Society for Ambulatory Assessment


Allen, Kristy Benoit; Silk, Jennifer S.; Meller, Suzanne; Tan, Patricia Z.; Ladouceur, Cecile D.; Sheeber, Lisa B. et al. (2016): Parental autonomy granting and child perceived control: Effects on the everyday emotional experience of anxious youth. In: J Child Psychol Psychiatry 57 (7), S. 835–842. DOI: 10.1111/jcpp.12482.

Background: Childhood anxiety is associated with low levels of parental autonomy granting and child perceived control, elevated child emotional reactivity and deficits in child emotion regulation. In early childhood, low levels of parental autonomy granting are thought to decrease child perceived control, which in turn leads to increases in child negative emotion. Later in development, perceived control may become a more stable, trait‐like characteristic that amplifies the relationship between parental autonomy granting and child negative emotion. The purpose of this study was to test mediation and moderation models linking parental autonomy granting and child perceived control with child emotional reactivity and emotion regulation in anxious youth. Methods: Clinically anxious youth (N = 106) and their primary caregivers were assessed prior to beginning treatment. Children were administered a structured diagnostic interview and participated in a parent–child interaction task that was behaviorally coded for parental autonomy granting. Children completed an ecological momentary assessment protocol during which they reported on perceived control, emotional reactivity (anxiety and physiological arousal) and emotion regulation strategy use in response to daily negative life events. Results: The relationship between parental autonomy granting and both child emotional reactivity and emotion regulation strategy use was moderated by child perceived control: the highest levels of self‐reported physiological responding and the lowest levels of acceptance in response to negative events occurred in children low in perceived control with parents high in autonomy granting. Evidence for a mediational model was not found. In addition, child perceived control over negative life events was related to less anxious reactivity and greater use of both problem solving and cognitive restructuring as emotion regulation strategies. Conclusion: Both parental autonomy granting and child perceived control play important roles in the everyday emotional experience of clinically anxious children. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


 Am Gimenez-Arnau; Spector, S.; Antonova, E.; Trzaskoma, B.; Rosen, K.; Omachi, T. A. et al. (2016): Improvement of sleep in patients with chronic idiopathic/spontaneous urticaria treated with omalizumab: results of three randomized, double-blind, placebo-controlled studies. In: Clinical and translational allergy 6, S. 32. DOI: 10.1186/s13601-016-0120-0.

BACKGROUND: Patients with chronic idiopathic/spontaneous urticaria (CIU/CSU) report difficulty with sleep. METHODS: We examined the effect of omalizumab on sleep-related outcomes during 3-6 months omalizumab or placebo treatment and a 16-week follow-up period within three Phase III double-blind randomized placebo-controlled pivotal trials in CIU/CSU: ASTERIA I, ASTERIA II, and GLACIAL. Sleep quality was assessed in all three studies using sleep-related questions included in an electronic diary, the Chronic Urticaria Quality of Life Questionnaire, and the Medical Outcomes Study Sleep Scale. Score changes from baseline in the treatment arms were compared with that in the placebo arm and adjusted for baseline score and weight. We also examined correlations of sleep scores at baseline, week 12, and week 24 and the slopes of change between sleep and itch and hive. RESULTS: Patients treated with omalizumab reported a larger reduction in sleep problems than those in the placebo arm; omalizumab 300 mg demonstrated the greatest improvement on all sleep components among all treatment arms. The largest reduction in sleep problems was reported within the first 4 weeks of therapy. After treatment discontinuation, sleep quality worsened. Sleep scores demonstrated moderate-to-strong correlation between them, and the change in sleep scores was associated with changes in itch and hives. CONCLUSIONS: Improvement in sleep was reported after the first dose of omalizumab. Sleep continued to improve throughout the active treatment period. Patients receiving omalizumab 300 mg achieved greater improvement in sleep than those in other treatment arms. Trial registration, NCT01287117 (ASTERIA I), NCT01292473 (ASTERIA II), and NCT01264939 (GLACIAL).


Andrewes, H. E.; Hulbert, C.; Cotton, S. M.; Betts, J.; Am Chanen (2016): Ecological momentary assessment of nonsuicidal self-injury in youth with borderline personality disorder. In: Personality disorders. DOI: 10.1037/per0000205.

Nonsuicidal self-injury (NSSI) is highly prevalent among individuals with borderline personality disorder (BPD). The aim of this study was to investigate the cognitive, emotional, and contextual experience of NSSI in 107 youth (aged 15-25 years) with BPD who had minimal prior exposure to treatment. Using ecological momentary assessment, participants completed a randomly prompted questionnaire about their affect, self-injurious thoughts, and behaviors six times per day for 6 days. Twenty-four youth with BPD engaged in 52 counts of NSSI, with 56 motives identified. Open-ended questions revealed that on occasions of NSSI, a large minority of participants could identify neither their motives (27%, = 15) nor the environmental precipitants (46%, = 24) for NSSI. Changes in affect revealed a pattern of increasing negative and decreasing positive affect prior to NSSI, with a reduction in negative and an increase in positive affect following NSSI. These changes were absent for those who did not engage in NSSI. Initial self-injurious thoughts and changes in negative and positive affect occurred a median of 35, 15, and 10 hr prior to NSSI, respectively. These findings suggest that youth with BPD have limited capacity to reflect on their motives and environment preceding NSSI. The patterns of affect change indicate that NSSI is maintained by reward incentives as well as negative reinforcement. The time between initial self-injurious thoughts and engagement in NSSI reveals a window of opportunity for intervention. (PsycINFO Database Record


Arean, Patricia A.; Hoa Ly, Kien; Andersson, Gerhard (2016): Mobile technology for mental health assessment. In: Dialogues in clinical neuroscience 18 (2), S. 163–169.

Assessment and outcome monitoring are critical for the effective detection and treatment of mental illness. Traditional methods of capturing social, functional, and behavioral data are limited to the information that patients report back to their health care provider at selected points in time. As a result, these data are not accurate accounts of day-to-day functioning, as they are often influenced by biases in self-report. Mobile technology (mobile applications on smartphones, activity bracelets) has the potential to overcome such problems with traditional assessment and provide information about patient symptoms, behavior, and functioning in real time. Although the use of sensors and apps are widespread, several questions remain in the field regarding the reliability of off-the-shelf apps and sensors, use of these tools by consumers, and provider use of these data in clinical decision-making.


Baillet, Marion; Cosin, Charlotte; Schweitzer, Pierre; Peres, Karine; Catheline, Gwenaelle; Swendsen, Joel; Mayo, Willy (2016): Mood influences the concordance of subjective and objective measures of sleep duration in older adults. In: Frontiers in aging neuroscience 8, S. 181. DOI: 10.3389/fnagi.2016.00181.

OBJECTIVE/BACKGROUND: Sleep plays a central role in maintaining health and cognition. In most epidemiologic studies, sleep is evaluated by self-report questionnaires but several reports suggest that these evaluations might be less accurate than objective measures such as polysomnography or actigraphy. Determinants of the discrepancy between objective and subjective measures remain to be investigated. The aim of this pilot-study was to examine the role of mood states in determining the discrepancy observed between objective and subjective measures of sleep duration in older adults. PATIENTS/METHODS: Objective sleep quantity and quality were recorded by actigraphy in a sample of 45 elderly subjects over at least three consecutive nights. Subjective sleep duration and supplementary data, such as mood status and memory, were evaluated using ecological momentary assessment (EMA). RESULTS: A significant discrepancy was observed between EMA and actigraphic measures of sleep duration (p < 0.001). The magnitude of this difference was explained by the patient’s mood status (p = 0.020). No association was found between the magnitude of this discrepancy and age, sex, sleep quality or memory performance. CONCLUSION: The discrepancy classically observed between objective and subjective measures of sleep duration can be explained by mood status at the time of awakening. These results have potential implications for epidemiologic and clinical studies examining sleep as a risk factor for morbidity or mortality.


Bak, Maarten; Drukker, Marjan; Hasmi, Laila; van Os, Jim (2016): An n=1 clinical network analysis of symptoms and treatment in psychosis.In: PloS one 11 (9), e0162811. DOI: 10.1371/journal.pone.0162811.

INTRODUCTION: Dynamic relationships between the symptoms of psychosis can be shown in individual networks of psychopathology. In a single patient, data collected with the Experience Sampling Method (ESM-a method to construct intensive time series of experience and context) can be used to study lagged associations between symptoms in relation to illness severity and pharmacological treatment. METHOD: The patient completed, over the course of 1 year, for 4 days per week, 10 daily assessments scheduled randomly between 10 minutes and 3 hours apart. Five a priori selected symptoms were analysed: ‘hearing voices’, ‘down’, ‘relaxed’, ‘paranoia’ and ‘loss of control’. Regression analysis was performed including current level of one symptom as the dependent variable and all symptoms at the previous assessment (lag) as the independent variables. Resulting regression coefficients were printed in graphs representing a network of symptoms. Network graphs were generated for different levels of severity: stable, impending relapse and full relapse. RESULTS: ESM data showed that symptoms varied intensely from moment to moment. Network representations showed meaningful relations between symptoms, e.g. ‘down’ and ‘paranoia’ fuelling each other, and ‘paranoia’ negatively impacting ‘relaxed’. During relapse, symptom levels as well as the level of clustering between symptoms markedly increased, indicating qualitative changes in the network. While ‘hearing voices’ was the most prominent symptom subjectively, the data suggested that a strategic focus on ‘paranoia’, as the most central symptom, had the potential to bring about changes affecting the whole network. CONCLUSION: Construction of intensive ESM time series in a single patient is feasible and informative, particularly if represented as a network, showing both quantitative and qualitative changes as a function of relapse.

Batink, T.; Bakker, J.; Vaessen, T.; Kasanova, Z.; Collip, D.; van Os, J. et al. (2016): Acceptance and commitment therapy in daily life training: A feasibility study of an mHealth intervention. In: JMIR mHealth and uHealth 4 (3), e103. DOI: 10.2196/mhealth.5437.

BACKGROUND: With the development of mHealth, it is possible to treat patients in their natural environment. Mobile technology helps to bridge the gap between the therapist’s office and the “real world.” The ACT in Daily Life training (ACT-DL) was designed as an add-on intervention to help patients practice with acceptance and commitment therapy in their daily lives. The ACT-DL consists of two main components: daily monitoring using experience sampling and ACT training in daily life. OBJECTIVES: To assess the acceptability and feasibility of the ACT-DL in a general outpatient population. A secondary objective was to conduct a preliminary examination of the effectiveness of the ACT-DL. METHODS: An observational comparative study was conducted. The experimental group consisted of 49 patients who volunteered for ACT-DL, and the control group consisted of 112 patients who did not volunteer. As part of an inpatient treatment program, both groups received a 6-week ACT training. Participants went home to continue their treatment on an outpatient basis, during which time the experimental group received the 4-week add-on ACT-DL. Acceptability and feasibility of the ACT-DL was assessed weekly by telephone survey. Effectiveness of the ACT-DL was evaluated with several self-report questionnaires ( Flexibility Index Test (FIT-60): psychological flexibility, Brief Symptom Inventory: symptoms, Utrechtse Coping List: coping, and Quality of life visual analog scale (QoL-VAS): quality of life). RESULTS: More than three-quarters of the participants (76%) completed the full 4-week training. User evaluations showed that ACT-DL stimulated the use of ACT in daily life: participants practiced over an hour a week (mean 78.8 minutes, standard deviation 54.4), doing 10.4 exercises (standard deviation 6.0) on average. Both ACT exercises and metaphors were experienced as useful components of the training (rated 5 out of 7). Repeated measures ANCOVA did not show significant effects of the ACT-DL on psychological flexibility (P=.88), symptoms (P=.39), avoidant coping (P=.28), or quality of life (P=.15). CONCLUSIONS: This is the first study that uses experience sampling to foster awareness in daily life in combination with acceptance and commitment therapy to foster skill building. Adherence to the ACT-DL was high for an intensive mHealth intervention. ACT-DL appears to be an acceptable and feasible mHealth intervention, suitable for a broad range of mental health problems. However, short-term effectiveness could not be demonstrated. Additional clinical trials are needed to examine both short-term and long-term effects.


Bishop, Todd M.; Maisto, Stephen A.; Britton, Peter C.; Pigeon, Wilfred R. (2016): Considerations in the use of interactive voice recording for the temporal assessment of suicidal ideation and alcohol use. In: Crisis, S. 1–7. DOI: 10.1027/0227-5910/a000408.

BACKGROUND: A greater understanding of the temporal variation of suicidal ideation and suicidal behavior is needed to inform more effective prevention efforts. Interactive voice recording (IVR) allows for the study of temporal relationships that cannot be captured with most traditional methodologies. AIMS: To examine the feasibility of implementing IVR for the assessment of suicidal ideation. METHOD: Participants (n = 4) receiving a brief intervention based on dialectical behavior therapy were asked to respond to three phone-based surveys each day over 6 weeks that assessed suicidal ideation and alcohol consumption. RESULTS: Participants completed 77.7% of daily assessments, reported that calls were not burdensome, and indicated that calls were sometimes helpful in interrupting suicidal ideation. CONCLUSION: The preliminary data reported here provide optimism for the use of IVR and other forms of ecological momentary assessment in the exploration of the antecedents of suicidal behavior.


Blaauw, F. J.; Schenk, H. M.; Jeronimus, B. F.; van der Krieke, L.; Jonge, P. de; Aiello, M.; Emerencia, A. C. (2016): Let’s get Physiqual – an intuitive and generic method to combine sensor technology with ecological momentary assessments. In: Journal of biomedical informatics. DOI: 10.1016/j.jbi.2016.08.001.

The emergence of wearables and smartwatches is making sensors a ubiquitous technology to measure daily rhythms in physiological measures, such as movement and heart rate. An integration of sensor data from wearables and self-report questionnaire data about cognition, behaviors, and emotions can provide new insights into the interaction of mental and physiological processes in daily life. Hitherto no method existed that enables an easy-to-use integration of sensor and self-report data. To fill this gap, we present ‘Physiqual’, a platform for researchers that gathers and integrates data from commercially available sensors and service providers into one unified format for use in Ecological Momentary Assessments (EMA) or Experience Sampling Methods (ESM), and Quantified Self (QS). Physiqual currently supports sensor data provided by two well-known service providers and therewith a wide range of smartwatches and wearables. To demonstrate the features of Physiqual, we conducted a case study in which we assessed two subjects by means of data from an EMA study combined with sensor data as aggregated and exported by Physiqual. To the best of our knowledge, the Physiqual platform is the first platform that allows researchers to conveniently aggregate and integrate physiological sensor data with EMA studies.


Bold, Krysten W.; Witkiewitz, Katie; McCarthy, Danielle E. (2016): Multilevel factor analysis of smokers’ real-time negative affect ratings while quitting. In: Psychol Assess 28 (9), S. 1033–1042. DOI: 10.1037/pas0000305.

Smoking is a serious public health problem, and accurate real-time assessment of risk factors associated with smoking is critical to understanding smoking relapse. Negative affect is often described as a critical risk factor related to smoking relapse, and ecological momentary assessment (EMA) methods have been widely used to study real-time relations between negative affect and smoking. However, the factor structure of momentary negative affect ratings is unknown. The current investigation examined the multilevel factor structure and internal consistency of an EMA measure of negative affect. Daily assessments were collected for 1 week prequit and 3 weeks postquit from 113 adult daily smokers receiving nicotine replacement therapy and counseling to quit smoking. Results supported a 2-factor model with correlated but distinct agitation and distress factors, rather than a single-factor model of negative affect. The agitation factor was indicated by these items: impatient, tense/anxious, restless. The distress factor was indicated by these items: sad/depressed, upset, distressed. The 2-factor model had acceptable model fit and consistent factor loadings across 3 separate cessation phases: prequit, postquit with recent smoking, and postquit without recent smoking. The 2 factors were highly correlated, showed good internal consistency, and showed strong associations with theoretically relevant smoking and affect variables. Agitation was more strongly related to urge to smoke, and distress was more strongly related to recent stress. This study provides support for a 2-factor model of an EMA measure of negative affect and highlights distinct facets that may be useful for future investigations of affect and smoking. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Brannon, Erin E.; Cushing, Christopher C.; Crick, Christopher J.; Mitchell, Tarrah B. (2016): The promise of wearable sensors and ecological momentary assessment measures for dynamical systems modeling in adolescents: a feasibility and acceptability study. In: Translational behavioral medicine. DOI: 10.1007/s13142-016-0442-4.

Intervention development can be accelerated by using wearable sensors and ecological momentary assessment (EMA) to study how behaviors change within a person. The purpose of this study was to determine the feasibility and acceptability of a novel, intensive EMA method for assessing physiology, behavior, and psychosocial variables utilizing two objective sensors and a mobile application (app). Adolescents (n = 20) enrolled in a 20-day EMA protocol. Participants wore a physiological monitor and an accelerometer that measured sleep and physical activity and completed four surveys per day on an app. Participants provided approximately 81 % of the expected survey data. Participants were compliant to the wrist-worn accelerometer (75.3 %), which is a feasible measurement of physical activity/sleep (74.1 % complete data). The data capture (47.8 %) and compliance (70.28 %) with the physiological monitor were lower than other study variables. The findings support the use of an intensive assessment protocol to study real-time relationships between biopsychosocial variables and health behaviors.


Braybrook, Michelle; O’Connor, Sam; Churchward, Philip; Perera, Thushara; Farzanehfar, Parisa; Horne, Malcolm (2016): An ambulatory tremor score for parkinson’s disease.In: Journal of Parkinson’s disease. DOI: 10.3233/JPD-160898.

BACKGROUND: While tremor in Parkinson’s Disease (PD) can be characterised in the consulting room, its relationship to treatment and fluctuations can be clinically helpful. OBJECTIVE: To develop an ambulatory assessment of tremor of PD. METHODS: Accelerometry data was collected using the Parkinson’s KinetiGraph System (PKG, Global Kinetics). An algorithm was developed, which could successfully distinguish been subjects with a resting or postural tremor that involved the wrist whose frequency was greater than 3 Hz. Percent of time that tremor was present (PTT) between 09 : 00 and 18 : 00 was calculated. RESULTS: This algorithm was applied to 85 people with PD who had been assessed clinically for the presence and nature of tremor. The Sensitivity and Selectivity of a PTT >/=0.8% was 92.5% and 92.9% in identifying tremor, providing that the tremor was not a fine kinetic and postural tremor or was not in the upper limb. A PTT >1% provide high likely hood of the presence of clinical meaningful tremor. These cut-offs were retested on a second cohort (n = 87) with a similar outcome. The Sensitivity and Selectivity of the combined group was 88.7% and 89.5% respectively. Using the PTT, 50% of 22 newly diagnosed patients had a PTT >1.0%.The PKG’s simultaneous bradykinesia scores was used to find a threshold for the emergence of tremor. Tremor produced artefactual increase in the PKG’s dyskinesia score in 1% of this sample. CONCLUSIONS: We propose this as a means of assessing the presence of tremor and its relationship to bradykinesia.


Bringmann, Laura F.; Pe, Madeline L.; Vissers, Nathalie; Ceulemans, Eva; Borsboom, Denny; Vanpaemel, Wolf et al. (2016): Assessing temporal emotion dynamics using networks. In: Assessment 23 (4), S. 425–435.

Multivariate psychological processes have recently been studied, visualized, and analyzed as networks. In this network approach, psychological constructs are represented as complex systems of interacting components. In addition to insightful visualization of dynamics, a network perspective leads to a new way of thinking about the nature of psychological phenomena by offering new tools for studying dynamical processes in psychology. In this article, we explain the rationale of the network approach, the associated methods and visualization, and illustrate it using an empirical example focusing on the relation between the daily fluctuations of emotions and neuroticism. The results suggest that individuals with high levels of neuroticism had a denser emotion network compared with their less neurotic peers. This effect is especially pronounced for the negative emotion network, which is in line with previous studies that found a denser network in depressed subjects than in healthy subjects. In sum, we show how the network approach may offer new tools for studying dynamical processes in psychology. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Brown, Elizabeth A. (2016): The fitbit fault line: two proposals to protect health and fitness data at work. In: Yale journal of health policy, law, and ethics 16 (1), S. 1–49.

Employers are collecting and using their employees’ health data, mined from wearable fitness devices and health apps, in new, profitable, and barely regulated ways. The importance of protecting employee health and fitness data will grow exponentially in the future. This is the moment for a robust discussion of how law can better protect employees from the potential misuse of their health data. While scholars have just begun to examine the problem of health data privacy, this Article contributes to the academic literature in three important ways. First, it analyzes the convergence of three trends resulting in an unprecedented growth of health-related data: the Internet of Things, the Quantified Self movement, and the Rise of Health Platforms. Second, it describes the insufficiencies of specific data privacy laws and federal agency actions in the context of protecting employee health data from employer misuse. Finally, it provides two detailed and workable solutions for remedying the current lack of protection of employee health data that will realign employer use with reasonable expectations of health and fitness privacy. The Article proceeds in four Parts. Part I describes the growth of self-monitoring apps, devices, and other sensor-enabled technology that can monitor a wide range of data related to an employee’s health and fitness and the relationship of this growth to both the Quantified Self movement and the Internet of Things. Part II explains the increasing use of employee monitoring through a wide range of sensors, including wearable devices, and the potential uses of that health and fitness data. Part III explores the various regulations and agency actions that might protect employees from the potential misuse of their health and fitness data and the shortcomings of each. Part IV proposes two specific measures that would help ameliorate the ineffective legal protections that currently exist in this context. In order to improve employee notice of and control over the disclosure of their health data, I recommend the adoption of a mandatory privacy labeling law for health-related devices and apps to be enacted and enforced by the Federal Trade Commission (FTC). As a complementary measure, I also recommend that be amended so that its protections extend to the health-related data that employers may acquire about their employees. The Article concludes with suggestions for additional scholarly discussion.


Bruening, M.; van Woerden, I.; Todd, M.; Brennhofer, S.; Laska, M. N.; Dunton, G. (2016): A mobile ecological momentary assessment tool (devilSPARC) for nutrition and physical activity behaviors in college students: A validation study. In: Journal of medical Internet research 18 (7), e209. DOI: 10.2196/jmir.5969.

BACKGROUND: The majority of nutrition and physical activity assessments methods commonly used in scientific research are subject to recall and social desirability biases, which result in over- or under-reporting of behaviors. Real-time mobile-based ecological momentary assessments (mEMAs) may result in decreased measurement biases and minimize participant burden. OBJECTIVE: The aim was to examine the validity of a mEMA methodology to assess dietary and physical activity levels compared to 24-hour dietary recalls and accelerometers. METHODS: This study was a pilot test of the SPARC (Social impact of Physical Activity and nutRition in College) study, which aimed to determine the mechanism by which friendship networks impact weight-related behaviors among young people. An mEMA app, devilSPARC, was developed to assess weight-related behaviors in real time. A diverse sample of 109 freshmen and community mentors attending a large southwestern university downloaded the devilSPARC mEMA app onto their personal mobile phones. Participants were prompted randomly eight times per day over the course of 4 days to complete mEMAs. During the same 4-day period, participants completed up to three 24-hour dietary recalls and/or 4 days of accelerometry. Self-reported mEMA responses were compared to 24-hour dietary recalls and accelerometry measures using comparison statistics, such as match rate, sensitivity and specificity, and mixed model odds ratios, adjusted for within-person correlation among repeated measurements. RESULTS: At the day level, total dietary intake data reported through the mEMA app reflected eating choices also captured by the 24-hour recall. Entrees had the lowest match rate, and fruits and vegetables had the highest match rate. Widening the window of aggregation of 24-hour dietary recall data on either side of the mEMA response resulted in increased specificity and decreased sensitivity. For physical activity behaviors, levels of activity reported through mEMA differed for sedentary versus non-sedentary activity at the day level as measured by accelerometers. CONCLUSIONS: The devilSPARC mEMA app is valid for assessing eating behaviors and the presence of sedentary activity at the day level. This mEMA may be useful in studies examining real-time weight-related behaviors.


Carlson, Eve B.; Field, Nigel P.; Ruzek, Josef I.; Bryant, Richard A.; Dalenberg, Constance J.; Keane, Terence M.; Spain, David A. (2016): ‘Advantages and psychometric validation of proximal intensive assessments of patient-reported outcomes collected in daily life’: Erratum. In: Qual Life Res 25 (9), S. 2399. DOI: 10.1007/s11136-016-1280-z.

Reports an error in ‘Advantages and psychometric validation of proximal intensive assessments of patient-reported outcomes collected in daily life’ by Eve B. Carlson, Nigel P. Field, Josef I. Ruzek, Richard A. Bryant, Constance J. Dalenberg, Terrence M. Keane and David A. Spain (Quality of Life Research: An International Journal of Quality of Life Aspects of Treatment, Care & Rehabilitation, 2016[Mar], Vol 25[3], 507-516). This article has been published with a spelling error in the first name of one of the co-authors. His name should appear as ‘Terence M. Keane.’ (The following abstract of the original article appeared in record [rid]2015-52231-001[/rid]). Objectives: Ambulatory assessment data collection methods are increasingly used to study behavior, experiences, and patient-reported outcomes (PROs), such as emotions, cognitions, and symptoms in clinical samples. Data collected close in time at frequent and fixed intervals can assess PROs that are discrete or changing rapidly and provide information about temporal dynamics or mechanisms of change in clinical samples and individuals, but clinical researchers have not yet routinely and systematically investigated the reliability and validity of such measures or their potential added value over conventional measures. The present study provides a comprehensive, systematic evaluation of the psychometrics of several proximal intensive assessment (PIA) measures in a clinical sample and investigates whether PIA appears to assess meaningful differences in phenomena over time. Methods: Data were collected on a variety of psychopathology constructs on handheld devices every 4 h for 7 days from 62 adults recently exposed to traumatic injury of themselves or a family member. Data were also collected on standard self-report measures of the same constructs at the time of enrollment, 1 week after enrollment, and 2 months after injury. Results: For all measure scores, results showed good internal consistency across items and within persons over time, provided evidence of convergent, divergent, and construct validity, and showed significant between- and within-subject variability. Conclusions: Results indicate that PIA measures can provide valid measurement of psychopathology in a clinical sample. PIA may be useful to study mechanisms of change in clinical contexts, identify targets for change, and gauge treatment progress. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Carpenter, Ryan W.; Wycoff, Andrea M.; Trull, Timothy J. (2016): Ambulatory assessment: New adventures in characterizing dynamic processes. In: Assessment 23 (4), S. 414–424. DOI: 10.1037/t15771-000.

In recent years, significant technological advances have changed our understanding of dynamic processes in clinical psychology. A particularly important agent of change has been ambulatory assessment (AA). AA is the assessment of individuals in their daily lives, combining the twin benefits of increased ecological validity and minimized retrospective biases. These benefits make AA particularly well-suited to the assessment of dynamic processes, and recent advancements in technology are providing exciting new opportunities to understand these processes in new ways. In the current article, we briefly detail the capabilities currently offered by smartphones and mobile physiological devices, as well as some of the practical and ethical challenges of incorporating these new technologies into AA research. We then provide several examples of recent innovative applications of AA methodology in clinical research, assessment, and intervention and provide a case example of AA data generated from a study utilizing multiple mobile devices. In this way, we aim to provide a sense of direction for researchers planning AA studies of their own. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Cerrada, Christian Jules; Ra, Chaelin Karen; Shin, Hee-Sung; Dzubur, Eldin; Huh, Jimi (2016): Using ecological momentary assessment to identify common smoking situations among korean american emerging adults. In: Prev Sci. DOI: 10.1007/s11121-016-0687-7.

The present study provides detailed contextual information about smoking habits among young Korean American smokers with the goal of characterizing situations where they are most at risk for smoking. Relevant situational factors included location, social context, concurrent activities, time of day, affective states, and food and beverage consumption. Using ecological momentary assessment (EMA) over 7 days, participants (N = 78) were instructed to respond to smoking prompts (n = 2614) and non-smoking prompts (n = 2136) randomly scheduled throughout the day. At each prompt, participants completed a short survey about immediate contextual factors. We used multilevel models to evaluate the association between contextual factors and smoking and further explored the distribution of smoking locations and concurrent activities across each social context and reason for smoking. Compared to non-smoking events, smoking events were associated with being outside, the presence of Korean friends, socializing, consuming alcohol, and experiencing more stress relative to one’s average stress level (all ps < .01). Further analyses involving only smoking events showed that when participants smoked alone, they were most commonly at home (50 %) and most often studying/working (28 %). When smoking with Korean friends, participants were most often outside (38 %) and socializing (54 %). When smoking to reduce craving, participants were most often at home (39 %) and studying/working (25 %). To our knowledge, this is the first study to provide detailed descriptions of real-time smoking contexts among young Korean American smokers. Information with this level of granularity is needed to develop effective just-in-time adaptive interventions (JITAIs) for smoking cessation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Chapman, Alexander L.; Rosenthal, M. Zachary; Dixon-Gordon, Katherine L.; Turner, Brianna J.; Kuppens, Peter (2016): Borderline personality disorder and the effects of instructed emotional avoidance or acceptance in daily life. In: Journal of personality disorders, S. 1–20. DOI: 10.1521/pedi_2016_30_264.

This study examined the effects of avoidance- versus acceptance-oriented emotion regulation instructions among individuals with borderline personality disorder (BPD; n = 48), major depressive disorder (MDD; n = 54), and non-psychiatric controls (NPC; n = 50) using ecological momentary assessment. Participants were randomly assigned to either accept or avoid negative emotions, and monitored their moods, urges, and distress tolerance several times per day over 6 days. Avoidance instructions resulted in reduced negative affect and urges for maladaptive behaviors uniquely among BPD participants. Together with past research, and consistent with treatment approaches emphasizing the short-term use of skills to avoid or distract from emotions (e.g., DBT; Linehan, 1993b, 2015), these findings suggest that avoidance of negative emotions may have temporary benefits for individuals with BPD. Acceptance-oriented strategies may take longer or may require more extensive training to be beneficial for emotional functioning in everyday life in BPD.


Cogan, Diana; Birjandtalab, Javad; Nourani, Mehrdad; Harvey, Jay; Nagaraddi, Venkatesh (2016): Multi-biosignal analysis for epileptic seizure monitoring. In: International journal of neural systems, S. 1650031. DOI: 10.1142/S0129065716500313.

Persons who suffer from intractable seizures are safer if attended when seizures strike. Consequently, there is a need for wearable devices capable of detecting both convulsive and nonconvulsive seizures in everyday life. We have developed a three-stage seizure detection methodology based on 339 h of data (26 seizures) collected from 10 patients in an epilepsy monitoring unit. Our intent is to develop a wearable system that will detect seizures, alert a caregiver and record the time of seizure in an electronic diary for the patient’s physician. Stage I looks for concurrent activity in heart rate, arterial oxygenation and electrodermal activity, all of which can be monitored by a wrist-worn device and which in combination produce a very low false positive rate. Stage II looks for a specific pattern created by these three biosignals. For the patients whose seizures cannot be detected by Stage II, Stage III detects seizures using limited-channel electroencephalogram (EEG) monitoring with at most three electrodes. Out of 10 patients, Stage I recognized all 11 seizures from seven patients, Stage II detected all 10 seizures from six patients and Stage III detected all of the seizures of two out of the three patients it analyzed.


Comulada, W. Scott; Swendeman, Dallas; Wu, Nancy (2016): Cell phone-based ecological momentary assessment of substance use context for Latino youth in outpatient treatment: Who, what, when and where. In: Drug and alcohol dependence 167, S. 207–213. DOI: 10.1016/j.drugalcdep.2016.08.623.

BACKGROUND: Relationships between alcohol, marijuana and other drug (AOD) use and contextual factors have mostly been established through retrospective self-report. Given the embeddedness of cell phones in adolescents’ daily activities, cell phone-based ecological momentary assessment (CEMA) provides an opportunity to better understand AOD use in youth and how cell phones can be used to self-monitor and deliver interventions. We use CEMA to examine AOD use in Latino youth who have been especially understudied. METHODS: Twenty-eight mostly Latino youth (ages 13-18) in outpatient substance abuse treatment recorded AOD use, contextual factors, cravings, and affect through once-daily CEMA over one month periods. Random-effects logistic regression was used to compare contextual factors between periods of AOD use and non-use. RESULTS: The most frequent contextual factors reported during AOD use were being with close friends and “hanging out” as the primary activity. During AOD use compared to non-use, youth were more likely to be with close friends (OR=4.76; p<0.01), around users (OR=17.69; p<0.01), and at a friend’s house (OR=5.97; p<0.01). Alcohol use was more frequently reported at night (63% vs 34%) and on weekends relative to other substances (64% vs 49%). Strong cravings were more frequently reported on AOD-use days (OR=7.34; p<0.01). Types of positive and negative affect were reported with similar frequencies, regardless of AOD use. CONCLUSIONS: Reporting on social context, location, day and time of day, and cravings all show promise in developing cell phone-based interventions triggered by contextual data.



Connelly, K.; Stein, K. F.; Chaudry, B.; Trabold, N. (2016): Development of an ecological momentary assessment mobile app for a low-literacy, mexican american population to collect disordered eating behaviors. In: JMIR public health and surveillance 2 (2), e31. DOI: 10.2196/publichealth.5511.

BACKGROUND: Ecological momentary assessment (EMA) is a popular method for understanding population health in which participants report their experiences while in naturally occurring contexts in order to increase the reliability and ecological validity of the collected data (as compared to retrospective recall). EMA studies, however, have relied primarily on text-based questionnaires, effectively eliminating low-literacy populations from the samples. OBJECTIVE: To provide a case study of design of an EMA mobile app for a low-literacy population. In particular, we present the design process and final design of an EMA mobile app for low literate, Mexican American women to record unhealthy eating and weight control behaviors (UEWCBs). METHODS: An iterative, user-centered design process was employed to develop the mobile app. An existing EMA protocol to measure UEWCBs in college-enrolled Mexican American women was used as the starting point for the application. The app utilizes an icon interface, with optional audio prompts, that is culturally sensitive and usable by a low-literacy population. A total of 41 women participated over the course of 4 phases of the design process, which included 2 interview and task-based phases (n=8, n=11), focus groups (n=15), and a 5-day, in situ deployment (n=7). RESULTS: Participants’ mental models of UEWCBs differed substantially from prevailing definitions found in the literature, prompting a major reorganization of the app interface. Differences in health literacy and numeracy were better identified with the Newest Vital Sign tool, as compared with the Short Assessment of Health Literacy tool. Participants had difficulty imagining scenarios in the interviews to practice recording a specific UEWCB; instead, usability was best tested in situ. Participants were able to use the EMA mobile app over the course of 5 days to record UEWCBs. CONCLUSIONS: Results suggest that the iterative, user-centered design process was essential for designing the app to be made usable by the target population. Simply taking the protocol designed for a higher-literacy population and replacing words with icons and/or audio would have been unsuccessful with this population.


Cristobal-Narvaez, P.; Sheinbaum, T.; Rosa, A.; Ballespi, S.; Castro-Catala, M. de; Pena, E. et al. (2016): The Interaction between childhood bullying and the FKBP5 gene on psychotic-like experiences and stress reactivity in real life. In: PloS one 11 (7), e0158809. DOI: 10.1371/journal.pone.0158809.

AIM: The present study employed Experience Sampling Methodology to examine whether the interaction between childhood bullying and FKBP5 variability (i) is associated with the expression of psychotic-like experiences, paranoia, and negative affect, and (ii) moderates psychotic-like, paranoid, and affective reactivity to different forms of momentary stress (situational and social) in daily life. METHODS: A total of 206 nonclinical young adults were interviewed for bullying with the Childhood Experience of Care and Abuse and were prompted randomly eight times daily for one week to complete assessments of their current experiences, affect, and stress appraisals. Participants were genotyped for three FKBP5 single nucleotide polymorphisms (SNPs) (rs3800373, rs9296158, and rs1360780) that have been linked to hypothalamus-pituitary-adrenal axis reactivity. Multilevel analyses were conducted to examine the effect of the interaction between childhood bullying and the FKBP5 haplotype derived from these three SNPs. RESULTS: The interaction between bullying and the FKBP5 haplotype was associated with positive, but not negative, psychotic-like experiences, paranoia, and negative affect. The bullying x FKBP5 interaction also moderated the association of a social stress appraisal (specifically, being alone because people do not want to be with you) with psychotic-like experiences and negative affect in daily life. Simple slopes analyses indicated that, in all cases, the associations were significantly increased by exposure to bullying in participants with the risk haplotype, but not for those with the non-risk haplotype. DISCUSSION: The present study provides the first evidence of the interplay between childhood bullying and FKBP5 variability in the real-world expression of psychosis proneness and social stress reactivity. The findings underscore the importance of investigating how gene-environment interactions are involved in mechanistic pathways to the extended psychosis phenotype and lend further support to the increasing relevance given to socially defeating appraisals in the experience of reality distortion.


Dedert, Eric A.; Hicks, Terrell A.; Dennis, Paul A.; Calhoun, Patrick S.; Beckham, Jean C. (2016): Roles of inter-individual differences and intra-individual acute elevations in early smoking lapse in people with posttraumatic stress disorder. In: Addict Behav 60, S. 171–176. DOI: 10.1016/j.addbeh.2016.04.007.

Existing models of the role of posttraumatic stress disorder (PTSD) symptoms and smoking have almost exclusively examined mean symptom levels, rather than the acute elevations that might trigger smoking lapse immediately or increase risk of a smoking lapse in the next few hours. We examined ecological momentary assessments (EMA) of PTSD symptom clusters and smoking in the first week of a quit attempt in 52 people with PTSD. In multilevel models including PTSD symptom means, acute elevations, and lagged acute elevations together as simultaneous predictors of odds of smoking in the same models, pre-quit smoking occasions were significantly related to acute elevations in symptoms, including PTSD totals (OR = 1.20; 95% CI, 1.10 to 1.31), PTSD re-experiencing symptoms (OR = 1.16; 95% CI, 1.06 to 1.27), PTSD avoidance symptoms (OR = 1.20; 95% CI, 1.10 to 1.31), PTSD numbing symptoms (OR = 1.14; 95% CI, 1.04 to 1.24), and PTSD hyperarousal symptoms (OR = 1.20; 95% CI, 1.09 to 1.31). In contrast, post-quit smoking was related to lagged acute elevations in PTSD re-experiencing (OR = 1.24, 95% CI, 1.03 to 1.50) avoidance (OR = 1.27, 95% CI, 1.05 to 1.53), and numbing symptoms (OR = 1.24, 95% CI, 1.02 to 1.51). During a quit attempt, individuals with PTSD delayed smoking in response to acute elevations in PTSD re-experiencing and Avoidance. This period presents an opportunity to use mobile health interventions to prevent smoking lapse and to use coping skills acquired in trauma-focused therapy to respond to acute PTSD symptom elevation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Demirci, Jill R.; Bogen, Debra L. (2016): Feasibility and acceptability of a mobile app in an ecological momentary assessment of early breastfeeding. In: Maternal & child nutrition. DOI: 10.1111/mcn.12342.

Ecological momentary assessment (EMA) is a novel data collection method that samples subject experiences in real-time – minimizing recall bias. Here, we describe the feasibility of EMA to track breastfeeding behaviour through a mobile phone app. During their birth hospitalization, we approached healthy, first-time mothers intending to exclusively breastfeed for at least 2 months to participate in a study tracking breastfeeding through 8 weeks postpartum. Participants downloaded a commercially available smartphone app, entered information and thoughts about breastfeeding as they occurred, and emailed this data weekly. We called participants at 2 and 8 weeks to assess breastfeeding status. At the 8-week call, we also assessed participants’ experiences using the app. Of the 61 participants, 38% sent complete or nearly complete feeding data, 24% sent some data, and 38% sent no data; 58% completed at least one free-text breastfeeding entry, and five women logged daily or near daily entries. Compared with women who sent no data, those who sent any were more likely to be married, highly educated, intend to breastfeed more than 6 months, have a more favourable baseline attitude towards breastfeeding, and less likely to have used formula during hospitalization. There was a high degree of agreement between participant-reported proportion of breast milk feeds via app and interview data at 2 weeks (ICC 0.97). Experiences with the app ranged from helpful to too time-consuming or anxiety-provoking. Participants and researchers encountered technical issues related to app use and analysis, respectively. While our data do not support the feasibility of stand-alone app-based EMA to track breastfeeding behaviour, it may provide rich accounts of the breastfeeding experience for certain subgroups of women. (c) 2016 John Wiley & Sons Ltd.


Dennis, Paul A.; Dedert, Eric A.; van Voorhees, Elizabeth E.; Watkins, Lana L.; Hayano, Junichiro; Calhoun, Patrick S. et al. (2016): Examining the crux of autonomic dysfunction in posttraumatic stress disorder: Whether chronic or situational distress underlies elevated heart rate and attenuated heart rate variability. In: Psychosomatic Medicine 78 (7), S. 805–809. DOI: 10.1097/PSY.0000000000000326.

Objective: Posttraumatic stress disorder (PTSD) has been linked to elevated heart rate (HR) and reduced heart rate variability (HRV) in cross-sectional research. Using ecological momentary assessment and minute-to-minute HRV/HR monitoring, we examined whether cross-sectional associations between PTSD symptom severity and HRV/HR were due to overall elevations in distress levels or to attenuated autonomic regulation during episodes of acute distress. Methods: Two hundred nineteen young adults (18–39 years old), 99 with PTSD, underwent 1 day of Holter monitoring and concurrently reported distress levels via ecological momentary assessment. Using multilevel modeling, we examined the associations between momentary distress and the 5-minute means for low-frequency (LF) and high-frequency (HF) HRV and HR immediately following distress ratings, and whether PTSD symptom severity moderated these associations. Results: Compared with the controls, participants with PTSD recorded higher ambulatory distress (mean [standard deviation] = 1.7 [0.5] versus 1.2 [0.3], p < .001) and HR (87.2 [11.8] versus 82.9 [12.6] beats/min, p = .011), and lower ambulatory LF HRV (36.9 [14.7] versus 43.7 [16.9 ms, p = .002) and HF HRV (22.6 [12.3] versus 26.4 [14.6] milliseconds, p = .043). Overall distress level was not predictive of HR or HRV (p values > .27). However, baseline PTSD symptom severity was associated with elevated HR (t(1257) = 2.76, p = .006) and attenuated LF (t(1257) = −3.86, p < .001) and HF (t(1257) = −2.62, p = .009) in response to acute momentary distress. Conclusions: Results suggest that PTSD is associated with heightened arousal after situational distress and could explain prior findings associating PTSD with HR/HRV. Implications for treatment and cardiovascular risk are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Dennis, Paul A.; Kimbrel, Nathan A.; Dedert, Eric A.; Beckham, Jean C.; Dennis, Michelle F.; Calhoun, Patrick S. (2016): Supplemental nicotine preloading for smoking cessation in posttraumatic stress disorder: Results from a randomized controlled trial. In: Addict Behav 59, S. 24–29. DOI: 10.1016/j.addbeh.2016.03.004.

Background: Individuals with posttraumatic stress disorder (PTSD) are more likely to smoke and more likely to relapse following a quit attempt than individuals without PTSD. Thus, there is a significant need to study promising interventions that might improve quit rates for smokers with PTSD. One such intervention, supplemental nicotine patch-preloading, entails the use of nicotine replacement therapy prior to quitting. Objective The objective of this study was to conduct a randomized controlled trial of the efficacy of supplemental nicotine patch-preloading among smokers with PTSD. We hypothesized that, relative to participants in the placebo condition, participants in the nicotine patch-preloading condition would: (1) smoke less and experience reduced craving for cigarettes during the nicotine patch-preloading phase; (2) experience less smoking-associated relief from PTSD symptoms and negative affect during the preloading phase; and (3) exhibit greater latency to lapse, and higher short- and long-term abstinence rates. Methods: Sixty-three smokers with PTSD were randomized to either nicotine or placebo patch for three weeks prior to their quit date. Ecological momentary assessment was used to assess craving, smoking, PTSD symptoms, and negative affect during the preloading period. Results: Nicotine patch-preloading failed to reduce smoking or craving during the preloading phase, nor was it associated with less smoking-associated relief from PTSD symptoms and negative affect. Moreover, no differences were observed between the treatment conditions for time to lapse, 6-week abstinence, or 6-month abstinence. Conclusions: The findings from the present research suggest that supplemental nicotine patch-preloading is unlikely to substantially enhance quit rates among smokers with PTSD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Depp, C. A.; Moore, R. C.; Perivoliotis, D.; Granholm, E. (2016): Technology to assess and support self-management in serious mental illness. In: Dialogues in clinical neuroscience 18 (2), S. 171–183.

The functional impairment associated with serious mental illness (SMI) places an immense burden on individuals and society, and disability often persists even after efficacious treatment of psychopathologic symptoms. Traditional methods of measuring functioning have limitations, and numerous obstacles reduce the reach and impact of evidence-based interventions developed to improve functioning in SMI. This review describes the potential of technological innovations for overcoming the challenges involved in both functional assessment and intervention in people with SMI. Ecological momentary assessment (EMA), which involves the repeated sampling of naturalistic behaviors and experiences while individuals carry out their daily lives, has provided a new window through which the determinants of day-to-day function in SMI can be observed. EMA has several advantages over traditional assessment methods and has in recent years evolved to use mobile-based platforms, such as text messaging and smartphone applications, for both assessment and promotion of self-management in people with SMI. We will review promising data regarding the acceptability, adherence, and efficacy of EMA-based mobile technologies; explore ways in which these technologies can extend the reach and impact of evidence-based psychosocial rehabilitative interventions in SMI; and outline future directions for research in this important area.


Deuring, G.; Kiss, A.; Halter, J. P.; Passweg, JR; Grossman, P. (2016): Cardiac autonomic functioning is impaired among allogeneic hematopoietic stem cell transplantation survivors: a controlled study. In: Bone marrow transplantation. DOI: 10.1038/bmt.2016.176.

Healthy cardiac autonomic functioning (CAF) is essential for maintaining homeostasis in response to the environmental demands of everyday life. Impaired CAF is associated with higher morbidity and higher mortality. To explore CAF in survivors of allogeneic hematopoietic stem cell transplantation (allo-HSCT) 1-10 years after transplant (median=4.3 years), an ambulatory assessment was performed with 104 patients, and 45 age- and gender-matched healthy controls. Heart rate (HR) and respiratory sinus arrhythmia (RSA, that is, high-frequency HR variability) were measured in a laboratory setting and during a 12-hour naturalistic period of daily life. Cancer-related fatigue was assessed by the Functional Assessment of Chronic Illness – Fatigue questionnaire; physical fitness by bicycle-ergometry VO2max. In contrast to healthy controls, 4-year post-HSCT fatigue was greater in patients (P<0.0001, Cohen’s d effect size [d]=1.14), and fitness was lower in patients (P<0.0001, d=1.09). In both laboratory and real-life ambulatory conditions, average HR was persistently higher (P<0.0001, d=0.88) and mean RSA magnitude lower (P<0.001, d=0.69) among patients, compared with controls. Severely fatigued patients showed higher HR and lower parasympathetic cardiac control than non-fatigued patients (HR: P=0.02, d=0.47; RSA: P=0.02, d=0.72), and this was unrelated to fitness. These findings may have important implications for predicting long-term treatment outcome and consequences for routine post-HSCT care.Bone Marrow Transplantation advance online publication, 4 July 2016; doi:10.1038/bmt.2016.176.


Dirk, Judith; Schmiedek, Florian (2016): Fluctuations in elementary school children’s working memory performance in the school context. In: J Educ Psychol 108 (5), S. 722–739. DOI: 10.1037/edu0000076.

Children experience good and bad days in their performance. Although this phenomenon is well-known to teachers, parents, and students it has not been investigated empirically. We examined whether children’s working memory performance varies systematically from day to day and to which extent fluctuations at faster timescales (i.e., occasions, moments) contribute to daily WM fluctuations in the school context. In an ambulatory assessment study, Grade 3 and Grade 4 students (8 to 11 years old; N = 110) completed WM tasks on smartphones 3 times a day in school and at home for 4 weeks. Results showed substantial within-person fluctuations in children’s daily WM performance. Across task conditions, day-to-day, occasion-to-occasion, and moment-to-moment variability accounted for roughly the same extent of observed day-to-day variability with large individual differences in the amount of reliable fluctuations at the different timescales. Grade 3 students were more variable than were Grade 4 students at the faster timescales, more variable WM performance at all timescales was related to lower school achievement, and more day-to-day variability was associated with lower fluid intelligence. These findings build the foundation for research on the antecedents and consequences of children’s fluctuating cognitive resources. Theories about cognitive development and learning should consider performance fluctuations across and within days to understand the processes underlying long-term changes. Educational practice may be informed by the substantial WM fluctuations at all timescales and adopt interventions that increase children’s attentional focus and self-regulation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Dunton, Genevieve F.; Dzubur, Eldin; Huh, Jimi; Belcher, Britni R.; Maher, Jaclyn P.; O’Connor, Sydney; Margolin, Gayla (2016): Daily Associations of stress and eating in mother-child dyads. In: Health education & behavior : the official publication of the Society for Public Health Education. DOI: 10.1177/1090198116663132.

BACKGROUND AND AIMS: This study used Ecological Momentary Assessment (EMA) in mother-child dyads to examine the day-level associations of stress and eating. METHOD: Mothers and their 8- to 12-year-old children (N = 167 dyads) completed between three (weekday) and eight (weekend) EMA survey prompts per day at random nonschool times across 8 days. EMA measured perceived stress, and past 2-hour healthy (i.e., fruit and vegetables) and unhealthy (e.g., pastries/sweets, soda/energy drinks) eating. RESULTS: Children reported more healthy and unhealthy eating on days when their mothers also engaged in more healthy and unhealthy eating, respectively. On days when mothers’ perceived stress was greater than usual, they reported more healthy eating. DISCUSSION AND CONCLUSIONS: Eating behaviors were coupled between mothers and children at the day level. Mothers’ stress was related to their own eating but not to children’s eating.


Edwards, Clementine J.; Cella, Matteo; Tarrier, Nicholas; Wykes, Til (2016): The optimisation of experience sampling protocols in people with schizophrenia. In: Psychiatry research 244, S. 289–293. DOI: 10.1016/j.psychres.2016.07.048.

Experience sampling methodology (ESM) involves completing questionnaires during daily life and has been used extensively in people with schizophrenia to assess symptoms and behaviours. Despite considerable advantages over interview measures, there is limited information about its external validity. Our aim is to investigate whether ESM protocol implementation is affected differentially in people with schizophrenia and healthy individuals by factors such as mood, medication and symptoms which would have implications for validity. Fifty-three people with schizophrenia and fifty-eight controls from the general population completed seven ESM questionnaires per day for six consecutive days. Compliance and acceptability, including overall experience, training and disruption of normal routines, were recorded. Overall questionnaire completion rate in people with schizophrenia was comparable to controls (i.e. over 70%). People with schizophrenia completed significantly fewer questionnaires in the morning but did not show fatigue effects over the experience sampling period. Excluding questionnaires in the morning did not significantly alter the findings. In the schizophrenia group medication level and symptoms did not influence adherence. However, higher disruption was associated with reduced questionnaire completion in this group. These findings suggest that minimising disruption may enhance validity and completion rates. ESM is a valid methodology to use with people with schizophrenia.


Elliston, Katherine G.; Ferguson, Stuart G.; Schuz, Natalie; Schuz, Benjamin (2016): Situational cues and momentary food environment predict everyday eating behavior in adults with overweight and obesity. In: Health psychology : official journal of the Division of Health Psychology, American Psychological Association. DOI: 10.1037/hea0000439.

Individual eating behavior is a risk factor for obesity and highly dependent on internal and external cues. Many studies also suggest that the food environment (i.e., food outlets) influences eating behavior. This study therefore examines the momentary food environment (at the time of eating) and the role of cues simultaneously in predicting everyday eating behavior in adults with overweight and obesity. Intensive longitudinal study using ecological momentary assessment (EMA) over 14 days in 51 adults with overweight and obesity (average body mass index = 30.77; = 4.85) with a total of 745 participant days of data. Multiple daily assessments of eating (meals, high- or low-energy snacks) and randomly timed assessments. Cues and the momentary food environment were assessed during both assessment types. Random effects multinomial logistic regression shows that both internal (affect) and external (food availability, social situation, observing others eat) cues were associated with increased likelihood of eating. The momentary food environment predicted meals and snacking on top of cues, with a higher likelihood of high-energy snacks when fast food restaurants were close by (odds ratio [] = 1.89, 95% confidence interval [CI] = 1.22, 2.93) and a higher likelihood of low-energy snacks in proximity to supermarkets ( = 2.29, 95% CI = 1.38, 3.82). Real-time eating behavior, both in terms of main meals and snacks, is associated with internal and external cues in adults with overweight and obesity. In addition, perceptions of the momentary food environment influence eating choices, emphasizing the importance of an integrated perspective on eating behavior and obesity prevention. (PsycINFO Database Record


Engelen, L.; Chau, J. Y.; Burks-Young, S.; Bauman, A. (2016): Application of ecological momentary assessment in workplace health evaluation. In: Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals. DOI: 10.1071/HE16043.

Issue addressed: Ecological momentary assessment (EMA) involves repeated sampling of current behaviours and experiences in real-time at random intervals. EMA is an innovative measurement method for program evaluation, using mobile technology (e.g. smartphones) to collect valid contextual health promotion data with good compliance. The present study examined the feasibility of using EMA for measuring workplace health outcomes.Methods: Twenty-two office-based adults were prompted at four random times per work-day during a 5-day period to respond to a short survey via a smartphone application. The prompting stopped when participants had either responded 12 times or the 5-day period had ended. The questions pertained to posture, task currently being undertaken, social interactions, musculoskeletal issues, mood, and perceptions of engagement and creativity.Results: In total 156 responses were collected. Nine participants completed all 12 surveys; the average completion rate was 58% (7/12). The average completion time was initially 50s and reduced to 24s during the later surveys. On average the participants were sitting and standing in 79% and 14% of survey instances, respectively. The participants reported they were working alone at their desks in 68% of instances. Reported productivity and stress were on average 6 and 3 out of 10, respectively, but varied up to 6-8 points within one person, hence the method appears sensitive to temporal variations in perceptions and mood.Conclusion: Given the rich real-time data, minimal participant burden and use of readily available technology, EMA has substantial potential in workplace health promotion evaluation through the measurement of participants’ well being, activities, and behaviour change.So what?: An in-the-moment method using readily available mobile technology to assess participants’ perceptions, mood and activity that provides rich information with minimal participant burden is a promising way to evaluate future health promotion programs.


Fanning, Jason; Mackenzie, Michael; Roberts, Sarah; Crato, Ines; Ehlers, Diane; McAuley, Edward (2016): Physical activity, mind wandering, affect, and sleep: An ecological momentary assessment. In: JMIR mHealth and uHealth 4 (3), e104. DOI: 10.2196/mhealth.5855.

BACKGROUND: A considerable portion of daily thought is spent in mind wandering. This behavior has been related to positive (eg, future planning, problem solving) and negative (eg, unhappiness, impaired cognitive performance) outcomes. OBJECTIVE: Based on previous research suggesting future-oriented (ie, prospective) mind wandering may support autobiographical planning and self-regulation, this study examined associations between hourly mind wandering and moderate-to-vigorous physical activity (MVPA), and the impact of affect and daily sleep on these relations. METHODS: College-aged adults (N=33) participated in a mobile phone-delivered ecological momentary assessment study for 1 week. Sixteen hourly prompts assessing mind wandering and affect were delivered daily via participants’ mobile phones. Perceived sleep quality and duration was assessed during the first prompt each day, and participants wore an ActiGraph accelerometer during waking hours throughout the study week. RESULTS: Study findings suggest present-moment mind wandering was positively associated with future MVPA (P=.03), and this relationship was moderated by affective state (P=.04). Moreover, excessive sleep the previous evening was related to less MVPA across the following day (P=.007). Further, mind wandering was positively related to activity only among those who did not oversleep (P=.007). CONCLUSIONS: Together, these results have implications for multiple health behavior interventions targeting physical activity, affect, and sleep. Researchers may also build on this work by studying these relationships in the context of other important behaviors and psychosocial factors (eg, tobacco use, depression, loneliness).


Fazeli, Pariya L.; Turan, Janet M.; Budhwani, Henna; Smith, Whitney; Raper, James L.; Mugavero, Michael J.; Turan, Bulent (2016): Moment-to-moment within-person associations between acts of discrimination and internalized stigma in people living with HIV: An experience sampling study. In: Stigma and Health. DOI: 10.1037/sah0000051.

Internalized stigma related to HIV is associated with poorer outcomes for people living with HIV (PLWH). However, little is known about the association between experiences of daily acts of discrimination by others and the activation of internalized stigma, including factors that may moderate this association. One hundred 9 men living with HIV responded to experience sampling method (ESM) questions 3 times a day for 7 days via smart-phones. ESM questions included experiences of recent acts of discrimination, internalized HIV stigma, avoidance coping with HIV, and recent social support. We also administered several traditional questionnaire measures assessing psychosocial constructs. In hierarchical linear modeling analyses controlling for age, race, socioeconomic status, and time on antiretroviral therapy, experiencing discrimination predicted internalized stigma within persons. Individuals higher on attachment-related avoidance, attachment-related anxiety, avoidance coping, perceived community stigma, and helplessness, and individuals lower on social support had stronger associations between discrimination and current internalized stigma. Similarly, results from 2 state moderator variables supported our trait analyses: State-level (ESM) social support and avoidance coping were significant moderators. Thus, when PLWH experience incidents of discrimination due to HIV, this may lead to increased feelings of internalized stigma. We extend the literature by demonstrating that the associations between experienced and internalized stigma are not just at the generalized trait level, but also occur at the state level, accounting for within-person variability. Results provide implications for interventions aiming to modify maladaptive interpersonal traits as well as interventions to increase social support to reduce the impact of discrimination on PLWH. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Firth, Joseph; Torous, John; Yung, Alison R. (2016): Ecological momentary assessment and beyond: The rising interest in e-mental health research. In: J Psychiatr Res 80, S. 3–4. DOI: 10.1016/j.jpsychires.2016.05.002.

Comments on an article by R.C. Moore et al. (see record [rid]2016-11334-018[/rid]). Authors read with interest the recent article by Moore et al., which used smartphones as a means of capturing ecological momentary assessment (EMA) data in a trial of mindfulness. As the authors point out, the smartphone-based EMA measures outperformed the traditional methods (i.e. paper-and-pencil), even among older adults. This interesting paper is a clear example of the potential benefits of ‘eHealth’, which refers to the use of computerized technologies applied within the healthcare setting. In response to the potential for improving healthcare, these novel methods are increasingly adopted, and studied, in medical research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Fitzsimmons-Craft, Ellen E.; Bardone-Cone, Anna M.; Crosby, Ross D.; Engel, Scott G.; Wonderlich, Stephen A.; Bulik, Cynthia M. (2016): Mediators of the relationship between thin-ideal internalization and body dissatisfaction in the natural environment. In: Body image 18, S. 113–122. DOI: 10.1016/j.bodyim.2016.06.006.

Social comparisons (i.e., body, eating, exercise) and body surveillance were tested as mediators of the thin-ideal internalization-body dissatisfaction relationship using ecological momentary assessment (EMA). Participants were 232 college women who completed a 2-week EMA protocol, responding to questions three times per day. Multilevel path analysis was used to examine a 2-1-1 mediation model (thin-ideal internalization assessed as trait; between-person effects examined) and a 1-1-1 model (component of thin-ideal internalization [thin-ideal importance] assessed momentarily; within- and between-person effects examined). For the 2-1-1 model, only body comparison and body surveillance were significant specific mediators of the between-person effect. For the 1-1-1 model, all four variables were significant specific mediators of the within-person effect. Only body comparison was a significant specific mediator of the between-person effect. At the state level, many processes explain the thin-ideal internalization-body dissatisfaction relationship. However, at the trait level, body comparison and body surveillance are more important explanatory factors.


Fleig, Lena; Ashe, Maureen C.; Voss, Christine; Therrien, Suzanne; Sims-Gould, Joanie; McKay, Heather A.; Winters, Meghan (2016): Environmental and psychosocial correlates of objectively measured physical activity among older adults. In: Health Psychol. DOI: 10.1037/hea0000403.

Objective: Neighborhood environments can support or hinder physical activity especially as health declines with age. This study puts psychological theories of health behavior change in context with built environment research to better understand the interplay of environmental and psychosocial characteristics impacting older adults’ sedentary behavior and physical activity. Method: The Active Streets, Active People study recruited 193 older adults living in a highly walkable neighborhood in Vancouver, British Columbia, Canada. Participants completed questionnaires on attitudes toward walking, behavioral control for walking, and perceived built environment variables. To assess behavior, participants wore an ActiGraph GT3X + accelerometer for 7 consecutive days. Regression-based path analysis was conducted to examine whether the link between the perceived environment and behavior is mediated by psychosocial variables. Results: In total, 174 participants had valid accelerometry data (Mage = 70.3, SD = 7.2) and demonstrated a daily average of 525.7 min of sedentary behavior (SD = 65.1) as well as high levels of total physical activity (M = 254.3, SD = 65.1 min/day). Mediation analysis revealed that perceived street connectivity and diversity of land use were negatively related to sedentary behavior, but only indirectly through behavioral control. Similarly, effects of street connectivity and diversity of land use on physical activity were mediated by behavioral control. Conclusions: Results highlighted that the perceived built environment is important for physical activity and sedentary behavior, largely because these environmental perceptions are positively linked to older adults’ confidence in walking. By integrating environmental and psychosocial correlates of preventive health behaviors within a theoretical structure, the psychosocial mechanisms through which the environment affects activity can be better understood. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Forman, Evan M.; Shaw, Jena A.; Goldstein, Stephanie P.; Butryn, Meghan L.; Martin, Lindsay M.; Meiran, Nachshon et al. (2016): Mindful decision making and inhibitory control training as complementary means to decrease snack consumption. In: Appetite 103, S. 176–183. DOI: 10.1016/j.appet.2016.04.014.

Objective: Obesity is largely attributable to excess caloric intake, in particular from ‘junk’ foods, including salty snack foods. Evidence suggests that neurobiological preferences to consume highly hedonic foods translate (via implicit processes) into poor eating choices, unless overturned by inhibitory mechanisms or interrupted by explicit processes. The primary aim of the current study was to test the independent and combinatory effects of a computerized inhibitory control training (ICT) and a mindful decision-making training (MDT) designed to facilitate de-automatization. Methods: We randomized 119 habitual salty snack food eaters to one of four short, training conditions: MDT, ICT, both MDT and ICT, or neither (i.e., psychoeducation). For 7 days prior to the intervention and 7 days following the intervention, participants reported on their salty snack food consumption 2 times per day, on 3 portions of their days, using a smartphone-based ecological momentary assessment system. Susceptibility to emotional eating cues was measured at baseline. Results: Results indicated that the effect of MDT was consistent across levels of trait emotional eating, whereas the benefit of ICT was apparent only at lower levels of emotional eating. No synergistic effect of MDT and ICT was detected. Conclusions: These results provide qualified support for the efficacy of both types of training for decreasing hedonically-motivated eating. Moderation effects suggest that those who eat snack foods for reasons unconnected to affective experiences (i.e., lower in emotional eating) may derive benefit from a combination of ICT and MDT. Future research should investigate the additive benefit of de-automization training to standard weight loss interventions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Gao, Weihua; Hedeker, Donald; Mermelstein, Robin; Xie, Hui (2016): A scalable approach to measuring the impact of nonignorable nonresponse with an EMA application. In: Statistics in medicine. DOI: 10.1002/sim.7078.

There is often a need to assess the dependence of standard analyses on the strong untestable assumption of ignorable missingness. To tackle this problem, past research developed simple sensitivity index measures assuming a linear impact of nonignorability and missingness in outcomes only. These restrictions limit their applicability for studies with missingness in both outcome and covariates. Nonignorable missingness in this setting poses significant new analytic challenges and calls for more general and flexible methods that are also computationally tractable even for large datasets. In this paper, we relax the restrictions of extant linear sensitivity index methods and develop nonlinear sensitivity indices that maintain computational simplicity and perform equally well when the impact of nonignorability is locally linear. On the other hand, they can substantially improve the effectiveness of local sensitivity analysis when regression outcomes and covariates are subject to concurrent missingness. In this situation, the local linear sensitivity analysis fails to detect the impact of nonignorability while the proposed nonlinear sensitivity measures can. Because the new sensitivity indices avoid fitting complicated nonignorable models, they are computationally tractable (i.e., scalable) for use in large datasets. We develop general formula for nonlinear sensitivity index measures, and evaluate the new measures in simulated data and a real dataset collected using the ecological momentary assessment method. Copyright (c) 2016 John Wiley & Sons, Ltd.


Garcia, Jeanette M.; Sirard, John R.; Deutsch, Nancy L.; Weltman, Arthur (2016): The influence of friends and psychosocial factors on physical activity and screen time behavior in adolescents: A mixed-methods analysis. In: J Behav Med 39 (4), S. 610–623. DOI: 10.1007/s10865-016-9738-6.

(1) Determine the association between adolescent moderate-to-vigorous physical activity (MVPA) and screen time with their nominated friends’ behaviors and (2) explore potential mechanisms of friends’ social influences on MVPA and screen time. Participants consisted of 152 adolescents (mean age: 14.5 years, 53 % female, 50 % high school, 80 % Caucasian). MVPA was measured with an Actigraph GT3X+ accelerometer. Demographic and psychosocial variables were assessed via questionnaires. Participants nominated up to 5 friends who completed MVPA and screen time questionnaires. A subset of adolescents (n = 108) participated in focus groups that examined potential mechanism of friends’ influence on MVPA and screen time. Multiple regression analysis examined the association of demographic, psychological, and nominated friend variables with participants’ MVPA and screen time. NVivo 10.0 was used to analyze qualitative data. Greater levels of friends’ MVPA was associated with greater levels of MVPA in both males (p < .0001) and females (p < .0001). Greater levels of friends’ screen time was associated with greater levels of screen time in males (p = .04) while psychosocial variables, such as increased screen time enjoyment, were associated with increased screen time in females (p = .01). School level was not associated with either MVPA or screen time. Focus group data indicated that friends positively influenced participants’ MVPA through engaging in activity with participants, verbal encouragement, and modeling of MVPA. All participants preferred to be active with friends rather than alone, however, females preferred activity with a close friend while males preferred to be active with a group. Enjoyment of MVPA was the most cited reason for engaging in MVPA with friends. The majority of participants reported friends not having an influence on screen time. Adolescents with active friends are more likely to be physically active and spend less time engaging in screen-based behaviors. Interventions to increase MVPA in youth could be designed to include the recruitment of friends to increase enjoyment of MVPA. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Geiser, Christian; Griffin, Daniel; Shiffman, Saul (2016): Using multigroup-multiphase latent state-trait models to study treatment-induced changes in intra-individual state variability: An application to smokers’ affect. In: Frontiers in psychology 7, S. 1043. DOI: 10.3389/fpsyg.2016.01043.

Sometimes, researchers are interested in whether an intervention, experimental manipulation, or other treatment causes changes in intra-individual state variability. The authors show how multigroup-multiphase latent state-trait (MG-MP-LST) models can be used to examine treatment effects with regard to both mean differences and differences in state variability. The approach is illustrated based on a randomized controlled trial in which N = 338 smokers were randomly assigned to nicotine replacement therapy (NRT) vs. placebo prior to quitting smoking. We found that post quitting, smokers in both the NRT and placebo group had significantly reduced intra-individual affect state variability with respect to the affect items calm and content relative to the pre-quitting phase. This reduction in state variability did not differ between the NRT and placebo groups, indicating that quitting smoking may lead to a stabilization of individuals’ affect states regardless of whether or not individuals receive NRT.


Gerteis, Ann Kathrin S.; Schwerdtfeger, Andreas R. (2016): When rumination counts: Perceived social support and heart rate variability in daily life. In: Psychophysiology 53 (7), S. 1034–1043. DOI: 10.1111/psyp.12652.

Rumination and social support could modulate cardiac activity. Although both variables are somehow interrelated, they are often studied independently, and their interplay is seldom considered. We aimed to analyze the interaction of rumination and perceived social support on vagally mediated heart rate variability (HRV) in daily life. The sample consisted of 117 healthy participants (57% female, mean age = 27.9, SD = 5.5 years). Ambulatory HRV (root mean squared successive differences), respiration, body position, and body movements were recorded continuously on three consecutive weekdays. Momentary social, situational, and cognitive‐affective variables (affect, ruminative thoughts, perceived social support) were assessed using a computerized diary. There was a significant interaction between momentary rumination and perceived social support on ambulatory HRV: When participants were involved in social interactions with low social support, concurrent rumination was associated with attenuated HRV. However, when rumination was accompanied by a strong sense of support, HRV significantly increased. The quality of social interactions and rumination seem to interact in daily life to predict cardiac autonomic control. The results stress the necessity to consider the interplay of psychological and social factors in order to evaluate beneficial or adverse effects on cardiac health. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Giffin, Nicola J.; Lipton, Richard B.; Silberstein, Stephen D.; Olesen, Jes; Goadsby, Peter J. (2016): The migraine postdrome: An electronic diary study. In: Neurology 87 (3), S. 309–313. DOI: 10.1212/WNL.0000000000002789.

Objective: To report migraine postdrome symptoms in patients who report nonheadache symptoms as part of their attacks. Methods: A prospective daily electronic diary study was conducted over 3 months in 120 patients with migraine. Nonheadache symptoms before, during, and after headache were collected on a daily basis. Visual analogue scales were used to capture the overall level of functioning and the severity of the headache. The postdrome was defined as the time from resolution of troublesome headache to return to normal. Results: Of 120 evaluable patients, 97 (81%) reported at least one nonheadache symptom in the postdrome. Postdrome symptoms, in order of frequency, included feeling tired/weary and having difficulty concentrating and stiff neck. Many patients also reported a mild residual head discomfort. In most attacks (93%), there was return to normal within 24 hours after spontaneous pain resolved. There was no relationship between medication taken for the headache and the duration of the postdrome. The severity of the migraine was not associated with the duration of the postdrome. Overall state of health scores remained low during the postdrome. Conclusion: Nonheadache symptoms in the postdrome were common and may contribute to the distress and disability in the patients studied. Postdrome symptoms merit larger observational studies and careful recording in clinical trials of acute and preventive migraine treatments. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Gotink, R. A.; Hermans, K. S.; Geschwind, N.; Nooij, R. de; Groot, W. T. de; Speckens, A. E. (2016): Mindfulness and mood stimulate each other in an upward spiral: a mindful walking intervention using experience sampling. In: Mindfulness 7 (5), S. 1114–1122. DOI: 10.1007/s12671-016-0550-8.

The aim of this study was to explore the feasibility and effectiveness of mindful walking in nature as a possible means to maintain mindfulness skills after a mindfulness-based cognitive therapy (MBCT) or mindfulness-based stress reduction (MBSR) course. Mindful walking alongside the river Rhine took place for 1, 3, 6, or 10 days, with a control period of a similar number of days, 1 week before the mindful walking period. In 29 mindfulness participants, experience sampling method (ESM) was performed during the control and mindful walking period. Smartphones offered items on positive and negative affect and state mindfulness at random times during the day. Furthermore, self-report questionnaires were administered before and after the control and mindful walking period, assessing depression, anxiety, stress, brooding, and mindfulness skills. ESM data showed that walking resulted in a significant improvement of both mindfulness and positive affect, and that state mindfulness and positive affect prospectively enhanced each other in an upward spiral. The opposite pattern was observed with state mindfulness and negative affect, where increased state mindfulness predicted less negative affect. Exploratory questionnaire data indicated corresponding results, though non-significant due to the small sample size. This is the first time that ESM was used to assess interactions between state mindfulness and momentary affect during a mindfulness intervention of several consecutive days, showing an upward spiral effect. Mindful walking in nature may be an effective way to maintain mindfulness practice and further improve psychological functioning.


Haan-Rietdijk, Silvia de; Kuppens, Peter; Hamaker, Ellen L. (2016): What’s in a Day? A guide to decomposing the variance in intensive longitudinal data. In: Frontiers in psychology 7, S. 891. DOI: 10.3389/fpsyg.2016.00891.

In recent years there has been a growing interest in the use of intensive longitudinal research designs to study within-person processes. Examples are studies that use experience sampling data and autoregressive modeling to investigate emotion dynamics and between-person differences therein. Such designs often involve multiple measurements per day and multiple days per person, and it is not clear how this nesting of the data should be accounted for: That is, should such data be considered as two-level data (which is common practice at this point), with occasions nested in persons, or as three-level data with beeps nested in days which are nested in persons. We show that a significance test of the day-level variance in an empty three-level model is not reliable when there is autocorrelation. Furthermore, we show that misspecifying the number of levels can lead to spurious or misleading findings, such as inflated variance or autoregression estimates. Throughout the paper we present instructions and R code for the implementation of the proposed models, which includes a novel three-level AR(1) model that estimates moment-to-moment inertia and day-to-day inertia. Based on our simulations we recommend model selection using autoregressive multilevel models in combination with the AIC. We illustrate this method using empirical emotion data from two independent samples, and discuss the implications and the relevance of the existence of a day level for the field.


Hare, Dougal Julian; Gracey, Carolyn; Wood, Christopher (2016): Anxiety in high-functioning autism: A pilot study of experience sampling using a mobile platform. In: Autism 20 (6), S. 730–743. DOI: 10.1177/1362361315604817.

Anxiety and stress are everyday issues for many people with high-functioning autism, and while cognitive-behavioural therapy is the treatment of choice for the management of anxiety, there are challenges in using it with people with high-functioning autism. This study used modified experience sampling techniques to examine everyday anxiety and stress in adults with high-functioning autism and to explore the feasibility of delivering real-time stress management techniques using a mobile platform. High levels of anxiety were found to be characterised by worry, confusing thoughts and being alone but was not associated with internal focus, imagery or rumination. Participants reported improved mood and less worry and anxious thinking in the active phase of the study. These results support previous studies indicating that people with high-functioning autism differ in their experience of anxiety and provided preliminary data on the feasibility of real-time stress management. The limitations of this approach are discussed together with considerations for future work in the area of developing clinical interventions on mobile platforms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Hegade, V. S.; Kendrick, S. F.; Dobbins, R. L.; Miller, SR; Richards, D.; Storey, J. et al. (2016): BAT117213: Ileal bile acid transporter (IBAT) inhibition as a treatment for pruritus in primary biliary cirrhosis: study protocol for a randomised controlled trial. In: BMC gastroenterology 16 (1), S. 71. DOI: 10.1186/s12876-016-0481-9.

BACKGROUND: Pruritus (itch) is a symptom commonly experienced by patients with cholestatic liver diseases such as primary biliary cholangitis (PBC, previously referred to as primary biliary cirrhosis). Bile acids (BAs) have been proposed as potential pruritogens in PBC. The ileal bile acid transporter (IBAT) protein expressed in the distal ileum plays a key role in the enterohepatic circulation of BAs. Pharmacological inhibition of IBAT with GSK2330672 may reduce BA levels in the systemic circulation and improve pruritus. METHODS: This clinical study (BAT117213 study) is sponsored by GlaxoSmithKline (GSK) with associated exploratory studies supported by the National Institute for Health Research (NIHR). It is a phase 2a, multi-centre, randomised, double bind, placebo controlled, cross-over trial for PBC patients with pruritus. The primary objective is to investigate the safety and tolerability of repeat doses of GSK2330672, and explore whether GSK2330672 administration for 14 days improves pruritus compared with placebo. The key outcomes include improvement in pruritus scores evaluated on a numerical rating scale and other PBC symptoms in an electronic diary completed twice daily by the patients. The secondary outcomes include the evaluation of the effect of GSK2330672 on total serum bile acid (BA) concentrations, serum markers of BA synthesis and steady-state pharmacokinetics of ursodeoxycholic acid (UDCA). DISCUSSION: BAT117213 study is the first randomised controlled crossover trial of ileal bile acid transporter inhibitor, a novel class of drug to treat pruritus in PBC. The main strengths of the trial are utility of a novel, study specific, electronic symptom diary as patient reported outcome to measure the treatment response objectively and the crossover design that allows estimating the treatment effect in a smaller number of patients. The outcome of this trial will inform the trial design of future development phase of the IBAT inhibitor drug. The trial will also provide opportunity to conduct metabonomic and gut microbiome studies as explorative and mechanistic research in patients with cholestatic pruritus. TRIAL REGISTRATION: EudraCT number: 2012-005531-84, Identifier: NCT01899703 , registered on 3(rd) July 2013.


Helbig-Lang, Sylvia; Auer, Maxie von; Neubauer, Karolin; Murray, Eileen; Gerlach, Alexander L. (2016): Post-event processing in social anxiety disorder after real-life social situations – An ambulatory assessment study. In: Behaviour research and therapy 84, S. 27–34. DOI: 10.1016/j.brat.2016.07.003.

Excessive post-mortem processing after social situations, a core symptom of social anxiety disorder (SAD), is thought to contribute to the perpetuation of social anxiety by consolidating negative self-schemata. Empirical findings on actual mechanisms underlying this so-called Post-Event Processing (PEP) are still scarce. The present study sought to identify variables associated with the experience of PEP after real-life social situations in a sample of 49 individuals diagnosed with SAD. Using an ambulatory assessment approach, individuals were asked to report on each distressing social event experienced during one week. A total of 192 events were captured. Hierarchical linear modeling indicated that next to trait social anxiety, the type of social situation (performance vs. interaction situations), self-focused attention, safety behavior use, and negative affect predicted levels of PEP after social situations. These findings add to the growing literature that emphasizes the importance of situational factors for the experience of PEP, and highlight potential venues to prevent it.


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: Personal Disord 7 (4), S. 384–393. 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. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


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: J Affect Disord 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. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Holland, Elise; Koval, Peter; Stratemeyer, Michelle; Thomson, Fiona; Haslam, Nick (2016): Sexual objectification in women’s daily lives: A smartphone ecological momentary assessment study. In: The British journal of social psychology. DOI: 10.1111/bjso.12152.

Sexual objectification, particularly of young women, is highly prevalent in modern industrialized societies. Although there is plenty of experimental and cross-sectional research on objectification, prospective studies investigating the prevalence and psychological impact of objectifying events in daily life are scarce. We used ecological momentary assessment to track the occurrence of objectifying events over 1 week in the daily lives of young women (N = 81). Participants reported being targeted by a sexually objectifying event – most often the objectifying gaze – approximately once every 2 days and reported witnessing sexual objectification of others approximately 1.35 times per day. Further, multilevel linear regression analyses showed that being targeted by sexual objectification was associated with a substantial increase in state self-objectification. Overall, individual differences had little impact in moderating these effects.


Hoorelbeke, Kristof; Koster, Ernst H. W.; Demeyer, Ineke; Loeys, Tom; Vanderhasselt, Marie-Anne (2016): Effects of cognitive control training on the dynamics of (mal)adaptive emotion regulation in daily life. In: Emotion 16 (7), S. 945–956. DOI: 10.1037/emo0000169.

Cognitive control plays a key role in both adaptive emotion regulation, such as positive reappraisal, and maladaptive emotion regulation, such as rumination, with both strategies playing a major role in resilience and well-being. As a result, cognitive control training (CCT) targeting working memory functioning may have the potential to reduce maladaptive emotion regulation and increase adaptive emotion regulation. The current study explored the effects of CCT on positive reappraisal ability in a lab context, and deployment and efficacy of positive appraisal and rumination in daily life. A sample of undergraduates (n = 83) was allocated to CCT or an active control condition, performing 10 online training sessions over a period of 14 days. Effects on regulation of affective states in daily life were assessed using experience sampling over a 7-day posttraining period. Results revealed a positive association between baseline cognitive control and self-reported use of adaptive emotion regulation strategies, whereas maladaptive emotion regulation strategies showed a negative association. CCT showed transfer to working memory functioning on the dual n-back task. Overall, effects of CCT on emotion regulation were limited to reducing deployment of rumination in low positive affective states. However, we did not find beneficial effects on indicators of adaptive emotion regulation. These findings are in line with previous studies targeting maladaptive emotion regulation but suggest limited use in enhancing adaptive emotion regulation in a healthy sample. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Husen, K.; Rafaeli, E.; Rubel, J. A.; Bar-Kalifa, E.; Lutz, W. (2016): Daily affect dynamics predict early response in CBT: Feasibility and predictive validity of EMA for outpatient psychotherapy. In: Journal of affective disorders 206, S. 305–314. DOI: 10.1016/j.jad.2016.08.025.

BACKGROUND: Previous studies have shown that individual differences in affect dynamics during depressed patients’ everyday lives allow the prediction of treatment outcome and of symptom reoccurrence in remitted patients. In this study, we analyze whether understanding patients’ affective states and their fluctuation patterns helps predict early treatment response (until session 5). METHODS: Ecological Momentary Assessment (EMA) strategies allow in-depth analyses of real-time affective states and of their dynamics. Repeated assessments were made four times a day during a two-week period to capture real-life affective states (positive affect, PA and negative affect, NA) and dynamics (fluctuations in NA and PA) before the start of outpatient treatment of 39 patients. Due to the nested structure of the data, hierarchical linear models were conducted. RESULTS: PA/NA ratios, as well as fluctuations in NA predicted early treatment response, even when adjusting for initial impairment. In contrast, mean levels of NA or PA, as well as fluctuations in PA did not predict treatment response. LIMITATIONS: The time between the EMA assessment and treatment onset varied between patients. However, this variation was not associated with early change. CONCLUSIONS: The results suggest that pre-treatment affect dynamics could provide valuable information for predicting treatment response independent of initial impairment levels. Better predictions of early treatment response help to improve treatment choices early in the treatment progress.


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: Ann Behav Med 50 (4), S. 516–522. 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. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Ishii, Tadashi; Nakayama, Masaharu; Abe, Michiaki; Takayama, Shin; Kamei, Takashi; Abe, Yoshiko et al. (2016): Development and verification of a mobile shelter assessment system “rapid assessment system of evacuation center condition featuring gonryo and miyagi (RASECC-GM)” for major disasters. In: Prehospital and disaster medicine 31 (5), S. 539–546. DOI: 10.1017/S1049023X16000674.

Introduction There were 5,385 deceased and 710 missing in the Ishinomaki medical zone following the Great East Japan Earthquake that occurred in Japan on March 11, 2011. The Ishinomaki Zone Joint Relief Team (IZJRT) was formed to unify the relief teams of all organizations joining in support of the Ishinomaki area. The IZJRT expanded relief activity as they continued to manually collect and analyze assessments of essential information for maintaining health in all 328 shelters using a paper-type survey. However, the IZJRT spent an enormous amount of time and effort entering and analyzing these data because the work was vastly complex. Therefore, an assessment system must be developed that can tabulate shelter assessment data correctly and efficiently. The objective of this report was to describe the development and verification of a system to rapidly assess evacuation centers in preparation for the next major disaster. Report Based on experiences with the complex work during the disaster, software called the “Rapid Assessment System of Evacuation Center Condition featuring Gonryo and Miyagi” (RASECC-GM) was developed to enter, tabulate, and manage the shelter assessment data. Further, a verification test was conducted during a large-scale Self-Defense Force (SDF) training exercise to confirm its feasibility, usability, and accuracy. The RASECC-GM comprises three screens: (1) the “Data Entry screen,” allowing for quick entry on tablet devices of 19 assessment items, including shelter administrator, living and sanitary conditions, and a tally of the injured and sick; (2) the “Relief Team/Shelter Management screen,” for registering information on relief teams and shelters; and (3) the “Data Tabulation screen,” which allows tabulation of the data entered for each shelter, as well as viewing and sorting from a disaster headquarters’ computer. During the verification test, data of mock shelters entered online were tabulated quickly and accurately on a mock disaster headquarters’ computer. Likewise, data entered offline also were tabulated quickly on the mock disaster headquarters’ computer when the tablet device was moved into an online environment. CONCLUSIONS: The RASECC-GM, a system for rapidly assessing the condition of evacuation centers, was developed. Tests verify that users of the system would be able to easily, quickly, and accurately assess vast quantities of data from multiple shelters in a major disaster and immediately manage the inputted data at the disaster headquarters. Ishii T , Nakayama M , Abe M , Takayama S , Kamei T , Abe Y , Yamadera J , Amito K , Morino K . Development and verification of a mobile shelter assessment system “Rapid Assessment System of Evacuation Center Condition featuring Gonryo and Miyagi (RASECC-GM)” for major disasters. Prehosp Disaster Med. 2016;31(5):539-546.


Jones, Kelly K.; Zenk, Shannon N.; McDonald, Ashley; Corte, Colleen (2016): Experiences of african‐american women with smartphone‐based ecological momentary assessment. In: Public Health Nurs 33 (4), S. 371–380. DOI: 10.1111/phn.12239.

Objective: Smartphone-based ecological momentary assessment (EMA), or real-time, repeated sampling of participants states, behaviors, or experiences over time, is a promising approach to understanding obesity-related behaviors in African-American women—a population with the highest obesity prevalence. In this study, we explored participants’ experiences with this methodology. Design and Sample: In this secondary analysis of data, 100 African-American women participated in seven consecutive days of EMA data collection. Measures: Measures related to acceptability (technical challenges, daily burden, emotional responses, willingness to participate in future studies) and data quality (reporting accuracy, behavior reactivity, adherence), as well as demographics, were collected. Results: While there were few demographic differences, women who were unemployed, had the lowest educational levels, or had the lowest per capita income reported the greatest enjoyment with mobile technology-based EMA, while at the same time reporting the highest levels of challenge with use of the equipment. Participants consistently indicated willingness to participate in future EMA studies and indicated that the study method was acceptable. EMA methodology produced data of sufficient quality. Conclusion: Findings suggest future studies using smartphone-based EMA with African-American women are feasible. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Kanning, Martina; Hansen, Sylvia (2016): Need satisfaction moderates the association between physical activity and affective states in adults aged 50+: An activity-triggered ambulatory assessment. In: Ann Behav Med. DOI: 10.1007/s12160-016-9824-6.

Background: Substantial evidence shows that physical activities of daily living are positively correlated with affective states in middle-aged and older adults. However, people’s physical activity decreases when they grow older, and conditions that enhance older individuals’ physical activities of daily living are not well understood.Purpose: This study investigated need satisfaction (competence, relatedness, and autonomy) and its moderating effect on the within-subject relation between physical activities of daily living and three dimensions of affective states (valence, energetic arousal, and calmness) based on an ambulatory assessment that used activity-triggered e-diaries.Method: The physical activities of daily living of 68 adults aged 50+ (mean age = 60.1 ± 7.1) were measured objectively for three consecutive days, and need satisfaction and affective states were assessed as a function of the amount of physical activity during the preceding 10 min before the affect measurement (in activity-triggered e-diaries). Hierarchical multilevel analyses were performed.Results: Need satisfaction was significantly and positively correlated with the three dimensions of affective states. Further, physical activities of daily living were significantly associated with energetic arousal and calmness, but not valence. However, when physical activities of daily living were more autonomously regulated, the association of physical activities of daily living and valence became significant and positive.Conclusion: The findings regarding the significant moderating effects of need satisfaction are crucial for interventions aiming to improve the health-enhancing effects of physical activity in adults aged 50+. Positive feelings owing to physical activities in daily living depend on the extent that psychological needs are satisfied. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Kanske, P.; Sharifi, M.; Smallwood, J.; Dziobek, I.; Singer, T. (2016): Where the narcissistic mind wanders: increased self-related thoughts are more positive and future oriented. In: Journal of personality disorders, S. 1–24. DOI: 10.1521/pedi_2016_30_263.

Narcissism is characterized by a preoccupation with fantasies of unlimited success, power, beauty, and similar values, which has been discussed as intra-individual regulation of a grandiose, but vulnerable self-concept. To explore where the narcissistic mind wanders, we used an experience-sampling approach in a sample with large variability in pathological narcissism inventory scores. Multilevel modeling revealed (1) more mind-wandering in participants with higher levels of narcissism and (2) a difference in the content of these thoughts (more self- and other-related, past and future oriented, negative content). Critically, (3) in high levels of narcissism, the self-related thoughts were associated with more positive valence and were also more future oriented. The results demonstrate the validity of the assumed grandiose, self-absorbed view of oneself in narcissism, which includes self-indulgent fantasies of future success. We also found additional evidence for negative, past-oriented thoughts in narcissism, a dysfunctional pattern reminiscent of rumination, possibly linked to increased psychopathological vulnerability in narcissism.


Kaufmann, C. N.; Gershon, A.; Eyler, L. T.; Depp, C. A. (2016): Clinical significance of mobile health assessed sleep duration and variability in bipolar disorder. In: Journal of psychiatric research 81, S. 152–159. DOI: 10.1016/j.jpsychires.2016.07.008.

OBJECTIVE: Sleep disturbances are prevalent, persistent, and impairing features of bipolar disorder. However, the near-term and cumulative impact of the severity and variability of sleep disturbances on symptoms and functioning remains unclear. We examined self-reported daily sleep duration and variability in relation to mood symptoms, medication adherence, cognitive functioning, and concurrent daily affect. METHODS: Forty-one outpatients diagnosed with bipolar disorder were asked to provide daily reports of sleep duration and affect collected via ecological momentary assessment with smartphones over eleven weeks. Measures of depressive and manic symptoms, medication adherence, and cognitive function were collected at baseline and concurrent assessment of affect were collected daily. Analyses examined whether sleep duration or variability were associated with baseline measures and changes in same-day or next-day affect. RESULTS: Greater sleep duration variability (but not average sleep duration) was associated with greater depressive and manic symptom severity, and lower medication adherence at baseline, and with lower and more variable ratings of positive affect and higher ratings of negative affect. Sleep durations shorter than 7-8 h were associated with lower same-day ratings of positive and higher same-day ratings of negative affect, however this did not extend to next-day affect. CONCLUSIONS: Greater cumulative day-to-day sleep duration variability, but not average sleep duration, was related to more severe mood symptoms, lower self-reported medication adherence and higher levels of negative affect. Bouts of short- or long-duration sleep had transient impact on affect. Day-to-day sleep variability may be important to incorporate into clinical assessment of sleep disturbances in bipolar disorder.


Kawada, Tomoyuki (2016): Comparison of two accelerometers for monitoring sleep: Agreement and validity. In: Physiol Behav 163, S. 332. DOI: 10.1016/j.physbeh.2016.05.033.

Comments on an article by Nicola Cellini et al. (see record [rid]2016-12833-014[/rid]). First, the authors summarized each sleep parameters with different sensitivity settings. They did not measure sleep polysomnography as a gold standard, and intra-class correlation coefficient and Bland-Altman plots present the level of agreement on each sleep parameters fromdifferent apparatus. Second, the authors showed data from healthy young adults. I confirm that total sleep time (TST), sleep efficiency, and wakefulness after sleep onset by default setting of each apparatus showed acceptable agreement, but the discrepancy of sleep parameters between accelerometer and sleep polysomnography would be obvious for insomniacs. In case of handling participants with insomnia, validation study with use of sleep polysomnography is indispensable to confirm the appropriate cut-off point of each accelerometer. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Keng, Shian-Ling; Tong, Eddie M. W. (2016): Riding the tide of emotions with mindfulness: Mindfulness, affect dynamics, and the mediating role of coping. In: Emotion 16 (5), S. 706–718. DOI: 10.1037/emo0000165.

Little research has examined ways in which mindfulness is associated with affect dynamics, referring to patterns of affect fluctuations in daily life. Using ecological momentary assessment (EMA), the present study examined the associations between trait mindfulness and several types of affect dynamics, namely affect variability, affect inertia, affect switch, and affect instability. Three hundred ninety undergraduate students from Singapore reported their current emotions and coping styles up to 19 times per day across 2 days. Results showed that trait mindfulness correlated negatively with variability, instability, and inertia of negative affect and positively with negative-to-positive affect switch. These relationships were independent of openness, habitual reappraisal, habitual suppression, depression, and self-esteem. Importantly, lower maladaptive coping was found to mediate these relationships. The study suggests that trait mindfulness independently promotes adaptive patterns of affective experiences in daily life by inhibiting maladaptive coping styles. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Kirchner, T. R.; Shiffman, S. (2016): Spatio-temporal determinants of mental health and well-being: advances in geographically-explicit ecological momentary assessment (GEMA). In: Social psychiatry and psychiatric epidemiology 51 (9), S. 1211–1223. DOI: 10.1007/s00127-016-1277-5.

PURPOSE: Overview of geographically explicit momentary assessment research, applied to the study of mental health and well-being, which allows for cross-validation, extension, and enrichment of research on place and health. METHODS: Building on the historical foundations of both ecological momentary assessment and geographic momentary assessment research, this review explores their emerging synergy into a more generalized and powerful research framework. RESULTS: Geographically explicit momentary assessment methods are rapidly advancing across a number of complimentary literatures that intersect but have not yet converged. Key contributions from these areas reveal tremendous potential for transdisciplinary and translational science. CONCLUSIONS: Mobile communication devices are revolutionizing research on mental health and well-being by physically linking momentary experience sampling to objective measures of socio-ecological context in time and place. Methodological standards are not well-established and will be required for transdisciplinary collaboration and scientific inference moving forward.


Knippenberg, R.J.M.; Vugt, M. E.; Ponds, R. W.; Myin‐Germeys, I.; Twillert, B.; Verhey, F.R.J. (2016): Dealing with daily challenges in dementia (deal‐id study): An experience sampling study to assess caregiver functioning in the flow of daily life. In: Int J Geriatr Psychiatry. DOI: 10.1002/gps.4552.

Objective Accurate assessment of caregiver functioning is of great importance to gain better insight into daily caregiver functioning and to prevent high levels of burden. The experience sampling methodology (ESM) is an innovative approach to assess subjective experiences and behavior within daily life. In this study, the feasibility of the ESM in spousal caregivers of people with dementia was examined, and the usability of ESM data for clinical and scientific practice was demonstrated. Methods Thirty‐one caregivers collected ESM data for six consecutive days using an electronic ESM device that generated ten random alerts per day. After each alert, short reports of the caregiver’s current mood state and context were collected. Feasibility was assessed by examining compliance and subjective experiences with the ESM. Usability was described using group and individual ESM data. Results Participants on average completed 78.8% of the reports. One participant completed less than 33% of the reports and was excluded from data analyses. Participants considered the ESM device to be a user‐friendly device in which they could accurately describe their feelings and experiences. The ESM was not experienced as too burdensome. Zooming in on the ESM data, personalized patterns of mood and contextual factors were revealed. Conclusions The ESM is a feasible method to assess caregiver functioning. In addition to standard retrospective measurements, it offers new opportunities to gain more insight into the daily lives of people with dementia and their caregivers. It also provides new possibilities to tailor caregiver support interventions to the specific needs of the caregiver. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Kolmodin MacDonell, Karen; Naar, Sylvie; Gibson-Scipio, Wanda; Lam, Phebe; Secord, Elizabeth (2016): The detroit young adult asthma project: Pilot of a technology-based medication adherence intervention for african-american emerging adults. In: The Journal of adolescent health : official publication of the Society for Adolescent Medicine 59 (4), S. 465–471. DOI: 10.1016/j.jadohealth.2016.05.016.

PURPOSE: To conduct a randomized controlled pilot of a multicomponent, technology-based intervention promoting adherence to controller medication in African-American emerging adults with asthma. The intervention consisted of two computer-delivered sessions based on motivational interviewing combined with text messaged reminders between sessions. METHODS: Participants (N = 49) were 18-29 years old, African-American, with persistent asthma requiring controller medication. Participants had to report poor medication adherence and asthma control. Youth were randomized to receive the intervention or an attention control. Data were collected through computer-delivered self-report questionnaires at baseline, 1, and 3 months. Ecological Momentary Assessment via two-way text messaging was also used to collect “real-time” data on medication use and asthma control. RESULTS: The intervention was feasible and acceptable to the target population, as evidenced by high retention rates and satisfaction scores. Changes in study outcomes from pre- to postintervention favored the intervention, particularly for decrease in asthma symptoms, t (42) = 2.22, p < .05 (Cohen’s d = .071). CONCLUSIONS: Results suggest that the intervention is feasible and effective. However, findings are preliminary and should be replicated with a larger sample and more sophisticated data analyses.


Könen, Tanja; Dirk, Judith; Leonhardt, Anja; Schmiedek, Florian (2016): The interplay between sleep behavior and affect in elementary school children’s daily life. In: J Exp Child Psychol 150, S. 1–15. DOI: 10.1016/j.jecp.2016.04.003.

Recent reviews raised the idea of a bidirectional relation between sleep behavior and affect in adults, but little is known about this interplay in general and especially regarding children. In this micro-longitudinal study, the interplay of sleep and affect was captured directly in children’s daily life context in and out of school through ambulatory assessment. For 31 consecutive days, 110 elementary school children (8–11 years old) provided information about their last night’s sleep and reported their current affect at four daily occasions in school and at home on smartphones. A multilevel approach was used to analyze the relation between sleep and affect the next day (morning, noon, and afternoon) and the relation between evening affect and subsequent sleep. At the within-person level, sleep quality was related to all observed facets of affect the next day and the strongest effects were found in the morning. The effect of sleep quality on positive affect was particularly pronounced for children who on average went to bed early and slept long. There were, however, no direct within-person effects of sleep quantity on affect. Furthermore, evening affect was related to subsequent sleep. The findings support the idea of a bidirectional relation between affect and sleep in children’s daily life (including school). They suggest that good sleep provides a basis and resource for children’s affective well-being the next day and demonstrate the importance of analyzing within-person variations of children’s sleep. Micro-longitudinal findings can contribute to explain how macro-longitudinal relations between sleep and affect develop over time. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Kovac, Megan; Mosner, Maya; Miller, Stephanie; Hanna, Eleanor K.; Dichter, Gabriel S. (2016): Experience sampling of positive affect in adolescents with autism: Feasibility and preliminary findings. In: Res Autism Spectr Disord 29-30, S. 57–65. DOI: 10.1016/j.rasd.2016.06.003.

Background: Experience sampling is a powerful method for obtaining ecologically valid data from research participants in real-world contexts. Given the urgent need for innovative and sensitive outcome measures in autism spectrum disorder (ASD) research, the present study sought to examine the feasibility of using experience sampling of positive affect and behavior in adolescents with ASD. Method: Nineteen high functioning adolescents with ASD and 20 sex and age matched controls completed smartphone- and Qualtrics®−based experience sampling of positive affect and behavior six times over four days. Results: Adherence was excellent: adolescents with ASD completed 85% of the assessments, compared to 93% in controls, and response rates were not impacted by age or IQ. Groups did not differ in positive affect overall or as a function of activities, nor did groups differ in the proportion of assessments completed during social or nonsocial activities. However, groups did differ in the proportion of assessments completed during preferred activities. Conclusions: Results suggest that smartphone- and Qualtrics®−based experience sampling with high functioning adolescents with ASD is feasible and captures real-world behaviors that would not be possible using laboratory-based measures. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Krause, Amanda E.; North, Adrian C.; Hewitt, Lauren Y. (2016): The role of location in everyday experiences of music. In: Psychol Pop Media Cult 5 (3), S. 232–257. DOI: 10.1037/ppm0000059.

Mehrabian and Russell’s (1974) Pleasure–Arousal–Dominance model states that a propensity to approach/avoid an environment can be conceptualized in terms of the pleasure and arousal it elicits and one’s degree of dominance therein. Using the Experience Sampling Method, 177 individuals provided responses concerning Mehrabian and Russell’s model throughout 1 wk regarding music experiences that occurred in their daily life (including how the music was heard and how their responses related to the listening location). Results indicate that the time of day and day of week are related to where music is experienced, and that the consequences of what was heard are related to both time and location. Although music was experienced more often in private locations than in public overall, interesting patterns of music experiences that occurred in public locations demonstrate in detail how music listening varies by location. Specifically, portable devices were associated with positive responses, which contrasted sharply with the responses to music broadcasted publicly in public settings. Participants’ ratings of choice, liking, and arousal demonstrated the importance of considering choice as an indication of dominance, such that music usage is consistent with Mehrabian and Russell’s model, and has functions that vary according to the specific characteristics of the situation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Kurum, E.; Li, R.; Shiffman, S.; Yao, W. (2016): Time varying coefficient models joint modeling binary and continuous outcomes in longitudinal data. In: Statistica Sinica 26 (3), S. 979–1000. DOI: 10.5705/ss.2014.213.

Motivated by an empirical analysis of ecological momentary assessment data (EMA) collected in a smoking cessation study, we propose a joint modeling technique for estimating the time-varying association between two intensively measured longitudinal responses: a continuous one and a binary one. A major challenge in joint modeling these responses is the lack of a multivariate distribution. We suggest introducing a normal latent variable underlying the binary response and factorizing the model into two components: a marginal model for the continuous response, and a conditional model for the binary response given the continuous response. We develop a two-stage estimation procedure and establish the asymptotic normality of the resulting estimators. We also derived the standard error formulas for estimated coefficients. We conduct a Monte Carlo simulation study to assess the finite sample performance of our procedure. The proposed method is illustrated by an empirical analysis of smoking cessation data, in which the question of interest is to investigate the association between urge to smoke, continuous response, and the status of alcohol use, the binary response, and how this association varies over time.


Kwan, Matthew Y. W.; Bedard, Chloe; King-Dowling, Sara; Wellman, Sarah; Cairney, John (2016): MovingU: A prospective cohort study to understand behavioural and environmental contexts influencing physical activity during the transition into emerging adulthood. In: BMC public health 16, S. 728. DOI: 10.1186/s12889-016-3372-7.

BACKGROUND: Children and youth are often considered the most active segment of the population, however, research indicates that physical activity (PA) tends to peak during the adolescent years, declining thereafter with age. In particular, the acute transition out of high school is a period for which individuals appear to be at high-risk for becoming less active. Relatively few studies have investigated the factors influencing the changes in PA during this transition period. Therefore the purpose of the MovingU study is to gain a comprehensive understanding of the behavioural patterns and the socio-ecological factors related to the changes in PA during the transition out of high school. METHODS/DESIGN: MovingU is comprised of two phases. Phase I is a prospective cohort design and aims to follow 120 students in their last year of high school through to their first year out of high school. Students will be asked to complete questionnaires measuring various psychosocial and socio-environmental variables (e.g., self-efficacy and distress) four times throughout this transition period. Students will also be given a wrist-worn accelerometer to wear for 7-days at each of the four assessments. Phase II is a cross-sectional study involving 100 first-year university students. Students will be asked to complete the same questionnaire from phase I, wear a wrist-worn accelerometer for 5-days, and complete ecological momentary assessments (EMA) using their smartphones at randomly selected times throughout the day for 5-days. EMA items will capture information regarding contextual and momentary correlates of PA. DISCUSSION: The MovingU study represents the first to evaluate the social and environmental influences of PA behaviour changes, including the use of intensive real-time data capture strategies during the transition out of high school. This information will be critical in the development of interventions aimed to prevent or attenuate such drastic declines in PA during emerging adulthood period.


Lanaj, Klodiana; Johnson, Russell E.; Wang, Mo (2016): When lending a hand depletes the will: The daily costs and benefits of helping. In: J Appl Psychol 101 (8), S. 1097–1110. DOI: 10.1037/apl0000118.

Employees help on a regular daily basis while at work, yet surprisingly little is known about how responding to help requests affects helpers. Although recent theory suggests that helping may come at a cost to the helper, the majority of the helping literature has focused on the benefits of helping. The current study addresses the complex nature of helping by simultaneously considering its costs and benefits for helpers. Using daily diary data across 3 consecutive work weeks, we examine the relationship between responding to help requests, perceived prosocial impact of helping, and helpers’ regulatory resources. We find that responding to help requests depletes regulatory resources at an increasing rate, yet perceived prosocial impact of helping can replenish resources. We also find that employees’ prosocial motivation moderates these within-person relationships, such that prosocial employees are depleted to a larger extent by responding to help requests, and replenished to a lesser extent by the perceived prosocial impact of helping. Understanding the complex relationship of helping with regulatory resources is important because such resources have downstream effects on helpers’ behavior in the workplace. We discuss the implications of our findings for both theory and practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Lavender, Jason M.; Mason, Tyler B.; Utzinger, Linsey M.; Wonderlich, Stephen A.; Crosby, Ross D.; Engel, Scott G. et al. (2016): Examining affect and perfectionism in relation to eating disorder symptoms among women with anorexia nervosa. In: Psychiatry Res 241, S. 267–272. DOI: 10.1016/j.psychres.2016.04.122.

This study examined personality and affective variables in relation to eating disorder symptoms in anorexia nervosa (AN). Women (N = 118) with DSM-IV AN completed baseline questionnaires (Beck Depression Inventory, Frost Multidimensional Perfectionism Scale) and interviews (Eating Disorder Examination, Yale-Brown-Cornell Eating Disorder Scale), followed by two weeks of ecological momentary assessment (EMA) involving multiple daily reports of affective states and eating disorder behaviors. Hierarchical regression analyses were conducted using eating disorder symptoms as dependent variables (i.e., EMA binge eating, EMA self-induced vomiting, eating disorder rituals, eating disorder preoccupations, dietary restraint). Predictor variables were maladaptive perfectionism (baseline), depressive symptoms (baseline), and affect lability (EMA). Results revealed that affect lability was independently associated with binge eating, whereas depressive symptoms were independently associated with self-induced vomiting. Depressive symptoms were independently associated with eating disorder rituals, whereas both depressive symptoms and maladaptive perfectionism were independently associated with eating disorder preoccupations. Finally, maladaptive perfectionism and affect lability were both independently associated with dietary restraint. This pattern of findings suggests the importance of affective and personality constructs in relation to eating disorder symptoms in AN and may highlight the importance of targeting these variables in the context of treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Leikas, Sointu; Ilmarinen, Ville‐Juhani (2016): Happy now, tired later? Extraverted and conscientious behavior are related to immediate mood gains, but to later fatigue. In: J Pers. DOI: 10.1111/jopy.12264.

Objective Experience sampling studies on Big Five–related behavior show that people display the whole spectrum of each trait in their daily behavior, and that desirable Big Five states—especially state Extraversion—are related to positive mood. However, other research lines suggest that extraverted and conscientious behavior may be mentally depleting. The present research examined this possibility by extending the time frame of the measured personality processes. Method A 12‐day experience sampling study (N = 48; observations = 2,328) measured Big Five states, mood, stress, and fatigue five times a day. Results Extraverted and conscientious behavior were concurrently related to positive mood and lower fatigue, but to higher fatigue after a 3‐hour delay. These relations were not moderated by personality traits. The relation between extraverted behavior and delayed fatigue was mediated by the number of people the person had encountered. Whether the person had a goal mediated the relation between conscientious behavior and delayed fatigue. Conclusion Extraverted and conscientious behavior predict mental depletion after a 3‐hour delay. The results help reconcile previous findings regarding the consequences of state Extraversion and provide novel information about the consequences of state Conscientiousness. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Liao, Y.; Solomon, O.; Dunton, G. F. (2016): Does the company of a dog influence affective response to exercise? Using ecological momentary assessment to study dog-accompanied physical activity. In: American journal of health promotion : AJHP. DOI: 10.1177/0890117116666947.

PURPOSE: This study used ecological momentary assessment (EMA), a real-time self-report strategy, to examine (1) whether dog owners were more likely to be physically active when they were with their dogs and (2) whether being with a dog amplifies positive and dampens negative affective response during physical activity. DESIGN: Electronic EMA surveys for 12 days. SETTING: Free-living. PARTICIPANTS: Seventy-one adult dog owners. MEASURES: The EMA survey included 1 question about current activity, 3 questions about positive affect (Cronbach alpha = .837), 4 questions about negative affect (Cronbach alpha = .865), and 1 question about the presence of dog. ANALYSIS: Multilevel modeling. RESULTS: The company of a dog did not increase the likelihood of being active versus sedentary at any given EMA prompt. However, greater positive affect during physical activity was reported in the company of a dog. Negative affect did not differ between active and sedentary activity, regardless of being with a dog or not. CONCLUSION: This study demonstrates the utility of electronic EMA as a promising methodology to study dog-accompanied physical activity. Future studies may use EMA to collect further contextual information about dog-accompanied activity to inform the development of innovative physical activity interventions.


Linnemann, Alexandra; Strahler, Jana; Nater, Urs M. (2016): The stress-reducing effect of music listening varies depending on the social context. In: Psychoneuroendocrinology 72, S. 97–105. DOI: 10.1016/j.psyneuen.2016.06.003.

OBJECTIVE: Given that music listening often occurs in a social context, and given that social support can be associated with a stress-reducing effect, it was tested whether the mere presence of others while listening to music enhances the stress-reducing effect of listening to music. METHODS: A total of 53 participants responded to questions on stress, presence of others, and music listening five times per day (30min after awakening, 1100h, 1400h, 1800h, 2100h) for seven consecutive days. After each assessment, participants were asked to collect a saliva sample for the later analysis of salivary cortisol (as a marker for the hypothalamic-pituitary-adrenal axis) and salivary alpha-amylase (as a marker for the autonomic nervous system). RESULTS: Hierarchical linear modeling revealed that music listening per se was not associated with a stress-reducing effect. However, listening to music in the presence of others led to decreased subjective stress levels, attenuated secretion of salivary cortisol, and higher activity of salivary alpha-amylase. When listening to music alone, music that was listened to for the reason of relaxation predicted lower subjective stress. CONCLUSION: The stress-reducing effect of music listening in daily life varies depending on the presence of others. Music listening in the presence of others enhanced the stress-reducing effect of music listening independently of reasons for music listening. Solitary music listening was stress-reducing when relaxation was stated as the reason for music listening. Thus, in daily life, music listening can be used for stress reduction purposes, with the greatest success when it occurs in the presence of others or when it is deliberately listened to for the reason of relaxation.


Loeffler, Simone N.; Hennig, Juergen; Peper, Martin (2016): Psychophysiological assessment of social stress in natural and laboratory situations: Using the experience sampling method and additional heart rate measures. In: J Psychophysiol. DOI: 10.1027/0269-8803/a000170.

Experience sampling and psychophysiological ambulant assessment methods were employed to compare reactions to social stress using a laboratory stressor (The Trier Social Stress Test [TSST]) or a corresponding real-life condition (seminar presentation). Stress reactions were assessed by self-report as well as additional heart rate (AHR, i.e., heart rate increases corrected for physical activity and initial values) and were compared to a control condition in each group. Twenty-five participants gave a talk in a university seminar course and twenty-two participants took part in the TSST. The TSST elicited a greater overall physiological stress reaction as compared to the seminar presentation. However, analyses of dynamic AHR levels revealed that the groups of speakers showed different response profiles during the time course of the stress situations. AHR levels of both groups were similar at the beginning of the free speech. During the course of their presentation, seminar speakers downregulated their arousal level. The arousal level of TSST participants showed a further increase in the later portion of the TSST during the mental arithmetic task. Thus, the more prominent overall physiological stress reaction during the TSST as compared to the seminar presentation appeared to depend on different demand characteristics rather than on differences of laboratory versus real-life situations per se. The experience of emotional strain was greater in response to the social stressors than in response to control situations in both the TSST and seminar speaker group with no differential effects of the experimental setting (laboratory vs. real life). During the TSST procedure, salivary cortisol concentrations were also assessed. Significant correlations of AHR with cortisol level and subjective experience indicate that AHR measurement provides a valid psychophysiological indicator of social stress. These findings suggest that ambulatory assessment techniques successfully contribute to the validation of a common social stress task. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Lopez, Richard B.; Milyavskaya, Marina; Hofmann, Wilhelm; Heatherton, Todd F. (2016): Motivational and neural correlates of self-control of eating: A combined neuroimaging and experience sampling study in dieting female college students. In: Appetite 103, S. 192–199. DOI: 10.1016/j.appet.2016.03.027.

Self-regulation is a critical ability for maintaining a wide range of health behaviors, especially in preventing overeating and weight gain. Previous work has identified various threats to self-control in the eating domain, chief among which are desire strength and negative affect. In the present study, we examined individual differences in college-aged dieters’ experiences of these threats as they encountered temptations to eat in their daily lives, and tested whether these differences characterized sub-groups of dieters with divergent self-control outcomes. Specifically, 75 dieting females (age range: 18–23) participated in a combined functional magnetic resonance imaging (fMRI) and experience sampling study. Participants passively viewed food cues during a fMRI session, and then reported their daily eating behaviors for one week via ecological momentary assessment. We examined the characteristics of dieters who exhibited the most favorable combination of the aforementioned factors (i.e., low desire strength and positive mood) and who were thus most successful at regulating their eating. These dieters endorsed more autonomous reasons for their self-regulatory goals, and during the food cue reactivity task more readily recruited the inferior frontal gyrus, a brain region associated with inhibitory control. We suggest that these motivational and neural correlates may also be implicated in self-regulation of other important health behaviors. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Lüdtke, Thies; Kriston, Levente; Schröder, Johanna; Lincoln, Tania M.; Moritz, Steffen (2016): Negative affect and a fluctuating jumping to conclusions bias predict subsequent paranoia in daily life: An online experience sampling study. In: J Behav Ther Exp Psychiatry. DOI: 10.1016/j.jbtep.2016.08.014.

BACKGROUND AND OBJECTIVES: Negative affect and a tendency to ‘jump to conclusions’ (JTC) are associated with paranoia. So far, only negative affect has been examined as a precursor of subsequent paranoia in daily life using experience sampling (ESM). We addressed this research gap and used ESM to test whether JTC fluctuates in daily life, whether it predicts subsequent paranoia, and whether it mediates the effect of negative affect on paranoia. METHODS: Thirty-five participants with schizophrenia spectrum disorders repeatedly self-reported negative affect, JTC, and paranoia via online questionnaires on two consecutive days. We measured JTC with a paradigm consisting of ambiguous written scenarios. Multilevel linear models were conducted. RESULTS: Most participants showed JTC consistently on two days rather than only on one day. When time was used as a predictor of JTC, significant slope variance indicated that for a subgroup of participants JTC fluctuated over time. For 48% of participants, these fluctuations equaled changes of approximately ±1 point on the four-point JTC scale within one day. There was no mediation. However, negative affect and JTC both significantly predicted subsequent paranoia. LIMITATIONS: The ESM assessment period was short and encompassed few assessments (8 in total). CONCLUSIONS: Our findings indicate that JTC is both stable (regarding its mere occurrence) and fluctuating simultaneously (regarding its magnitude). Although JTC was not a mediator linking negative affect and paranoia, it did predict paranoia. Further ESM studies on JTC are needed to confirm our findings in longer assessment periods and with other JTC paradigms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Lydon, David M.; Ram, Nilam; Conroy, David E.; Pincus, Aaron L.; Geier, Charles F.; Maggs, Jennifer L. (2016): The within-person association between alcohol use and sleep duration and quality in situ: An experience sampling study. In: Addict Behav 61, S. 68–73. DOI: 10.1016/j.addbeh.2016.05.018.

Objective: Despite evidence for detrimental effects of alcohol on sleep quality in laboratory studies, alcohol is commonly used as a self-prescribed sleep aid. This study examined the within-person associations of alcohol use with sleep duration and quality in everyday life to gain insight into the ecological validity of laboratory findings on the association between sleep and alcohol. Method: A sample of 150 adults (age 19–89 years) were followed for 60+days as part of an intensive experience sampling study wherein participants provided daily reports of their alcohol use, sleep duration, and sleep quality. Within-person and between-person associations of daily sleep duration and quality with alcohol use were examined using multilevel models. Results: A significant, negative within-person association was observed between sleep quality and alcohol use. Sleep quality was lower on nights following alcohol use. Sleep duration did not vary as a function of within-person variation in alcohol use. Conclusions: In line with laboratory assessments, alcohol use was associated with low sleep quality but was not associated with sleep duration, suggesting that laboratory findings generalize to everyday life. This examination of individuals’ daily lives suggests that alcohol does not systematically improve sleep quality or duration in real life. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Lydon-Staley, David M.; Cleveland, H. Harrington; Huhn, Andrew S.; Cleveland, Michael J.; Harris, Jonathan; Stankoski, Dean et al. (2016): Daily sleep quality affects drug craving, partially through indirect associations with positive affect, in patients in treatment for nonmedical use of prescription drugs. In: Addict Behav. DOI: 10.1016/j.addbeh.2016.08.026.

OBJECTIVE: Sleep disturbance has been identified as a risk factor for relapse in addiction to a range of substances. The relationship between sleep quality and treatment outcome has received relatively little attention in research on nonmedical use of prescription drugs (NMUPD). This study examined the within-person association between sleep quality and craving in medically detoxified patients in residence for the treatment of NMUPD. METHOD: Participants (n=68) provided daily reports of their sleep quality, negative affect (NA), positive affect (PA), and craving for an average of 9.36 (SD=2.99) days. Within-person associations of sleep quality and craving were examined using multilevel modeling. Within-person mediation analyses were used to evaluate the mediating roles of NA and PA in the relationship between sleep quality and craving. RESULTS: Greater cravings were observed on days of lower than usual sleep quality (γ10=−0.10, p=0.003). Thirty-one percent of the overall association between sleep quality and craving was explained by PA, such that poorer sleep quality was associated with lower PA and, in turn, lower PA was associated with greater craving. No evidence emerged for an indirect association between sleep quality and craving through NA. CONCLUSIONS: Daily fluctuations in sleep quality were associated with fluctuations in craving, an association partially explained by the association between sleep quality and daily PA. These data encourage further research on the relationship between sleep, affect, and craving in NMUPD patients, as well as in patients with other substance use disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Magallon-Neri, E.; Kirchner-Nebot, T.; Forns-Santacana, M.; Calderon, C.; Planellas, I. (2016): Ecological momentary assessment with smartphones for measuring mental health problems in adolescents. In: World journal of psychiatry 6 (3), S. 303–310. DOI: 10.5498/wjp.v6.i3.303.

AIM: To analyze the viability of Ecological Momentary Assessment (EMA) for measuring the mental states associated with psychopathological problems in adolescents. METHODS: In a sample of 110 adolescents, a sociodemographic data survey and an EMA Smartphone application over a one-week period (five times each day), was developed to explore symptom profiles, everyday problems, coping strategies, and the contexts in which the events take place. RESULTS: The positive response was 68.6%. Over 2250 prompts about mental states were recorded. In 53% of situations the smartphone was answered at home, 25.5% of cases they were with their parents or with peers (20.3%). Associations were found with attention, affective and anxiety problems (P < 0.001) in the participants who took longer to respond to the EMA app. Anxious and depressive states were highly interrelated (rho = 0.51, P < 0.001), as well as oppositional defiant problems and conduct problems (rho = 0.56, P < 0.001). Only in 6.2% of the situations the subjects perceived they had problems, mainly associated with inter-relational aspects with family, peers, boyfriends or girlfriends (31.2%). We also found moderate-high reliability on scales of satisfaction level on the context, on positive emotionality, and on the discomfort index associated with mental health problems. CONCLUSION: EMA methodology using smartphones is a useful tool for understanding adolescents’ daily dynamics. It achieved moderate-high reliability and accurately identified psychopathological manifestations experienced by community adolescents in their natural context.


Maher, Jaclyn P.; Dzubur, Eldin; Huh, Jimi; Intille, Stephen; Dunton, Genevieve F. (2016): Within-day time-varying associations between behavioral cognitions and physical activity in adults. In: Journal of sport & exercise psychology, S. 1–34. DOI: 10.1123/jsep.2016-0058.

This study used time-varying effect modeling to examine time of day differences in how behavioral cognitions predict subsequent physical activity (PA). Adults (N =116) participated in three, four-day “bursts” of Ecological Momentary Assessment (EMA). Participants were prompted with eight EMA questionnaires/day assessing behavioral cognitions (i.e., intentions, self-efficacy, outcome expectations) and wore an accelerometer during waking hours. Subsequent PA was operationalized as accelerometer-derived minutes of moderate- or vigorous-intensity PA in the two hours following the EMA prompt. On weekdays, intentions positively predicted subsequent PA in the morning (9:25am-11:45am) and in the evening (8:15pm-10:00pm). Self-efficacy positively predicted subsequent PA on weekday evenings (7:35pm-10:00pm). Outcome expectations were unrelated to subsequent PA on weekdays. On weekend days, behavior cognitions and subsequent PA were unrelated regardless of time of day. This study identifies windows of opportunity and vulnerability for motivation-based PA interventions aiming to deliver intervention content within the context of adults’ daily lives.


Mareva, Silvana; Thomson, David; Marenco, Pietro; Muñoz, Víctor Estal; Ott, Caroline V.; Schmidt, Barbara et al. (2016): Study protocol on ecological momentary assessment of health-related quality of life using a smartphone application. In: Front Psychol 7. DOI: 10.1037/t05178-000.

Health-Related Quality of Life (HRQoL) is a construct of increasing importance in modern healthcare, and has typically been assessed using retrospective instruments. While such measures have been shown to have predictive utility for clinical outcomes, several cognitive biases associated with human recall and current mood state may undermine their validity and reliability. Retrospective tools can be further criticized for their lack of ecology, as individuals are usually assessed in less natural settings such as hospitals and health centers, and may be obliged to spend time and money traveling to receive assessment. Ecological momentary assessment (EMA) is an alternative, as mobile assessment using mobile health (mHealth) technology has the potential to minimize biases and overcome many of these limitations. Employing an EMA methodology, we will use a smartphone application to collect data on real-time HRQoL, with an adapted version of the widely used WHOQOL-BREF questionnaire. We aim to recruit a total of 450 healthy participants. Participants will be prompted by the application to report their real-time HRQoL over 2 weeks together with information on mood and current activities. At the end of 2 weeks, they will complete a retrospective assessment of their HRQoL and they will provide information about their sleep quality and perceived stress. The psychometric properties of real-time HRQoL will be assessed, including analysis of the factorial structure, reliability and validity of the measure, and compared with retrospective HRQoL responses for the same 2-week testing period. Further, we aim to identify factors associated with real-time HRQoL (e.g., mood, activities), the feasibility of the application, and within- and between-person variability in real-time HRQoL. We expect real-time HRQoL to have adequate validity and reliability, and positive responses on the feasibility of using a smartphone application for routine HRQoL assessment. The direct comparison of real-time and retrospective measures in this study will provide important novel insight into the efficacy of mHealth applications for HRQoL assessment. If shown to be valid, reliable and feasible for the collection of HRQoL data, mHealth applications may have future potential for facilitating clinical assessment, patient-physician communication, and monitoring individual HRQoL over course of treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Matthews, Mark; Abdullah, Saeed; Murnane, Elizabeth; Voida, Stephen; Choudhury, Tanzeem; Gay, Geri; Frank, Ellen (2016): Development and evaluation of a smartphone-based measure of social rhythms for bipolar disorder. In: Assessment 23 (4), S. 472–483. DOI: 10.1037/t04100-000;

Dynamic psychological processes are most often assessed using self-report instruments. This places a constraint on how often and for how long data can be collected due to the burden placed on human participants. Smartphones are ubiquitous and highly personal devices, equipped with sensors that offer an opportunity to measure and understand psychological processes in real-world contexts over the long term. In this article, we present a novel smartphone approach to address the limitations of self-report in bipolar disorder where mood and activity are key constructs. We describe the development of MoodRhythm, a smartphone application that incorporates existing self-report elements from interpersonal and social rhythm therapy, a clinically validated treatment, and combines them with novel inputs from smartphone sensors. We reflect on lessons learned in transitioning from an existing self-report instrument to one that involves smartphone sensors and discuss the potential impact of these changes on the future of psychological assessment. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Matthews, Russell A.; Ritter, Kelsey-Jo (2016): A concise, content valid, gender invariant measure of workplace incivility. In: J Occup Health Psychol 21 (3), S. 352–365. DOI: 10.1037/ocp0000017.

The authors present a short, valid, gender invariant measure of workplace incivility that should have a high degree of utility in a variety of research designs, especially those concerned with reducing participant burden such as experience sampling and multiwave longitudinal designs. Given ongoing concerns about the psychometric properties of workplace mistreatment constructs, they validated a 4-item measure of experienced incivility based on series of 3 independent field studies (N = 2,636). In addition to retaining items on the basis of employee rated conceptual alignment (i.e., judgmental criteria) with a standard incivility definition (i.e., ambiguous intent to harm), items were also chosen based on external criteria in terms of their ability to explain incremental variance in outcomes of interest (e.g., role overload, interpersonal deviance). Items with large systematic relationships with other mistreatment constructs (i.e., abusive supervision, supervisor undermining) were excluded. In turn, the authors demonstrated that the 4-item measure is gender invariant, a critical issue that has received limited attention in the literature to date. They also experimentally investigated the effect of recall window (2 weeks, 1 month, 1 year) and found a differential pattern of effect sizes for various outcomes of interest. A fourth independent field study was conducted as a practical application of the measure within a longitudinal framework. An autoregressive model examining experienced incivility and counterproductive work behaviors was tested. Data was collected from a sample of 278 respondents at 3 time points with 1 month between assessments. Implications of these findings are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


McIntyre, Teresa M.; McIntyre, Scott E.; Barr, Christopher D.; Woodward, Phillip S.; Francis, David J.; Durand, Angelia C. et al. (2016): Longitudinal study of the feasibility of using ecological momentary assessment to study teacher stress: Objective and self-reported measures. In: J Occup Health Psychol 21 (4), S. 403–414. DOI: 10.1037/a0039966.

There is a lack of comprehensive research on Ecological Momentary Assessment (EMA) feasibility to study occupational stress, especially its long-term sustainability. EMA application in education contexts has also been sparse. This study investigated the feasibility of using EMA to study teacher stress over 2 years using both objective compliance data and a self-reported feasibility survey. It also examined the influence of individual and school factors on EMA feasibility. Participants were 202 sixth through eighth grade teachers from 22 urban middle schools in the southern United States. EMA was implemented via an iPod-based Teacher Stress Diary (TSD). Teachers recorded demands, stress responses, and resources during 12 days (6 waves) over 2 years. Feasibility was assessed via compliance data generated by the TSD (e.g., entry completion) and an EMA Feasibility Survey of self-reported user-friendliness and EMA interference. The results showed high compliance regarding entry and item completion, and completion time, which was sustained over time. User-friendliness was appraised as very high and EMA interference as low. Initial difficulties regarding timing and length of assessments were addressed via EMA method refinement, resulting in improved feasibility. Teachers’ ethnicity, age, marital status, grade/course taught, class size, class load, and daily workload impacted feasibility. The results supported the feasibility of using EMA to study work stress longitudinally and the value of continued feasibility monitoring. They also support EMA use to study teacher stress and inform EMA implementation in schools. Some teacher and school factors need to be taken into consideration when deciding on EMA implementation in education contexts. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Mennis, Jeremy; Mason, Michael; Light, John; Rusby, Julie; Westling, Erika; Way, Thomas et al. (2016): Does substance use moderate the association of neighborhood disadvantage with perceived stress and safety in the activity spaces of urban youth? In: Drug Alcohol Depend 165, S. 288–292. DOI: 10.1016/j.drugalcdep.2016.06.019.

Background: This study investigates the association of activity space-based exposure to neighborhood disadvantage with momentary perceived stress and safety, and the moderation of substance use on those associations, among a sample of 139 urban, primarily African American, adolescents. Method: Geospatial technologies are integrated with Ecological Momentary Assessment (EMA) to capture exposure to neighborhood disadvantage and perceived stress and safety in the activity space. A relative neighborhood disadvantage measure for each subject is calculated by conditioning the neighborhood disadvantage observed at the EMA location on that of the home neighborhood. Generalized estimating equations (GEE) are used to model the effect of relative neighborhood disadvantage on momentary perceived stress and safety, and the extent to which substance use moderates those associations. Results: Relative neighborhood disadvantage is significantly associated with higher perceived stress, lower perceived safety, and greater substance use involvement. The association of relative neighborhood disadvantage with stress is significantly stronger among those with greater substance use involvement. Conclusion: This research highlights the value of integrating geospatial technologies with EMA and developing personalized measures of environmental exposure for investigating neighborhood effects on substance use, and suggests substance use intervention strategies aimed at neighborhood conditions. Future research should seek to disentangle the causal pathways of influence and selection that relate neighborhood environment, stress, and substance use, while also accounting for the role of gender and family and peer social contexts. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Morgenstern, Jon; Kuerbis, Alexis; Houser, Jessica; Muench, Frederick J.; Shao, Sijing; Treloar, Hayley (2016): Within-person associations between daily motivation and self-efficacy and drinking among problem drinkers in treatment. In: Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors 30 (6), S. 630–638. DOI: 10.1037/adb0000204.

Gaining a better understanding of the change process holds promise to improve alcohol treatment. Ecological momentary assessment (EMA) coupled with intensive longitudinal data (ILD) approaches have been proposed as promising methods that can advance change process research but have been used infrequently in alcohol use disorder (AUD) treatment research. The current study used these approaches to examine the within-person associations of motivation and self-efficacy and drinking among treatment-seeking problem drinkers. Participants (N = 96) received daily EMA surveys before, during, and after treatment for 7 weeks spread over a 9-month period. Multilevel modeling was used to test the within-person relationships between the change processes and drinking, controlling for between-person associations and prior drinking. Results indicated that daily fluctuations in motivation and self-efficacy significantly predicted drinking over the next 24 hours; however, several theory-driven hypotheses regarding factors that might moderate that relationship were not supported. Overall, results support the advantages of EMA and ILD as methods that can advance AUD treatment research. (PsycINFO Database Record


Mulligan, L. D.; Haddock, G.; Emsley, R.; Neil, S. T.; Kyle, S. D. (2016): High resolution examination of the role of sleep disturbance in predicting functioning and psychotic symptoms in schizophrenia: A novel experience sampling study. In: Journal of abnormal psychology 125 (6), S. 788–797. DOI: 10.1037/abn0000180.

Sleep disturbance is common in schizophrenia, but its role in predicting functioning and psychotic symptoms has yet to be rigorously examined. The purpose of this study was to conduct a prospective, high-resolution examination of the relationship between nightly sleep and next-day functioning and psychotic symptoms in people with a diagnosis of schizophrenia. Experience sampling methodology was integrated with actigraphy and sleep diaries across 7 days in 22 patients with a diagnosis of schizophrenia. Momentary assessments of mood, psychotic symptoms, and functioning were gathered at 5 points each day following pseudorandom schedules. Multilevel modeling was performed to evaluate the links between variables. Objective and subjective sleep disturbance predicted reduced next-day functioning, which remained significant after controlling for psychotic symptom severity. Increased sleep fragmentation and reduced subjective and objective sleep efficiency predicted greater next-day auditory hallucinations, whereas increased objective sleep fragmentation and reduced subjective sleep quality predicted greater paranoia and delusions of control. Negative affect on awakening mediated a proportion of these relationships (range: 17.9-57.3%). For the first time, we show that sleep disturbance is a predictor of next-day impaired functioning and psychotic symptom severity in people with a diagnosis of schizophrenia. Therefore, interventions targeting sleep may have the potential to directly and indirectly enhance functional and symptomatic recovery in those experiencing psychosis. (PsycINFO Database Record


Ohta, Y.; Kawano, Y.; Hayashi, S.; Iwashima, Y.; Yoshihara, F.; Nakamura, S. (2016): Effects of cigarette smoking on ambulatory blood pressure, heart rate, and heart rate variability in treated hypertensive patients. In: Clinical and experimental hypertension (New York, N.Y. : 1993) 38 (6), S. 510–513. DOI: 10.3109/10641963.2016.1148161.

We investigated the influence of cigarette smoking on the levels and circadian patterns of blood pressure (BP), heart rate (HR), and HR variability (HRV) in hypertensive patients. Sixteen hypertensive smokers (57 +/- 2 years old) receiving antihypertensive treatments participated in this study. Ambulatory monitoring of BP, HR, and electrocardiograms was performed every 30 min for 24 hours on a smoking day and nonsmoking day in a randomized crossover manner. Average 24-hour BP and daytime BP were significantly higher in the smoking period than in the nonsmoking period. No significant differences were observed in nighttime BP between the two periods. Average 24-hour and daytime HR, but not nighttime HR, were also higher in the smoking period than in the nonsmoking period. The daytime high frequency (HF) component of HRV was attenuated more in the smoking period than in the nonsmoking period. No significant differences were observed in the low frequency (LF) components of HRV or LF/HF ratio between the two periods. These results demonstrated that cigarette smoking increased the daytime and average 24-hour BP and HR, and the increases observed in daytime BP and HR were associated with the attenuation of parasympathetic nerve activity.


Oppenheimer, Caroline W.; Ladouceur, Cecile D.; Waller, Jennifer M.; Ryan, Neal D.; Allen, Kristy Benoit; Sheeber, Lisa et al. (2016): Emotion socialization in anxious youth: Parenting buffers emotional reactivity to peer negative events. In: J Abnorm Child Psychol 44 (7), S. 1267–1278. 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. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Paty, Jean; Elash, Celeste A.; Turner-Bowker, Diane M. (2016): Content validity for the vvsymq® instrument: A new patient-reported outcome measure for the assessment of varicose veins symptoms. In: Patient. DOI: 10.1007/s40271-016-0183-y.

Background: Varicose veins are common and can impact patients’ quality of life, but consensus regarding the evaluation of varicose vein symptoms is lacking and existing measures have limitations.Objective: This research aimed to develop and establish the content validity of a new electronic patient-reported outcome (PRO) measure, the VVSymQ® instrument, to assess symptoms of superficial venous insufficiency (varicose veins) in clinical trials.Methods: The development of the VVSymQ® instrument began with qualitative interviews with patients based on the symptom domain of the VEINES-QOL/Sym, an existing PRO instrument for chronic venous disorders of the leg. Three phases of qualitative research were conducted to examine the relevance and importance of the symptoms to patients with varicose veins, and the patients’ ability to understand and use the VVSymQ® instrument. The development included evaluating questions that had 1-week and 24-h recall periods, and paper and electronic versions of the new instrument.Results: Five symptoms (heaviness, achiness, swelling, throbbing, and itching [HASTI™]) were consistently reported by patients across all sources of qualitative data. The final version of the VVSymQ® instrument queries patients on the HASTI™ symptoms using a 24-h recall period and a 6-point duration-based response scale ranging from ‘None of the time’ to ‘All of the time,’ and is administered daily via an electronic diary. Cognitive interviews demonstrated varicose vein patients’ understanding of and their ability to use the final version of the VVSymQ® instrument.Conclusion: Content validity was established for the VVSymQ® instrument, which assesses the five HASTI™ symptoms of varicose veins daily via an electronic diary and has promise for use in research and practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Pearson, Carolyn M.; Pisetsky, Emily M.; Goldschmidt, Andrea B.; Lavender, Jason M.; Wonderlich, Stephen A.; Crosby, Ross D. et al. (2016): Personality psychopathology differentiates risky behaviors among women with bulimia nervosa. In: Int J Eat Disord 49 (7), S. 681–688. DOI: 10.1002/eat.22570.

Objective: Individuals with bulimia nervosa (BN) frequently endorse risky behaviors such as self-harm and substance use. However, no studies of BN to date have examined factors associated with engaging in individual or co-occurring risky behaviors. Given that individuals with BN often have personality psychopathology, which has been linked to symptoms and course of illness, this study sought to examine how personality may differentiate engagement in risky behaviors among BN individuals. Method: A sample of 133 women with BN completed self-report measures of personality psychopathology at baseline, and then reported on bulimic and risky behaviors (e.g., substance misuse, self-harm) over 2 weeks using ecological momentary assessment. A series of hierarchical multiple regression analyses were conducted to examine the unique associations between state-level predictor variables (each risky behavior, e.g., substance misuse, and combination of risky behaviors, e.g., substance misuse plus self-harm) and trait-level personality constructs. Results: Substance misuse behavior, above and beyond all other risky behaviors, was significantly associated with higher scores on trait dissocial behavior (P = 0.004). Discussion: Substance misuse in BN has a unique association with dissocial behavior, a personality trait characterized by hostility, impulsivity, and entitlement. These results suggest that targeting personality variables may help facilitate more effective treatment of risky behaviors, including substance use in BN. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Pemberton, Rachel; Tyszkiewicz, Matthew D. Fuller (2016): Factors contributing to depressive mood states in everyday life: A systematic review. In: J Affect Disord 200, S. 103–110. DOI: 10.1016/j.jad.2016.04.023.

Background: Although accumulated evidence suggests that fluctuations in depressed mood are common among individuals with depression, and may be associated with onset, duration, and severity of illness, a systematic appraisal of putative predictors of depressed mood is lacking. Methods: A systematic search for relevant studies in the literature was conducted using PsycInfo and PubMed databases via EbscoHost in February 2016. The search was limited to articles using the experience sampling method, an approach suitable for capturing in situ fluctuations in mood states. Results: Forty-two studies met inclusion criteria for the review, from which three key risk factors (poor sleep, stress, and significant life events) and two protective factors (physical activity and quality of social interactions) were identified. The majority of papers supported concurrent and lagged associations between these putative protective/risk factors and depressed mood. Limitations: Despite support for each of the proposed protective/risk factors, few studies evaluated multiple factors in the same study. Moreover, the time course for the effects of these predictors on depressed mood remains largely unknown. Conclusions: The present review identified several putative risk and protective factors for depressed mood. A review of the literature suggests that poor sleep, negative social interactions, and stressful negative events may temporally precede spikes in depressed mood. In contrast, exercise and positive social interactions have been shown to predict subsequent declines in depressed mood. However, the lack of multivariate models in which the unique contributions of various predictors could be evaluated means that the current state of knowledge prevents firm conclusions about which factors are most predictive of depressed mood. More complex modeling of these effects is necessary in order to provide insights useful for clinical treatment in daily life of the depressed mood component of depressive disorders. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Perret, J. L.; Bonevski, B.; McDonald, C. F.; Abramson, M. J. (2016): Smoking cessation strategies for patients with asthma: improving patient outcomes. In: Journal of asthma and allergy 9, S. 117–128. DOI: 10.2147/JAA.S85615.

Smoking is common in adults with asthma, yet a paucity of literature exists on smoking cessation strategies specifically targeting this subgroup. Adverse respiratory effects from personal smoking include worse asthma control and a predisposition to lower lung function and chronic obstructive pulmonary disease. Some data suggest that individuals with asthma are more likely than their non-asthmatic peers to smoke regularly at an earlier age. While quit attempts can be more frequent in smokers with asthma, they are also of shorter duration than in non-asthmatics. Considering these asthma-specific characteristics is important in order to individualize smoking cessation strategies. In particular, asthma-specific information such as “lung age” should be provided and longer-term follow-up is advised. Promising emerging strategies include reminders by cellular phone and web-based interventions using consumer health informatics. For adolescents, training older peers to deliver asthma education is another promising strategy. For smokers who are hospitalized for asthma, inpatient nicotine replacement therapy and counseling are a priority. Overall, improving smoking cessation rates in smokers with asthma may rely on a more personalized approach, with the potential for substantial health benefits to individuals and the population at large.


Phillips, Siobhan M.; Lloyd, Gillian R.; Awick, Elizabeth A.; McAuley, Edward (2016): Relationship between self‐reported and objectively measured physical activity and subjective memory impairment in breast cancer survivors: Role of self‐efficacy, fatigue and distress. In: Psychooncology. DOI: 10.1002/pon.4156.

Purpose Many breast cancer survivors report cancer and cancer treatment‐associated cognitive change. However, very little is known about the relationship between physical activity and subjective memory impairment (SMI) in this population. The purpose of this study is to examine the relationship between physical activity and SMI and longitudinally test a model examining the role of self‐efficacy, fatigue and distress as potential mediators. Methods Post‐treatment breast cancer survivors (N = 1477) completed measures of physical activity, self‐efficacy, distress (depression, concerns about recurrence, perceived stress, anxiety), fatigue and SMI at baseline and 6‐month follow‐up. A subsample (n = 362) was randomly selected to wear an accelerometer. It was hypothesized that physical activity indirectly influences SMI via exercise self‐efficacy, distress and fatigue. Relationships were examined using panel analysis within a covariance modeling framework. Results The hypothesized model provided a good fit in the full sample (χ2 = 1462.5, df = 469, p = <0.001; CFI = 0.96; SRMR = 0.04) and the accelerometer subsample (χ2 = 961.8, df = 535, p = <0.001, CFI = 0.94, SRMR = 0.05) indicating increased physical activity is indirectly associated with reduction in SMI across time, via increased exercise self‐efficacy and reduced distress and fatigue. Conclusions Higher levels of physical activity, lower levels of fatigue and distress and higher exercise self‐efficacy may play an important role in understanding SMI in breast cancer survivors across time. Future research is warranted to replicate and explore these relationships further. Copyright © 2016 John Wiley & Sons, Ltd. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Poerio, Giulia L.; Kellett, Stephen; Totterdell, Peter (2016): Tracking potentiating states of dissociation: An intensive clinical case study of sleep, daydreaming, mood, and depersonalization/derealization. In: Front Psychol 7. DOI: 10.1037/t07472-000.

This study examined in real time the role of sleep and daydreaming as potentiating states for subsequent dissociation in depersonalization/derealization disorder (DDD). Research and theory suggests that dissociation may be exacerbated and maintained by a labile sleep-wake cycle in which ‘dream-like’ mentation intrudes into waking life and fuels dissociative symptoms. We explore and extend this idea by examining the state of daydreaming in dissociation. Daydreaming is a state of consciousness between dreaming and waking cognition that involves stimulus-independent and task-unrelated mentation. We report the results of a unique intensive N = 1 study with an individual meeting diagnostic criteria for DDD. Using experience-sampling methodology, the participant rated (six times daily for 40 days) current daydreaming, mood, and dissociative symptoms. At the start of each day sleep quality and duration was also rated. Daydreaming was reported on 45% of occasions and significantly predicted greater dissociation, in particular when daydreams were repetitive and negative (but not fanciful) in content. These relationships were mediated by feelings of depression and anxiety. Sleep quality but not duration was a negative predictor of daily dissociation and also negatively predicted depression but not anxiety. Findings offer initial evidence that the occurrence and content of daydreams may act as potentiating states for heightened, in the moment, dissociation. The treatment implications of targeting sleep and daydreaming for dissociative disorders are discussed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Preston, K. L.; Jobes, M. L.; Phillips, K. A.; Epstein, D. H. (2016): Real-time assessment of alcohol drinking and drug use in opioid-dependent polydrug users. In: Behavioural pharmacology 27 (7), S. 579–584. DOI: 10.1097/FBP.0000000000000250.

We investigated relationships between drinking, other drug use, and drug craving, using ecological momentary assessment (EMA), in a sample of polydrug users who were not heavy drinkers. In a prospective longitudinal cohort study, 114 heroin and cocaine users on methadone-maintenance treatment carried handheld electronic diaries during waking hours and were screened for drug and alcohol use for up to 25 weeks. Individuals who fulfilled the Diagnostic and Statistical Manual of Mental Disorders criteria for alcohol abuse or dependence were excluded. Participants responded to 2-5 random prompts per day to report on their moods, cravings, and activities and initiated entries when they used or acutely craved heroin or cocaine. Drinking alcohol was assessed in both types of entries. Breath alcohol was measured three times weekly. Participants reported drinking alcohol in 1.6% of random-prompt entries, 3.7% of event-contingent entries when craving cocaine and/or heroin, and 11.6% of event-contingent entries when using cocaine and/or heroin. Alcohol drinking was also associated with higher craving ratings and prestudy alcohol use. More drinking was detected by ambulatory self-report than by in-clinic breath testing. Even though we had screened out heavy drinkers from our sample of polydrug users, drinking was associated with heroin and cocaine craving and actual use.


Ramsey, Alex T.; Wetherell, Julie Loebach; Depp, Colin; Dixon, David; Lenze, Eric (2016): Feasibility and acceptability of smartphone assessment in older adults with cognitive and emotional difficulties. In: Journal of technology in human services 34 (2), S. 209–223. DOI: 10.1080/15228835.2016.1170649.

OBJECTIVES: Ecological momentary assessment (EMA) has several advantages in clinical research yet little is known about the feasibility of collecting EMA data with mobile technologies in older adults, particularly those with emotional or cognitive difficulties. The aim of this feasibility study was to assess perceived acceptability, adherence rates, and reasons for non-adherence to smartphone-based EMA. METHOD: At two sites, participants (n=103) aged 65 years or older with a DSM-IV-defined anxiety or depressive disorder and cognitive concerns responded three times daily to smartphone-based EMA questions assessing clinical outcomes for two 10-day periods. Quantitative and qualitative measures assessed acceptability, adherence, and reasons for non-adherence following both 10-day EMA periods. RESULTS: Participants were moderately satisfied with and comfortable using smartphone-based EMA. Overall, 76% of participants completed surveys on >/=10 of the 20 assessment days, and 70% of participants completed at least 30% of the total surveys. Reasons for non-adherence included technical (malfunction), logistical (competing demands), physiological (hearing difficulties), and cognitive (forgetting) issues. DISCUSSION: Smartphone-based EMA is feasible in older adults with cognitive and emotional difficulties. EMA tools should be responsive to the needs and preferences of participants to ensure adequate acceptability and adherence in this population. Our findings can inform the design, development, and implementation of mobile technologies in older adults in research and clinical contexts.


Rauthmann, John F.; Jones, Ashley Bell; Sherman, Ryne A. (2016): Directionality of person–situation transactions: Are there spillovers among and between situation experiences and personality states? In: Pers Soc Psychol Bull 42 (7), S. 893–909. DOI: 10.1177/0146167216647360.

To elucidate temporal sequences among and between person and situation variables, this work examines cross-measurement spillovers between situation experiences S (on the Situational Eight DIAMONDS characteristics [Duty, Intellect, Adversity, Mating, pOsitivity, Negativity, Deception, Sociality]) and personality states P (on the Big Six HEXACO dimensions [Honesty/Humility, Emotionality, eXtraversion, Agreeableness, Conscientiousness, Openness to Experience]) in experience sampling data. Multi-level modeling of lagged data at tn-1 and non-lagged data at tn grants the opportunity to examine (a) the stability (P → P, S → S), (b) cross-sectional associations (S ↔ P), and (c) cross-lagged associations among and between situation experiences and personality states (S → P, P → S). Findings indicated that there were (a) moderate stability paths, (b) small to moderate cross-sectional paths, and (c) only very small cross-lagged paths (though the different situation characteristics and personality states showed differential tendencies toward no directionality, S → P or P → S unidirectionality, or bidirectionality). Findings are discussed in light of refining studies on dynamic person–situation transactions. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Reichenberger, Julia; Kuppens, Peter; Liedlgruber, Michael; Wilhelm, Frank H.; Tiefengrabner, Martin; Ginzinger, Simon; Blechert, Jens (2016): No haste, more taste: An ema study of the effects of stress, negative and positive emotions on eating behavior. In: Biol Psychol, S. 1–9. DOI: 10.1016/j.biopsycho.2016.09.002.

OBJECTIVES: Stress and emotions alter eating behavior in several ways: While experiencing negative or positive emotions typically leads to increased food intake, stress may result in either over- or undereating. Several participant characteristics, like gender, BMI and restrained, emotional, or external eating styles seem to influence these relationships. Thus far, most research relied on experimental laboratory studies, thereby reducing the complexity of real-life eating episodes. The aim of the present study was to delineate the effects of stress, negative and positive emotions on two key facets of eating behavior, namely taste- and hunger-based eating, in daily life using ecological momentary assessment (EMA). Furthermore, the already mentioned individual differences as well as time pressure during eating, an important but unstudied construct in EMA studies, were examined. METHODS: Fifty-nine participants completed 10days of signal-contingent sampling and data were analyzed using multilevel modeling. RESULTS: Results revealed that higher stress led to decreased taste-eating which is in line with physiological stress-models. Time pressure during eating resulted in less taste- and more hunger-eating. In line with previous research, stronger positive emotions went along with increased taste-eating. Emotional eating style moderated the relationship between negative emotions and taste-eating as well as hunger-eating. BMI moderated the relationship between negative as well as positive emotions and hunger-eating. CONCLUSIONS: These findings emphasize the importance of individual differences for understanding eating behavior in daily life. Experienced time pressure may be an important aspect for future EMA eating studies. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Reichert, Markus; Tost, Heike; Reinhard, Iris; Zipf, Alexander; Salize, Hans-Joachim; Meyer-Lindenberg, Andreas; Ebner-Priemer, Ulrich W. (2016): Within-subject associations between mood dimensions and non-exercise activity: An ambulatory assessment approach using repeated real-time and objective data. In: Frontiers in psychology 7, S. 918. DOI: 10.3389/fpsyg.2016.00918.

A physically active lifestyle has been related to positive health outcomes and high life expectancy, but the underlying psychological mechanisms maintaining physical activity are rarely investigated. Tremendous technological progress yielding sophisticated methodological approaches, i.e., ambulatory assessment, have recently enabled the study of these mechanisms in everyday life. In practice, accelerometers allow to continuously and objectively monitor physical activity. The combination with e-diaries makes it feasible to repeatedly assess mood states in real-time and real life and to relate them to physical activity. This state-of-the-art methodology comes with several advantages, like bypassing systematic distortions of retrospective methods, avoiding distortions seen in laboratory settings, and revealing an objective physical activity assessment. Most importantly, ambulatory assessment studies enable to analyze how physical activity and mood wax and wane within persons over time in contrast to existing studies on physical activity and mood which mostly investigated between-person associations. However, there are very few studies on how mood dimensions (i.e., feeling well, energetic and calm) drive non-exercise activity (NEA; such as climbing stairs) within persons. Recent reviews argued that some of these studies have methodological limitations, e.g., scarcely representative samples, short study periods, physical activity assessment via self-reports, and low sampling frequencies. To overcome these limitations, we conducted an ambulatory assessment study in a community-based sample of 106 adults over 1 week. Participants were asked to report mood ratings on e-diaries and to wear an accelerometer in daily life. We conducted multilevel analyses to investigate whether mood predicted NEA, which was defined as the mean acceleration within the 10-min interval directly following an e-diary assessment. Additionally, we analyzed the effects of NEA on different time frames following the e-diary prompts in an exploratory manner. Our results revealed that valence significantly and positively predicted NEA within persons (p = 0.001). Feeling more energetic was associated with significantly increased NEA (p < 0.001), whereas feeling calmer was associated with significantly decreased NEA (p < 0.001) on the within-person level. The analyses on different time frames of NEA largely confirmed our findings. In conclusion, we showed that mood predicted NEA within adults but with distinct magnitudes and directions of effects for each mood dimension.


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: Hum Commun Res 42 (3), S. 441–461. 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. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Reininghaus, U.; Gayer-Anderson, C.; Valmaggia, L.; Kempton, M. J.; Calem, M.; Onyejiaka, A. et al. (2016): Psychological processes underlying the association between childhood trauma and psychosis in daily life: an experience sampling study. In: Psychological medicine 46 (13), S. 2799–2813. DOI: 10.1017/S003329171600146X.

BACKGROUND: Evidence has accumulated that implicates childhood trauma in the aetiology of psychosis, but our understanding of the putative psychological processes and mechanisms through which childhood trauma impacts on individuals and contributes to the development of psychosis remains limited. We aimed to investigate whether stress sensitivity and threat anticipation underlie the association between childhood abuse and psychosis. METHOD: We used the Experience Sampling Method to measure stress, threat anticipation, negative affect, and psychotic experiences in 50 first-episode psychosis (FEP) patients, 44 At-Risk Mental State (ARMS) participants, and 52 controls. Childhood abuse was assessed using the Childhood Trauma Questionnaire. RESULTS: Associations of minor socio-environmental stress in daily life with negative affect and psychotic experiences were modified by sexual abuse and group (all p FWE < 0.05). While there was strong evidence that these associations were greater in FEP exposed to high levels of sexual abuse, and some evidence of greater associations in ARMS exposed to high levels of sexual abuse, controls exposed to high levels of sexual abuse were more resilient and reported less intense negative emotional reactions to socio-environmental stress. A similar pattern was evident for threat anticipation. CONCLUSIONS: Elevated sensitivity and lack of resilience to socio-environmental stress and enhanced threat anticipation in daily life may be important psychological processes underlying the association between childhood sexual abuse and psychosis.


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 16 (5), S. 684–690. 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. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Roekel, Eeskevan; Wichers, Marieke; Hartmann, Jessica A.; Verhagen, Maaike (2016): The 5-HTTLPR genotype moderates the association between sleep quality and positive affect: A replication study. In: Eur Neuropsychopharmacol 26 (8), S. 1350–1351. DOI: 10.1016/j.euroneuro.2016.06.001.

Comments on an article by J. A. Hartmann et al. (see record [rid]2014-04048-001[/rid]). Hartmann et al. reported results from an experience sampling study in which the effects of the 5-HTTLPR polymorphism on the association between nighttime self-reported sleep quality and next day affect were reported in female adults. The authors found a significant interaction between 5-HTTLPR and sleep quality on next day positive affect (PA), in that short allele carriers showed a steeper slope than long–long carriers. No interactions were found for negative affect (NA). As one of the limitations from the study by Hartmann et al. was the exclusively female sample, the current authors further explored whether sex differences were present in the interaction by adding a three-way interaction between sex, 5-HTTLPR and sleep. No significant interactions were found for PA, nor for NA, indicating that the effects were similar for boys and girls. Results provide further evidence that serotonin may play a role in the association between sleep quality and positive affect regulation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Rosen, Christopher C.; Koopman, Joel; Gabriel, Allison S.; Johnson, Russell E. (2016): Who Ssrikes back? A daily investigation of when and why incivility begets incivility. In: J Appl Psychol. DOI: 10.1037/apl0000140.

Incivility at work—low intensity deviant behaviors with an ambiguous intent to harm—has been on the rise, yielding negative consequences for employees’ well-being and companies’ bottom-lines. Although examinations of incivility have gained momentum in organizational research, theory and empirical tests involving dynamic, within-person processes associated with this negative interpersonal behavior are limited. Drawing from ego depletion theory, we test how experiencing incivility precipitates instigating incivility toward others at work via reduced self-control. Using an experience sampling design across 2 work weeks, we found that experiencing incivility earlier in the day reduced one’s levels of self-control (captured via a performance-based measure of self-control), which in turn resulted in increased instigated incivility later in the day. Moreover, organizational politics—a stable, environmental factor—strengthened the relation between experienced incivility and reduced self-control, whereas construal level—a stable, personal factor—weakened the relation between reduced self-control and instigated incivility. Combined, our results yield multiple theoretical, empirical, and practical implications for the study of incivility at work. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Rothlin, P.; Birrer, D.; Horvath, S.; Grosse, Holtforth M. (2016): Psychological skills training and a mindfulness-based intervention to enhance functional athletic performance: design of a randomized controlled trial using ambulatory assessment. In: BMC psychology 4 (1), S. 39. DOI: 10.1186/s40359-016-0147-y.

BACKGROUND: Struggling to deliver performance in competitions is one of the main reasons why athletes seek the advice of sport psychologists. Psychologists apply a variety of intervention techniques, many of which are not evidence-based. Evidence-based techniques promote quality management and could help athletes, for example, to increase and maintain functional athletic behavior in competitions/games (i.e., being focused on task relevant cues and executing movements and actions in high quality). However, well-designed trials investigating the effectiveness of sport psychological interventions for performance enhancement are scarce. The planed study is founded by the Swiss National Science Foundation and examines the effectiveness of two interventions with elite and sub-elite athletes. A psychological skills training (PST) and a mindfulness-based intervention (MI), administered as group-program, will be compared to a waiting-list control group concerning how they enhance functional athletic behavior – which is a prerequisite for optimal performance. Furthermore, we will investigate underlying mechanisms (mediators) and moderators (e.g., task difficulty, individual characteristics, intervention-expectancy and intervention-integrity). METHODS/DESIGN: The presented trial uses a randomized controlled design with three groups, comparing PST, MI and a waiting list control condition. Both group interventions will last 5 weeks, consist of four 2 h sessions and will be administered by a trained sport psychologist. Primary outcome is functional athletic behavior assessed using ambulatory assessment in a competition/game. As secondary outcomes competition anxiety, cognitive interference and negative outcome expectations will be assessed. Assessments are held at pre- and post-intervention as well as at 2 months follow up. The study has been approved by the ethical committee of the Swiss Federal Institute of Sport. DISCUSSION: Both PST and MI are expected to help improve functional behavior in athletes. By examining potential mechanisms of change and moderators of outcome we will not only be able to answer the question whether the interventions work, but also how, under what conditions, and for whom. This study may also fill a gap in sport psychology research, considering the current lack of randomized controlled trials. In the future, researchers could use the presented study protocol as template to investigate similar topics in sport psychology. TRIAL REGISTRATION: ISRCTN11147748 , date of registration: 11 July 2016.


Ruscio, Aimee C.; Muench, Christine; Brede, Emily; MacIntyre, Jessica; Waters, Andrew J. (2016): Administration and assessment of brief mindfulness practice in the field: A feasibility study using ecological momentary assessment. In: Mindfulness (N Y) 7 (4), S. 988–999. DOI: 10.1007/s12671-016-0538-4.

Measuring the construct, component processes, and practice of mindfulness remains challenging. 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 mindfulness and performance-based cognition. Adult community smokers were randomly assigned to a Brief-MP or Control (sham meditation) group. Participants carried a personal digital assistant (PDA) for 2 weeks and were instructed to initiate 20 min of meditation (or control) training on the PDA daily, and to complete an assessment of mindfulness and cognition immediately afterwards. Additionally, participants completed assessments at random times up to four times per day. Primary outcome variables were feasibility and acceptability, state and trait mindfulness, a decentered perspective to depressive stimuli, and attentional bias to smoking stimuli. Thirty-seven participants provided EMA data totaling 1874 assessments. Fifteen of 18 Brief-MP participants completed over 75 % of mindfulness trainings in the field. The majority of Brief-MP participants endorsed favorable descriptions of the intervention: ‘acceptable,’ and ‘willing to recommend to a friend’. Linear Mixed Model analyses on EMA data revealed that, over time, Brief-MP (vs. Control) increased self-reported Curiosity and Decentering assessed by the Toronto Mindfulness Scale. Brief-MP did not change trait mindfulness or cognition. In sum, Brief-MP administered in the field was acceptable and increased state mindfulness. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Samuel, Douglas B.; Suzuki, Takakuni; Griffin, Sarah A. (2016): Clinicians and clients disagree: Five implications for clinical science. In: J Abnorm Psychol. DOI: 10.1037/abn0000201.

Recent findings highlight the limited agreement between diagnostic ratings provided by practicing clinicians and the self-report and interview methods typically employed in research settings. Such discrepancies between the diagnoses assigned in research and applied settings greatly complicate the translation of empirical findings into practice. This review highlights these disagreements, offers explanations for these observed differences, and provides 5 implications for research. Specifically, we provide evidence that, despite criticisms, self-reported psychopathology may be at least as valid as clinicians’ unstructured diagnoses. Further, we highlight the need for research that provides clinicians with the most valid tools, including those that focus on dimensional constructs, rather than diagnostic categories. In addition, we recommend that adult psychopathology research incorporate methodologies from general personality for unraveling informant discrepancies. We highlight recent work that has provided valuable tools for incorporating metaperception—the extent to which one is aware of how they are perceived by others—for contextualizing these differences. We also underscore the utility of emerging technologies that provide rich data, such as ambulatory assessment, for overcoming the criterion problem. Finally, we recommend that advances in combining data from multiple sources from the childhood psychopathology literature, such as examining the extent to which discrepancies themselves might aid in diagnosis, be incorporated into adult psychopathology research. In sum, we hope that these implications inspire research that improves the science of diagnostic assessment in a way that might ultimately improve practice. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

General Scientific Summary—This paper reviews studies reporting limited agreement between diagnoses assigned in research and clinical settings. We highlight the implications of these findings and offer recommendations for improving research on personality disorders and mental disorders, more broadly. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Santangelo, P. S.; Limberger, M. F.; Stiglmayr, C.; Houben, M.; Coosemans, J.; Verleysen, G. et al. (2016): Analyzing subcomponents of affective dysregulation in borderline personality disorder in comparison to other clinical groups using multiple e-diary datasets. In: Borderline personality disorder and emotion dysregulation 3, S. 5. DOI: 10.1186/s40479-016-0039-z.

BACKGROUND: Affective dysregulation is widely regarded as being the core problem in patients with borderline personality disorder (BPD). Moreover, BPD is the disorder mainly associated with affective dysregulation. However, the empirical confirmation of the specificity of affective dysregulation for BPD is still pending. We used a validated approach from basic affective science that allows for simultaneously analyzing three interdependent components of affective dysregulation that are disturbed in patients with BPD: homebase, variability, and attractor strength (return to baseline). METHODS: We applied two types of multilevel models on two e-diary datasets to investigate group differences regarding three subcomponents between BPD patients (n = 43; n = 51) and patients with posttraumatic stress disorder (PTSD; n = 28) and those with bulimia nervosa (BN; n = 20) as clinical control groups in dataset 1, and patients with panic disorder (PD; n = 26) and those with major depression (MD; n = 25) as clinical control groups in dataset 2. In addition, healthy controls (n = 28; n = 40) were included in the analyses. In both studies, e-diaries were used to repeatedly collect data about affective experiences during participants’ daily lives. In study 1 a high-frequency sampling strategy with assessments in 15 min-intervals over 24 h was applied, whereas the assessments occurred every waking hour over 48 h in study 2. The local ethics committees approved both studies, and all participants provided written informed consent. RESULTS: In contradiction to our hypotheses, BPD patients did not consistently show altered affective dysregulation compared to the clinical patient groups. The only differences in affective dynamics in BPD patients emerged with regard to one of three subcomponents, affective homebase. However, these results were not even consistent. Conversely, comparing the patients to healthy controls revealed a pattern of more negative affective homebases, higher levels of affective variability, and (partially) reduced returns to baseline in the patient groups. CONCLUSIONS: Our results indicate that affective dysregulation constitutes a transdiagnostic mechanism that manifests in similar ways in several different mental disorders. We point out promising prospects that might help to elucidate the common and distinctive mechanisms that underlie several different disorders and that should be addressed in future studies.


Schlier, Björn; Moritz, Steffen; Lincoln, Tania M. (2016): Measuring fluctuations in paranoia: Validity and psychometric properties of brief state versions of the paranoia checklist. In: Psychiatry Res 241, S. 323–332. DOI: 10.1016/j.psychres.2016.05.002.

Research increasingly assesses momentary changes in paranoia in order to elucidate causal mechanisms. Observed or manipulated changes in postulated causal factors should result in fluctuations in state paranoid ideation. Previous studies often employed a state-adapted Paranoia Checklist (Freeman et al., 2005) to measure state paranoia. This study examined whether the Paranoia Checklist or subsets of its items are appropriate for this purpose. Thirteen studies (N = 860) were subjected to meta-analyses of each Paranoia Checklist item. We selected items based on (1) whether they showed pre-to-post change in the expected direction and (2) whether this effect was larger in experimental vs. control conditions. All resulting item selections were cross-validated on a hold-out sample (n = 1893). Finally, we explored how much variation in paranoia was captured by the state-adapted version in a brief ambulatory assessment study (N = 32). A thirteen item State Paranoia Checklist as well as a five item and a three item Brief State Paranoia Checklist were extracted. Cross validation revealed better model fit and increased sensitivity to change. Multilevel analysis indicated 25-30% of the variance in the Brief State Paranoia Checklists to be due to intra-individual daily fluctuations in paranoia. Our analyses produced reliable and valid revised scales. Increases in change sensitivity indicate that future assessment of state paranoia in experimental and ambulatory assessment studies can be optimized by using the revised scales. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


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 111 (8), S. 1466–1476. 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, oversampled 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 1 week of data capture. WM was assessed at the end of each EMA assessment. Contextual variables that may influence WM were recorded via EMA. Findings: There were main effects for marijuana and tobacco: WM was poorer with marijuana [odds ratio (OR) = 0.91, 95% confidence interval (CI) = 0.84–0.99] and better with tobacco (OR = 1.11, 95% CI = 1.04–1.18). These effects were not qualified by an interaction (OR = 1.03, 95% CI = 0.84–1.26). Alcohol also reduced WM (OR = 0.87, 95% CI = 0.79–0.95), and the tobacco × alcohol interaction was significant (OR = 0.81, 95% CI = 0.66–0.99), indicating that the facilitative effect of tobacco disappeared with concurrent alcohol use. Conclusions: Relative to when individuals did not use these substances, working memory decreased with acute marijuana and alcohol use and increased with acute tobacco use. However, the putative effect of marijuana on working memory and the facilitative effect of tobacco on working memory were no longer present when used simultaneously with tobacco and alcohol, respectively. Data suggest that tobacco use may compensate for working memory decrements from marijuana among young adults and highlight the importance of investigating further the negative impact of alcohol use on cognition. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Schweitzer, Pierre; Husky, Mathilde; Allard, Michèle; Amieva, Hélène; Pérès, Karine; Foubert‐Samier, Alexandra et al. (2016): Feasibility and validity of mobile cognitive testing in the investigation of age‐related cognitive decline. In: Int J Methods Psychiatr Res. DOI: 10.1002/mpr.1521.

Mobile cognitive testing may be used to help characterize subtle deficits at the earliest stages of cognitive decline. Despite growing interest in this approach, comprehensive information concerning its feasibility and validity has been lacking in elderly samples. Over a one‐week period, this study applied mobile cognitive tests of semantic memory, episodic memory and executive functioning in a cohort of 114 elderly non‐demented community residents. While the study acceptance rate was moderate (66%), the majority of recruited individuals met minimal compliance thresholds and responded to an average of 82% of the repeated daily assessments. Missing data did not increase over the course of the study, but practice effects were observed for several test scores. However, even when controlling for practice effects, traditional neuropsychological tests were significantly associated with mobile cognitive test scores. In particular, the Isaacs Set Test was associated with mobile assessments of semantic memory (γ = 0.084, t = 5.598, p < 0.001), the Grober and Buschke with mobile assessments of episodic memory (γ = 0.069, t = 3.156, p < 0.01, and the Weschler symbol coding with mobile assessments of executive functioning (γ = 0.168, t = 4.562, p < 0.001). Mobile cognitive testing in the elderly may provide complementary and potentially more sensitive data relative to traditional neuropsychological assessment. Copyright © 2016 John Wiley & Sons, Ltd. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Silva, de Lima AL; Hahn, T.; Vries, N. M. de; Cohen, E.; Bataille, L.; Little, M. A. et al. (2016): Large-scale wearable sensor deployment in parkinson’s patients: The parkinson@home study protocol. In: JMIR research protocols 5 (3), e172. DOI: 10.2196/resprot.5990.

BACKGROUND: Long-term management of Parkinson’s disease does not reach its full potential because we lack knowledge about individual variations in clinical presentation and disease progression. Continuous and longitudinal assessments in real-life (ie, within the patients’ own home environment) might fill this knowledge gap. OBJECTIVE: The primary aim of the Parkinson@Home study is to evaluate the feasibility and compliance of using multiple wearable sensors to collect clinically relevant data. Our second aim is to address the usability of these data for answering clinical research questions. Finally, we aim to build a database for future validation of novel algorithms applied to sensor-derived data from Parkinson’s patients during daily functioning. METHODS: The Parkinson@Home study is a two-phase observational study involving 1000 Parkinson’s patients and 250 physiotherapists. Disease status is assessed using a short version of the Parkinson’s Progression Markers Initiative protocol, performed by certified physiotherapists. Additionally, participants will wear a set of sensors (smartwatch, smartphone, and fall detector), and use these together with a customized smartphone app (Fox Insight), 24/7 for 3 months. The sensors embedded within the smartwatch and fall detector may be used to estimate physical activity, tremor, sleep quality, and falls. Medication intake and fall incidents will be measured via patients’ self-reports in the smartphone app. Phase one will address the feasibility of the study protocol. In phase two, mathematicians will distill relevant summary statistics from the raw sensor signals, which will be compared against the clinical outcomes. RESULTS: Recruitment of 300 participants for phase one was concluded in March, 2016, and the follow-up period will end in June, 2016. Phase two will include the remaining participants, and will commence in September, 2016. CONCLUSIONS: The Parkinson@Home study is expected to generate new insights into the feasibility of integrating self-collected information from wearable sensors into both daily routines and clinical practices for Parkinson’s patients. This study represents an important step towards building a reliable system that translates and integrates real-life information into clinical decisions, with the long-term aim of delivering personalized disease management support. CLINICALTRIAL: NCT02474329; (Archived at


Simons, Jeffrey S.; Emery, Noah N.; Simons, Raluca M.; Wills, Thomas A.; Webb, Michael K. (2016): Effects of alcohol, rumination, and gender on the time course of negative affect. In: Cognition & emotion, S. 1–14. DOI: 10.1080/02699931.2016.1226162.

This study modelled associations between gender, ruminative cognitive style, alcohol use, and the time course of negative affect over the course of 43,111 random assessments in the natural environment. Participants (N = 263) completed 49 days of experience sampling over 1.3 years. The data indicated that rumination at baseline was positively associated with alcohol dependence symptoms at baseline as well as higher negative affect over the course of the study. Consistent with negative reinforcement models, drinking served to decrease the persistence of negative affect from moment to moment. However, this ameliorative effect of drinking was evident only among women, suggesting an increased risk for negative reinforcement driven drinking behaviour. In addition, rumination appeared to counteract the desired effects of alcohol on mood among women. This suggests that women who ruminate more may be motivated to consume larger amounts of alcohol to achieve the desired effects. Overall, the results indicate that ruminative cognitive style and the persistence of negative affect from moment to moment may reflect an individual vulnerability for the development of alcohol use disorder especially among women.


Sitko, K.; Varese, F.; Sellwood, W.; Hammond, A.; Bentall, R. (2016): The dynamics of attachment insecurity and paranoid thoughts: An experience sampling study. In: Psychiatry research 246, S. 32–38. DOI: 10.1016/j.psychres.2016.08.057.

It has been proposed that insecure attachment can have adverse effects on the course of psychosis once symptoms have emerged. There is longitudinal evidence that increased insecure attachment is associated with increased severity of psychotic symptoms. The present study examined whether in the flow of daily life attachment insecurity fluctuates, whether elevated stress precedes the occurrence of attachment insecurity, and whether elevated attachment insecurity precedes the occurrence of paranoia. Twenty clinical participants with a psychosis-spectrum diagnosis and twenty controls were studied over six consecutive days using the experience sampling method (ESM). The findings revealed that fluctuations in attachment insecurity were significantly higher in the clinical group, that elevated stress predicted a subsequent increase in attachment insecurity, and that elevated attachment insecurity predicted a subsequent increase in paranoia; this effect was not observed in auditory hallucinations once co-occurring symptoms were controlled for. Finally, although previous ESM studies have shown that low self-esteem precedes the occurrence of paranoia, attachment insecurity continued to predict paranoia even when self-esteem was controlled for. The findings suggest that attachment security may be associated with a lower risk of paranoia, and that psychological interventions should address attachment beliefs and work towards establishing a sense of attachment security.


Smith, P. K.; Hofmann, W. (2016): Power in everyday life. In: Proceedings of the National Academy of Sciences of the United States of America 113 (36), S. 10043–10048. DOI: 10.1073/pnas.1604820113.

How does power manifest itself in everyday life? Using experience-sampling methodology, we investigated the prevalence, sources, and correlates of power in people’s natural environments. Participants experienced power-relevant situations regularly, though not frequently. High power was not restricted to a limited few: almost half of the sample reported experiencing high-power positions. Positional power and subjective feelings of power were strongly related but had unique relations with several individual difference measures and independent effects on participants’ affect, cognition, and interpersonal relations. Subjective feelings of power resulted more from within-participant situational fluctuation, such as the social roles participants held at different times, than from stable differences between people. Our data supported some theoretical predictions about power’s effects on affect, cognition, and interpersonal relations, but qualified others, particularly highlighting the role of responsibility in power’s effects. Although the power literature has focused on high power, we found stronger effects of low power than high power.


Smyth, Joshua M.; Zawadzki, Matthew J.; Juth, Vanessa; Sciamanna, Christopher N. (2016): Global life satisfaction predicts ambulatory affect, stress, and cortisol in daily life in working adults. In: Journal of behavioral medicine. DOI: 10.1007/s10865-016-9790-2.

Global life satisfaction has been linked with long-term health advantages, yet how life satisfaction impacts the trajectory of long-term health is unclear. This paper examines one such possible mechanism-that greater life satisfaction confers momentary benefits in daily life that accumulate over time. A community sample of working adults (n = 115) completed a measure of life satisfaction and then three subsequent days of ecological momentary assessment surveys (6 times/day) measuring affect (i.e., emotional valence, arousal), and perceived stress, and also provided salivary cortisol samples. Multilevel models indicated that people with higher (vs. lower) levels of life satisfaction reported better momentary affect, less stress, marginally lower momentary levels and significantly altered diurnal slopes of cortisol. Findings suggest individuals with high global life satisfaction have advantageous daily experiences, providing initial evidence for potential mechanisms through which global life satisfaction may help explain long-term health benefits.


Snir, Avigal; Bar-Kalifa, Eran; Berenson, Kathy R.; Downey, Geraldine; Rafaeli, Eshkol (2016): Affective instability as a clinical feature of avoidant personality disorder. In: Personal Disord, S. 1–7. DOI: 10.1037/per0000202.

The current study’s main goal was to examine whether affective instability is elevated among individuals suffering from avoidant personality disorder (APD) by comparing it to the affective instability found among individuals suffering from borderline personality disorder (BPD) as well that found among healthy controls. Adults (N = 152, aged 18–65 years) with BPD, APD, or no psychopathology participated in a 3-week computerized diary study. We examined temporal instability in negative affect using experience-sampling methods. Both within and between days, individuals with APD showed greater affective instability compared to the healthy control individuals, although less affective instability compared to individuals with BPD. The findings are in line with affective instability (or emotional lability) as a key dimension relevant across personality disorders. Additionally, they emphasize the need for research and clinical attention to affective characteristics (alongside the more readily recognized interpersonal characteristics) of APD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Spieler, Ines; Scheibe, Susanne; Stamov-Roßnagel, Christian; Kappas, Arvid (2016): Help or hindrance? Day-level relationships between flextime use, work–nonwork boundaries, and affective well-being. In: J Appl Psychol. DOI: 10.1037/apl0000153.

Flexible working time arrangements are becoming increasingly popular around the globe, but do they actually benefit employees? To address this question, we take a differentiated look at employees’ day-specific use of flextime and its effect on the intersection of work and nonwork life. Specifically, we examined whether links between day-specific flextime use and affective well-being at work and at home can be explained by level of goal completion and the subjective boundaries around one’s work and private life domains (i.e., the strength of work–nonwork boundaries). During 2 consecutive workweeks, 150 bank employees from various functions (Study 1) and a heterogeneous sample of 608 employees (Study 2) reported their day-specific use of flextime, boundary strength at work and home, and affective well-being in the evening and the next day. Multilevel structural equation modeling of 2,223 (Study 1) and 3,164 (Study 2) observations revealed that flextime use was associated with stronger boundaries at home in both studies and stronger boundaries at work in Study 2. Stronger boundaries were, in turn, positively associated with affective well-being, both in the same evening and the next day. Study 2 further revealed that day-specific nonwork goal completion mediated the positive association between daily flextime use and boundary strength at work. However, whereas occasional flextime use had unequivocal positive consequences, chronic flextime use undermined the completion of work goals. Overall, findings suggest that flextime use benefits employees when used in moderation. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Stawarczyk, David; D’Argembeau, Arnaud (2016): Conjoint influence of mind-wandering and sleepiness on task performance. In: J Exp Psychol Hum Percept Perform 42 (10), S. 1587–1600. DOI: 10.1037/xhp0000254.

Recent research suggests that sleepiness and mind-wandering—the experience of thoughts that are both stimulus-independent and task-unrelated—frequently co-occur and are both associated with poorer cognitive functioning. Whether these two phenomena have distinguishable effects on task performance remains unknown, however. To investigate this question, we used the online experience sampling of mind-wandering episodes and subjective sleepiness during a laboratory task (the Sustained Attention to Response Task; SART), and also assessed mind-wandering frequency and sleep-related disturbances in daily life using self-report questionnaires. The results revealed that the tendency to experience mind-wandering episodes during the SART and daily life was associated with higher levels of daytime sleepiness and sleep-related disturbances. More important, however, mind-wandering and sleepiness were independent predictors of SART performance at both the within- and between-individuals levels. These findings demonstrate that, although mind-wandering and sleepiness frequently co-occur, these two phenomena have distinguishable and additive effects on task performance. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Stefano, Emily C.; Hudson, Danae L.; Whisenhunt, Brooke L.; Buchanan, Erin M.; Latner, Janet D. (2016): Examination of body checking, body image dissatisfaction, and negative affect using ecological momentary assessment. In: Eat Behav 22, S. 51–54. DOI: 10.1016/j.eatbeh.2016.03.026.

Research has shown that non-clinical women, particularly those with high body concern, engage in frequent body checking behaviors. The purpose of this study was to use ecological momentary assessment (EMA) to examine the frequency and correlates of body checking behavior, including its association with body image dissatisfaction and negative affect, in non-clinical women with high body concern. Undergraduate female participants with high body concern (n = 22) were assessed five times per day for five days via text messages sent to their smart phones. During each assessment, participants reported the number of times they engaged in eight different body checking behaviors and their current level of negative affect and body dissatisfaction. After aggregation, a total of 3064 body checking behaviors were reported by the sample during the five-day period. All participants reported engaging in body checking at least once per day, with a mean of 27.85 checking behaviors per day. Hierarchical Linear Modeling revealed that body checking significantly predicted both body dissatisfaction and negative affect. These results provide preliminary support for the cognitive behavioral theory of eating disorders, suggesting that as women engage in more frequent body checking behaviors, they also experience higher levels of body dissatisfaction and negative affect. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Swendsen, Joel (2016): Contributions of mobile technologies to addiction research. In: Dialogues in clinical neuroscience 18 (2), S. 213–221.

Mobile technologies are revolutionizing the field of mental health, and particular progress has been made in their application to addiction research and treatment. The use of smartphones and other mobile devices has been shown to be feasible with individuals addicted to any of a wide range of substances, with few biases being observed concerning the repeated monitoring of daily life experiences, craving, or substance use. From a methodological point of view, the use of mobile technologies overcomes longstanding limitations of traditional clinical research protocols, including the more accurate assessment of temporal relationships among variables, as well as the reduction in both contextual constraints and discipline-specific methodological isolation. The present article presents a conceptual review of these advances while using illustrations of research applications that are capable of overcoming specific methodological barriers. Finally, a brief review of both the benefits and risks of mobile technology use for the treatment of patients will be addressed.


Tassorelli, C.; Jensen, R.; Allena, M.; Icco, R. de; Katsarava, Z.; Miguel, Lainez J. et al. (2016): The added value of an electronic monitoring and alerting system in the management of medication-overuse headache: A controlled multicentre study. In: Cephalalgia : an international journal of headache. DOI: 10.1177/0333102416660549.

BACKGROUND: Medication-overuse headache (MOH) is a chronic disabling condition associated with a high rate of relapse. METHODS: We evaluated whether the adoption of electronic-assisted monitoring, advice and communication would improve the outcome over a follow-up of 6 months in a controlled, multicentre, multinational study conducted in six headache centres located in Europe and Latin America. A total of 663 MOH subjects were enrolled and divided into two groups: the Comoestas group was monitored with an electronic diary associated with an alert system and a facilitated communication option, and the Classic group with a paper headache diary. RESULTS: We observed a significantly higher percentage of overuse-free subjects in the Comoestas group compared with the Classic group: 73.1 vs 64.1% (odds ratio 1.45, 95% confidence interval 1.07-2.09, p = 0.046). The Comoestas group performed better also regarding the number of days/month with intake of acute drugs and the level of disability [Migraine Disability Assessment Score: Comoestas group - 42.5 +/- 53.6 (35.5-49.3) and Classic group - 27.5 +/- 56.1 (20.6-34.3) (p < 0.003)]. CONCLUSION: The adoption of the electronic tool improved the outcome of patients suffering from MOH after withdrawal from overused drugs. Information and communication technology represents a valid aid for optimizing the management of chronic conditions at risk of worsening or of relapsing. TRIAL REGISTRATION: The trial was registered at (no. NCT02435056).


Thompson, Renee J.; Kircanski, Katharina; Gotlib, Ian H. (2016): The grass is not as green as you think: Affect evaluation in people with internalizing disorders. In: J Affect Disord 203, S. 233–240. DOI: 10.1016/j.jad.2016.06.006.

Background: Affect evaluation—how people evaluate their emotion experiences—has important implications for mental health. Methods: We examined how 70 adults diagnosed with Major Depressive Disorder and/or Generalized Anxiety Disorder or no psychiatric disorders (control group) believe they should feel in the moment (should affect). We repeatedly assessed participants’ current affect and should affect over one week using experience sampling. To examine the psychometric properties of should affect, participants rated their level of rumination at each survey and completed trait measures of brooding and ideal affect at the lab. Results and conclusions: Independent of group status, participants reported that they should be feeling more positive affect and less negative affect. Even after accounting for mean affect, the clinical groups’ reports were generally more extreme than were those of the control group. We documented good convergent and discriminant validity of should affect. Finally, we describe clinical implications and directions for future research. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Tong, Eddie M. W.; Jia, Lile (2016): Positive emotion, appraisal, and the role of appraisal overlap in positive emotion co-occurrence. In: Emotion (Washington, D.C.). DOI: 10.1037/emo0000203.

Appraisal research has traditionally focused on negative emotions but has not addressed issues concerning the relationships between several positive emotions and appraisals in daily life and the extent to which co-occurrence of positive emotions can be explained by overlap in appraisals. Driven by a priori hypotheses on appraisal-emotion relationships, this study investigated 12 positive emotions and 13 appraisal dimensions using Ecological Momentary Assessment. The results provide strong evidence that positive emotions and appraisals correlate significantly in daily life. Importantly, we found that the positive emotions’ overlap on theoretically relevant, as compared to irrelevant, appraisals was stronger and more predictive of their co-occurrence. Furthermore, appraisal overlap on theoretically relevant appraisals predicted the co-occurrence of positive emotions even when the appraisal of pleasantness was excluded, indicating that positive emotions do not co-occur just by virtue of their shared valence. Our findings affirmed and refined the appraisal profiles of positive emotions and underscore the importance of appraisals in accounting for the commonality and differences among positive emotions. (PsycINFO Database Record


Trull, T. J.; Lane, S. P.; Koval, P.; Ebner-Priemer, U. W. (2015): Affective dynamics in psychopathology. In: Emotion review : journal of the International Society for Research on Emotion 7 (4), S. 355–361. DOI: 10.1177/1754073915590617.

We discuss three varieties of affective dynamics (affective instability, emotional inertia, and emotional differentiation). In each case, we suggest how these affective dynamics should be operationalized and measured in daily life using time-intensive methods, like ecological momentary assessment or ambulatory assessment, and recommend time-sensitive analyses that take into account not only the variability but also the temporal dependency of reports. Studies that explore how these affective dynamics are associated with psychological disorders and symptoms are reviewed, and we emphasize that these affective processes are within a nexus of other components of emotion regulation.


Trull, Timothy J.; Wycoff, Andrea M.; Lane, Sean P.; Carpenter, Ryan W.; Brown, Whitney C. (2016): Cannabis and alcohol use, affect and impulsivity in psychiatric out‐patients’ daily lives. In: Addiction 111 (11), S. 2052–2059. DOI: 10.1111/add.13471.

Background and Aims Cannabis and alcohol are the most commonly used (il)licit drugs world‐wide. We compared the effects of cannabis and alcohol use on within‐person changes in impulsivity, hostility and positive affect at the momentary and daily levels, as they occurred in daily life. Design Observational study involving ecological momentary assessments collected via electronic diaries six random times a day for 28 consecutive days. Setting Out‐patients’ everyday life contexts in Columbia, MO, USA. Participants Ninety‐three adult psychiatric out‐patients (85% female; mean = 30.9 years old) with borderline personality or depressive disorders, who reported using only cannabis (n = 3), only alcohol (n = 58) or both (n = 32) at least once during the study period. Measurements Real‐time, standard self‐report measures of impulsivity, hostility and positive affect, as impacted by momentary reports of cannabis and alcohol use. Findings Cannabis use was associated with elevated feelings of impulsivity at the day level [b = 0.83, 95% confidence interval (CI) = 0.17–1.49] and increased hostility at the momentary (b = 0.07, 95% CI = 0.01–0.12) and person (b = 0.81, 95% CI = 0.15–1.47) level. Alcohol use was associated with elevated feelings of impulsivity at the momentary (b = 0.42, 95% CI = 0.13–0.71) and day levels (b = 0.82, 95% CI = 0.22–1.41) and increased positive affect at the momentary (b = 0.12, 95% CI = 0.06–0.18) and day (b = 0.33, 95% CI = 0.16–0.49) levels. Conclusions Cannabis and alcohol use are associated with increases in impulsivity (both), hostility (cannabis) and positive affect (alcohol) in daily life, and these effects are part of separate processes that operate on different time‐scales (i.e. momentary versus daily). (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Turan, Bulent; Fazeli, Pariya L.; Raper, James L.; Mugavero, Michael J.; Johnson, Mallory O. (2016): Social support and moment-to-moment changes in treatment self-efficacy in men living with HIV: Psychosocial moderators and clinical outcomes. In: Health Psychol 35 (10), S. 1126–1134. DOI: 10.1037/hea0000356.

Objective: For people living with HIV, treatment adherence self-efficacy is an important predictor of treatment adherence and, therefore, of clinical outcomes. Using experience sampling method (ESM), this study aimed to examine: (1) the within-person association between moment-to-moment changes in social support and HIV treatment self-efficacy; (2) the moderators of this within-person association; (3) the concordance between questionnaire and ESM measurement of treatment self-efficacy; and (4) the utility of each approach (ESM and questionnaire) in predicting adherence to medication, adherence to clinic visits, CD4 counts, and viral load. Method: Men living with HIV (N = 109) responded to the same set of ESM questions 3 times a day for 7 days via a smart phone given to them for the study. They also completed cross-sectional questionnaires and their clinic data was extracted from medical records to examine predictors and consequences of state and trait treatment self-efficacy. Results: In within-person hierarchical linear modeling (HLM) analyses, receipt of recent social support predicted higher current ESM treatment self-efficacy. This association was stronger for individuals reporting higher avoidance coping with HIV. The correlation between ESM and questionnaire measures of treatment self-efficacy was r = .37. ESM measure of average treatment self-efficacy predicted medication adherence, visit adherence, CD4 counts, and viral load, while questionnaire-based self-efficacy did not predict these outcomes. Conclusion: Interventions aimed at improving treatment adherence may target social support processes, which may improve treatment self-efficacy and adherence. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Turner, Brianna J.; Yiu, Angelina; Claes, Laurence; Muehlenkamp, Jennifer J.; Chapman, Alexander L. (2016): Occurrence and co-occurrence of nonsuicidal self-injury and disordered eating in a daily diary study: Which behavior, when? In: Psychiatry research 246, S. 39–47. DOI: 10.1016/j.psychres.2016.09.012.

Although research has explored between-person traits that may account for the co-occurrence of non-suicidal self-injury (NSSI) and disordered eating (DE), little is known about within-person processes that predict when each behavior occurs. This study describes the socioemotional contexts of NSSI and DE behaviors during a two-week daily diary period. Young adults (aged 18-35) who reported >/=1 episode of NSSI and >/=1 episode of DE (binge eating, purging, or fasting) during the diary period were included (N=25). NSSI and DE co-occurred approximately one third of the time. Participants were more likely to act on NSSI thoughts following arguments and feelings of rejection. They were more likely to act on binge eating/purging thoughts after eating or watching television, and when they felt self-hatred. They were more likely to act on fasting thoughts after discussing upsetting memories, and when they were in a public setting. NSSI days were marked by more intense negative mood in the evenings relative to fasting days, and greater fatigue in the morning relative to binge eating/purging days. This study underscores the utility of using experience-sampling methods to develop and test within-person models to advance our understanding of co-occurring behaviors.


Vachon, Hugo; Bourbousson, Marina; Deschamps, Thibault; Doron, Julie; Bulteau, Samuel; Sauvaget, Anne; Thomas-Ollivier, Veronique (2016): Repeated self-evaluations may involve familiarization: An exploratory study related to ecological momentary assessment designs in patients with major depressive disorder. In: Psychiatry research 245, S. 99–104. DOI: 10.1016/j.psychres.2016.08.034.

A growing body of research in clinical psychology is now relying on Ecological Momentary Assessment (EMA). EMA is fitted to investigate fluctuating processes and as such, it is of particular interest in a clinical context in which patients are often characterized by fluctuating behaviors and affective states or symptoms. EMA typically involves frequent self-evaluations over long periods, which may influence patient response. The present study aimed to determine whether EMA follow-ups could influence the participants’ self-evaluations over time. The sample comprised 24 outpatients suffering from a Major Depressive Disorder (15 women, age = 51.4 +/- 9.6). This study relied on an EMA protocol involving self-evaluations of seven depressive symptoms twice a day over 5 months. Patients did not show any clinical improvement following the clinical screening and the level of depressive symptoms during the follow-up. As a novel finding, significant moderate to large effects were observed for decreased variability and instability of psychological states over time. The main difference in temporal properties of psychological states was found after the first two weeks of the follow-up. This study characterized early changes in patients’ self-evaluations, suggesting the idea of a valuable familiarization period during the first two weeks of an EMA follow-up.


Vahia, Ipsit V.; Sewell, Daniel D. (2016): Late-life depression: A role for accelerometer technology in diagnosis and management. In: Am J Psychiatry 173 (8), S. 763–768. DOI: 10.1176/appi.ajp.2015.15081000.

This article discuses the role for accelerometer technology in diagnosis and management. It is well established that depressive symptoms in late life can be challenging to diagnose because of heterogeneity of clinical presentation. Moreover, older adults with depressive symptoms frequently fail to meet DSM criteria for depressive episodes. In older adults like Mr. G in the vignette, with comorbid mood symptoms and cognitive impairment, clinical information as well as collateral information may be unreliable or biased. This case highlights how accelerometer-based technology can have an impact on several dimensions of diagnosis and management of depressive symptoms in late life by providing a more accurate clinical understanding of specific factors that can be key determinants of care. The case of Mr. G highlights several important points. It demonstrates the feasibility of utilizing motion-sensing technology in a clinical environment with older adults who have comorbid mood and cognitive symptoms. It also demonstrates that the use of such technology can add a dimension to clinical diagnostics that was not previously readily available. Future work should assess clinician attitudes and concerns about using commercially available devices for psychiatric care. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


van der Krieke, Lian; Blaauw, Frank J.; Emerencia, Ando C.; Schenk, Hendrika M.; Slaets, Joris P. J.; Bos, Elisabeth H. et al. (2016): Temporal dynamics of health and well-being: A crowdsourcing approach to momentary assessments and automated generation of personalized feedback. In: Psychosomatic Medicine. DOI: 10.1097/PSY.0000000000000378.

OBJECTIVE: Recent developments in research and mobile health enable a quantitative idiographic approach in health research. The present study investigates the potential of an electronic diary crowdsourcing study in the Netherlands for (1) large-scale automated self-assessment for individual-based health promotion and (2) enabling research at both the between-persons and within-persons level. To illustrate the latter, we examined between-persons and within-persons associations between somatic symptoms and quality of life. METHODS: A website provided the general Dutch population access to a 30-day (3 times a day) diary study assessing 43 items related to health and well-being, which gave participants personalized feedback. Associations between somatic symptoms and quality of life were examined with a linear mixed model. RESULTS: A total of 629 participants completed 28,430 assessments, with a mean (SD) of 45 (32) assessments per participant. Most participants (n = 517 [82%]) were women and 531 (84%) had high education. Almost 40% of the participants (n = 247) completed enough assessments (t = 68) to generate personalized feedback including temporal dynamics between well-being, health behavior, and emotions. Substantial between-person variability was found in the within-person association between somatic symptoms and quality of life. CONCLUSIONS: We successfully built an application for automated diary assessments and personalized feedback. The application was used by a sample of mainly highly educated women, which suggests that the potential of our intensive diary assessment method for large-scale health promotion is limited. However, a rich data set was collected that allows for group-level and idiographic analyses that can shed light on etiological processes and may contribute to the development of empirical-based health promotion solutions.


van Knippenberg, R J M; Vugt, M. E. de; Ponds, R. W.; Myin-Germeys, I.; van Twillert, B.; Verhey, F. R. J. (2016): Dealing with daily challenges in dementia (deal-id study): an experience sampling study to assess caregiver functioning in the flow of daily life. In: International journal of geriatric psychiatry. DOI: 10.1002/gps.4552.

OBJECTIVE: Accurate assessment of caregiver functioning is of great importance to gain better insight into daily caregiver functioning and to prevent high levels of burden. The experience sampling methodology (ESM) is an innovative approach to assess subjective experiences and behavior within daily life. In this study, the feasibility of the ESM in spousal caregivers of people with dementia was examined, and the usability of ESM data for clinical and scientific practice was demonstrated. METHODS: Thirty-one caregivers collected ESM data for six consecutive days using an electronic ESM device that generated ten random alerts per day. After each alert, short reports of the caregiver’s current mood state and context were collected. Feasibility was assessed by examining compliance and subjective experiences with the ESM. Usability was described using group and individual ESM data. RESULTS: Participants on average completed 78.8% of the reports. One participant completed less than 33% of the reports and was excluded from data analyses. Participants considered the ESM device to be a user-friendly device in which they could accurately describe their feelings and experiences. The ESM was not experienced as too burdensome. Zooming in on the ESM data, personalized patterns of mood and contextual factors were revealed. CONCLUSIONS: The ESM is a feasible method to assess caregiver functioning. In addition to standard retrospective measurements, it offers new opportunities to gain more insight into the daily lives of people with dementia and their caregivers. It also provides new possibilities to tailor caregiver support interventions to the specific needs of the caregiver.


van Roekel, Eeske; Bennik, Elise C.; Bastiaansen, Jojanneke A.; Verhagen, Maaike; Ormel, Johan; Engels, Rutger C. M. E.; Oldehinkel, Albertine J. (2016): Depressive symptoms and the experience of pleasure in daily life: An exploration of associations in early and late adolescence. In: J Abnorm Child Psychol 44 (5), S. 999–1009. DOI: 10.1007/s10802-015-0090-z.

Although loss of pleasure (i.e., anhedonia) is one of the two core symptoms of depression, very little research has examined the relation between depressive symptoms and the experience of pleasure in daily life. This exploratory study in two population-based adolescent samples aimed to examine how depressive symptoms and anhedonia specifically were related to (1) the proportion and intensity of positive events, (2) mean and variability of positive affect (PA), (3) reactivity to positive events, and (4) reactivity to PA (i.e., whether PA elicits positive events). We used Experience Sampling to measure positive events and PA several times a day during 6 to 14 days in early (N = 284) and late (N = 74) adolescents. Results showed that depressive symptoms were related to a lower proportion and intensity of positive events, lower mean PA, and higher variability in PA regardless of sex and stage of adolescence. No clear evidence was found for differential reactivity to positive events or to PA. Anhedonia was not associated with most daily life experiences of pleasure. Our findings, though preliminary, suggest that although adolescents with many depressive symptoms experience less positive events and lower PA, they are able to enjoy pleasurable events to the same extent as individuals with fewer depressive symptoms. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Vancampfort, Davy; Firth, Joseph; Schuch, Felipe; Rosenbaum, Simon; Hert, Marc de; Mugisha, James et al. (2016): Physical activity and sedentary behavior in people with bipolar disorder: A systematic review and meta-analysis. In: J Affect Disord 201, S. 145–152. DOI: 10.1016/j.jad.2016.05.020.

Background: Mortality rates are approximately two to three times higher in people with bipolar disorder (BD) than in general population. Lack of physical activity (PA) and sedentary behavior (SB) are independent risk factors for cardiovascular disease and premature mortality. Aims: We conducted a meta-analysis to investigate PA and SB levels and its predictors in BD. Methods: Major electronic databases were searched from inception till 02/2016 for articles measuring PA and SB with a self-report questionnaire (SRQ) or objective measure (e.g. accelerometer) in BD. A random effects meta-analysis and meta-regression analysis were conducted. Results: Six studies were eligible including 279 (129♂) people with BD (mean age = 43.9 years; range: 32.0–51.5 years). The trim and fill analysis demonstrated people with BD spent in total 210.1min (95%CI = 146.3–273.9min) per day being physically active and 613.3min (95%CI = 389.9–836.6min) during waking hours being sedentary. No significant difference in total PA per day was observed between people with BD and controls (g = −0.62, 95% CI = −1.55 to 0.31, I² = 88.5%, n BD = 82, n controls = 86). Objective measures of PA recorded significantly lower levels (P = 0.03) compared to self-report PA. Meta-regression demonstrated that older age and a higher body mass index predicted lower PA levels. Limitations: Only a limited number of studies were identified assessing SB in people with BD. Conclusions: Adults with BD engage in high levels of sedentary behavior during waking hours. Given that sedentary behavior is an independent predictor of cardiovascular disease, future lifestyle interventions specifically targeting the prevention of sedentary behavior are warranted. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Vansteelandt, Kristof; Verbeke, Geert (2016): A mixed model to disentangle variance and serial autocorrelation in affective instability using ecological momentary assessment data. In: Multivariate Behav Res 51 (4), S. 446–465. DOI: 10.1037/t15771-000.

Affective instability, the tendency to experience emotions that fluctuate frequently and intensively over time, is a core feature of several mental disorders including borderline personality disorder. Currently, affect is often measured with Ecological Momentary Assessment protocols, which yield the possibility to quantify the instability of affect over time. A number of linear mixed models are proposed to examine (diagnostic) group differences in affective instability. The models contribute to the existing literature by estimating simultaneously both the variance and serial dependency component of affective instability when observations are unequally spaced in time with the serial autocorrelation (or emotional inertia) declining as a function of the time interval between observations. In addition, the models can eliminate systematic trends, take between subject differences into account and test for (diagnostic) group differences in serial autocorrelation, short-term as well as long-term affective variability. The usefulness of the models is illustrated in a study on diagnostic group differences in affective instability in the domain of eating disorders. Limitations of the model are that they pertain to group (and not individual) differences and do not focus explicitly on circadian rhythms or cycles in affect. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Vasconcelos E Sa, Debora; Wearden, Alison; Hartley, Samantha; Emsley, Richard; Barrowclough, Christine (2016): Expressed Emotion and behaviourally controlling interactions in the daily life of dyads experiencing psychosis. In: Psychiatry research 245, S. 406–413. DOI: 10.1016/j.psychres.2016.08.060.

While research using Experience Sampling Methodology (ESM) suggests that, in general, contact with relatives or friends may be protective for psychotic experiences, contact with high-Expressed Emotion (high-EE) relatives can have adverse consequences for patients. This study investigated whether contact with high-EE relatives, and relatives’ behaviourally controlling interactions (BCI) are related to patients’ symptoms and to both patients’ and relatives’ affect when measured using structured diary assessments in the course of everyday life. Twenty-one patients experiencing psychosis and their closest relatives provided synchronized self-reports of symptoms (patients only), affect, dyadic contact and BCI over a 6-days period. Relatives’ EE was obtained from Camberwell Family Interviews. Multi-level modeling showed that patients’ reports of relatives taking control of them and helping them were associated with increased patient negative affect and symptoms. Relatives’ self-reports of nagging, taking control and keeping an eye on the patient were related to fluctuations in relatives’ affect. No evidence was found for the moderating effect of EE status on the association between dyadic contact and affect or, in the case of patients, symptoms. When measured using an ecologically valid methodology, momentary behaviourally controlling interactions within dyads experiencing psychosis can impact on patients’ affect and symptoms.


Verhagen, S. J.; Hasmi, L.; Drukker, M.; van Os, J.; Delespaul, P. A. (2016): Use of the experience sampling method in the context of clinical trials. In: Evidence-based mental health 19 (3), S. 86–89. DOI: 10.1136/ebmental-2016-102418.

OBJECTIVE: The experience sampling method (ESM) is a structured diary technique to appraise subjective experiences in daily life. It is applied in psychiatric patients, as well as in patients with somatic illness. Despite the potential of ESM assessment, the improved logistics and its increased administration in research, its use in clinical trials remains limited. This paper introduces ESM for clinical trials in psychiatry and beyond. METHODS: ESM is an ecologically valid method that yields a comprehensive view of an individual’s daily life. It allows the assessment of various constructs (eg, quality of life, psychopathology) and psychological mechanisms (eg, stress-sensitivity, coping). These constructs are difficult to assess using cross-sectional questionnaires. ESM can be applied in treatment monitoring, as an ecological momentary intervention, in clinical trials, or in single case clinical trials. Technological advances (eg, smartphone applications) make its implementation easier. RESULTS: Advantages of ESM are highlighted and disadvantages are discussed. Furthermore, the ecological nature of ESM data and its consequences are explored, including the potential pitfalls of ambiguously formulated research questions and the specificities of ESM in statistical analyses. The last section focuses on ESM in relation to clinical trials and discusses its future use in optimising clinical decision-making. CONCLUSIONS: ESM can be a valuable asset in clinical trial research and should be used more often to study the benefits of treatment in psychiatry and somatic health.


Walerius, Danielle M.; Fogleman, Nicholas D.; Rosen, Paul J. (2016): The role of ADHD and negative emotional lability in predicting changes in parenting daily hassles. In: J Child Fam Stud 25 (7), S. 2279–2291. DOI: 10.1007/s10826-016-0381-1.

The present study examined the extent to which children’s negative emotional lability (measured via ecological momentary assessment—EMA) and ADHD diagnostic status predicted changes in the frequency of daily parenting hassles and the stress resulting from daily hassles at one-week follow-up when controlling for baseline parenting hassles. Parents of 84 children 8–12 years-old (47 with ADHD, 37 without ADHD) completed a measure of parenting daily hassles at baseline and follow-up and participated in EMA assessment protocol ratings of their child’s mood (3-times daily) for one week. Analyses of covariance indicated that parents of children with ADHD reported significantly greater frequency of daily parenting hassles and intensity of parenting stress resulting from daily hassles than parents of children without ADHD at baseline and follow-up. Hierarchical regression analyses suggested that children’s negative emotional lability was a significant predictor of the intensity of parenting stress resulting from daily hassles, but not the frequency of daily parenting hassles. There was also an interaction of ADHD diagnostic status and greater EMA-derived negative emotional lability in the prediction of the frequency of daily parenting hassles due to children’s challenging behaviors. Specifically, greater negative emotional lability predicted more frequent daily parenting hassles due to children’s challenging behaviors among parents of children without ADHD but not among parents of children with ADHD. Overall, this study suggests that children’s negative emotional lability is a significant predictor of aspects of daily parenting hassles across parents of children with and without ADHD. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Welz, Annett; Huffziger, Silke; Reinhard, Iris; Alpers, Georg W.; Ebner-Priemer, Ulrich; Kuehner, Christine (2016): Anxiety and rumination moderate menstrual cycle effects on mood in daily life. In: Women Health 56 (5), S. 540–560. DOI: 10.1080/03630242.2015.1101739.

Evidence for menstrual cycle-related mood fluctuations in the general population of women has been mixed. While most previous research has relied on retrospective self-report and did not consider possible moderators, the present study aimed to examine cycle-related mood variations in daily life and possible moderating effects of anxiety and trait rumination. Fifty-nine women with natural menstrual cycles, aged 18–44 years, were examined between January and October, 2012. Mood components of calmness, positive valence, energetic-arousal, and irritability were assessed, using smartphones, by ambulatory assessment ten times per day on eight days across the cycle. The menstrual, follicular, ovulatory, and late luteal phases were each covered by two consecutive assessment days. Moderators were assessed with questionnaires. Hierarchical linear models (HLMs) revealed higher calmness in the luteal and menstrual than in the follicular and ovulatory phase, while the menstrual cycle did not exhibit significant main effects on other mood components. Anxiety and ruminative self-reflection moderated the association between menstrual cycle and all mood variables. Specifically, highly anxious and ruminative women showed an increase in irritability, while women with lower anxiety and lower rumination were protected against mood deterioration toward the end of the cycle. Further research could examine whether reducing anxiety and rumination helps to prevent premenstrual syndrome-related syndromes. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Williams, D. M.; Dunsiger, S.; Emerson, J. A.; Gwaltney, C. J.; Monti, P. M.; Miranda, R., JR (2016): Self-paced exercise, affective response, and exercise adherence: A preliminary investigation using ecological momentary assessment. In: Journal of sport & exercise psychology. DOI: 10.1123/jsep.2015-0232.

Affective response to exercise may mediate the effects of self-paced exercise on exercise adherence. Fifty-nine low-active (exercise<60 min/week), overweight (BMI: 25.0-39.9) adults (ages 18-65) were randomly assigned to self-paced (but not to exceed 76% maximum HR) or prescribed moderate intensity exercise (64-76% maximum HR) in the context of otherwise identical six-month print-based exercise promotion programs. Frequency and duration of exercise sessions and affective responses (good/bad) to exercise were assessed via ecological momentary assessment throughout the six-month program. A regression-based mediation model was used to estimate: (a) effects of experimental condition on affective response to exercise (path a=0.20, SE=0.28, f2=0.02); (b) effects of affective response on duration/latency of the next exercise session (path b=0.47, SE=0.25, f2=0.04); and (c) indirect effects of experimental condition on exercise outcomes via affective response (path ab=0.11, SE=0.06 , f2=0.10). Results provide modest preliminary support for a meditational pathway linking self-paced exercise, affective response, and exercise adherence.


Willner‐Reid, Jessica; Whitaker, Damiya; Epstein, David H.; Phillips, Karran A.; Pulaski, Amber R.; Preston, Kenzie L.; Willner, Paul (2016): Cognitive‐behavioural therapy for heroin and cocaine use: Ecological momentary assessment of homework simplification and compliance. In: Psychol Psychother 89 (3), S. 276–293. DOI: 10.1111/papt.12080.

Objectives: The purpose of this study was to evaluate the effects of homework‐task difficulty and electronic‐diary reminders on written homework completion during cognitive‐behavioural therapy (CBT) for addiction. Completion of homework is an important element in CBT that may affect outcome. Design: All participants received all combinations of our two interventions in a factorial 2 × 2 counterbalanced Latin‐square design. Methods: Methadone‐maintained cocaine and heroin users were given homework between each of 12 weekly CBT sessions and carried electronic diaries that collected ecological momentary assessment (EMA) data on craving and exposure to drug‐use triggers in four 3‐week blocks assessing two levels of homework difficulty and prompted and unprompted homework. Results: Neither simplified (picture‐based) homework nor electronic reminders increased homework completion. In EMA reports, standard but not simplified homework seemed to buffer the craving that followed environmental exposure to drug cues. EMA recordings before and after the CBT intervention confirmed a decrease over time in craving for cocaine and heroin. Conclusions: These findings demonstrate the utility of EMA to assess treatment effects. However, the hypothesis that simplified homework would increase compliance was not supported. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Wong, Elena; Tschan, Franziska; Semmer, Norbert K. (2016): Effort in emotion work and well-being: The role of goal attainment. In: Emotion. DOI: 10.1037/emo0000196.

It is well established that regulating one’s emotion display in social settings entails psychological costs such as lower well-being. However, regulating emotion display may also help achieving goals, and goal attainment is known to enhance well-being. We therefore investigated the hypothesis that success in attaining goals during social interactions would reduce the negative impact of regulatory effort on well-being. In an experience sampling study, 115 Swiss employees reported their social encounters for 7 consecutive days. For each interaction, participants were asked to report their effort in regulating their emotions, their level of goal attainment, and their momentary well-being after the interaction. Data being nested (Level 1: interactions; Level 2: person), multilevel analyses were conducted. Continuous level 1 predictors were group mean centered, implying that their effects on well-being were strictly intraindividual. Gender, age, extraversion, and neuroticism were controlled on the person level, the context of the interaction (private vs. work) as well as positive and negative emotions felt during the social encounter were controlled on the situation level. Analysis of 1,674 social interactions containing a goal confirmed that regulatory effort predicted lower well-being after social interactions (Hypothesis 1), that degree of goal attainment predicted better well-being after these interactions (Hypothesis 2), and that degree of goal attainment buffered the negative effect of effort (Hypothesis 3). Research and theory should pay more attention to the fact that emotions often are regulated in the service of goals, and that attaining these goals may, at least partially, compensate for the effort invested. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Wray, Tyler B.; Kahler, Christopher W.; Monti, Peter M. (2016): Using ecological momentary assessment (EMA) to study sex events among very high-risk men who have sex with men (MSM). In: AIDS Behav 20 (10), S. 2231–2242. 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. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Wright, Aidan G. C.; Hallquist, Michael N.; Stepp, Stephanie D.; Scott, Lori N.; Beeney, Joseph E.; Lazarus, Sophie A.; Pilkonis, Paul A. (2016): Modeling heterogeneity in momentary interpersonal and affective dynamic processes in borderline personality disorder. In: Assessment 23 (4), S. 484–495. DOI: 10.1037/t04754-000.

Borderline personality disorder (BPD) is a diagnosis defined by impairments in several dynamic processes (e.g., interpersonal relating, affect regulation, behavioral control). Theories of BPD emphasize that these impairments appear in specific contexts, and emerging results confirm this view. At the same time, BPD is a complex construct that encompasses individuals with heterogeneous pathology. These features—dynamic processes, situational specificity, and individual heterogeneity—pose significant assessment challenges. In the current study, we demonstrate assessment and analytic methods that capture both between-person differences and within-person changes over time. Twenty-five participants diagnosed with BPD completed event-contingent, ambulatory assessment protocols over 21 days. We used p-technique factor analyses to identify person-specific psychological structures consistent with clinical theories of personality. Five exemplar cases are selected and presented in detail to showcase the potential utility of these methods. The presented cases’ factor structures reflect not only heterogeneity but also suggest points of convergence. The factors also demonstrated significant associations with important clinical targets (self-harm, interpersonal violence). (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Wright, Aidan G. C.; Simms, Leonard J. (2016): Stability and fluctuation of personality disorder features in daily life. In: J Abnorm Psychol 125 (5), S. 641–656. DOI: 10.1037/abn0000169.

Very little is known about the daily stability and fluctuation of personality pathology. To address this gap in knowledge, we investigated the naturalistic manifestation of personality pathology over the course of 100 days. A group of individuals (N = 101) diagnosed with any personality disorder (PD) completed a daily diary study over 100 consecutive days (Mdn = 94 days, range = 33–101 days). Participants completed daily ratings of 30 manifestations of personality pathology. Patterns of stability and variability over the course of the study were then examined. Results indicated that individual PD manifestations and domains of PD manifestations were variable across days and differed widely in their frequency. Additionally, individual averages and level of variability in PD domains were highly stable across months, individual averages of PD domains were predicted by baseline dispositional ratings of PD traits with a high degree of specificity, and daily variability PD domains was associated with elevated levels of PD traits. This pattern of findings suggests that dynamic processes of symptom exacerbation and diminution that are stable in mean level and variability in expression over time characterizes personality pathology. Further, dispositional ratings are significant predictors of average daily expression of PD features. (PsycINFO Database Record (c) 2016 APA, all rights reserved)

General Scientific Summary—The general definition of personality disorders includes descriptors of the relative stability in their expression (e.g., ‘enduring,’ ‘pervasive,’ and ‘inflexible’). This naturalistic daily diary study shows that personality disorders are, in fact, a combination of stability and variability in their expression. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Wu, H. T.; Lewis, G. F.; Davila, M. I.; Daubechies, I.; Porges, S. W. (2016): Optimizing estimates of instantaneous heart rate from pulse wave signals with the synchrosqueezing transform. In: Methods of information in medicine 55 (5). DOI: 10.3414/ME16-01-0026.

BACKGROUND: With recent advances in sensor and computer technologies, the ability to monitor peripheral pulse activity is no longer limited to the laboratory and clinic. Now inexpensive sensors, which interface with smartphones or other computer-based devices, are expanding into the consumer market. When appropriate algorithms are applied, these new technologies enable ambulatory monitoring of dynamic physiological responses outside the clinic in a variety of applications including monitoring fatigue, health, workload, fitness, and rehabilitation. Several of these applications rely upon measures derived from peripheral pulse waves measured via contact or non-contact photoplethysmography (PPG). As technologies move from contact to non-contact PPG, there are new challenges. The technology necessary to estimate average heart rate over a few seconds from a noncontact PPG is available. However, a technology to precisely measure instantaneous heat rate (IHR) from non-contact sensors, on a beat-to-beat basis, is more challenging. OBJECTIVES: The objective of this paper is to develop an algorithm with the ability to accurately monitor IHR from peripheral pulse waves, which provides an opportunity to measure the neural regulation of the heart from the beat-to-beat heart rate pattern (i.e., heart rate variability). METHODS: The adaptive harmonic model is applied to model the contact or non-contact PPG signals, and a new methodology, the Synchrosqueezing Transform (SST), is applied to extract IHR. The body sway rhythm inherited in the non-contact PPG signal is modeled and handled by the notion of wave-shape function. RESULTS: The SST optimizes the extraction of IHR from the PPG signals and the technique functions well even during periods of poor signal to noise. We contrast the contact and non-contact indices of PPG derived heart rate with a criterion electrocardiogram (ECG). ECG and PPG signals were monitored in 21 healthy subjects performing tasks with different physical demands. The root mean square error of IHR estimated by SST is significantly better than commonly applied methods such as autoregressive (AR) method. In the walking situation, while AR method fails, SST still provides a reasonably good result. CONCLUSIONS: The SST processed PPG data provided an accurate estimate of the ECG derived IHR and consistently performed better than commonly applied methods such as autoregressive method.


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