Chu, M. K.; Kim, J. M.; Park, S. G.; Cho, S. J. (2016): Analysis of Trigger Factors in Episodic Migraineurs Using a Smartphone Headache Diary Applications. In: PloS one 11 (2), S. e0149577. DOI: 10.1371/journal.pone.0149577.

BACKGROUND: Various stimuli can trigger migraines in susceptible individuals. We examined migraine trigger factors by using a smartphone headache diary application. METHOD: Episodic migraineurs who agreed to participate in our study downloaded smartphone headache diary application, which was designed to capture the details regarding headache trigger factors and characteristics for 3 months. The participants were asked to access the smartphone headache diary application daily and to confirm the presence of a headache and input the types of trigger factors. RESULTS: Sixty-two participants kept diary entries until the end of the study. The diary data for 4,579 days were analyzed. In this data set, 1,099 headache days (336 migraines, 763 non-migraine headaches) were recorded; of these, 772 headache events had with trigger factors, and 327 events did not have trigger factors. The common trigger factors that were present on headache days included stress, fatigue, sleep deprivation, hormonal changes, and weather changes. The likelihood of a headache trigger was 57.7% for stress, 55.1% for sleep deprivation, 48.5% for fatigue, and 46.5% for any trigger. The headaches with trigger factors were associated with greater pain intensity (p<0.001), headache-related disability (p<0.001), abortive medication use (p = 0.02), and the proportion of migraine (p < 0.001), relative to those without trigger factors. Traveling (odd ratios [OR]: 6.4), hormonal changes (OR: 3.5), noise (OR: 2.8), alcohol (OR: 2.5), overeating (OR: 2.4), and stress (OR:1.8) were significantly associated with migraines compared to non-migraine headaches. The headaches that were associated with hormonal changes or noise were more often migraines, regardless of the preventive medication. The headaches due to stress, overeating, alcohol, and traveling were more often migraines without preventive medication, but it was not evident with preventive medication. CONCLUSION: Smartphone headache diary application is an effective tool to assess migraine trigger factors. The headaches with trigger factors had greater severity or migraine features. The type of triggers and the presence of preventive medication influenced the headache characteristics; hence, an investigation of trigger factors would be helpful in understanding migraine occurrences.

Partridge, Stephanie R.; Allman-Farinelli, Margaret; McGeechan, Kevin; Balestracci, Kate; Wong, Annette T. Y.; Hebden, Lana et al. (2016): Process evaluation of TXT2BFiT: a multi-component mHealth randomised controlled trial to prevent weight gain in young adults. In: The international journal of behavioral nutrition and physical activity 13 (1), S. 7. DOI: 10.1186/s12966-016-0329-2.

BACKGROUND: TXT2BFiT was one of the first few innovative mHealth programs designed for young adults (18-35 years) with demonstrated efficacy in weight management. However, research is lacking to understand intervention effectiveness, especially in complex, multi-component mHealth programs. This paper investigates participant perceptions of and engagement with the mHealth program components in the TXT2BFiT to understand program effects. METHODS: Process evaluation data were collected continuously for the study duration. The TXT2BFiT program was a multi-component lifestyle program delivered intensively for 3-month followed by a 6-month maintenance phase. Program components included personalised coaching calls, text messages, emails, smartphone apps and website access. Process evaluation measures included frequency of use of components and frequency for number of components used (online survey data); dose delivered and engagement with program components (researcher logs and web platform reports); frequency, timing and difficulties experienced with program components (online survey data) and overall perceptions of program components (online survey data and semi-structured telephone interviews). Qualitative data analysis was performed using NVivo10. RESULTS: Over 80 % of participants completed post-intervention (3-months, intervention, n = 110, control n = 104) and follow-up surveys (9-months, intervention, n = 96, control n = 104). Thirty intervention participants completed semi-structured telephone interviews. Participants reported high use of coaching calls, text messages and emails and no issues in content delivery from these components. These components were described as helping them to achieve their goals. Website and app use and engagement was low for the duration of the program. Participants would prefer incorporation of the self-monitoring apps and website resources into one smartphone application that can be individualised by entry of their personal data. CONCLUSIONS: Our process evaluation has allowed a comprehensive understanding of use and preference for different program components. The high value placed on the coaching calls is consistent with a desire for personalisation of the mHealth program and even further tailoring of text messages and emails. The findings of this study will be used to revise TXT2BFiT for future users. TRIAL REGISTRATION: The trial is registered with the Australian New Zealand Clinical Trials Registry ( ACTRN12612000924853 ).

Piasecki, T. M.; Hedeker, D.; Dierker, L. C.; Mermelstein, R. J. (2016): Progression of Nicotine Dependence, Mood Level, and Mood Variability in Adolescent Smokers. In: Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors. DOI: 10.1037/adb0000165.

Mood processes are theorized to play a role in the initiation and progression of smoking behavior. Available work using real-time assessments in samples of young smokers, including several reports from the Social and Emotional Contexts of Adolescent Smoking Patterns (SECASP) study, has indicated that smoking events acutely improve mood and that escalating smoking frequency may stabilize mood. However, prior analyses have not specifically evaluated within-person change in nicotine dependence, which is conceptually distinguishable from frequent smoking and may be associated with unique mood consequences. The current investigation addressed this question using data from 329 adolescent SECASP participants (9th or 10th grade at recruitment) who contributed mood reports via ecological momentary assessment in up to four 1-week bursts over the course of 24 months. Mixed-effects location scale analyses revealed that within-person increases in scores on the Nicotine Dependence Syndrome Scale were associated with elevations in negative mood level and increased variability of both positive and negative moods. These effects remained when within-person changes in smoking frequency were covaried and were not fully attributable to a subgroup of youth who rapidly escalated their smoking frequency over time. The findings indicate that adolescents tend to show increasing levels of positive mood states, decreasing levels of negative mood, and diminishing mood variability between ages 16 to 18, but progression of nicotine dependence may counteract some of these developmental gains. Emergence of withdrawal symptoms is a likely explanation for the adverse mood effects associated with dependence progression.

Pike, James Russell; Xie, Bin; Tan, Nasya; Sabado-Liwag, Melanie Dee; Orne, Annette; Toilolo, Tupou et al. (2016): Developing an Internet- and Mobile-Based System to Measure Cigarette Use Among Pacific Islanders: An Ecological Momentary Assessment Study. In: JMIR mHealth and uHealth 4 (1), S. e2. DOI: 10.2196/mhealth.4437.

BACKGROUND: Recent prevalence data indicates that Pacific Islanders living in the United States have disproportionately high smoking rates when compared to the general populace. However, little is known about the factors contributing to tobacco use in this at-risk population. Moreover, few studies have attempted to determine these factors utilizing technology-based assessment techniques. OBJECTIVE: The objective was to develop a customized Internet-based Ecological Momentary Assessment (EMA) system capable of measuring cigarette use among Pacific Islanders in Southern California. This system integrated the ubiquity of text messaging, the ease of use associated with mobile phone apps, the enhanced functionality offered by Internet-based Cell phone-optimized Assessment Techniques (ICAT), and the high survey completion rates exhibited by EMA studies that used electronic diaries. These features were tested in a feasibility study designed to assess whether Pacific Islanders would respond to this method of measurement and whether the data gathered would lead to novel insights regarding the intrapersonal, social, and ecological factors associated with cigarette use. METHODS: 20 young adult smokers in Southern California who self-identified as Pacific Islanders were recruited by 5 community-based organizations to take part in a 7-day EMA study. Participants selected six consecutive two-hour time blocks per day during which they would be willing to receive a text message linking them to an online survey formatted for Web-enabled mobile phones. Both automated reminders and community coaches were used to facilitate survey completion. RESULTS: 720 surveys were completed from 840 survey time blocks, representing a completion rate of 86%. After adjusting for gender, age, and nicotine dependence, feeling happy (P=<.001) or wanting a cigarette while drinking alcohol (P=<.001) were positively associated with cigarette use. Being at home (P=.02) or being around people who are not smoking (P=.01) were negatively associated with cigarette use. CONCLUSIONS: The results of the feasibility study indicate that customized systems can be used to conduct technology-based assessments of tobacco use among Pacific Islanders. Such systems can foster high levels of survey completion and may lead to novel insights for future research and interventions.

Poerio, G. L.; Totterdell, P.; Emerson, L. M.; Miles, E. (2016): Social Daydreaming and Adjustment: An Experience-Sampling Study of Socio-Emotional Adaptation During a Life Transition. In: Frontiers in psychology 7, S. 13. DOI: 10.3389/fpsyg.2016.00013.

Estimates suggest that up to half of waking life is spent daydreaming; that is, engaged in thought that is independent of, and unrelated to, one’s current task. Emerging research indicates that daydreams are predominately social suggesting that daydreams may serve socio-emotional functions. Here we explore the functional role of social daydreaming for socio-emotional adjustment during an important and stressful life transition (the transition to university) using experience-sampling with 103 participants over 28 days. Over time, social daydreams increased in their positive characteristics and positive emotional outcomes; specifically, participants reported that their daydreams made them feel more socially connected and less lonely, and that the content of their daydreams became less fanciful and involved higher quality relationships. These characteristics then predicted less loneliness at the end of the study, which, in turn was associated with greater social adaptation to university. Feelings of connection resulting from social daydreams were also associated with less emotional inertia in participants who reported being less socially adapted to university. Findings indicate that social daydreaming is functional for promoting socio-emotional adjustment to an important life event. We highlight the need to consider the social content of stimulus-independent cognitions, their characteristics, and patterns of change, to specify how social thoughts enable socio-emotional adaptation.

Possemato, K.; Maisto, S. A.; Wade, M.; Barrie, K.; McKenzie, S.; Lantinga, L. J.; Ouimette, P. (2015): Ecological momentary assessment of PTSD symptoms and alcohol use in combat veterans. In: Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors 29 (4), S. 894–905. DOI: 10.1037/adb0000129.

Despite high rates of comorbid hazardous alcohol use and posttraumatic stress disorder (PTSD), the nature of the functional relationship between these problems is not fully understood. Insufficient evidence exists to fully support models commonly used to explain the relationship between hazardous alcohol use and PTSD including the self-medication hypothesis and the mutual maintenance model. Ecological momentary assessment (EMA) can monitor within-day fluctuations of symptoms and drinking to provide novel information regarding potential functional relationships and symptom interactions. This study aimed to model the daily course of alcohol use and PTSD symptoms and to test theory-based moderators, including avoidance coping and self-efficacy to resist drinking. A total of 143 recent combat veterans with PTSD symptoms and hazardous drinking completed brief assessments of alcohol use, PTSD symptoms, mood, coping, and self-efficacy 4 times daily for 28 days. Our results support the finding that increases in PTSD are associated with more drinking within the same 3-hr time block, but not more drinking within the following time block. Support for moderators was found: Avoidance coping strengthened the relationship between PTSD and later drinking, while self-efficacy to resist drinking weakened the relationship between PTSD and later drinking. An exploratory analysis revealed support for self-medication occurring in certain times of the day: Increased PTSD severity in the evening predicted more drinking overnight. Overall, our results provide mixed support for the self-medication hypothesis. Also, interventions that seek to reduce avoidance coping and increase patient self-efficacy may help veterans with PTSD decrease drinking.

Powers, Katherine E.; Chavez, Robert S.; Heatherton, Todd F. (2016): Individual differences in response of dorsomedial prefrontal cortex predict daily social behavior. In: Social Cognitive and Affective Neuroscience 11 (1), S. 121–126. DOI: 10.1093/scan/nsv096.

The capacity to accurately infer the thoughts and intentions of other people is critical for effective social interaction, and neural activity in dorsomedial prefrontal cortex (dmPFC) has long been linked with the extent to which people engage in mental state attribution. In this study, we combined functional neuroimaging and experience sampling methodologies to test the predictive value of this neural response for daily social behaviors. We found that individuals who displayed greater activity in dmPFC when viewing social scenes spent more time around other people on a daily basis. These findings suggest a specific role for the neural mechanisms that support the capacity to mentalize in guiding individuals toward situations containing valuable social outcomes.

Prem, Roman; Kubicek, Bettina; Diestel, Stefan; Korunka, Christian (2016): Regulatory job stressors and their within-person relationships with ego depletion: The roles of state anxiety, self-control effort, and job autonomy. In: Journal of Vocational Behavior 92, S. 22–32. DOI: 10.1016/j.jvb.2015.11.004.

Our research aimed at disentangling the underlying processes of the adverse relationship between regulatory job stressors and ego depletion. Specifically, we analyzed whether state anxiety and self-control effort would mediate the within-person relationships of time pressure, planning and decision-making, and emotional dissonance with ego depletion. In addition, we also tested potential attenuating effects of situational job autonomy on the adverse effects of regulatory job stressors on state anxiety, self-control effort, and ego depletion. Based on an experience sampling design, we gathered a sample of 97 eldercare workers who provided data on 721 experience-sampling occasions. Multilevel moderated serial mediation analyses revealed that time pressure and emotional dissonance, but not planning and decision-making, exerted significant serial indirect effects on ego depletion via state anxiety and self-control effort. Finally, we found conditional serial indirect effects of all three regulatory job stressors on ego depletion as a function of job autonomy. Theoretical implications for scholarly understanding of coping with regulatory job stressors are discussed.

Price, Rebecca B.; Allen, Kristy Benoit; Silk, Jennifer S.; Ladouceur, Cecile D.; Ryan, Neal D.; Dahl, Ronald E. et al. (2016): Vigilance in the laboratory predicts avoidance in the real world: A dimensional analysis of neural, behavioral, and ecological momentary data in anxious youth. In: Developmental cognitive neuroscience 19, S. 128–136. DOI: 10.1016/j.dcn.2016.03.001.

Vigilance and avoidance of threat are observed in anxious adults during laboratory tasks, and are posited to have real-world clinical relevance, but data are mixed in anxious youth. We propose that vigilance-avoidance patterns will become evident in anxious youth through a focus on individual differences and real-world strategic avoidance. Decreased functional connectivity between the amygdala and prefrontal cortex (PFC) could play a mechanistic role in this link. 78 clinically anxious youth completed a dot-probe task to assess vigilance to threat while undergoing fMRI. Real-world avoidance was assessed using Ecological Momentary Assessment (EMA) of self-reported suppression and distraction during negative life events. Vigilance toward threat was positively associated with EMA distraction and suppression. Functional connectivity between a right amygdala seed region and dorsomedial and right dorsolateral PFC regions was inversely related to EMA distraction. Dorsolateral PFC-amygdalar connectivity statistically mediated the relationship between attentional vigilance and real-world distraction. Findings suggest anxious youth showing attentional vigilance toward threat are more likely to use suppression and distraction to regulate negative emotions. Reduced PFC control over limbic reactivity is a possible neural substrate of this pattern. These findings lend ecological validity to laboratory vigilance assessments and suggest PFC-amygdalar connectivity is a neural mechanism bridging laboratory and naturalistic contexts.

Probst, Thomas; Pryss, Rudiger; Langguth, Berthold; Schlee, Winfried (2016): Emotional states as mediators between tinnitus loudness and tinnitus distress in daily life: Results from the “TrackYourTinnitus” application. In: Scientific reports 6, S. 20382. DOI: 10.1038/srep20382.

The psychological process how tinnitus loudness leads to tinnitus distress remains unclear. This cross-sectional study investigated the mediating role of the emotional state “stress level” and of the two components of the emotional state “arousal” and “valence” with N = 658 users of the “TrackYourTinnitus” smartphone application. Stress mediated the relationship between tinnitus loudness and tinnitus distress in a simple mediation model and even in a multiple mediation model when arousal and valence were held constant. Arousal mediated the loudness-distress relationship when holding valence constant, but not anymore when controlling for valence as well as for stress. Valence functioned as a mediator when controlling for arousal and even when holding arousal and stress constant. The direct effect of tinnitus loudness on tinnitus distress remained significant in all models. This study demonstrates that emotional states affect the process how tinnitus loudness leads to tinnitus distress. We thereby could show that the mediating influence of emotional valence is at least equally strong as the influence of stress. Implications of the findings for future research, assessment, and clinical management of tinnitus are discussed.

Ravesloot, Craig; Ward, Bryce; Hargrove, Tannis; Wong, Jennifer; Livingston, Nick; Torma, Linda; Ipsen, Catherine (2016): Why stay home? Temporal association of pain, fatigue and depression with being at home. In: Disability and health journal 9 (2), S. 218–225. DOI: 10.1016/j.dhjo.2015.10.010.

BACKGROUND: Community participation is important to most people with disabilities despite the fact that common secondary conditions like pain, fatigue and depression may increase the difficulty of leaving home. Despite decades of research on these secondary conditions, little is known about how they are associated with being at home. OBJECTIVE: We used Ecological Momentary Assessment data to examine within subject fluctuation in these secondary conditions to examine their effect on the likelihood that participants remain at or return home. METHODS: Participants (n = 139) were recruited from a population based sampling frame to complete an Ecological Momentary Assessment that queried their location and experience with secondary conditions six times a day for two weeks. RESULTS: Between subjects secondary condition ratings averaged across time periods indicated that pain and depression were associated with the share of measurement periods that respondents reported being at home. Within subject results indicated that a standard unit increase in pain, fatigue and depression was associated with being home one to two days later. Within day results indicated that increases in pain and fatigue were associated with increased likelihood of being home later, but increases in depression were associated with lower likelihood of being home later. CONCLUSION: These results suggest there may be a complicated relationship among these secondary conditions and community participation with effects observed both across and within days. One interpretation suggests that secondary condition severity is tempered by adjusting participation. These results may have implications for intervening on these secondary conditions.

Ray, Lara A.; Bujarski, Spencer (2016): Mechanisms of topiramate effects: Refining medications development for alcoholism. In: Addiction Biology 21 (1), S. 183–184. DOI: 10.1111/adb.12226.

Comment on the articles, Self-efficacy mediates the effects of topiramate and GRIK1 genotype on drinking by H. R. Kranzler et al. (2014) and Biobehavioral mechanisms of topiramate’s effects on alcohol use: An investigation pairing laboratory and ecological momentary assessments by R. Miranda et al. (see record [rid]2016-04794-006[/rid]). Kranzler et al. described analyses of night-time drinking behavior among treatment-seeking patients during a 12-week randomized and controlled trial of topiramate (200 mg/day) for alcohol dependence. Interestingly, this study found that the pharmacogenetic effect on nighttime drinking was accounted for by mean ratings of self-efficacy. Kranzler et al. used interactive voice response (IVR) technology to obtain daily diary data in the context of a clinical trial, whereas Miranda et al. combined ecological momentary assessment (EMA) with human laboratory paradigms such as cue-exposure and alcohol challenge. One of the most notable strengths of both studies is their ability to test mechanisms in relation to carefully ascertained alcohol use over the course of each trial. As noted by Miranda et al. and discussed in detail elsewhere, the association between a particular mechanism and alcohol use is often implied in human laboratory studies when in fact it should be explicitly examined. These two studies do a commendable job of capturing the dynamic nature of constructs such as craving and self-efficacy, while interrogating the association between these putative mechanisms of action and alcohol use.

Reinecke, Leonard; Hofmann, Wilhelm (2016): Slacking off or winding down? An experience sampling study on the drivers and consequences of media use for recovery versus procrastination. In: Human Communication Research. DOI: 10.1111/hcre.12082.

Today’s constant availability of media content provides users with various recreational resources. It may also challenge self‐control, however, once media exposure conflicts with other goals and obligations. How media users deal with these self‐regulatory chances and risks in their daily lives is largely unknown. Our study addressed the predictors and consequences of recreational and procrastinatory media use using experience sampling methodology (N = 215; 1,094 media use episodes). Results suggest that trait (self‐control, performance goal orientation) as well as state variables (exhaustion) are significant predictors of media use for recovery versus procrastination. Whereas recreational media use showed a positive effect on entertainment, which in turn enhanced subjective well‐being, negative self‐evaluation elicited by procrastinatory media use negatively affected well‐being.

Reininghaus, U.; Kempton, M. J.; Valmaggia, L.; Craig, T. K.; Garety, P.; Onyejiaka, A. et al. (2016): Stress Sensitivity, Aberrant Salience, and Threat Anticipation in Early Psychosis: An Experience Sampling Study. In: Schizophrenia bulletin. DOI: 10.1093/schbul/sbv190.

While contemporary models of psychosis have proposed a number of putative psychological mechanisms, how these impact on individuals to increase intensity of psychotic experiences in real life, outside the research laboratory, remains unclear. We aimed to investigate whether elevated stress sensitivity, experiences of aberrant novelty and salience, and enhanced anticipation of threat contribute to the development of psychotic experiences in daily life. We used the experience sampling method (ESM) to assess stress, negative affect, aberrant salience, threat anticipation, and psychotic experiences in 51 individuals with first-episode psychosis (FEP), 46 individuals with an at-risk mental state (ARMS) for psychosis, and 53 controls with no personal or family history of psychosis. Linear mixed models were used to account for the multilevel structure of ESM data. In all 3 groups, elevated stress sensitivity, aberrant salience, and enhanced threat anticipation were associated with an increased intensity of psychotic experiences. However, elevated sensitivity to minor stressful events (chi2 = 6.3, P = 0.044), activities (chi2 = 6.7, P = 0.036), and areas (chi2 = 9.4, P = 0.009) and enhanced threat anticipation (chi2 = 9.3, P = 0.009) were associated with more intense psychotic experiences in FEP individuals than controls. Sensitivity to outsider status (chi2 = 5.7, P = 0.058) and aberrantly salient experiences (chi2 = 12.3, P = 0.002) were more strongly associated with psychotic experiences in ARMS individuals than controls. Our findings suggest that stress sensitivity, aberrant salience, and threat anticipation are important psychological processes in the development of psychotic experiences in daily life in the early stages of the disorder.

Righetti, Francesca; Gere, Judith; Hofmann, Wilhelm; Visserman, Mariko L.; Van Lange, Paul A M (2016): The Burden of Empathy: Partners’ Responses to Divergence of Interests in Daily Life. In: Emotion (Washington, D.C.). DOI: 10.1037/emo0000163.

Empathy has often been discussed as a beneficial process from which favorable individual and interpersonal experiences may be derived. The present work investigates whether empathy may sometimes be a burden rather than a benefit, under certain interpersonal circumstances. Specifically, we hypothesized that encountering situations of divergence of interests with a partner may cause discomfort, and that empathizing with one’s partner would exacerbate this discomfort, resulting in higher levels of negative mood and stress that can affect relationship satisfaction. We tested these hypotheses using innovative experience sampling methodology in which both partners reported on their experiences in their natural environments. In support, we found that when people encountered divergence of interests with one’s partner, as compared with when they did not, they experienced higher negative mood and stress and, consequently, lower relationship satisfaction. These effects were intensified, rather than reduced, by empathy.

Ruscio, Aimee C.; Muench, Christine; Brede, Emily; Waters, Andrew J. (2016): Effect of brief mindfulness practice on self-reported affect, craving, and smoking: A pilot randomized controlled trial using ecological momentary assessment. In: Nicotine & Tobacco Research 18 (1), S. 64–73. DOI: 10.1037/t37822-000;

Introduction: Despite efficacious pharmacological and behavioral treatments, most smokers attempt to quit without assistance and fail to quit. Mindfulness practice may be useful in smoking cessation. Methods: This ecological momentary assessment (EMA) study was a pilot parallel group randomized controlled trial of a brief mindfulness practice (Brief-MP) intervention on self-reported smoking behavior delivered to smokers on a Personal Digital Assistant (PDA) in the field. Adult community smokers (N = 44) were randomly assigned to a Brief-MP (n = 24) or Control (sham meditation; n = 20) group. Participants were instructed to smoke as much or as little as they liked. Participants carried a PDA for 2 weeks and were instructed to initiate 20 minutes of meditation (or control) training on the PDA daily, completing an assessment of cognitive and affective processes immediately afterwards. Additionally, they completed assessments at random times up to four times per day. Primary outcome variables were negative affect, craving, and cigarettes smoked per day, all self-reported. Results: Thirty-seven participants provided EMA data totaling 1874 assessments. Linear Mixed Model analyses on EMA data revealed that Brief-MP (vs. Control) reduced overall negative affect, F(1, 1798) = 13.8, P = .0002; reduced craving immediately post-meditation, (Group × Assessment Type interaction, F(2, 1796) = 12.3, P = .0001); and reduced cigarettes smoked per day over time (Group × Day interaction, F(1, 436) = 5.50, P = .01). Conclusions: Brief-MP administered in the field reduced negative affect, craving, and cigarette use, suggesting it may be a useful treatment.

Salmela-Aro, Katariina; Moeller, Julia; Schneider, Barbara; Spicer, Justina; Lavonen, Jari (2016): Integrating the light and dark sides of student engagement using person-oriented and situation-specific approaches. In: Learning and Instruction. DOI: 10.1016/j.learninstruc.2016.01.001.

This study contributes to the research on student engagement in three ways: 1) by combining questionnaire and situational measures of engagement using the Experience Sampling Method (ESM), 2) by applying a demands-resources model to describe the positive and negative aspects of student engagement, and 3) by adopting a person-oriented approach to describe subgroups of students with different profiles of engagement and burnout symptoms. Two studies were conducted: sample one comprised 255 US high school students (45.5% female, 9th – 12th grade), and sample two 188 Finnish comprehensive and high school students (59.6% female, 9th to 10th grade). Latent profile analyses (LPA) of person-level measures of schoolwork engagement and burnout in the US and Finland revealed four profiles: 1) engaged, 2) engaged-exhausted, 3) moderately burned out (risk for burnout) and 4) burned out. These four groups were identified in both samples, but differed in their prevalence. The groups differed in their state experiences of situational demands, resources and engagement at school. Engagement is not wholly an experience of ‘flourishing’: some students experienced elevated levels of both engagement and burnout. Thus, positive and negative aspects of engagement should be studied and modeled together.

Sandstrom, J.; Swanepoel, de W.; Carel, Myburgh H.; Laurent, C. (2016): Smartphone threshold audiometry in underserved primary health-care contexts. In: International journal of audiology 55 (4), S. 232–238. DOI: 10.3109/14992027.2015.1124294.

OBJECTIVE: To validate a calibrated smartphone-based hearing test in a sound booth environment and in primary health-care clinics. DESIGN: A repeated-measure within-subject study design was employed whereby air-conduction hearing thresholds determined by smartphone-based audiometry was compared to conventional audiometry in a sound booth and a primary health-care clinic environment. STUDY SAMPLE: A total of 94 subjects (mean age 41 years +/- 17.6 SD and range 18-88; 64% female) were assessed of whom 64 were tested in the sound booth and 30 within primary health-care clinics without a booth. RESULTS: In the sound booth 63.4% of conventional and smartphone thresholds indicated normal hearing (</=15 dBHL). Conventional thresholds exceeding 15 dB HL corresponded to smartphone thresholds within </=10 dB in 80.6% of cases with an average threshold difference of -1.6 dB +/- 9.9 SD. In primary health-care clinics 13.7% of conventional and smartphone thresholds indicated normal hearing (</=15 dBHL). Conventional thresholds exceeding 15 dBHL corresponded to smartphone thresholds within </=10 dB in 92.9% of cases with an average threshold difference of -1.0 dB +/- 7.1 SD. CONCLUSIONS: Accurate air-conduction audiometry can be conducted in a sound booth and without a sound booth in an underserved community health-care clinic using a smartphone.

Scheiderer, E. M.; Wang, T.; Tomko, R. L.; Wood, P. K.; Trull, T. J. (2016): Negative Affect Instability among Individuals with Comorbid Borderline Personality Disorder and Posttraumatic Stress Disorder. In: Clinical psychological science : a journal of the Association for Psychological Science 4 (1), S. 67–81. DOI: 10.1177/2167702615573214.

Ecological momentary assessment (EMA; Stone & Shiffman, 1994) was utilized to examine affective instability (AI) in the daily lives of outpatients with borderline personality disorder (BPD; n=78) with and without posttraumatic stress disorder (PTSD). A psychiatric control group (n=50) composed of outpatients with major depressive disorder/dysthymia (MDD/DYS) was employed to compare across subgroups: BPD-only, BPD+PTSD, MDD/DYS-only, and MDD/DYS+PTSD. Compared to the BPD-only group, the BPD+PTSD group had significantly greater instability of fear and sadness, but did not significantly differ in instability of hostility or aggregate negative affect. This pattern of elevated instability of fear and sadness was not present-and, in fact, was reversed-in the MDD/DYS group. Results emphasize the importance of examining AI within the context of specific comorbidities and affect types. Treatment and research addressing AI in the context of BPD-PTSD comorbidity may benefit from a focus on fear and sadness as separate from hostility or general negative affect.

Schloneger, Matthew J.; Hunter, Eric J. (2016): Assessments of Voice Use and Voice Quality Among College/University Singing Students Ages 18-24 Through Ambulatory Monitoring With a Full Accelerometer Signal. In: Journal of voice : official journal of the Voice Foundation. DOI: 10.1016/j.jvoice.2015.12.018.

The multiple social and performance demands placed on college/university singers could put their still-developing voices at risk. Previous ambulatory monitoring studies have analyzed the duration, intensity, and frequency (in Hertz) of voice use among such students. Nevertheless, no studies to date have incorporated the simultaneous acoustic voice quality measures into the acquisition of these measures to allow for direct comparison during the same voicing period. Such data could provide greater insight into how young singers use their voices, as well as identify potential correlations between vocal dose and acoustic changes in voice quality. The purpose of this study was to assess the voice use and the estimated voice quality of college/university singing students (18-24 years old, N = 19). Ambulatory monitoring was conducted over three full, consecutive weekdays measuring voice from an unprocessed accelerometer signal measured at the neck. From this signal, traditional vocal dose metrics such as phonation percentage, dose time, cycle dose, and distance dose were analyzed. Additional acoustic measures included perceived pitch, pitch strength, long-term average spectrum slope, alpha ratio, dB sound pressure level 1-3 kHz, and harmonic-to-noise ratio. Major findings from more than 800 hours of recording indicated that among these students (a) higher vocal doses correlated significantly with greater voice intensity, more vocal clarity and less perturbation; and (b) there were significant differences in some acoustic voice quality metrics between nonsinging, solo singing, and choral singing.

Schuster, Randi Melissa; Mermelstein, Robin J.; Hedeker, Donald (2016): Ecological Momentary Assessment of Working Memory Under Conditions of Simultaneous Marijuana and Tobacco Use. In: Addiction (Abingdon, England). DOI: 10.1111/add.13342.

BACKGROUND AND AIMS: The neuropsychological correlates of simultaneous marijuana and tobacco use are largely unknown, which is surprising as both substances have similar neural substrates and have opposing influences on working memory (WM). This study examined the effects of marijuana alone, tobacco alone, and simultaneous marijuana and tobacco use on WM. DESIGN: Primary aims were tested using a within-subject design, controlling for multiple subject- and momentary-level confounds via ecological momentary assessment (EMA). SETTING: Data collection occurred in the Chicago, USA area in participants’ natural environments. PARTICIPANTS: Participants were 287 community young adults from a larger natural history study, over-sampled for ever smoking, all of whom event-recorded at least one substance use occasion during the study week. MEASUREMENTS: Momentary tobacco, marijuana and alcohol use were recorded during multiple EMA across one week of data capture. WM was assessed at the end of each EMA. Contextual variables that may influence WM were recorded via EMA. FINDINGS: There were main effects for marijuana and tobacco: WM was poorer with marijuana (OR=0.91, 95%CI = 0.84 to 0.99) and better with tobacco (OR=1.11, 95%CI = 1.04 to 1.18). These effects were not qualified by an interaction (OR=1.03, 95%CI = 0.84 to 1.26). Alcohol also reduced WM (OR=0.87, 95%CI = 0.79 to 0.95), and the tobacco by alcohol interaction was significant (OR=0.81, 95%CI = 0.66 to 0.99), indicating that the facilitative effect of tobacco disappeared with concurrent alcohol use. CONCLUSIONS: Relative to when individuals did not use these substances, working memory (WM) decreased with acute marijuana and alcohol use, and increased with acute tobacco use. However, the putative effect of marijuana on WM and the facilitative effect of tobacco on WM were no longer present when used simultaneously with tobacco and alcohol, respectively. Data suggest that tobacco use may compensate for WM decrements from marijuana among young adults and highlight the importance of further investigating the negative impact of alcohol use on cognition.

Schuz, N.; Eid, M.; Schuz, B.; Ferguson, S. G. (2016): Immediate effects of plain packaging health warnings on quitting intention and potential mediators: Results from two ecological momentary assessment studies. In: Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors 30 (2), S. 220–228. DOI: 10.1037/adb0000146.

The purpose of this study is to examine the immediate, everyday impact of health warnings on cigarette packages on potential smoking cessation mediators and to test for differences in immediate reactions to branded and plain tobacco packaging during the transition phase when plain packs where first introduced in Australia. Two Ecological Momentary Assessment studies tested whether smokers report higher risk appraisals, self-efficacy, and quitting intentions immediately after seeing a warning compared to random times of the day (Study 1), and whether smoking from plain packs results in higher quitting intention, risk appraisal, and self-efficacy than smoking from branded packs (Study 2). There was no immediate increase in self-efficacy, risk appraisal, or intention after encountering health warnings, and no differences in cognitions when using plain compared with branded packs. Moreover, cognitions were not different when warnings were encountered in proximity to smoking compared to nonsmoking events. However, self-efficacy and risk appraisal were significantly associated with quitting intention. Current health warnings do not seem to have an immediate impact on important predictors of quitting intention and might benefit from including messages that place a stronger focus on increasing smokers’ confidence that they can quit. Replication of the results with larger sample and cluster sizes is warranted.

Seidel, Maria; Petermann, Juliane; Diestel, Stefan; Ritschel, Franziska; Boehm, Ilka; King, Joseph A. et al. (2016): A naturalistic examination of negative affect and disorder-related rumination in anorexia nervosa. In: European Child & Adolescent Psychiatry. DOI: 10.1007/s00787-016-0844-3.

In anorexia nervosa (AN), volitional inhibition of rewarding behaviors, such as eating, involves a conflict between the desire to suppress appetite and the inherent motive to consume. This conflict is thought to have costs that carry over into daily life, e.g., triggering negative affect and/or recurring ruminations, which may ultimately impact long term outcome. Hence, increasing research effort is being dedicated to understand the link between emotional and ruminative processes in the etiology and maintenance of AN. We investigated whether affective states influence disorder-related rumination in AN applying “ecological momentary assessment”, a method which allows the experimenter to gain insight into psychological processes in the natural environment and assess data in real time. Participants (AN = 37, healthy controls = 33) were given a smartphone for 14 days. A ringtone signaled at six random time-points each day to fill in a questionnaire, which gauged disorder-typical thoughts about food and weight as well as affective state. Analyses, applying hierarchical linear models confirmed that AN patients spend more time thinking about food, body shape and weight than controls (p < 0.001). Additionally, the results support the hypothesis that momentary negative affect (but not baseline depression (p = 0.56) or anxiety symptoms (p = 0.60) are positively associated with a higher amount of disorder-related rumination in patients (p < 0.001). Our findings are in line with theories which claim that ruminative thinking induces a vulnerability to negative stimuli which, in turn, fosters heightened negative affect. Thus, therapeutic interventions could be improved by implementing modules that specifically target disorder-related rumination.

Shernoff, David J.; Kelly, Sean; Tonks, Stephen M.; Anderson, Brett; Cavanagh, Robert F.; Sinha, Suparna; Abdi, Beheshteh (2016): Student engagement as a function of environmental complexity in high school classrooms. In: Learning and Instruction. DOI: 10.1016/j.learninstruc.2015.12.003.

The purpose of this study was to investigate the linkage between the quality of the learning environment and the quality of students’ experience in seven high school classrooms in six different subject areas. The quality of the learning environment was conceptualized in terms of environmental complexity, or the simultaneous presence of environmental challenge and environmental support. The students (N = 108) in each class participated in the Experience Sampling Method (ESM) measuring their engagement and related experiential variables. Concurrently, environmental complexity and its subdimensions were observed and rated from video with a new observational instrument, The Optimal Learning Environments – Observational Log and Assessment (OLE-OLA). Using two-level HLM regression models, ratings from the OLE-OLA were utilized to predict student engagement and experiential variables as measured by the ESM. Results showed that environmental complexity predicted student engagement and sense of classroom self-esteem. Implications for research, theory and practice are discussed.

Siddiquee, A.; Sixsmith, J.; Lawthom, R.; Haworth, J. (2016): Paid work, life-work and leisure: A study of wellbeing in the context of academic lives in higher education. In: Leisure Studies 35 (1), S. 36–45. DOI: 10.1080/02614367.2014.967711.

Living, working, leisure, and well-being are of increasing concern to educators, policy-makers, governments and people generally. The aim of this research note is to investigate the relationships between paid work, life work and leisure in terms of well-being associated with activity. The research used a modified experience sampling method for a one-week period with a staff group based in an educational institution. The data collection period included a bank holiday (three days holiday and four days work). A mobile phone was used to collect data eight times a day, over seven days, on activity, enjoyment, interest, visual interest, challenge, skill and happiness. Data analysis showed a significant correlation between enjoyment and happiness; enjoyment and interest; and visual interest, which also correlated with happiness. Enjoyment and happiness were experienced more in leisure than in paid work and life work. Level of enjoyment was greatest when skills were greater than moderate challenge in activity, though high enjoyment was more frequent when moderate and high challenge were met with equal skills (satisfying conditions of ‘flow’). High enjoyment came as much from paid work as from leisure. The findings replicate and extend earlier research, and the research note emphasises the importance of measures of enjoyment in the investigation of national wellbeing.

Silk, Jennifer S.; Tan, Patricia Z.; Ladouceur, Cecile D.; Meller, Suzanne; Siegle, Greg J.; McMakin, Dana L. et al. (2016): A Randomized Clinical Trial Comparing Individual Cognitive Behavioral Therapy and Child-Centered Therapy for Child Anxiety Disorders. In: Journal of clinical child and adolescent psychology : the official journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, S. 1–13. DOI: 10.1080/15374416.2016.1138408.

This study compared individual cognitive behavioral therapy (CBT) and a supportive child-centered therapy (CCT) for child anxiety disorders on rates of treatment response and recovery at posttreatment and 1-year follow-up, as well as on real-world measures of emotional functioning. Youth (N = 133; ages 9-14) with anxiety disorders (generalized, separation, and/or social anxiety) were randomized using a 2:1 ratio to CBT (n = 90) or CCT (n = 43), which served as an active comparison. Treatment response and recovery at posttreatment and 1-year follow-up were assessed by Independent Evaluators, and youth completed ecological momentary assessment of daily emotions throughout treatment. The majority of youth in both CBT and CCT were classified as treatment responders (71.1% for CBT, 55.8% for CCT), but youth treated with CBT were significantly more likely to fully recover, no longer meeting diagnostic criteria for any of the targeted anxiety disorders and no longer showing residual symptoms (66.7% for CBT vs. 46.5% for CCT). Youth treated with CBT also reported significantly lower negative emotions associated with recent negative events experienced in daily life during the latter stages of treatment relative to youth treated with CCT. Furthermore, a significantly higher percentage of youth treated with CBT compared to CCT were in recovery at 1-year follow-up (82.2% for CBT vs. 65.1% for CCT). These findings indicate potential benefits of CBT above and beyond supportive therapy on the breadth, generalizability, and durability of treatment-related gains.

Spronken, Maitta; Holland, Rob W.; Figner, Bernd; Dijksterhuis, Ap (2016): Temporal focus, temporal distance, and mind-wandering valence: Results from an experience sampling and an experimental study. In: Consciousness and cognition 41, S. 104–118. DOI: 10.1016/j.concog.2016.02.004.

When mind-wandering, people may think about events that happened in the past, or events that may happen in the future. Using experience sampling, we first aimed to replicate the finding that future-oriented thoughts show a greater positivity bias than past-oriented thoughts. Furthermore, we investigated whether there is a relation between the temporal distance of past- and future-oriented thoughts and the frequency of positive thoughts, a factor that has received little attention in previous work. Second, we experimentally investigated the relation between temporal focus, temporal distance, and thought valence. Both studies showed that future-oriented thoughts were more positive compared to past-oriented thoughts. Regarding temporal distance, thoughts about the distant past and future were more positive than thoughts about the near past and future in the experiment. However, the experience sampling study did not provide clear insight into this relation. Potential theoretical and methodological explanations for these findings are discussed.

Stewart, Orion T.; Vernez Moudon, Anne; Saelens, Brian E.; Lee, Chanam; Kang, Bumjoon; Doescher, Mark P. (2016): Comparing associations between the built environment and walking in rural small towns and a large metropolitan area. In: Environment and behavior 48 (1), S. 13–36. DOI: 10.1177/0013916515612253.

The association between the built environment (BE) and walking has been studied extensively in urban areas, yet little is known whether the same associations hold for smaller, rural towns. This analysis examined objective measures of the BE around participants’ residence and their utilitarian and recreational walking from two studies, one in the urban Seattle area (n = 464) and the other in nine small U.S. towns (n = 299). After adjusting for sociodemographics, small town residents walked less for utilitarian purposes but more for recreational purposes. These differences were largely explained by differential associations of the BE on walking in the two settings. In Seattle, the number of neighborhood restaurants was positively associated with utilitarian walking, but in small towns, the association was negative. In small towns, perception of slow traffic on nearby streets was positively associated with recreational walking, but not in Seattle. These observations suggest that urban–rural context matters when planning BE interventions to support walking.

Streb, Markus; Mecklinger, Axel; Anderson, Michael C.; Johanna, Lass-Hennemann; Michael, Tanja (2016): Memory control ability modulates intrusive memories after analogue trauma. In: Journal of affective disorders 192, S. 134–142. DOI: 10.1016/j.jad.2015.12.032.

BACKGROUND: Most people suffer from intrusive memories in the aftermath of trauma. For survivors’ well-being, it is key that these intrusions are controlled. Memory control can be exerted through retrieval suppression. Poor retrieval suppression, however, should be associated with persistent distressing intrusions and posttraumatic stress disorder (PTSD). This study tested the hypothesis that individual differences in retrieval suppression predict intrusive memories after trauma. Retrieval suppression was examined with the think/no-think task (TNT) using behavioral and event related potential (ERP) measures. METHODS: Twenty-four healthy participants watched a “traumatic” film after performing the TNT task. The frequency and distress of intrusions from the “traumatic” film was measured with an electronic diary. Additionally the Impact of Event Scale (IES) was assessed. RESULTS: In line with our hypothesis, behavioral measures of retrieval suppression ability predicted reduced distress ratings for intrusions (r=-.53, p<.01). Further ERP markers of retrieval suppression (a fronto-centrally distributed N2) predicted reduced distress ratings for intrusions (r=-.45, p<.05) and reduced IES Intrusion scores (r=-.56, p<.01). LIMITATIONS: The presented film is a relatively mild stressor as compared to a real-life trauma. Further studies are needed to explore the role of memory control processes for real-life trauma. CONCLUSIONS: Participants with lower retrieval suppression ability exhibited less distressing intrusive memories after analogue trauma. The ERP correlate of retrieval suppression was associated with less distressing intrusive memories and reduced IES Intrusion scores, suggesting that deficient memory control is a potential risk factor for developing PTSD.

Thomas, J. G.; Pavlovic, J.; Lipton, R. B.; Roth, J.; Rathier, L.; O’Leary, K. C. et al. (2016): Ecological momentary assessment of the relationship between headache pain intensity and pain interference in women with migraine and obesity. In: Cephalalgia : an international journal of headache. DOI: 10.1177/0333102415625613.

BACKGROUND: While pain intensity during migraine headache attacks is known to be a determinant of interference with daily activities, no study has evaluated: (a) the pain intensity-interference association in real-time on a per-headache basis, (b) multiple interference domains, and (c) factors that modify the association. METHODS: Participants were 116 women with overweight/obesity and migraine seeking behavioral treatment to lose weight and decrease headaches in the Women’s Health and Migraine trial. Ecological momentary assessment, via smartphone-based 28-day headache diary, and linear mixed-effects models were used to study associations between pain intensity and total- and domain-specific interference scores using the Brief Pain Inventory. Multiple factors (e.g. pain catastrophizing (PC) and headache management self-efficacy (HMSE)) were evaluated either as independent predictors or moderators of the pain intensity-interference relationship. RESULTS: Pain intensity predicted degree of pain interference across all domains either as a main effect (coeff = 0.61-0.78, p < 0.001) or interaction with PC, allodynia, and HMSE (p < 0.05). Older age and greater allodynia consistently predicted higher interference, regardless of pain intensity (coeff = 0.04-0.19, p < 0.05). CONCLUSIONS: Pain intensity is a consistent predictor of pain interference on migraine headache days. Allodynia, PC, and HMSE moderated the pain intensity-interference relationship, and may be promising targets for interventions to reduce pain interference.

Thurston, Rebecca C.; Matthews, Karen A.; Chang, Yuefang; Santoro, Nanette; Barinas-Mitchell, Emma; Kanel, Roland von et al. (2016): Changes in heart rate variability during vasomotor symptoms among midlife women. In: Menopause (New York, N.Y.). DOI: 10.1097/GME.0000000000000586.

OBJECTIVE: Most midlife women report vasomotor symptoms (VMS), yet their physiology remains poorly understood. This study tested whether acute decreases in cardiac vagal control would occur with VMS in a large sample of women monitored during wake and sleep. METHODS: Two hundred and fifteen nonsmoking women aged 40 to 60 years with evidence of VMS were included. Women were free of a history of clinical cardiovascular disease or arrhythmia; or use of insulin, beta blockers, calcium channel blockers, or medications impacting VMS. Women underwent 24 hours of ambulatory monitoring for physiological (sternal skin conductance) and self-report (electronic diary) measurement of VMS; heart rate variability (electrocardiogram); and respiratory rate. Changes in cardiac vagal control as assessed by respiratory sinus arrhythmia during VMS, relative to periods before and after VMS, were tested in linear mixed models. RESULTS: Significant decreases in respiratory sinus arrhythmia were observed during physiologically measured VMS relative to periods preceding (b[SE] = 0.13 (0.004), P < 0.0001) and after the vasomotor symptoms (b[SE] = 0.13 (0.004), P < 0.0001), adjusted for age, race, body mass index, and sleep/wake status. Decreases were observed for women not aware of their VMS, and differences persisted controlling for respiration rate. Interactions indicated that respiratory sinus arrhythmia decreases were most pronounced during sleep and for younger women. CONCLUSIONS: Physiologically measured VMS were accompanied by an inhibition of cardiac vagal control in a large sample of women. Changes were observed irrespective of whether the VMS were reported, were most pronounced during sleep, and were greatest among younger women. These findings contribute to the understanding of vasomotor symptom physiology.

Torous, John; Firth, Joseph (2016): The digital placebo effect: Mobile mental health meets clinical psychiatry. In: The Lancet Psychiatry 3 (2), S. 100–102. DOI: 10.1016/S2215-0366(15)00565-9.

This article introduce the concept of the digital placebo effect, referring to placebo-like effects seen from mobile health interventions, such as smartphone apps. Many people have a high level of affinity for their digital devices, and place particular expectations upon their capabilities. Indeed, smartphone separation has been documented to induce anxiety. The digital placebo effect is best thought of as a collection of various effects and processes that we do not fully understand. Clinical research has shown that effective elements of cognitive therapies might not maintain the same level of effectiveness when presented on a mobile platform. Similarly, interventions that have previously been found to be ineffective in conventional care might be effective when delivered via a smartphone. Beliefs about technology, perceptions of being more connected to health-care providers through remote monitoring, design of the app itself, and information provided to participants are just some examples of potential contributors to the digital placebo effect, although none have been well characterized. The digital placebo effect has important implications for mobile mental health research and clinical care. Examination of the digital placebo effect and its mechanisms is an important endeavour. Owing to rapid advances in technology and software, individual apps that are assessed in randomised controlled trials will have most likely been changed, upgraded, or replaced before their evidence can be implemented in clinical practice. Therefore, to study app mechanisms of change and explore common principles of use is arguably more fruitful than doing trials focused on efficacy of a single app

Turner, Brianna J.; Cobb, Rebecca J.; Gratz, Kim L.; Chapman, Alexander L. (2016): The Role of Interpersonal Conflict and Perceived Social Support in Nonsuicidal Self-Injury in Daily Life. In: Journal of Abnormal Psychology. DOI: 10.1037/abn0000141.

Although accumulating microlongitudinal research has examined emotion regulatory models of nonsuicidal self-injury (NSSI), few studies have examined how interpersonal contingencies influence daily NSSI behavior. Participants with repeated NSSI (N = 60) provided daily ratings of perceived social support, interpersonal conflict, and NSSI urges and behaviors for 14 days. Consistent with interpersonal models of NSSI, we hypothesized that participants would be more likely to engage in NSSI on days when they experienced high levels of interpersonal conflict, that NSSI acts that were revealed to others would be followed by desirable interpersonal changes (i.e., greater support, less conflict), and that these interpersonal changes would, in turn, predict stronger NSSI urges and more frequent NSSI behavior. Consistent with hypotheses, daily conflict was associated with stronger same-day NSSI urges and greater likelihood of NSSI acts. Perceived support increased following NSSI acts that had been revealed to others, but not unrevealed NSSI acts. This perceived support was, in turn, associated with a stronger NSSI urges and greater likelihood of engaging in NSSI on the following day. Moreover, participants whose NSSI was revealed to others engaged in more total NSSI acts during the diary period than those whose NSSI was not revealed to others. Inconsistent with hypotheses, interpersonal conflict did not decrease following NSSI, regardless of whether or not these acts were revealed to others. Together, these results provide preliminary support for interpersonal reinforcement models of NSSI and highlight the importance of expanding research in this area to include interpersonal contingencies that may influence this behavior.

Tymms, Peter B.; Curtis, Sarah E.; Routen, Ash C.; Thomson, Katie H.; Bolden, David S.; Bock, Susan et al. (2016): Clustered randomised controlled trial of two education interventions designed to increase physical activity and well-being of secondary school students: the MOVE Project. In: BMJ open 6 (1), S. e009318. DOI: 10.1136/bmjopen-2015-009318.

OBJECTIVE: To assess the effectiveness of 2 interventions in improving the physical activity and well-being of secondary school children. DESIGN: A clustered randomised controlled trial; classes, 1 per school, were assigned to 1 of 3 intervention arms or a control group based on a 2×2 factorial design. The interventions were peer-mentoring and participative learning. Year 7 children (aged 11-12) in the peer-mentoring intervention were paired with year 9 children for 6 weekly mentoring meetings. Year 7 children in the participative learning arm took part in 6 weekly geography lessons using personalised physical activity and Global Positioning System (GPS) data. Year 7 children in the combined intervention received both interventions, with the year 9 children only participating in the mentoring sessions. PARTICIPANTS: 1494 year 7 students from 60 schools in the North of England took part in the trial. Of these, 43 students opted out of taking part in the evaluation measurements, 2 moved teaching group and 58 changed school. Valid accelerometry outcome data were collected for 892 students from 53 schools; and well-being outcome data were available for 927 students from 52 schools. MAIN OUTCOME MEASURES: The primary outcomes were mean minutes of accelerometer-measured moderate-to-vigorous intensity physical activity per day, and well-being as evaluated by the KIDSCREEN-27 questionnaire. These data were collected 6 weeks after the intervention; a 12-month follow-up is planned. RESULTS: No significant effects (main or interaction) were observed for the outcomes. However, small positive differences were found for both outcomes for the participative learning intervention. CONCLUSIONS: These findings suggest that the 2 school-based interventions did not modify levels of physical activity or well-being within the period monitored. Change in physical activity may require more comprehensive individual behavioural intervention, and/or more system-based efforts to address wider environmental influences such as family, peers, physical environment, transport and educational policy. TRIAL REGISTRATION NUMBER: ISRCTN82956355.

Ubhi, H. K.; Kotz, D.; Michie, S.; van Schayck, O. C.; Sheard, D.; Selladurai, A.; West, R. (2016): Comparative analysis of smoking cessation smartphone applications available in 2012 versus 2014. In: Addictive behaviors 58, S. 175–181. DOI: 10.1016/j.addbeh.2016.02.026.

BACKGROUND AND AIMS: Smartphone applications (apps) offer a potentially cost-effective and a wide-reach aid to smoking cessation. In 2012, a content analysis of smoking cessation apps suggested that most apps did not adopt behaviour change techniques (BCTs), which according to previous research had suggested would promote higher success rates in quitting smoking. This study examined whether or not, this situation had changed by 2014 for free smoking cessation apps available in the Apple App Store. It also compared the use of engagement and ease-of-use features between the two time points. METHODS: 137 free apps available in the Apple App Sore in 2014 were coded using an established framework for the presence or absence of evidence-based BCTs, and engagement and ease-of-use features. The results from the 2014 data were compared with a similar exercise conducted on 83 free apps available in 2012. RESULTS: BCTs supporting identity change, rewarding abstinence and advising on changing routines were less prevalent in 2014 as compared with 2012 (14.6% vs. 42.2%, 18.2% vs. 48.2%, and 17.5% vs. 24.1%, respectively). Advice on coping with cravings and advice on the use of stop-smoking medication were more prevalent in 2014 as compared with 2012 (27.7% vs. 20.5% and 14.6% vs 3.6%, respectively). The use of recognised engagement features was less common in 2014 than in 2012 (45.3% vs. 69.6%) while ease-of-use features remained very high (94.5% vs. 82.6%). CONCLUSION: There was little evidence of improvement in the use of evidence-based BCTs in free smoking cessation iPhone-based apps between 2012 and 2014.

van Lenten, S. A.; Doane, L. D. (2016): Examining multiple sleep behaviors and diurnal salivary cortisol and alpha-amylase: Within- and between-person associations. In: Psychoneuroendocrinology 68, S. 100–110. DOI: 10.1016/j.psyneuen.2016.02.017.

Sleep has been linked to the daily patterns of stress-responsive physiological systems, specifically the hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS). However, extant research examining sleep and diurnal patterns of cortisol, the primary end product of the HPA axis, has primarily focused on sleep duration with limited attention on other facets of sleep. For example, it is not clear how specific aspects of sleep (e.g., sleep quality, sleep duration variability) are related to specific components of diurnal cortisol rhythms. Salivary alpha-amylase (sAA) has been recognized as a surrogate marker of ANS activity, but limited research has explored relations between sleep and sAA diurnal rhythms. The current study utilized an ecological momentary assessment protocol to examine within- and between-person relations between several facets of sleep behavior using multiple methods (e.g., subjective report, actigraphy) and salivary cortisol and sAA. Older adolescents (N=76) provided saliva samples and diary entries five times per day over the course of three days. Sleep was assessed via questionnaire, through daily diaries, and monitored objectively using actigraphy over a four day period. Between-person results revealed that shorter average objective sleep duration and greater sleep duration variability were related to lower levels of waking cortisol and flatter diurnal slopes across the day. Within-person results revealed that on nights when individuals slept for shorter durations than usual they also had lower levels of waking cortisol the next day. Sleep was not related to the cortisol awakening response (CAR) or diurnal patterns of sAA, in either between-person or within-person analyses. However, typical sleep behaviors measured via questionnaire were related to waking levels of sAA. Overall, this study provides a greater understanding of how multiple components of sleep, measured in naturalistic environments, are related to cortisol and sAA diurnal rhythms, and how day-to-day, within-person changes in sleep duration contribute to daily variations in cortisol.

Villain, M.; Sibon, I.; Renou, P.; Poli, M.; Swendsen, J. (2016): Very early social support following mild stroke is associated with emotional and behavioral outcomes three months later. In: Clinical rehabilitation. DOI: 10.1177/0269215515623600.

OBJECTIVE: To investigate whether social contact and support received during hospitalization for acute ischemic stroke predict depression and daily life functioning three months later. DESIGN: Prospective observational study using Ecological Momentary Assessments to evaluate the number of social contacts as well as social support received from family, friends and medical staff within 24 hours following admission for stroke. Patients also monitored depression symptoms and behavior in real-time and in daily life contexts three months later. SETTING: A university hospital acute stroke unit. SUBJECTS: Thirty-four mild ischemic stroke patients. INTERVENTIONS: None. MAIN MEASURES: One-day Ecological Momentary Assessments immediately following stroke collected information concerning perceived social support, number of social contacts and depression symptoms. Ecological Momentary Assessments was repeated three months later and addressed depression levels as well as activities of daily living, such as working, cooking, shopping and housework. RESULTS: The number of social interactions received at hospitalization did not predict three-month outcomes. However, a better quality of moral support from friends and family immediately after stroke was associated with decreases in later depression levels (p = 0.041) and increases in activities of daily living (p = 0.011). Material support from friends and family was associated with increases in activities of daily living (p = 0.012). No effect was observed for support received from medical staff. CONCLUSIONS: Patient perceptions of better support quality, and not quantity, immediately following mild stroke, are associated with better behavioral and emotional outcomes three months later.

Volkova, Ekaterina; Li, Nicole; Dunford, Elizabeth; Eyles, Helen; Crino, Michelle; Michie, Jo; Ni Mhurchu, Cliona (2016): “Smart” RCTs: Development of a Smartphone App for Fully Automated Nutrition-Labeling Intervention Trials. In: JMIR mHealth and uHealth 4 (1), S. e23. DOI: 10.2196/mhealth.5219.

BACKGROUND: There is substantial interest in the effects of nutrition labels on consumer food-purchasing behavior. However, conducting randomized controlled trials on the impact of nutrition labels in the real world presents a significant challenge. OBJECTIVE: The Food Label Trial (FLT) smartphone app was developed to enable conducting fully automated trials, delivering intervention remotely, and collecting individual-level data on food purchases for two nutrition-labeling randomized controlled trials (RCTs) in New Zealand and Australia. METHODS: Two versions of the smartphone app were developed: one for a 5-arm trial (Australian) and the other for a 3-arm trial (New Zealand). The RCT protocols guided requirements for app functionality, that is, obtaining informed consent, two-stage eligibility check, questionnaire administration, randomization, intervention delivery, and outcome assessment. Intervention delivery (nutrition labels) and outcome data collection (individual shopping data) used the smartphone camera technology, where a barcode scanner was used to identify a packaged food and link it with its corresponding match in a food composition database. Scanned products were either recorded in an electronic list (data collection mode) or allocated a nutrition label on screen if matched successfully with an existing product in the database (intervention delivery mode). All recorded data were transmitted to the RCT database hosted on a server. RESULTS: In total approximately 4000 users have downloaded the FLT app to date; 606 (Australia) and 1470 (New Zealand) users met the eligibility criteria and were randomized. Individual shopping data collected by participants currently comprise more than 96,000 (Australia) and 229,000 (New Zealand) packaged food and beverage products. CONCLUSIONS: The FLT app is one of the first smartphone apps to enable conducting fully automated RCTs. Preliminary app usage statistics demonstrate large potential of such technology, both for intervention delivery and data collection. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry ACTRN12614000964617. New Zealand trial: Australian New Zealand Clinical Trials Registry ACTRN12614000644662.

Voss, Christine; Winters, Meghan; Frazer, Amanda D.; McKay, Heather A. (2014): They go straight home – don’t they? Using global positioning systems to assess adolescent school-travel patterns. In: Journal of transport & health 1 (4), S. 282–287. DOI: 10.1016/j.jth.2014.09.013.

BACKGROUND: Active travel to school is a potential source of physical activity for adolescents, but its assessments often rely on assumptions around travel patterns. Global positioning system (GPS) and accelerometry provide an objective assessment of physical activity from school-travel and the context in which it occurs (where, when, how long). PURPOSE: To describe school-travel patterns of adolescents and to compare estimates of physical activity during the hour before/after school – a commonly used proxy for school-travel time – with physical activity accrued during school trips identified through GPS (‘GPS-trips’). METHODS: Adolescents (n=49, 13.3+/-0.7 years, 37% female) from Downtown Vancouver wore an accelerometer (GT3X+) and GPS (Qstarz) for 7 days (October 2012). Minutes of moderate-to-vigorous physical activity (MVPA) during the hour before/after school and during GPS-trips were calculated for the n=130 school-trips made by 43 students. We used multilevel linear regression to assess the association between MVPA during GPS-trips and MVPA during the hour/before school. RESULTS: Only 55% of school-trips were from/to home and within the hour before/after school (‘normal’). Estimates of MVPA during the hour before/after school were higher than during GPS-trips (12.0 vs. 8.0 min). On average, MVPA during GPS-trips was linearly associated with MVPA during the hour before/after school, suggesting that physical activity levels during the hour before/after school are broadly reflective of physical activity from school-travel. CONCLUSION: GPS and accelerometry provide context-rich information relating to school-travel. The hour before/after school may – on average – provide a simple means to crudely estimate physical activity from school-travel when GPS are not available.

Wenzel, Mario; Kubiak, Thomas; Ebner-Priemer, Ulrich W. (2016): Ambulatory assessment as a means of longitudinal phenotypes characterization in psychiatric disorders. In: Neuroscience Research 102, S. 13–21. DOI: 10.1016/j.neures.2014.10.018.

Ambulatory Assessment (AA) comprises the use of in-field methods to assess individuals’ behavior, physiology, and the experience as they unfold in naturalistic settings. We propose that AA is favorable for the investigation of gene–environment interactions and for the search for endophenotypes, being able to assess the experienced environment and to track basic regulatory processes, such as stress reactivity, affective instability, and reward experience, which are potential common factors that underlie psychiatric disorders. In this article, we (a) first describe briefly the rationale of AA and summarize the key advantages of the approach, (b) highlight within-subject regulatory processes, such as stress reactivity, affective instability, and reward experience, (c) describe studies that used AA to examine genetic influences in psychiatric disorders, and (d) briefly review longitudinal studies that have investigated phenotypes of psychiatric disorders. The reported studies yielded promising, although sometimes inconclusive evidence for genetic effects on endophenotypes of psychiatric disorders. Moreover, most studies were twin or family studies, especially in stress-sensitivity research; thus, it is unclear which specific single nucleotide polymorphisms contribute to the endophenotypes of psychiatric disorders. We do hope that within-subject regulatory processes will enable us to clarify the fundamental psychological dimensions that cut across traditional disorders and link them to their genetic underpinnings.

Wiechmann, W.; Kwan, D.; Bokarius, A.; Toohey, S. L. (2016): There’s an App for That? Highlighting the Difficulty in Finding Clinically Relevant Smartphone Applications. In: The western journal of emergency medicine 17 (2), S. 191–194. DOI: 10.5811/westjem.2015.12.28781.

INTRODUCTION: The use of personal mobile devices in the medical field has grown quickly, and a large proportion of physicians use their mobile devices as an immediate resource for clinical decision-making, prescription information and other medical information. The iTunes App Store (Apple, Inc.) contains approximately 20,000 apps in its “Medical” category, providing a robust repository of resources for clinicians; however, this represents only 2% of the entire App Store. The App Store does not have strict criteria for identifying content specific to practicing physicians, making the identification of clinically relevant content difficult. The objective of this study is to quantify the characteristics of existing medical applications in the iTunes App Store that could be used by emergency physicians, residents, or medical students. METHODS: We found applications related to emergency medicine (EM) by searching the iTunes App Store for 21 terms representing core content areas of EM, such as “emergency medicine,” “critical care,” “orthopedics,” and “procedures.” Two physicians independently reviewed descriptions of these applications in the App Store and categorized each as the following: Clinically Relevant, Book/Published Source, Non-English, Study Tools, or Not Relevant. A third physician reviewer resolved disagreements about categorization. Descriptive statistics were calculated. RESULTS: We found a total of 7,699 apps from the 21 search terms, of which 17.8% were clinical, 9.6% were based on a book or published source, 1.6% were non-English, 0.7% were clinically relevant patient education resources, and 4.8% were study tools. Most significantly, 64.9% were considered not relevant to medical professionals. Clinically relevant apps make up approximately 6.9% of the App Store’s “Medical” Category and 0.1% of the overall App Store. CONCLUSION: Clinically relevant apps represent only a small percentage (6.9%) of the total App volume within the Medical section of the App Store. Without a structured search-and-evaluation strategy, it may be difficult for the casual user to identify this potentially useful content. Given the increasing adoption of devices in healthcare, national EM associations should consider curating these resources for their members.

Wilt, Joshua; Bleidorn, Wiebke; Revelle, William (2016): Finding a life worth living: Meaning in life and graduation from college. In: European Journal of Personality. DOI: 10.1002/per.2046.

Graduation from college is an important milestone for young adults, marked by mixed emotions and poignancy, and therefore is an especially salient context for studying meaning in life. The present research used experience‐sampling methodology to examine the antecedents and consequences of students’ experience of meaning in life over the course of graduation. Participants were 74 graduating students who provided a total of 538 reports over the span of 3 days, including commencement day. Increased levels of state meaning in life during the days around commencement were linked to spending time with people in general and with family in particular, and thinking about one’s years in college. Thinking about one’s years in college mediated the effects of present company on state meaning in life. Graduates who experienced higher levels of state meaning in life during the days around their commencement ceremony had higher trait levels of meaning in life 1 week following commencement. We discuss how making meaning of a poignant experience has implications for healthy psychological development. Copyright © 2016 European Association of Personality Psychology

Wray, T. B.; Kahler, C. W.; Monti, P. M. (2016): Using Ecological Momentary Assessment (EMA) to Study Sex Events Among Very High-Risk Men Who Have Sex with Men (MSM). In: AIDS and behavior. DOI: 10.1007/s10461-015-1272-y.

MSM continue to represent the largest share of new HIV infections in the United States each year due to high infectivity associated with unprotected anal sex. Ecological momentary assessment (EMA) has the potential to provide a unique view of how high-risk sexual events occur in the real world and can impart detailed information about aspects of decision-making, antecedents, and consequences that accompany these events. EMA may also produce more accurate data on sexual behavior by assessing it soon after its occurrence. We conducted a study involving 12 high-risk MSM to explore the acceptability and feasibility of a 30 day, intensive EMA procedure. Results suggest this intensive assessment strategy was both acceptable and feasible to participants. All participants provided response rates to various assessments that approached or were in excess of their targets: 81.0 % of experience sampling assessments and 93.1 % of daily diary assessments were completed. However, comparing EMA reports with a Timeline Followback (TLFB) of the same 30 day period suggested that participants reported fewer sexual risk events on the TLFB compared to EMA, and reported a number of discrepancies about specific behaviors and partner characteristics across the two methods. Overall, results support the acceptability, feasibility, and utility of using EMA to understand sexual risk events among high-risk MSM. Findings also suggest that EMA and other intensive longitudinal assessment approaches could yield more accurate data about sex events.

Wright, Cassandra J. C.; Dietze, Paul M.; Crockett, Belinda; Lim, Megan S. C. (2016): Participatory development of MIDY (Mobile Intervention for Drinking in Young people). In: BMC public health 16 (1), S. 184. DOI: 10.1186/s12889-016-2876-5.

BACKGROUND: There are few effective strategies that respond to the widespread practice of risky single-occasion drinking in young people. Brief interventions, which involve screening of alcohol consumption and personalised feedback, have shown some efficacy in reducing alcohol consumption, but are typically delivered in clinical settings. Mobile phones can be used to reach large populations instantaneously, both for data collection and intervention, but this has not been studied in combination during risky drinking events METHODS: Our study investigated the feasibility and acceptability of a mobile-phone delivered Ecological Momentary Assessment (EMA) and brief intervention for young people during drinking events. Our participatory design involved development workshops, intervention testing and evaluation with 40 young people in Melbourne, Australia. The final intervention included text message prompts to fill in mobile-based questionnaires, which measured drinks consumed, spending, location and mood, with additional questions in the initial and final questionnaire relating to plans, priorities, and adverse events. Participants received a tailored feedback SMS related to their drinking after each hourly questionnaire. The intervention was tested on a single drinking occasion. Prompts were sent between 6 pm and 2 am during a drinking event, with one follow up at 12 pm the following day. RESULTS: Participants reported being comfortable with hourly mobile data collection and intervention during social occasions, and found the level of intrusion acceptable; we achieved an 89 % response rate on the single occasion of testing. Participants were proactive in suggesting additional questions that would assist in the tailoring of feedback content, despite the added time burden. While we did not test the effectiveness of the intervention, participants reported value in the tracking and feedback process, with many stating that they would normally not be aware of how much alcohol they consumed in a night. CONCLUSIONS: Findings suggest that the intervention was considered acceptable, feasible and novel to our participants; it now requires comprehensive testing and evaluation.

Zenk, Shannon N.; Horoi, Irina; Jones, Kelly K.; Finnegan, Lorna; Corte, Colleen; Riley, Barth; Wilbur, JoEllen (2016): Environmental and Personal Correlates of Physical Activity and Sedentary Behaviors in African American Women: an Ecological Momentary Assessment Study. In: Women & health. DOI: 10.1080/03630242.2016.1170093.

This study examined within-person associations of environmental factors (weather, built and social environmental barriers) and personal factors (daily hassles, affect) with moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) in African American women aged 25-64 years living in metropolitan Chicago (n = 97). In 2012-13, for 7 days, women wore an accelerometer and were signaled five times per day to complete a survey covering environmental and personal factors on a study-provided smartphone. Day-level measures of each were derived, and mixed regression models were used to test associations. Poor weather was associated with a 27.3% reduction in daily MVPA. Associations between built and social environmental barriers and daily MVPA or SB were generally not statistically significant. Negative affect at the first daily signal was associated with a 38.6% decrease in subsequent daily MVPA and a 33.2-minute increase in subsequent daily SB. Each 1-minute increase in MVPA during the day was associated with a 2.2% higher likelihood of positive affect at the end of the day. SB during the day was associated with lower subsequent positive affect. Real-time interventions that address overcoming poor weather and negative affect may help African American women increase MVPA and/or decrease SB.

Zhang, M. W.; Fang, P.; Ho, R. C. (2016): Global outreach and user preferences of a smartphone application developed for drinkers. In: Technology and health care : official journal of the European Society for Engineering and Medicine. DOI: 10.3233/THC-161143.

INTRODUCTION: Alcohol use disorders has been known and recently highlighted by the World Health Organization as a major worldwide problem. Harmful usage of alcohol has been linked to increased morbidity and mortality arising from common alcohol related disorders, such as liver disease, hypertension and violent deaths. Looking at the current literature, there have been previous peer reviewed publications about how technology has helped alcohol users. Of significance, a previous content analysis showed that the vast majority of the applications catered for alcohol use disorder which are currently available on the stores are not only not supported by evidence-base, but some of them seemed to be promoting drinking instead. Zhang et al. have described how they have attempted to overcome the limitations of current alcohol applications in their video feature recently published. OBJECTIVE: The objective of this article is to evaluate (a) the receptiveness of the general population toward an alcohol tracker application and to determine (b) user preferences with regards to the different features present in an alcohol tracker. METHODS: Android Java Developmental kit (ADK) was utilized to program the core functions of the applications. The entire developmental process took approximately 6 weeks to complete and the android version of the application was launched and offered for free download on the android play store since the 4th of February 2015. The utilization of the application was then monitored and recorded using Google analytics. User perspectives with regards to the individual features of the application were collated via an application feedback survey embedded within the application. RESULTS: Based on the analytics, a total of 339 users have had access to the application. A cumulative total of 2029 downloads of the application have been made to date. Most of the participants are male (66%) and are of the age group of 30-39 years old (34%). The vast majority of the participants (94%) do not have any prior treatment for alcohol. Interestingly, the vast majority of the users have indicated that they have a drink 4 or more times a week (61%) and tend to drink between 3 to 4 drinks on a typical day they are out drinking. the vast majority reported that they were slightly and moderately comfortable with managing their alcohol use problem (25%). After the usage of the application, 27% of the individuals were moderately comfortable with managing their alcohol use problems and 20% of individuals were extremely comfortable with managing their alcohol use problems. CONCLUSION: In conclusion, this is perhaps one of the first few studies to demonstrate the receptiveness of an alcohol tracker that has included other behavioral change methods within as well as a variant of the conventional methodology of tracking alcohol consumption. The current study shows the receptiveness of global users as well as how such an intervention could help them gain more control about managing their underlying alcohol issue.


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