Society for Ambulatory Assessment

First quarter 2017 (January to March)

Adams, Zachary W.; McClure, Erin A.; Gray, Kevin M.; Danielson, Carla Kmett; Treiber, Frank A.; Ruggiero, Kenneth J. (2017): Mobile devices for the remote acquisition of physiological and behavioral biomarkers in psychiatric clinical research.

In: Journal of psychiatric research 85, S. 1–14. DOI: 10.1016/j.jpsychires.2016.10.019.

Psychiatric disorders are linked to a variety of biological, psychological, and contextual causes and consequences. Laboratory studies have elucidated the importance of several key physiological and behavioral biomarkers in the study of psychiatric disorders, but much less is known about the role of these biomarkers in naturalistic settings. These gaps are largely driven by methodological barriers to assessing biomarker data rapidly, reliably, and frequently outside the clinic or laboratory. Mobile health (mHealth) tools offer new opportunities to study relevant biomarkers in concert with other types of data (e.g., self-reports, global positioning system data). This review provides an overview on the state of this emerging field and describes examples from the literature where mHealth tools have been used to measure a wide array of biomarkers in the context of psychiatric functioning (e.g., psychological stress, anxiety, autism, substance use). We also outline advantages and special considerations for incorporating mHealth tools for remote biomarker measurement into studies of psychiatric illness and treatment and identify several specific opportunities for expanding this promising methodology. Integrating mHealth tools into this area may dramatically improve psychiatric science and facilitate highly personalized clinical care of psychiatric disorders. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Ammerman, Brooke A.; Olino, Thomas M.; Coccaro, Emil F.; McCloskey, Michael S. (2017): Predicting nonsuicidal self-Injury in borderline personality disorder using ecological momentary assessment.

In: Journal of personality disorders, S. 1–12. DOI: 10.1521/pedi_2017_31_278.

Borderline personality disorder (BPD) is a highly comorbid disorder, and these comorbidities increase the impairment associated with BPD. For example, depression, which occurs in the majority of individuals with BPD, increases the likelihood of an individual with BPD to engage in nonsuicidal self-injury (NSSI). Little research, however, has investigated potential mechanisms of NSSI engagement in this population. The current study aimed to fill this gap by examining momentary experiences, levels of distress tolerance, and NSSI among 51 individuals meeting current diagnostic criteria for BPD and a comorbid depressive disorder. Using data from an ecological momentary assessment across 7 days, it was found that daily urges to hurt oneself and impulsive urges, but not daily negative affect or aggressive urges, predicted NSSI occurrence. Furthermore, low levels of distress tolerance was a stronger predictor of NSSI behavior than daily experiences. These findings have important implications with regard to state versus trait dispositions in NSSI engagement among those with BPD and depression.


Andrewes, Holly E.; Hulbert, Carol; Cotton, Susan M.; Betts, Jennifer; Chanen, Andrew M. (2017): An ecological momentary assessment investigation of complex and conflicting emotions in youth with borderline personality disorder.

In: Psychiatry research 252, S. 102–110. DOI: 10.1016/j.psychres.2017.01.100.

Non-suicidal self-injury (NSSI) is a prevalent behaviour among people with borderline personality disorder (BPD) but many aspects of the emotional changes that trigger and maintain this behaviour are unknown. This study examines the relationships between NSSI and the number of negative (‘negative complex’) and opposing valence (‘conflicting’) emotions. One hundred and seven youth (aged 15-25 years) with first-presentation BPD were assessed using a combination of self-report and ecological momentary assessment to investigate trait levels of emotional acceptance and in vivo changes in the number of negative complex and conflicting emotions before and after self-injurious thoughts and behaviours. Multilevel modelling revealed that changes in the number of negative complex emotions mirrored distress levels before and after self-injurious thoughts and behaviours, approximating a quadratic curve. Increases in the number of negative complex emotions reported prior to self-injurious thoughts and behaviours were associated with lower acceptance of negative emotions. These findings indicate that the number of negative emotions experienced contributes to distress prior to engagement in NSSI. The relationship between non-acceptance of negative emotions and negative complex emotions prior to NSSI suggests that improved emotional awareness and acceptance should be a focus for early interventions aimed at reducing self-injury.


Anttila, Katriina I.; Anttila, Minna J.; Kurki, Marjo H.; Valimaki, Maritta A. (2017): Social relationships among adolescents as described in an electronic diary. A mixed methods study.

In: Patient preference and adherence 11, S. 343–352. DOI: 10.2147/PPA.S126327.

Social relationships among adolescents with mental disorders are demanding. Adolescents with depressive symptoms may have few relationships and have difficulties sharing their problems. Internet may offer reliable and easy to use tool to collect real-time information from adolescents. The aim of this study is to explore how adolescents describe their social relationships with an electronic diary. Mixed methods were used to obtain a broad picture of adolescents’ social relationships with the data gathered from network maps and reflective texts written in an electronic diary. Adolescents who visited an outpatient clinic and used an intervention (N=70) designed for adolescents with signs of depression were invited to use the electronic diary; 29 did so. The quantitative data gathered in the electronic diary were summarized with descriptive statistics, and the qualitative data were categorized using a thematic analysis with an inductive approach. We found that social relationships among adolescents with signs of depression can vary greatly in regards to the number of existing relationships (from lacking to 21) and the quality of the relationships (from trustful to difficult). However, the relationships may change, and the adolescents are also willing to build up their social relationships. Professionals need to be aware of the diversity of adolescents’ social relationships and their need for personalized support.


Balasundaram, Arun Prasad; Athens, Josie; Schneiders, Anthony Gerard; McCrory, Paul; Sullivan, Stephen John (2017): Psychological and lifestyle factors that influence the serial reporting of postconcussion-like symptoms in a non-concussed population.

In: PM & R : the journal of injury, function, and rehabilitation. DOI: 10.1016/j.pmrj.2017.01.004.

BACKGROUND: Symptoms related to concussion are generally found to be nonspecific in nature, as they are also reported by non-concussed individuals. What is currently not known is whether the symptoms vary over time, and whether they are also influenced by a multitude of factors. OBJECTIVE: The aim of this study was to investigate the potential influence of psychological, lifestyle, and situational factors on the change in postconcussion-like symptoms reported over 7 consecutive days in a cohort of normal individuals. DESIGN: This was a longitudinal observational study. SETTING: The setting was a real-world context. PARTICIPANTS: A convenience sample of 180 non-concussed university students were enrolled. Of these, 110 participants provided data for the entire period of the study. METHODS: An experience-sampling methodology was used to document the symptoms reported over time. Stepwise multivariate linear mixed-effects modeling was performed to identify the predictors contributing to the serially reported symptoms. INDEPENDENT VARIABLES: Independent variables considered were gender, time of the day, location, primary activity, and type of interactant (person) of the participant, physical activity status, trouble sleeping, alcohol consumption, caffeine consumption, stress, anxiety, depression, mental and physical fatigue, and life stressors. MAIN OUTCOME MEASURES: The key outcome measures were the change in total symptom score (TSSchange) and symptom severity score (SSSchange) reported over 7 consecutive days. RESULTS: The predictors of location at the time of reporting, physical fatigue (estimate: -0.98, P < . 001) and mental fatigue (estimate: -0.53, P < . 001) contributed to the TSSchange. Post hoc analysis of the variable of location at the time of reporting revealed that participants reported increased TSSchange when they were at a cafe/restaurant compared to a flat/college or university. CONCLUSIONS: A number of factors within the context of daily life influenced the postconcussion-like symptoms reported over time. These findings indicate that clinicians need to be cautious when interpreting the serially assessed symptom scores to track the recovery profile of a concussed athlete to make decisions on return-to-play. Additional investigation is warranted to examine the change in symptom scores reported over time by concussed individuals, considering that this study was conducted in a nonconcussed cohort. LEVEL OF EVIDENCE: To be determined.


Band, Rebecca; Barrowclough, Christine; Caldwell, Kim; Emsley, Richard; Wearden, Alison (2017): Activity patterns in response to symptoms in patients being treated for chronic fatigue syndrome. An experience sampling methodology study.

In: Health psychology : official journal of the Division of Health Psychology, American Psychological Association 36 (3), S. 264–269. DOI: 10.1037/hea0000422.

Objective: Cognitive–behavioral models of chronic fatigue syndrome (CFS) propose that patients respond to symptoms with 2 predominant activity patterns—activity limitation and all-or-nothing behaviors—both of which may contribute to illness persistence. The current study investigated whether activity patterns occurred at the same time as, or followed on from, patient symptom experience and affect. Method: Twenty-three adults with CFS were recruited from U.K. CFS services. Experience sampling methodology (ESM) was used to assess fluctuations in patient symptom experience, affect, and activity management patterns over 10 assessments per day for a total of 6 days. Assessments were conducted within patients’ daily life and were delivered through an app on touchscreen Android mobile phones. Multilevel model analyses were conducted to examine the role of self-reported patient fatigue, pain, and affect as predictors of change in activity patterns at the same and subsequent assessment. Results: Current experience of fatigue-related symptoms and pain predicted higher patient activity limitation at the current and subsequent assessments whereas subjective wellness predicted higher all-or-nothing behavior at both times. Current pain predicted less all-or-nothing behavior at the subsequent assessment. In contrast to hypotheses, current positive affect was predictive of current activity limitation whereas current negative affect was predictive of current all-or-nothing behavior. Both activity patterns varied at the momentary level. Conclusions: Patient symptom experiences appear to be driving patient activity management patterns in line with the cognitive–behavioral model of CFS. ESM offers a useful method for examining multiple interacting variables within the context of patients’ daily life. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Barrigon, Maria Luisa; Berrouiguet, Sofian; Carballo, Juan Jose; Bonal-Gimenez, Covadonga; Fernandez-Navarro, Pablo; Pfang, Bernadette et al. (2017): User profiles of an electronic mental health tool for ecological momentary assessment. MEmind.

In: International journal of methods in psychiatric research 26 (1). DOI: 10.1002/mpr.1554.

Ecological momentary assessment (EMA) is gaining importance in psychiatry. This article assesses the characteristics of patients who used a new electronic EMA tool: the MEmind Wellness Tracker. Over one year, 13811 adult outpatients in our Psychiatry Department were asked to use MEmind. We collected information about socio-demographic data, psychiatric diagnoses, illness severity, stressful life events and suicidal thoughts/behavior. We compared active users (N = 2838) and non-active users (N = 10,973) of MEmind and performed a Random Forest analysis to assess which variables could predict its use. Univariate analyses revealed that MEmind-users were younger (42.2 +/- 13.5 years versus 48.5 +/- 16.3 years; chi2 = 18.85; P < 0.001) and more frequently diagnosed with anxiety related disorders (57.9% versus 46.7%; chi2 = 105.92; P = 0.000) than non-active users. They were more likely to report thoughts about death and suicide (up to 24% of active users expressed wish for death) and had experienced more stressful life events than non-active users (57% versus 48.5%; chi2 = 64.65; P < 0.001). In the Random Forest analysis, 31 variables showed mean decrease accuracy values higher than zero with a 95% confidence interval (CI), including sex, age, suicidal thoughts, life threatening events and several diagnoses. In the light of these results, strategies to improve EMA and e-Mental Health adherence are discussed.


Begh, Rachna; Smith, Margaret; Ferguson, Stuart G.; Shiffman, Saul; Munafo, Marcus R.; Aveyard, Paul (2016): Association between smoking-related attentional bias and craving measured in the clinic and in the natural environment.

In: Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors 30 (8), S. 868–875. DOI: 10.1037/adb0000231.

Previous laboratory studies have investigated associations between attentional bias and craving, but ecological momentary assessment (EMA) may provide ecologically-valid data. This study examines whether clinic-measured attentional bias is associated with noticing smoking cues, attention to smoking, and craving assessed by EMA and whether EMA-assessed cues and attention to smoking are associated with craving in a secondary analysis of data from 100 cigarette smokers attempting cessation. Two weeks before quitting, participants completed attentional bias assessments on visual probe (VP) and Stroop tasks and completed random EMA-assessments for seven weeks thereafter. Participants completed 9,271 random assessments, averaging 3.3 prompts/day. Clinic-measured attentional bias was not associated with cues seen (VP: OR = 1.00, 95% CI = [0.99, 1.01]; Stroop: OR = 1.00, 95% CI [0.99, 1.00]), attention toward smoking (VP: OR = 1.00, 95% CI [0.99, 1.02]; Stroop: OR = 1.00, 95% CI [0.99, 1.00]), or craving (VP: OR = 1.00, 95% CI [0.99, 1.02]; Stroop: OR = 1.00, 95% CI [0.99, 1.01]). EMA responses to seeing a smoking cue (OR = 1.94, 95% CI [1.74, 2.16]) and attention toward smoking (OR = 3.69, 95% CI [3.42, 3.98]) were associated with craving. Internal reliability was higher for the Stroop (alpha = .75) than visual probe task (alpha = .20). In smokers attempting cessation, clinic measures of attentional bias do not predict noticing smoking cues, focus on smoking, or craving. However, associations exist between noticing smoking cues, attention toward smoking, and craving assessed in the moment, suggesting that attentional bias may not be a stable trait. (PsycINFO Database Record


Belak, Lauren; Gianini, Loren; Klein, Diane A.; Sazonov, Edward; Keegan, Kathryn; Neustadt, Esther et al. (2017): Measurement of fidgeting in patients with anorexia nervosa using a novel shoe-based monitor.

In: Eating behaviors 24, S. 45–48. DOI: 10.1016/j.eatbeh.2016.11.005.

Objective: To objectively assess seated non-exercise physical activity in patients with anorexia nervosa (AN) relative to healthy controls (HCs) and examine the associations between this physical activity, eating disorder pathology, and levels of anxiety and depression. Method: Eleven inpatients with AN and 10 HCs wore a shoe-based accelerometer (SmartShoe) at three time points: a) while eating lunch, b) filling out questionnaires, and c) watching television for 1h. Results: Across all three tasks, patients with AN were significantly more active than HCs, thereby engaging in a greater degree of restless or fidgeting behavior. Degree of physical activity was positively correlated with eating disorder psychopathology in the sample with AN, and a trend towards a positive association between physical activity and levels of depression and anxiety was also found in this sample. Among individuals with AN, physical activity was not significantly correlated with BMI, duration of illness, or number of days since hospital admission. Discussion: Use of a minimally invasive, shoe-based monitor revealed patients with AN engaged in a greater degree of fidgeting relative to HCs during quiet, seated tasks and this heightened activity was related to measures of pathology. Non-exercise physical activity, including fidgeting, may warrant further clinical attention in this patient population. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Bellone, Giannina J.; Plano, Santiago A.; Cardinali, Daniel P.; Chada, Daniel Perez; Vigo, Daniel E.; Golombek, Diego A. (2016): Comparative analysis of actigraphy performance in healthy young subjects.

In: Sleep Science (Sao Paulo, Brazil) 9 (4), S. 272–279. DOI: 10.1016/j.slsci.2016.05.004.

Sleep-related health disorders are increasing worldwide; diagnosis and treatment of such sleep diseases are commonly invasive and sometimes unpractical or expensive. Actigraphy has been recently introduced as a tool for the study of sleep and circadian disorders; however, there are several devices that claim to be useful for research and have not been thoroughly tested. This comparative study provides activity, sleep and temperature information regarding several of the most commonly used actigraphers: Micro-Mini Motion Logger; Act Trust; Misfit Flash; Fitbit Flex & Thermochron. Twenty-two healthy young subjects were assessed with five different commercial actigraphs (Micro-Mini Motionlogger Watch, Condor Act Trust, MisFit Flash and Fitbit Flex) and a temperature recorder (Thermochron), and also completed a sleep diary for a week. There were not significant differences in the analysis of rest-activity pattern between devices. Temperature rhythm comparison between the Act Trust and the Thermochron showed significant differences in rhythm percentage (p<0.05) and mesor (p<0.0563) but not in amplitude or acrophase. Although data accessibility and ease of use was very different for the diverse devices, there were no significant differences for sleep onset, total sleep time and sleep efficiency recordings, where applicable. In conclusion, depending on the type of study and analysis desired (as well as cost and compliance of use), we propose some relative advantages for the different actigraphy/temperature recording devices.


Björling, Elin A.; Singh, Narayan (2017): Exploring temporal patterns of stress in adolescent girls with headache.

In: Stress Health 33 (1), S. 69–79. DOI: 10.1002/smi.2675.

As part of a larger study on perceived stress and headaches in 2009, momentary perceived stress, head pain levels and stress‐related symptom data were collected. This paper explores a temporal analysis of the patterns of stress, as well as an analysis of momentary and retrospective stress‐related symptoms compared by level of headache activity. Adolescent girls (N = 31) ages 14–18 were randomly cued by electronic diaries 7 times per day over a 21‐day period responding to momentary questions about level of head pain, perceived stress and stress‐related symptoms. Multivariate general linear modelling was used to determine significant differences among headache groups in relation to temporal patterns of stress. Significant headache group differences were found on retrospective and momentary stress‐related symptom measures. A total of 2841 diary responses captured stress levels, head pain and related symptoms. The chronic headache (CH) group reported the highest levels of hourly and daily stress, followed by the moderate headache (MH) and low headache (LH) groups. Patterns of stress for the three headache groups were statistically distinct, illustrating increased stress in girls with more frequent head pain. This evidence suggests that because of increased stress, girls with recurrent head pain are likely a vulnerable population who may benefit from stress‐reducing interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Bold, Krysten Williams (2017): Independent and interactive effects of real-time risk factors on later temptations and lapses among smokers trying to quit.

In: Dissertation Abstracts International: Section B: The Sciences and Engineering 77 (7-B(E)).

Research on the proximal influences on smoking relapse has focused primarily on the independent effects of risk factors, yet relapse may also be governed by complex, interactive processes. The current study sought to expand our understanding of relapse mechanisms by identifying the independent and interactive effects of real-time risk factors on temptations and the ability to resist temptations in smokers during a quit attempt. This study was a secondary analysis of ecological momentary assessment data collected from 109 treatment-seeking smokers 4 times a day for 21 days following a quit attempt. All smokers received nicotine replacement therapy and smoking cessation counseling. Multinomial hierarchical linear models were used to evaluate ways momentary impulsiveness, affect, urge, cigarette exposure, alcohol use and their interactions predicted temptations and smoking up to 8 hours later. Level-one data comprised report-level predictors and outcomes nested within individuals at level-two. Results suggested temptations were predicted by higher momentary agitation, distress, and urge; and lower positive affect. The inability to resist temptations was predicted by prior smoking, higher distress, and recent alcohol use. There were significant interactions between level-one predictors that influenced the risk of temptations (positive affect x impulsiveness, urge x agitation, agitation x cigarette exposure, urge x cigarette exposure) and the odds of resisting a temptation (alcohol x impulsiveness). These results suggest studies of complex relationships between proximal risk factors may provide new information about relapse processes and inform smoking cessation interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Bouwmans, Mara E. J.; Bos, Elisabeth H.; Hoenders, H. J. Rogier; Oldehinkel, Albertine J.; Jonge, Peter de (2017): Sleep quality predicts positive and negative affect but not vice versa. An electronic diary study in depressed and healthy individuals.

In: Journal of affective disorders 207, S. 260–267. DOI: 10.1016/j.jad.2016.09.046.

Background: The exact nature of the complex relationship between sleep and affect has remained unclear. This study investigated the temporal order of change in sleep and affect in participants with and without depression. Methods: 27 depressed patients and 27 pair-matched healthy controls assessed their sleep in the morning and their affect 3 times a day for 30 consecutive days in their natural environment. Daily sleep quality and average positive affect (PA) and negative affect (NA) were used to examine whether changes in sleep quality preceded or followed changes in PA and NA, and whether this was different for patients and healthy controls. Second, presumptive mediating factors were investigated. We hypothesized that fatigue mediated the effect of changes in sleep quality on subsequent PA/NA, and that rumination mediated the effect of changes in PA/NA on subsequent sleep quality. Results: Multilevel models showed that changes in sleep quality predicted changes in PA (B = 0.08, p < 0.001) and NA (B = −0.06, p < 0.001), but not the other way around (PA: B = 0.03, p = 0.70, NA: B=−0.05, p = 0.60). Fatigue was found to be a significant mediator of the relationship between sleep quality and PA (Indirect Effect = 0.03, p < 0.001), and between sleep quality and NA (Indirect Effect = −0.02, p = 0.01). Rumination was not investigated because of non-significant associations between PA/NA and sleep quality. The associations were not different for patients and controls. Limitations: The analyses were restricted to self-reported sleep quality, and conclusions about causality could not be drawn. Conclusions: Improvements in sleep quality predicted improvements in affect the following day, partly mediated by fatigue. Treatment of sleep symptoms would benefit affect in clinical care and beyond. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Brandrup, Morten; Ostergaard, Kija Lin; Hertzum, Morten; Karasti, Helena; Simonsen, Jesper (2017): Effects-driven participatory design. Learning from Sampling Interruptions.

In: Studies in health technology and informatics 233, S. 113–127.

Participatory design (PD) can play an important role in obtaining benefits from healthcare information technologies, but we contend that to fulfil this role PD must incorporate feedback from real use of the technologies. In this paper we describe an effects-driven PD approach that revolves around a sustained focus on pursued effects and uses the experience sampling method (ESM) to collect real-use feedback. To illustrate the use of the method we analyze a case that involves the organizational implementation of electronic whiteboards at a Danish hospital to support the clinicians’ intra- and interdepartmental coordination. The hospital aimed to reduce the number of phone calls involved in coordinating work because many phone calls were seen as unnecessary interruptions. To learn about the interruptions we introduced an app for capturing quantitative data and qualitative feedback about the phone calls. The investigation showed that the electronic whiteboards had little potential for reducing the number of phone calls at the operating ward. The combination of quantitative data and qualitative feedback worked both as a basis for aligning assumptions to data and showed ESM as an instrument for triggering in-situ reflection. The participant-driven design and redesign of the way data were captured by means of ESM is a central contribution to the understanding of how to conduct effects-driven PD.


Britto, Maria T.; Rohan, Jennifer M.; Dodds, Cassandra M.; Byczkowski, Terri L. (2017): A randomized trial of user-controlled text messaging to improve asthma outcomes.

In: Clinical pediatrics, 9922816684857. DOI: 10.1177/0009922816684857.

We enrolled 64 patients age 12 to 22 years with a diagnosis of poorly controlled persistent asthma in a 6-month longitudinal crossover study. During the 3 intervention months, participants created personalized text messages to be sent to their phones. Adherence was objectively monitored in 22 of the participants. The adolescent participants gave high ratings on the acceptability of the text messaging system. Asthma control improved from baseline to month 1 regardless of whether teens were in the texting or control group. While participants were in the texting group, their quality of life improved and worry about their asthma decreased. Receiving the text intervention resulted in an increase in adherence of 2.75% each month relative to no intervention, but the improvements were not sustained. There was modest improvement in asthma control and quality of life outcomes, as well as improved adherence during the texting intervention.


Brose, Annette; Wichers, Marieke; Kuppens, Peter (2017): Daily stressful experiences precede but do not succeed depressive symptoms. Results from a longitudinal experience sampling study.

In: J Soc Clin Psychol 36 (3), S. 196–220. DOI: 10.1521/jscp.2017.36.3.196.

This study investigates the proposition that micro-level experiences in the realm of stress (e.g., daily stress exposure) are among the building blocks of maladjustment, in particular, depression. Data were collected with experience sampling methods and in the lab. A sample of 202 students who had just entered university participated in a three-wave longitudinal study (October 2012–October 2013). Each wave consisted of the assessment of depressive symptoms and the examination of stressful experiences in daily life by means of experience sampling (70 occasions per wave). Cross-lagged panel models revealed that the perceived intensity of daily stressors, stressed and depressed feelings in daily life, as well as depressed reactions to daily stressors predict an increase in future depressive symptoms in young females but not males. Other cross-lagged effects, particularly from depressive symptoms to stressful experiences in daily life, were not significant. Findings are in line with the stress exposure model according to which stress can cause increases in depressive symptoms. Importantly, this study focused on stressful experiences in daily life. Micro-level experiences thus seem to be among the etiological factors of depression. We discuss consequences of these findings and possibilities to alleviate the burden of depression in individuals and society. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Burg, Matthew M.; Schwartz, Joseph E.; Kronish, Ian M.; Diaz, Keith M.; Alcantara, Carmela; Duer-Hefele, Joan; Davidson, Karina W. (2017): Does stress result in you exercising less? Or does exercising result in you being less sdtressed? Or ss it both? testing the bi-directional stress-exercise association at the group and person (N of 1) level.

In: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine. DOI: 10.1007/s12160-017-9902-4.

BACKGROUND: Psychosocial stress contributes to heart disease in part by adversely affecting maintenance of health behaviors, while exercise can reduce stress. Assessing the bi-directional relationship between stress and exercise has been limited by lack of real-time data and theoretical and statistical models. This lack may hinder efforts to promote exercise maintenance. PURPOSE: We test the bi-directional relationship between stress and exercise using real-time data for the average person and the variability-individual differences-in this relationship. METHODS: An observational study was conducted within a single cohort randomized controlled experiment. Healthy young adults, (n = 79) who reported only intermittent exercise, completed 12 months of stress monitoring by ecological momentary assessment (at the beginning of, end of, and during the day) and continuous activity monitoring by Fitbit. A random coefficients linear mixed model was used to predict end-of-day stress from the occurrence/non-occurrence of exercise that day; a logistic mixed model was used to predict the occurrence/non-occurrence of exercise from ratings of anticipated stress. Separate regression analyses were also performed for each participant. Sensitivity analysis tested all models, restricted to the first 180 days of observation (prior to randomization). RESULTS: We found a significant average inverse (i.e., negative) effect of exercise on stress and of stress on exercise. There was significant between-person variability. Of N = 69, exercise was associated with a stress reduction for 15, a stress increase for 2, and no change for the remainder. We also found that an increase in anticipated stress reported the previous night or that morning was associated with a significant 20-22% decrease (OR = 0.78-0.80) in the odds of exercising that day. Of N = 69, this increase in stress reduced the likelihood of exercise for 17, increased the odds for 1, and had no effect for the remainder. We were unable to identify psychosocial factors that moderate the individual differences in these effects. CONCLUSIONS: The relationship of stress to exercise can be uni- or bi-directional and varies from person to person. A precision medicine approach may improve exercise uptake.


Burke, Lora E.; Shiffman, Saul; Music, Edvin; Styn, Mindi A.; Kriska, Andrea; Smailagic, Asim et al. (2017): Ecological momentary assessment in behavioral research. Addressing Technological and Human Participant Challenges.

In: Journal of medical Internet research 19 (3), e77. DOI: 10.2196/jmir.7138.

BACKGROUND: Ecological momentary assessment (EMA) assesses individuals’ current experiences, behaviors, and moods as they occur in real time and in their natural environment. EMA studies, particularly those of longer duration, are complex and require an infrastructure to support the data flow and monitoring of EMA completion. OBJECTIVE: Our objective is to provide a practical guide to developing and implementing an EMA study, with a focus on the methods and logistics of conducting such a study. METHODS: The EMPOWER study was a 12-month study that used EMA to examine the triggers of lapses and relapse following intentional weight loss. We report on several studies that informed the implementation of the EMPOWER study: (1) a series of pilot studies, (2) the EMPOWER study’s infrastructure, (3) training of study participants in use of smartphones and the EMA protocol and, (4) strategies used to enhance adherence to completing EMA surveys. RESULTS: The study enrolled 151 adults and had 87.4% (132/151) retention rate at 12 months. Our learning experiences in the development of the infrastructure to support EMA assessments for the 12-month study spanned several topic areas. Included were the optimal frequency of EMA prompts to maximize data collection without overburdening participants; the timing and scheduling of EMA prompts; technological lessons to support a longitudinal study, such as proper communication between the Android smartphone, the Web server, and the database server; and use of a phone that provided access to the system’s functionality for EMA data collection to avoid loss of data and minimize the impact of loss of network connectivity. These were especially important in a 1-year study with participants who might travel. It also protected the data collection from any server-side failure. Regular monitoring of participants’ response to EMA prompts was critical, so we built in incentives to enhance completion of EMA surveys. During the first 6 months of the 12-month study interval, adherence to completing EMA surveys was high, with 88.3% (66,978/75,888) completion of random assessments and around 90% (23,411/25,929 and 23,343/26,010) completion of time-contingent assessments, despite the duration of EMA data collection and challenges with implementation. CONCLUSIONS: This work informed us of the necessary preliminary steps to plan and prepare a longitudinal study using smartphone technology and the critical elements to ensure participant engagement in the potentially burdensome protocol, which spanned 12 months. While this was a technology-supported and -programmed study, it required close oversight to ensure all elements were functioning correctly, particularly once human participants became involved.


Byrnes, Hilary F.; Miller, Brenda A.; Morrison, Christopher N.; Wiebe, Douglas J.; Woychik, Marcie; Wiehe, Sarah E. (2017): Association of environmental indicators with teen alcohol use and problem behavior. Teens’ observations vs. objectively-measured indicators.

In: Health & place 43, S. 151–157. DOI: 10.1016/j.healthplace.2016.12.004.

Most prior studies use objectively measured data (e.g., census-based indicators) to assess contextual risks. However, teens’ observations might be more important for their risk behavior. OBJECTIVES: 1) determine relationships between observed and objective indicators of contextual risks 2) determine relations of observed and objective indicators with teen alcohol use and problem behavior. Teens aged 14-16 (N=170) carried GPS-enabled smartphones for one month, with locations documented. Ecological momentary assessment (EMA) measured teens’ observations via texts regarding risk behaviors and environmental observations. Objective indicators of alcohol outlets and disorganization were spatially joined to EMAs based on teens’ location at the time of the texts. Observed and objective disorganization, and objective indicators of alcohol outlets were related to alcohol use. Observed disorganization was related to problem behavior, while objective indicators were unrelated. Findings suggest the importance of considering teens’ observations of contextual risk for understanding influences on risk behavior and suggest future directions for research and prevention strategies.


Cabrita, Miriam; Lousberg, Richel; Tabak, Monique; Hermens, Hermie J.; Vollenbroek-Hutten, Miriam M. R. (2017): An exploratory study on the impact of daily activities on the pleasure and physical activity of older adults.

In: European review of aging and physical activity : official journal of the European Group for Research into Elderly and Physical Activity 14, S. 1. DOI: 10.1186/s11556-016-0170-2.

BACKGROUND: Pleasure is one determinant of intrinsic motivation and yet a dimension often forgotten when promoting physical activity among the older population. In this study we investigate the relation between daily activities and physical activity, experience of pleasure, and the interaction between pleasure and physical activity in the daily lives of community-dwelling older adults. METHODS: Participants carried a hip-worn accelerometer during 30 consecutive days resulting in a total of 320 days of data collection. Current activity, location, companion and experience of pleasure during each activity were assessed through experience sampling on a smartphone every 1-2 h. Between- and within-individual differences were analysed with multi-level models and 10xN = 1 regression analysis. RESULTS: Outdoor activities were associated with higher physical activity than indoor activities (p < 0.001). Performing leisure activities, outdoors and not alone significantly predicted pleasure in daily life (all p’s < 0.05). Being more active while performing leisure activities resulted in higher experiences of pleasure (p < 0.001). However, when performing basic activities of daily living (e.g. commuting or households) this relation was inverted. Results provide meaningful indication for individual variance. The 30 days of data collected from each participant allow for identification of individual differences. CONCLUSIONS: Daily activities and their contexts do influence the experience of pleasure and physical activity of older adults in daily life of older adults, although similar research with larger population is recommended. Results are in accordance with the literature, indicating that the method adopted (accelerometry combined with experience sampling) provides reliable representation of daily life. Identification of individual differences can eventually be automatically performed through data mining techniques. Further research could look at innovative approaches to promote Active Ageing using mobile technology in the daily life, by promoting physical activity through recommendation of pleasurable activities, and thus likely to increase the intrinsic motivation to become physically active.


Cerin, Ester; Mitáš, Josef; Cain, Kelli L.; Conway, Terry L.; Adams, Marc A.; Schofield, Grant et al. (2017): Do associations between objectively-assessed physical activity and neighbourhood environment attributes vary by time of the day and day of the week? IPEN adult study.

In: Int J Behav Nutr Phys Act 14. DOI: 10.1186/s12966-017-0493-z.

Background: To more accurately quantify the potential impact of the neighbourhood environment on adults’ physical activity (PA), it is important to compare environment-PA associations between periods of the day or week when adults are more versus less likely to be in their neighbourhood and utilise its PA resources. We examined whether, among adults from 10 countries, associations between objectively-assessed neighbourhood environment attributes and moderate-to-vigorous physical activity (MVPA) varied by time of the day and day of the week. The secondary aim was to examine whether such associations varied by employment status, gender and city. Methods: This cross-sectional study included 6,712 adults from 14 cities across 10 countries with ≥1 day of valid accelerometer-assessed MVPA and complete information on socio-demographic and objectively-assessed environmental characteristics within 0.5 and 1 km street-network buffers around the home. Accelerometer measures (MVPA min/h) were created for six time periods from early morning until late evening/night, for weekdays and weekend days separately. Associations were estimated using generalized additive mixed models. Results: Time of the day, day of week, gender and employment status were significant moderators of environment-MVPA associations. Land use mix was positively associated with MVPA in women who were employed and in men irrespective of their employment status. The positive associations between MVPA and net residential density, intersection density and land use mix were stronger in the mornings of weekdays and the afternoon/evening periods of both weekdays and weekend days. Associations between number of parks and MVPA were stronger in the mornings and afternoon/evenings irrespective of day of the week. Public transport density showed consistent positive associations with MVPA during weekends, while stronger effects on weekdays were observed in the morning and early evenings. Conclusions: This study suggests that space and time constraints in adults’ daily activities are important factors that determine the impact of neighbourhood attributes on PA. Consideration of time-specific associations is important to better characterise the magnitude of the effects of the neighbourhood environment on PA. Future research will need to examine the contribution of built environment characteristics of areas surrounding other types of daily life centres (e.g., workplaces) to explaining adults’ PA at specific times of the day. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Cerrada, Christian Jules; Dzubur, Eldin; Blackman, Kacie C. A.; Mays, Vickie; Shoptaw, Steven; Huh, Jimi (2017): Development of a just-in-time adaptive intervention for smoking cessation among korean american emerging adults.

In: International journal of behavioral medicine. DOI: 10.1007/s12529-016-9628-x.

Purpose: Cigarette smoking is a preventable risk factor that contributes to unnecessary lung cancer burden among Korean Americans and there is limited research on effective smoking cessation strategies for this population. Smartphone-based smoking cessation apps that leverage just-in-time adaptive interventions (JITAIs) hold promise for smokers attempting to quit. However, little is known about how to develop and tailor a smoking cessation JITAI for Korean American emerging adult (KAEA) smokers.Method: This paper documents the development process of MyQuit USC according to design guidelines for JITAI. Our development process builds on findings from a prior ecological momentary assessment study by using qualitative research methods. Semi-structured interviews and a focus group were conducted to inform which intervention options to offer and the decision rules that dictate their delivery.Results: Qualitative findings highlighted that (1) smoking episodes are highly context-driven and that (2) KAEA smokers believe they need personalized cessation strategies tailored to different contexts. Thus, MyQuit USC operates via decision rules that guide the delivery of personalized implementation intentions, which are contingent on dynamic factors, to be delivered ‘just in time’ at user-scheduled, high-risk smoking situations.Conclusion: Through an iterative design process, informed by quantitative and qualitative formative research, we developed a smoking cessation JITAI tailored specifically for KAEA smokers. Further testing is under way to optimize future versions of the app with the most effective intervention strategies and decision rules. MyQuit USC has the potential to provide cessation support in real-world settings, when KAEAs need them the most. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Chen, Yu-Wei; Bundy, Anita C.; Cordier, Reinie; Chien, Yi-Ling; Einfeld, Stewart L. (2017): A cross-cultural exploration of the everyday social participation of individuals with autism spectrum disorders in Australia and Taiwan. An experience sampling study.

In: Autism 21 (2), S. 231–241. DOI: 10.1177/1362361316636756.

Individuals with an autism spectrum disorder commonly have limited social participation. This study aimed to examine the similarities and differences of everyday participation among males and females with autism spectrum disorder in Australia and Taiwan, using an experience sampling methodology. A total of 14 Australians (4 males, aged 16–43 years) and 16 Taiwanese (12 males, aged 19–45 years) with autism spectrum disorder who are cognitively able were asked to carry a device which prompted them seven times per day for 7 days, to record everyday participation: where they were, what they were doing, and who they were with. Multilevel analyses were used to identify the relationships between everyday participation and associated factors including gender, country of residence, clinical severity of autism spectrum disorder, and social anxiety. The results showed that Taiwanese participants were more likely to stay at home than Australian participants. However, female participants were more likely to engage in social situations than males. Furthermore, participants with fewer autism spectrum disorder symptoms and those with higher levels of social anxiety were less likely to engage in social interactions. This study sheds light on ways that culture and gender affect social participation and highlights the relationship of social anxiety to social participation. The findings have implications for interventions for social participation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Chevalier, A.; Coxon, K.; Chevalier, A. J.; Clarke, E.; Rogers, K.; Brown, J. et al. (2017): Predictors of older drivers’ involvement in rapid deceleration events.

In: Accid Anal Prev 98, S. 312–319. DOI: 10.1016/j.aap.2016.10.010.

Rapid deceleration occurs when substantial force slows the speed of a vehicle. Rapid deceleration events (RDEs) have been proposed as a surrogate safety measure. As there is concern about crash involvement of older drivers and the effect of age-related declining visual and cognitive function on driving performance, we examined the relationship between RDEs and older driver’s vision, cognitive function and driving confidence, using naturalistic driving measures. Participants aged 75 to 94 years had their vehicle instrumented for 12 months. To minimise the chance of identifying false positives, accelerometer data was processed to identify RDEs with a substantial deceleration of >750 milli-g (7.35 m/s²). We examined the incidence of RDEs amongst older drivers, and how this behaviour is affected by differences in age; sex; visual function, cognitive function; driving confidence; and declines over the 12 months. Almost twothirds (64%) of participants were involved in at least one RDE, and 22% of these participants experienced a meaningful decline in contrast sensitivity during the 12 months. We conducted regression modelling to examine associations between RDEs and predictive measures adjusted for (i) duration of monitoring and (ii) distance driven. We found the rate of RDEs per distance increased with age; although, this did not remain in the multivariate model. In the multivariate model, we found older drivers who experienced a decline in contrast sensitivity over the 12 months and those with lower baseline driving confidence were at increased risk of involvement in RDEs adjusted for distance driven. In other studies, contrast sensitivity has been associated with increased crash involvement for older drivers. These findings lend support for the use of RDEs as a surrogate safety measure, and demonstrate an association between a surrogate safety measure and a decline in contrast sensitivity of older drivers. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Chin, Alycia; Markey, Amanda; Bhargava, Saurabh; Kassam, Karim S.; Loewenstein, George (2017): Bored in the USA. Experience sampling and boredom in everyday life.

In: Emotion (Washington, D.C.) 17 (2), S. 359–368. DOI: 10.1037/emo0000232.

We report new evidence on the emotional, demographic, and situational correlates of boredom from a rich experience sample capturing 1.1 million emotional and time-use reports from 3,867 U.S. adults. Subjects report boredom in 2.8% of the 30-min sampling periods, and 63% of participants report experiencing boredom at least once across the 10-day sampling period. We find that boredom is more likely to co-occur with negative, rather than positive, emotions, and is particularly predictive of loneliness, anger, sadness, and worry. Boredom is more prevalent among men, youths, the unmarried, and those of lower income. We find that differences in how such demographic groups spend their time account for up to one third of the observed differences in overall boredom. The importance of situations in predicting boredom is additionally underscored by the high prevalence of boredom in specific situations involving monotonous or difficult tasks (e.g., working, studying) or contexts where one’s autonomy might be constrained (e.g., time with coworkers, afternoons, at school). Overall, our findings are consistent with cognitive accounts that cast boredom as emerging from situations in which engagement is difficult, and are less consistent with accounts that exclusively associate boredom with low arousal or with situations lacking in meaning. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Chue, Amanda E.; Gunthert, Kathleen C.; Ahrens, Anthony H.; Skalina, Lauren M. (2017): How does social anger expression predict later depression symptoms? It depends on how often one is angry.

In: Emotion (Washington, D.C.) 17 (1), S. 6–10. DOI: 10.1037/emo0000239.

Research has suggested that there are benefits to socially sharing anger as an emotion regulation strategy. We hypothesized that these benefits may depend on the frequency with which one is experiencing anger. We used an experience sampling methodology to explore the interaction between frequency of anger and reliance on social expression of anger as a predictor of changes in depression symptoms 4 months later. We found that a strong reliance on social expression prospectively predicted lower depression symptoms when participants endorsed anger infrequently but predicted an increase in subsequent depression symptoms when anger was endorsed frequently. This interaction was specific to anger and did not extend to sadness or anxiety. These results highlight the importance of considering the effectiveness of emotion regulation strategies in the context of specific emotions and the frequency of the experienced emotion in everyday life. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Chun, Charlotte A.; Barrantes-Vidal, Neus; Sheinbaum, Tamara; Kwapil, Thomas R. (2017): Expression of schizophrenia-spectrum personality traits in daily life.

In: Personality disorders 8 (1), S. 64–74. DOI: 10.1037/per0000141.

The present study examined the expression of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM–5) schizotypal, schizoid, and paranoid personality disorder (PD) traits in daily life using experience sampling methodology in 206 nonclinically ascertained Spanish young adults oversampled for risk for schizophrenia-spectrum psychopathology. This study examined the overlap and differentiation of pathological personality traits in daily life settings, according to both diagnostic and multidimensional models. Daily life outcomes differentiated among schizophrenia-spectrum disorders. The assignment of Cluster A personality traits to positive, negative, paranoid, and disorganized dimensions provided an alternative to the traditional PD diagnoses. Positive, disorganized, and paranoid schizotypy were associated with elevated stress reactivity, whereas negative schizotypy was associated with diminished reactivity in daily life. The current diagnostic model is limited by the considerable overlap among the PD traits. Nonetheless, experience sampling methodology is sensitive enough to detect differences in day-to-day impairment and can be a powerful research tool for the examination of dynamic constructs such as personality pathology. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Cioffi, I.; Farella, M.; Chiodini, P.; Ammendola, L.; Capuozzo, R.; Klain, C. et al. (2017): Effect of weather on temporal pain patterns in patients with temporomandibular disorders and migraine.

In: Journal of oral rehabilitation 44 (5), S. 333–339. DOI: 10.1111/joor.12498.

Patients with masticatory muscle pain and migraine typically report that the intensity of pain fluctuates over time and is affected by weather changes. Weather variables, such as ambient temperature and humidity, may vary significantly depending on whether the individual is outdoor or indoor. It is, therefore, important to assess these variables at the individual level using portable monitors, during everyday life. This study aimed to determine and compare the temporal patterns of pain in individuals affected with facial and head pain and to investigate its relation with weather changes. Eleven patients (27.3 +/- 7.4 years) with chronic masticatory muscle pain (MP) and twenty (33.1 +/- 8.7 years) with migraine headache (MH) were asked to report their current pain level on a visual analogue scale (VAS) every hour over fourteen consecutive days. The VAS scores were collected using portable data-loggers, which were also used to record temperature, atmospheric pressure and relative humidity. VAS scores varied markedly over time in both groups. Pain VAS scores fluctuate less in the MP group than in the MH group, but their mean, minimum and maximum values were higher than those of migraine patients (all P < 0.05). Pain scores <2 cm were more common in the MH than in the MP group (P < 0.001). Perceived intensity of pain was negatively associated with atmospheric pressure in the MP group and positively associated with temperature and atmospheric in the MH group. Our results reveal that patients with masticatory muscle pain and patients with migraine present typical temporal pain patterns that are influenced in a different way by weather changes.


Corpuz, Randy (2017): The enduring impact of a male’s early environment on his neuroendocrine and behavioral response to becoming a first-time father.

In: Dissertation Abstracts International: Section B: The Sciences and Engineering 77 (9-B(E)).

This dissertation research tested a model predicting that human fathers invest in offspring in patterns that vary as a function of information assayed from a father’s own early environment (e.g., cues indicating environmental harshness and/or unpredictability during a father’s early development). Human fathers exhibit plasticity with regard to the level of investment provided to offspring. The endocrine substrates that have evolved to support these facultative paternal responses to environmental conditions should also demonstrate similar (and closely aligned) variation from one ecological context to the next. The nature of the specific ecological cues that a father’s endocrine and behavioral systems rely on for developmental calibration has not been entirely elucidated. This study provided a test of the level of paternal investment in a newborn infant’s life, based on a father’s own early life experience with environmental harshness and instability and the degree to which a father’s neuroendocrine system (i.e., testosterone) responds to the birth of his child. Our research team conducted three home visits that were scheduled across a 9-10 month period: Time 1 was in the late third trimester of pregnancy, Time 2 was three months following the birth of the child, and Time 3 took place when the infant was 9-10 months old. We recruited 226 two-parent, first-birth families. Participants provided self-report measures of early life experiences: i.e., scales designed to measure early SES and exposure to trauma. At each visit, participants also provided two saliva samples (AM and PM) at each collection period to be assayed for testosterone. Lastly, we measured investment in two ways: (1) an Experience Sampling Method administered survey that measured the quantity of time fathers spent with their infants; (2) a measure of paternal quality of care—infants (9-10 months) old were exposed to novel stimuli intended to elicit a fear response. Videos of paternal behaviors were coded by independent raters (for quality of care, e.g., warmth, support). While we did see significant variation between fathers in the quantity of time they reported interacting with their infants, the level of trauma experienced in childhood or a father’s own childhood SES could not account for this variance. When measuring paternal investment quality however, early childhood experience influenced how fathers interacted with their infants during the stimuli exercise. Fathers who reported being raised in low SES environments and who experienced trauma in childhood displayed lower levels of quality care. Levels of testosterone (on average) decreased from Time 1 to Time 2. We detected significant individual variation between males in (1) their baseline level of testosterone prior to childbirth; (2) the slope of their testosterone response to childbirth; and (3) the slope of their testosterone’s ascent back to baseline levels. However, neither childhood SES nor trauma could account for this variability. We did detect (non-significant statistical trends) that the degree (i.e., slope) to which testosterone recovered from Time 2 to Time 3 was related to paternal investment of both time and investment quality. Fathers who had a higher slope of recovery demonstrated decreased levels of investment quality and quantity. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Crescenzo, Franco de; Economou, Alexis; Sharpley, Ann L.; Gormez, Aynur; Quested, Digby J. (2017): Actigraphic features of bipolar disorder. A systematic review and meta-analysis.

In: Sleep medicine reviews 33, S. 58–69. DOI: 10.1016/j.smrv.2016.05.003.

Sleep disruptions represent a core feature of bipolar disorders and have been widely studied through the use of actigraphy, which is an objective measure of motor activity and sleep. Finding objective outcomes, which reliably measure sleep in bipolar disorders, is essential in developing better therapies and improving follow-up monitoring strategies. Our aim is to understand the role of actigraphy as an objective measure of sleep in bipolar disorder. We undertook a systematic review and meta-analysis on studies using actigraphy to detect changes in activity and sleep patterns in bipolar patients versus healthy controls. The primary outcome measures were the analyses of ‘activity mean’ and ‘sleep duration’. As secondary outcomes we analysed ‘sleep onset latency’, ‘sleep efficiency’, and ‘time awake after sleep onset’. Thirteen studies comprising 821 subjects met quality criteria for inclusion. The results show a decrease in activity mean and an altered pattern of sleep in bipolar patients. Further analyses suggest that the results might be generalized to a bipolar condition which underlies manic and depressed episodes as well as euthymic phases. This study highlights the role of actigraphy as an important objective tool for the ambulatory monitoring of sleep and activity in bipolar disorders.


Cushing, Christopher C.; Marker, Arwen M.; Bejarano, Carolina M.; Crick, Christopher J.; Huffhines, Lindsay P. (2017): Latent variable mixture modeling of ecological momentary assessment data. Implications for screening and adolescent mood profiles.

In: J Child Fam Stud. DOI: 10.1007/s10826-017-0689-5.

Ecological momentary assessment (EMA) studies typically rely on arbitrary decision rules for identifying and excluding invalid responses from the data. In addition, most studies treat independent variables as separate from each other even if their combinations might have importance above the independent contribution of each. Our study aimed to conduct an exploratory latent profile analysis of EMA data to demonstrate an empirical method of identifying invalid responses, and to provide a preliminary investigation of mood profiles. We recruited 20 adolescents between the ages of 13–18 to complete 4 surveys about their internal states each day for 20 days. Participants provided responses on study smartphones using an Android app developed by the study team. Our profile analysis revealed 9 independent profiles. We determined that 3 of these profiles consisted of invalid responses because the integers provided by the participant were nearly invariant. The invalid responses comprised 24.9% of the sample. We also identified 6 valid profiles that were labeled: fatigued (8.7%), good mood/energetic (19.9%), angry/depressed (2.3%), good mood (37.1%), angry (5.7%), and depressed (1.4%). One important implication of the current study is that researchers and clinicians should screen electronic diary data, especially for invariant responding. In addition, it is important for clinicians to note that more than one internal state may drive the mood of an adolescent patient. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Dahling, Jason J. (2017): Exhausted, mistreated, or indifferent? Explaining deviance from emotional display rules at work.

In: European Journal of Work and Organizational Psychology 26 (2), S. 171–182. DOI: 10.1080/1359432X.2016.1229307.


This article explores different theoretical explanations for deviance from display rules (DDR), which occurs when employees consciously display emotions to customers that are unsanctioned by the organization. DDR is an important outcome in service organizations because it triggers strong negative reactions from customers, such as negative reputation and business losses. To better explain why DDR occurs, the author compared predictors drawn from organizational justice theory, conservation of resources theory and goal-setting theory in a comprehensive model to explore complementary and competing effects. The model was tested using hierarchical linear modelling with data from 1146 transactions performed by 51 service employees who participated in an experience sampling study over several weeks. Results demonstrated that emotional valence mediated the transaction-level relationship between customer interpersonal injustice and DDR. Similarly, negative emotions mediated the transaction-level relationship between mental exhaustion and DDR. However, person-level differences in goal commitment to organizational display rules had a buffering effect on the relationship between negative emotions and DDR. Overall, the results demonstrate that unfair treatment from customers and mental exhaustion can promote the expression of unsanctioned emotions to customers via negative emotional experiences, but employees who are committed to emotional labour goals are more resistant to engaging in DDR. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


D’Amico, Elizabeth J.; Martino, Steven C.; Collins, Rebecca L.; Shadel, William G.; Tolpadi, Anagha; Kovalchik, Stephanie; Becker, Kirsten M. (2017): Factors associated with younger adolescents’ exposure to online alcohol advertising.

In: Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors 31 (2), S. 212–219. DOI: 10.1037/adb0000224.

Little is known about the extent and nature of youth exposure to online alcohol advertising, or factors that may be associated with exposure. The current study recruited middle school students who completed a paper survey and then logged each alcohol advertisement that they encountered over a 2-week period using cell phones as part of an ecological momentary assessment design. We examined the percentage of youth who reported exposure to online alcohol advertising in the past 2 weeks, average weekly rate of exposure, types of online alcohol advertisements youth reported seeing, and factors that increased youths’ risk of exposure to online alcohol advertising. Analyses are based on 485 participants (47% female; 25% Hispanic, 25% White, 27% Black; 6% Asian, 16% other). Youth logged exposures to a total of 3,966 (16,018 weighted for underreporting) alcohol advertisements across the monitoring period; 154 (568 weighted) or 3.6% were online ads. Seventeen percent of youth reported seeing any online alcohol ad; the majority of online ads seen were video commercials (44.8%) and banner/side ads (26.6%). Factors associated with greater ad exposure were being older, rebellious, and Black race; greater parental monitoring and more hours spent on social media were associated with less exposure. Findings provide important information about adolescents’ exposure to online alcohol advertising and what might contribute to a greater likelihood of exposure. Given that online ad exposure is linked to drinking behavior, prevention programming for younger adolescents should continue to address this issue to help youth make healthy choices regarding alcohol use. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Davidson, Collin L.; Anestis, Michael D.; Gutierrez, Peter M. (2017): Ecological momentary assessment is a neglected methodology in suicidology.

In: Arch Suicide Res 21 (1), S. 1–11. DOI: 10.1080/13811118.2015.1004482.

Ecological momentary assessment (EMA) is a group of research methods that collect data frequently, in many contexts, and in real-world settings. EMA has been fairly neglected in suicidology. The current article provides an overview of EMA for suicidologists including definitions, data collection considerations, and different sampling strategies. Next, the benefits of EMA in suicidology (i.e., reduced recall bias, accurate tracking of fluctuating variables, testing assumptions of theories, use in interventions), participant safety considerations, and examples of published research that investigate self-directed violence variables using EMA are discussed. The article concludes with a summary and suggested directions for EMA research in suicidology with the particular aim to spur the increased use of this methodology among suicidologists. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Debrot, Anik; Meuwly, Nathalie; Muise, Amy; Impett, Emily A.; Schoebi, Dominik (2017): More than just sex. Affection mediates the association between sexual activity and well-being.

In: Pers Soc Psychol Bull 43 (3), S. 287–299. DOI: 10.1177/0146167216684124.

Positive interpersonal interactions such as affection are central to well-being. Sex is associated with greater individual wellbeing, but little is known about why this occurs. We predicted that experienced affection would account for the association between sex and well-being. Cross-sectional results indicated that affection mediated the association between sex and both life satisfaction (Study 1) and positive emotions (however, among men only in Study 2). In Study 3, an experience sampling study with 106 dual-earner couples with children, affection mediated the association between sex and increased positive affect in daily life. Cross-lagged analyses in Study 3 to 4 supported the predicted direction of the associations. Moreover, the strength of the daily association between sex and positive affect predicted both partners’ relationship satisfaction 6 months later. Our findings underscore the importance of affection and positive affect for understanding how sex promotes well-being and has long-term relational benefits. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Depp, Colin A.; Thompson, Wesley K.; Frank, Ellen; Swartz, Holly A. (2017): Prediction of near-term increases in suicidal ideation in recently depressed patients with bipolar II disorder using intensive longitudinal data.

In: Journal of affective disorders 208, S. 363–368. DOI: 10.1016/j.jad.2016.09.054.

Background: There are substantial gaps in understanding near-term precursors of suicidal ideation in bipolar II disorder. We evaluated whether repeated patient-reported mood and energy ratings predicted subsequent near-term increases in suicide ideation. Methods: Secondary data were used from 86 depressed adults with bipolar II disorder enrolled in one of 3 clinical trials evaluating Interpersonal and Social Rhythm Therapy and/or pharmacotherapy as treatments for depression. Twenty weeks of daily mood and energy ratings and weekly Hamilton Depression Rating Scale (HDRS) were obtained. Penalized regression was used to model trajectories of daily mood and energy ratings in the 3 week window prior to HDRS Suicide Item ratings. Results: Participants completed an average of 68.6 (sd = 52) days of mood and energy ratings. Aggregated across the sample, 22% of the 1675 HDRS Suicide Item ratings were non-zero, indicating presence of at least some suicidal thoughts. A cross-validated model with longitudinal ratings of energy and depressed mood within the three weeks prior to HDRS ratings resulted in an AUC of 0.91 for HDRS Suicide item > 2, accounting for twice the variation when compared to baseline HDRS ratings. Energy, both at low and high levels, was an earlier predictor than mood. Limitations: Data derived from a heterogeneous treated sample may not generalize to naturalistic samples. Identified suicidal behavior was absent from the sample so it could not be predicted. Conclusions: Prediction models coupled with intensively gathered longitudinal data may shed light on the dynamic course of near-term risk factors for suicidal ideation in bipolar II disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Doerr, Johanna M.; Fischer, Susanne; Nater, Urs M.; Strahler, Jana (2017):Influence of stress systems and physical activity on different dimensions of fatigue in female fibromyalgia patients.

In: Journal of psychosomatic research 93, S. 55–61. DOI: 10.1016/j.jpsychores.2016.12.005.

Objective: Fatigue is a defining characteristic and one of the most debilitating features of fibromyalgia syndrome (FMS). The mechanisms underlying different dimensions of fatigue in FMS remain unclear. The aim of the current study was to test whether stress-related biological processes and physical activity modulate fatigue experience. Methods: Using an ambulatory assessment design, 26 female FMS patients reported general, mental, and physical fatigue levels at six time points per day for 14 consecutive days. Salivary cortisol and alpha-amylase were analyzed as markers of neuroendocrine functioning. Participants wore wrist actigraphs for the assessment of physical activity. Results: Lower increases in cortisol after awakening predicted higher mean daily general and physical fatigue levels. Additionally, mean daily physical activity positively predicted next-day mean general fatigue. Levels of physical fatigue at a specific time point were positively associated with momentary cortisol levels. The increase in cortisol after awakening did not mediate the physical activity – fatigue relationship. There were no associations between alpha-amylase and fatigue. Conclusion: Our findings imply that both changes in hypothalamic-pituitary-adrenal axis activity and physical activity contribute to variance in fatigue in the daily lives of patients with FMS. This study helps to paint a clearer picture of the biological and behavioral underpinnings of fatigue in FMS and highlight the necessity of interdisciplinary treatment approaches targeting biological, behavioral and psychological aspects of FMS. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Droit-Volet, Sylvie; Trahanias, Panos; Maniadakis, Michail (2017):Passage of time judgments in everyday life are not related to duration judgments except for long durations of several minutes.

In: Acta psychologica 173, S. 116–121. DOI: 10.1016/j.actpsy.2016.12.010.

This study investigated relations between judgments of passage of time and judgments of long durations in everyday life with an experience sampling method. Several times per day, the participants received an alert via mobile phone. On each alert, at the same time as reporting their experience of the passage of time, the participants also estimated durations, between 3 and 33s in Experiment 1, and between 2 and 8min in Experiment 2. The participants’ affective states and the difficulty and attentional demands of their current activity were also assessed. The results replicated others showing that affective states and the focus of attention on current activity are significant predictors of individual differences in passage-of-time judgments. In addition, the passage-of-time judgments were significantly related to the duration judgments but only for long durations of several minutes. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Ejiofor, Stanley I.; Stolk, Jan; Fernandez, Pablo; Stockley, Robert A. (2017):Patterns and characterization of COPD exacerbations using real-time data collection.

In: International journal of chronic obstructive pulmonary disease 12, S. 427–434. DOI: 10.2147/COPD.S126158.

INTRODUCTION: Patients with chronic obstructive pulmonary disease often experience exacerbations. These events are important as they are a major cause of morbidity and mortality. Recently, it has been increasingly recognized that patients may experience symptoms suggestive of an exacerbation but do not seek treatment, which are referred to as unreported or untreated exacerbations. Symptom diaries used in clinical trials have the benefit of identifying both treated and untreated exacerbation events. METHODS: The Kamada study was a multicenter, double-blind randomized controlled trial of inhaled augmentation therapy in alpha-1 antitrypsin deficiency (AATD). A retrospective review of daily electronic symptom diary cards was undertaken from the two leading centers to identify symptomatic episodes consistent with a definition of an exacerbation. The aims were to explore the relationship between exacerbation events and classical “Anthonisen” symptoms and to characterize treated and untreated episodes. RESULTS: Forty-six AATD patients with airflow obstruction and history of exacerbations were included in the analysis. Two hundred thirty-three exacerbation episodes were identified: 103 untreated and 130 treated. Untreated episodes were significantly shorter (median 6 days; interquartile range [IQR] 3-10 days) than the treated episodes (median 10 days; IQR 5-18.25 days: P<0.001). Using logistic regression analysis, Anthonisen type and length of dyspnea were significant predictors of the treatment of an exacerbation event. CONCLUSION: Real-time electronic diary cards provide valuable information about the characterization of exacerbations. Untreated episodes are common and are significantly shorter in duration than the treated episodes. Dyspnea is the most important single Anthonisen symptom in the prediction and/or driver of treatment.


Escartín, Jordi; Monzani, Lucas; Leong, Frederick; Rodríguez-Carballeira, Álvaro (2017):A reduced form of the workplace bullying scale – the EAPA-T-R. A useful instrument for daily diary and experience sampling studies.

In: Work Stress 31 (1), S. 42–62. DOI: 10.1080/02678373.2017.1295113.

The need for more longitudinal studies (i.e. daily diary and experience sampling studies) focused on counterproductive work behaviours such as bullying requires shorter scales that at the same time do not compromise their content validity. Our main objective is to develop and validate a reduced version of the Workplace Bullying Scale (Escala de Abuso Psicológico Aplicado en el Lugar de Trabajo): the EAPA-T-R. Two studies (Study 1: 1506 and Study 2: 932 employees, respectively) were conducted to evaluate its psychometric properties and to ensure the external validity of the EAPA-T-R. Correlation and regression analyses were performed to reduce the current 12-item scale to a more parsimonious 4-item scale. Moreover, the psychometric properties of potential models were compared. Subsequently, the new scale was assessed using confirmatory factor analysis. Likewise, statistically significant relationships were found between the EAPA-T-R and other dimensions evaluated, such as job characteristics, transformational leadership, engagement, job satisfaction, and subjective performance. Moreover, bullying mediated the relationship between transformational leadership and burnout. To sum up, the EAPA-T-R showed good reliability and validity across studies, supporting its use in future research. The benefits of this short scale for daily diary and experience sampling studies and when using large surveys are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Forman, Evan M.; Schumacher, Leah M.; Crosby, Ross; Manasse, Stephanie M.; Goldstein, Stephanie P.; Butryn, Meghan L. et al. (2017):Ecological momentary assessment of dietary lapses across behavioral weight loss treatment. Characteristics, predictors, and relationships with weight change.

In: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine. DOI: 10.1007/s12160-017-9897-x.

Background: Adherence to dietary prescriptions is critical for successful weight loss and weight loss maintenance. However, research on specific instances of inadherence (lapses) is limited, and findings regarding the frequency, nature, and causes of lapses are mixed. Additionally, no studies have examined lapses over the course of a weight loss program.Purpose: In the context of a reduced calorie diet prescribed as part of a behavioral treatment, we aimed to characterize lapse occurrence, examine lapse frequency across treatment, examine predictors of lapses, and assess the relationship between lapses and weight loss.Methods: Adults (n = 189) enrolled in a 12-month behavioral weight loss program completed ecological momentary assessment (EMA) at baseline, mid-treatment, and end of treatment. At each EMA survey, participants indicated whether a lapse had occurred, and responded to questions assessing situational, environmental, and affective states.Results: Lapse frequency showed a curvilinear relationship over time, such that frequency first decreased and then increased. Lapse frequency at baseline was negatively associated with early and overall weight loss. Lapses most often occurred at home, in the evenings, on the weekends, and entailed eating a forbidden food. Greater overall levels of assessed affective and environmental triggers predicted lapses, and greater momentary hunger and deprivation, and the presence of palatable food, also prospectively predicted lapses.Conclusions: In addition to characterizing lapse frequency, the current study identified prospective predictors of lapses across treatment. These findings support the importance of lapses to weight control and provide insight for potential targets of intervention to prevent lapse occurrence. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Fritz, Heather; Tarraf, Wassim; Saleh, Dan J.; Cutchin, Malcolm P. (2017):Using a smartphone-based ecological momentary assessment protocol with community dwelling older african americans.

In: The journals of gerontology. Series B, Psychological sciences and social sciences. DOI: 10.1093/geronb/gbw166.

OBJECTIVES: Little is known about the feasibility of smartphone-based Ecological Momentary Assessment (EMA) approaches to collect psychosocial data from older populations, especially disadvantaged older populations. In response to this gap, this report provides evidence of the feasibility and utility of a smartphone-based EMA approach for real-time assessment with older African Americans. In addition, we share lessons learned about how to improve utility. METHODS: Ninety-seven older African Americans ages 55 and older (range: 55-95 years) used an Android smartphone loaded with an EMA application to provide data about their everyday activities and stress four times per day for seven consecutive days. RESULTS: Exit interviews early in the study suggested enhancements to the EMA interface. Adherence was demonstrated with response completion rates of 92-98% on EMA measures and no participant attrition based on the EMA protocol. DISCUSSION: Our findings suggest using a smartphone-based EMA approach for data collection is feasible and has utility with older African Americans. We most likely enhanced adherence by testing, training, monitoring, and adapting the EMA protocol using input from older adults early in the EMA design process.


Galante, Julieta; Dufour, Geraldine; Benton, Alice; Howarth, Emma; Vainre, Maris; Croudace, Timothy J. et al. (2016):Protocol for the mindful student study. A randomised controlled trial of the provision of a mindfulness intervention to support university students’ well-being and resilience to stress.

In: BMJ open 6 (11), e012300. DOI: 10.1136/bmjopen-2016-012300.

INTRODUCTION: Levels of stress in UK university students are high, with an increase in the proportion of students seeking help in recent years. Academic pressure is reported as a major trigger. Mindfulness training has been shown to reduce stress and is popular among students, but its effectiveness in this context needs to be ascertained. In this pragmatic randomised controlled trial, we hypothesise that the provision of a preventative mindfulness intervention in universities could reduce students’ psychological distress during the examination period (primary outcome), improve their resilience to stress up to at least 1 year later, reduce their use of mental health support services and improve academic performance. METHODS AND ANALYSIS: At least 550 University of Cambridge students free from active crises or severe mental illness will be randomised to joining an 8-week mindfulness course or to mental health provision as usual (one-to-one allocation rate). Psychological distress will be measured using the Clinical Outcomes in Routine Evaluation Outcome Measure at baseline, postintervention, examination term and 1-year follow-up. Other outcomes are use of mental health services, inability to sit examinations or special circumstance requests, examination grades, well-being, altruism and coping measured with ecological momentary assessment. Outcome assessment and intention-to-treat primary analysis using linear mixed models adjusted for baseline scores will be blind to intervention allocation. We will also conduct per-protocol, subgroup and secondary outcome analyses. An Independent Data Monitoring and Ethics Committee will be set up. We will systematically monitor for, and react to, possible adverse events. An advisory reference group will comprise student representatives, members of the University Counselling Service and other student welfare staff. ETHICS AND DISSEMINATION: Approval has been obtained from Cambridge Psychology Research Ethics Committee (PRE.2015.060). Results will be published in peer-reviewed journals. A lay summary will be disseminated to a wider audience including other universities. TRIAL REGISTRATION NUMBER: ACTRN12615001160527; pre-results.


Gibbons, Chris J. (2017):Turning the page on pen-and-paper questionnaires. Combining ecological momentary assessment and computer adaptive testing to transform psychological assessment in the 21st century.

In: Frontiers in psychology 7. DOI: 10.3389/fpsyg.2016.01933.

The current paper describes new opportunities for patient-centred assessment methods which have come about by the increased adoption of affordable smart technologies in biopsychosocial research and medical care. In this commentary, we review modern assessment methods including item response theory (IRT), computer adaptive testing (CAT), and ecological momentary assessment (EMA) and explain how these methods may be combined to improve psychological assessment. We demonstrate both how a ‘naïve’ selection of a small group of items in an EMA can lead to unacceptably unreliable assessments and how IRT can provide detailed information on the individual information that each item gives thus allowing short form assessments to be selected with acceptable reliability. The combination of CAT and IRT can ensure assessments are precise, efficient, and well targeted to the individual; allowing EMAs to be both brief and accurate. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Gilbert, Kirsten; Mineka, Susan; Zinbarg, Richard E.; Craske, Michelle G.; Adam, Emma K. (2017):Emotion regulation regulates more than emotion. Associations of momentary emotion regulation with diurnal cortisol in current and past depression and anxiety.

In: Clinical psychological science : a journal of the Association for Psychological Science 5 (1), S. 37–51. DOI: 10.1177/2167702616654437.

Maladaptive emotion regulation and dysregulated hypothalamic-pituitary-adrenal (HPA) axis functioning are characteristic of depression and anxiety. However, little research examines whether and how emotion regulation affects HPA axis functioning. We utilized an experience sampling methodology to examine associations between three emotion regulation strategies (problem solving, disengagement, and emotional expression/support seeking) and diurnal cortisol rhythms and reactivity in everyday life. Participants were young adults with current, past, or no history of internalizing disorders (depression or anxiety; N = 182). Across participants, problem solving was associated with an elevated cortisol awakening response (CAR), whereas disengagement was associated with a steeper cortisol slope. Only for individuals with internalizing disorders was momentary problem solving and emotional expression/support seeking associated with higher cortisol reactivity and emotional expression/support seeking associated with a flatter diurnal slope and blunted CAR. Results provide insight into associations between emotion regulation and day-to-day HPA axis functioning. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Gill, Nazia P.; Bos, Elisabeth H.; Wit, Ernst C.; Jonge, Peter de (2017):The association between positive and negative affect at the inter- and intra-individual level.

In: Pers Individ Dif 105, S. 252–256. DOI: 10.1016/j.paid.2016.10.002.

Background: It is unclear to what extent positive affect (PA) and negative affect (NA) may co-occur across and within people. The present study aimed to find unbiased estimates of the between- and within-subjects association between PA and NA. Methods: 85 participants recorded their PA and NA daily by means of an electronic diary (mean 38 observations, range 2 to 56). A linear mixed-effects model was applied. The covariances between the random effects at the person- and measurement level were used to simultaneously estimate the between- and within-subjects correlation between PA and NA. Results: The within- and between-subjects correlation between PA and NA were large: r = −0.56 (95% CI −0.58 to −0.54) and r = −0.52 (95% CI −0.69 to −0.40), respectively. The difference between the correlations was not significant (Fisher Z = −0.56; P = 0.58). In participants who completed ≥80% of the measurements (n = 46), the within- and between-subjects correlation were r = −0.59 (95% CI −0.61 to −0.57) and r = −0.50 (95% CI −0.67 to −0.28), respectively (Z = −0.98; P = 0.33). Conclusion: Our study suggests that the correlation between PA and NA is large, both at the within- and between-subjects level. The discrepancy between the two correlations as estimated by mixed-effects models may be larger if more repeated assessments are available. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Ginty, Annie T.; Muldoon, Matthew F.; Kuan, Dora C. H.; Schirda, Brittney; Kamarck, Thomas W.; Jennings, J. Richard et al. (2017):Omega-3 supplementation and the neural correlates of negative affect and impulsivity. A Double-Blind, Randomized, Placebo-Controlled Trial in Midlife Adults.

In: Psychosomatic medicine. DOI: 10.1097/PSY.0000000000000453.

OBJECTIVE: In clinical trials, omega-3 fatty acid supplementation improves symptoms in psychiatric disorders involving dysregulated mood and impulse control, yet it is unclear whether in healthy adults omega-3 fatty acid supplementation affects mood, impulse control and the brain systems supporting these processes. Accordingly, this study tested the hypotheses that eciosapentaenoic (EPA) and docosahexaenoic (DHA) acid supplementation reduces negative affect and impulsive behaviors in healthy adults and that these changes correspond to alterations in corticolimbic and corticostriatal brain systems which support affective and impulsive processes. METHODS: Healthy volunteers (N = 272) consuming 300 mg/day or less of EPA and DHA were enrolled in a double-blind, randomized, placebo controlled clinical trial. Participants received either capsules providing 1000 mg of EPA and 400 mg of DHA versus identical appearing soybean oil capsules per day for 18 weeks. Negative affect and impulsivity were measured by questionnaire and ecological momentary assessment (EMA), as well as functional alterations in corticolimbic and corticostriatal brain systems evoked by standardized fMRI tasks. RESULTS: There were no group-by-time interactions for any questionnaire or EMA measures of mood and impulsivity. Likewise, no group-by-time interactions were observed for fMRI responses evoked within corticolimbic and corticostriatal systems. CONCLUSIONS: In healthy adults with low intake of omega-3 fatty acids, moderate-dose supplementation for 18 weeks did not alter affect or impulsive behaviors, nor alter corticolimbic and corticostriatal brain functionality. TRIAL REGISTRATION: Trial number NCT00663871, URL:


Gleeson, John; Lederman, Reeva; Herrman, Helen; Koval, Peter; Eleftheriadis, Dina; Bendall, Sarah et al. (2017):Moderated online social therapy for carers of young people recovering from first-episode psychosis. Study protocol for a randomised controlled trial.

In: Trials 18 (1), S. 27. DOI: 10.1186/s13063-016-1775-5.

BACKGROUND: First-episode psychosis most often has its onset during late adolescence. In caring for the young person, families endure high levels of stress and depression. Meanwhile, the social networks of families often erode. Our group has previously shown that family cognitive behaviour therapy (CBT) leads to significantly improved perceived stress compared with specialist first-episode treatment as usual; however, there are well-known barriers to the dissemination of effective family interventions. To address this, we have developed a novel online intervention entitled ‘Altitudes’ that fully integrates purpose-built online social networking, expert and peer moderation, and evidence-based psychoeducation within a single application. The primary aim of this trial is to evaluate the effectiveness of Altitudes in reducing stress in carers over a 6-month period. METHODS/DESIGN: We describe here a single-blinded cluster randomised controlled trial (cRCT) with permutated blocks. The clusters comprise individual families. The two treatment conditions include Altitudes plus Specialist Treatment as Usual (STAU) and STAU alone. Altitudes involves participation in our novel online programme whereas STAU comprises specialist family work at the Early Psychosis Prevention and Intervention Centre (EPPIC), Melbourne, Australia. We aim to recruit 160 family members of young, 15-27 year-old, patients registered for treatment for first-episode psychosis (FEP) at EPPIC. The design includes two assessment time points, namely, baseline and 6-month follow-up. The study is due for completion within 2 years including an 18-month recruitment period and a 6-month treatment phase. The primary outcome is carers’ perceived stress at 6 months. Secondary outcome measures include a biomarker of stress, depressive symptoms, worry, substance use, loneliness, social support, satisfaction with life, and a range of measures that tap into coping resources. We seek to gain a dynamic picture of carer stress through our Smartphone Ecological Momentary Assessment (SEMA) tool. DISCUSSION: This is the first randomised controlled trial designed to evaluate an online intervention for carers of young people recovering from FEP. It has the potential to produce evidence in support of a highly novel, accessible, and cost-effective intervention to reduce stress in carers who are providing support to young people at a critical phase in their recovery from psychosis. TRIAL REGISTRATION: Australian New Zealand Clinical Trial Registry, identifier: ACTRN12616000968471 . Retrospectively registered on 22 July 2016.


Goldschmidt, Andrea B.; Crosby, Ross D.; Cao, Li; Pearson, Carolyn M.; Utzinger, Linsey M.; Pacanowski, Carly R. et al. (2017):Contextual factors associated with eating in the absence of hunger among adults with obesity.

In: Eating behaviors 26, S. 33–39. DOI: 10.1016/j.eatbeh.2017.01.005.

Eating in the absence of hunger (EAH) is under-explored in adults with obesity. In this study, 50 adults with obesity recorded eating episodes and theoretically-relevant environmental, perceptual, and emotional correlates in the natural environment for 2weeks via ecological momentary assessment (EMA). Generalized linear models and mixed models were used to characterize correlates and consequences of EAH vs. non-EAH episodes/tendencies (within-subjects and between-subjects effects, respectively), time of day, and time of dayxEAH interactions. Approximately 21% of EMA-recorded eating episodes involved EAH, and 70% of participants reported at least 1 EAH episode. At the within-person level, participants’ EAH episodes were associated with greater self-labeled overeating than their non-EAH episodes. At the between-person level, participants who tended to engage in more EAH reported less self-labeled overeating than those who engaged in less EAH. Across EAH and non-EAH episodes, eating in the evening was associated with overeating, expecting eating to be more rewarding, greater alcoholic beverage consumption, eating alone, eating because others are eating, and eating while watching television. Significant EAHxtime of day interactions were also observed but the pattern of findings was not consistent. Findings suggest that EAH may be a relevant target for reducing food intake in individuals with obesity given its high prevalence and association with perceptions of overeating, although results should be extended using objective measures of food intake. Associations between evening eating episodes and perceptual and environmental factors should be further explored.


Gonda-Kotani, Chiaki; White, Glen W. (2017):The effects of contingency contracts and performance feedback on completing data entries to self-monitor community participation of people with physical disabilities. An ecological momentary study.

In: Journal of prevention & intervention in the community 45 (2), S. 86–99. DOI: 10.1080/10852352.2017.1281042.

This article examines the use of ecological momentary assessment (EMA) to analyze the effect of contingent contracts and performance feedback in completing data entries to self-monitor community participation of people with mobility-related disabilities. Two participants with mobility-related disabilities were assigned to self-monitor their community participation activities using a personal digital assistant (PDA), which had been preprogrammed to signal four times a day throughout the entire study. At each prompt, participants were asked to complete a brief survey on a PDA. Participants received the monetary rewards based on their PDA completion rate. All participants maintained more than 95% completion and received the full monetary reward available.


Goode, Adam P.; Hall, Katherine S.; Batch, Bryan C.; Huffman, Kim M.; Hastings, S. Nicole; Allen, Kelli D. et al. (2017):The impact of interventions that integrate accelerometers on physical activity and weight loss. A systematic review.

In: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 51 (1), S. 79–93. DOI: 10.1007/s12160-016-9829-1.

Background: Regular physical activity is important for improving and maintaining health, but sedentary behavior is difficult to change. Providing objective, real-time feedback on physical activity with wearable motion-sensing technologies (activity monitors) may be a promising, scalable strategy to increase physical activity or decrease weight. Purpose: We synthesized the literature on the use of wearable activity monitors for improving physical activity and weight-related outcomes and evaluated moderating factors that may have an impact on effectiveness. Methods: We searched five databases from January 2000 to January 2015 for peer-reviewed, English-language randomized controlled trials among adults. Random-effects models were used to produce standardized mean differences (SMDs) for physical activity outcomes and mean differences (MDs) for weight outcomes. Heterogeneity was measured with I 2. Results: Fourteen trials (2972 total participants) met eligibility criteria; accelerometers were used in all trials. Twelve trials examined accelerometer interventions for increasing physical activity. A small significant effect was found for increasing physical activity (SMD 0.26; 95 % CI 0.04 to 0.49; I² = 64.7 %). Intervention duration was the only moderator found to significantly explain high heterogeneity for physical activity. Eleven trials examined the effects of accelerometer interventions on weight. Pooled estimates showed a small significant effect for weight loss (MD −1.65 kg; 95 % CI −3.03 to −0.28; I² = 81 %), and no moderators were significant. Conclusions: Accelerometers demonstrated small positive effects on physical activity and weight loss. The small sample sizes with moderate to high heterogeneity in the current studies limit the conclusions that may be drawn. Future studies should focus on how best to integrate accelerometers with other strategies to increase physical activity and weight loss. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Graf, Allyson Stella; Long, Dustin M.; Patrick, Julie Hicks (2017):Successful aging across adulthood. Hassles, uplifts, and self-assessed health in daily context.

In: J Adult Dev. DOI: 10.1007/s10804-017-9260-2.

To examine the ways in which age, sex, daily uplifts, and daily hassles influence fluctuations in self-assessed health (SAH). A 14-day experience sampling study was conducted among community-dwelling adults (N = 87). The distribution-free method of generalized estimating equations was used to examine whether changes in the intensity of daily hassles and changes in intensities of daily uplifts predicted subsequent changes in SAH. Both hassles and uplifts influenced SAH, although neither age nor sex influenced these associations. Findings are discussed in terms of the benefits of examining the daily context as an influence on successful aging. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Hamaker, Ellen L.; Wichers, Marieke (2017):No time like the present. Discovering the hidden dynamics in intensive longitudinal data.

In: Curr Dir Psychol Sci 26 (1), S. 10–15. DOI: 10.1177/0963721416666518.

There has been a strong increase in the number of studies based on intensive longitudinal data, such as those obtained with experience sampling and daily diaries. These data contain a wealth of information regarding the dynamics of processes as they unfold within individuals over time. In this article, we discuss how combining intensive longitudinal data with either time-series analysis, which consists of modeling the temporal dependencies in the data for a single individual, or dynamic multilevel modeling, which consists of using a time-series model at Level 1 to describe the within-person process while allowing for individual differences in the parameters of these processes at Level 2, has led to new insights in clinical psychology. In addition, we discuss several methodological and statistical challenges that researchers face when they are interested in studying the dynamics of psychological processes using intensive longitudinal data. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Harari, Gabriella M.; Gosling, Samuel D.; Wang, Rui; Chen, Fanglin; Chen, Zhenyu; Campbell, Andrew T. (2017):Patterns of behavior change in students over an academic term. A preliminary study of activity and sociability behaviors using smartphone sensing methods.

In: Comput Human Behav 67, S. 129–138. DOI: 10.1016/j.chb.2016.10.027.

The recent arrival of smartphone-sensing methods has made it possible to objectively track consequential everyday health-related behaviors rather than rely on self-reports. To evaluate the viability of using sensing methods to monitor such behaviors in detail, the present research used a smartphone-sensing application to describe the patterns of stability and change that characterize a cohort of students’ activity and sociability behaviors over the course of a 10-week academic term. Data were collected from 48 students using a smartphone-sensing application, StudentLife, which was designed to track daily durations of activity (via the accelerometer sensor) and sociability (via the microphone sensor). Results showed stability estimates were moderate to high for activity (rmean = 0.66) and sociability (rmean = 0.72) across the 10 weeks. Students started the term with generally healthy levels of activity (M = 1.87 h) and sociability (M = 4.99 h), which then dropped (activity by 0.42 h, sociability by 0.90 h) over the first half of the term (i.e., before midterm exams). Over the second half of the term, activity levels did not change but sociability increased (by 0.88 h). Students’ ethnicity and academic class predicted variation in the activity and sociability trajectories. Discussion focuses on the implications of our results for designing mHealth interventions to address consequential student outcomes (e.g., mental health, physical health). (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Hebert, Emily T. (2017):Tobacco product message exposure and use in real-time. An ecological momentary assessment approach.

In: Dissertation Abstracts International: Section B: The Sciences and Engineering 77 (10-B(E)).

Background: The nature and extent of tobacco industry online marketing and pro-tobacco social media content is poorly understood. Current methods to measure exposure to tobacco ads or promotions are severely limited, relying on recall, recognition, or proxy measures. The present study used ecological momentary assessment (EMA) to examine exposure to tobacco and e-cigarette related messaging among young adults. The specific aims were: 1) To determine the feasibility and validity of a smartphone application for the measurement of tobacco and e-cigarette message exposure via EMA; 2) To evaluate the relationship between daily-reported exposure to pro-tobacco messages and daily tobacco and e-cigarette use; and 3) To evaluate the relationship between the affective response to pro-tobacco messages and intentions to use tobacco and e-cigarettes. Methods: Participants in this study were 148 young adults aged 18-29 living in Austin, Texas and its surrounding areas. Participants were instructed to record all sightings of marketing or social media related to tobacco or e-cigarettes seen over the course of 4 weeks, using a smartphone application. Tobacco product use and recall of message sightings were evaluated every 24 hours, and participants were asked to submit reports of any messages encountered in real time. To examine the study aims, paper 1 utilized descriptive statistics, zero-order correlations, and paired samples t-tests. Papers 2 and 3 utilized generalized linear mixed models. Results: Paper 1 revealed that a smartphone application was a feasible and acceptable method to measure exposure to pro-tobacco marketing and messages among young adults using EMA. The majority of tobacco and e-cigarette-related messages encountered by young adults were seen on the Internet, and many were user-generated. Daily recall and 30-day recall of messages encountered were reasonably well-correlated, with a stronger correlation for user-generated messages than for industry-sponsored messages. In contrast, the correlations between the actual number of messages reported and the perceived frequency of messages encountered in various locations was extremely poor, with a small but significant correlation only for messages seen in convenience stores. Paper 2 demonstrated that there was a significant relationship between daily exposure to tobacco and e-cigarette messages and use of these products, even controlling for baseline product use. Paper 3 revealed that messages depicting e-cigarettes or hookah were associated with significantly higher positive affective responses compared to traditional cigarettes, and that positive affective response to a message was significantly associated with intentions to use tobacco and e-cigarettes. Discussion: Research examining the nature, extent, and impact of pro-tobacco and e-cigarette messages on the Internet and social media is still in its nascent stages. These findings suggest that EMA is a valuable method for the measurement of tobacco message exposure. This study adds unique, timely, and critically needed information to the extant knowledge base that will inform future research and regulation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Heinig, Ingmar; Pittig, Andre; Richter, Jan; Hummel, Katrin; Alt, Isabel; Dickhover, Kristina et al. (2017):Optimizing exposure-based CBT for anxiety disorders via enhanced extinction. Design and methods of a multicentre randomized clinical trial.

In: International journal of methods in psychiatric research. DOI: 10.1002/mpr.1560.

Exposure-based psychological interventions currently represent the empirically best established first line form of cognitive-behavioural therapy for all types of anxiety disorders. Although shown to be highly effective in both randomized clinical and other studies, there are important deficits: (1) the core mechanisms of action are still under debate, (2) it is not known whether such treatments work equally well in all forms of anxiety disorders, including comorbid diagnoses like depression, (3) it is not known whether an intensified treatment with more frequent sessions in a shorter period of time provides better outcome than distributed sessions over longer time intervals. This paper reports the methods and design of a large-scale multicentre randomized clinical trial (RCT) involving up to 700 patients designed to answer these questions. Based on substantial advances in basic research we regard extinction as the putative core candidate model to explain the mechanism of action of exposure-based treatments. The RCT is flanked by four add-on projects that apply experimental neurophysiological and psychophysiological, (epi)genetic and ecological momentary assessment methods to examine extinction and its potential moderators. Beyond the focus on extinction we also involve stakeholders and routine psychotherapists in preparation for more effective dissemination into clinical practice.


Hernandez Rivera, Javier (2017):Towards wearable stress measurement.

In: Dissertation Abstracts International: Section B: The Sciences and Engineering 77 (9-B(E)).

Chronic psychological stress carries a wide array of pathophysiological risks, including cardiovascular and cerebrovascular diseases, diabetes, and immune dysregulation. An important step in managing stress, before it becomes chronic, is recognizing precisely when and where it occurs. This thesis creates and evaluates new methods to improve the measurement of stress by leveraging state-of-the-art wearable devices. The first part of the thesis systematically compares gathering self-reported stress levels with head and wrist-worn devices, and compares them to the traditional cellphone in the pocket. In particular, 15 participants were asked to carry these devices during five days of their regular work day and to self-report their emotional state several times a day with our custom experience sampling application. We found that both head and wrist-worn devices significantly outperformed the phone in terms of the amount of answered prompts and the speed to start answering. However, different factors such as interaction types, screen size, and familiarity with the devices affected users’ experience and responses. The second part of the thesis develops novel methods to comfortably capture physiological signals associated with the stress response. In particular, 36 participants were asked to carry either a head-worn device, a smartwatch or a smartphone while performing different ‘still’ body postures in a controlled laboratory study. Using the proposed methods, we demonstrated that wearable motion-sensitive sensors inside these devices can capture heart and breathing rates as accurately as FDA-cleared devices from traditional body locations. Furthermore, using the data collected from the 15 participants, we demonstrated that our methods can be opportunistically used in real-life when people are relatively ‘still. ‘ In our study, for instance, the head-worn device provided accurate heart rate assessments around 20% of the work day. Finally, the third part of the thesis uses supervised learning methods to automatically infer self-reported stress levels from different types of wearable data, including physiological, contextual and behavioral signals. While there is not a one-size-fits-all solution, we found that electrodermal activity, head motion and atmospheric pressure were the more relevant signals across the 15 participants. Furthermore, we characterized many of the challenges that plague the task of real-life stress recognition. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Hershenberg, Rachel; Mavandadi, Shahrzad; Wright, Erin; Thase, Michael E. (2017):Anhedonia in the daily lives of depressed Veterans. A pilot report on experiential avoidance as a moderator of emotional reactivity.

In: Journal of affective disorders 208, S. 414–417. DOI: 10.1016/j.jad.2016.10.011.

Background: Decreased enjoyment from pleasant events is a key component of anhedonia, but evidence has been inconsistent demonstrating its association across levels of depressive symptom severity. We test the hypothesis that depressed participants who engage in greater (rather than lower) concurrent use of experiential avoidance strategies will demonstrate impaired positive (PA) and negative (NA) emotional reactivity when pleasant events take place. Methods: 50 Veterans with a range of depression severity completed a 7-day phone-based ecological momentary assessment protocol that assessed the pleasantness of their recent activity, level of PA and NA, and concurrent use of experiential avoidance strategies. Results: As events were rated as more pleasant, depressed Veterans using less experiential avoidance were distinguished from depressed Veterans using greater experiential avoidance, such that greater experiential avoidance interfered with PA and NA reactivity. Limitations: Small sample of primarily older men, all were Veterans, and assessments relied on self-reports of event pleasantness and depression; we did not include a control group. Conclusions: It is critical to understand how depressed individuals experience potentially rewarding aspects of their environments. Our study provides preliminary data that depressed individuals may benefit from positive events in daily life when experiential avoidance is low and may demonstrate impaired reactivity when avoidance is high. This study may help clinicians to identify the contexts that support hedonic responses to potentially rewarding aspects of their depressed patients’ environments. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Hinrichs, Rebecca; Michopoulos, Vasiliki; Winters, Sterling; Rothbaum, Alex O.; Rothbaum, Barbara O.; Ressler, Kerry J.; Jovanovic, Tanja (2017):Mobile assessment of heightened skin conductance in posttraumatic stress disorder.

In: Depression and anxiety. DOI: 10.1002/da.22610.

Background Increased psychophysiological reactivity is a hallmark intermediate phenotype of posttraumatic stress disorder (PTSD). Individuals with PTSD exhibit greater skin conductance (SC) responses to trauma scripts than trauma survivors without PTSD. However, trauma scripts require time for development and cannot be easily used in a single visit. Thus, there is a need for a low‐cost, easy‐to‐use, SC recording protocol for PTSD assessment. Methods Using a mobile device (eSense) connected to a portable tablet computer, we assessed SC reactivity to a standard trauma interview (STI) in 63 participants recruited from Grady Memorial Hospital in Atlanta, GA, approximately 1 year after trauma exposure. SC response (SCR) was calculated by subtracting the SC level (SCL) at the end of the baseline recording from the maximum SCL during the STI. Results SCL was significantly higher during the STI compared to baseline (P < .001), and individuals with PTSD showed significantly greater SCR than individuals without PTSD (P = .006). Logistic regression using SCR with PTSD diagnosis as the outcome showed an odds ratio of 1.76 (95% CI: 1.11–2.78). Lastly, higher SCR during the STI was also significantly associated with PTSD symptom total score controlling for demographics and trauma severity (b = 0.42, P = .001). Conclusions The current study demonstrated feasibility of the use of a mobile device for assessing psychophysiological reactivity in those with PTSD. The use of this low‐cost, easy‐to‐use mobile device to collect objective physiological data in concert with a STI can be easily disseminated in clinical and research settings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Hoeppner, Bettina B.; Hoeppner, Susanne S.; Kelly, Lourah; Schick, Melissa; Kelly, John F. (2017):Smiling instead of smoking. Development of a positive psychology smoking cessation smartphone app for non-daily smokers.

In: International journal of behavioral medicine. DOI: 10.1007/s12529-017-9640-9.

Purpose: The usefulness of mobile technology in supporting smoking cessation has been demonstrated, but little is known about how smartphone apps could best be leveraged. The purpose of this paper is to describe the program of research that led to the creation of a smoking cessation app for non-daily smokers, so as to stimulate further ideas to create ‘smart’ smartphone apps to support health behavior change.Method: Literature reviews to evaluate the appropriateness of the proposed app, content analyses of existing apps, and smoking cessation sessions with non-daily smokers (n = 38) to inform the design of the app.Results: The literature reviews showed that (1) smoking cessation apps are sought after by smokers, (2) positive affect plays an important role in smoking cessation, (3) short, self-administered exercises consistently bring about enduring positive affect enhancements, and (4) low treatment-seeking rates of non-daily smokers despite high motivation to quit indicate a need for novel smoking cessation support. Directed content analyses of existing apps indicated that tailoring, two-way interactions, and proactive features are under-utilized in existing apps, despite the popularity of such features. Conventional content analyses of audio-recorded session tapes suggested that difficulty in quitting was generally linked to specific, readily identifiable occasions, and that social support was considered important but not consistently sought out.Conclusion: The ‘Smiling Instead of Smoking’ (SIS) app is an Android app that is designed to act as a behavioral, in-the-pocket coach to enhance quitting success in non-daily smokers. It provides proactive, tailored behavioral coaching, interactive tools (e.g., enlisting social support), daily positive psychology exercises, and smoking self-monitoring. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Hofer, Manfred; Fries, Stefan; Grund, Axel (2017):Multiple Ziele und Lernmotivation. Das Forschungsprogramm „Theorie motivationaler Handlungskonflikte’. = Multiple goals and motivation at school: The theory of motivational action conflicts.

In: Zeitschrift für Pädagogische Psychologie / German Journal of Educational Psychology 31 (1), S. 69–85. DOI: 10.1024/1010-0652/a000197.

This article presents the research program ‘Theory of Motivational Action Conflicts’, which addresses situations in which persons aim at achieving more than one important goal. The theory was studied with students striving simultaneously to reach academic and nonacademic goals. When students experience goal conflicts, incentives attached to options not chosen may interfere with the execution of the chosen action. Cross-sectional, longitudinal, experience-sampling, and experimental studies show that, depending on its strength, motivational interference can impair the achievements as well as the well-being of students. The article provides hints on how students can minimize goal conflicts in order to experience a better balance across developmental contexts. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Der Beitrag berichtet über das Forschungsprogramm „Theorie motivationaler Handlungskonfl ikte’, das Situationen behandelt, in denen Personen zwei gleichwertige Ziele verfolgen. Die Theorie wird an Lernenden untersucht, die Konfl ikte zwischen schulischen und außerschulischen Zielen erleben. Diese Konfl ikte spiegeln prototypisch die gesellschaftlich relevante Konkurrenz zwischen wohlbefi ndens- und leistungsbezogenen Werten und Zielen wider. Mit dem Anstreben von Zielen zeigen Lernende an, dass sie ihre altersspezifi schen Entwicklungsaufgaben bearbeiten. Die Theorie spezifiziert die Interferenz von Anreizen der nichtgewählten Handlung mit der Ausübung der gewählten Lern- oder Freizeithandlung. In quer- und längsschnittlichen-, Experience-Sampling- sowie experimentellen Studien wird gezeigt, dass motivationale Interferenz Leistung und affektives Wohlbefi nden der Lernenden beeinträchtigen kann. Bei den Bedingungen motivationaler Interferenz stehen gesellschaftlich vermittelte Werte der Leistung und des Wohlbefindens im Mittelpunkt. Wir schlagen Maßnahmen zur Minimierung von Zielkonfl ikten und zur Herstellung einer ausgewogenen Zeitverteilung auf verschiedene Lebensbereiche vor. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Holton, Nicholas Skeets (2017):Eudaimonia and engagement in the classroom. Using experience sampling in an exploratory study of well-being in high school students.

In: Dissertation Abstracts International Section A: Humanities and Social Sciences 77 (9-A(E)).

This study examined 21 high school students’ self-reports of their feelings of Eudaimonia, and academic engagement (Marks, 2000) in their classes over a two-week period. Data were collected using the Experience Sampling Method (Csikszentmihalyi & Larson, 1987) by repeatedly sending an Experience Sampling Form (ESF) to students’ mobile phones during the school day. The students responded from 5 to 35 times for a total of 279 responses to the survey. Eudaimonia is a type of well-being centered around the psychological concept of self-actualization. Eudaimonia was measured using a 15-item scale adapted from the work of Waterman (2010) and Ryff (1989). Measures of academic engagement were drawn from the work of Marks (2000). The study focused on three research questions: Students’ reports of their experience of Eudaimonia in the classroom, how these reports varied by context and whether Eudaimonia and engagement shared a relationship in these classroom experiences. Overall the students reported their states of well-being over this two-week period to be between neutral and eudaimonic on the 5-point Likert scales, with a smaller number of reports of occasions when they were very eudaimonic or non-eudaimonic. Students’ reports of their levels of Eudaimonia and academic engagement varied significantly across different subject matter classes and time of day. This exploratory study shows the potential value of using the Experience Sampling Method to teachers and schools to gather real-time self-reports of students’ engagement and Eudaimonia levels. The results suggest a specific logic model where subject matter departments influence the experiencing of 4 components of Eudaimonia. This model may further imply that these 4 components may work together to form the larger construct of Eudaimonia, which in turn may act as a predictor of academic engagement. Keeping in mind what should be considerable concerns over the final sample size used in the study, methods and models such as these could be used to better understand how to create more optimal learning environments to promote students to engage in authentic, self-actualizing activities leading to academically engaged states. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Houben, Marlies; Claes, Laurence; Vansteelandt, Kristof; Berens, Ann; Sleuwaegen, Ellen; Kuppens, Peter (2017):The emotion regulation function of nonsuicidal self-injury. A momentary assessment study in inpatients with borderline personality disorder features.

In: Journal of abnormal psychology 126 (1), S. 89–95. DOI: 10.1037/abn0000229.

Studies using retrospective self-report or proxies of nonsuicidal self-injury (NSSI) in the lab have shown that NSSI is often preceded by intense negative emotions and followed by a decrease in negative emotions/tension, suggesting an emotion regulation function of NSSI. To investigate this emotion regulation function of NSSI in a more ecologically valid way, we used experience sampling methods to examine the temporal relationship between NSSI behavior and emotional experiences throughout the day in 30 inpatients currently staying in psychiatric hospitals. Because NSSI is especially prevalent and severe in patients with a borderline personality disorder (BPD), we focused on patients with high levels of BPD symptomatology. Results confirmed that high levels of negative emotion prospectively predicted a higher probability of engaging in NSSI in the next time interval. However, the occurrence of NSSI itself was related to concurrent increases in negative emotion and decreases in positive emotion, and even prospectively predicted an increase in negative emotion in the consecutive time interval. These preliminary results show that on a time scale of hours, instead of resulting in emotional relief, NSSI seems to be associated with a further increase in negative emotionality, shedding light on the cyclic nature of NSSI. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

General Scientific Summary—Nonsuicidal self-injury (NSSI) is often considered as serving an emotion regulation function, leading to the decrease of negative feelings. Here, we show that while NSSI is indeed preceded by elevated levels of negative emotionality, it is in fact followed by an increase, not a decrease, of negative emotion within the timespan of hours in inpatients with borderline personality disorder features, shedding light on the cyclic nature of NSSI. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Hughes, John R.; Shiffman, Saul; Naud, Shelly; Peters, Erica N. (2017):Day to day variability in self-reported cigarettes per day.

In: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. DOI: 10.1093/ntr/ntx057.

Background and Aims: Nicotine addiction theory predicts small day to day variability in cigarettes/day (CPD) whereas social learning theory predicts large variability. A description of the variability in CPD over multiple days is not available. Methods: We conducted secondary analyses of two natural history studies with daily smokers – one of smokers not intending to quit, and one of smokers intending to quit sometime in the next 3 months. In the former, smokers recorded their smoking during the day by Ecological Momentary Assessment, using a palm-top computer. In the latter, participants reported CPD nightly via a phone Interactive Voice Response system. Analyses were based on smokers who reported averaging > 10 CPD, and on days in which there was no attempt to stop or reduce smoking. Results: Across the two studies, on average, smokers had small changes in day-to-day CPD (mean changes were 2.2 and 2.9 CPD). However a minority averaged changing by > 5 CPD from one day to the next (7% and 11%), and many changed by > 5 CPD on at least 10 of the 90 days (8% and 31%). Neither smoking restrictions, dependence, stereotypy ratings, nor interest in quitting predicted variability. Conclusion: Although on average, smokers have little change day-to-day CPD, a substantial minority of smokers often change by 5 CPD from day-to-day. We did not find potential causes of this variability. Implications: Across day variability in CPD is larger than implied in prior studies. Determining causes of day to day variability should increase our understanding of the determinants of smoking.


Hurlburt, Russell T.; Alderson-Day, Ben; Fernyhough, Charles; Kühn, Simone (2017):Can inner experience be apprehended in high fidelity? Examining brain activation and experience from multiple perspectives.

In: Frontiers in psychology 8.

We discuss the historical context for explorations of ‘pristine inner experience,’ attempts to apprehend and describe the inner experiences that directly present themselves in natural environments. There is no generally accepted method for determining whether such apprehensions/descriptions should be considered high fidelity. By analogy from musical recording, we present and discuss one strategy for establishing experiential fidelity: the examining of brain activation associated with a variety of experiential perspectives that had not been specified at the time of data collection. We beeped participants in an fMRI scanner at randomly-determined times and recorded time-locked brain activations. We used Descriptive Experience Sampling (DES) to apprehend and describe the participant’s experience that was ongoing at each beep. These apprehensions/descriptions were obtained with no specific theoretical perspective or experimental intention when originally collected. If these apprehensions/descriptions were of high fidelity, then these pairings of moments of experience and brain activations should be able to be productively examined and re-examined in multiple ways and from multiple theoretical perspectives. We discuss a small set of such re-examinations and conclude that this strategy is worthy of further examination. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Ilies, Remus; Wagner, David; Wilson, Kelly; Ceja, Lucia; Johnson, Michael; DeRue, Scott; Ilgen, Dan (2017):Flow at work and basic psychological needs. Effects on well-being.

In: Appl Psychol 66 (1), S. 3–24. DOI: 10.1111/apps.12075.

Recent conceptual work draws meaningful distinctions between experiential and declarative well‐being (Shmotkin, ), but little has been done to apply such distinctions in organisational psychology. We use this framework to integrate self‐determination theory (Deci & Ryan, ) and flow theory (Csikszentmihalyi, ), leading to hypotheses proposing that flow experiences at work (experiential well‐being) lead to declarative well‐being outcomes through their influence on the satisfaction of basic psychological needs for competence and autonomy. Findings from a two‐week experience sampling study of full‐time employees offer support for our hypotheses. This study also shows support for the moderating effect of individual differences in personality on the relationships among flow experiences, need fulfillment, and declarative well‐being. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Jahng, Seungmin; Wood, Phillip K. (2017):Multilevel models for Intensive longitudinal data with heterogeneous autoregressive errors. The Effect of Misspecification and Correction with Cholesky Transformation.

In: Frontiers in psychology 8, S. 262. DOI: 10.3389/fpsyg.2017.00262.

Intensive longitudinal studies, such as ecological momentary assessment studies using electronic diaries, are gaining popularity across many areas of psychology. Multilevel models (MLMs) are most widely used analytical tools for intensive longitudinal data (ILD). Although ILD often have individually distinct patterns of serial correlation of measures over time, inferences of the fixed effects, and random components in MLMs are made under the assumption that all variance and autocovariance components are homogenous across individuals. In the present study, we introduced a multilevel model with Cholesky transformation to model ILD with individually heterogeneous covariance structure. In addition, the performance of the transformation method and the effects of misspecification of heterogeneous covariance structure were investigated through a Monte Carlo simulation. We found that, if individually heterogeneous covariances are incorrectly assumed as homogenous independent or homogenous autoregressive, MLMs produce highly biased estimates of the variance of random intercepts and the standard errors of the fixed intercept and the fixed effect of a level 2 covariate when the average autocorrelation is high. For intensive longitudinal data with individual specific residual covariance, the suggested transformation method showed lower bias in those estimates than the misspecified models when the number of repeated observations within individuals is 50 or more.


Jarnecke, Amber M.; Miller, Michelle L.; South, Susan C. (2017):Daily diary study of personality disorder traits. Momentary affect and cognitive appraisals in response to stressful events.

In: Personality disorders 8 (1), S. 75–86. DOI: 10.1037/per0000157.

Difficulties in emotional expression and emotion regulation are core features of many personality disorders (PDs); yet, we know relatively little about how individuals with PDs affectively respond to stressful situations. The present study seeks to fill this gap in the literature by examining how PD traits are associated with emotional responses to subjective daily stressors, while accounting for cognition and type of stressor experienced (interpersonal vs. noninterpersonal). PD features were measured with the Schedule for Nonadaptive and Adaptive Personality-2 (SNAP-2) diagnostic scores. Participants (N = 77) completed a 1-week experience sampling procedure that measured affect and cognition related to a current stressor 5 times per day. Hierarchical linear modeling (HLM) was used to examine whether and how baseline PD features, momentary cognitions, and type of stressor predicted level of affect. Results demonstrated that paranoid, borderline, and avoidant PD traits predicted negative affect beyond what could be accounted for by cognitions and type of stressor. No PD traits predicted positive affect after accounting for the effects of cognitive appraisals and type of stressor. Findings have implications for validating the role of affect in PDs and understanding how individuals with PDs react in the presence of daily hassles. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Kang, Johanah Yoosun (2017):Examining the inner experience of individuals with bipolar disorder.

In: Dissertation Abstracts International: Section B: The Sciences and Engineering 77 (7-B(E)).

Bipolar disorder (BD) is a serious, chronic mood disorder. The diagnostic criteria for BD provide a description of expected experiences of individuals with BD (e.g., sadness, expansive mood, inflated self-esteem, anhedonia). Despite these criteria, the details of inner experience of individuals with BD are generally unknown. Understanding the inner experience of individuals with BD may provide greater understanding of the lived experience of BD and may provide insights into treating BD. The present study examined the inner experience of six individuals with BD using Descriptive Experience Sampling (DES), a method aimed at apprehending high- fidelity accounts of momentary inner experience. Results revealed that our participants varied in their ability to have clear inner experience, but they had clear experiences of sensory awareness and/or inner seeing. They had a high frequency of no clear inner experience or inner experience that was unclear in some way in the moment. They also had a low frequency of the coherent experience of feelings. Lastly, four participants experienced noteworthy perceptual experiences at a higher than average frequency as compared to the inner experience of individuals without a psychiatric diagnosis. This study highlights the importance of increasing efforts to explore the inner experience of individuals diagnosed with BD and/or other mental illnesses, and the utility of the DES method for investigating these individuals’ inner experience. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Kanning, Martina; Hansen, Sylvia (2017):Need satisfaction moderates the association between physical activity and affective states in adults aged 50+. An activity-triggered ambulatory assessment.

In: Annals of behavioral medicine : a publication of the Society of Behavioral Medicine 51 (1), S. 18–29. 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) 2017 APA, all rights reserved)


Kimhy, David; Wall, Melanie M.; Hansen, Marie C.; Vakhrusheva, Julia; Choi, C. Jean; Delespaul, Philippe et al. (2017):Autonomic regulation and auditory hallucinations in individuals with schizophrenia. An Experience Sampling Study.

In: Schizophrenia bulletin. DOI: 10.1093/schbul/sbw219.

Auditory Hallucinations (AH) cause substantial suffering and dysfunction, yet remain poorly understood and modeled. Previous reports have linked AH to increases in negative emotions, suggesting a role for the autonomic nervous system (ANS) in underlying this link. Employing an Experience Sampling Method (ESM) approach, 40 individuals with schizophrenia completed a 36-hour ambulatory assessment of AH and cardiac autonomic regulation. Participants carried mobile electronic devices that prompted them to report 10 times/d the severity of their momentary AH, along with a Holter monitor that continuously recorded their cardiac autonomic regulation. The clocks of the devices and monitors were synchronized, allowing for high time-resolution temporal linking of the AH and concurrent autonomic data. Power spectral analysis was used to determine the relative vagal (parasympathetic) contribution to autonomic regulation during 5 minutes prior to each experience sample. The participants also completed interview-based measures of AH (SAPS; PSYRATS). The ESM-measured severity of AH was significantly correlated with the overall SAPS-indexed AH severity, along with the PSYRATS-indexed AH frequency, duration, loudness, degree of negative content, and associated distress. A mixed-effect regression model indicated that momentary increases in autonomic arousal, characterized by decreases in vagal input, significantly predicted increases in ESM-measured AH severity. Vagal input averaged over the 36-hour assessment displayed a small but significant inverse correlation with the SAPS-indexed AH. The results provide preliminary support for a link between ANS regulation and AH. The findings also underscore the highly dynamic nature of AH and the need to utilize high time-resolution methodologies to investigate AH.


King, Eden B.; Mohr, Jonathan J.; Peddie, Chad I.; Jones, Kristen P.; Kendra, Matt (2017):Predictors of identity management. An exploratory experience-sampling study of lesbian, gay, and bisexual workers.

In: J Manage 43 (2), S. 476–502. DOI: 10.1177/0149206314539350.

This study examined workplace interactions in which lesbian, gay, and bisexual (LGB) workers faced decisions related to revealing or concealing their LGB identities at work (i.e., identity management situations). Participants were 61 LGB adults who completed a baseline survey about their organization and, over 3 weeks, responded to event-based surveys immediately after identity management situations. Results suggested that LGB workers manage their stigmatized identity strategically according to situational characteristics. Indeed, much of the variance in use of revealing and concealing strategies was due to differences within people from situation to situation. Use of identity management strategies was predicted by interaction partner cues of acceptance or rejection as well as perception of LGB-related organizational climate and policies. Results at the within-person and between-person levels diverged in noteworthy ways. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


King, Rachel C.; Villeneuve, Emma; White, Ruth J.; Sherratt, R. Simon; Holderbaum, William; Harwin, William S. (2017):Application of data fusion techniques and technologies for wearable health monitoring.

In: Medical engineering & physics 42, S. 1–12. DOI: 10.1016/j.medengphy.2016.12.011.

Technological advances in sensors and communications have enabled discrete integration into everyday objects, both in the home and about the person. Information gathered by monitoring physiological, behavioural, and social aspects of our lives, can be used to achieve a positive impact on quality of life, health, and well-being. Wearable sensors are at the cusp of becoming truly pervasive, and could be woven into the clothes and accessories that we wear such that they become ubiquitous and transparent. To interpret the complex multidimensional information provided by these sensors, data fusion techniques are employed to provide a meaningful representation of the sensor outputs. This paper is intended to provide a short overview of data fusion techniques and algorithms that can be used to interpret wearable sensor data in the context of health monitoring applications. The application of these techniques are then described in the context of healthcare including activity and ambulatory monitoring, gait analysis, fall detection, and biometric monitoring. A snap-shot of current commercially available sensors is also provided, focusing on their sensing capability, and a commentary on the gaps that need to be bridged to bring research to market.


Kircanski, Katharina; Thompson, Renee J.; Sorenson, James; Sherdell, Lindsey; Gotlib, Ian H. (2017):The everyday dynamics of rumination and worry. Precipitant events and affective consequences.

In: Cognition & emotion, S. 1–13. DOI: 10.1080/02699931.2017.1278679.

Rumination and worry are two perseverative, negatively valenced thought processes that characterise depressive and anxiety disorders. Despite significant research interest, little is known about the everyday precipitants and consequences of rumination and worry. Using an experience sampling methodology, we examined and compared rumination and worry with respect to their relations to daily events and affective experience. Participants diagnosed with Major Depressive Disorder (MDD), Generalized Anxiety Disorder (GAD), co-occurring MDD-GAD, or no diagnosis carried an electronic device for one week and reported on rumination, worry, significant events, positive affect (PA), and negative affect (NA). Across the clinical groups, occurrences of everyday events predicted subsequent increases in rumination, but not worry. Further, higher momentary levels of rumination, but not worry, predicted subsequent decreases in PA and increases in NA. Thus, in these clinical groups, rumination was more susceptible to daily events and produced stronger affective changes over time. We discuss implications for theory and clinical intervention.


Klein, Nicola S.; van Rijsbergen, Gerard D.; Doesschate, Mascha C. ten; Hollon, Steven D.; Burger, Huibert; Bockting, Claudi L. H. (2017):Beliefs about the causes of depression and recovery and their impact on adherence, dosage, and successful tapering of antidepressants.

In: Depression and anxiety 34 (3), S. 227–235. DOI: 10.1002/da.22598.

Background: Continuation of antidepressant medication (ADM) after remission is widely used to prevent depressive relapse/recurrence. Little is known about predictors of ADM use in terms of adherence, dosage, and successful tapering. The current study aimed to explore beliefs about the causes of depression and recovery (i.e., causal beliefs) and to examine whether they predict ADM use. Methods: The data were drawn from a controlled trial and an extension of this trial with additional experience sampling. In total, 289 remitted patients with recurrent depression (ADM ≥ 6 months) were randomly assigned to Preventive Cognitive Therapy (PCT)with ADM tapering, PCT with maintenance ADM, or maintenance ADM alone. Adherence, ADM dosage, and causal beliefs regarding the first and last depressive episodes were explored via questionnaires. Results: Most patients mentioned stressful life events as cause of depression, although more patients tended to endorse external causes for the first episode and internal causes for the last episode. ADM was most often mentioned as helpful during recovery from both episodes. Over half of all patients were adherent and under half of the patients in the tapering condition were able to complete the taper. Causal beliefs did not predict ADM use. Conclusions: The results suggest that causal beliefs play little role in the use of maintenance ADM. More information is needed on factors contributing to successful tapering. The results must be interpreted with caution as this is not a naturalistic study and the results might be biased toward amore favorable view regarding ADM. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Klippel, Annelie; Myin-Germeys, Inez; Chavez-Baldini, UnYoung; Preacher, Kristopher J.; Kempton, Matthew; Valmaggia, Lucia et al. (2017):Modeling the interplay between psychological processes and adverse, stressful contexts and experiences in pathways to psychosis. An Experience Sampling Study.

In: Schizophrenia bulletin 43 (2), S. 302–315. DOI: 10.1093/schbul/sbw185.

Several integrated models of psychosis have implicated adverse, stressful contexts and experiences, and affective and cognitive processes in the onset of psychosis. In these models, the effects of stress are posited to contribute to the development of psychotic experiences via pathways through affective disturbance, cognitive biases, and anomalous experiences. However, attempts to systematically test comprehensive models of these pathways remain sparse. Using the Experience Sampling Method in 51 individuals with first-episode psychosis (FEP), 46 individuals with an atrisk mental state (ARMS) for psychosis, and 53 controls, we investigated how stress, enhanced threat anticipation, and experiences of aberrant salience combine to increase the intensity of psychotic experiences. We fitted multilevel moderated mediation models to investigate indirect effects across these groups. We found that the effects of stress on psychotic experiences were mediated via pathways through affective disturbance in all 3 groups. The effect of stress on psychotic experiences was mediated by threat anticipation in FEP individuals and controls but not in ARMS individuals. There was only weak evidence of mediation via aberrant salience. However, aberrant salience retained a substantial direct effect on psychotic experiences, independently of stress, in all 3 groups. Our findings provide novel insights on the role of affective disturbance and threat anticipation in pathways through which stress impacts on the formation of psychotic experiences across different stages of early psychosis in daily life.


Klippel, Annelie; Viechtbauer, Wolfgang; Reininghaus, Ulrich; Wigman, Johanna; van Borkulo, Claudia; Myin-Germeys, Inez; Wichers, Marieke (2017):The cascade of stress. A Network Approach to Explore Differential Dynamics in Populations Varying in Risk for Psychosis.

In: Schizophrenia bulletin. DOI: 10.1093/schbul/sbx037.

Stress plays a central role in the development and persistence of psychosis. Network analysis may help to reveal mechanisms at the level of the micro-dynamic effects between stress, other daily experiences and symptomatology. This is the first study to examine time-lagged networks of the relations between minor daily stress, momentary affect/thoughts, psychotic experiences, and other potentially relevant daily life contexts in individuals varying in risk for psychosis. Intensive longitudinal data were obtained through 6 studies. The combined sample consisted of 654 individuals varying in risk for psychosis: healthy control subjects (n = 244), first-degree relatives of psychotic patients (n = 165), and psychotic patients (n = 245). Using multilevel models combined with permutation testing, group-specific time-lagged network connections between daily experiences were compared between groups. Specifically, the role of stress was examined. Risk for psychosis was related to a higher number of significant network connections. In all populations, stress had a central position in the network and showed direct and significant connections with subsequent psychotic experiences. Furthermore, the higher the risk for psychosis, the more variables “loss of control” and “suspicious” were susceptible to influences by other network nodes. These findings support the idea that minor daily stress may play an important role in inducing a cascade of effects that may lead to psychotic experiences.


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: Research in autism spectrum disorders 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(R) -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(R) -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.


Kratz, A. L.; Kalpakjian, C. Z.; Hanks, R. A. (2017):Are intensive data collection methods in pain research feasible in those with physical disability? A study in persons with chronic pain and spinal cord injury.

In: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 26 (3), S. 587–600. DOI: 10.1007/s11136-016-1494-0.

Purpose: Intensive repeated measures data collection procedures, such as ecological momentary assessment (EMA) and end-of-day (EOD) diaries, are becoming more prominent in pain research. Existing data on the feasibility of such methods is encouraging; however, almost nothing is known about feasibility in clinical populations with significant physical disabilities. Research methodology feasibility is crucial to the inclusion of individuals with physical disability in pain research given the high prevalence and impact of pain in these populations. The aim of this study was to examine study compliance, protocol acceptability, and reactivity of intensive data collection methods in adults with chronic pain and spinal cord injury (SCI). Methods: Secondary analysis of data from a 7-day EMA and EOD diary study in a sample of 131 community dwelling adults with SCI. Results: Results showed rates of missing data ranged from 18.4 to 22.8% across measures. Participant compliance was related to time of day/presence of audible prompts, mobility aid use, race, and baseline levels of pain and pain interference, with more missing data at wake and bedtimes/no prompts, and for those who used hand-held mobility devices, identified as black/African American, and/or reported higher baseline pain and pain interference. Participants rated the study methodology as generally highly acceptable and expressed willingness to participate in similar studies of much longer duration. There was no evidence of reactivity, defined as temporal shifts in pain or pain interference ratings. Conclusions: Overall, intensive pain data collection is feasible in persons with SCI with no evidence that the methodology impacts pain intensity or pain interference ratings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Kratz, Anna L.; Ehde, Dawn M.; Bombardier, Charles H.; Kalpakjian, Claire Z.; Hanks, Robin A. (2017):Pain acceptance decouples the momentary associations between pain, pain interference, and physical activity in the daily lives of people with chronic pain and spinal cord injury.

In: The journal of pain : official journal of the American Pain Society 18 (3), S. 319–331. DOI: 10.1016/j.jpain.2016.11.006.

Pain acceptance is a robust predictor of adjustment to chronic pain; however, the dynamics of pain acceptance in daily life are largely unexamined. Furthermore, research on pain acceptance in those with pain and physical disability is needed. To examine pain acceptance in daily life, we collected 7 days of ecological momentary assessments of pain intensity and pain interference (5 times per day) with continuous accelerometry (physical activity) in 128 individuals with chronic pain and spinal cord injury. Multilevel modeling revealed that pain acceptance significantly moderated the momentary association between pain intensity and pain interference; those with higher pain acceptance experienced a blunted increase in interference when pain was high. Pain acceptance also moderated the association between pain intensity and physical activity; high pain acceptance was associated with an increase and low pain acceptance with a decrease in physical activity in the context of high pain. The activities engagement component of pain acceptance was a slightly more robust driver of these interaction effects; whereas activities engagement significantly moderated the association between momentary pain and pain interference as well as physical activity, pain willingness exerted a significant moderating effect on the momentary association between pain intensity and pain interference only. These findings suggest that both components contribute to the decoupling effects of pain acceptance. Task persistence did not show the same moderating effects, indicating that pain acceptance may be unique from other types of behavioral pain coping in its ability to decouple expected associations between pain intensity, pain interference, and physical activity. Perspective: In the daily lives of individuals with chronic pain and spinal cord injury, pain acceptance buffered expected increases in pain interference and decreases in physical activity in the context of high pain. These findings can inform further development of models of chronic pain adjustment and of more efficient, effective treatment approaches. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Kwasnicka, Dominika; Dombrowski, Stephan U.; White, Martin; Sniehotta, Falko F. (2017):N-of-1 study of weight loss maintenance assessing predictors of physical activity, adherence to weight loss plan and weight change.

In: Psychology & health 32 (6), S. 686–708. DOI: 10.1080/08870446.2017.1293057.

OBJECTIVE: Behaviour change interventions are effective in supporting individuals to achieve clinically significant weight loss, but weight loss maintenance (WLM) is less often attained. This study examined predictive variables associated with WLM. DESIGN: N-of-1 study with daily ecological momentary assessment combined with objective measurement of weight and physical activity, collected with wireless devices (Fitbit) for six months. Eight previously obese adults who had lost over 5% of their body weight in the past year took part. Data were analysed using time series methods. MAIN OUTCOMES MEASURES: Predictor variables were based on five theoretical themes: maintenance motives, self-regulation, personal resources, habits, and environmental influences. Dependent variables were: objectively estimated step count and weight, and self-reported WLM plan adherence. RESULTS: For all participants, daily fluctuations in self-reported adherence to their WLM plan were significantly associated with most of the explanatory variables, including maintenance motivation and satisfaction with outcomes, self-regulation, habit, and stable environment. Personal resources were not a consistent predictor of plan adherence. CONCLUSION: This is the first study to assess theoretical predictions of WLM within individuals. WLM is a dynamic process including the interplay of motivation, self-regulation, habit, resources, and perceptions of environmental context. Individuals maintaining their weight have unique psychological profiles which could be accounted for in interventions.


Lane, Sean P.; Carpenter, Ryan W.; Sher, Kenneth J.; Trull, Timothy J. (2016):Alcohol craving and consumption in borderline personality disorder. When, Where, and with Whom.

In: Clinical psychological science : a journal of the Association for Psychological Science 4 (5), S. 775–792. DOI: 10.1177/2167702615616132.

Substance use is highly prevalent in our society, and substance use disorders are comorbid with most psychiatric disorders, including borderline personality disorder (BPD; Grant et al., 2006, 2008). Craving is a fundamental feature of addiction and disorder, yet the contexts in which craving occurs and is associated with substance use is still under-researched. We examined alcohol craving and consumption in a sample of 56 BPD individuals and a comparison group of community drinkers (COM; n = 60) who carried electronic diaries for approximately 21 days. BPD individuals reported more craving than COM individuals in most contexts. Compared to COM individuals, elevated craving in BPD individuals was paralleled by more drinking when at work, at home, and with romantic partners, coworkers, and children. These findings identify contexts of particular relevance to those with BPD and other mood/anxiety disorders in which craving may lead to risky and maladaptive alcohol use.


Le, Bonnie (2017):Parental caregiving goals and the subjective experience of caregiving.

In: Dissertation Abstracts International: Section B: The Sciences and Engineering 77 (8-B(E)).

The current investigation identified the goals that motivate parents to provide care to their children and how these goals relate to parents’ subjective experiences of caregiving. In two pilot studies and Study 1, a total of 1,137 parents were surveyed to develop the Parental Caregiving Goals Scale (PCGS), which captures four unique goals: child love and security, child growth and development, parent self-consciousness, and child acceptance. In Study 2, a cross-sectional study of 701 parents, the four-factor structure of the PCGS was confirmed and each goal was found to be related in unique ways to individual differences in parenting beliefs, concern for others, and self-focused concerns. The pursuit of child love and security goals was associated with greater emotional well-being, parent-child relationship quality, and responsiveness to a child’s needs, whereas parent self-consciousness and child growth and development goals were both associated with lower emotional well-being, parent-child relationship quality, and responsiveness to a child’s needs. Child acceptance goals predicted greater positive emotions only. In Study 3, a 10-day experience sampling study of 118 parents, the daily pursuit of child love and security goals and child acceptance goals predicted more positive caregiving experiences, whereas daily pursuit of parent self-consciousness goals and child growth and development goals predicted more negative caregiving experiences. Parents’ daily pursuit of each goal was also uniquely predictive of the caregiving behaviors in which they engaged. Lastly, while parental caregiving goal pursuit varied at the mean level based on parents’ own and their child’s demographics, these demographic characteristics largely did not change how caregiving goals predicted the subjective caregiving experience. Collectively, the current findings shed light on the goals that motivate parents to care for their children, provide insight into why parenting is both joyful and frustrating, and identify when parents feel most responsive to their children’s needs. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Leibach, Gillian G.; Everhart, Robin S. (2017):Family assessment device. Real-World Validity in Urban Families of Children With Asthma.

In: Journal of family psychology : JFP : journal of the Division of Family Psychology of the American Psychological Association (Division 43). DOI: 10.1037/fam0000313.

Ecological momentary assessment (EMA) was used to further validate the real-world predictability of the Family Assessment Device (FAD) among low income, racial and ethnic minority, urban families of children (7–12 years) with asthma. Caregivers completed self-report measures at baseline, as well as daily assessments of family functioning for 2 weeks through EMA delivered via smartphone. Concurrent validity was established with measures of caregiver perceived stress and positive and negative affect at baseline. Better family functioning at baseline was associated with EMA reports of families getting along better and of being better able to balance multiple family needs, including child asthma management. Consistent with previous literature, findings suggest the FAD is an ecologically valid measure for use with urban families of children with asthma. Researchers and clinicians may be confident that assessments of family functioning in research and clinical settings are predictive of what may be happening in the family’s everyday life. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Lennarz, Hannah K.; Lichtwarck-Aschoff, Anna; Finkenauer, Catrin; Granic, Isabela (2017):Jealousy in adolescents’ daily lives. How does it relate to interpersonal context and well-being?

In: Journal of adolescence 54, S. 18–31. DOI: 10.1016/j.adolescence.2016.09.008.

Past studies have shown that jealousy peaks in adolescence. However, little is known about how and when adolescents experience jealousy in their daily lives. The current study aimed to examine the relation between state jealousy, the more general propensity to feel jealous, the interpersonal contexts in which jealousy arises, and different forms of social comparison. The impact of jealousy on perceptions of well-being was also explored. We used an experience sampling method during two weekends with 68 adolescents (Mage = 13.94; 64.70% girls). Jealousy was common: On average, 90% of our sample experienced jealousy in 20% of the assessments. Adolescents reported more jealousy with peers than with family. Additionally, they experienced more jealousy when in online contexts than when in face-to-face peer contexts. The normative nature of jealousy, its developmental function and relation with well-being, and implications for understanding jealousy triggered in (highly social) online contexts are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Lin, Katrina Jia; Ilies, Remus; Pluut, Helen; Pan, Su-Ying (2017):You are a helpful co-worker, but do you support your spouse? A resource-based work-family model of helping and support provision.

In: Organ Behav Hum Decis Process 138, S. 45–58. DOI: 10.1016/j.obhdp.2016.12.004.

Drawing from the literature on behavioral spillover effects, the work-home resources model and research on helping at work, we investigate how help provision at work spills over to influence the provision of spousal support at home by examining a resource generation mechanism and a resource depletion mechanism. Across two experience-sampling studies, we collected data from employees and their spouses multiple times per day in different domains for ten workdays. Results from our two-study examination supported both the resource generation mechanism and the resource depletion mechanism. On days when employees helped colleagues more, they reported higher positive affect, which led to higher support provision to their spouses; meanwhile, higher levels of helping translated in less time for the family, which led to lower support provided to spouses. In Study 2, we tested and found that prosocial motivation enhanced the resource-generating effect of help provision. Theoretical and practical implications are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Liu, Wu; Song, Zhaoli; Li, Xian; Liao, Zhenyu (2017):Why and when leaders’ affective states influence employee upward voice.

In: Acad Manage J 60 (1), S. 236–263. DOI: 10.5465/amj.2013.1082.

Although researchers have argued that employees often carefully examine social contexts before speaking up to leaders, the role of leaders’ affective states has received little attention. The current research addresses this important issue from an emotion-as-social-information perspective by exploring whether, why, and when leaders’ affect influences employees’ voice behavior. By collecting data of 640 daily interactions from both sides of 85 leader–employee dyads using the experience sampling method through mobile surveys, we found that leaders’ positive affect was positively related to employees’ voice behavior. Furthermore, such a relationship could be accounted for through employees’ psychological safety directly via the emotional contagion mechanism (through employees’ own positive affect) but not directly via the signaling mechanism (through employees’ assessment of leaders’ positive affect); and the effects of both employees’ own positive affect and their assessments of leaders’ positive affect on psychological safety were stronger when the leader–member exchange relationship was weak. Interestingly, we also found that leaders’ negative affect was positively related to employees’ voice, but neither emotional contagion nor signaling mechanisms explained this effect. These findings highlight the important role of leaders’ affect in the voice process and also provide insights for when employees would choose to speak up to their leaders. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Lydon-Staley, David M.; Cleveland, H. Harrington; Huhn, Andrew S.; Cleveland, Michael J.; Harris, Jonathan; Stankoski, Dean et al. (2017):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 65, S. 275–282. 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) 2017 APA, all rights reserved)


Maher, Jaclyn P.; Rhodes, Ryan E.; Dzubur, Eldin; Huh, Jimi; Intille, Stephen; Dunton, Genevieve F. (2017):Momentary assessment of physical activity intention-behavior coupling in adults.

In: Translational behavioral medicine. DOI: 10.1007/s13142-017-0472-6.

Research attempting to elucidate physical activity (PA) intention-behavior relations has focused on differences in long-term behavior forecasting between people. However, regular PA requires a repeated performance on a daily or within-daily basis. An empirical case study application is presented using intensive longitudinal data from a study of PA in adults to (a) describe the extent to which short-term intention-behavior coupling occurs and (b) explore time-varying predictors of intention formation and short-term intention-behavior coupling. Adults (n = 116) participated in three 4-day waves of ecological momentary assessment (EMA). Each day, participants received EMA questionnaires assessing short-term PA intentions and wore accelerometers to assess whether they engaged in >/=10 min of moderate-to-vigorous physical activity (MVPA) in the 3-hour period after each EMA prompt. Concurrent affective states and contexts were also assessed through EMA. Participants reported having short-term intentions to engage in PA in 41% of EMA prompts. However, participants only engaged in >/=10 min of MVPA following 16% of the prompts that short-term PA intentions were reported indicating an intention-behavior gap of 84%. Odds of intentions followed by PA were greater on occasions when individuals reported higher levels of positive affect than was typical for them. This study is the first to take an EMA approach to describe short-term intention-behavior coupling in adults. Results suggest that adults have difficulty translating intentions into behavior at the momentary level, more so than over longer timescales, and that positive affect may be a key to successfully translating intentions into behavior.


Maisto, Stephen A.; Xie, Feng Chang; Witkiewitz, Katie; Ewart, Craig K.; Connors, Gerard J.; Zhu, Hongtu et al. (2017):How chronic self-regulatory stress, poor anger regulation, and momentary affect undermine treatment for alcohol use disorder. Integrating social action theory with the dynamic model of relapse.

In: J Soc Clin Psychol 36 (3), S. 238–263. DOI: 10.1521/jscp.2017.36.3.238.

We tested the hypothesis that indices of chronic self-regulatory stress specified by Social Action Theory (SAT; Ewart, 2011) and indices of affect specified by the Dynamic Model of Relapse (DMR; Witkiewitz & Marlatt, 2004) predict daily alcohol use by persons in outpatient treatment for alcohol use disorder (AUD). Participants (69 men, 50 women; aged 19–76) in AUD outpatient programs completed 2 baseline laboratory assessments, then provided daily ecological momentary assessment (EMA) reports of state affect and alcohol use for 28 days. SAT indices of chronic self-regulatory stress were obtained in the laboratory with the Social Competence Interview (SCI) and the Anger Transcendence Challenge (ATC). Chronic regulatory stress was indexed by blood pressure responses to both tasks. Emotion regulation capabilities were indexed by anger regulation behavior observed during ATC, and by self-ratings of recent positive social interactions and goal thoughts. DMR indices of trait and state affect were obtained with the General Psychiatric Distress scale of the Brief Symptom Inventory, the trait anger scale of the Buss-Perry Aggression Questionnaire, and intensive EMA ratings of state affect (anger, sadness, fear, happiness, stress) during each day. The outcomes were: (a) not drinking on a given day, and (b) number of drinks consumed when drinking. Statistical models accounting for problems of zero inflation in drinking data and missing data evaluated the hypothesis that ‘tonic’ (cumulative) and phasic (situational) processes specified by the SAT and DMR models together shape drinking in a given moment. No drinking was reported on 91% of days; reports were missing on 7.2% of days. Both drinking outcomes were predicted by SAT indices of SCI self-directive stress, ATC anger regulation, positive goal cognitions and social interactions, and by DMR indices of general distress and state affect (sad, angry, stressed). Unexpected and potentially informative associations emerged also. The findings were robust under models that accounted for different missing data assumptions. Findings suggest that SAT and DMR models and methods may advance scientific understanding of drinking risk during outpatient AUD treatment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Majumder, Sumit; Mondal, Tapas; Deen, M. Jamal (2017):Wearable sensors for remote health monitoring.

In: Sensors (Basel, Switzerland) 17 (1). DOI: 10.3390/s17010130.

Life expectancy in most countries has been increasing continually over the several few decades thanks to significant improvements in medicine, public health, as well as personal and environmental hygiene. However, increased life expectancy combined with falling birth rates are expected to engender a large aging demographic in the near future that would impose significant burdens on the socio-economic structure of these countries. Therefore, it is essential to develop cost-effective, easy-to-use systems for the sake of elderly healthcare and well-being. Remote health monitoring, based on non-invasive and wearable sensors, actuators and modern communication and information technologies offers an efficient and cost-effective solution that allows the elderly to continue to live in their comfortable home environment instead of expensive healthcare facilities. These systems will also allow healthcare personnel to monitor important physiological signs of their patients in real time, assess health conditions and provide feedback from distant facilities. In this paper, we have presented and compared several low-cost and non-invasive health and activity monitoring systems that were reported in recent years. A survey on textile-based sensors that can potentially be used in wearable systems is also presented. Finally, compatibility of several communication technologies as well as future perspectives and research challenges in remote monitoring systems will be discussed.


Marcusson-Clavertz, David; Gušić, Sabina; Bengtsson, Hans; Jacobsen, Heidi; Cardeña, Etzel (2017):The relation of dissociation and mind wandering to unresolved/disorganized attachment. An experience sampling study.

In: Attachment & human development 19 (2), S. 170–190. DOI: 10.1080/14616734.2016.1261914.

Individuals with unresolved/disorganized representations of childhood trauma (U/d attachment) report more psychological distress than others, but little is known about their everyday mentation. In the present study adults with childhood trauma (N = 45) completed the Berkeley-Leiden Adult Attachment Questionnaire-Unresolved (BLAAQ-U) and the Adult Attachment Interview (AAI), and reported everyday mentation during 5 days of experience sampling. The BLAAQ-U and the AAI showed a medium association with each other, but only the former significantly predicted negative affect, dissociation, and low control/awareness of mentation. Contrary to our predictions, U/d attachment did not significantly predict mind wandering, but the BLAAQ-U predicted endorsements of a negative mind wandering style. U/d attachment, as assessed by both instruments, was associated with the Poor attentional control style and beliefs in anomalous mental phenomena. Experience sampling is a valuable way to investigate everyday experiences in individuals with U/d attachment. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Mason, Tyler B.; Lavender, Jason M.; Wonderlich, Stephen A.; Steiger, Howard; Cao, Li; Engel, Scott G. et al. (2017):Comfortably numb. The Role of Momentary Dissociation in the Experience of Negative Affect Around Binge Eating.

In: The Journal of nervous and mental disease 205 (5), S. 335–339. DOI: 10.1097/NMD.0000000000000658.

Evidence suggests that both dissociation and negative affect (NA) may precipitate binge eating. The extent to which dissociation may impact the experience of NA around binge eating is unclear. Women with bulimia nervosa completed a 2-week ecological momentary assessment protocol of dissociation, NA, and binge eating. Multilevel modeling was used to examine dissociation as a moderator of NA before and after binge eating. NA was greater at the time of binge eating for participants higher in average dissociation (between subjects) and when momentary dissociation was greater than one’s average (within subjects). The trajectory of NA was characterized by a sharper increase before binge eating for participants higher in average dissociation; the NA trajectories were characterized by sharper increases before and decreases after binge eating when momentary dissociation was greater than one’s average. Results support the salience of both dissociation and NA in relation to the occurrence of binge eating.


Metcalf, David; Milliard, Sharlin T. J.; Gomez, Melinda; Schwartz, Michael (2016):Wearables and the internet of things for health. Wearable, Interconnected Devices Promise More Efficient and Comprehensive Health Care.

In: IEEE pulse 7 (5), S. 35–39. DOI: 10.1109/MPUL.2016.2592260.

In our recent book Health-e Everything: Wearables and the Internet of Things for Health, we capture in an interactive e-book format some global thought-leader perspectives as well as early examples of case studies and novel innovations that are driving this emerging technology domain. Here, we provide a brief snapshot of key findings related to these novel technologies and use cases, which are driving both health care practitioners and health consumers (patients). As technologists, having a firm understanding of customer-driven innovation and the actual user benefits of interconnective devices for health will help us engineer better solutions that are more targeted to the triple aim of better, faster, and cheaper health solutions.


Miner, Philip B., JR; Koltun, William D.; Wiener, Gregory J.; La Portilla, Marianela de; Prieto, Blas; Shailubhai, Kunwar et al. (2017):A randomized phase III clinical trial of plecanatide, a uroguanylin analog, in patients with chronic Idiopathic Constipation.

In: The American journal of gastroenterology 112 (4), S. 613–621. DOI: 10.1038/ajg.2016.611.

OBJECTIVES: This study assessed the efficacy and safety of plecanatide, a guanylate cyclase-C (GC-C) agonist and the first uroguanylin analog approved for the treatment of chronic idiopathic constipation (CIC). METHODS: This phase III, multicenter, double-blind, placebo-controlled study randomized 1,394 patients with CIC. Patients received either plecanatide (3 or 6 mg) or placebo, orally, once daily, for 12 weeks. The primary efficacy endpoint was the percentage of patients who were durable overall complete spontaneous bowel movement (CSBM) responders over the 12-week treatment period. Patients were instructed to record their daily bowel movements, stool consistency scores, and abdominal symptoms in an electronic diary. Treatment-emergent adverse events (AEs) were collected. RESULTS: Each dose of plecanatide resulted in a significantly greater percentage of durable overall CSBM responders (21.0%, 3 mg; 19.5%, 6 mg) as compared with placebo (10.2%; P<0.001 for both). Plecanatide (3 and 6 mg) also significantly increased mean weekly CSBM frequency from baseline (increase of 2.5 and 2.2/week, respectively) vs. placebo (1.2/week; P<0.001 for both) and mean weekly spontaneous bowel movement frequency (increase of 3.2 and 3.1/week, respectively) vs. placebo (1.3/week; P<0.001, for both) over the 12-week treatment period. Both plecanatide doses significantly improved all secondary and additional efficacy endpoints. The most common AE, diarrhea, occurred in 1.3% (placebo), 5.9% (3 mg) and 5.7% (6 mg) of patients. CONCLUSIONS: Plecanatide significantly improved constipation and its related symptoms with a low rate of adverse events. These results suggest that plecanatide will be a useful treatment option in the management of CIC. NCT01982240.


Moehring, Anne; Schroeders, Ulrich; Leichtmann, Benedikt; Wilhelm, Oliver (2017):Corrigendum to ‘ecological momentary assessment of digital literacy. Influence of fluid and crystallized intelligence, domain-specific knowledge, and computer usage’.

In: Intelligence 60, S. 63. DOI: 10.1016/j.intell.2016.12.003.

Reports an error in ‘Ecological momentary assessment of digital literacy: Influence of fluid and crystallized intelligence, domain-specific knowledge, and computer usage’ by Anne Moehring, Ulrich Schroeders, Benedikt Leichtmann and Oliver Wilhelm (Intelligence, 2016[Nov-Dec], Vol 59, 170-180). The original publication of this article excluded the abstract and keywords. The abstract and keywords are present in the erratum. (The following abstract of the original article appeared in record [rid]2016-55934-007[/rid]). The ability to comprehend new information is closely related to the successful acquisition of new knowledge. With the ubiquitous availability of the Internet, the procurement of information online constitutes a key aspect in education, work, and our leisure time. In order to investigate individual differences in digital literacy, test-takers were presented with health-related comprehension problems with task-specific time restrictions. Instead of reading a given text, they were instructed to search the Internet for the information required to answer the questions. We investigated the relationship between this newly developed test and fluid and crystallized intelligence, while controlling for computer usage, in two studies with adults (n₁ = 120) and vocational high school students (n₂ = 171). Structural equation modeling was used to investigate the amount of unique variance explained by each predictor. In both studies, about 85% of the variance in the digital literacy factor could be explained by reasoning and knowledge while computer usage did not add to the variance explained. In Study 2, prior health-related knowledge was included as a predictor instead of general knowledge. While the influence of fluid intelligence remained significant, prior knowledge strongly influenced digital literacy (β=.81). Together both predictor variables explained digital literacy exhaustively. These findings are in line with the view that knowledge is a major determinant of higher-level cognition. Further implications about the influence of the restrictiveness of the testing environment are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Moitra, Ethan; Gaudiano, Brandon A.; Davis, Carter H.; Ben-Zeev, Dror (2017):Feasibility and acceptability of post-hospitalization ecological momentary assessment in patients with psychotic-spectrum disorders.

In: Comprehensive psychiatry 74, S. 204–213. DOI: 10.1016/j.comppsych.2017.01.018.

BACKGROUND: Up to 50% of patients with psychotic-spectrum disorders are medication nonadherent. The use of real-time assessment via ecological momentary assessment (EMA) on mobile devices might offer important insights into adherence behaviors that cannot be measured in the clinic. However, existing EMA studies have only studied acutely ill patients during hospitalization or more stable patients in the community. METHODS: Feasibility and acceptability of EMA in 65 patients with psychotic-spectrum disorders who were recently discharged from the hospital were assessed. EMA was administered for four weeks via study-provided mobile devices. Feasibility was measured by study recruitment/retention rates, patients’ connectivity, and completion rates. Quantitative and qualitative acceptability data were collected. RESULTS: Participants completed 28-31% of offered EMA assessments. The only significant predictor of reduced EMA completion was recent cannabis use. EMA completion was maintained from weeks 1 to 3 but significantly dropped at the fourth week. Patient acceptability feedback was generally positive; negative comments related primarily to technological problems. CONCLUSIONS: This was the first study to use EMA in recently discharged patients with psychotic-spectrum disorders. EMA is feasible and acceptable in this population, but completion rates were lower than in more stable samples. Future research should consider limiting the assessment period, screening for substance use, and integrating assessment with intervention elements to increase EMA engagement.


Moore, Raeanne C.; Kaufmann, Christopher N.; Rooney, Alexandra S.; Moore, David J.; Eyler, Lisa T.; Granholm, Eric et al. (2016):Feasibility and acceptability of ecological momentary assessment of daily functioning among older adults with HIV.

In: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. DOI: 10.1016/j.jagp.2016.11.019.

OBJECTIVE: This study aimed to examine the feasibility, acceptability, and initial validity of using smartphone-based ecological momentary assessment (EMA) to assess daily functioning and other behavioral factors among older HIV+ adults. METHODS: Twenty older HIV+ adults (mean age: 59 years) completed laboratory-based neurobehavioral and functional assessments then completed EMA surveys via smartphones five times per day for one week. RESULTS: Excellent EMA adherence (86.4%) was found, and participants rated their experience with EMA methods positively. Time-use data indicated participants were spending 74% of their waking-sampled time at home, 63% of their time alone, and 32% of their time engaged in passive leisure activities (e.g., watching TV). Better neurocognitive and functional capacity abilities were correlated with less time spent in passive leisure activities. Lastly, mood and cognitive symptom data collected via EMA were significantly associated with scores from laboratory-based assessments of these same constructs. CONCLUSIONS: EMA via smartphones is a feasible and acceptable data collection method among older HIV+ adults and appears to be a promising mobile tool to assess daily functioning behaviors in HIV. These preliminary findings indicate older HIV+ adults are spending a considerable amount of time at home, alone, and engaged in passive leisure activities, primarily watching TV. EMA may contribute to future research examining functional disability among the growing population of older HIV+ adults.


Moran, Erin K.; Culbreth, Adam J.; Barch, Deanna M. (2017):Ecological momentary assessment of negative symptoms in schizophrenia. Relationships to effort-based decision making and reinforcement learning.

In: Journal of abnormal psychology 126 (1), S. 96–105. DOI: 10.1037/abn0000240.

Negative symptoms are a core clinical feature of schizophrenia, but conceptual and methodological problems with current instruments can make their assessment challenging. One hypothesis is that current symptom assessments may be influenced by impairments in memory and may not be fully reflective of actual functioning outside of the laboratory. The present study sought to investigate the validity of assessing negative symptoms using ecological momentary assessment (EMA). Participants with schizophrenia (N = 31) completed electronic questionnaires on smartphones 4 times a day for 1 week. Participants also completed effort-based decision making and reinforcement learning (RL) tasks to assess the relationship between EMA and laboratory measures, which tap into negative symptom relevant domains. Hierarchical linear modeling analyses revealed that clinician-rated and self-report measures of negative symptoms were significantly related to negative symptoms assessed via EMA. However, working memory moderated the relationship between EMA and retrospective measures of negative symptoms, such that there was a stronger relationship between EMA and retrospective negative symptom measures among individuals with better working memory. The authors also found that negative symptoms assessed via EMA were related to poor performance on the effort task, whereas clinician-rated symptoms and self-reports were not. Further, they found that negative symptoms were related to poorer performance on learning reward contingencies. The findings suggest that negative symptoms can be assessed through EMA and that working memory impairments frequently seen in schizophrenia may affect recall of symptoms. Moreover, these findings suggest the importance of examining the relationship between laboratory tasks and symptoms assessed during daily life. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

General Scientific Summary—Recent advances have been made in the assessment of negative symptoms, however, questions remain regarding whether current assessment techniques reflect how people actually feel as they go about their daily life. In the current study, the authors found that ecological momentary assessment is a feasible method for assessing impairments in motivation and pleasure. Moreover, they found that impairments in working memory may impact participants’ ability to report their negative symptoms via currently used assessment strategies. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Moran, Landhing M.; Phillips, Karran A.; Kowalczyk, William J.; Ghitza, Udi E.; Agage, Daniel A.; Epstein, David H.; Preston, Kenzie L. (2017):Aripiprazole for cocaine abstinence. A randomized–controlled trial with ecological momentary assessment.

In: Behavioural pharmacology 28 (1), S. 63–73. DOI: 10.1097/FBP.0000000000000268.

Aripiprazole blocks psychostimulant seeking in a rat model of relapse. However, in humans, it may increase ongoing use. We tested aripiprazole specifically for relapse prevention. Methadone-maintained outpatients who were abstinent from cocaine in weeks 11–12 were randomized to double-blind aripiprazole (15 mg daily) or placebo in weeks 13–27 after 12 weeks of contingency management. Participants reported craving through ecological momentary assessment. We stopped the trial because very few (18/41) participants fulfilled the abstinence criterion. The results suggested that aripiprazole delayed lapse [hazard ratio (HR) = 0.45, 95% confidence interval (CI) = 0.14–1.42, P = 0.17] and relapse (HR = 0.31, 95% CI = 0.07–1.27, P = 0.10), but the effects did not reach statistical significance. Unexpectedly, the proportion of participants reporting cocaine craving was higher in the aripiprazole group (Fisher’s exact P = 0.026), although the frequency of craving was similar in the aripiprazole and placebo groups (1.89 vs. 1.16%, reffect = 0.43, 95% CI = −0.08−0.76). The results suggest that in recently abstinent cocaine users, aripiprazole might delay relapse, but might also slightly increase craving. Difficulty in trial implementation underscores the fact that initial abstinence from cocaine is not a trivial hurdle. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Muench, Frederick; van Stolk-Cooke, Katherine; Kuerbis, Alexis; Stadler, Gertraud; Baumel, Amit; Shao, Sijing et al. (2017):A randomized controlled pilot trial of different mobile messaging interventions for problem drinking Compared to Weekly Drink Tracking.

In: PloS one 12 (2), e0167900. DOI: 10.1371/journal.pone.0167900.

INTRODUCTION: Recent evidence suggests that text messaging may help to reduce problem drinking as an extension to in-person services, but very little is known about the effectiveness of remote messaging on problem drinking as a stand-alone intervention, or how different types of messages may improve drinking outcomes in those seeking to moderate their alcohol consumption. METHODS: We conducted an exploratory, single-blind randomized controlled pilot study comparing four different types of alcohol reduction-themed text messages sent daily to weekly drink self-tracking texts in order to determine their impact on drinking outcomes over a 12-week period in 152 participants ( approximately 30 per group) seeking to reduce their drinking on the internet. Messaging interventions included: weekly drink self-tracking mobile assessment texts (MA), loss-framed texts (LF), gain-framed texts (GF), static tailored texts (ST), and adaptive tailored texts (TA). Poisson and least squares regressions were used to compare differences between each active messaging group and the MA control. RESULTS: When adjusting for baseline drinking, participants in all messaging groups except GF significantly reduced the number of drinks consumed per week and the number of heavy drinking days compared to MA. Only the TA and GF groups were significantly different from MA in reducing the number of drinking days. While the TA group yielded the largest effect sizes on all outcome measures, there were no significant differences between active messaging groups on any outcome measure. 79.6% of individuals enrolled in the study wanted to continue receiving messages for an additional 12 weeks at the end of the study. DISCUSSION: Results of this pilot study indicate that remote automated text messages delivered daily can help adult problem drinkers reduce drinking frequency and quantity significantly more than once-a-week self-tracking messages only, and that tailored adaptive texts yield the largest effect sizes across outcomes compared to MA. Larger samples are needed to understand differences between messaging interventions and to target their mechanisms of efficacy.


Nelson, Barnaby; McGorry, Patrick D.; Wichers, Marieke; Wigman, Johanna T. W.; Hartmann, Jessica A. (2017):Moving from static to dynamic models of the onset of mental disorder. A Review.

In: JAMA psychiatry 74 (5), S. 528–534. DOI: 10.1001/jamapsychiatry.2017.0001.

Importance: In recent years, there has been increased focus on subthreshold stages of mental disorders, with attempts to model and predict which individuals will progress to full-threshold disorder. Given this research attention and the clinical significance of the issue, this article analyzes the assumptions of the theoretical models in the field. Observations: Psychiatric research into predicting the onset of mental disorder has shown an overreliance on one-off sampling of cross-sectional data (ie, a snapshot of clinical state and other risk markers) and may benefit from taking dynamic changes into account in predictive modeling. Cross-disciplinary approaches to complex system structures and changes, such as dynamical systems theory, network theory, instability mechanisms, chaos theory, and catastrophe theory, offer potent models that can be applied to the emergence (or decline) of psychopathology, including psychosis prediction, as well as to transdiagnostic emergence of symptoms. Conclusions and Relevance: Psychiatric research may benefit from approaching psychopathology as a system rather than as a category, identifying dynamics of system change (eg, abrupt vs gradual psychosis onset), and determining the factors to which these systems are most sensitive (eg, interpersonal dynamics and neurochemical change) and the individual variability in system architecture and change. These goals can be advanced by testing hypotheses that emerge from cross-disciplinary models of complex systems. Future studies require repeated longitudinal assessment of relevant variables through either (or a combination of) micro-level (momentary and day-to-day) and macro-level (month and year) assessments. Ecological momentary assessment is a data collection technique appropriate for micro-level assessment. Relevant statistical approaches are joint modeling and time series analysis, including metric-based and model-based methods that draw on the mathematical principles of dynamical systems. This next generation of prediction studies may more accurately model the dynamic nature of psychopathology and system change as well as have treatment implications, such as introducing a means of identifying critical periods of risk for mental state deterioration.


Papp, Lauren M.; Kouros, Chrystyna D. (2017):Predicting young adults’ risk for engaging in prescription drug misuse in daily life from individual, partner, and relationship factors.

In: Substance abuse 38 (1), S. 61–68. DOI: 10.1080/08897077.2016.1263590.

Background: Mounting evidence based on retrospective and global assessments has established associations between prescription drug misuse and illicit drug use, alcohol abuse, mental health problems, risky sexual behaviors, and overdose deaths. However, there is a notable absence of identified risk and protective factors for an individual’s likelihood of engaging in misuse in real-world environments. Methods: Using an experience sampling approach, the authors collected repeated moments of young adults’ (n = 95 participants drawn from 49 romantic couples) prescription drug misuse instances in daily life and tested multiple factors associated with the misuse. Results: When examined in separate multilevel models, individual and relationship factors (but not partner factors) reliably predicted the likelihood of females’ and males’ prescription drug misuse in daily life. Specifically, females’ elevated dysphoria symptoms, alcohol problems, and relationship closeness were linked with an increased likelihood of misuse, whereas cohabiting decreased the likelihood of their misuse. Males’ higher levels of illicit drug use and relationship closeness were associated with increased likelihood of misuse, whereas their dysphoria symptoms were related to a lower likelihood of misuse. When examined in models that considered the predictors simultaneously, females’ misuse was associated with individual, partner, and relationship factors, whereas males’ misuse was not reliably associated with any of the factors. Conclusions: An experience sampling approach was effective for the near-real-time assessment of young adults’ prescription drug misuse in daily environments, and the likelihood of misuse was associated with risk and protective factors from multiple levels of influence. Education and treatment efforts designed to reduce prescription drug misuse may need to be tailored to accommodate males’ and females’ distinct predictors of misuse. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Paty, Jean; Elash, Celeste A.; Turner-Bowker, Diane M. (2017):Content validity for the VVSymQ® instrument. A new patient-reported outcome measure for the assessment of varicose veins symptoms.

In: Patient 10 (1), S. 51–63. 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) 2017 APA, all rights reserved)


Pavlović, Maša; Zezelj, Iris (2017):Not only when feeling down. The relationship between mood intensity and smoking behavior.

In: Substance use & misuse 52 (4), S. 488–492. DOI: 10.1080/10826084.2016.1245334.

Background: There is substantial empirical evidence that negative mood triggers smoking behavior, and less support for the similar effect of positive mood. However, the relationship between the intensity of mood and smoking remains relatively under-researched. Objectives: The present study explored the association between mood intensity and smoking behavior. Methods: Seventy-three ad libitum smokers recorded their mood and concurrent number of smoked cigarettes three times daily for one week using electronic diary application. Real time assessment in natural environment enabled greater reliability, validity and generalizability of the collected data. Results: We analyzed results using within-subjects approach and obtained significant growth trend in smoking behavior that concurred with the increase of mood intensity—smokers tended to increase their consumption of cigarettes when they were feeling either happy or sad in comparison to the situation when they were in neutral mood. Importance: These findings raise implications regarding the role of mood intensity in initiating smoking behavior. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Perry, Tamara T.; Marshall, Alexandra; Berlinski, Ariel; Rettiganti, Mallikarjuna; Brown, Rita H.; Randle, Shemeka M. et al. (2017):Smartphone-based vs paper-based asthma action plans for adolescents.

In: Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology 118 (3), S. 298–303. DOI: 10.1016/j.anai.2016.11.028.

BACKGROUND: Adolescents with asthma are at risk of poor outcomes and are traditionally difficult to reach. OBJECTIVE: To examine adolescents’ use of and asthma outcomes associated with smartphone- vs paper-based asthma action plans (AAPs). METHODS: We conducted a 6-month randomized clinical trial with adolescents (12-17 years old) with persistent asthma. Participants used their respective smartphone or paper AAPs for medication instructions and peak flow or asthma symptoms logging. AAP use was measured electronically for smartphone users and via mail-in diaries for the paper group. Changes in Asthma Control Test (ACT) and self-efficacy scores were examined. RESULTS: Thirty-four adolescents participated in this study (median age, 15.4 years). Participants were mostly African American (62%) with state-issued insurance (71%). Adolescents in the smartphone group accessed the AAP a median of 12.17 times per week or 4.36 days per week but only recorded medications or symptoms and peak flow data in the electronic diary a median of 10 days per month during the 6-month period. Participants in the paper group recorded data a median of 23.5 days per month on their paper diaries. Overall, there were no changes in ACT and self-efficacy scores between groups. Adolescents with uncontrolled asthma (baseline ACT score </=19) had an improvement in ACT for the smartphone group (before, 11; after, 20) ([P = .04) compared with no change in the paper group (before, 17; after, 17) (P = .64). Adolescent satisfaction with the application was high, with 100% stating they would recommend the smartphone AAP to a friend. CONCLUSION: Adolescents were frequent and highly satisfied users of the smartphone AAP with a subset of participants with uncontrolled asthma demonstrating possible clinical benefit. Findings suggest a need for larger-scale studies to determine the effectiveness of smartphone-based AAPs among high-risk patients with asthma. TRIAL REGISTRATION: Identifier: NCT02091869.


Pihet, Sandrine; Ridder, Jill de; Suter, Maya (2017):Ecological momentary assessment (EMA) goes to jail. Capturing daily antisocial behavior in its context, a feasibility and reliability study in incarcerated juvenile offenders.

In: Eur J Psychol Assess 33 (2), S. 87–96. DOI: 10.1027/1015-5759/a000275.

Ecological Momentary Assessment (EMA) involves the repeated collection of data in everyday life. This method has helped uncover underlying mechanisms in several mental disorders. EMA studies are still scarce in adolescent patients and particularly incarcerated juvenile offenders (IJO), possibly due to their frequent rule-breaking and high impulsivity. This study evaluated the feasibility and reliability of EMA in IJO. One hundred three antisocial adolescents (mean age 14.8, 78% boys, including 52 IJO and 51 institutionalized antisocial adolescents, IAA) answered four times a day during 8 days questions about their antisocial behavior, negative affect, impulsivity, and fear of punishment, on a handheld computer. Staff members also regularly reported on each participant’s antisocial behavior. This first application of EMA in IJO overall supported its feasibility, with an excellent participation rate (95%) and a good compliance in completers (84%). About one-third of IJO participants dropped out, with no evidence of sampling bias across a wide range of indicators, while 96% of IAA completed EMA. No reactivity or lack of objectivity was observed. One- to two-thirds of the variance was within-person and reliability was acceptable to good. EMA can thus be reliably used in IJO to study the dynamics of daily antisocial behavior as it naturally unfolds in its context. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Piper, Megan E.; Vasilenko, Sara A.; Cook, Jessica W.; Lanza, Stephanie T. (2017):What a difference a day makes. Differences in initial abstinence response during a smoking cessation attempt.

In: Addiction (Abingdon, England) 112 (2), S. 330–339. DOI: 10.1111/add.13613.

Aims: To (1) identify distinct classes of smokers based on quit day withdrawal symptoms and (2) explore the relations between withdrawal classes and demographics, tobacco dependence, treatment and smoking outcomes. Design: Secondary data analysis of participants (n = 1504) in a randomized double‐blind placebo‐controlled multi‐site smoking cessation trial who provided ecological momentary assessments of withdrawal symptoms on their quit day. Participants received smoking cessation counseling and were randomized to receive placebo or one of five active pharmacotherapies. Setting: Research offices in Madison and Milwaukee, Wisconsin, USA. Participants: Adult smokers (n = 1236; 58% female, 86% white), recruited from the community via advertisements, who abstained on their quit day. Measurements: Demographics and tobacco dependence were assessed at baseline and participants carried palmtop computers to record withdrawal symptoms (craving, negative affect, difficulty concentrating, hunger and anhedonia) on their quit day. Point‐prevalence abstinence and latency to relapse were assessed at 8 weeks and 6 months post‐quit. Findings: Latent class analysis identified four withdrawal classes [Akaike information criterion (AIC) = 70.09]: Moderate withdrawal (64% of sample), high craving–anhedonia (8% of sample), affective withdrawal (13% of sample) and hunger (15% of sample). The high craving–anhedonia class reported significantly higher dependence (P < 0.01), were less likely to have received combination nicotine replacement, reported lower week 8 abstinence rates and relapsed sooner than those in the moderate withdrawal class (P < 0.05). The affective withdrawal class reported higher levels of baseline negative affect and life‐time psychopathology (P < 0.05) and relapsed more quickly than the moderate withdrawal class (P < 0.01). Conclusions: While the majority of smokers report typical levels of withdrawal symptoms on their quit day, more than one‐third report extreme craving or extreme negative affective or extreme hunger responses to initial abstinence. These distinct quit‐day withdrawal symptom patterns are related to baseline characteristics, treatment and cessation success. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Powell, Daniel J. H.; Liossi, Christina; Schlotz, Wolff; Moss-Morris, Rona (2017):Tracking daily fatigue fluctuations in multiple sclerosis. Ecological momentary assessment provides unique insights.

In: Journal of behavioral medicine. DOI: 10.1007/s10865-017-9840-4.

Studies investigating the prevalence, cause, and consequence of multiple sclerosis (MS) fatigue typically use single measures that implicitly assume symptom-stability over time, neglecting information about if, when, and why severity fluctuates. We aimed to examine the extent of moment-to-moment and day-to-day variability in fatigue in relapsing-remitting MS and healthy individuals, and identify daily life determinants of fluctuations. Over 4 weekdays, 76 participants (38 relapsing-remitting MS; 38 controls) recruited from multiple sites provided real-time self-reports six times daily (n = 1661 observations analyzed) measuring fatigue severity, stressors, mood, and physical exertion, and daily self-reports of sleep quality. Fatigue fluctuations were evident in both groups. Fatigue was highest in relapsing-remitting MS, typically peaking in late-afternoon. In controls, fatigue started lower and increased steadily until bedtime. Real-time stressors and negative mood were associated with increased fatigue, and positive mood with decreased fatigue in both groups. Increased fatigue was related to physical exertion in relapsing-remitting MS, and poorer sleep quality in controls. In relapsing-remitting MS, fatigue fluctuates substantially over time. Many daily life determinants of fluctuations are similar in relapsing-remitting MS and healthy individuals (stressors, mood) but physical exertion seems more relevant in relapsing-remitting MS and sleep quality most relevant in healthy individuals.


Priebe, Stefan; Golden, Eoin; Kingdon, David; Omer, Serif; Walsh, Sophie; Katevas, Kleomenis et al. (2017 Feb):Effective patient-clinician interaction to improve treatment outcomes for patients with psychosis. A mixed-methods design.

NIHR Journals Library. Southampton (UK) (Programme Grants for Applied Research).

At least 100,000 patients with schizophrenia receive care from community mental health teams (CMHTs) in England. These patients have regular meetings with clinicians, who assess them, engage them in treatment and co-ordinate care. As these routine meetings are not commonly guided by research evidence, a new intervention, DIALOG, was previously designed to structure consultations. Using a hand-held computer, clinicians asked patients to rate their satisfaction with eight life domains and three treatment aspects, and to indicate whether or not additional help was needed in each area, with responses being graphically displayed and compared with previous ratings. In a European multicentre trial, the intervention improved patients’ quality of life over a 1-year period. The current programme builds on this research by further developing DIALOG in the UK. (1) How can the practical procedure of the intervention be improved, including the software used and the design of the user interface? (2) How can elements of resource-oriented interventions be incorporated into a clinician manual and training programme for a new, more extensive ‘DIALOG+’ intervention? (3) How effective and cost-effective is the new DIALOG+ intervention in improving treatment outcomes for patients with schizophrenia or a related disorder? (4) What are the views of patients and clinicians regarding the new DIALOG+ intervention? We produced new software on a tablet computer for CMHTs in the NHS, informed by analysis of videos of DIALOG sessions from the original trial and six focus groups with 18 patients with psychosis. We developed the new ‘DIALOG+’ intervention in consultation with experts, incorporating principles of solution-focused therapy when responding to patients’ ratings and specifying the procedure in a manual and training programme for clinicians. We conducted an exploratory cluster randomised controlled trial with 49 clinicians and 179 patients with psychosis in East London NHS Foundation Trust, comparing DIALOG+ with an active control. Clinicians working as care co-ordinators in CMHTs (along with their patients) were cluster randomised 1 : 1 to either DIALOG+ or treatment as usual plus an active control, to prevent contamination. Intervention and control were to be administered monthly for 6 months, with data collected at baseline and at 3, 6 and 12 months following randomisation. The primary outcome was subjective quality of life as measured on the Manchester Short Assessment of Quality of Life; secondary outcomes were also measured. We also established the cost-effectiveness of the DIALOG intervention using data from the Client Service Receipt Inventory, which records patients’ retrospective reports of using health- and social-care services, including hospital services, outpatient services and medication, in the 3 months prior to each time point. Data were supplemented by the clinical notes in patients’ medical records to improve accuracy. We conducted an exploratory thematic analysis of 16 video-recorded DIALOG+ sessions and measured adherence in these videos using a specially developed adherence scale. We conducted focus groups with patients (n = 19) and clinicians (n = 19) about their experiences of the intervention, and conducted thematic analyses. We disseminated the findings and made the application (app), manual and training freely available, as well as producing a protocol for a definitive trial. Patients receiving the new intervention showed more favourable quality of life in the DIALOG+ group after 3 months (effect size: Cohen’s d = 0.34), after 6 months (Cohen’s d = 0.29) and after 12 months (Cohen’s d = 0.34). An analysis of video-recorded DIALOG+ sessions showed inconsistent implementation, with adherence to the intervention being a little over half of the possible score. Patients and clinicians from the DIALOG+ arm of the trial reported many positive experiences with the intervention, including better self-expression and improved efficiency of meetings. Difficulties reported with the intervention were addressed by further refining the DIALOG+ manual and training. Cost-effectiveness analyses found a 72% likelihood that the intervention both improved outcomes and saved costs. The research was conducted solely in urban east London, meaning that the results may not be broadly generalisable to other settings. (1) Although services might consider adopting DIALOG+ based on the existing evidence, a definitive trial appears warranted; (2) applying DIALOG+ to patient groups with other mental disorders may be considered, and to groups with physical health problems; (3) a more flexible use with variable intervals might help to make the intervention even more acceptable and effective; (4) more process evaluation is required to identify what mechanisms precisely are involved in the improvements seen in the intervention group in the trial; and (5) what appears to make DIALOG+ effective is that it is not a separate treatment and not a technology that is administered by a specialist; rather, it changes and utilises the existing therapeutic relationship between patients and clinicians in CMHTs to initiate positive change, helping the patients to improve their quality of life. Future studies should include a definitive trial on DIALOG+ and test the effectiveness of the intervention with other populations, such as people with depression. Current Controlled Trials ISRCTN34757603. The National Institute for Health Research Programme Grants for Applied Research programme.


Quilty, Lena C.; Watson, Chris; Toneatto, Tony; Bagby, R. Michael (2017):A prospective investigation of affect, the desire to gamble, gambling motivations and gambling behavior in the mood disorders.

In: J Gambl Stud 33 (1), S. 115–129. DOI: 10.1007/s10899-016-9616-8.

Time-sampling methodology was implemented to examine the prospective associations between affect, desire to gamble, and gambling behavior in individuals diagnosed with a mood disorder. Thirty (9 male, 21 female) adults with a lifetime diagnosis of a depressive or bipolar disorder diagnosis who endorsed current gambling and lifetime gambling harm participated in the present study. Participants completed electronic diary entries of their current affective state, desire to gamble, and gambling behavior for 30 consecutive days. Hierarchical linear modelling revealed that affect was not a predictor of gambling behavior. Instead, affect predicted the desire to gamble, with high levels of sadness and arousal independently predicting an increased desire to gamble. Desire to gamble predicted actual gambling behavior. There were no differences across diagnostic groups in terms of gambling motivations at baseline; however, during the 30-day period, participants with bipolar disorder endorsed gambling to cope with negative affect more often than did participants with depressive disorder, whereas those with depressive disorder more often endorsed gambling for social reasons or enhancement of positive affect. The present findings provide evidence that negative affect is not directly related to actual gambling behavior, and suggest that affective states rather impact the desire to gamble. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Reina-Tamayo, Andrea M.; Bakker, Arnold B.; Derks, Daantje (2017):Episodic Demands, Resources, and Engagement. An Experience-Sampling Study.

In: Journal of Personnel Psychology. DOI: 10.1027/1866-5888/a000177.

This study contributes to the literature on work engagement and job demands-resources (JD-R) theory by exploring the momentary relations between episodic demands, resources, engagement, and performance during various activities (e.g., checking e-mails) within a day. Using experience-sampling methodology, 61 Dutch employees completed activity characteristics, engagement, and performance surveys at three different times during the day for one week. Results from 413 observations showed that 88% of the total variance in engagement fluctuates from activity to activity. Multilevel path analysis results confirmed that during activities, episodic engagement was positively related to performance, and mediated the positive associations of resources and negative associations of hindering demands with performance. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Reis, Dorota; Hoppe, Annekatrin; Arndt, Charlotte; Lischetzke, Tanja (2017):Time pressure with state vigour and state absorption. Are they non-linearly related?

In: European Journal of Work and Organizational Psychology 26 (1), S. 94–106. DOI: 10.1080/1359432X.2016.1224232.

On the basis of activation theory and the challenge-hindrance demands model, this study was conducted to clarify the functional form (linear vs. curvilinear) of the within-persons relations of time pressure with vigour and absorption. Further, we investigated whether these relations would be moderated by time-varying job control. A total of 52 full-time employees (44% female) participated in the study, which included two assessments per day over the course of 2 work weeks. Our analyses confirmed an inverted U-shaped within-persons association between state time pressure and state vigour and a moderator effect of job control on the curvilinear relation. By contrast, state time pressure and state absorption displayed only a positive linear relation. This study demonstrates that within-persons high levels of time pressure may impair employees’ energy levels but still promote their absorption at work. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Richard, Anna; Meule, Adrian; Reichenberger, Julia; Blechert, Jens (2017):Food cravings in everyday life. An EMA study on snack-related thoughts, cravings, and consumption.

In: Appetite 113, S. 215–223. DOI: 10.1016/j.appet.2017.02.037.

Food craving refers to an intense desire to consume a specific food and is regularly experienced by the majority of individuals. Yet, there are interindividual differences in the frequency and intensity of food craving experiences, which is often referred to as trait food craving. The characteristics and consequences of trait and state food craving have mainly been investigated in questionnaire-based and laboratory studies, which may not reflect individuals’ behavior in daily life. In the present study, sixty-one participants completed the Food Cravings Questionnaire-Trait-reduced (FCQ-T-r) as measure of trait food craving, followed by seven days of Ecological Momentary Assessment (EMA), during which they reported snack-related thoughts, craving intensity, and snack consumption at five times per day. Results showed that 86 percent of reported snacks were high-caloric, with chocolate-containing foods being the most often reported snacks. Individuals with high FCQ-T-r scores (high trait food cravers, HCs) thought more often about high-calorie than low-calorie snacks whereas no differences were found in individuals with low FCQ-T-r scores (low trait food cravers, LCs). Further, the relationship between craving intensity and snack-related thoughts was stronger in HCs than in LCs. Higher craving intensity was associated with more consumption of snacks and again this relationship was stronger in HCs than in LCs. Finally, more snack-related thoughts were related to more frequent consumption of snacks, independent of trait food craving. Thus, HCs are more prone to think about high-calorie snacks in their daily lives and to consume more snack foods when they experience intense cravings, which might be indicative of a heightened responding towards high-calorie foods. Thus, trait-level differences as well as snack-related thoughts should be targeted in dietary interventions.


Rogers, Adam; Fuller-Tyszkiewicz, Matthew; Lewis, Vivienne; Krug, Isabel; Richardson, Ben (2017):A Person-by-Situation Account of Why Some People More Frequently Engage in Upward Appearance Comparison Behaviors in Everyday Life.

In: Behavior therapy 48 (1), S. 19–28. DOI: 10.1016/j.beth.2016.09.007.

Although the influence of stable, trait-like factors (such as trait body dissatisfaction and appearance internalization) on instances of appearance comparison has been well documented, the additive and interactive influence of contextual factors (such as one’s current body satisfaction) on comparison behaviors is unknown. Therefore, the present study tested a PersonxSituation model in which both state and trait body image variables interacted to predict engagement in various forms of comparison (upward, downward, and lateral). Participants included 161 women who completed a baseline measure of trait body dissatisfaction and internalization, and then completed, via an iPhone app, an ecological momentary assessment phase in which they reported momentary experiences of mood and comparison behaviors at up to 6 random times per day for 7days. Multilevel analyses revealed that upward comparisons (comparisons against more attractive people) were more likely for individuals with heightened trait and/or state negative body image, but these predictive effects of state and trait on appearance comparisons appear largely independent of each other. Furthermore, neither state nor trait body image variables were related to the other forms of comparison, and time lag at the state-level between predictor and outcome did not seem to influence the strength of these associations. Present findings are consistent with the notion that how an individual feels in the moment about their appearance may influence engagement in deleterious appearance behaviors. However, further testing is needed to confirm these causal hypotheses.


Sather, Thomas W. (2017):Flow experiences among individuals with aphasia.

In: Dissertation Abstracts International: Section B: The Sciences and Engineering 77 (7-B(E)).

Flow has been described as positive experiences of intense concentration, distorted time passage, and loss of self-consciousness. While flow has been reported for multiple populations in various settings, it has not been studied among individuals with aphasia. The purpose of this three paper dissertation is to examine flow experiences among individuals with mild aphasia, including environmental and personal factors associated with flow. Advocates of life participation approaches to aphasia stress the importance of interventions that support full engagement in life. Research on flow experiences and related environmental and personal factors may foster improved service delivery and outcomes for this population. In Study One, eight participants at a weekend aphasia camp completed the Short Flow State Scale — 2 and ranked activities based on self-perceived flow experiences at the camp. Results of Wilcoxon-signed rank and paired t-tests indicate high perceptions of flow and stability of flow across ratings and ranking over the course of a weekend. In Study Two, the Experience Sampling Method was used to prompt nine participants to provide ratings of skill, challenge and environmental and personal factors associated with flow (defined operationally as high skill and high challenge ratings based on z-scores calculated within individuals). They used the FlowAphasia application for iOS, designed specifically for this study. Participant ratings met definitions for the quadrant experiences: apathy (31.6%), flow (27.3%), boredom (23%), and anxiety (18.1%). For Study Three, semi-structured interviews were completed with participants from Study Two and analyzed using qualitative content analysis. Results indicate that participants experienced flow. Environmental factors that functioned as barriers to flow were coded as Mismatch of Demands, Task Characteristics, Other People, Physical Environments, and Non-stroke Related. Environmental factors that functioned as facilitators were coded as Task Characteristics, Other People, and Physical Environment. Personal factors identified as hindrances of flow included Avoidance, Emotional State, and Non-stroke Related. Personal factors identified as supports of flow included Strategic Management, Goal-directed Characteristics, Gaining Perspective, and Motivation to Help. Additionally, traits of the autotelic personality were observed in some participants. Implications and directions for future study are discussed in this dissertation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Saunders, K. E. A.; Bilderbeck, A. C.; Panchal, P.; Atkinson, L. Z.; Geddes, J. R.; Goodwin, G. M. (2017):Experiences of remote mood and activity monitoring in bipolar disorder. A qualitative study.

In: European psychiatry : the journal of the Association of European Psychiatrists 41, S. 115–121. DOI: 10.1016/j.eurpsy.2016.11.005.

BACKGROUND: Mobile technology enables high frequency mood monitoring and automated passive collection of data (e.g. actigraphy) from patients more efficiently and less intrusively than has previously been possible. Such techniques are increasingly being deployed in research and clinical settings however little is known about how such approaches are experienced by patients. Here, we explored the experiences of individuals with bipolar disorder engaging in a study involving mood and activity monitoring with a range of portable and wearable technologies. METHOD: Patients were recruited from a wider sample of 50 individuals with Bipolar Disorder taking part in the Automated Monitoring of Symptom Severity (AMoSS) study in Oxford. A sub-set of 21 patients participated in a qualitative interview that followed a semi-structured approach. RESULTS: Monitoring was associated with benefits including increased illness insight, behavioural change. Concerns were raised about the potential preoccupation with, and paranoia about, monitoring. Patients emphasized the need for personalization, flexibility, and the importance of context, when monitoring mood. CONCLUSIONS: Mobile and electronic health approaches have potential to lend new insights into mental health and transform healthcare. Capitalizing on the perceived utility of these approaches from the patients’ perspective, while addressing their concerns, will be essential for the promise of new technologies to be realised.


Scherer, Emily A.; Huang, Lin; Shrier, Lydia A. (2017):Application of correlated time-to-event models to ecological momentary assessment data.

In: Psychometrika 82 (1), S. 233–244. DOI: 10.1007/s11336-016-9495-z.

Ecological momentary assessment data consist of in-the-moment sampling several times per day aimed at capturing phenomena that are highly variable. When research questions are focused on the association between a construct measured repeatedly and an event that occurs sporadically over time interspersed between repeated measures, the data consist of correlated observed or censored times to an event. In such a case, specialized time-to-event models that account for correlated observations are required to properly assess the relationships under study. In the current study, we apply two time-to-event analysis techniques, proportional hazards, and accelerated failure time modeling, to data from a study of affective states and sexual behavior in depressed adolescents and illustrate differing interpretations from the models. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Schöndube, Anna; Bertrams, Alex; Sudeck, Gorden; Fuchs, Reinhard (2017):Self-control strength and physical exercise. An ecological momentary assessment study.

In: Psychol Sport Exerc 29, S. 19–26. DOI: 10.1016/j.psychsport.2016.11.006.

Objective: We tested predictions made by the self-control strength model on a day level using ecological momentary assessment methodology. The study examined the relationship between self-control strength and physical exercise in participants who intended to exercise on a regular basis. We hypothesized that individuals would exercise more on days when their self-control strength was high than on days when their self-control strength was low and that trait self-control would moderate this relationship. Methods: N = 63 students aged between 19 and 32 years participated in the study. Self-control strength and physical exercise were assessed daily over a period of 20 days with an electronic diary. Results: Multilevel analyses revealed that the level of self-control strength was positively associated with physical exercise (p = 0.01), and this relationship was stronger in individuals with low trait self-control than in those with high trait self-control (interaction effect: p = 0.03). Conclusion: These findings highlight the interplay between momentarily fluctuating variables such as self-control strength and dispositional variables such as trait self-control in the prediction of physical exercise. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Schuz, Benjamin; Revell, Sarah; Hills, Andrew P.; Schuz, Natalie; Ferguson, Stuart G. (2017):Higher BMI is associated with stronger effects of social cues on everyday snacking behaviour.

In: Appetite 114, S. 1–5. DOI: 10.1016/j.appet.2017.03.012.

Discretionary food choices (snacks) contribute up to a third of the daily energy intake and potentially contribute to energy imbalance and weight gain. Individual snack intake behaviour is guided by internal and external cues, with social cues (seeing others eat, being alone) consistently showing large effects. A wide body of (mainly laboratory-based) research suggests marked differences in people’s response to eating cues based on BMI. Here, we show that these BMI differences in cue responsiveness also pertain to everyday snacking behaviour. In two combined ecological momentary assessment studies, 122 participants with BMIs ranging from 18.34 to 45.71 kg/m2 logged their everyday snacking behaviour in real-time over two weeks along with the presence or absence of social cues. Random-effects modelling showed that people with higher BMI were more likely to consume high-energy snacks when alone, and were more likely to consume low-energy snacks in the presence of others eating. This suggests BMI differences in cue responsiveness that are in line with impression management theory and underlines the importance of social cues for snacking behaviour and provides avenues for both theory and intervention development.


Scott, Jan; Murray, Greg; Henry, Chantal; Morken, Gunnar; Scott, Elizabeth; Angst, Jules et al. (2017):Activation in bipolar disorders. A systematic review.

In: JAMA psychiatry 74 (2), S. 189–196. DOI: 10.1001/jamapsychiatry.2016.3459.

Importance: Increased activity and energy alongside mood change are identified in the DSM-5 as cardinal symptoms of mania and hypomania. A wide range of existing research suggests that this revision may be valid, but systematic integration of the evidence has not been reported. The term activation is understood as emerging from underlying physiological change and having objective (observable motor activity) and related subjective (energy) levels. Objectives: To systematically review studies of the clinical phenomenon of activation in bipolar disorder, to determine whether activation is statistically abnormal in bipolar disorder and demonstrably distinct from mood, and to identify any significant between- and within-individual differences in the dynamics of activation. Evidence Review: This systematic review of MEDLINE, PsycINFO, EMBASE, CINAHL, and PubMed databases from January 1, 1970, until September 30, 2016, identified 56 of a possible 3284 citations for (1) data-driven analyses of the dimensions and factor structure of mania and bipolar depression and (2) longitudinal studies reporting real-time objective monitoring or momentary assessment of daytime activity in individuals with bipolar disorder compared with other clinical or healthy control samples. Hand search of reference lists, specialty journals, websites, published conference proceedings, and dissertation abstracts and contact with other researchers ensured inclusion of gray literature and additional analyses as well as raw data if appropriate. Quality assessment was perfomed using the National Institutes of Health quality assessment tool. Findings: A total of 56 studies met eligibility criteria for inclusion in the review including 29 analyses of the factor structure of bipolar disorder, 3 of activity data from experimental sampling or ecological momentary assessment, and 20 actigraphy and 4 laboratory-based studies. Synthesizing findings across the studies revealed that the most robust finding was that mean levels of activity are lower during euthymia and depression in patients with bipolar disorder compared with healthy controls and other comparison groups (11 studies). The 7 ecological and laboratory studies show less organized or predictable patterns of behavior and a relative lack of habituation among patients with bipolar disorders compared with others. Factor analytic studies provide fairly consistent evidence that mood and activation represent distinct dimensions of bipolar disorder. Ten studies that examined interindividual and intraindividual patterns of activity suggest that mania may be better characterized by differences in robustness, variability, predictability, or complexity of activation rather than mean levels of activity. Conclusions and Relevance: Within the limitations of the data, this synthesis of available evidence broadly supports the elevation of activation as a criterion A symptom for bipolar disorder in DSM-5. Although the importance of activation in bipolar disorders has been acknowledged for more than a century, this review suggests that this critical construct is understudied and should be the topic of more systematic high-quality research. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Scott, Stacey B.; Ram, Nilam; Smyth, Joshua M.; Almeida, David M.; Sliwinski, Martin J. (2017):Age differences in negative emotional responses to daily stressors depend on time since event.

In: Developmental psychology 53 (1), S. 177–190. DOI: 10.1037/dev0000257.

Research on age differences in the experience of negative emotional states have produced inconsistent results, particularly when emotion is examined in the context of daily stress. Strength and vulnerability integration (SAVI; Charles, 2010) theory postulates that age differences in emotional states are contingent upon whether a stressor occurred, and whether sufficient time has passed since the stressor to allow older adults to benefit from theorized strengths. The present study uses an ecological momentary assessment design to examine how timing of daily stressors relates to age differences in negative emotional responses. Participants (N = 199, aged 25–65) completed mobile surveys up to 5 times daily for 14 days. They reported current mood and stressor exposure, as well as how long ago the stressor occurred. As expected, no age differences were observed in current negative affect (NA) for stressors which occurred in the previous 0–10 min. As predicted, older age was associated with less of a stressor-related increase in NA when a greater time had passed (i.e., 10 min to 2.5 hours) since stressor exposure. Consistent with previous results, there were no age differences in the effects of more distal stressors that occurred 2.5 to 5 hr ago, although NA remained significantly elevated. The present findings are consistent with SAVI’s predictions and advance understanding age differences in the time course relating everyday stressors to emotional responses. (PsycINFO Database Record (c) 2016 APA, all rights reserved)


Sels, Laura; Ceulemans, Eva; Kuppens, Peter (2017):Partner-Expected Affect. How You Feel Now Is Predicted by How Your Partner Thought You Felt Before.

In: Emotion (Washington, D.C.). DOI: 10.1037/emo0000304.

Romantic partners can modulate each other’s emotions in many ways, resulting in interwoven emotional lives. Here, building on findings from basic psychological research, we propose a novel way of such interconnectedness, termed partner-expected affect, in which perceptions of a partner’s feelings may positively predict how this partner will actually feel at a later moment in time. We evaluated this hypothesis by means of an experience sampling study in which 100 romantic partners (50 couples) reported on the level of valence and arousal of their own feelings and of the perceived feelings of their partners 10 times a day throughout a week. In line with expectations, we found that how individuals were feeling at a particular moment was positively predicted by how their partner thought they felt at the previous moment (on top of how they felt at the previous moment and how their partner felt at the previous moment), at least when they had interacted with each other in between. This finding identifies a novel potential way in which people may shape each other’s feelings and paves the way to further examine the nature and boundary conditions of such partner-expected affect. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Shieh, Beverly S. (2017):Cyberpal. A mobile resource for cyberbullying.

In: Dissertation Abstracts International: Section B: The Sciences and Engineering 77 (9-B(E)).

Bullying continues to be a global concern in schools and communities, especially in light of its adverse short- and long-term impacts on youth with respect to both psychiatric and physical health (Espelage & Swearer, 2003; Rodkin, Espelage, & Hanish, 2015; Witted & Dupper, 2005). As a result, numerous programs and resources aimed at preventing bullying and intervening with both victims and perpetrators have been developed. An increased use of computer-mediated communications (CMCs) among adolescents (Patchin, 2013) has lead to the emergence of a new form of bullying called cyberbullying, which involves intentional acts of aggression through online or cellular phone communications. Therefore a need for resources specifically targeting cyberbullying that are accessible and easy-to-use is also needed. The current project involved developing a resource in the form of wireframing for a mobile-app, aimed at decreasing cyberbullying among adolescents (ages 12-18 years) by providing them with a reflective learning tool to heighten their awareness of their involvement in cyberbullying, its potential adverse consequences, and to connect them with relevant resources. The project was informed by a review of the literature on physical bullying, cyberbullying (e.g., prevalence, forms, and roles involved), and the efficacy of current prevention/treatment programs and resources. The resulting mobile-app wireframe is presented in the form of a manual and simulation using the JustinMind program (Farrell-Vinary, 2011). The wireframe is comprised of four modules: (1) An Assessment Module to assess user’s cyberbullying role (bully, victim, bully/victim) and tailor the mobile-app’s content, (2) a Psychoeducation Module providing information on the adverse affects, signs, and symptoms of cyberbullying, (3) a Daily Log Module to monitor online behaviors and increase online awareness, and (4) a Resources Module to provide additional support to other programs, information, and personal contacts. Although the resource is intended primarily for use by teens as a self-help tool, it may be implemented as part of a hybrid approach in conjunction with therapy or school-based programs. Following a discussion of strengths, limitations and potential improvements to the current resource, plans for evaluating its efficacy once developed into a functional mobile-app and disseminating it to relevant professionals are described. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Shiyko, Mariya P.; Perkins, Seth; Caldwell, Linda (2017):Feasibility and Adherence Paradigm to Ecological Momentary Assessments in Urban Minority Youth.

In: Psychological assessment. DOI: 10.1037/pas0000386.

All adolescents in general, including ethnic and racial minorities, report high levels of cell phone use, making mobile technology a useful tool for assessment and intervention. Known health and education disparities based on minority status motivated us to conduct an in-depth investigation regarding feasibility of and adherence to the ecological momentary assessment (EMA) research protocol, studying daily life of urban minority youth. In addition, this paper presents a methodological approach to conceptualizing and reporting adherence in EMA studies. The sample was comprised of 126 youth (41.3% boys; 40.5% 7th and 59.5% 8th graders; 75.4% African American, and 20.6% Hispanic) who carried a mobile phone for 10 days, including 2 weekends and reported on activities, moods, and attitudes. Mean level of adherence was 81% for momentary and 93.8% for daily assessments; it decreased over time and was higher during the week compared to weekends. Adherence was lower on days when participants reported high levels of negative affect and on days when they were engaged in physical activities. Our findings underscore the importance of differentiating between human and technology-related factors when computing adherence rates and portray adherence as a complex and dynamic construct that can vary across individuals. Specific study recommendations and methodological discussion provide guidelines for designing future studies. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Public Significance Statement—Minority youth are successful at using mobile technology in reporting their daily experiences. Mobile devices can be used for bridging disparity gaps. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Shoham, Adi; Goldstein, Pavel; Oren, Ravit; Spivak, David; Bernstein, Amit (2017):Decentering in the process of cultivating mindfulness. An experience-sampling study in time and context.

In: Journal of consulting and clinical psychology 85 (2), S. 123–134. DOI: 10.1037/ccp0000154.

Objective: Through intensive experience sampling, we studied the practice and development of mindfulness as a dynamic process in time and context. We focused on role(s) and salutary function(s) of mindfulness and decentering for emotional experience over the course of mindfulness practice and development. Method: Eighty-two meditation-naive adults from the general community, 52% women, Mage (SD) = 25.05 (3.26) years, participated in a 1-month, 6-session, Mahasi-based mindfulness-training intervention (Mahasi, 1978). We collected 52 digital experience samples of mindfulness, decentering, and emotional experience, in the context of daily living and meditative states, over the course of the program. Results: Data were analyzed via time-varying effects models (TVEMs) and mixed-linear models (MLMs) within a single-subject, multiple-baseline experimental design. First, over the course of the intervention, participants grew more mindful and decentered in daily living and meditative states. Second, the association between mindfulness and decentering was significant in daily living, although the magnitude of this association was stronger in meditative states. Third, we observed the same contextualized pattern of relations between mindfulness and emotional valence (happy > sad) as well as arousal (calm > nervous). Finally, whereas decentering mediated the effect of mindfulness on reduced emotional arousal in meditative states, it did not similarly mediate the effect of mindfulness on positive emotional valence. Conclusions: The present findings illustrate the insights that may be gained about mindfulness mechanisms broadly and decentering specifically through the study of mindfulness as a dynamic, contextualized developmental process over time. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

What is the public health significance of this article?—The study demonstrates the importance of intensive assessment over the course of mindfulness training for illuminating the practice and cultivation of mindfulness as a contextualized, developmental process in time, in people’s real-world environments. The study was a rigorous examination of the role of decentering in the effects of mindfulness training on central emotional outcomes important to mental health. Finally, the study illustrates that integrating single-subject, multiple-baseline experimental designs with emerging data-analytic methods (e.g., multilevel modeling) may help guide the development and delivery of personalized mindfulness-based interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Smiley, Sabrina L.; Elmasry, Hoda; Hooper, Monica Webb; Niaura, Raymond S.; Hamilton, Alison B.; Milburn, Norweeta G. (2017):Feasibility of ecological momentary assessment of daily sexting and substance use among young adult African American gay and bisexual men. A pilot study.

In: Journal of medical Internet research 19 (2). DOI: 10.1037/t15771-000;

Background: Recent evidence suggests that sexualized text communication (‘sexting’) is associated with substance use and sexual risk behaviors among young adults, yet little is known about this relationship among young adult African American gay and bisexual men, a population disproportionately impacted by HIV in the United States. Rapid advances in mobile phone technology indicate a clear need for research using mobile health (mHealth) methods such as ecological momentary assessment (EMA) to serve as a viable counterpart to retrospective evaluation methods by using real-time data collection to assess sexting and substance use among this population. Objective: The objective of this pilot study was to (1) describe the EMA study design and protocol, (2) characterize the study population, and (3) assess the feasibility of a random prompt text message-based thrice-daily EMA over 14 days, as a means of prospectively studying sexting, marijuana, and alcohol use among a sample of young adult African American gay and bisexual men ages 21 to 25. Methods: Participants were recruited through flyers and snowball sampling during spring and summer 2015 at a community-based HIV/AIDS prevention, care, and support organization in Washington, DC. Eligible participants were enrolled in a one-time in-person study visit that consisted of informed written consent to participate in the study, a self-administered survey, a semi-structured interview, and enrollment and training in EMA data collection. Commencing the day after the study visit, a random prompt survey was texted to participants on their personal mobile phones 3 times a day over a 14-day data collection period assessing mood, texts sent, texts received, sexts sent, sexts received, marijuana want, marijuana use, and alcohol use. Results: EMA feasibility was tested with 25 self-identified African American gay (n = 16) and bisexual (n = 9) men (mean age of 23.48 years, SD 1.5). Each random prompt survey had 8 questions with responses including yes/no and Likert scale options. There were 104 total days of EMA observation, and the retention rate was 72% (18 out of 25 participants). Participants responded to the random prompt surveys with a 57.3% compliance rate providing a total of 544 completed surveys out of 949 surveys. The overall mean response time to complete a survey was 6.1 minutes. There were significant positive associations between EMA texts sent and received questions (ρ 0.84, P < .001) as well as sexts sent and received queries (ρ 0.72, P < .001). Conclusions: The use of an EMA protocol has the potential to be a very useful research tool for understanding episodic behaviors such as sexting and substance use in this relatively understudied and underserved population, and has implications for practice. Additional research is needed on how to maximize survey compliance. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Snippe, Evelien; Jeronimus, Bertus F.; Aan Het Rot, Marije; Bos, Elisabeth H.; Jonge, Peter de; Wichers, Marieke (2017):The reciprocity of prosocial behavior and positive affect in daily life.

In: Journal of personality. DOI: 10.1111/jopy.12299.

Objective To examine whether prosocial behaviors help sustain a positive mood, we tested the dynamic reciprocal associations between prosocial behavior and positive affect (PA) in daily life. A second aim was to examine whether the personality traits Neuroticism and Extraversion moderate these associations. Method The study included a community sample (N = 553). Participants completed an electronic diary assessing prosocial behavior and PA three times a day over 30 days. A subsample of 322 participants filled out the NEO Five‐Factor Inventory to assess Neuroticism and Extraversion. Multilevel autoregressive models were performed to examine the within‐person bidirectional associations between prosocial behavior and PA and possible moderation by Neuroticism and Extraversion. Results Within individuals, more PA was followed by more prosocial behavior at the next assessment, and more prosocial behavior was followed by more PA. The effect of prosocial behavior on PA was stronger for individuals high on Neuroticism. Extraversion did not moderate the associations under study. Conclusions The findings indicate that prosocial behavior and PA reinforce each other in daily life. Prosocial behavior seems most beneficial for individuals high on Neuroticism. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Soares Teles, Ariel; Rocha, Artur; Jose da Silva E Silva, Francisco; Correia Lopes, Joao; O’Sullivan, Donal; van de Ven, Pepijn; Endler, Markus (2017):Enriching mental health mobile assessment and intervention with situation awareness.

In: Sensors (Basel, Switzerland) 17 (1). DOI: 10.3390/s17010127.


Current mobile devices allow the execution of sophisticated applications with the capacity for identifying the user situation, which can be helpful in treatments of mental disorders. In this paper, we present SituMan, a solution that provides situation awareness to MoodBuster, an ecological momentary assessment and intervention mobile application used to request self-assessments from patients in depression treatments. SituMan has a fuzzy inference engine to identify patient situations using context data gathered from the sensors embedded in mobile devices. Situations are specified jointly by the patient and mental health professional, and they can represent the patient’s daily routine (e.g., “studying”, “at work”, “working out”). MoodBuster requests mental status self-assessments from patients at adequate moments using situation awareness. In addition, SituMan saves and displays patient situations in a summary, delivering them for consultation by mental health professionals. A first experimental evaluation was performed to assess the user satisfaction with the approaches to define and identify situations. This experiment showed that SituMan was well evaluated in both criteria. A second experiment was performed to assess the accuracy of the fuzzy engine to infer situations. Results from the second experiment showed that the fuzzy inference engine has a good accuracy to identify situations.


Sperry, Sarah H.; Kwapil, Thomas R. (2017):What can daily life assessment tell us about the bipolar spectrum?

In: Psychiatry research 252, S. 51–56. DOI: 10.1016/j.psychres.2017.02.045.

Evidence suggests that bipolar psychopathology is better characterized as a spectrum than by categorical diagnoses. The examination of symptoms and impairment associated with bipolar spectrum psychopathology is important and can be enhanced by methods that examine affect, thoughts, and behavior in daily life. The present study extended findings that provide validation of a continuum of bipolar psychopathology in daily life. Young adults (n=294) completed the Hypomanic Personality Scale (HPS) and experience sampling using smartphones. Participants were signaled eight times daily for one week to complete surveys in their normal daily environment. Bipolar spectrum psychopathology was characterized by increased positive and negative affect, confidence, racing thoughts, energy, and impulsivity in daily life. The HPS moderated the association of stress with trouble concentrating, irritability with dysphoria and impulsivity, and confidence with feeling like one’s emotions were out of control. This study demonstrated that bipolar spectrum psychopathology is associated with disruptions in affect, thoughts, and behaviors and provided further evidence for a continuum of bipolar psychopathology. ESM is a promising method for examining dynamic constructs such as bipolar spectrum psychopathology and has the potential to be a strong research and clinical tool.


Steen, Y.; Gimpel‐Drees, J.; Lataster, T.; Viechtbauer, W.; Simons, C. J. P.; Lardinois, M. et al. (2017):Clinical high risk for psychosis. The association between momentary stress, affective and psychotic symptoms.

In: Acta psychiatrica Scandinavica. DOI: 10.1111/acps.12714.

Objective The aim of this study was to assess associations between momentary stress and both affective and psychotic symptoms in everyday life of individuals at clinical high risk (CHR), compared to chronic psychotic patients and healthy controls, in search for evidence of early stress sensitization. It also assessed whether psychotic experiences were experienced as stressful. Method The experience sampling method was used to measure affective and psychotic reactivity to everyday stressful activities, events and social situations in 22 CHR patients, 24 patients with a psychotic disorder and 26 healthy controls. Results Multilevel models showed significantly larger associations between negative affect (NA) and activity‐related stress for CHR patients than for psychotic patients (P = 0.008) and for CHR compared to controls (P < 0.001). Similarly, the association between activity‐related stress and psychotic symptoms was larger in CHR than in patients (P = 0.02). Finally, the association between NA and symptoms (P < 0.001) was larger in CHR than in patients. Conclusion Stress sensitization seems to play a role particularly in the early phase of psychosis development as results suggest that CHR patients are more sensitive to daily life stressors than psychotic patients. In this early phase, psychotic experiences also contributed to the experience of stress. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Strahler, Jana; Nater, Urs M. (2017):Differential effects of eating and drinking on wellbeing—an ecological ambulatory assessment study.

In: Biological psychology. DOI: 10.1016/j.biopsycho.2017.01.008.

INTRODUCTION: Various behaviors, such as physical activity and sleep, have been shown to have stress-reducing and beneficial effects on wellbeing. In contrast, the rewarding effects of eating and drinking have rarely been investigated, particularly using ecologically valid approaches, and little is known about mediating mechanisms on the biological level. METHODS: Seventy-seven healthy young adults completed items on eating and drinking as well as momentary wellbeing (measured by mood, energy, tension, stress and fatigue levels) on an iPod touch 5×/day for 4 consecutive days. With each entry, a saliva sample was collected for the later assessment of cortisol, alpha-amylase and salivary flow rate as markers of neuroendocrine and autonomic activity, respectively. RESULTS: Hierarchical linear models showed better momentary wellbeing on various scales after the consumption of juice, coffee and alcohol. Having a snack predicted lower fatigue levels. In contrast, consuming high-fat food resulted in impaired wellbeing. With regard to affect-induced eating as well as biomarkers, only a few associations emerged as significant. However, autonomic activity partially mediated the alcohol-stress association. CONCLUSION: These findings corroborate previous reports that dietary behaviors could have rewarding effects, but also challenge the assumption of a general mood-enhancing and stress-relieving effect of certain foods. Findings on biomarkers provide first insights into underlying biological mechanisms. Research on further assumed mechanisms (reward-associated brain networks) and moderators (hedonic overeating) is highly warranted. Moreover, implications for addiction research are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Terhorst, Lauren; Beck, Kelly Battle; McKeon, Ashlee B.; Graham, Kristin M.; Ye, Feifei; Shiffman, Saul (2017):Hierarchical linear modeling for analysis of ecological momentary assessment data in physical medicine and rehabilitation research.

In: American journal of physical medicine & rehabilitation. DOI: 10.1097/PHM.0000000000000690.

Ecological momentary assessment (EMA) methods collect real-time data in real-world environments, which allow physical medicine and rehabilitation researchers to examine objective outcome data and reduces bias from retrospective recall. The statistical analysis of EMA data is directly related to the research question and the temporal design of the study. Hierarchical linear modeling, which accounts for multiple observations from the same participant, is a particularly useful approach to analyzing EMA data. The objective of this paper was to introduce the process of conducting hierarchical linear modeling analyses with EMA data. This is accomplished using exemplars from recent physical medicine and rehabilitation literature.


Thompson, Renee J.; Spectre, Aleksandr; Insel, Philip; Mennin, Douglas; Gotlib, Ian H.; Gruber, June (2017):Positive and negative affective forecasting in remitted individuals with bipolar I disorder, and major depressive disorder, and healthy controls.

In: Cognit Ther Res. DOI: 10.1007/s10608-017-9840-2.

Although emotional disturbances characterize mood disorders, little is known about the affective forecasts of these individuals. We examined forecasted intensity and accuracy for negative affect (NA) and positive affect (PA) among two remitted clinical groups: individuals with Bipolar I (BD; n = 31) and Major Depressive Disorder (MDD; n = 21), and healthy controls (CTL; n = 32). We also examined whether each group’s forecasting accuracy varied by valence. At the lab, participants forecasted their short-term (next day) and long-term (next week) NA and PA; then they completed a week of experience sampling. The MDD group forecasted lower PA and higher NA than the CTL group; the BD group’s forecasts varied across time frames. There were no group differences in forecasting accuracies. Regarding within group forecasting accuracy, the CTL group was more accurate in PA than NA; the BD group was similarly accurate across valence, and the MDD group’s accuracy varied based on the time frame. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Tomko, Rachel L.; Saladin, Michael E.; McClure, Erin A.; Squeglia, Lindsay M.; Carpenter, Matthew J.; Tiffany, Stephen T. et al. (2017):Alcohol consumption as a predictor of reactivity to smoking and stress cues presented in the natural environment of smokers.

In: Psychopharmacology 234 (3), S. 427–435. DOI: 10.1007/s00213-016-4472-x.

Background and rationale: The high prevalence of co-occurring alcohol and tobacco use underscores the importance of understanding the influence of alcohol consumption on risk factors for smoking and relapse. Alcohol has been shown to impact reactivity to smoking and stress-related cues, both of which are common antecedents to smoking and smoking relapse. Objective: The objective of the current study is to examine associations between alcohol use, cigarette craving, and stress reactivity following exposure to smoking and stress cues delivered in participants’ daily lives. Methods: Using cue-reactivity ecological momentary assessment (CREMA), adult smokers (n = 138) reported cigarette craving, stress, and past hour alcohol use on a mobile device four times per day for 2 weeks, resulting in a range of 4493–5983 data points per analysis. Questions were followed by exposure to pictorial neutral, stressful, or smoking cues delivered via the mobile device. Craving and affect were re-assessed following cue exposure. Results: Results showed that recent (past hour) alcohol use was significantly associated with increases in the following: (a) tonic (non-cue-elicited) cigarette craving, (b) stress cue-elicited cigarette craving, and (c) stress cue-elicited stress reactivity, in the context of high-baseline stress. There was no significant association between alcohol use and smoking cue-elicited craving. Conclusions: Alcohol use may increase risk for smoking and relapse to smoking by increasing cigarette craving and, in certain contexts, stress following stress cue exposure. Though alcohol is known for its anxiolytic properties, under some conditions, it may increase reactivity to stress cues. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Tonetti, Lorenzo; Scher, Anat; Atun-Einy, Osnat; Samuel, Moran; Boreggiani, Michele; Natale, Vincenzo (2017):Actigraphic motor activity during sleep from infancy to adulthood.

In: Chronobiol Int 34 (2), S. 246–253. DOI: 10.1080/07420528.2016.1219362.

A secondary analysis of longitudinal and cohort studies was carried out to quantitatively investigate the motor activity pattern, recorded through actigraphy, during the first six hours of nocturnal sleep. The first study was of longitudinal nature. Ten healthy participants (four females) were monitored three times, at baseline (T1) when they were infants (mean age 7.10 ± 0.32 months), at the first follow-up examination (T2) around 4 months later (mean age 11.20 ± 0.63 months) and at the second follow-up (T3) around three years later, when they were preschoolers (mean age 4.68 ± 0.14 years). At T1, T2 and T3 each participant wore the actigraph Basic Mini-Motionlogger (Ambulatory Monitoring, Inc., Ardsley, NY, USA) over at least two consecutive nycthemeral cycles, with the aim to measure the mean hourly motor activity count. Seven- and 11-month-old infants had a higher level of motor activity over the night compared to preschoolers. Furthermore, motor activity increased as the night progressed, with a pronounced increment at both T1 and T2, while at T3 such an increase was less marked. The second study was cross-sectional and aimed to explore the motor activity pattern, using actigraphy, during the first six hours of nocturnal sleep in multiple-age healthy groups, from infancy to adulthood. We assigned participants to eight groups according to age: 20 (five females) aged around 10 months old (mean age 10.65 ± 0.67 months); 13 (nine females) aged around 4 years (mean age 4.38 ± 0.51 years); 21 (10 females) aged around 10 years (mean age 9.67 ± 0.91 years); 21 (nine females) aged around 20 years (mean age 19.33 ± 2.44 years); 20 (10 females) aged around 30 years (mean age 29.80 ± 1.99 years); 20 (15 females) aged around 40 years (mean age 40.70 ± 1.26 years); 20 (11 females) aged around 50 years (mean age 50.15 ± 2.80 years) and 20 (nine females) aged around 60 years (mean age 59.25 ± 3.23 years). The participants aged between 10 and 60 years wore the actigraph Basic Mini-Motionlogger over seven consecutive nycthemeral cycles (infants and preschoolers wore the actigraph over at least two consecutive nycthemeral cycles), with the aim to measure the mean hourly motor activity count. The results indicated a significantly higher motor activity count in 10-month-old infants compared to all the remaining age groups. Moreover, the pattern of motor activity of 10-month-old infants was different from that of all other groups, with the highest motor activity counts from the second to the sixth hour of sleep. Considered as a whole, the results of both studies converge regarding the high motor activity detected among infants, which could be explained by the presence of a maturational process that has not yet been fully completed at this stage of life. In both studies, only the motor activity of infants was above the cutoff level established for normal adults, highlighting the need to establish a specific cutoff value for infants. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Tong, Eddie M. W.; Jia, Lile (2017):Positive emotion, appraisal, and the role of appraisal overlap in positive emotion co-occurrence.

In: Emotion (Washington, D.C.) 17 (1), S. 40–54. 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 (c) 2017 APA, all rights reserved)


Turner, Caitlin M.; Coffin, Phillip; Santos, Deirdre; Huffaker, Shannon; Matheson, Tim; Euren, Jason et al. (2017):Race/ethnicity, education, and age are associated with engagement in ecological momentary assessment text messaging among substance-using MSM in San Francisco.

In: Journal of substance abuse treatment 75, S. 43–48. DOI: 10.1016/j.jsat.2017.01.007.

BACKGROUND: Ecological momentary assessments (EMA) are data collection approaches that characterize behaviors in real-time. However, EMA is underutilized in alcohol and substance use research among men who have sex with men (MSM). The aim of this analysis is to explore the correlates of engagement in EMA text messages among substance-using MSM in San Francisco. METHODS: The present analysis uses data collected from the Project iN pilot study (n=30). Over a two-month period, participants received and responded to EMA daily text messages inquiring about their study medication, alcohol, and methamphetamine use. Baseline characteristics including demographics, alcohol use, and substance use were examined as potential correlates of engagement in EMA text messages in logistic regression and proportional hazards models. RESULTS: Participants had a 74% response rate to EMA text messages over the study period. MSM of color had significantly lower adjusted odds of responding to EMA texts 80% of the time or more, compared to white MSM (adjusted odds ratio=0.05, 95%CI=0.01-0.38). College-educated MSM had a lower adjusted hazard of week-long discontinuation in EMA texts (adjusted hazard ratio=0.12, 95%CI=0.02-0.63). Older MSM had a higher adjusted hazard of week-long discontinuation in EMA texts (adjusted hazard ratio=1.15, 95%CI=1.01-1.31). CONCLUSION: Differences in engagement in EMA text prompts were discovered for MSM with different racial/ethnic backgrounds, ages, and education levels. Substance use variables were not correlated with engagement in text messages, suggesting that EMA may be a useful research tool among actively substance-using MSM in San Francisco.


Turner, Dio Kevin, II (2017):The experience of participating in DES.

In: Dissertation Abstracts International: Section B: The Sciences and Engineering 77 (7-B(E)).

The Descriptive Experience Sampling method (DES, Hurlburt, 1990, 1993) is designed to help researchers collect and describe participants’ inner experience in a way that minimizes the impact of the participant’s presuppositions and the researcher’s worldview on the description of participants’ inner experience. This study was an exploratory examination of the potential therapeutic effects of DES. It used three sources of data: pre and post-DES SCL-90-R questionnaires, observation of the process that unfolded during DES interviews, and a post-DES exit interview. Participants (n = 14) were drawn from the Psychology 101 Subject Pool. After five days of DES, there was a statistically significant improvement in reported psychological symptoms with a moderate effect size . Participant engagement was associated with symptom improvement. These findings suggest the desirability of further research into the potential ameliorative effects of DES. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Uink, Bep Norma; Modecki, Kathryn Lynn; Barber, Bonnie L. (2017):Disadvantaged youth report less negative emotion to minor stressors when with peers. An experience sampling study.

In: Int J Behav Dev 41 (1), S. 41–51.

Previous Experience Sampling Method (ESM) studies demonstrate that adolescents’ daily emotional states are heavily influenced by their immediate social context. However, despite adolescence being a risk period for exposure to daily stressors, research has yet to examine the influence of peers on adolescents’ emotional responses to stressors encountered in their daily life. Adolescents (N = 108) from a low-SES school completed ESM reports of their social context, minor stressors and emotions, 5 times a day for 7 days. Based on previous findings that the peer context is experienced as positive and rewarding, we expected being with peers would be associated with lower post-stress negative emotions and higher happiness, compared to being with family or alone. As expected, being with peers after a stressor was associated with lower sadness, worry and jealousy compared to being alone, and lower sadness compared to being with family. Gender differences emerged for the influence of peers on sadness, worry, jealousy and happiness. These findings highlight the salient influence of peers on adolescents’ emotional reactivity to stressors as they occur in their natural environment. Findings are discussed in reference to peers as important emotion socialization agents during adolescence and in terms of theories of coping and emotion regulation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Uy, Jessica P.; Galván, Adriana (2017):Acute stress increases risky decisions and dampens prefrontal activation among adolescent boys.

In: Neuroimage 146, S. 679–689. DOI: 10.1016/j.neuroimage.2016.08.067.

Adolescence is characterized by increased risky decision-making, enhanced mesolimbic response to risk and reward, increased perceived stress, and heightened physiological response to stress relative to other age groups. In adults, evidence suggests that acute stress increases risky decision-making by stress-induced increases of dopamine in regions implicated in reward processing and decision-making. Acute stress also increases risky decision-making in adolescents, but the underlying neurobiological mechanisms remained unexplored. In this study, daily self-reports of stress were documented in adolescents and adults. Participants completed two fMRI visits during which they performed a risky decision-making task: once each when they endorsed a high and low level of stress. Results revealed that adolescent males took more advantageous risks under high stress relative to low stress whereas adult males took fewer non-advantageous risks under high stress relative to low stress. Adolescent males also showed a stress-related decrease in prefrontal activation when making risky decisions from high stress to low stress while adult males maintained prefrontal activation when making risky decisions across stress conditions. Adolescent and adult females did not exhibit stress-related changes in risky decisions. Moreover, greater prefrontal activation under stress was associated with fewer non-advantageous risks taken under stress. Implications for risk-taking under stress are discussed in light of these findings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


van Calster, Laurens; D’Argembeau, Arnaud; Salmon, Eric; Peters, Frédéric; Majerus, Steve (2017):Fluctuations of attentional networks and default mode network during the resting state reflect variations in cognitive states. Evidence from a novel resting-state experience sampling method.

In: J Cogn Neurosci 29 (1), S. 95–113. DOI: 10.1162/jocn_a_01025.

Neuroimaging studies have revealed the recruitment of a range of neural networks during the resting state, which might reflect a variety of cognitive experiences and processes occurring in an individual’s mind. In this study, we focused on the default mode network (DMN) and attentional networks and investigated their association with distinct mental states when participants are not performing an explicit task. To investigate the range of possible cognitive experiences more directly, this study proposes a novel method of resting-state fMRI experience sampling, informed by a phenomenological investigation of the fluctuation of mental states during the resting state. We hypothesized that DMN activity would increase as a function of internal mentation and that the activity of dorsal and ventral networks would indicate states of top–down versus bottom–up attention at rest. Results showed that dorsal attention network activity fluctuated as a function of subjective reports of attentional control, providing evidence that activity of this network reflects the perceived recruitment of controlled attentional processes during spontaneous cognition. Activity of the DMN increased when participants reported to be in a subjective state of internal mentation, but not when they reported to be in a state of perception. This study provides direct evidence for a link between fluctuations of resting-state neural activity and fluctuations in specific cognitive processes. (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. (2017):Temporal dynamics of health and well-being. A crowdsourcing approach to momentary assessments and automated generation of personalized feedback.

In: Psychosomatic medicine 79 (2), S. 213–223. DOI: 10.1037/t03592-000.

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: Awebsite 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. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


van der Steen, Y.; Gimpel-Drees, J.; Lataster, T.; Viechtbauer, W.; Simons, C. J. P.; Lardinois, M. et al. (2017):Clinical high risk for psychosis. The association between momentary stress, affective and psychotic symptoms.

In: Acta psychiatrica Scandinavica. DOI: 10.1111/acps.12714.

OBJECTIVE: The aim of this study was to assess associations between momentary stress and both affective and psychotic symptoms in everyday life of individuals at clinical high risk (CHR), compared to chronic psychotic patients and healthy controls, in search for evidence of early stress sensitization. It also assessed whether psychotic experiences were experienced as stressful. METHOD: The experience sampling method was used to measure affective and psychotic reactivity to everyday stressful activities, events and social situations in 22 CHR patients, 24 patients with a psychotic disorder and 26 healthy controls. RESULTS: Multilevel models showed significantly larger associations between negative affect (NA) and activity-related stress for CHR patients than for psychotic patients (P = 0.008) and for CHR compared to controls (P < 0.001). Similarly, the association between activity-related stress and psychotic symptoms was larger in CHR than in patients (P = 0.02). Finally, the association between NA and symptoms (P < 0.001) was larger in CHR than in patients. CONCLUSION: Stress sensitization seems to play a role particularly in the early phase of psychosis development as results suggest that CHR patients are more sensitive to daily life stressors than psychotic patients. In this early phase, psychotic experiences also contributed to the experience of stress.


van Knippenberg, Rosalia J. M.; Vugt, Marjolein E. de; Ponds, Rudolf W.; Myin-Germeys, Inez; Verhey, Frans R. J. (2016):Dealing with daily challenges in dementia (Deal-id Study). An experience sampling study to assess caregivers’ sense of competence and experienced positive affect in daily life.

In: The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry. DOI: 10.1016/j.jagp.2016.10.015.

OBJECTIVE: Positive emotions and feelings of competence seem to play an important role in the well-being of caregivers of people with dementia. Both are likely to fluctuate constantly throughout the caretaking process. Unlike standard retrospective methods, momentary assessments in daily life can provide insight into these moment-to-moment fluctuations. Therefore, in this study both retrospective and momentary assessments were used to examine the relationship between caregivers’ sense of competence and their experienced positive affect (PA) in daily life. METHODS: Thirty Dutch caregivers provided momentary data on PA and daily sense of competence ratings for 6 consecutive days using the experience sampling methodology. Additionally, they reported retrospectively on their sense of competence with a traditional questionnaire. RESULTS: A positive association was found between retrospective and daily measured sense of competence. Caregivers reported corresponding levels of sense of competence on both measures. Both daily and retrospective sense of competence were positively associated with the experienced levels of PA. However, daily sense of competence appeared to be the strongest predictor. Regarding the variability in PA, only daily sense of competence showed a significant association, with a higher daily sense of competence predicting a more stable PA pattern. CONCLUSION: This study provides support for redirecting caregiver support interventions toward enhancement of positive rather than negative experiences and focusing more on caregivers’ momentary emotional experiences. Momentary assessments are a valuable addition to standard retrospective measures and provide a more comprehensive and dynamic view of caregiver functioning.


Vansteelandt, Kristof; Houben, Marlies; Claes, Laurence; Berens, Ann; Sleuwaegen, Ellen; Sienaert, Pascal; Kuppens, Peter (2017):The affect stabilization function of nonsuicidal self injury in borderline personality disorder. An Ecological Momentary Assessment study.

In: Behaviour research and therapy 92, S. 41–50. DOI: 10.1016/j.brat.2017.02.003.

Nonsuicidal Self-Injury (NSSI) is prominent in individuals with Borderline Personality Disorder (BPD), and there is abundant evidence that affect regulation plays an important role in NSSI in the majority of patients. Affective variability is a core feature of BPD, and thus, we hypothesize that NSSI has an affect stabilization function in BPD. Affect stabilization is a process through which individuals attempt to make their affect more stable by reducing affective variability. We tested this hypothesis in 32 participants with BPD who reported on their NSSI and affect -using a displeasure-pleasure (valence) and activation-deactivation (activation) dimension- in an experience sampling study with 10 random signals scheduled per day for 8 days. Results indicated that individuals who engaged in NSSI show more Within Subject (WS) variance in valence and activation than individuals who did not engage in NSSI. However, within the NSSI patients, individuals who engaged more frequently in NSSI during the study showed less WS variance in valence and activation than patients who engaged less frequently in NSSI. This suggests that NSSI may be reinforced by its affect stabilization function. In the discussion, we explore alternative explanations for the relation between NSSI and affective variability, and consider the clinical implications.


Vicente, Jose M.; Avila-Navarro, Ernesto; Juan, Carlos G.; Garcia, Nicolas; Sabater-Navarro, Jose M. (2016):Design of a wearable bio-patch for monitoring patient’s temperature.

In: Conference proceedings : … Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference 2016, S. 4792–4795. DOI: 10.1109/EMBC.2016.7591799.

New communication technologies allow us developing useful and more practical medical applications, in particular for ambulatory monitoring. NFC communication has the advantages of low powering and low influence range area, what makes this technology suitable for health applications. This work presents an explanation of the design process of planar NFC antennas in a wearable biopatch. The problem of optimizing the communication distance is addressed. Design of a biopatch for continuous temperature monitoring and experimental results obtained wearing this biopatch during daily activities are presented.


Villain, Marie; Sibon, Igor; Renou, Pauline; Poli, Mathilde; Swendsen, Joel (2017):Very early social support following mild stroke is associated with emotional and behavioral outcomes three months later.

In: Clin Rehabil 31 (1), S. 135–141. DOI: 10.1177/0269215515623600.

Objective: To investigate whether social contact and support received during hospitalization for acute ischemic stroke predict depression and daily life functioning three months later. Design: Prospective observational study using Ecological Momentary Assessments to evaluate the number of social contacts as well as social support received from family, friends and medical staff within 24 hours following admission for stroke. Patients also monitored depression symptoms and behavior in real-time and in daily life contexts three months later. Setting: A university hospital acute stroke unit. Subjects: Thirty-four mild ischemic stroke patients. Interventions: None. Main measures: One-day Ecological Momentary Assessments immediately following stroke collected information concerning perceived social support, number of social contacts and depression symptoms. Ecological Momentary Assessments was repeated three months later and addressed depression levels as well as activities of daily living, such as working, cooking, shopping and housework. Results: The number of social interactions received at hospitalization did not predict three-month outcomes. However, a better quality of moral support from friends and family immediately after stroke was associated with decreases in later depression levels (p = 0.041) and increases in activities of daily living (p = 0.011). Material support from friends and family was associated with increases in activities of daily living (p = 0.012). No effect was observed for support received from medical staff. Conclusions: Patient perceptions of better support quality, and not quantity, immediately following mild stroke, are associated with better behavioral and emotional outcomes three months later. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Westgate, Erin C.; Wilson, Timothy D.; Gilbert, Daniel T. (2017):With a little help for our thoughts. Making it easier to think for pleasure.

In: Emotion (Washington, D.C.). DOI: 10.1037/emo0000278.

Can people enjoy thinking if they set their mind to it? Previous work suggests that many people do not enjoy the deliberate attempt to have pleasurable thoughts. We suggest that deliberately thinking for pleasure requires mental resources that people are either unwilling or unable to devote to the task. If so, then people should enjoy pleasant thoughts that occur unintentionally more than pleasant thoughts that occur intentionally. This hypothesis was confirmed in an experience sampling study (Study 1) in which participants were contacted 4 times a day for 7 days and asked to rate what they had been thinking about. In Studies 2–5 we experimentally manipulated how easy it was for people to engage in pleasurable thought when given the goal of doing so. All participants listed topics they would enjoy thinking about; then some were given a simple ‘thinking aid’ that was designed to make this experience easier. Participants who received the aid found the experience easier and enjoyed it more. The findings suggest that thinking for pleasure is cognitively demanding, but that a simple thinking aid makes it easier and more enjoyable. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Wong, Elena; Tschan, Franziska; Semmer, Norbert K. (2017):Effort in emotion work and well-being. The role of goal attainment.

In: Emotion (Washington, D.C.) 17 (1), S. 67–77. 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) 2017 APA, all rights reserved)


Wood, Julie; Oravecz, Zita; Vogel, Nina; Benson, Lizbeth; Chow, Sy-Miin; Cole, Pamela et al. (2017):Modeling intraindividual dynamics using stochastic differential equations. Age differences in affect regulation.

In: The journals of gerontology. Series B, Psychological sciences and social sciences. DOI: 10.1093/geronb/gbx013.

Objectives: Life-span theories of aging suggest improvements and decrements in individuals’ ability to regulate affect. Dynamic process models, with intensive longitudinal data, provide new opportunities to articulate specific theories about individual differences in intraindividual dynamics. This paper illustrates a method for operationalizing affect dynamics using a multilevel stochastic differential equation (SDE) model, and examines how those dynamics differ with age and trait-level tendencies to deploy emotion regulation strategies (reappraisal and suppression). Method: Univariate multilevel SDE models, estimated in a Bayesian framework, were fit to 21 days of ecological momentary assessments of affect valence and arousal (average 6.93/day, SD = 1.89) obtained from 150 adults (age 18-89 years)-specifically capturing temporal dynamics of individuals’ core affect in terms of attractor point, reactivity to biopsychosocial (BPS) inputs, and attractor strength. Results: Older age was associated with higher arousal attractor point and less BPS-related reactivity. Greater use of reappraisal was associated with lower valence attractor point. Intraindividual variability in regulation strategy use was associated with greater BPS-related reactivity and attractor strength, but in different ways for valence and arousal. Discussion: The results highlight the utility of SDE models for studying affect dynamics and informing theoretical predictions about how intraindividual dynamics change over the life course.


Wu, Haijing; Mata, Jutta; Furman, Daniella J.; Whitmer, Anson J.; Gotlib, Ian H.; Thompson, Renee J. (2017):Anticipatory and consummatory pleasure and displeasure in major depressive disorder. An experience sampling study.

In: Journal of abnormal psychology 126 (2), S. 149–159. DOI: 10.1037/abn0000244.

Pleasure and displeasure can be parsed into anticipatory and consummatory phases. However, research on pleasure and displeasure in major depressive disorder (MDD), a disorder characterized by anhedonia, has largely focused on deficits in the consummatory phase. Moreover, most studies in this area have been laboratory-based, raising the question of how component processes of pleasure and displeasure are experienced in the daily lives of depressed individuals. Using experience sampling, we compared anticipatory and consummatory pleasure and displeasure for daily activities reported by adults with MDD (n = 41) and healthy controls (n = 39). Participants carried electronic devices for one week and were randomly prompted eight times a day to answer questions about activities to which they most and least looked forward. Compared to healthy controls, MDD participants reported blunted levels of both anticipatory and consummatory pleasure and elevated levels of both anticipatory and consummatory displeasure for daily activities. Independent of MDD status, participants accurately predicted pleasure but overestimated displeasure. These results are the first to provide evidence that, across both anticipatory and consummatory phases, individuals with MDD experience blunted pleasure and elevated displeasure for daily activities. Our findings clarify the disturbances in pleasure and displeasure that characterize MDD and may inform treatment for this debilitating disorder. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

General Scientific Summary—Pleasure and displeasure can be separated into two phases: anticipation and experience. This is the first study outside of the laboratory to show that individuals with major depressive disorder (MDD) have deficits in the anticipation and the experience of both pleasure and displeasure for everyday activities. Specifically, for both anticipation and experience, individuals with MDD reported blunted pleasure and elevated displeasure when compared to reports from healthy individuals. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Ye, Xu (2017):Automatic eating detection using wearable devices.

In: Dissertation Abstracts International: Section B: The Sciences and Engineering 77 (9-B(E)).

This dissertation is motivated by the growing prevalence of obesity, a health problem currently affecting over 700 million people worldwide. According to the World Health Organization, obesity is a considerable risk factor of diabetes, heart disease and certain cancer. Automatic Eating Detection (AED) can provide an important tool to help users regulate their dietary behavior for many health applications, including weight management. Our first pilot study was conducted to explore the feasibility and usability of automatic eating detection using head-mount and wrist-worn accelerometer. We proposed an AED solution using. motion patterns derived from accelerometers that are commonly available in commercial wearable devices. Experimental results validated that the proposed approach is highly effective to detect head motion from chewing and to detect hand-to-mouth (HtM) gestures when eating. By combining the features from both devices, we could achieve higher accuracy and predict the duration of eating. We developed a smartwatch-based system using this solution to generate just-intime reminders based on automatically detected eating gestures during food consumption, in order to facilitate food journaling. We recruited 7 participants in a two-week in-field study to evaluate the usability of the system. Study results show that partici-pants were able to sustain journaling throughout a 2-week period with the help of our eating detection system, as the number of reminders correlates well with the number of logged meals. However, quite a few false positives were observed in such real-world deployment as the classification model was trained without participants’ data. In general, activity recognition systems are built and evaluated on a set of predefined activities and assume the samples are representative of all activities in real life. In reality, activity recognition systems trained in this manner generate many false positives when encountering new activities not included in the training process. To address this challenge, we used PUL (Positive and Unlabeled Learning) approach leveraging the large amount of unlabeled data collected in real life to reduce the false positives of our AED algorithm. By achieving a high detection accuracy with low false positive rate, we significantly improved the performance of our eating detection system in real world deployment. We believe that our work can be used in many potential applications, including general diet monitoring through assisted reminders, improving 24-hour recall or food frequency survey to accurately measure food intake, or being used by clinical practitioners to monitor the eating patterns of patients (e.g. during diabetes treatment). (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Zhang, Fan (2017):How mixed emotion influences the health outcomes of different age groups from different cultures.

In: Dissertation Abstracts International: Section B: The Sciences and Engineering 77 (8-B(E)).

Mixed emotion, as the co-occurrence of positive and negative affects, is found to be associated with positive health outcomes, greater subjective well-being and adaptive coping. Although the experience of mixed emotion is altered by age and culture, it is still not clear how its effects vary at the individual level, cultural level or situational level. Moreover, little empirical evidence has been provided for the underlying mechanism of the effects of mixed emotion. Therefore, two studies were conducted to clarify 1) the roles of age, culture and situation in how mixed emotion influences health, and 2) the processes underlying this emotion-health association. In Study 1, with experience sampling data of 212 participants aged from 18 to 83 years, the effects of mixed emotion on physical health were compared in three culture groups (European American, Chinese American and Hong Kong Chinese). Given the inconsistency of previous findings, two different approaches were adopted to measure mixed emotion. Although the covariation approach found mixed emotion was positively associated with age while the ambivalence approach revealed an opposite pattern, both measures showed that greater mixed emotion predicted fewer physical symptoms among Hong Kong Chinese, particularly in pleasant situations. In Study 2, I collected the physiological and behavioral data of 131 college students to compare the effects of mixed emotion and positive emotion in reducing psychosocial stress. It was found both mixed emotion and positive emotion could help with individuals’ cardiovascular recovery, but in the mixed emotion group, participants showed more solution-oriented choices and greater emotional flexibility. These findings advanced our understanding of mixed emotion, and provided empirical evidences for the theoretical models on the emotion-health link. Key words: mixed emotion, physical Health, age, coping, emotional flexibility. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

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