Society for Ambulatory Assessment


Albert, Mark V.; Azeze, Yohannes; Courtois, Michael; Jayaraman, Arun (2017): In-lab versus at-home activity recognition in ambulatory subjects with incomplete spinal cord injury.

In: Journal of neuroengineering and rehabilitation 14 (1), S. 10. DOI: 10.1186/s12984-017-0222-5.

BACKGROUND: Although commercially available activity trackers can aid in tracking therapy and recovery of patients, most devices perform poorly for patients with irregular movement patterns. Standard machine learning techniques can be applied on recorded accelerometer signals in order to classify the activities of ambulatory subjects with incomplete spinal cord injury in a way that is specific to this population and the location of the recording-at home or in the clinic. METHODS: Subjects were instructed to perform a standardized set of movements while wearing a waist-worn accelerometer in the clinic and at-home. Activities included lying, sitting, standing, walking, wheeling, and stair climbing. Multiple classifiers and validation methods were used to quantify the ability of the machine learning techniques to distinguish the activities recorded in-lab or at-home. RESULTS: In the lab, classifiers trained and tested using within-subject cross-validation provided an accuracy of 91.6%. When the classifier was trained on data collected in the lab but tested on at home data, the accuracy fell to 54.6% indicating distinct movement patterns between locations. However, the accuracy of the at-home classifications, when training the classifier with at-home data, improved to 85.9%. CONCLUSION: Individuals with unique movement patterns can benefit from using tailored activity recognition algorithms easily implemented using modern machine learning methods on collected movement data.


Allen, Chelsea McCarty; Griffith, Sandra D.; Shiffman, Saul; Heitjan, Daniel F. (2017): Proximity and gravity. Modeling heaped self-reports.

In: Statistics in medicine. DOI: 10.1002/sim.7327.

Self-reported daily cigarette counts typically exhibit a preponderance of round numbers, a phenomenon known as heaping or digit preference. Heaping can be a substantial nuisance, as scientific interest lies in the distribution of the underlying true values rather than that of the heaped data. In principle, we can estimate parameters of the underlying distribution from heaped data if we know the conditional distribution of the heaped count given the true count, denoted the heaping mechanism (analogous to the missingness mechanism for missing data). In general, it is not possible to estimate the heaping mechanism robustly from heaped data only. A doubly-coded smoking cessation trial data set that includes daily cigarette count as both a conventional heaped retrospective recall measurement and a precise instantaneous measurement offers the rare opportunity to directly estimate the heaping mechanism. We propose a novel model that describes the conditional probability of the self-reported count as a function of its proximity to the truth and its intrinsic attractiveness, denoted its gravity. We apply variations of the model to the cigarette count data, illuminating the cognitive processes that influence self-reporting behaviors. The principal application of the model will be to enabling the correct analysis of heaped-only data sets. Copyright (c) 2017 John Wiley & Sons, Ltd.


Allen, Alicia; Tosun, Nicole; Carlson, Sam; Allen, Sharon (2017): Postpartum Changes in Mood and Smoking-Related Symptomatology. An Ecological Momentary Assessment Investigation.

In: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. DOI: 10.1093/ntr/ntx118.

Introduction: Postpartum smoking relapse is a highly prevalent public health problem. Mood and breastfeeding are significantly associated with smoking relapse, though less is known about the temporality of these relationships. Therefore, this study utilized ecological momentary assessments (EMA) to prospectively examine changes mood and smoking-related symptomatology in relationship to three events – childbirth, termination of breastfeeding and smoking relapse. We expected all three events to significantly alter mood and smoking-related symptomatology. Methods: We enrolled a sample of pregnant women who had recently quit smoking and intended to remain quit during the postpartum. Participants were randomized to active/placebo progesterone to prevent postpartum relapse. Participants also completed daily EMA to collect data mood and smoking-related symptomatology, as well as our three events of interest. Results: Participants (n=46) were, on average, 26.5+/-0.8 years old and, prior to pregnancy, smoked 10.1+/-0.7 cigarettes/day. We noted a number of significant within and between subject relationships. For example, participants reported a 24% decline in negative affect after childbirth (p=0.0016). Among those who relapsed to smoking (n=23), participants randomized to placebo had a significant increase in cigarette craving after relapse (beta = 1.06, 95% CI = 0.62, 1.49, p-value = 0.0003) whereas participants randomized to active progesterone did not (beta = 0.63, 95% CI = -0.35, 1.62, p-value = 0.1824). Conclusions: These observations suggest that mood and smoking-related symptomatology are influenced by childbirth, breastfeeding, smoking relapse and use of exogenous progesterone. Future research should explore how these observations may inform novel postpartum smoking relapse prevention interventions. IMPLICATIONS: Postpartum smoking relapse has been a persistent public health problem for more than 40 years. Although a number of significant predictors of postpartum smoking relapse have been identified (e.g., depression, breastfeeding), much of these analyses have relied on cross-sectional and/or self-reported retrospective data. Therefore, for the first time, we utilized ecological momentary assessment to explore the effect of childbirth, termination of breastfeeding and smoking relapse on mood and smoking-related symptomatology (e.g., craving). Numerous significant relationships were observed, including a 96% increase in craving after smoking relapse. These novel observations can inform new and effective postpartum smoking relapse prevention programs.


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.


Arndt, Charlotte; Lischetzke, Tanja; Crayen, Claudia; Eid, Michael (2017): The assessment of emotional clarity via response times to emotion items. Shedding light on the response process and its relation to emotion regulation strategies.

In: Cognition & emotion, S. 1–19. DOI: 10.1080/02699931.2017.1322039.

Researchers have begun to use response times (RTs) to emotion items as an indirect measure of emotional clarity. Our first aim was to scrutinise the properties of this RT measure in more detail than previously. To be able to provide recommendations as to whether (and how) emotional intensity – as a possible confound – should be controlled for, we investigated the specific form of the relation between emotional intensity and RTs to emotion items. In particular, we assumed an inverted U-shaped relation at the item level. Moreover, we analysed the RT measure’s convergent validity with respect to individuals’ confidence in their emotion ratings. As a second aim, we compared the predictive validity of emotional clarity measures (RT measure, self-report) with respect to daily emotion regulation. The results of three experience sampling studies showed that the association between emotional intensity and RT followed an inverted U shape. RT was in part related to confidence. Emotional clarity measures were unrelated to reappraisal. There was some evidence that lower emotional clarity was related to a greater use of suppression. The findings highlight that emotional intensity and squared emotional intensity should be controlled for when using the RT measure of emotional clarity in future research.


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.


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.


Bedard, Chloe; King-Dowling, Sara; McDonald, Madeline; Dunton, Genevieve; Cairney, John; Kwan, Matthew (2017): Understanding Environmental and Contextual Influences of Physical Activity During First-Year University. The Feasibility of Using Ecological Momentary Assessment in the MovingU Study.

In: JMIR public health and surveillance 3 (2), e32. DOI: 10.2196/publichealth.7010.

BACKGROUND: It is well established that drastic declines in physical activity (PA) occur during young adults’ transition into university; however, our understanding of contextual and environmental factors as it relates to young adults’ PA is limited. OBJECTIVE: The purpose of our study was to examine the feasibility of using wrist-worn accelerometers and the use of ecological momentary assessment (EMA) to assess the context and momentary correlates of PA on multiple occasions each day during first-year university. METHODS: First-year university students were asked to participate in the study. The participants completed a brief questionnaire and were subsequently asked to wear an ActiGraph GT9X-Link accelerometer and respond to a series of EMA prompts (7/day) via their phones for 5 consecutive days. RESULTS: A total of 96 first-year university students with smartphones agreed to participate in the study (mean age 18.3 [SD 0.51]; n=45 females). Overall, there was good compliance for wearing the accelerometers, with 91% (78/86) of the participants having >/=2 days of >/=10 hours of wear time (mean=3.53 valid days). Students were generally active, averaging 10,895 steps/day (SD 3413) or 1123.23 activity counts/min (SD 356.10). Compliance to EMA prompts was less desirable, with 64% (55/86) of the participants having usable EMA data (responding to a minimum of >/=3 days of 3 prompts/day or >/=4 days of 2 prompts/day), and only 47% (26/55) of these participants were considered to have excellent EMA compliance (responding to >/=5 days of 4 prompts/day or >/= 4 days of 5 prompts/day). CONCLUSIONS: This study represents one of the first studies to use an intensive real-time data capture strategy to examine time-varying correlates of PA among first-year university students. These data will aim to describe the physical and social contexts in which PA occurs and examine the relationships between momentary correlates of PA among the first-year university students. Overall, current results suggest that wrist-worn accelerometers and EMA are feasible methods for data collection among the young adult population; however, more work is needed to understand how to improve upon compliance to a real-time data capture method such as EMA.


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


Benedek, Mathias; Jauk, Emanuel; Kerschenbauer, Kevin; Anderwald, Ruth; Grond, Leonhard (2017): Creating Art. An Experience Sampling Study in the Domain of Moving Image Art.

In: Psychol Aesthet Creat Arts. DOI: 10.1037/aca0000102.

This study investigated work-related behaviors and feelings in the process of creating art. In a collaborative effort by creativity researchers and artistic researchers, we invited artists to create a short film or video for an international art competition and monitored them for 2 weeks while producing the artwork. The artists provided daily reflections on their work process via smartphone or online experience sampling, and we assessed relevant person data via an online questionnaire. Multilevel models were used to explain variability in artwork advancement beyond linear increases over time. Artwork advancement was predicted by deliberate engagement, engrossment in details and enjoyment of work, and by reduced work-related feelings of anxiety and ‘walking in a fog.’ Between-person analyses revealed that artists with higher past artistic achievement and lower agreeableness produced artworks of higher quality in terms of the evaluations by the competition jury. This study demonstrates the feasibility of experience sampling methods for the investigation of extended creative work and highlights some general processes and relevant traits in the process of creating art. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Bentley, Kate H.; Nock, Matthew K.; Sauer-Zavala, Shannon; Gorman, Bernard S.; Barlow, David H. (2017): A functional analysis of two transdiagnostic, emotion-focused interventions on nonsuicidal self-injury.

In: Journal of consulting and clinical psychology 85 (6), S. 632–646. DOI: 10.1037/ccp0000205.

OBJECTIVE: Nonsuicidal self-injury (NSSI) is prevalent and associated with clinically significant consequences. Developing time-efficient and cost-effective interventions for NSSI has proven difficult given that the critical components for NSSI treatment remain largely unknown. The aim of this study was to examine the specific effects of mindful emotion awareness training and cognitive reappraisal, 2 transdiagnostic treatment strategies that purportedly address the functional processes thought to maintain self-injurious behavior, on NSSI urges and acts. METHOD: Using a counterbalanced, combined series (multiple baseline and data-driven phase change) aggregated single-case experimental design, the unique and combined impact of these 2 4-week interventions was evaluated among 10 diagnostically heterogeneous self-injuring adults. Ecological momentary assessment was used to provide daily ratings of NSSI urges and acts during all study phases. RESULTS: Eight of 10 participants demonstrated clinically meaningful reductions in NSSI; 6 participants responded to 1 intervention alone, whereas 2 participants responded after the addition of the alternative intervention. Group analyses indicated statistically significant overall effects of study phase on NSSI, with fewer NSSI urges and acts occurring after the interventions were introduced. The interventions were also associated with moderate to large reductions in self-reported levels of anxiety and depression, and large improvements in mindful emotion awareness and cognitive reappraisal skills. CONCLUSIONS: Findings suggest that brief mindful emotion awareness and cognitive reappraisal interventions can lead to reductions in NSSI urges and acts. Transdiagnostic, emotion-focused therapeutic strategies delivered in time-limited formats may serve as practical yet powerful treatment approaches, especially for lower-risk self-injuring individuals. (PsycINFO Database Record


Berner, Laura A.; Crosby, Ross D.; Cao, Li; Engel, Scott G.; Lavender, Jason M.; Mitchell, James E.; Wonderlich, Stephen A. (2017): Temporal associations between affective instability and dysregulated eating behavior in bulimia nervosa.

In: Journal of psychiatric research 92, S. 183–190. DOI: 10.1016/j.jpsychires.2017.04.009.

Prior research suggests that the construct of emotional instability may be salient to bulimia nervosa (BN), but no study to date has used ecological momentary assessment (EMA) to examine its temporal association with binge eating and purging. In the current study, 133 women with DSM-IV BN used portable digital devices to provide multiple daily negative affect (NA) and positive affect (PA) ratings and record eating disorder behaviors over 2 weeks. Two state-of-the art indices quantified affective instability: probability of acute change (PAC), which represents the likelihood of extreme affective increases, and mean squared successive difference (MSSD), which represents average change over successive recordings. For extreme affective change, results revealed that on bulimic behavior days, extreme NA increases were less likely after bulimic behaviors than before them, and extreme increases in PA were more likely after bulimic behaviors than during the same time period on non-bulimic behavior days. However, average NA instability (i.e., MSSD) was (a) greater on bulimic behavior days than non-bulimic behavior days, (b) greater after bulimic behaviors than during the same time period on non-bulimic behavior days, and (c) greater after bulimic behaviors than before them. Results lend support to the notion that bulimic behaviors are negatively reinforcing (i.e., via post-behavior acute affective changes), but also indicate that these behaviors may exacerbate overall affective dysregulation. These findings may improve understanding of BN maintenance and inform the development of novel interventions or refinement of existing treatments.


Berrios, Raul; Totterdell, Peter; Kellett, Stephen (2017): Individual differences in mixed emotions moderate the negative consequences of goal conflict on life purpose.

In: Pers Individ Dif 110, S. 18–22. DOI: 10.1016/j.paid.2017.01.013.

Pursuing two incompatible goals (goal conflict) is commonly viewed as pernicious for individual well-being. Recent research has also shown that sometimes goal conflict instigates the experience of mixed emotions (co-activation of positive and negative emotions), and in turn, mixed emotions has been linked to some beneficial outcomes, including self-control and eudaimonic well-being. In the present study we formulated mixed emotions as an individual difference, and hypothesized that individual differences in mixed emotions can moderate the relationship between goal conflict and life purpose, a dimension of eudaimonic well-being. A sample of 73 individuals participated in an experience sampling study, producing over 2500 observations. Moderation analysis using multilevel modeling showed that goal conflict was negatively related to life-purpose, but more importantly this effect was qualified by a significant cross-level interaction, such that the negative effect of goal conflict on life purpose was weaker for individuals who commonly experienced greater mixed emotions. Given that conflicting goals are commonplace, experiencing mixed emotions may be beneficial for individuals. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Bhidayasiri, Roongroj; Martinez-Martin, Pablo (2017): Clinical Assessments in Parkinson’s Disease. Scales and Monitoring.

In: International review of neurobiology 132, S. 129–182. DOI: 10.1016/bs.irn.2017.01.001.

Measurement of disease state is essential in both clinical practice and research in order to assess the severity and progression of a patient’s disease status, effect of treatment, and alterations in other relevant factors. Parkinson’s disease (PD) is a complex disorder expressed through many motor and nonmotor manifestations, which cause disabilities that can vary both gradually over time or come on suddenly. In addition, there is a wide interpatient variability making the appraisal of the many facets of this disease difficult. Two kinds of measure are used for the evaluation of PD. The first is subjective, inferential, based on rater-based interview and examination or patient self-assessment, and consist of rating scales and questionnaires. These evaluations provide estimations of conceptual, nonobservable factors (e.g., symptoms), usually scored on an ordinal scale. The second type of measure is objective, factual, based on technology-based devices capturing physical characteristics of the pathological phenomena (e.g., sensors to measure the frequency and amplitude of tremor). These instrumental evaluations furnish appraisals with real numbers on an interval scale for which a unit exists. In both categories of measures, a broad variety of tools exist. This chapter aims to present an up-to-date summary of the most relevant characteristics of the most widely used scales, questionnaires, and technological resources currently applied to the assessment of PD. The review concludes that, in our opinion: (1) no assessment methods can substitute the clinical judgment and (2) subjective and objective measures in PD complement each other, each method having strengths and weaknesses.


Blanke, Elisabeth S.; Brose, Annette (2017): Mindfulness in daily life. A multidimensional approach.

In: Mindfulness (N Y) 8 (3), S. 737–750. DOI: 10.1007/s12671-016-0651-4.

Trait mindfulness is often conceptualized to comprise multiple facets such as attention to and acceptance of present-moment experiences. State mindfulness however is mostly conceptualized as unidimensional. As research on trait mindfulness indicates that differentiating aspects of mindfulness deepens our understanding of its associations with well-being, we tested the presence of four facets at both, the trait and the state level: acting with awareness, nonjudgmental acceptance, present-moment attention, and nonreactivity. Via an experience-sampling technology, 70 participants (aged 20–30 years, 50% female) reported their state mindfulness six times a day for several days. In multiple multilevel confirmatory factor analyses, three of the four facets were corroborated at both levels of analysis. The final three-factor model including acting with awareness, nonjudgmental acceptance, and present-moment attention was superior to a one-factor model implying that state mindfulness can be conceptualized as multidimensional. A multidimensional state assessment will likely be informative for future research questions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Blanke, Elisabeth S.; Riediger, Michaela; Brose, Annette (2017): Pathways to Happiness Are Multidirectional. Associations Between State Mindfulness and Everyday Affective Experience.

In: Emotion (Washington, D.C.). DOI: 10.1037/emo0000323.

Mindfulness is commonly defined as a multidimensional mode of being attentive to, and aware of, momentary experiences while taking a nonjudgmental and accepting stance. These qualities have been linked to 2 different facets of affective well-being: being attentive is proposed to lead to an appreciation of experiences as they are, and thus to positive affect (PA). Accepting unpleasant experiences in a nonjudgmental fashion has been hypothesized to reduce negative affect (NA). Alternatively, however, attention may increase both positive and negative affectivity, whereas nonjudgmental acceptance may modify how people relate to their experiences. Previous research has considered such differential associations at the trait level, although a mindful mode may be understood as a state of being. Using an experience-sampling methodology (ESM) with smartphones, the present research therefore links different state mindfulness facets to positive and NA in daily life. Seventy students (50% female, 20-30 years old) of different disciplines participated in the study. Based on multidimensional assessments of self-reported state mindfulness and state affect, the findings corroborate the hypotheses on the differential predictive value of 2 mindfulness facets: Participants experienced more PA when they were attentive to the present moment and less NA when they nonjudgmentally accepted momentary experiences. Furthermore, only nonjudgmental acceptance buffered the impact of daily hassles on affective well-being. The study contributes to a more fine-grained understanding of the within-person mechanisms relating mindfulness to affective well-being in daily life. Future interventions may be able to enhance different aspects of affective well-being by addressing specific facets of mindfulness. (PsycINFO Database Record


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.


Bray, Paula; Bundy, Anita C.; Ryan, Monique M.; North, Kathryn N. (2017): Can in-the-moment diary methods measure health-related quality of life in Duchenne muscular dystrophy?

In: Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation 26 (5), S. 1145–1152. DOI: 10.1007/s11136-016-1442-z.

Aim: To investigate whether in-the-moment diary reports of daily experience, taken collectively, are a valid representation of health-related quality of life (HRQL). Methods: A total of 35 boys with Duchenne muscular dystrophy (DMD) were recruited through four neuromuscular care providers across Australia. Participants completed the PedsQL™ Generic Core scales and one week of experience-sampling diary reporting on a personal digital assistant. Rasch analysis was undertaken on the diary data to derive a single valid measure score. The resulting measure score for each participant was correlated with the summary score from the PedsQL™ Generic Core scales to examine whether daily experience was representative of HRQL. Results: The daily diary method showed good metric properties, with adequate goodness of fit for data from items and participants suggesting unidimensionality of the construct: quality of everyday experience. The correlation of the daily diary measure score with overall PedsQL™ summary score showed moderate agreement (r = .60, p = 0.001). Conclusions: The benefits of measuring daily quality of life include detailed descriptions of day-to-day experiences of children without the need for retrospective recall. Diary methods on an electronic platform or software application for personal devices may be a useful tool to understand HRQL as the repeated measures data provide a detailed experience directly from the child and the platform makes data completion highly motivating. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Brick, Timothy R.; Koffer, Rachel E.; Gerstorf, Denis; Ram, Nilam (2017): Feature Selection Methods for Optimal Design of Studies for Developmental Inquiry.

In: The journals of gerontology. Series B, Psychological sciences and social sciences. DOI: 10.1093/geronb/gbx008.

Objectives: As diary, panel, and experience sampling methods become easier to implement, studies of development and aging are adopting more and more intensive study designs. However, if too many measures are included in such designs, interruptions for measurement may constitute a significant burden for participants. We propose the use of feature selection-a data-driven machine learning process-in study design and selection of measures that show the most predictive power in pilot data. Method: We introduce an analytical paradigm based on the feature importance estimation and recursive feature elimination with decision tree ensembles and illustrate its utility using empirical data from the German Socio-Economic Panel (SOEP). Results: We identified a subset of 20 measures from the SOEP data set that maintain much of the ability of the original data set to predict life satisfaction and health across younger, middle, and older age groups. Discussion: Feature selection techniques permit researchers to choose measures that are maximally predictive of relevant outcomes, even when there are interactions or nonlinearities. These techniques facilitate decisions about which measures may be dropped from a study while maintaining efficiency of prediction across groups and reducing costs to the researcher and burden on the participants.


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.


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 Stressed? Or Is 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.


Cameron, Linda D.; Overall, Nickola C. (2017): Suppression and Expression as Distinct Emotion-Regulation Processes in Daily Interactions. Longitudinal and Meta-Analyses.

In: Emotion (Washington, D.C.). DOI: 10.1037/emo0000334.

Emotional suppression and expression both occur frequently in daily social interactions, yet research examining these emotion regulation processes simultaneously in naturalistic contexts remains limited. Although theory and research tend to reflect an implicit assumption that suppression and expression represent opposite sides of the same construct, they are likely to occur independently and exert different influences on intrapersonal and interpersonal experiences. In 4 experience-sampling and longitudinal studies, we assessed the personal and interpersonal consequences of daily emotional suppression and expression within romantic and close relationships. Mixed-model analyses revealed that suppression and expression consistently predicted independent and distinct outcomes across the studies. When individuals suppressed their emotions, they experienced more intrapersonal costs such as greater depressed mood, greater fatigue, lower self-esteem, and lower life satisfaction. Interpersonally, they also felt less acceptance from others, more distancing by others, and less relationship satisfaction. Greater suppression in daily life also predicted increases in depressive symptoms and reductions in relationship satisfaction 3 months later. In contrast, when individuals were more emotionally expressive during daily interactions, they experienced interpersonal benefits such as greater acceptance from others, greater relatedness and relationship satisfaction, and less distancing by others. Greater emotional expression in daily life also predicted increases in self-esteem and relationship satisfaction across time. Meta-analyses of the 4 studies confirmed the reliability and significance of these relationships; |r’s| = .12-.33. These studies demonstrate that suppression and expression are distinct processes used to manage emotions within social relationships and operate differently in shaping personal well-being and relationship functioning. (PsycINFO Database Record


Carlson, Jordan A.; Mitchell, Tarrah B.; Saelens, Brian E.; Staggs, Vincent S.; Kerr, Jacqueline; Frank, Lawrence D. et al. (2017): Within-person associations of young adolescents’ physical activity across five primary locations. Is there evidence of cross-location compensation?

In: The international journal of behavioral nutrition and physical activity 14. DOI: 10.1186/s12966-017-0507-x.

Background: Youth are active in multiple locations, but it is unknown whether more physical activity in one location is associated with less in other locations. This cross-sectional study examines whether on days with more physical activity in a given location, relative to their typical activity in that location, youth had less activity in other locations (i.e., within-person associations/compensation). Methods: Participants were 528 adolescents, ages 12 to 16 (M = 14.12, SD = 1.44, 50% boys, 70% White non-Hispanic). Accelerometer and Global Positioning System devices were used to measure the proportion of time spent in moderate-to-vigorous physical activity (MVPA) in five locations: home, home neighborhood, school, school neighborhood, and other locations. Mixed-effects regression was used to examine within-person associations of MVPA across locations and moderators of these associations. Results: Two of ten within-participant associations tested indicated small amounts of compensation, and one association indicated generalization across locations. Higher at-school MVPA (relative to the participant’s average) was related to less at-home MVPA and other-location MVPA (Bs = −0.06 min/day). Higher home-neighborhood MVPA (relative to the participant’s average) was related to more at-home MVPA (B = 0.07 min/day). Some models showed that compensation was more likely (or generalization less likely) in boys and non-whites or Hispanic youth. Conclusions: Consistent evidence of compensation across locations was not observed. A small amount of compensation was observed for school physical activity, suggesting that adolescents partially compensated for high amounts of school activity by being less active in other locations. Conversely, home-neighborhood physical activity appeared to carry over into the home, indicating a generalization effect. Overall these findings suggest that increasing physical activity in one location is unlikely to result in meaningful decreases in other locations. Supporting physical activity across multiple locations is critical to increasing overall physical activity in youth. (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.


Chaudhury, Sadia R.; Galfalvy, Hanga; Biggs, Emily; Choo, Tse-Hwei; Mann, J. John; Stanley, Barbara (2017): Affect in response to stressors and coping strategies. An ecological momentary assessment study of borderline personality disorder.

In: Borderline personality disorder and emotion dysregulation 4, S. 8. DOI: 10.1186/s40479-017-0059-3.

BACKGROUND: Affect instability is a core symptom of borderline personality disorder (BPD). Ecological momentary assessment allows for an understanding of real-time changes in affect in response to various daily stressors. The purpose of this study was to explore changes in affect in response to specific stressors and coping strategies in subjects with BPD utilizing ecological momentary assessment (EMA) methodology. METHODS: Subjects (n = 50) with BPD were asked to complete real-time assessments about stressors experienced, affect felt, and coping strategies employed six times per day for a 1-week period. Mixed effect regression models were used to measure the effect of stressors and coping strategies on affect change. RESULTS: While most stressors led to experiencing more negative affect, only being in a disagreement was independently associated with increased negative affect. Among coping strategies, only doing something good for oneself independently reduced negative affect, controlling for all other coping strategies used. CONCLUSIONS: These findings provide valuable insights into affective instability in BPD and can help inform treatment with individuals with the disorder.


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.


Collins, Rebecca L.; Martino, Steven C.; Kovalchik, Stephanie A.; D’Amico, Elizabeth J.; Shadel, William G.; Becker, Kirsten M.; Tolpadi, Anagha (2017): Exposure to Alcohol Advertising and Adolescents’ Drinking Beliefs. Role of Message Interpretation.

In: Health psychology : official journal of the Division of Health Psychology, American Psychological Association. DOI: 10.1037/hea0000521.

OBJECTIVE: Recent research revealed momentary associations between exposure to alcohol advertising and positive beliefs about alcohol among adolescents (Martino et al., 2016). We reanalyzed those data to determine whether associations depend on adolescents’ appraisal of ads. METHOD: Over a 10-month period in 2013, 589 youth, ages 11-14, in the Los Angeles, CA, area, participated in a 14-day ecological momentary assessment, logging all exposures to alcohol advertisements as they occurred and completing brief assessments of their skepticism toward, liking of, and identification with any people in each ad, as well as their alcohol-related beliefs at the moment. Participants also completed measures of their alcohol- related beliefs at random moments of nonexposure throughout each day. Mixed-effects regression models compared beliefs about alcohol at moments of exposure to alcohol advertising that was appraised in a particular way (e.g., with liking, without liking) to beliefs at random moments. RESULTS: When youth encountered ads they appraised positively, their beliefs about alcohol were significantly more positive than when they were queried at random moments. Beliefs in the presence of ads that were not positively appraised were generally similar to beliefs at random moments. CONCLUSION: Youth are active participants in the advertising process. How they respond to and process alcohol advertising strongly moderates the association between exposure and alcohol-related beliefs. More effort is needed to identify attributes of alcohol advertisements, and of youth, that determine how youth process alcohol ads. This information can be used to either limit exposure to problematic ads or make youth more resilient to such exposure. (PsycINFO Database Record


Cook, Jessica W.; Lanza, Stephanie T.; Chu, Wanghuan; Baker, Timothy B.; Piper, Megan E. (2017): Anhedonia. Its Dynamic Relations With Craving, Negative Affect, and Treatment During a Quit Smoking Attempt.

In: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 19 (6), S. 703–709. DOI: 10.1093/ntr/ntw247.

Introduction: Research shows that abstinence from tobacco leads to a withdrawal-related decrement in responsivity to nondrug rewards (ie, anhedonia). However, it remains unclear how anhedonia relates to other key withdrawal symptoms and withdrawal-related constructs over time. We analyzed ecological momentary assessment data to examine whether a decrement in response to rewards during a 10-day period following quitting shows a pattern of associations with other variables (ie, treatment, tobacco dependence, negative affect, and craving) that is consistent with anhedonia being a tobacco withdrawal symptom. Methods: As part of a randomized controlled trial of smoking cessation therapies, 1122 adults (58% female) were assigned to: placebo (n = 131), bupropion (alone or with nicotine lozenge; n = 401), or nicotine replacement therapy (NRT; lozenge, patch, both; n = 590). Participants completed 4 ecological momentary assessments per day for 10 days postquit, resulting in 22 575 assessments. Results: Time-varying effect modeling showed that anhedonia was significantly greater among those high in dependence relative to lower dependent smokers out to day 9 postquit. The placebo group showed elevated anhedonia immediately postquit, which fell to levels similar to the treatment groups by day 7. NRT effectively reduced anhedonia and its time-varying association with craving early in the quit attempt. The positive association between negative affect and anhedonia was moderate and stable over time for both active treatment groups. Conclusions: These results provide additional support that anhedonia following quitting smoking is a manifestation of the tobacco withdrawal syndrome. Implications: This study supported the hypothesis that diminished responsivity to nondrug rewards (ie, anhedonia) is a symptom of the tobacco withdrawal syndrome. Results showed that anhedonia: (1) was significantly associated with dependence, especially during the early postquit period when withdrawal was at its peak intensity; (2) showed significant time-varying associations with other withdrawal symptoms, especially craving; and (3) was significantly suppressed by agonist administration as was its association with craving over time.


Costello, Nessan; Deighton, Kevin; Dyson, Joshua; Mckenna, Jim; Jones, Ben (2017): Snap-N-Send. A valid and reliable method for assessing the energy intake of elite adolescent athletes.

In: European journal of sport science, S. 1–13. DOI: 10.1080/17461391.2017.1337815.

To ensure that elite adolescent athletes meet their unique training, growth and maturation demands, it is imperative to have access to valid measures of energy intake. Contemporary methods demand close attention-to-detail, meaning that athletes often do not fully adhere to real-time protocols. This study represents the first investigation of a real-time dietary assessment designed using a comprehensive behaviour change framework (COM-B). In a crossover design, 12 elite adolescent male rugby players recorded their energy intake via an estimated food diary (est-FD) and photography-based mobile assessment (‘Snap-n-Send’), combined with a 24-h dietary recall interview. Two 4-day assessment periods were divided into three separate recording environments: 96 h free-living and researcher-observed; 72 h free-living and 10 h researcher-observed. Assessment periods were one month apart. All foods and beverages were provided and weighed by the research team to quantify actual intakes. ‘Snap-n-Send’ reported a small mean bias for under-reporting across 96 h (-0.75 MJ day-1; 95% confidence interval [CI] for bias = -5.7% to -2.2%, p < .001), 72 h (-0.76 MJ day-1; 95% CI for bias = -5.6% to -2.1%, p = .004) and 10 h (-0.72 MJ day-1; 95% CI for bias = -8.1% to -0.1%; p = .067) environments. The est-FD reported a moderate mean bias for under-reporting across 96 h (-2.89 MJ day-1; 95% CI for bias = -17.9% to -10.2%; p < .001), 72 h (-2.88 MJ day-1; 95% CI for bias = -17.9% to -10.1%; p < .001) and 10 h (-2.52 MJ day-1;-26.1% to -5.3%; p = .023) environments. Results evidence the ability of ‘Snap-n-Send’ to accurately assess the diet of elite adolescent athletes, signalling the exciting promise of this comprehensive and theoretical behavioural approach within valid dietary assessment.


Cotter, Katherine N.; Silvia, Paul J. (2017): Measuring Mental Music. Comparing Retrospective and Experience Sampling Methods for Assessing Musical Imagery.

In: Psychol Aesthet Creat Arts. DOI: 10.1037/aca0000124.

Musical imagery—hearing music in your mind that isn’t playing in the environment—has been investigated using both retrospective methods (self-report scales of typical experiences) and in vivo methods (assessing inner music as it happens in daily life). But because musical imagery is often fleeting and on the fringe of conscious attention, retrospective self-report measures of inner music might correspond poorly with people’s actual experience of inner music. The present research thus compared reports from a retrospective measure of musical imagery (the Involuntary Musical Imagery Scale) and a week of intensive experience sampling in a sample of 132 young adults. For 7 days, participants were signaled 14 times daily between 8 a.m. and midnight. Both methods assessed the frequency and length of imagery episodes and the subjective qualities of the experience: its valence, whether people moved along with the imagery, and if the imagery helped their current activities. People’s retrospective reports of the frequency and length of their musical imagery experiences were more strongly related to their in-the-moment reports, whereas their retrospective reports of the qualities of inner music experiences were largely unrelated to in-the-moment reports. In general, musical expertise was more strongly related to the in-the-moment reports of musical imagery than their retrospective counterparts. The gap between how people actually experience inner music in daily life and their beliefs about their experiences suggests that musical imagery, like other subtle and fleeting experiences, is better captured by in vivo methods. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Crouch, Tara A.; Lewis, Jamie A.; Erickson, Thane M.; Newman, Michelle G. (2017): Prospective Investigation of the Contrast Avoidance Model of Generalized Anxiety and Worry.

In: Behavior therapy 48 (4), S. 544–556. DOI: 10.1016/j.beth.2016.10.001.

The factors that maintain generalized anxiety disorder (GAD) symptoms and worry over time are not entirely clear. The Contrast Avoidance Model (CAM) postulates that individuals at risk for pathological worry and GAD symptoms uniquely fear emotional shifts from neutral or positive emotions into negative emotional states, and consequently use worry to maintain negative emotion in order to avoid shifts or blunt the effect of negative contrasts. This model has received support in laboratory experiments, but has not been investigated prospectively in the naturalistic context of daily life. The present study tested the CAM in a longitudinal experience sampling study with a subclinical sample. Participants selected to represent a broad range of symptoms (N = 92) completed baseline measures of GAD and depression symptoms, and eight weekly assessments of worry, experiences of negative emotional contrasts during their worst event of the week, and situation-specific negative emotion. Consistent with the CAM, GAD symptoms prospectively predicted higher endorsement of negative contrast experiences as worst events, independent of depression symptoms. Unsurprisingly, higher negative contrasts predicted higher negative emotion. However, both higher baseline GAD symptoms and weekly worry uniquely moderated (reduced) this relationship, providing consistent support for the idea that worry may blunt the emotional effects of contrasts. Depression symptoms did not have the same moderating effect. These findings support the CAM in an ecologically valid context.


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 26 (6), S. 1565–1572. 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)


Dao, Duy; Salehizadeh, S. M. A.; Noj, Yeon; Chong, Jo Woon; Cho, Chae; Mcmanus, Dave et al. (2016): A Robust Motion Artifact Detection Algorithm for Accurate Detection of Heart Rates from Photoplethysmographic Signals using Time-Frequency Spectral Features.

In: IEEE journal of biomedical and health informatics. DOI: 10.1109/JBHI.2016.2612059.

Motion and noise artifacts (MNAs) impose limits on the usability of the photoplethysmogram (PPG), particularly in the context of ambulatory monitoring. MNAs can distort PPG, causing erroneous estimation of physiological parameters such as heart rate (HR) and arterial oxygen saturation (SpO2). In this study we present a novel approach, “TifMA,” based on using the Time-frequency spectrum of PPG to first detect the MNA-corrupted data and next discard the non-usable part of the corrupted data. The term “non-usable” refers to segments of PPG data from which the HR signal cannot be recovered accurately. Two sequential classification procedures were included in the TifMA algorithm. The first classifier distinguishes between MNA-corrupted and MNA-free PPG data. Once a segment of data is deemed MNA-corrupted, the next classifier determines whether the HR can be recovered from the corrupted segment or not. A support vector machine (SVM) classifier was used to build a decision boundary for the first classification task using data segments from a training data set. Features from time-frequency spectra of PPG were extracted to build the detection model. Five datasets were considered for evaluating TifMA performance: (1) and (2) were lab-controlled PPG recordings from forehead and finger pulse oximeter sensors with subjects making random movements, (3) and (4) were actual patient PPG recordings from UMass Memorial Medical Center with random free movements and (5) was a lab-controlled PPG recording dataset measured at the forehead while the subjects ran on a treadmill. The first dataset was used to analyze the noise sensitivity of the algorithm. Datasets 2-4 were used to evaluate the MNA detection phase of the algorithm. The results from the first phase of the algorithm (MNA detection) were compared to results from three existing MNA detection algorithms: the Hjorth, kurtosis-Shannon Entropy and time-domain variability-SVM approaches. This last is an approach recently developed in our lab. The proposed TifMA algorithm consistently provided higher detection rates than the other 3 methods, with accuracies greater than 95% for all data. Moreover, our algorithm was able to pinpoint the start and end time of the MNA with an error of less than 1 sec in duration, whereas the next-best algorithm had a detection error of more than 2.2 seconds. The final, most challenging, dataset was collected to verify the performance of the algorithm in discriminating between corrupted data that were usable for accurate HR estimations and data that were non-usable. It was found that on average 48% of the data segments were found to have MNA, and of these, 38% could be used to provide reliable HR estimation.


Debusscher, Jonas; Hofmans, Joeri; Fruyt, Filip (2017): Core self-evaluations as a moderator of the relationship between task complexity, job resources, and performance.

In: European Journal of Work and Organizational Psychology 26 (3), S. 411–420. DOI: 10.1080/1359432X.2016.1277706.

In this study we examined the role of trait core self-evaluations (CSE) as a person-related resource, hypothesizing that the relationship between task complexity and performance would be positive for people high in trait CSE and negative for people low in trait CSE. Moreover, we hypothesized that trait CSE would influence the buffering effect of job-related resources on the complexity–performance relationship, with such a buffering effect showing for people high but not for people low in trait CSE. To test our hypotheses, we conducted a five-day spanning experience sampling study. Our results showed that trait CSE indeed influenced the complexity–performance relationship in the sense that this relationship was only positive for employees high in CSE. Results on the hypothesized three-way interaction between task complexity, job-related resources, and CSE were less univocal as only one out of four three-way interactions approached conventional levels of significance. By showing that the complexity–performance relationship is only positive for employees high in CSE, our results go against the well-accepted idea that challenge demands act as a two-edged sword for all employees alike. Instead, the effect of challenge demands on performance depends on the individual’s level of person-related resources. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Demirci, Jill R.; Bogen, Debra L. (2017): An Ecological Momentary Assessment of Primiparous Women’s Breastfeeding Behavior and Problems From Birth to 8 Weeks.

In: Journal of human lactation : official journal of International Lactation Consultant Association 33 (2), S. 285–295. DOI: 10.1177/0890334417695206.

BACKGROUND: Primiparous women are at risk for early, unintended breastfeeding reduction and cessation. Breastfeeding patterns that contribute to these outcomes require further exploration. Research aim: This study aimed to describe early, “real-time” breastfeeding behaviors and perceived problems of primiparous women. METHODS: First-time mothers intending to exclusively breastfeed downloaded a commercial infant-feeding app during their postpartum hospitalization. Women logged feedings and their breastfeeding experiences, as they occurred, through 8 weeks postpartum. Additional feeding and background data were collected via electronic medical records and questionnaires administered at enrollment and 2 and 8 weeks postpartum. Summary statistics were compiled to examine weekly breastfeeding behaviors and problems. RESULTS: In this sample of 61 primarily highly educated, White women committed to breastfeeding, 38% ( n = 23) used formula during the postpartum hospitalization and 68% ( n = 34) used formula at least once by 2 weeks. Nine women stopped breastfeeding during the study. Women using any formula in the hospital and those with less positive baseline attitudes toward breastfeeding were less likely to be exclusively breastfeeding at 2 and 8 weeks, respectively ( p < .05). There was a trend toward declining at-breast feeds and high rates of milk expression during the study. Breastfeeding problems peaked at Week 2, with 81% of women ( n = 39) endorsing at least one problem at that time. The most prevalent problems included perception of inadequate milk, pain, latching, and inefficient feeds. CONCLUSION: Interventions to address suboptimal breastfeeding in primiparous women should consider the pervasiveness of early milk expression and in-hospital formula supplementation in this population, as well as the trajectory of common problems.


Dennis, Paul A.; Kimbrel, Nathan A.; Sherwood, Andrew; Calhoun, Patrick S.; Watkins, Lana L.; Dennis, Michelle F.; Beckham, Jean C. (2017): Trauma and Autonomic Dysregulation. Episodic-Versus Systemic-Negative Affect Underlying Cardiovascular Risk in Posttraumatic Stress Disorder.

In: Psychosomatic medicine 79 (5), S. 496–505. DOI: 10.1097/PSY.0000000000000438.

OBJECTIVE: Posttraumatic stress disorder (PTSD) has been linked to elevated heart rate (HR) and reduced heart rate variability (HRV) in cross-sectional research. Recent evidence suggests that this link may be driven by individual differences in autonomic arousal associated with momentary negative affect (NA). Using ecological momentary assessment (EMA) of NA and minute-to-minute HR/HRV monitoring, we examined whether NA-related HR/HRV mediated the association of PTSD symptom severity with 24-hour HRV and endothelial functioning. METHODS: One hundred ninety-seven young adults (18-39 years), 93 with PTSD, underwent 1 day of Holter monitoring while concurrently reporting NA levels via EMA. Two noninvasive measures of endothelial functioning-flow-mediated dilation and hyperemic flow-were also collected. Multilevel modeling was used to assess the associations of momentary NA with HR and low- and high-frequency HRV during the 5-minute intervals after each EMA reading. Latent variable modeling was then used to determine whether individual differences in these associations mediated the association of PTSD symptom severity with 24-hour HRV, flow-mediated dilation, and hyperemic flow. RESULTS: PTSD symptom severity was positively associated with NA-related autonomic arousal (beta = .21, p < .001), which significantly mediated the association of PTSD symptom severity with 24-hour HRV and hyperemic flow, accounting for 62% and 34% of their associations, respectively, while overshadowing the influence of smoking, lifetime alcohol dependence, sleep duration, mean NA, and episodes of acute NA. CONCLUSIONS: Results suggest that NA-related autonomic arousal is both a primary factor driving cardiovascular risk in PTSD and a potential point of intervention.


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.


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.


Dubad, M.; Winsper, C.; Meyer, C.; Livanou, M.; Marwaha, S. (2017): A systematic review of the psychometric properties, usability and clinical impacts of mobile mood-monitoring applications in young people.

In: Psychological medicine, S. 1–21. DOI: 10.1017/S0033291717001659.

BACKGROUND: Mobile mood-monitoring applications are increasingly used by mental health providers, widely advocated within research, and a potentially effective method to engage young people. However, little is known about their efficacy and usability in young populations. METHOD: A systematic review addressing three research questions focused on young people: (1) what are the psychometric properties of mobile mood-monitoring applications; (2) what is their usability; and (3) what are their positive and negative clinical impacts? Findings were synthesised narratively, study quality assessed and compared with evidence from adult studies. RESULTS: We reviewed 25 articles. Studies on the psychometric properties of mobile mood-monitoring applications were sparse, but indicate questionable to excellent internal consistency, moderate concurrent validity and good usability. Participation rates ranged from 30% to 99% across studies, and appeared to be affected by methodological factors (e.g. payments) and individual characteristics (e.g. IQ score). Mobile mood-monitoring applications are positively perceived by youth, may reduce depressive symptoms by increasing emotional awareness, and could aid in the detection of mental health and substance use problems. There was very limited evidence on potential negative impacts. CONCLUSIONS: Evidence for the use of mood-monitoring applications in youth is promising but limited due to a lack of high-quality studies. Future work should explicate the effects of mobile mood-monitoring applications on effective self-regulation, clinical outcomes across disorders and young people’s engagement with mental health services. Potential negative impacts in this population should also be investigated, as the adult literature suggests that application use could potentially increase negativity and depression symptoms.


Eddington, Kari M.; Burgin, Chris J.; Silvia, Paul J.; Fallah, Niloofar; Majestic, Catherine; Kwapil, Thomas R. (2017): The Effects of Psychotherapy for Major Depressive Disorder on Daily Mood and Functioning. A Longitudinal Experience Sampling Study.

In: Cognitive therapy and research 41 (2), S. 266–277. DOI: 10.1007/s10608-016-9816-7.

Experience sampling methodology (ESM) was used in a randomized controlled trial of short-term therapy to examine changes in daily affect and reactivity to daily event appraisals among depressed patients. Fifty-five depressed adults (mean age 37 years, 80% female) were randomly assigned to one of two therapy conditions. Using an interactive voice response system, participants rated activities and emotional functioning eight times per day for seven days. Thirty-one participants completed treatment and repeated ESM post-treatment. Broad improvements in mood, cognition, and physical functioning were similar across treatment conditions, with the largest improvements for markers of positive affect. Participants demonstrated increased resilience, i.e., diminished reactivity to stressors at post-treatment. Changes in reactivity to positive daily situations were minimal. Findings underscore the utility of ESM in psychotherapy research and the importance of including measures of both positive and negative affect and experiences.


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.


Elliston, Katherine G.; Ferguson, Stuart G.; Schüz, Natalie; Schüz, Benjamin (2017): Situational cues and momentary food environment predict everyday eating behavior in adults with overweight and obesity.

In: Health psychology : official journal of the Division of Health Psychology, American Psychological Association 36 (4), S. 337–345. DOI: 10.1037/hea0000439.

Objectives: Individual eating behavior is a risk factor for obesity and highly dependent on internal and external cues. Many studies also suggest that the food environment (i.e., food outlets) influences eating behavior. This study therefore examines the momentary food environment (at the time of eating) and the role of cues simultaneously in predicting everyday eating behavior in adults with overweight and obesity. Method: Intensive longitudinal study using ecological momentary assessment (EMA) over 14 days in 51 adults with overweight and obesity (average body mass index = 30.77; SD = 4.85) with a total of 745 participant days of data. Multiple daily assessments of eating (meals, high- or low-energy snacks) and randomly timed assessments. Cues and the momentary food environment were assessed during both assessment types. Results: Random effects multinomial logistic regression shows that both internal (affect) and external (food availability, social situation, observing others eat) cues were associated with increased likelihood of eating. The momentary food environment predicted meals and snacking on top of cues, with a higher likelihood of high-energy snacks when fast food restaurants were close by (odds ratio [OR] = 1.89, 95% confidence interval [CI] = 1.22, 2.93) and a higher likelihood of low-energy snacks in proximity to supermarkets (OR = 2.29, 95% CI = 1.38, 3.82). Conclusions: Real-time eating behavior, both in terms of main meals and snacks, is associated with internal and external cues in adults with overweight and obesity. In addition, perceptions of the momentary food environment influence eating choices, emphasizing the importance of an integrated perspective on eating behavior and obesity prevention. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Farmer, Shu; Mindry, Deborah; Comulada, W. Scott; Swendeman, Dallas (2017): Mobile Phone Ecological Momentary Assessment of Daily Stressors Among People Living With HIV. Elucidating Factors Underlying Health-Related Challenges in Daily Routines.

In: The Journal of the Association of Nurses in AIDS Care : JANAC. DOI: 10.1016/j.jana.2017.04.001.

Stressful life events and daily hassles affect people living with HIV (PLWH). However, capturing stress-related events and cognitive impairment is often plagued with recall biases. Incorporating reliable information technology, such as mobile phones, can be a resourceful method for measuring health behaviors (MHB). We report findings from an MHB pilot study with 32 African American, Latino/Hispanic, and White PLWH from Los Angeles. Participants reported perceived stressors in their daily routines using a smartphone Ecological Momentary Assessment (EMA) application. Participants self-initiated in-the-moment stressful events reports for up to 6 weeks. Stressful event EMAs queried perceived stress levels (1-10 scale) and open-ended text descriptions. Qualitative analysis of participant text responses was completed using grounded thematic coding. Participants reported multiple stressors in their daily routines, impacting activities of daily living or daily functioning. Eliciting input from PLWH via EMA in real time is a novel approach for assessing and identifying sources of stress.


Farooq, Muhammad; McCrory, Megan A.; Sazonov, Edward (2017): Reduction of energy intake using just-in-time feedback from a wearable sensor system.

In: Obesity (Silver Spring, Md.) 25 (4), S. 676–681. DOI: 10.1002/oby.21788.

OBJECTIVE: This work explored the potential use of a wearable sensor system for providing just-in-time (JIT) feedback on the progression of a meal and tested its ability to reduce the total food mass intake. METHODS: Eighteen participants consumed three meals each in a lab while monitored by a wearable sensor system capable of accurately tracking chew counts. The baseline visit was used to establish the self-determined ingested mass and the associated chew counts. Real-time feedback on chew counts was provided in the next two visits, during which the target chew count was either the same as that at baseline or the baseline chew count reduced by 25% (in randomized order). The target was concealed from the participant and from the experimenter. Nonparametric repeated-measures ANOVAs were performed to compare mass of intake, meal duration, and ratings of hunger, appetite, and thirst across three meals. RESULTS: JIT feedback targeting a 25% reduction in chew counts resulted in a reduction in mass and energy intake without affecting perceived hunger or fullness. CONCLUSIONS: JIT feedback on chewing behavior may reduce intake within a meal. This system can be further used to help develop individualized strategies to provide JIT adaptive interventions for reducing energy intake.


Felsman, Peter; Verduyn, Philippe; Ayduk, Ozlem; Kross, Ethan (2017): Being Present. Focusing on the Present Predicts Improvements in Life Satisfaction But Not Happiness.

In: Emotion (Washington, D.C.). DOI: 10.1037/emo0000333.

Mindfulness theorists suggest that people spend most of their time focusing on the past or future rather than the present. Despite the prevalence of this assumption, no research that we are aware of has evaluated whether it is true or what the implications of focusing on the present are for subjective well-being. We addressed this issue by using experience sampling to examine how frequently people focus on the present throughout the day over the course of a week and whether focusing on the present predicts improvements in the 2 components of subjective well-being over time-how people feel and how satisfied they are with their lives. Results indicated that participants were present-focused the majority of the time (66%). Moreover, focusing on the present predicted improvements in life satisfaction (but not happiness) over time by reducing negative rumination. These findings advance our understanding of how temporal orientation and well-being relate. (PsycINFO Database Record


Fischer, Sarah; Breithaupt, Lauren; Wonderlich, Joseph; Westwater, Margaret L.; Crosby, Ross D.; Engel, Scott G. et al. (2017): Impact of the neural correlates of stress and cue reactivity on stress related binge eating in the natural environment.

In: Journal of psychiatric research 92, S. 15–23. DOI: 10.1016/j.jpsychires.2017.03.017.

Women with symptoms of bulimia nervosa (BN) exhibit decreased response to visual food cues in several limbic and frontal regions compared to controls. Stress causes decreased blood oxygenation level dependent (BOLD) response in these regions in non-clinical samples; there is a lack of data on this topic in BN. This study examined the impact of individual differences in neural reactivity to palatable food cues following acute stress on stress-binge trajectories in everyday life. 16 women with BN symptoms viewed palatable food cues prior to and immediately following an acute stress induction in the scanner. Participants then responded to a series of prompts assessing daily ratings of stress and binge episodes for a period of two weeks. Decreased BOLD signal was observed in response to food cues pre to post stress in the anterior cingulate cortex (ACC), amygdala, and ventromedial prefrontal cortex (vmPFC). Ecological momentary assessment data collection demonstrated that stress increased prior to binge episodes in the natural environment, and decreased following. Changes in activation in the ACC, precuneus, and dorsolateral prefrontal cortex (dlPFC) significantly moderated the relationship of stress to binge eating in daily life, such that women who exhibited decreased response reported significantly increasing stress prior to binges, while women who did not exhibit decreases reported no significant change in stress prior to binges. Individual differences in neural response to food cues under stress appear to underlie distinct antecedants to binge eating.


Fitzsimmons-Craft, Ellen E. (2017): Eating disorder-related social comparison in college women’s everyday lives.

In: The International journal of eating disorders. DOI: 10.1002/eat.22725.

OBJECTIVE: This study examined: frequency of upward and downward body, eating, and exercise comparisons; context in which these comparisons occur; and body, eating, and exercise comparison direction as predictors of concurrent body dissatisfaction and disordered eating thoughts, urges, and behaviors in college women’s everyday lives using ecological momentary assessment (EMA). METHOD: Participants were 232 college women who completed a two-week EMA protocol, using their personal electronic devices to answer questions three times per day. RESULTS: First, body, eating, and exercise comparisons were common. Second, when these comparisons were made, they were typically upward. Third, body comparisons were most oftentimes made about weight and shape and eating comparisons about healthiness and amount of food. Exercise comparisons were made on a wider variety of dimensions. Fourth, most body and eating comparisons were made with strangers and close friends, respectively, while exercise comparisons were made with a variety of individuals. Upward comparisons were usually made with acquaintances and strangers. Fifth, results shed light on where college women compare themselves. Sixth, upward comparisons were found to have negative consequences, and downward comparisons were generally not found to have a buffering effect on eating pathology. DISCUSSION: Results suggest targeting not only body but also eating and exercise comparisons in intervention. Also, prevention/intervention approaches should not promote engagement in downward comparisons, as they were not found to be protective and were even harmful at times. Clinicians should be attuned to the categories on which, with whom, and where college women are most likely to compare.


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.


Franklin, Michael S.; Mrazek, Michael D.; Anderson, Craig L.; Johnston, Charlotte; Smallwood, Jonathan; Kingstone, Alan; Schooler, Jonathan W. (2017): Tracking distraction. The relationship between mind-wandering, meta-awareness, and ADHD symptomatology.

In: J Atten Disord 21 (6), S. 475–486. DOI: 10.1177/1087054714543494.

Objective: Although earlier work has shown a link between mind-wandering and ADHD symptoms, this relationship has not been further investigated by taking into account recent advances in mind-wandering research. Method: The present study provides a comprehensive assessment of the relationship between mind-wandering and ADHD symptomatology in an adult community sample (N = 105, 71 females, M age = 23.1) using laboratory measures and experience sampling during daily life. Results: Mind-wandering and detrimental mind-wandering were positively associated with ADHD symptoms. Meta-awareness of mind-wandering mediated the relationship between ADHD symptomatology and detrimental mind-wandering, suggesting that some of the negative consequences can be ameliorated by strategies that facilitate meta-awareness. Interestingly, participants with low ADHD scores showed a positive relationship between detrimental mind-wandering and useful mind-wandering; however, participants with high ADHD scores failed to engage in this type of ‘strategic’ mind-wandering. Conclusion: These results provide new insights into the relationship between ADHD symptomatology and mind-wandering that could have important clinical implications. (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.


Fuller, Nicholas R.; Fong, Mackenzie; Gerofi, James; Ferkh, Fatima; Leung, Chloris; Leung, Lisa et al. (2017): Comparison of an electronic versus traditional food diary for assessing dietary intake-A validation study.

In: Obesity research & clinical practice. DOI: 10.1016/j.orcp.2017.04.001.

BACKGROUND: Paper-based estimated food diaries are often used in research to collect dietary data, despite this method being burdensome for both participants and researchers. Such food diaries are often time consuming, labour intensive, and rely on participant literacy and therefore may lead to greater rates of under-reporting. METHODS: This study assessed the validity of the ‘Boden Food Plate’, a novel web-based electronic application, compared to a paper-based three-day estimated food diary. Participants were also asked to rate their satisfaction with the new electronic diary. Sixty-seven participants with overweight or obesity completed both the electronic and paper-based diaries at two different time-points. RESULTS: Baseline BMI of participants (mean+/-standard deviation (SD)) was 30.4+/-2.9kg/m2, body weight was 87.6+/-13.4kg, and age was 42.3+/-7.7years. Fifty four percent (n=41) of the cohort were female. Bland Altman plots for total energy, and percentage of total energy intake from fat, carbohydrate, and protein, indicated wide limits of agreement between the two methods of dietary data collection, and in some analyses there were a few cases that did not lie within the 95% confidence intervals. Approximately 70% of participants rated the electronic food diary as easier to use and more fun when compared to the traditional paper-based estimated food diary. CONCLUSION: Innovative and visual dietary collection applications such as the ‘Boden Food Plate’ provide an enjoyable and interactive means of measuring nutritional intake in a time efficient manner. Further validation studies incorporating micronutrient analysis and to improve the applications validity are warranted.


Fuller-Tyszkiewicz, Matthew; Karvounis, Tanya; Pemberton, Rachel; Hartley-Clark, Linda; Richardson, Ben (2017): Determinants of depressive mood states in everyday life. An experience sampling study.

In: Motiv Emot. DOI: 10.1007/s11031-017-9620-z.

This study tests relative contributions and time-course of proposed risk/protective factors (e.g., stress, coping, and lack of social interactions) for influencing depressed mood states in daily life. Seventy-three participants completed baseline measurement of major depressive disorder symptomatology, followed by smartphone app-based monitoring of momentary experiences of depressed mood and risk/protective factors for 7 days. All predictors had deteriorating impacts on mood as lag increased, and the optimal lag appears to be less than 120 min. Linear decay in effect sizes was found for physical activity, social interaction, and tiredness, whereas exponential decline in effect sizes was found for stress and coping ability. Stress, coping, and depressed mood at the prior time-point were the best predictors of subsequent mood. These effects did not differ as a function of trait depressive symptom severity. Findings highlight the influence of spacing of assessments in identification and magnitude of predictors of mood states, and provide insights into key drivers of change in mood and their time-course. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Gabriel, Allison S.; Koopman, Joel; Rosen, Christopher C.; Johnson, Russell E. (2017): Helping others or helping oneself? An episodic examination of the behavioral consequences of helping at work.

In: Pers Psychol. DOI: 10.1111/peps.12229.

Scholars have paid an increasing amount of attention to organizational citizenship behaviors (OCBs), with a particular emphasis on helping others at work. In addition, recent empirical work has focused on how OCB is an intraindividual phenomenon, such that employees vary daily in the extent to which they help others. However, one limitation of this research has been an overemphasis on well‐being consequences associated with daily helping (e.g., changes in affect and mental depletion) and far less attention on behavioral outcomes. In this study, we develop a self‐regulatory framework that articulates how helping others at work is a depleting experience that can lead to a reduction in subsequent acts of helping others, and an increase in behaviors aimed at helping oneself (i.e., engaging in political acts). We further theorize how two individual differences—prevention focus and political skill—serve as cross‐level moderators of these relations. In an experience sampling study of 91 full‐time employees across 10 consecutive workdays, our results illustrate that helping is a depleting act that makes individuals more likely to engage in self‐serving acts and less likely to help others. Moreover, the relation of helping acts with depletion is strengthened for employees who have higher levels of prevention focus. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


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.


Garland, Eric L.; Bryan, Craig J.; Finan, Patrick H.; Thomas, Elizabeth A.; Priddy, Sarah E.; Riquino, Michael R.; Howard, Matthew O. (2017): Pain, hedonic regulation, and opioid misuse. Modulation of momentary experience by Mindfulness-Oriented Recovery Enhancement in opioid-treated chronic pain patients.

In: Drug and alcohol dependence 173 Suppl 1, S65-S72. DOI: 10.1016/j.drugalcdep.2016.07.033.

BACKGROUND: Given the risk of opioid misuse among chronic pain patients being treated with long-term opioid pharmacotherapy, non-pharmacological treatments are needed. Further, in light of hedonic deficits in this population, therapies that enhance positive affect may be useful. The purpose of this study was to examine effects of a Mindfulness-Oriented Recovery Enhancement (MORE) intervention on ecological momentary assessments (EMA) of pain and positive affective experience, and to determine if changes in pain, affect, and their interaction were associated with opioid misuse at post-treatment. METHODS: This study examined unpublished EMA data from a subset of participants (N=55) in a previously published RCT (NCT01505101) of MORE versus a support group (SG) control. Across 8 weeks of treatment, patients completed up to 224 EMA measures of pain and affect. Multilevel models and generalized estimating equations examined effects of treatment on momentary pain and positive affect, and generalized linear models examined associations between pain and affect and changes in opioid misuse by post-treatment. RESULTS: Patients in MORE reported significantly greater improvements in momentary pain (p=0.01) and positive affect (p=0.004) than patients in the SG. Further, over the entire course of treatment, patients in MORE were significantly more likely to exhibit positive affect regulation (OR=2.75) than patients in the SG. Finally, improvements in positive affect (but not pain) over the course of intervention were associated with reduced risk of misusing opioids by post-treatment (p=0.02). CONCLUSION: MORE may be a useful non-pharmacological treatment for pain and hedonic deficits among chronic pain patients at risk for opioid misuse.


George, Madeleine J.; Russell, Michael A.; Piontak, Joy R.; Odgers, Candice L. (2017): Concurrent and Subsequent Associations Between Daily Digital Technology Use and High-Risk Adolescents’ Mental Health Symptoms.

In: Child development. DOI: 10.1111/cdev.12819.

Adolescents are spending an unprecedented amount of time using digital technologies (especially mobile technologies), and there are concerns that adolescents’ constant connectivity is associated with poor mental health, particularly among at-risk adolescents. Participants included 151 adolescents at risk for mental health problems (Mage = 13.1) who completed a baseline assessment, 30-day ecological momentary assessment, and 18 month follow-up assessment. Results from multilevel regression models showed that daily reports of both time spent using digital technologies and the number of text messages sent were associated with increased same-day attention deficit hyperactivity disorder (ADHD) and conduct disorder (CD) symptoms. Adolescents’ reported digital technology usage and text messaging across the ecological momentary assessment (EMA) period was also associated with poorer self-regulation and increases in conduct problem symptoms between the baseline and follow-up assessments.


Giannouli, Eleftheria; Bock, Otmar; Zijlstra, Wiebren (2017): Cognitive functioning is more closely related to real-life mobility than to laboratory-based mobility parameters.

In: Eur J Ageing. DOI: 10.1007/s10433-017-0434-3.

Increasing evidence indicates that mobility depends on cognitive resources, but the exact relationships between various cognitive functions and different mobility parameters still need to be investigated. This study examines the hypothesis that cognitive functioning is more closely related to real-life mobility performance than to mobility capacity as measured with standardized laboratory tests. The final sample used for analysis consisted of 66 older adults (72.3 ± 5.6 years). Cognition was assessed by measures of planning (HOTAP test), spatial working memory (Grid-Span test) and visuospatial attention (Attention Window test). Mobility capacity was assessed by an instrumented version of the Timed Up-and-Go test (iTUG). Mobility performance was assessed with smartphones which collected accelerometer and GPS data over one week to determine the spatial extent and temporal duration of real-life activities. Data analyses involved an exploratory factor analysis and correlation analyses. Mobility measures were reduced to four orthogonal factors: the factor ‘real-life mobility’ correlated significantly with most cognitive measures (between r = .229 and r = .396); factors representing ‘sit-to-stand transition’ and ‘turn’ correlated with fewer cognitive measures (between r = .271 and r = .315 and between r = .210 and r = .316, respectively), and the factor representing straight gait correlated with only one cognitive measure (r = .237). Among the cognitive functions tested, visuospatial attention was associated with most mobility measures, executive functions with fewer and spatial working memory with only one mobility measure. Capacity and real-life performance represent different aspects of mobility. Real-life mobility is more closely associated with cognition than mobility capacity, and in our data this association is most pronounced for visuospatial attention. The close link between real-life mobility and visuospatial attention should be considered by interventions targeting mobility in old age. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Gibbons, Chris J. (2016): 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, S. 1933. 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 ‘naive’ 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.


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 79 (5), S. 549–556. 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/d or less of EPA and DHA were enrolled in a double-blind, randomized, placebo controlled clinical trial. The 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, as well as functional alterations in corticolimbic and corticostriatal brain systems evoked by standardized functional magnetic resonance imaging tasks. RESULTS: There were no group by time interactions for any questionnaire or ecological momentary assessment measures of mood and impulsivity. Likewise, no group by time interactions were observed for functional magnetic resonance imaging 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.


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.


Goldberg, Rachel L.; Piccirillo, Marilyn L.; Nicklaus, Joyce; Skillington, Andrew; Lenze, Eric; Rodebaugh, Thomas L. et al. (2017): Evaluation of Ecological Momentary Assessment for Tinnitus Severity.

In: JAMA otolaryngology– head & neck surgery. DOI: 10.1001/jamaoto.2017.0020.

Importance: Existing patient-reported outcome measures of tinnitus assess the severity and disability retrospectively, which may result in adequate reliability, but cannot capture the fluctuating and individualized nature of tinnitus. Experience sampling may provide an alternative. Objective: To use an ecological momentary assessment (EMA) to measure tinnitus disability and associated constructs. Design, Setting, and Participants: Forty adults with tinnitus provided self-report of their tinnitus bother using 5 questions measured by EMA, as well as standard retrospective outcome measures. In this 6-week longitudinal observational study conducted from July 15 to December 22, 2014, participants provided EMA data for 2 weeks (part 1); then after a 2-week break, they provided EMA data for an additional 2 weeks (part 2). A text message with a link to the EMA survey was sent for a total of 56 assessments during each 2-week assessment period. Ecological momentary assessment responses were evaluated using multilevel confirmatory factor analysis to assess the fluctuating nature of bothersome tinnitus across the group and within the pool of individuals over time. Main Outcomes and Measures: Ecological momentary assessment questions measured tinnitus disability and associated constructs. Compliance in each study part was assessed based on response rates. The Tinnitus Functional Index and the Overall Global Rating of Bother Scale were assessed at the beginning and end of each 2-week assessment period to explore the effect of the frequent EMAs on the perceived level of bother from tinnitus. Results: Of the 40 participants in the study (10 women and 30 men; mean [SD] age, 60.0 [10.5] years), the median survey response rate was high (49 responses to 56 surveys sent [88%] for part 1 and 47 responses of 56 surveys sent [84%] for part 2). The latent factor identified by the 2-level confirmatory factor analysis models demonstrates that within-individual tinnitus bother, loudness, and stress vary together over time. In addition, tinnitus bother, feeling, and stress symptoms all vary together across individuals, which means that bother and stress covary strongly both across time and across individuals. Conclusions and Relevance: Ecological momentary assessment evaluates the moment-to-moment perception of tinnitus and the effect of emotional and environmental factors, which suggests that it is a superior tool to measure tinnitus outcomes compared with standard retrospective self-reports. Taken together, information from emotional and environmental factors can be summarized in an underlying (latent) factor that represents a vulnerability to bothersome tinnitus and that can be used to comprehensively describe the tinnitus experience. Momentary variability in tinnitus bother is strongly associated with levels of perceived stress.


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.


Gorka, Stephanie M.; Hedeker, Donald; Piasecki, Thomas M.; Mermelstein, Robin (2017): Impact of alcohol use motives and internalizing symptoms on mood changes in response to drinking. An ecological momentary assessment investigation.

In: Drug and alcohol dependence 173, S. 31–38. DOI: 10.1016/j.drugalcdep.2016.12.012.

BACKGROUND: Theory implies that individuals who use alcohol to cope with negative emotions experience the acute mood-altering effects they desire. However, no study to date has directly tested whether alcohol coping motives map onto alcohol-induced changes in mood in real-time or how co-occurring internalizing symptoms (i.e., depression and anxiety) impact the relation between coping motives and alcohol-induced changes in mood. METHOD: The current study tested the unique and interactive effects of alcohol coping motives and internalizing symptoms on mood changes during drinking using ecological momentary assessment (EMA) in a sample of young adults (n=257). Participants completed a battery of questionnaires and a 7-day EMA assessment protocol. RESULTS: In general, alcohol use was associated with greater positive mood and reduced negative mood while drinking. However, individuals who reported that they use alcohol to cope with anxiety, but not depression, experienced less mood benefits from alcohol relative to those without mood coping motives. In contrast, individuals with high internalizing symptoms experienced greater mood benefits while drinking relative to those with low levels of internalizing symptoms; and at high levels of anxiety, alcohol consumption was reinforcing for everyone regardless of coping motives. Only at low levels of anxiety symptoms, did coping with anxiety motives attenuate alcohol’s acute reinforcing effects. CONCLUSIONS: These results together confirm that alcohol has a robust impact on real-time mood in young adults and sheds light on the processes that may contribute to repeated alcohol use within individuals who do, and do not, use alcohol as a means of coping.


Greene, T.; Gelkopf, M.; Grinapol, S.; Werbeloff, N.; Carlson, E.; Lapid, L. (2017): Trajectories of traumatic stress symptoms during conflict. A latent class growth analysis.

In: Journal of affective disorders 220, S. 24–30. DOI: 10.1016/j.jad.2017.05.036.

BACKGROUND: The ways in which traumatic stress symptoms unfold under situations of ongoing threat and trauma exposure are poorly understood. The current study aims to identify traumatic stress symptom trajectories during conflict, as well as potential risk factors. METHODS: Experience sampling methods were used to study traumatic stress symptoms during the 2014 Israel-Gaza conflict in 100 Israeli civilians exposed to rocket fire. Summary reports of traumatic symptoms were made twice-daily for 30 days via mobile phone. RESULTS: Latent class growth analysis revealed four distinct classes (low, reducing, moderate, and high) characterised by their trajectory of traumatic stress symptoms during the conflict. Female gender, not being in a relationship, and higher prior trauma exposure were identified as potential risk factors. LIMITATIONS: Data were not collected in the early phase of the conflict, the sample was relatively small, and only traumatic stress symptoms were investigated as outcomes. CONCLUSIONS: This study identified heterogeneous traumatic stress symptom trajectories among civilians during a conflict, with different subgroups showing distinct response patterns over time, associated with various risk factors. Investigating responses to ongoing trauma, and identifying predictors of different stress symptom trajectories has clinical implications for the targeted delivery of interventions. Further exploration of heterogeneous trajectories could potentially elucidate mechanisms that drive resilience and recovery, including in situations of ongoing exposure such as during conflict.


Guloksuz, S.; Pries, L-K; van Os, J. (2017): Application of network methods for understanding mental disorders. Pitfalls and promise.

In: Psychological medicine, S. 1–10. DOI: 10.1017/S0033291717001350.

Galvanized with the availability of sophisticated statistical techniques and large datasets, network medicine has emerged as an active area of investigation. Following this trend, network methods have been utilized to understand the interplay between symptoms of mental disorders. This realistic approach that may provide an improved framework into understanding mental conditions and underlying mechanisms is certainly to be welcomed. However, we have noticed that symptom network studies tend to lose sight of the fundamentals, overlook major limitations embedded in study designs, and make inferences that are difficult to justify with current findings. There is concern that disregarding these flaws may halt the progress of the network approach in psychiatry. Therefore, in this paper, we first attempt to identify the pitfalls: (1) a reductionist understanding of medicine and psychiatry, thereby inadvertently reintroducing the dichotomy of medicine (lung cancer) and psychiatry (depression), (2) a shortsighted view of signs and symptoms, (3) overlooking the limitations of available datasets based on scales with embedded latent class structures, (4) overestimating the importance of the current findings beyond what is supported by the study design. By addressing current issues, the hope is to navigate this rapidly growing field to a more methodologically sound and reproducible path that will contribute to our understanding of mental disorders and its underlying mechanisms.


Hallensleben, Nina; Spangenberg, Lena; Forkmann, Thomas; Rath, Dajana; Hegerl, Ulrich; Kersting, Anette et al. (2017): Investigating the Dynamics of Suicidal Ideation.

In: Crisis, S. 1–5. DOI: 10.1027/0227-5910/a000464.

BACKGROUND: Although the fluctuating nature of suicidal ideation (SI) has been described previously, longitudinal studies investigating the dynamics of SI are scarce. AIM: To demonstrate the fluctuation of SI across 6 days and up to 60 measurement points using smartphone-based ecological momentary assessments (EMA). METHOD: Twenty inpatients with unipolar depression and current and/or lifetime suicidal ideation rated their momentary SI 10 times per day over a 6-day period. Mean squared successive difference (MSSD) was calculated as a measure of variability. Correlations of MSSD with severity of depression, number of previous depressive episodes, and history of suicidal behavior were examined. RESULTS: Individual trajectories of SI are shown to illustrate fluctuation. MSSD values ranged from 0.2 to 21.7. No significant correlations of MSSD with several clinical parameters were found, but there are hints of associations between fluctuation of SI and severity of depression and suicidality. LIMITATIONS: Main limitation of this study is the small sample size leading to low power and probably missing potential effects. Further research with larger samples is necessary to shed light on the dynamics of SI. CONCLUSION: The results illustrate the dynamic nature and the diversity of trajectories of SI across 6 days in psychiatric inpatients with unipolar depression. Prediction of the fluctuation of SI might be of high clinical relevance. Further research using EMA and sophisticated analyses with larger samples is necessary to shed light on the dynamics of SI.


Harrison, Flo; Goodman, Anna; van Sluijs, Esther M. F.; Andersen, Lars Bo; Cardon, Greet; Davey, Rachel et al. (2017): Weather and children’s physical activity; how and why do relationships vary between countries?

In: The international journal of behavioral nutrition and physical activity 14. DOI: 10.1186/s12966-017-0526-7.

Background: Globally most children do not engage in enough physical activity. Day length and weather conditions have been identified as determinants of physical activity, although how they may be overcome as barriers is not clear. We aim to examine if and how relationships between children’s physical activity and weather and day length vary between countries and identify settings in which children were better able to maintain activity levels given the weather conditions they experienced. Methods: In this repeated measures study, we used data from 23,451 participants in the International Children’s Accelerometry Database (ICAD). Daily accelerometer-measured physical activity (counts per minute; cpm) was matched to local weather conditions and the relationships assessed using multilevel regression models. Multilevel models accounted for clustering of days within occasions within children within study-cities, and allowed us to explore if and how the relationships between weather variables and physical activity differ by setting. Results: Increased precipitation and wind speed were associated with decreased cpm while better visibility and more hours of daylight were associated with increased cpm. Models indicated that increases in these variables resulted in average changes in mean cpm of 7.6/h of day length, −13.2/cm precipitation, 10.3/10 km visibility and −10.3/10kph wind speed (all p < 0.01). Temperature showed a cubic relationship with cpm, although between 0 and 20 degrees C the relationship was broadly linear. Age showed interactions with temperature and precipitation, with the associations larger among younger children. In terms of geographic trends, participants from Northern European countries and Melbourne, Australia were the most active, and also better maintained their activity levels given the weather conditions they experienced compared to those in the US and Western Europe. Conclusions: We found variation in the relationship between weather conditions and physical activity between ICAD studies and settings. Children in Northern Europe and Melbourne, Australia were not only more active on average, but also more active given the weather conditions they experienced. Future work should consider strategies to mitigate the impacts of weather conditions, especially among young children, and interventions involving changes to the physical environment should consider how they will operate in different weather conditions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


He, Fei; Teixeira-Pinto, Armando; Harezlak, Jaroslaw (2017): Autoregressive and cross-lagged model for bivariate non-commensurate outcomes.

In: Statistics in medicine 36 (19), S. 3110–3120. DOI: 10.1002/sim.7325.

Autoregressive and cross-lagged models have been widely used to understand the relationship between bivariate commensurate outcomes in social and behavioral sciences, but not much work has been carried out in modeling bivariate non-commensurate (e.g., mixed binary and continuous) outcomes simultaneously. We develop a likelihood-based methodology combining ordinary autoregressive and cross-lagged models with a shared subject-specific random effect in the mixed-model framework to model two correlated longitudinal non-commensurate outcomes. The estimates of the cross-lagged and the autoregressive effects from our model are shown to be consistent with smaller mean-squared error than the estimates from the univariate generalized linear models. Inclusion of the subject-specific random effects in the proposed model accounts for between-subject variability arising from the omitted and/or unobservable, but possibly explanatory, subject-level predictors. Our model is not restricted to the case with equal number of events per subject, and it can be extended to different types of bivariate outcomes. We apply our model to an ecological momentary assessment study with complex dependence and sampling data structures. Specifically, we study the dependence between the condom use and sexual satisfaction based on the data reported in a longitudinal study of sexually transmitted infections. We find negative cross-lagged effect between these two outcomes and positive autoregressive effect within each outcome. Copyright (c) 2017 John Wiley & Sons, Ltd.


Heavey, Christopher L.; Lefforge, Noelle L.; Lapping-Carr, Leiszle; Hurlburt, Russell T. (2017): Mixed emotions. Toward a phenomenology of blended and multiple feelings.

In: Emot Rev 9 (2), S. 105–110. DOI: 10.1177/1754073916639661.

After using descriptive experience sampling to study randomly selected moments of inner experience, we make observations about feelings, including blended and multiple feelings. We observe that inner experience usually does not contain feelings. Sometimes, however, feelings are directly present. When feelings are present, most commonly they are unitary. Sometimes people experience separate emotions as a single experience, which we call a blended feeling. Occasionally people have multiple distinct feelings present simultaneously. These distinct multiple feelings can be of opposite valence, with one pleasant and the other unpleasant. We provide examples that inform theories of emotions and discuss the important role observational methodology plays in the effort to understand inner experience including feelings. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Hebert, Emily T.; Vandewater, Elizabeth A.; Businelle, Michael S.; Harrell, Melissa B.; Kelder, Steven H.; Perry, Cheryl L. (2017): Feasibility and reliability of a mobile tool to evaluate exposure to tobacco product marketing and messages using ecological momentary assessment.

In: Addictive behaviors 73, S. 105–110. DOI: 10.1016/j.addbeh.2017.05.004.

INTRODUCTION: Existing measures of tobacco marketing and messaging exposure are limited, relying on recall, recognition, or proxy measures. This study aimed to determine the feasibility and reliability of a mobile application for the measurement of tobacco and e-cigarette marketing and message exposure using ecological momentary assessment (EMA). METHODS: Young adults from Austin, TX (n=181, ages 18-29) were instructed to use a mobile application to record all sightings of marketing or social media related to tobacco (including e-cigarettes) in real-time for 28days (Event EMAs). Tobacco product use and recall of message encounters were assessed daily using an app-initiated EMA (Daily EMAs). RESULTS: The mobile app was a feasible and acceptable method to measure exposure to tobacco messages. The majority of messages (45.0%) were seen on the Internet, and many were user-generated. Thirty-day recall of messages at baseline was poorly correlated with messages reported via Event EMA during the study period; however, the correlation between post-study 30-day recall and Event EMA was much stronger (r=0.603 for industry-sponsored messages, r=0.599 for user-generated messages). Correlations between Daily EMAs and 30-day recall of message exposure (baseline and post-study) were small (baseline: r=0.329-0.389) to large (post-study: r=0.656-0.766). CONCLUSIONS: These findings suggest that EMA is a feasible and reliable method for measuring tobacco message exposure, especially given the prevalence of messages encountered online and on social media. Recall measures are limited in their ability to accurately represent marketing exposure, but might be improved by a period of priming or clearer response categories.


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 26 (2). 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.


Heininga, V. E.; van Roekel, E.; Ahles, J. J.; Oldehinkel, A. J.; Mezulis, A. H. (2017): Positive affective functioning in anhedonic individuals’ daily life. Anything but flat and blunted.

In: Journal of affective disorders 218, S. 437–445. DOI: 10.1016/j.jad.2017.04.029.

BACKGROUND: Anhedonia, the decreased interest and pleasure, is often described as ‘flat’ or ‘blunted’ positive affect (PA). Yet, little is known about PA functioning in anhedonic individuals’ daily lives. The current study investigates PA reactivity to pleasurable experiences in anhedonia together with its relevant temporal dynamics (i.e., variability, instability, and inertia), and expands current knowledge by exploring the role of arousal therein. METHODS: Using the Experience Sampling Method (ESM), we collected 90 assessments of real-life PA experiences across 30 days in 18-24 year old individuals with anhedonia (N=69) and without anhedonia (N=69). RESULTS: Multilevel analyses showed that anhedonia was associated with less intense pleasure experience, and lower levels of PA. Contrary to predictions from laboratory research and depression theory, individuals with anhedonia showed more variability and less stability in PA, and no signs of blunted PA reactivity. In fact, when exploring high and low arousal PA, individuals with anhedonia showed a slightly stronger reactivity to pleasurable experiences in high-arousal PA but not low-arousal PA. LIMITATIONS: We did not control for previous pleasure experiences and, instead of the last positive event, accumulation of positive events may have determined the change in high-arousal PA. CONCLUSIONS: Individuals with anhedonia are likely less ‘flat’ or ‘blunted’ than generally thought. Although replication is warranted, impairments in high-arousal positive emotions may be of particular interest in the clinical treatment of anhedonia.


Hennig, Timo; Lincoln, Tania M. (2017): Sleeping Paranoia Away? An Actigraphy and Experience-Sampling Study with Adolescents.

In: Child psychiatry and human development. DOI: 10.1007/s10578-017-0729-9.

Paranoid symptoms co-occur with distress and poor functioning and constitute a risk for psychosis and other mental disorders. Poor sleep is known to be associated with paranoid symptoms, but the direction of the effect and the mediating factors have not been studied thoroughly. In an experience-sampling study, 61 adolescents wore an actigraph over eight nights and also rated their sleep, symptoms of paranoia, and potentially mediating factors. Shorter sleep time and more dreaming predicted paranoid symptoms in multilevel regression models. Paranoid symptoms did not significantly predict sleep parameters. Positive and negative affect partially mediated the effect of sleep time on paranoid symptoms. The effects were small, but encourage further research that might then be used to improve the prevention of paranoid symptoms.


Hepp, Johanna; Lane, Sean P.; Carpenter, Ryan W.; Niedtfeld, Inga; Brown, Whitney C.; Trull, Timothy J. (2017): Interpersonal problems and negative affect in Borderline Personality and Depressive Disorders in daily life.

In: Clinical psychological science : a journal of the Association for Psychological Science 5 (3), S. 470–484. DOI: 10.1177/2167702616677312.

Theories of Borderline Personality Disorder (BPD) suggest that interpersonal problems in BPD act as triggers for negative affect and, at the same time, are a possible result of affective dysregulation. Therefore, we assessed the relations between momentary negative affect (hostility, sadness, fear) and interpersonal problems (rejection, disagreement) in a sample of 80 BPD and 51 depressed outpatients at 6 time-points over 28 days. Data were analyzed using multivariate multi-level modeling to separate momentary-, day-, and person-level effects. Results revealed a mutually reinforcing relationship between disagreement and hostility, rejection and hostility, and between rejection and sadness in both groups, at the momentary and day level. The mutual reinforcement between hostility and rejection/disagreement was significantly stronger in the BPD group. Moreover, the link between rejection and sadness was present at all three levels of analysis for the BPD group, while it was localized to the momentary level in the depressed group.


Heron, Kristin E.; Everhart, Robin S.; McHale, Susan M.; Smyth, Joshua M. (2017): Systematic Review. Using mobile-technology-based Ecological Momentary Assessment (EMA) methods with youth: a systematic review and recommendations.

In: Journal of pediatric psychology. DOI: 10.1093/jpepsy/jsx078.

Ecological momentary assessment (EMA) methods are increasingly used in social and health sciences, but the feasibility and best practices for using EMA with youth are not yet clear. We conducted a systematic review of studies that used self-report EMA methods with youth; the goal was to identify common approaches and challenges to implementation and develop recommendations for future research. We examined 54 peer-reviewed papers that reported on 24 unique studies. Papers were evaluated using a standardized, three-dimensional coding scheme focused on the following: (1) sample characteristics; (2) EMA data collection methods (sampling duration, frequency, hardware/software); (3) study implementation methods (technical/logistical challenges, training participants, compliance). Overall, the research suggests EMA can be successfully implemented with youth (age approximately >/=7) from diverse backgrounds, but protocol adaptations may be necessary for younger children. Study design and implementation challenges and recommendations for research on youth are provided.


Herziger, Atar; Benzerga, Amel; Berkessel, Jana; Dinartika, Niken L.; Franklin, Matija; Steinnes, Kamilla K.; Sundstrom, Felicia (2017): A Study Protocol for Testing the Effectiveness of User-Generated Content in Reducing Excessive Consumption.

In: Frontiers in psychology 8, S. 972. DOI: 10.3389/fpsyg.2017.00972.

Excessive consumption is on the rise, as is apparent in growing financial debt and global greenhouse gas emissions. Voluntary simplicity, a lifestyle choice of reduced consumption and sustainable consumer behavior, provides a potential solution for excessive consumers. However, voluntary simplicity is unpopular, difficult to adopt, and under researched. The outlined research project will test a method of promoting voluntary simplicity via user-generated content, thus mimicking an existing social media trend (Minimalism) in an empirical research design. The project will test (a) whether the Minimalism trend could benefit consumers interested in reducing their consumption, and (b) whether self-transcendence (i.e., biospheric) and self-enhancement (i.e., egoistic and hedonic) values and goals have a similar impact in promoting voluntary simplicity. A one-week intervention program will test the efficacy of watching user-generated voluntary simplicity videos in reducing non-essential consumption. Each of the two intervention conditions will present participants with similar tutorial videos on consumption reduction (e.g., decluttering, donating), while priming the relevant values and goals (self-transcendence or self-enhancement). These interventions will be compared to a control condition, involving no user-generated content. Participants will undergo baseline and post-intervention evaluations of: voluntary simplicity attitudes and behaviors, buying and shopping behaviors, values and goals in reducing consumption, and life satisfaction. Experience sampling will monitor affective state during the intervention. We provide a detailed stepwise procedure, materials, and equipment necessary for executing this intervention. The outlined research design is expected to contribute to the limited literature on voluntary simplicity, online behavioral change interventions, and the use of social marketing principles in consumer interventions.


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.


Holland, Elise; Koval, Peter; Stratemeyer, Michelle; Thomson, Fiona; Haslam, Nick (2017): Sexual objectification in women’s daily lives. A smartphone ecological momentary assessment study.

In: Br J Soc Psychol 56 (2), S. 314–333. DOI: 10.1111/bjso.12152.

Sexual objectification, particularly of young women, is highly prevalent in modern industrialized societies. Although there is plenty of experimental and cross‐sectional research on objectification, prospective studies investigating the prevalence and psychological impact of objectifying events in daily life are scarce. We used ecological momentary assessment to track the occurrence of objectifying events over 1 week in the daily lives of young women (N = 81). Participants reported being targeted by a sexually objectifying event – most often the objectifying gaze—approximately once every 2 days and reported witnessing sexual objectification of others approximately 1.35 times per day. Further, multilevel linear regression analyses showed that being targeted by sexual objectification was associated with a substantial increase in state self‐objectification. Overall, individual differences had little impact in moderating these effects. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Horowitz, Sarah; Stermac, Lana (2017): The relationship between interpersonal trauma history and the functions of non-suicidal self-injury in young adults. An experience sampling study.

In: Journal of trauma & dissociation : the official journal of the International Society for the Study of Dissociation (ISSD), S. 1–15. DOI: 10.1080/15299732.2017.1330228.

Non-suicidal self-injury (NSSI) has been reported to serve a range of functions for individuals who engage in it. Despite considerable variation in NSSI functions between individuals, limited attention has been paid to exploring relationships between NSSI functions and other characteristics of self-injuring individuals, such as trauma history. This is despite allusion to trauma history in the suggested etiology of some NSSI functions (e.g., anti-dissociation, self-punishment). The present study used a 21-day online daily diary to explore possible relationships between common NSSI functions and past interpersonal trauma in community young adults (n = 38). The interpersonal boundaries and anti-dissociation functions significantly related to interpersonal trauma severity in multiple regression analyses; the interpersonal boundaries function continued to significantly relate to interpersonal trauma severity when controlling for the number of NSSI functions endorsed.


Hruska, Bryce; Pacella, Maria L.; George, Richard L.; Delahanty, Douglas L. (2017): The association between daily PTSD symptom severity and alcohol-related outcomes in recent traumatic injury victims.

In: Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors 31 (3), S. 326–335. DOI: 10.1037/adb0000262.

The self-medication hypothesis proposes that individuals experiencing posttraumatic stress disorder (PTSD) symptoms may use alcohol (or other substances) to self-medicate distress, while the mutual maintenance hypothesis proposes that alcohol use also exacerbates or maintains distress. Existing research largely supports the self-medication hypothesis. However, findings are often based upon retrospective reporting of problems and assessment of symptoms anchored to a trauma occurring in the remote past. To improve on these retrospective designs, the current study examined the relationship between daily PTSD symptom severity and alcohol-related outcomes during the early phase of recovery following a traumatic physical injury. Specifically, 36 injury victims reported on PTSD symptom severity, alcohol craving, alcohol consumption, and negative drinking consequences thrice daily (morning, afternoon, night) over 7 days beginning 6 weeks postinjury. Results indicated relationships between PTSD symptom severity and alcohol craving/negative consequences when these experiences were assessed concurrently within the same signal (particularly during the nighttime assessments). Prospective models found that nighttime PTSD symptom severity was related to negative drinking consequences occurring the following morning, even after controlling for consumption level, suggesting a more general behavioral regulation problem. Results were less supportive of the mutual maintenance hypothesis. Collectively, these results suggest that health interventions targeting PTSD symptom severity in recent injury victims—particularly when delivered at night—may be able to prevent problematic alcohol use. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Hssayeni, Murtadha D.; Burack, Michelle A.; Ghoraani, Behnaz (2016): Automatic assessment of medication states of patients with Parkinson’s disease using wearable sensors.

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. 6082–6085. DOI: 10.1109/EMBC.2016.7592116.

Motor fluctuations are a major focus of clinical managements in patients with mid-stage and advance Parkinson’s disease (PD). In this paper, we develop a new patient-specific algorithm that can classify those fluctuations during a variety of activities. We extract a set of temporal and spectral features from the ambulatory signals and then introduce a semi-supervised classification algorithm based on K-means and self-organizing tree map clustering methods. Two different types of cluster labeling are introduced: hard and fuzzy labeling. The developed algorithm is evaluated on a dataset from triaxial gyroscope sensors for 12 PD patients. The average result of using K-means and fuzzy labeling on the trunk and the more affected leg sensors’ readings was 75.96%, 70.57%, and 86.93% for accuracy, sensitivity, and specificity, respectively. The accuracy for individual patients varied from 99.95% to 42.53%, which was correlated with dyskinesia severity and the improvement of the PD symptoms with medication.


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; Kuhn, Simone (2017): Can Inner Experience Be Apprehended in High Fidelity? Examining Brain Activation and Experience from Multiple Perspectives.

In: Frontiers in psychology 8, S. 43. DOI: 10.3389/fpsyg.2017.00043.

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.


Husky, Mathilde; Swendsen, Joel; Ionita, Adela; Jaussent, Isabelle; Genty, Catherine; Courtet, Philippe (2017): Predictors of daily life suicidal ideation in adults recently discharged after a serious suicide attempt. A pilot study.

In: Psychiatry research 256, S. 79–84. DOI: 10.1016/j.psychres.2017.06.035.

The aims of the study are to examine the predictive role of fluctuations in daily life mood, social contexts, and behavior on subsequent suicidal ideation (SI); and to identify clinical and psychological factors associated with the general frequency of SI in a high-risk sample. The sample comprised 42 adults (73.8% female) hospitalized for a suicide attempt. Immediately following hospital discharge, they used Ecological Momentary Assessment for seven consecutive days, providing repeated measures of SI, environmental, contextual, and behavioral factors. Controlling for prior SI, a number of contextual variables were associated with subsequent SI. Being at home or at work were both associated with an increased probability of SI, while being in the home of close others, or in a festive or leisure environment decreased SI probability. Working, passive leisure and inactivity all increased the likelihood of SI. Being alone increased SI while being with close others significantly reduced this risk. Finally, no overall effect for stressful events was found but negative family events specifically were associated with increased likelihood of SI (gamma = 0.448, t = 2.255, df = 29, p < 0.05). The findings provide preliminary results regarding proximal environmental and behavioral factors associated with the occurrence of suicidal ideation in a high-risk sample.


Iijima, Yudai; Takano, Keisuke; Tanno, Yoshihiko (2017): Attentional Bias and Its Association With Anxious Mood Dynamics.

In: Emotion (Washington, D.C.). DOI: 10.1037/emo0000338.

Attentional bias toward threatening stimuli is recognized as 1 of the most important cognitive vulnerability factors for anxiety. However, the association between anxious attention and negative moods has not been fully elucidated, particularly in terms of the effect of such bias on mood fluctuations in daily life. We examined the associations between attentional bias and emotional dynamics under a daily life setting. Participants (46 university students) completed the dot-probe task in the laboratory, after which they entered a 6-day experience sampling measurement to assess temporal fluctuations of momentary levels of anxious mood and occurrence of stressful events. The results showed that attentional bias was significantly correlated with increased temporal instability of anxious mood. Furthermore, attentional bias was also associated with enhanced emotional reactivity immediately after occurrence of the stressful event, but not with either the sensitivity to detect stressors or to the recovery process aimed at calming the stress-induced anxious mood on a longer time scale. These findings suggest that attentional bias is associated with the acute impact of a stressor on moods, as evidenced by the increased temporal instability and stress-reactivity of anxious mood. (PsycINFO Database Record


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.


Kalantarian, Haik; Sideris, Costas; Le Tuan; Hosseini, Anahita; Sarrafzadeh, Majid (2016): Computation offloading for real-time health-monitoring devices.

In: Conference proceedings : … Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference 2016, S. 4971–4974. DOI: 10.1109/EMBC.2016.7591843.

Among the major challenges in the development of real-time wearable health monitoring systems is to optimize battery life. One of the major techniques with which this objective can be achieved is computation offloading, in which portions of computation can be partitioned between the device and other resources such as a server or cloud. In this paper, we describe a novel dynamic computation offloading scheme for real-time wearable health monitoring devices that adjusts the partitioning of data between the wearable device and mobile application as a function of desired classification accuracy.


Kang, Yoona; O’Donnell, Matthew Brook; Strecher, Victor J.; Falk, Emily B. (2017): Dispositional mindfulness predicts adaptive affective responses to health messages and increased exercise motivation.

In: Mindfulness (N Y) 8 (2), S. 387–397. DOI: 10.1007/s12671-016-0608-7.

Feelings can shape how people respond to persuasive messages. In health communication, adaptive affective responses to potentially threatening messages constitute one key to intervention success. The current study tested dispositional mindfulness, characterized by awareness of the present moment, as a predictor of adaptive affective responses to potentially threatening health messages and desirable subsequent health outcomes. Both general and discrete negative affective states (i.e., shame) were examined in relation to mindfulness and intervention success. Individuals (n = 67) who reported less than 195 weekly minutes of exercise were recruited. At baseline, participants’ dispositional mindfulness and exercise outcomes were assessed, including self-reported exercise motivation and physical activity. A week later, all participants were presented with potentially threatening and self-relevant health messages encouraging physical activity and discouraging sedentary lifestyle, and their subsequent affective response and exercise motivation were assessed. Approximately 1 month later, changes in exercise motivation and physical activity were assessed again. In addition, participants’ level of daily physical activity was monitored by a wrist-worn accelerometer throughout the entire duration of the study. Higher dispositional mindfulness predicted greater increases in exercise motivation 1 month after the intervention. Importantly, this effect was fully mediated by lower negative affect and shame specifically, in response to potentially threatening health messages among highly mindful individuals. Baseline mindfulness was also associated with increased self-reported vigorous activity, but not with daily physical activity as assessed by accelerometers. These findings suggest potential benefits of considering mindfulness as an active individual difference variable in theories of affective processing and health communication. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Karwowski, Maciej; Lebuda, Izabela; Szumski, Grzegorz; Firkowska-Mankiewicz, Anna (2017): From Moment-to-Moment to Day-to-Day. Experience Sampling and Diary Investigations in Adults’ Everyday Creativity.

In: Psychol Aesthet Creat Arts. DOI: 10.1037/aca0000127.

Two studies examined the dynamics and predictors of momentary creative activity among adults. Study 1 (N = 74) applied the experience sampling methodology (ESM) to investigate the likelihood of engaging in creative activity and explain its variability using both within-person predictors (experienced emotions) and between person-predictors (personality and creative activity). This study also demonstrated that the likelihood of momentary creative activity during a random week at the age 52 is predicted by participants’ intelligence measured 4 decades ago. Study 2 extended these findings: In a 2-week-long diary study, participants (N = 433) reported their everyday creative behaviors and activity in the spheres related to arts (painting, composing music, writing), science (writing scientific articles, solving technical problems), and everyday functioning (cooking, blogging). Active positive emotions generally predicted day-to-day variability of creative behavior, whereas the role of individual-differences was more complex and domain-specific. (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, 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.


Klaus, Kristina; Fischer, Susanne; Doerr, Johanna M.; Nater, Urs M.; Mewes, Ricarda (2017): Classifying fibromyalgia syndrome as a mental disorder?—An ambulatory assessment study.

In: International journal of behavioral medicine 24 (2), S. 230–238. DOI: 10.1007/s12529-016-9603-6.

Purpose: Fibromyalgia syndrome (FMS) is associated with psychological distress. The recent revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) raises the question of whether FMS is classifiable as ‘somatic symptom disorder’ (SSD) and consequently as a mental disorder. To address this, the present ambulatory assessment study focuses on the everyday life occurrence of SSD symptoms in FMS and their predictive value concerning severity indicators of widespread pain. Method: Ambulatory data were assessed six times daily on 14 consecutive days via iPod. Twenty-eight women suffering from FMS indicated symptoms associated with SSD (somatic illness beliefs, health anxiety, time/energy devoted to pain, or health concerns) and momentary pain levels. Questionnaires regarding potential covariates (such as somatization, depression, health status) were completed at two additional sessions in the research laboratory. Results: On average, SSD symptoms occurred three to four times daily and were mild to moderate in severity. Furthermore, these symptoms were both concurrently and prospectively associated with momentary pain intensity and subjective impairment by pain. Twenty percent of the variance in pain intensity and 28 % of the variance in subjective impairment were explained by momentary variables (SSD symptoms and intake of pain medication). Eighty-two percent of persons with FMS fulfilled the psychological SSD criterion when considering everyday occurring symptoms with at least mild severity. Conclusion: FMS might be diagnosed as a mental disorder according to DSM-5 in many cases. SSD symptoms proved to have predictive value for FMS severity and may thus have clinical relevance for diagnostic, prognostic, and intervention purposes. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Kleiman, Evan M.; Turner, Brianna J.; Fedor, Szymon; Beale, Eleanor E.; Huffman, Jeff C.; Nock, Matthew K. (2017): Examination of Real-Time Fluctuations in Suicidal Ideation and Its Risk Factors. Results From Two Ecological Momentary Assessment Studies.

In: Journal of abnormal psychology. DOI: 10.1037/abn0000273.

Two studies examined 2 important but previously unanswered questions about the experience of suicidal ideation: (a) How does suicidal ideation vary over short periods of time?, and (b) To what degree do risk factors for suicidal ideation vary over short periods and are such changes associated with changes in suicidal ideation? Participants in Study 1 were 54 adults who had attempted suicide in the previous year and completed 28 days of ecological momentary assessment (EMA; average of 2.51 assessments per day; 2,891 unique assessments). Participants in Study 2 were 36 adult psychiatric inpatients admitted for suicide risk who completed EMA throughout their time in the hospital (average stay of 10.32 days; average 2.48 assessments per day; 649 unique assessments). These studies revealed 2 key findings: (a) For nearly all participants, suicidal ideation varied dramatically over the course of most days: more than 1-quarter (Study 1 = 29%; Study 2 = 28%) of all ratings of suicidal ideation were a standard deviation above or below the previous response from a few hours earlier and nearly all (Study 1 = 94.1%; Study 2 = 100%) participants had at least 1 instance of intensity of suicidal ideation changing by a standard deviation or more from 1 response to the next. (b) Across both studies, well-known risk factors for suicidal ideation such as hopelessness, burdensomeness, and loneliness also varied considerably over just a few hours and correlated with suicidal ideation, but were limited in predicting short-term change in suicidal ideation. These studies represent the most fine-grained examination of suicidal ideation ever conducted. The results advance the understanding of how suicidal ideation changes over short periods and provide a novel method of improving the short-term prediction of suicidal ideation. (PsycINFO Database Record


Klein, Nicola S.; van Rijsbergen, Gerard D.; Doesschate, Mascha C.; 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 a more favorable view regarding ADM.


Klipker, Kathrin; Wrzus, Cornelia; Rauers, Antje; Riediger, Michaela (2017): Hedonic orientation moderates the association between cognitive control and affect reactivity to daily hassles in adolescent boys.

In: Emotion (Washington, D.C.) 17 (3), S. 497–508. DOI: 10.1037/emo0000241.

People often seek to regulate their affective reactions when confronted with hassles. Hassle reactivity is lower for people with higher cognitive control, presumably because of better affect regulation. Many adolescents, however, show higher hassle reactivity than children, despite better cognitive control. The present study aims to understand whether motivational differences when seeking to regulate affective experiences moderate the association between cognitive control and hassle reactivity in adolescence. We hypothesized that higher cognitive control is related to lower hassle reactivity only for adolescents with a strong hedonic orientation, that is, for adolescents who seek to maintain or enhance positive or to dampen negative affect. We investigated 149 boys’ (age range: 10–20 years) hedonic orientation and affect reactivity toward daily hassles during 2 weeks of experience sampling. Higher cognitive control, assessed with a working memory battery in the laboratory, was associated with stronger hassle reactivity in individuals with low hedonic orientation. The more hedonic-oriented individuals were, the lower was their hassle reactivity, but only in combination with high cognitive control. Our findings illustrate that higher cognitive control is not always related to lower hassle reactivity. Rather, when daily hassles compromise affect balance, hedonic orientation is equally important to understand affect reactivity in adolescent boys. (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 at-risk 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.


Klumb, Petra L.; Voelkle, Manuel C.; Siegler, Sebastian (2017): How negative social interactions at work seep into the home. A prosocial and an antisocial pathway.

In: J Organ Behav 38 (5), S. 629–649. DOI: 10.1002/job.2154.

We combined Bakker and Demerouti’s spillover–crossover model with Taylor’s biobehavioral perspective, tested the comprehensive model, and pursued a set of gender‐related research questions. Negative work interactions were expected to entail two strain responses, high‐ and low‐arousal negative affect. Both should be related to cortisol secretion but transmitted via different social pathways, a positive and a negative one. During a 7‐day ambulatory assessment with 56 couples, we assessed daily variations in the severity of negative social interactions at work and at home along with participants’ affect and cortisol levels. Using multilevel structural equation modeling, we found evidence for the three hypothesized processes: strain at work as a consequence of social stress, spillover of strain into the home, and crossover to the partner. On socially more stressful days, participants showed increased high‐ and low‐arousal negative affect at work. Low‐arousal negative affect spilled over into the home. Only for men, high‐arousal negative affect spilled over, and only women showed a tendency for slowed decline of cortisol levels on more socially stressful days (i.e., slower recovery). Surprisingly, high‐arousal negative affect at work tended to be negatively related to partners’ high‐arousal negative affect. Commonalities predominated differences between men and women. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Kovac, Megan; Mosner, Maya; Miller, Stephanie; Hanna, Eleanor K.; Dichter, Gabriel S. (2016): Experience Sampling of Positive Affect in Adolescents with Autism. Feasibility and Preliminary Findings.

In: 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.


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.


Leersnyder, Jozefien; Koval, Peter; Kuppens, Peter; Mesquita, Batja (2017): Emotions and Concerns. Situational Evidence for Their Systematic Co-Occurrence.

In: Emotion (Washington, D.C.). DOI: 10.1037/emo0000314.

People experience emotions when events are relevant to their current concerns, that is, when events affect their goals, values, or motives that are pertinent at that time. In the current research, we focused on one kind of concern-values-and examined whether different types of concerns are associated with different categories of emotion. More specifically, we investigated whether, at the situation level, the relevance of different types of values is linked to the intensity of different types of emotional experience. We conducted two retrospective survey studies (Studies 1 and 2)-one of which was cross-cultural-and one experience-sampling study (Study three). Together, the three studies provide convergent evidence for associations between the situational relevance of self-focused values (e.g., ambition, success) and socially disengaging emotions (e.g., pride, anger) on the one hand, and between the relevance of other-focused values (e.g., loyalty, helping) and socially engaging emotions (e.g., closeness, shame) on the other. These findings challenge the (often implicit) assumption of emotion theories that different types of concerns are interchangeable-that is, that it does not matter for emotion which concern is relevant as long as one is. In contrast, the current research proposes that different concerns are constitutive elements of different emotional experiences and thus encourages new ways of thinking about emotions. (PsycINFO Database Record


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


Lenaert, Bert; Colombi, Max; van Heugten, Caroline; Rasquin, Sascha; Kasanova, Zuzana; Ponds, Rudolf (2017): Exploring the feasibility and usability of the experience sampling method to examine the daily lives of patients with acquired brain injury.

In: Neuropsychological rehabilitation, S. 1–13. DOI: 10.1080/09602011.2017.1330214.

The experience sampling method (ESM) is a structured diary method with high ecological validity, in that it accurately captures the everyday context of individuals through repeated measurements in naturalistic environments. Our main objective was to investigate the feasibility of using ESM in individuals with acquired brain injury (ABI). A second goal was to explore the usability of ESM data on a clinical level, by illustrating the interactions between person, environment, and affect. The PsyMate device provided ABI patients (N = 17) with ten signals (beeps) per day during six consecutive days. Each beep was followed by a digital questionnaire assessing mood, location, activities, social context, and physical well-being. Results demonstrated high feasibility with a 71% response rate and a 99% completion rate of the questionnaires. There were no dropouts and the method was experienced as user-friendly. Time-lagged multilevel analysis showed that higher levels of physical activity and fatigue predicted higher levels of negative affect at the same point in time, but not at later time points. This study illustrates the potential of ESM to identify complex person-environment dynamics after ABI, while generating understandable and easy to use graphical feedback.


Lennarz, Hannah K.; Lichtwarck-Aschoff, Anna; Timmerman, Marieke E.; Granic, Isabela (2017): Emotion differentiation and its relation with emotional well-being in adolescents.

In: Cognition & emotion, S. 1–7. DOI: 10.1080/02699931.2017.1338177.

Emotion differentiation (ED) refers to the precision with which people can identify and distinguish their emotions and has been associated with well-being in adults. This study investigated ED and its relation with emotional well-being (i.e. depressive symptoms, positivity and negativity intensity and propensity, implicit theories of emotions) in adolescents. We used an experience sampling method with 72 participants (Mage = 14.00, 71% girls) to assess adolescents’ positive and negative emotions at different time points over the course of two weekends and a baseline questionnaire to assess emotional well-being. Differentiating negative emotions was related to less negativity intensity and propensity, and to the belief that emotions are malleable. Differentiating positive emotions was not related to any of the assessed well-being variables. Together, these results suggest that a detailed awareness of one’s negative emotional states is an important dimension of well-being, also in adolescence.


Liao, Yue; Chou, Chih-Ping; Huh, Jimi; Leventhal, Adam; Dunton, Genevieve (2017): Examining acute bi-directional relationships between affect, physical feeling states, and physical activity in free-living situations using electronic ecological momentary assessment.

In: Journal of behavioral medicine 40 (3), S. 445–457. DOI: 10.1007/s10865-016-9808-9.

Current knowledge about the relationship of physical activity with acute affective and physical feeling states is informed largely by lab-based studies, which have limited generalizability to the natural ecology. This study used ecological momentary assessment to assess subjective affective and physical feeling states in free-living settings across 4 days from 110 non-physically active adults (Age M = 40.4, SD = 9.7). Light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were measured objectively by an accelerometer. Multilevel modeling was used to test the bi-directional associations between affective and physical feeling states and LPA/MVPA minutes. Higher positive affect, lower negative affect and fatigue were associated with more MVPA over the subsequent 15 min, while higher negative affect and energy were associated with more LPA over the subsequent 15 and 30 min. Additionally, more LPA and MVPA were associated with feeling more energetic over the subsequent 15 and 30 min, and more LPA was additionally associated with feeling more negative and less tired over the subsequent 15 and 30 min. Positive and negative affective states might serve as antecedents to but not consequences of MVPA in adults’ daily lives. Changes in LPA may be predicted and followed by negative affective states. Physical feeling states appear to lead up to and follow changes in both LPA and MVPA. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Liddle, Jacki; Wishink, Anna; Springfield, Liz; Gustafsson, Louise; Ireland, David; Silburn, Peter (2017): Can smartphones measure momentary quality of life and participation? A proof of concept using experience sampling surveys with university students.

In: Australian occupational therapy journal. DOI: 10.1111/1440-1630.12360.

BACKGROUND: Understanding quality of life and participation is a key aspect of occupational therapy research. The use of smartphones to deliver experience-sampling surveys may provide an accessible way to monitor these outcomes. This study used smartphone-based experience sampling methods (ESM) to investigate factors influencing momentary quality of life (mQOL) of university students. METHODS: A convenience sample of students at an Australian university participated. Using a custom smartphone application, ESM surveys were sent six to eight times, every second day, over a week. Participants indicated their mQOL, occupational participation, occupational enjoyment, social context and location via surveys and provided demographic and health information in a single self-report questionnaire. The relationship between mQOL and variables was analysed at the survey level using logistic regression. RESULTS: Forty students completed 391 surveys. Higher mQOL was significantly related to participation in productive occupations (z = 3.48; P = 0.001), moderate (z = 4.00; P < 0.001) or high occupational enjoyment (z = 7.06; P < 0.001), being with someone (z = 2.15, P = 0.031), being at home (z = 2.49; P = 0.013) and an excellent self-rated health status (z = 2.35; P = 0.019). The magnitude of differences in mQOL was small. CONCLUSION: This study suggests that mQOL amongst university students relates to personal, environmental and occupational factors. The use of smartphone-based ESM appears to be a practical approach for investigating participation and QOL. Further research utilising a more diverse sample, analysing at the individual level, and using ESM in conjunction with other methodologies is recommended.


Liu, Shimeng; Feng, Wuwei; Chhatbar, Pratik Y.; Liu, Yumei; Ji, Xunming; Ovbiagele, Bruce (2017): Mobile health as a viable strategy to enhance stroke risk factor control. A systematic review and meta-analysis.

In: Journal of the neurological sciences 378, S. 140–145. DOI: 10.1016/j.jns.2017.04.050.

BACKGROUND: With the rapid growth worldwide in cell-phone use, Internet connectivity, and digital health technology, mobile health (mHealth) technology may offer a promising approach to bridge evidence-treatment gaps in stroke prevention. We aimed to evaluate the effectiveness of mHealth for stroke risk factor control through a systematic review and meta-analysis. METHODS: We searched PubMed from January 1, 2000 to May 17, 2016 using the following keywords: mobile health, mHealth, short message, cellular phone, mobile phone, stroke prevention and control, diabetes mellitus, hypertension, hyperlipidemia and smoking cessation. We performed a meta-analysis of all eligible randomized control clinical trials that assessed a sustained (at least 6months) effect of mHealth. RESULTS: Of 78 articles identified, 13 met eligibility criteria (6 for glycemic control and 7 for smoking cessation) and were included for the final meta-analysis. There were no eligible studies for dyslipidemia or hypertension. mHealth resulted in greater Hemoglobin A1c reduction at 6months (6 studies; 663 subjects; SMD: -0.44; 95% CI: [-0.82, -0.06], P=0.02; Mean difference of decrease in HbA1c: -0.39%; 95% CI: [-0.74, -0.04], P=0.03). mHealth also lead to relatively higher smoking abstinence rates at 6months (7 studies; 9514 subjects; OR: 1.54; 95% CI: [1.24, 1.90], P<0.0001). CONCLUSIONS: Our meta-analysis supports that use of mHealth improves glycemic control and smoking abstinence rates.


Lopez, Richard B.; Chen, Pin-Hao A.; Huckins, Jeremy F.; Hofmann, Wilhelm; Kelley, William M.; Heatherton, Todd F. (2017): A balance of activity in brain control and reward systems predicts self-regulatory outcomes.

In: Social cognitive and affective neuroscience 12 (5), S. 832–838. DOI: 10.1093/scan/nsx004.

Previous neuroimaging work has shown that increased reward-related activity following exposure to food cues is predictive of self-control failure. The balance model suggests that self-regulation failures result from an imbalance in reward and executive control mechanisms. However, an open question is whether the relative balance of activity in brain systems associated with executive control (vs reward) supports self-regulatory outcomes when people encounter tempting cues in daily life. Sixty-nine chronic dieters, a population known for frequent lapses in self-control, completed a food cue-reactivity task during an fMRI scanning session, followed by a weeklong sampling of daily eating behaviors via ecological momentary assessment. We related participants’ food cue activity in brain systems associated with executive control and reward to real-world eating patterns. Specifically, a balance score representing the amount of activity in brain regions associated with self-regulatory control, relative to automatic reward-related activity, predicted dieters’ control over their eating behavior during the following week. This balance measure may reflect individual self-control capacity and be useful for examining self-regulation success in other domains and populations.


MacLean, Robert Ross; Martino, Steve; Carroll, Kathleen M.; Smyth, Joshua M.; Pincus, Aaron L.; Wilson, Stephen J. (2017): Momentary Associations Between Reported Craving and Valuing Health in Daily Smokers.

In: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco 19 (6), S. 716–722. DOI: 10.1093/ntr/ntw253.

Introduction: Research suggests that a blunted response to nondrug rewards, especially under conditions associated with strong cigarette cravings, is associated with reduced abstinence motivation in daily smokers. One limitation of previous studies is that they have largely focused on monetary rewards as broad representative of nondrug rewards. It remains unclear whether craving dampens responses to more abstract nondrug rewards, such as personal values. Personal values often have a positive valence and are frequently assumed to remain stable across time and situations. However, there may be time-varying and contextual influences on smokers’ appraisal of values in daily life. Characterizing fluctuations in value importance in relation to relapse precipitants (eg, craving) may inform interventions that leverage personal values as motivation for cessation. Methods: Daily smokers (n = 18) completed ecological momentary assessment surveys measuring the importance of specific personal values and smoking-related variables during 8 days of monetarily reinforced cigarette abstinence. We hypothesized that value ratings would demonstrate adequate within-person heterogeneity for multilevel modeling and that within-person fluctuations in craving would be negatively related to valuing personal health. Results: All values demonstrated adequate within-person variability for multilevel modeling. Within-person craving was negatively related to health valuation (p = .012) and a cross-level interaction (p > .0001) suggested this effect is stronger for individuals who report greater overall craving. Conclusions: Greater craving is associated with decreased importance of personal health in the moment, particularly for those with high average levels of craving. Timely interventions that bolster importance of health during moments of elevated craving can potentially improve cessation outcomes. Implications: This study builds on research highlighting the positive influence of personal values in motivating behavior change. Values are an often used, but poorly studied, construct that has considerable utility in smoking cessation. Valuing personal health is frequently reported as a primary motivator for a quit attempt. Inasmuch as personal health is a distal nondrug reward used to motivate smoking abstinence, naturalistic evaluation of health importance, and motivators for continued smoking (ie, craving) could inform the timing and content of smoking treatment. This study is among the first to evaluate momentary assessment of personal values and craving within daily life.


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.


Malinen, Kaisa; Ronka, Anna; Sevon, Eija; Schoebi, Dominik (2017): The difficulty of being a professional, a parent, and a spouse on the same day. Daily spillover of workplace interactions on parenting, and the role of spousal support.

In: Journal of prevention & intervention in the community 45 (3), S. 156–167. DOI: 10.1080/10852352.2016.1198121.

Designing parenting interventions and preventions requires knowledge on the factors and processes that shape parenting behaviors. Using data collected over 10 days, during the last hour of work and before going to bed, this study examined the spillover of interpersonal work stresses into positive and negative parenting behaviors. Data were collected among 103 couples who had at least one child between the age of one and eight years. Of particular interest was the role of received emotional spousal support as a moderator of stress spillover. Dyadic variants of multilevel models were used to analyze the data. The results showed that on days on which mothers or fathers reported stressful interpersonal interactions in the workplace, they also reported less positive parenting behaviors. In addition, mothers reported more negative parenting behaviors on days characterized by these kinds of work experiences. Mothers and fathers were found to report more positive parenting behaviors, and mothers less negative parenting behaviors, on the days on which they received more spousal support. Received spousal support also moderated spillover of work stress into parenting behaviors and this finding was found to be gender-specific: for mothers, support enhanced spillover into positive behaviors, and for fathers, it enhanced spillover into negative parenting behaviors.


Manson, Joseph H.; Robbins, Megan L. (2017): New Evaluation of the Electronically Activated Recorder (EAR). Obtrusiveness, Compliance, and Participant Self-selection Effects.

In: Frontiers in psychology 8, S. 658. DOI: 10.3389/fpsyg.2017.00658.

The Electronically Activated Recorder (EAR) is a method for collecting periodic brief audio snippets of participants’ daily lives using a portable recording device. The EAR can potentially intrude into people’s privacy, alter their natural behavior, and introduce self-selection biases greater than in other types of social science methods. Previous research (Mehl and Holleran, 2007, hereafter M&H) has shown that participant non-compliance with, and perceived obtrusiveness of, an EAR protocol are both low. However, these questions have not been addressed in jurisdictions that require the consent of all parties to recording conversations. This EAR study required participants to wear a button bearing a microphone icon and the words “This conversation may be recorded” to comply with California’s all-party consent law. Results revealed self-reported obtrusiveness and non-compliance were actually lower in the present study than in the M&H study. Behaviorally assessed non-compliance did not differ between the two studies. Participants in the present study talked more about being in the study than participants in the M&H study, but such talk still comprised <2% of sampled conversations. Another potential problem with the EAR, participant self-selection bias, was addressed by comparing the EAR volunteers’ HEXACO personality dimensions to a non-volunteer sample drawn from the same student population. EAR volunteers were significantly and moderately higher in Conscientiousness, and lower in Emotionality, than non-volunteers. In conclusion, the EAR method can be successfully implemented in at least one all-party consent state (California). Interested researchers are encouraged to review this procedure with their own legal counsel.


Marcano Belisario, Jose Salvador; Doherty, Kevin; O’Donoghue, John; Ramchandani, Paul; Majeed, Azeem; Doherty, Gavin et al. (2017): A bespoke mobile application for the longitudinal assessment of depression and mood during pregnancy. Protocol of a feasibility study.

In: BMJ open 7 (5), e014469. DOI: 10.1136/bmjopen-2016-014469.

INTRODUCTION: Depression is a common mental health disorder during pregnancy, with important consequences for mothers and their children. Despite this, it goes undiagnosed and untreated in many women attending antenatal care. Smartphones could help support the prompt identification of antenatal depression in this setting. In addition, these devices enable the implementation of ecological momentary assessment techniques, which could be used to assess how mood is experienced during pregnancy. With this study, we will assess the feasibility of using a bespoke mobile application (app) running on participants’ own handsets for the longitudinal (6 months) monitoring of antenatal mood and screening of depression. METHODS AND ANALYSIS: We will use a randomised controlled study design to compare two types of assessment strategies: retrospective + momentary (consisting of the Edinburgh Postnatal Depression Scale plus five momentary and two contextual questions), and retrospective (consisting of the Edinburgh Postnatal Depression Scale only). We will assess the impact that these strategies have on participant adherence to a prespecified sampling protocol, dropout rates and timeliness of data completion. We will evaluate differences in acceptance of the technology through a short quantitative survey and open-ended questions. We will also assess the potential effect that momentary assessments could have on retrospective data. We will attempt to identify any patterns in app usage through the analysis of log data. ETHICS AND DISSEMINATION: This study has been reviewed and approved by the National Research Ethics Service Committee South East Coast-Surrey on 15 April 2016 as a notice of substantial amendment to the original submission (9 July 2015) under the Research Ethics Committee (REC) reference 15/LO/0977. This study is being sponsored by Imperial College London under the reference number 15IC2687 and has been included in the UK Clinical Research Network Study Portfolio under the Central Portfolio Management System number 19280. The findings of this study will be disseminated through academic peer-reviewed publications, poster presentations and abstracts at academic and professional conferences, discussion with peers, and social media. The findings of this study will also inform the PhD theses of JSMB and KD.


Mascaro, Jennifer S.; Rentscher, Kelly E.; Hackett, Patrick D.; Mehl, Matthias R.; Rilling, James K. (2017): Child gender influences paternal behavior, language, and brain function.

In: Behav Neurosci 131 (3), S. 262–273. DOI: 10.1037/bne0000199.

Multiple lines of research indicate that fathers often treat boys and girls differently in ways that impact child outcomes. The complex picture that has emerged, however, is obscured by methodological challenges inherent to the study of parental caregiving, and no studies to date have examined the possibility that gender differences in observed real-world paternal behavior are related to differential paternal brain responses to male and female children. Here we compare fathers of daughters and fathers of sons in terms of naturalistically observed everyday caregiving behavior and neural responses to child picture stimuli. Compared with fathers of sons, fathers of daughters were more attentively engaged with their daughters, sang more to their daughters, used more analytical language and language related to sadness and the body with their daughters, and had a stronger neural response to their daughter’s happy facial expressions in areas of the brain important for reward and emotion regulation (medial and lateral orbitofrontal cortex [OFC]). In contrast, fathers of sons engaged in more rough and tumble play (RTP), used more achievement language with their sons, and had a stronger neural response to their son’s neutral facial expressions in the medial OFC (mOFC). Whereas the mOFC response to happy faces was negatively related to RTP, the mOFC response to neutral faces was positively related to RTP, specifically for fathers of boys. These results indicate that real-world paternal behavior and brain function differ as a function of child gender. (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.


Mason, Tyler B.; Lavender, Jason M.; Wonderlich, Stephen A.; Crosby, Ross D.; Engel, Scott G.; Mitchell, James E. et al. (2017): Examining a momentary mediation model of appearance-related stress, anxiety, and eating disorder behaviors in adult anorexia nervosa.

In: Eating and weight disorders : EWD. DOI: 10.1007/s40519-017-0404-y.

PURPOSE: Appearance-related stress may result from appearance-focused events such as seeing one’s reflection, seeing media images, and shopping for clothes. The purpose of this study was to examine the prospective association between momentary appearance-related stress and eating disorder (ED) behaviors (i.e., binge eating and vomiting) among women with anorexia nervosa (AN) using ecological momentary assessment (EMA). We hypothesized that appearance-related stress at Time 1 would predict binge eating and vomiting at Time 2, and that this prospective association would be mediated by momentary anxiety at Time 2 (controlling for anxiety at Time 1). METHODS: Women with AN completed a 2-week EMA protocol involving repeated daily assessments of experiences and behaviors. RESULTS: Momentary appearance-related stress preceded binge eating and vomiting, and momentary anxiety mediated the prospective association between appearance-related stress and ED behaviors. CONCLUSIONS: Targeted momentary interventions delivered in the natural environment that address appearance-related stress may have utility in the treatment of ED behaviors.


Mason, Tyler B.; Smith, Kathryn E.; Crosby, Ross D.; Wonderlich, Stephen A.; Crow, Scott J.; Engel, Scott G.; Peterson, Carol B. (2017): Does the eating disorder examination questionnaire global subscale adequately predict eating disorder psychopathology in the daily life of obese adults?

In: Eating and weight disorders : EWD. DOI: 10.1007/s40519-017-0410-0.

The eating disorder examination questionnaire (EDE-Q) Global score is a self-report measure of global eating disorder (ED) psychopathology. This study used ecological momentary assessment (EMA) to evaluate the ecological validity of EDE-Q Global scores among obese adults. Fifty obese adults completed the EDE-Q and 2 weeks of EMA ratings prior to initiating eating episodes and subsequently after eating episodes. EMA items assessed behavioral symptoms [i.e., loss of control (LOC) eating and overeating] and cognitive symptoms (i.e., weight/shape concerns, eating concerns, and restraint). EDE-Q Global was associated with increased EMA weight/shape concerns and fear of LOC at pre-eating recordings. EDE-Q Global was associated with increased EMA post-episode weight/shape concerns, eating concerns, LOC eating, and overeating. There was no association between EDE-Q Global and EMA restraint. Results generally supported the ecological validity of EDE-Q Global scores. Future studies of ED psychopathology in obese adults may benefit from considering EDE-Q Restraint separately. Level of Evidence Level V, descriptive study.


Massoudi, Btissame; Blanker, Marco H.; van Valen, Evelien; Wouters, Hans; Bockting, Claudi L. H.; Burger, Huibert (2017): Blended care vs. usual care in the treatment of depressive symptoms and disorders in general practice BLENDING. Study protocol of a non-inferiority randomized trial.

In: BMC psychiatry 17 (1), S. 218. DOI: 10.1186/s12888-017-1376-1.

BACKGROUND: The majority of patients with depressive disorders are treated by general practitioners (GPs) and are prescribed antidepressant medication. Patients prefer psychological treatments but they are under-used, mainly due to time constraints and limited accessibility. A promising approach to deliver psychological treatment is blended care, i.e. guided online treatment. However, the cost-effectiveness of blended care formatted as an online psychological treatment supported by the patients’ own GP or general practice mental health worker (MHW) in routine primary care is unknown. We aim to demonstrate non-inferiority of blended care compared with usual care in patients with depressive symptoms or a depressive disorder in general practice. Additionally, we will explore the real-time course over the day of emotions and affect, and events within individuals during treatment. METHODS: This is a pragmatic non-inferiority trial including 300 patients with depressive symptoms, recruited by collaborating GPs and MHWs. After inclusion, participants are randomized to either blended care or usual care in routine general practice. Blended care consists of the ‘Act and Feel’ treatment: an eight-week web-based program based on behavioral activation with integrated monitoring of depressive symptomatology and automatized feedback. GPs or their MHWs coach the participants through regular face-to-face or telephonic consultations with at least three sessions. Depressive symptomatology, health status, functional impairment, treatment satisfaction, daily activities and resource use are assessed during a follow-up period of 12 months. During treatment, real-time fluctuations in emotions and affect, and daily events will be rated using ecological momentary assessment. The primary outcome is the reduction of depressive symptoms from baseline to three months follow-up. We will conduct intention-to-treat analyses and supplementary per-protocol analyses. DISCUSSION: This trial will show whether blended care might be an appropriate treatment strategy for patients with depressive symptoms and depressive disorder in general practice. TRIAL REGISTRATION: Netherlands Trial Register: NTR4757; 25 August 2014. . (Archived by WebCite(R) at ).


Matta, Fadel K.; Scott, Brent A.; Colquitt, Jason A.; Koopman, Joel; Passantino, Liana G. (2017): Is consistently unfair better than sporadically fair? An investigation of justice variability and stress.

In: Acad Manage J 60 (2), S. 743–770. DOI: 10.5465/amj.2014.0455.

Research on organizational justice has predominantly focused on between-individual differences in average levels of fair treatment experienced by employees. Recently, researchers have also demonstrated the importance of considering dynamic, within individual fluctuations in fair treatment experienced by employees over time. Drawing on uncertainty management theory, we merge these two streams of research and introduce the concept of ‘justice variability,’ which captures between-person differences in the stability of fairness over time. Contrary to the intuitive notion that more fairness is always better, our work shows that being treated consistently unfairly can be better for employees than being treated fairly sometimes and unfairly at other times. Specifically, in a lab study, variably fair treatment resulted in greater physiological stress than both consistently fair and consistently unfair treatment. In a multilevel, experience-sampling field study, we replicated the positive association between justice variability and stress, and we also showed that justice variability exacerbated the positive, daily relationship between general workplace uncertainty and stress. Moreover, daily stress mediated the effects of justice variability on daily job dissatisfaction and emotional exhaustion. Finally, we showed that supervisors with more self-control tended to be less variable in their fair treatment over time. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


McKeon, Ashlee; McCue, Michael; Skidmore, Elizabeth; Schein, Michelle; Kulzer, Jamie (2017): Ecological momentary assessment for rehabilitation of chronic illness and disability.

In: Disability and rehabilitation, S. 1–14. DOI: 10.1080/09638288.2017.1280545.

PURPOSE: The main objectives of this manuscript were to provide a theoretical perspective on naturalistic delivery in rehabilitation based upon a literature review and establish a rationale for using ecological momentary assessment (EMA) for naturalistic assessment for chronic illness and disability (CID) in rehabilitation. METHOD: Existing literature on EMA use across CID cohorts was gathered and analyzed to form a theoretical overview of implementation of this method in research. This review summarizes study results and provides a comprehensive literature table for greater analysis. RESULTS: EMA has been shown to optimize clinician time and reduce costs, reach greater numbers of people with disability-related needs, and reduce the need for retrospective recall through the collection of more objective data. Mixed method approaches were most commonly seen in the literature, and sampling schedules and the outcomes assessed varied widely. CONCLUSIONS: EMA is emerging as a novel modality of assessment in rehabilitation. Scientists and clinicians should consider incorporating this assessment approach as a rehabilitation tool that may more accurately assess the complex and dynamic nature of disability over the long-term through an objective and ecologically-valid data source. Implications for rehabilitation Ecological momentary assessment (EMA) has been underutilized in the rehabilitation field and should be considered by researchers and clinicians as a novel assessment method for capturing rich, ecologically-valid data. EMA methods provide a greater capability to assess complex or difficult to measure outcomes of interest when compared with more traditional approaches conducted during finite clinic hours due to data collection occurring, with or without any input from the user, through wearable technology, and without a needed clinician presence. EMA data can be integrated with other data sources (e.g., self-report or clinician observation) to assess a more comprehensive picture of outcomes of interest, including highlighting discordance and identifying the most efficient target areas for intervention.


Mehl, Matthias R. (2017): The Electronically Activated Recorder (EAR). A Method for the Naturalistic Observation of Daily Social Behavior.

In: Current directions in psychological science 26 (2), S. 184–190. DOI: 10.1177/0963721416680611.

This article reviews the Electronically Activated Recorder or EAR as an ambulatory ecological momentary assessment tool for the real-world observation of daily behavior. Technically, the EAR is an audio recorder that intermittently records snippets of ambient sounds while participants go about their lives. Conceptually, it is a naturalistic observation method that yields an acoustic log of a person’s day as it unfolds. The power of the EAR lies in unobtrusively collecting authentic real-life observational data. In preserving a high degree of naturalism at the level of the raw recordings, it resembles ethnographic methods; through its sampling and coding, it enables larger empirical studies. The article provides an overview of the EAR method, reviews its validity, utility, and limitations, and discusses it in the context of current developments in ambulatory assessment, specifically the emerging field of mobile sensing.


Mehta, Clare; Dementieva, Yulia (2016): The Contextual Specificity of Gender: Femininity and Masculinity in College Students’ Same- and Other-Gender Peer Contexts.

In: Sex Roles. DOI: 10.1007/s11199-016-0632-z.

Social constructivist models of gender suggest that gendered attitudes and behaviors, such as femininity and masculinity, are context-dependent (Deaux and Major 1987). If this is the case, femininity and masculinity may be better conceptualized as variable states rather than as stable traits. In the present study, we used Ecological Momentary Assessment to investigate variations in femininity and masculinity according to the gender of peers in female and male college students’ real-life social contexts. Cisgender participants were recruited from a small liberal arts college in the northeastern region of the United States. Sixteen female and 11 male college students (M age = 20) contributed 448 reports documenting their social context and femininity and masculinity over a 2-week period. We found that men reported greater femininity on a momentary version of the Bem Sex Role Inventory (BSRI) when they were with women in comparison to when they were with men. We also found that both women and men reported greater masculinity on a momentary version of the BSRI when they were with men in comparison to when they were with women. Our findings lend empirical support to social constructivist models of gender and highlight the importance of investigating how interpersonal contexts contribute to gender-typed attitudes and behaviors.


Mennis, Jeremy; Mason, Michael; Ambrus, Andreea; Way, Thomas; Henry, Kevin (2017): The spatial accuracy of geographic ecological momentary assessment (GEMA). Error and bias due to subject and environmental characteristics.

In: Drug and alcohol dependence 178, S. 188–193. DOI: 10.1016/j.drugalcdep.2017.05.019.

BACKGROUND: Geographic ecological momentary assessment (GEMA) combines ecological momentary assessment (EMA) with global positioning systems (GPS) and geographic information systems (GIS). This study evaluates the spatial accuracy of GEMA location data and bias due to subject and environmental data characteristics. METHODS: Using data for 72 subjects enrolled in a study of urban adolescent substance use, we compared the GPS-based location of EMA responses in which the subject indicated they were at home to the geocoded home address. We calculated the percentage of EMA locations within a sixteenth, eighth, quarter, and half miles from the home, and the percentage within the same tract and block group as the home. We investigated if the accuracy measures were associated with subject demographics, substance use, and emotional dysregulation, as well as environmental characteristics of the home neighborhood. RESULTS: Half of all subjects had more than 88% of their EMA locations within a half mile, 72% within a quarter mile, 55% within an eighth mile, 50% within a sixteenth of a mile, 83% in the correct tract, and 71% in the correct block group. There were no significant associations with subject or environmental characteristics. CONCLUSIONS: Results support the use of GEMA for analyzing subjects’ exposures to urban environments. Researchers should be aware of the issue of spatial accuracy inherent in GEMA, and interpret results accordingly. Understanding spatial accuracy is particularly relevant for the development of ‘ecological momentary interventions’ (EMI), which may depend on accurate location information, though issues of privacy protection remain a concern.


Milesi, Carolina; Perez-Felkner, Lara; Brown, Kevin; Schneider, Barbara (2017): Engagement, Persistence, and Gender in Computer Science. Results of a Smartphone ESM Study.

In: Frontiers in psychology 8, S. 602. DOI: 10.3389/fpsyg.2017.00602.

While the underrepresentation of women in the fast-growing STEM field of computer science (CS) has been much studied, no consensus exists on the key factors influencing this widening gender gap. Possible suspects include gender differences in aptitude, interest, and academic environment. Our study contributes to this literature by applying student engagement research to study the experiences of college students studying CS, to assess the degree to which differences in men and women’s engagement may help account for gender inequity in the field. Specifically, we use the Experience Sampling Method (ESM) to evaluate in real-time the engagement of college students during varied activities and environments. Over the course of a full week in fall semester and a full week in spring semester, 165 students majoring in CS at two Research I universities were “beeped” several times a day via a smartphone app prompting them to fill out a short questionnaire including open-ended and scaled items. These responses were paired with administrative and over 2 years of transcript data provided by their institutions. We used mean comparisons and logistic regression analysis to compare enrollment and persistence patterns among CS men and women. Results suggest that despite the obstacles associated with women’s underrepresentation in computer science, women are more likely to continue taking computer science courses when they felt challenged and skilled in their initial computer science classes. We discuss implications for further research.


Miner, Philip B.; Koltun, William D.; Wiener, Gregory J.; La Portilla, Marianela; 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.


Mneimne, Malek; Fleeson, William; Arnold, Elizabeth Mayfield; Furr, R. Michael (2017): Differentiating the Everyday Emotion Dynamics of Borderline Personality Disorder From Major Depressive Disorder and Bipolar Disorder.

In: Personality disorders. DOI: 10.1037/per0000255.

A major barrier to the understanding of emotion dynamics in borderline personality disorder (BPD) lies in its substantial comorbidity with major depressive disorder (MDD) and bipolar disorder (BD). Whereas BPD has often been characterized in terms of dynamic emotional processes, including instability, reactivity, and inertia, its substantial comorbidity with MDD and BD makes it difficult to discern the specificity of these dynamics. To differentiate the emotion dynamics of BPD from those of MDD and BD, an experience sampling study of 38 participants with BPD, 15 participants with MDD, 14 participants with BD, and 62 healthy controls obtained reports of interpersonal challenges and emotions 5 times daily for 2 weeks. Interpersonal challenges included rejection, betrayal, abandonment, offense, disappointment, and self-image challenge; emotions included anger, excitement, guilt, happiness, irritability, and shame. Multilevel analyses revealed that heightened interpersonal reactivity of guilt and shame and heightened inertia of shame were relatively specific to BPD. These findings could not be accounted for by the presence of current MDD or BD. By contrast, heightened instability of anger and irritability and heightened inertia of irritability appeared to be largely transdiagnostic. Implications for clinical assessment, research, and theory are discussed. (PsycINFO Database Record


Moeller, Julia; Dietrich, Julia; Eccles, Jacquelynne S.; Schneider, Barbara (2017): Passionate experiences in adolescence. Situational variability and long‐term stability.

In: J Res Adolesc 27 (2), S. 344–361. DOI: 10.1111/jora.12297.


This study investigates adolescents’ situational passionate experiences, defined as states of strong commitment and intense affect. We examine the extent to which experiencing passion was specific to situations versus individual differences, and explore which activities are likely to elicit adolescents’ passion. Using longitudinal experience sampling method (ESM) data from a representative sample of 996 adolescents (54.6% females) in three cohorts (6th, 8th, and 10th grade at baseline), we examine whether adolescents’ frequency of passionate experiences remained stable across 2 years. Results of multilevel analyses revealed that situational determinants accounted for 80% of variance in passion, while 20% were due to characteristics of the person that remained stable across 1 week of ESM assessment. An adolescent’s percentage of passionate experiences among all observed experiences remained stable across 2 years in rank order and mean level. (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.


Moore, Raeanne C.; Swendsen, Joel; Depp, Colin A. (2017): Applications for self-administered mobile cognitive assessments in clinical research. A systematic review.

In: International journal of methods in psychiatric research. DOI: 10.1002/mpr.1562.

Frequent, brief and repeated self-administered mobile assessments of cognitive function, conducted in everyday life settings, are a promising complementary tool to traditional assessment approaches. Mobile cognitive assessments promote patient-centered care and might enhance capacity to inform individual-level outcomes over time (i.e. detecting subtle declines in cognitive function), as well as in assessing cognition and its correlates in the naturalistic environment. The goal of this systematic review was to assess the feasibility and psychometric properties of mobile cognitive assessments. Through a comprehensive search, we identified 12 articles using self-administered, mobile phone-based cognitive assessments. Studies sampled participants between 1 and 6 times per day for 1-14 days. Samples ranged in age from 14 to 83 years old and were generally healthy populations without cognitive impairment. Working memory was the most frequently-assessed cognitive domain (n = 7), followed by attention/reaction time (n = 4). Seven studies reported adherence, with mean adherence rates of 79.2%. In addition to positive evidence of feasibility, there was general support for high levels of between- and within-person reliability and construct validity. While research has only begun to explore the utility of mobile cognitive assessments, studies to-date indicate they may be a promising complementary tool to traditional assessment methods with potential to improve clinical care and research.


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.


Nahum, Mor; van Vleet, Thomas M.; Sohal, Vikaas S.; Mirzabekov, Julie J.; Rao, Vikram R.; Wallace, Deanna L. et al. (2017): Immediate Mood Scaler. Tracking Symptoms of Depression and Anxiety Using a Novel Mobile Mood Scale.

In: JMIR mHealth and uHealth 5 (4), e44. DOI: 10.2196/mhealth.6544.

BACKGROUND: Mood disorders are dynamic disorders characterized by multimodal symptoms. Clinical assessment of symptoms is currently limited to relatively sparse, routine clinic visits, requiring retrospective recollection of symptoms present in the weeks preceding the visit. Novel advances in mobile tools now support ecological momentary assessment of mood, conducted frequently using mobile devices, outside the clinical setting. Such mood assessment may help circumvent problems associated with infrequent reporting and better characterize the dynamic presentation of mood symptoms, informing the delivery of novel treatment options. OBJECTIVES: The aim of our study was to validate the Immediate Mood Scaler (IMS), a newly developed, iPad-deliverable 22-item self-report tool designed to capture current mood states. METHODS: A total of 110 individuals completed standardized questionnaires (Patient Health Questionnaire, 9-item [PHQ-9]; generalized anxiety disorder, 7-Item [GAD-7]; and rumination scale) and IMS at baseline. Of the total, 56 completed at least one additional session of IMS, and 17 completed one additional administration of PHQ-9 and GAD-7. We conducted exploratory Principal Axis Factor Analysis to assess dimensionality of IMS, and computed zero-order correlations to investigate associations between IMS and standardized scales. Linear Mixed Model (LMM) was used to assess IMS stability across time and to test predictability of PHQ-9 and GAD-7 score by IMS. RESULTS: Strong correlations were found between standard mood scales and the IMS at baseline (r=.57-.59, P<.001). A factor analysis revealed a 12-item IMS (“IMS-12″) with two factors: a “depression” factor and an “anxiety” factor. IMS-12 depression subscale was more strongly correlated with PHQ-9 than with GAD-7 (z=1.88, P=.03), but the reverse pattern was not found for IMS-12 anxiety subscale. IMS-12 showed less stability over time compared with PHQ-9 and GAD-7 (.65 vs .91), potentially reflecting more sensitivity to mood dynamics. In addition, IMS-12 ratings indicated that individuals with mild to moderate depression had greater mood fluctuations compared with individuals with severe depression (.42 vs .79; P=.04). Finally, IMS-12 significantly contributed to the prediction of subsequent PHQ-9 (beta=1.03, P=.02) and GAD-7 scores (beta =.93, P=.01). CONCLUSIONS: Collectively, these data suggest that the 12-item IMS (IMS-12) is a valid tool to assess momentary mood symptoms related to anxiety and depression. Although IMS-12 shows good correlation with standardized scales, it further captures mood fluctuations better and significantly adds to the prediction of the scales. Results are discussed in the context of providing continuous symptom quantification that may inform novel treatment options and support personalized treatment plans.


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.


Oakes, Mark A.; Onyper, Serge V. (2017): The movement-induced self-reference effect. Enhancing memorability through movement toward the self.

In: Cognitive processing. DOI: 10.1007/s10339-017-0810-0.

Much evidence suggests that bodily actions affect cognitive states. In particular, pulling owned objects toward the self improves memory for those objects compared to memory for objects pushed away from the self. Experiments 1 and 2 examined the effect of incidental joystick movement on static stimuli, hypothesizing that using the physical self (rather than a computer monitor) as a reference point would enhance memory for items categorized via a toward-the-self action but not toward-the-computer-monitor action. Experiment 3 examined whether movement toward an external representation of self, one’s cellular phone, would enhance memory compared to the same movement toward an unfamiliar phone. Recognition memory was enhanced for both words and pictures evaluated during movements toward a representation of the self, regardless of whether the representation was a physical self or a disembodied self. Furthermore, movement toward the self enhanced memory, rather than movement away from the self depressing memory. These results suggest that self-referential processing can be induced by an approach motor action and impact episodic memory regardless of intention to learn, stimulus type, or motion of the stimuli. They also suggest that self-referential memory advantage can be disembodied.


O’Connor, Sydney G.; Koprowski, Carol; Dzubur, Eldin; Leventhal, Adam M.; Huh, Jimi; Dunton, Genevieve Fridlund (2017): Differences in Mothers’ and Children’s Dietary Intake during Physical and Sedentary Activities. An Ecological Momentary Assessment Study.

In: Journal of the Academy of Nutrition and Dietetics. DOI: 10.1016/j.jand.2017.02.012.

BACKGROUND: Physical activity and diet are major modifiable health behaviors contributing to obesity risk. Although patterns of these behaviors tend to cluster within individuals and within family units, it is unknown to what extent healthy and unhealthy dietary intake might differentially accompany sedentary and physical activities in mothers compared with their children. OBJECTIVE: Our goal was to examine differences in co-occurrence of activities and dietary intake between mothers and children, as measured in real time using ecological momentary assessment. PARTICIPANTS/SETTING: This study examined cross-sectional data from 175 mothers and their children aged 8 to 12 years. MAIN OUTCOME MEASURES: Participants completed 8 days of ecological momentary assessment surveys, reporting on whether the following activities had occurred during the past 2 hours: sedentary screen activity, physical activity, and intake of healthy (ie, fruits and vegetables) and unhealthy (ie, fast food, chips/fries, pastries/sweets, and soda/energy drinks) foods. STATISTICAL ANALYSES PERFORMED: Multilevel logistic regression models estimated the adjusted odds of consuming healthy and unhealthy dietary intake for mothers and children during time periods reporting physical activity (vs no physical activity) or sedentary screen activity (vs no sedentary screen activity). Post hoc tests compared estimates for mothers vs children. RESULTS: Children were significantly more likely than their mothers to consume unhealthy foods during 2-hour windows that included physical activity (odds ratio [children] 1.85, 95% CI 1.47 to 2.31; odds ratio [mothers] 0.83, 95% CI 0.58 to 1.20; Pdiff <0.05), but not sedentary screen activity (Pdiff=0.067). In addition, children and their mothers did not differ in their likelihood of consuming healthy foods during 2-hour windows with sedentary screen activity (Pdiff =0.497) or physical activity (Pdiff =0.170). CONCLUSIONS: Results indicate that the consumption of unhealthy foods may be more likely to co-occur within a 2-hour window including physical activity in children as compared to their mothers. Future research should examine reasons for this difference, and potential areas for intervention.


O’Leary, Kimberly; Small, Brent J.; Panaite, Vanessa; Bylsma, Lauren M.; Rottenberg, Jonathan (2017): Sleep quality in healthy and mood-disordered persons predicts daily life emotional reactivity.

In: Cognition & emotion 31 (3), S. 435–443. DOI: 10.1080/02699931.2015.1126554.

Disordered sleep has been linked to impaired emotional functioning in healthy and depressed individuals. Little is known, however, about how chronic sleep problems influence emotional reactivity in everyday life. Participants with major or minor unipolar depressive disorder (n = 60) and healthy controls (n = 35) reported on sleep and emotional responses to daily life events using a computerised Experience Sampling Method. We examined whether impaired sleep quality influenced emotional reactivity to daily events, and if this relationship was altered by unipolar mood disorders. Among healthy individuals, sleep difficulties were associated with enhanced negative affect (NA) to unpleasant events and a dulled response to neutral events. However, among mood-disordered persons, sleep difficulties were associated with higher NA across all types of everyday life events. Impaired sleep quality differentially affects daily life emotional reactions as a function of depression. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Pearson, Jennifer L.; Elmasry, Hoda; Das, Babita; Smiley, Sabrina L.; Rubin, Leslie F.; DeAtley, Teresa et al. (2017): Comparison of Ecological Momentary Assessment Versus Direct Measurement of E-Cigarette Use With a Bluetooth-Enabled E-Cigarette. A Pilot Study.

In: JMIR research protocols 6 (5), e84. DOI: 10.2196/resprot.6501.

BACKGROUND: Assessing the frequency and intensity of e-cigarette use presents special challenges beyond those posed by cigarette use. Accurate measurement of e-cigarette consumption, puff duration, and the stability of these measures over time will be informative for estimating the behavioral and health effects of e-cigarette use. OBJECTIVE: The purpose of this pilot study was to compare the accuracy of self-reported e-cigarette puff counts collected via ecological momentary assessment (EMA) to objective puff count data collected by a Bluetooth-enabled e-cigarette device and to examine the feasibility and acceptability of using a second-generation e-cigarette among adult smokers. METHODS: A total of 5 adult smokers were enrolled in a longitudinal parent study assessing how e-cigarette use affects cigarette use among e-cigarette-naive smokers. Using a text message-based EMA system, participants reported e-cigarette puffs for 2 weeks. Participants were also given a Bluetooth-enabled e-cigarette (Smokio) that passively collected puff counts and puff duration. Comparisons between mean reports of Smokio (device-report) and EMA (self-report) use were evaluated using paired t tests. Correlation and agreement between device- and self-reports were evaluated using Pearson correlation and the concordance correlation coefficient (CCC), respectively. A linear mixed effect model was used to determine the fixed effect of timing and Smokio-reported daily puffs on report accuracy. We examined the relationship between time of day and reporting accuracy using Tukey’s test for multiple pairwise comparisons. RESULTS: A total of 5 African American participants, 4 men and 1 woman, who ranged in age from 24 to 59 years completed the study, resulting in 5180 observations (device-report) of e-cigarette use. At baseline, participants reported smoking for 5 to 25 years and consumed a mean of 7 to 13 cigarettes per day (CPD); 4 smoked within 30 minutes of waking. At the 30-day follow-up, CPD range decreased to 1 to 3 cigarettes; 4 participants reported past 7-day e-cigarette use, and 1 participant reported no cigarette smoking in the past 7 days. Over 2 weeks of e-cigarette use, participants took an average of 1074 e-cigarette (SD 779.0) puffs per person as captured by the device reports. Each participant took a mean of 75.0 (SD 58.8) puffs per day, with each puff lasting an average of 3.6 (SD 2.4) seconds. Device reports captured an average of 33.3 (SD 47.8) more puffs per person per day than the self-reported e-cigarette puffs. In 87% of days, participants underestimated the number of puffs they had taken on the Smokio. There was significant moderate correlation (r=.47, P<.001) but poor agreement (pc=0.31, 95% CI 0.15-0.46) between the device- and self-reported data. Reporting accuracy was affected by amount and timing of e-cigarette use. CONCLUSIONS: Compared to self-reported e-cigarette use, the Bluetooth-enabled device captured significantly more e-cigarette use and allowed for examination of puff duration in addition to puff counts. A Bluetooth-enabled e-cigarette is a powerful and feasible tool for objective collection of e-cigarette use behavior in the real world.


Pendergast, Felicity J.; Ridgers, Nicola D.; Worsley, Anthony; McNaughton, Sarah A. (2017): Evaluation of a smartphone food diary application using objectively measured energy expenditure.

In: The international journal of behavioral nutrition and physical activity 14 (1), S. 30. DOI: 10.1186/s12966-017-0488-9.

BACKGROUND: Dietary assessment methods are limited in their ability to adequately measure food and beverage consumption. Smartphone applications may provide a novel method of dietary assessment to capture real-time food intake and the contextual factors surrounding eating occasions. The aim of this study is to evaluate the capability of a Smartphone meal diary app (“FoodNow”) to measure food intake using a validated objective method for assessing energy expenditure among young adults. METHODS: Participants (18-30 years) used FoodNow over four non-consecutive days recording all eating occasions through a combination of written text, and/or optional images and voice recordings. A series of contextual questions were also completed. Participants wore the validated SenseWear Armband (BodyMedia Inc, USA) during the same period to measure free-living energy expenditure. Intra-class correlation coefficients (ICC) estimated the reliability of FoodNow to measure estimated energy intake compared to measured energy expenditure. RESULTS: Ninety participants (71 female, 19 male; mean age = 24.9 +/- 4.1 years) were recruited to use the FoodNow app to record their eating occasions. Thirteen were excluded as they did not meet minimum requirements for number of reporting days (n = 3) or SenseWear Armband wear time (5 days of 11 h), while 21 participants were excluded after being identified as mis-reporters (Huang method). Among the remaining sample (n = 56), reliability between estimated energy intake and measured energy expenditure was high (ICC, 95% CI: 0.75, 0.61-0.84). CONCLUSIONS: FoodNow is a suitable method for capturing estimated energy intake data from young adults. Despite wide levels of agreement at the individual level (-3709 kJ to 2056 kJ), at the group level, FoodNow appears to have potential as a dietary assessment tool. This new dietary assessment method will offer an alternative and novel method of dietary assessment which is capable of collecting both estimated energy intake and contextual factors surrounding eating occasions. Information collected may be used to inform future public health messages or research interventions.


Perogamvros, Lampros; Baird, Benjamin; Seibold, Mitja; Riedner, Brady; Boly, Melanie; Tononi, Giulio (2017): The Phenomenal Contents and Neural Correlates of Spontaneous Thoughts across Wakefulness, NREM Sleep, and REM Sleep.

In: Journal of cognitive neuroscience, S. 1–12. DOI: 10.1162/jocn_a_01155.

Thoughts occur during wake as well as during dreaming sleep. Using experience sampling combined with high-density EEG, we investigated the phenomenal qualities and neural correlates of spontaneously occurring thoughts across wakefulness, non-rapid eye movement (NREM) sleep, and REM sleep. Across all states, thoughts were associated with activation of a region of the midcingulate cortex. Thoughts during wakefulness additionally involved a medial prefrontal region, which was associated with metacognitive thoughts during wake. Phenomenologically, waking thoughts had more metacognitive content than thoughts during both NREM and REM sleep, whereas thoughts during REM sleep had a more social content. Together, these results point to a core neural substrate for thoughts, regardless of behavioral state, within the midcingulate cortex, and suggest that medial prefrontal regions may contribute to metacognitive content in waking thoughts.


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.


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.


Powell, Daniel J. H.; McMinn, David; Allan, Julia L. (2017): Does real time variability in inhibitory control drive snacking behavior? An intensive longitudinal study.

In: Health psychology : official journal of the Division of Health Psychology, American Psychological Association 36 (4), S. 356–364. DOI: 10.1037/hea0000471.

Objective: Laboratory eating studies and cross-sectional surveys indicate individuals with inefficient executive function (EF) consume more unhealthy snacks than others. However, the importance of EF in determining snacking behavior in the 'real world' has not been established. Contemporary behavioral and self-control theories posit EF as a dynamic resource fluctuating over time. Consequently, a test of the relevance of EF to behavior within individuals is required. This study tested within- and between-person effects of real-time variability in objectively measured inhibitory control (a core facet of EF) on subsequent snacking behavior in daily life. Method: A community sample of 64 adults recorded snacking behavior and completed a short Go/No-Go test (assessing inhibitory control) hourly over 7 consecutive days, yielding a total well-powered sample of 6,284 data-points. Generalized linear mixed models using lagged effects examined within-person and between-person effects of inhibitory control efficiency on snacking behavior. Results: When Go/No-Go test responses were 100 ms slower than the person-mean (indicating periods of poorer inhibitory control), snack consumption in the following hour was 25.67% higher, Exp (γ) = 1.26, p = .002, 95% confidence interval (CI) [1.06, 1.49]. Between-individuals, person-mean reaction time (RT) did not predict snack consumption, Exp (γ) = 1.02, p = .965, 95% CI [0.71, 1.46]. Conclusions: RT variability in inhibitory control efficiency is highly relevant to snacking behavior within individuals. Inhibitory control is an important driver of snacking in everyday life and an important target for interventions. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Preston, Kenzie L.; Kowalczyk, William J.; Phillips, Karran A.; Jobes, Michelle L.; Vahabzadeh, Massoud; Lin, Jia-Ling et al. (2017): Context and craving during stressful events in the daily lives of drug-dependent patients.

In: Psychopharmacology. DOI: 10.1007/s00213-017-4663-0.

RATIONALE: Knowing how stress manifests in the lives of people with substance-use disorders could help inform mobile “just in time” treatment. OBJECTIVES: The purpose of this paper is to examine discrete episodes of stress, as distinct from the fluctuations in background stress assessed in most EMA studies. METHODS: For up to 16 weeks, outpatients on opioid-agonist treatment carried smartphones on which they initiated an entry whenever they experienced a stressful event (SE) and when randomly prompted (RP) three times daily. Participants reported the severity of stress and craving and the context of the report (location, activities, companions). Decomposition of covariance was used to separate within-person from between-person effects; r effect sizes below are within-person. RESULTS: Participants (158 of 182; 87%) made 1787 stress-event entries. Craving for opioids increased with stress severity (r effect = 0.50). Stress events tended to occur in social company (with acquaintances, 0.63, friends, 0.17, or on the phone, 0.41) rather than with family (spouse, -0.14; child, -0.18), and in places with more overall activity (bars, 0.32; outside, 0.28; walking, 0.28) and more likelihood of unexpected experiences (with strangers, 0.17). Being on the internet was slightly protective (-0.22). Our prior finding that being at the workplace protects against background stress in our participants was partly supported in these stressful-event data. CONCLUSIONS: The contexts of specific stressful events differ from those we have seen in prior studies of ongoing background stress. However, both are associated with drug craving.


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.


Rappaport, Lance M.; Moskowitz, D. S.; D’Antono, Bianca (2017): Depression symptoms moderate the association between emotion and communal behavior.

In: Journal of counseling psychology 64 (3), S. 269–279. DOI: 10.1037/cou0000194.

Depression is associated with emotion regulation deficits which manifest as elevated negative affect and greater continuation of negative affect over time. The present study examined a possible emotion regulatory deficit, whether depression symptoms attenuate the association between communal (i.e., agreeable, quarrelsome) behavior and affect. A community sample reported on depression and anxiety symptoms before recording their affect and behavior following naturally occurring interpersonal interactions over 21 days. Participants’ behaviors were measured using items selected to represent the Interpersonal Circumplex Model of behavior. Results indicated an association between affect and communal behavior, which was stronger for negative than positive affect. Depression symptoms moderated this association; elevated depression symptoms were associated with decreased association of affect and interpersonal behavior. Comorbid anxiety symptoms did not moderate this association. Results suggest that elevated depression symptoms are associated with a diminished ability to adapt communal behavior to emotion cues. Given prior evidence of elevated overall quarrelsome behavior among individuals with elevated depression symptoms, this may demonstrate an interpersonal mechanism by which emotion regulation deficits impact the generation of interpersonal problems. (PsycINFO Database Record (c) 2017 APA, all rights reserved)

Public Significance Statement—The present study demonstrates that interpersonal behavior is associated with people’s current affect. However, people who have elevated depression symptoms have weaker associations between behavior and affect, suggesting one way they may have difficulty regulating their affect. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Raudsepp, Lennart; Riso, Eva-Maria (2017): Longitudinal Associations Between Sedentary Behavior of Adolescent Girls, Their Mothers, and Best Friends.

In: Pediatric exercise science, S. 1–24. DOI: 10.1123/pes.2016-0255.

PURPOSE: The objective of this study was to examine the prospective relationship and changes in sedentary behavior between adolescent girls, their mothers and best friends over time Methods: The results are based on 122 girls aged 11-12 years at baseline measurement, their mothers and best friends who completed ecological momentary assessment diary for the assessment of sedentary behavior. All measurements were taken at three time points separated by one year. We used structural equation modeling to examine associations among sedentary behavior of adolescent girls, their mothers and best friends. RESULTS: A linear growth model for adolescent girls’ and their best friends’ sedentary behavior fit the data well, revealing an overall significant increase in sedentary behavior across time. Initial levels of mothers’ and best friends’ sedentary behavior were positively related with sedentary behavior of adolescent girls. The changes of adolescent girls’ and best friends’ sedentary behavior across three years were positively related. Cross-lagged panel analysis demonstrated significant reciprocal effects between adolescent girls’ and best friends’ sedentary behavior. Mothers’ sedentary behavior at baseline predicted daughters’ sedentary behavior at 1-year follow-up and vice versa. CONCLUSION: From early to mid-adolescence, changes in adolescent girls’ sedentary behavior were associated with changes in best friends’ sedentary behavior. These findings suggest reciprocal associations between sedentary behavior of adolescent girls and their best friends.


Razzoli, Maria; Pearson, Carolyn; Crow, Scott; Bartolomucci, Alessandro (2017): Stress, overeating, and obesity. Insights from human studies and preclinical models.

In: Neuroscience and biobehavioral reviews 76 (Pt A), S. 154–162. DOI: 10.1016/j.neubiorev.2017.01.026.

Eating disorders and obesity have become predominant in human society. Their association to modern lifestyle, encompassing calorie-rich diets, psychological stress, and comorbidity with major diseases are well documented. Unfortunately the biological basis remains elusive and the pharmacological treatment inadequate, in part due to the limited availability of valid animal models. Human research on binge eating disorder (BED) proves a strong link between stress exposure and bingeing: state-levels of stress and negative affect are linked to binge eating in individuals with BED both in laboratory settings and the natural environment. Similarly, classical animal models of BED reveal an association between acute exposure to stressors and binging but they are often associated with unchanged or decreased body weight, thus reflecting a negative energy balance, which is uncommon in humans where most commonly BED is associated with excessive or unstable body weight gain. Recent mouse models of subordination stress induce spontaneous binging and hyperphagia, altogether more closely mimicking the behavioral and metabolic features of human BED. Therefore the translational relevance of subordination stress models could facilitate the identification of the neurobiological basis of BED and obesity-associated disease and inform on the development of innovative therapies.


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.


Richardson, Ben; Fuller-Tyszkiewicz, Matthew; O’Donnell, Renee; Ling, Mathew; Staiger, Petra K. (2017): Regression tree analysis of ecological momentary assessment data.

In: Health psychology review, S. 1–7. DOI: 10.1080/17437199.2017.1343677.

An increasingly popular form of data collection in health psychology research is Ecological Momentary Assessment (EMA); that is, using diaries or smartphones to collect intensive longitudinal data. This method is increasingly applied to the study of relationships between state-based aspects of individuals’ functioning and health outcomes (e.g., binge eating, alcohol use). Analysis of such data is challenging and regression tree modelling (RTM) may be a useful alternative to multilevel modelling for investigating the association between a set of explanatory variables and a continuous outcome. Furthermore, RTM outputs ‘decision trees’ that could be used by health practitioners to guide assessment and tailor intervention. In contrast to regression, RTM is able to easily accommodate many complex, higher-order interactions between predictor variables (without the need to create explicit interaction terms). These benefits make the technique useful for those interested in monitoring and intervening upon health and psychological outcomes (e.g., mood, eating behaviour, risky alcohol use, and treatment adherence). Using real data, this paper demonstrates both the benefits and limitations of RTM and how to extend these models to accommodate analysis of nested data; that is, data that arise from EMA where repeated observations are nested within individuals.


Roberts, Megan E.; Lu, Bo; Browning, Christopher R.; Ferketich, Amy K. (2017): Tracking Young Adults’ Attitudes Toward Tobacco Marketing Using Ecological Momentary Assessment (EMA).

In: Substance use & misuse, S. 1–6. DOI: 10.1080/10826084.2017.1302958.

BACKGROUND: Decades of research demonstrate the pernicious effects of targeted cigarette marketing on young people. Now, with tobacco marketing shifting toward greater incorporation of alternative products, it is critical to identify current attitudes toward the new landscape of tobacco advertisements. OBJECTIVES: The purpose of this study was to understand the present landscape of tobacco marketing to which young adults are exposed, and to assess how they respond to it. METHOD: During 2015-2016, we used ecological momentary assessment (EMA), in which 44 young adults (aged 18-28) carried smartphones equipped with a survey app. Seventy-seven percent were ever-users of tobacco and 29.5% were intermittent users of tobacco (someday users of cigarettes and/or those who used another tobacco product >5 times within the past year). For ten days, participants were prompted at three random times/day to complete a brief survey about their exposures and responses to tobacco-related advertising. Analyses used t-test and multilevel modeling. RESULTS: Intermittent users reported greater exposure than non-intermittent users to tobacco advertising. Further, both intermittent and ever-users reported more positive attitudes toward the tobacco advertising. Of the tobacco advertisements reported, 22% were for products unregulated by the FDA at the time of data collection. Conclusions/Importance: These findings indicate that young adults, and especially young adults who use tobacco, are exposed to a fair amount of tobacco advertising on a weekly basis. As the tobacco users in our sample were largely experimental and occasional users, these marketing exposures could put young adults at risk for progression toward regular use.


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.


Roth, Alexis M.; Rossi, John; Goldshear, Jesse L.; Truong, Quan; Armenta, Richard F.; Lankenau, Stephen E. et al. (2017): Potential Risks of Ecological Momentary Assessment Among Persons Who Inject Drugs.

In: Substance use & misuse 52 (7), S. 840–847. DOI: 10.1080/10826084.2016.1264969.

BACKGROUND: Ecological momentary assessment (EMA)-which often involves brief surveys delivered via mobile technology-has transformed our understanding of the individual and contextual micro-processes associated with legal and illicit drug use. However, little empirical research has focused on participant’s perspective on the probability and magnitude of potential risks in EMA studies. OBJECTIVES: To garner participant perspectives on potential risks common to EMA studies of illicit drug use. METHODS: We interviewed 38 persons who inject drugs living in San Diego (CA) and Philadelphia (PA), United States. They completed simulations of an EMA tool and then underwent a semi-structured interview that systematically explored domains of risk considered within the proposed revisions to the Federal Policy for the Protection of Human Subjects or the “Common Rule.” Interviews were transcribed verbatim and coded systematically to explore psychological, physical, social, legal, and informational risks from participation. RESULTS: Participants perceived most risks to be minimal. Some indicated that repetitive questioning about mood or drug use could cause psychological (i.e., anxiety) or behavioral risks (i.e., drug use relapse). Ironically, the questions that were viewed as risky were considered motivational to engage in healthy behaviors. The most cited risks were legal and social risks stemming from participant concerns about data collection and security. IMPORTANCE: Improving our understanding of these issues is an essential first step to protect human participants in future EMA research. We provide a brief set of recommendations that can aid in the design and ethics review of the future EMA protocol with substance using populations.


Russell, Emma; Woods, Stephen A.; Banks, Adrian P. (2017): Examining conscientiousness as a key resource in resisting email interruptions. Implications for volatile resources and goal achievement.

In: J Occup Organ Psychol. DOI: 10.1111/joop.12177.

Within the context of the conservation of resources model, when a resource is deployed, it is depleted – albeit temporarily. However, when a ‘key’, stable resource, such as Conscientiousness, is activated (e.g., using a self‐control strategy, such as resisting an email interruption), we predicted that (1) another, more volatile resource (affective well‐being) would be impacted and that (2) this strategy would be deployed as a trade‐off, allowing one to satisfy task goals, at the expense of well‐being goals. We conducted an experience‐sampling field study with 52 email‐users dealing with their normal email as it interrupted them over the course of a half‐day period. This amounted to a total of 376 email reported across the sample. Results were analysed using random coefficient hierarchical linear modelling and included cross‐level interactions for Conscientiousness with strategy and well‐being. Our first prediction was supported – deploying the stable, key resource of Conscientiousness depletes the volatile, fluctuating resource of affective well‐being. However, our second prediction was not fully realized. Although resisting or avoiding an email interruption was perceived to hinder well‐being goal achievement by Conscientious people, it had neither a positive nor negative impact on task goal achievement. Implications for theory and practice are discussed. Practitioner points It may be necessary for highly Conscientious people to turn off their email interruption alerts at work, in order to avoid the strain that results from an activation‐resistance mechanism afforded by the arrival of a new email. Deploying key resources means that volatile resources may be differentially spent, depending on one’s natural tendencies and how these interact with the work task and context. This suggests that the relationship between demands and resources is not always direct and predictable. Practitioners may wish to appraise the strategies they use to deal with demands such as email at work, to identify if these strategies are assisting with task or well‐being goal achievement, or whether they have become defunct through automation. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Salvy, Sarah-Jeanne; Feda, Denise M.; Epstein, Leonard H.; Roemmich, James N. (2017): The social context moderates the relationship between neighborhood safety and adolescents’ activities.

In: Preventive medicine reports 6, S. 355–360. DOI: 10.1016/j.pmedr.2017.04.009.

Studies of neighborhood safety and physical activity have typically neglected to consider the youth’s peer context as a modifier of these relationships. This study fills this gap in testing the independent and interactive effects of perceived neighborhood safety and time spent with friends and peers on young adolescents’ physical activity and sedentary behavior. Participants (N = 80; ages 13-17) completed the Pedestrian/Traffic Safety and Crime Safety subscales of the adolescent version of the Neighborhood Environment Walkability Scale (NEWS). An experience sampling methodology was used to assess sedentary behaviors/screen time and the social context in which physical activity and sedentary time/behavior occurred. Physical activity was assessed via accelerometry. Multilevel models were used to estimate the relationships between predictors (neighborhood safety and social context) and outcomes (physical activity and sedentary time/behavior). Frequency of peer/friend interactions moderated the relationships between neighborhood safety and adolescents’ physical activity and sedentary behavior. Specifically, physical activity was more strongly influenced by neighborhood safety among adolescents who reported spending less time with peers and friends than among those who reported frequent peer interactions. Among youths who perceived that their neighborhoods were safer, spending more time with friends and peers was related to greater engagement in sedentary activities, whereas this was not the case among adolescents who perceived that their neighborhoods were less safe. The peer social context moderates the relationship between perceived neighborhood safety and adolescents’ physical activity and sedentary behavior. Improving social interactions at the individual level within neighborhoods may decrease concerns of safety.


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.


Schneider, M.; Reininghaus, U.; van Nierop, M.; Janssens, M.; Myin-Germeys, I. (2017): Does the Social Functioning Scale reflect real-life social functioning? An experience sampling study in patients with a non-affective psychotic disorder and healthy control individuals.

In: Psychological medicine, S. 1–10. DOI: 10.1017/S0033291717001295.

BACKGROUND: The ecological validity of retrospective measures of social functioning is currently unknown in patients with schizophrenia. In the present study, patients with a diagnosis of non-affective psychosis were compared with controls on two measures of social functioning: the Social Functioning Scale (SFS) and daily-life measures collected with the Experience Sampling Methodology (ESM). The associations between both measures were examined in each group of participants to test for the ecological validity of the SFS. METHODS: A total of 126 participants with a non-affective psychotic disorder and 109 controls completed the SFS and a 6-day momentary ESM protocol assessing various aspects of social functioning. Multiple linear and multilevel regression analyses were performed to test for group differences in social functioning level and examine associations between the two assessment techniques. RESULTS: Lower social functioning was observed in patients compared with controls on retrospective and momentary measures. The SFS interpersonal domain (social engagement/withdrawal and interpersonal behaviour dimensions) was associated with the percentage of time spent alone and negative appraisal of social interactions. The SFS activity domain (pro-social and recreational activities dimensions) was negatively associated with time spent in leisure activities. CONCLUSIONS: The SFS showed some degree of ecological validity at assessing broad aspects of social functioning. Low scores on the SFS social engagement/withdrawal and interpersonal behaviour dimensions captured social isolation and social avoidance in daily life, but not lack of interest in socializing. Ecological validity of the SFS activity domain was low. ESM offers a rich alternative to classical assessment techniques of social functioning.


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, Lori N.; Wright, Aidan G. C.; Beeney, Joseph E.; Lazarus, Sophie A.; Pilkonis, Paul A.; Stepp, Stephanie D. (2017): Borderline personality disorder symptoms and aggression. A within-person process model.

In: Journal of abnormal psychology 126 (4), S. 429–440. DOI: 10.1037/abn0000272.

Theoretical and empirical work suggests that aggression in those with borderline personality disorder (BPD) occurs primarily in the context of emotional reactivity, especially anger and shame, in response to perceived rejection. Using intensive repeated measures, we examined a within-person process model in which perceived rejection predicts increases in aggressive urges and behaviors via increases in negative affect (indirect effect) and in which BPD symptoms exacerbate this process (moderated mediation). Participants were 117 emerging adult women (ages 18-24) with recent histories of aggressive behavior who were recruited from a community-based longitudinal study of at-risk youth. Personality disorder symptoms were assessed by semistructured clinical interview, and aggressive urges, threats, and behaviors were measured in daily life during a 3-week ecological momentary assessment protocol. Multilevel path models revealed that within-person increases in perceived rejection predicted increases in negative affect, especially in women with greater BPD symptoms. In turn, increases in negative affect predicted increased likelihood of aggressive urges or behaviors. Further analysis revealed that BPD symptoms predicted greater anger and shame reactivity to perceived rejection, but not to criticism or insult. Additionally, only anger was associated with increases in aggression after controlling for other negative emotions. Whereas BPD symptoms exacerbated the link between perceived rejection and aggression via increases in negative affect (particularly anger), this process was attenuated in women with greater antisocial personality disorder symptoms. These findings suggest that anger reactivity to perceived rejection is one unique pathway, distinct from antisocial personality disorder, by which BPD symptoms increase risk for aggression. (PsycINFO Database Record


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


Seo, Jang-Won (2017): How do you restrain yourself from avoidance when distressed? Distress tolerance and affective associations of avoidance/withstanding behaviors in college-aged heavy drinkers.

In: Pers Individ Dif 111, S. 1–5. DOI: 10.1016/j.paid.2017.01.058.

Distress tolerance (DT) has been considered an important contributor to manifestation, maintenance, and relapse of alcohol use problems. However, factors that could influence DT among heavy drinkers are unclear. The current study examined the role of affects linked to avoidance/withstanding behavioral options in deciding whether to withstand distressful experiences with a sample of heavy drinkers. To this end, the author administered a well-validated instrument to assess implicit affective associations of avoidance/withstanding options to 36 heavy drinkers and conducted ecological momentary assessment to measure DT of the participants for one week. Multilevel model analyses revealed that affects linked to avoidance/withstanding options were closely related to DT. Affects linked to avoidance/withstanding options could influence DT in heavy drinkers and warrant further exploration. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Servaas, Michelle N.; Riese, Harriette; Renken, Remco J.; Wichers, Marieke; Bastiaansen, Jojanneke A.; Figueroa, Caroline A. et al. (2017): Associations Between Daily Affective Instability and Connectomics in Functional Subnetworks in Remitted Patients with Recurrent Major Depressive Disorder.

In: Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology. DOI: 10.1038/npp.2017.65.

Remitted patients with major depressive disorder (rMDD) often report more fluctuations in mood as residual symptomatology. It is unclear how this affective instability is associated with information processing related to the default mode (DMS), salience/reward (SRS), and frontoparietal (FPS) subnetworks in rMDD patients at high risk of recurrence (rrMDD). Sixty-two unipolar, drug-free rrMDD patients (2 MDD episodes) and 41 healthy controls (HCs) were recruited. We used experience sampling methodology to monitor mood/cognitions (10 times a day for 6 days) and calculated affective instability using the mean adjusted absolute successive difference. Subsequently, we collected resting-state functional magnetic resonance imaging data and performed graph theory to obtain network metrics of integration within (local efficiency) the DMS, SRS, and FPS, and between (participation coefficient) these subnetworks and others. In rrMDD patients compared with HCs, we found that affective instability was increased in most negative mood/cognition variables and that the DMS had less connections with other subnetworks. Furthermore, we found that rrMDD patients, who showed more instability in feeling down and irritated, had less connections between the SRS and other subnetworks and higher local efficiency coefficients in the FPS, respectively. In conclusion, rrMDD patients, compared with HCs, are less stable in their negative mood and these dynamics are related to differences in information processing within- and between-specific functional subnetworks. These results are a first step to gain a better understanding of how mood fluctuations in real life are represented in the brain and provide insights into the vulnerability profile of MDD.Neuropsychopharmacology advance online publication, 10 May 2017; doi:10.1038/npp.2017.65.


Seshadri, Dhruv R.; Drummond, Colin; Craker, John; Rowbottom, James R.; Voos, James E. (2017): Wearable Devices for Sports. New Integrated Technologies Allow Coaches, Physicians, and Trainers to Better Understand the Physical Demands of Athletes in Real time.

In: IEEE pulse 8 (1), S. 38–43. DOI: 10.1109/MPUL.2016.2627240.

Elite-level athletes and professional sports teams are continually searching for opportunities to improve athletic performance and gain a competitive advantage on the field. Advances in technology have provided new avenues to maximize player health and safety. Over the last decade, time?motion analysis systems, such as video recording and computer digitization, have been used to measure human locomotion and improve sports performance. While these techniques were state of the art at the time, their usefulness is inhibited by the questionable validity of the acquired data, the labor-intensive nature of collecting data with manual hand-notation techniques, and their inability to track athlete position, movement, displacement, and velocity.


Shackman, Alexander J.; Weinstein, Jennifer S.; Hudja, Stanton N.; Bloomer, Conor D.; Barstead, Matthew G.; Fox, Andrew S.; Lemay, Edward P. (2017): Dispositional Negativity in the Wild. Social Environment Governs Momentary Emotional Experience.

In: Emotion (Washington, D.C.). DOI: 10.1037/emo0000339.

Dispositional negativity-the tendency to experience more frequent or intense negative emotions-is a fundamental dimension of temperament and personality. Elevated levels of dispositional negativity have profound consequences for public health and wealth, drawing the attention of researchers, clinicians, and policymakers. Yet, relatively little is known about the factors that govern the momentary expression of dispositional negativity in the real world. Here, we used smart phone-based experience-sampling to demonstrate that the social environment plays a central role in shaping the moment-by-moment emotional experience of 127 young adults selectively recruited to represent a broad spectrum of dispositional negativity. Results indicate that individuals with a more negative disposition derive much larger emotional benefits from the company of close companions-friends, romantic partners, and family members-and that these benefits reflect heightened feelings of social connection and acceptance. These results set the stage for developing improved interventions and provide new insights into the interaction of emotional traits and situations in the real world, close to clinically and practically important end-points. (PsycINFO Database Record


Shaw, Jordan A.; Bryant, Lauren K.; Malle, Bertram F.; Povinelli, Daniel J.; Pruett, John R. (2017): The relationship between joint attention and theory of mind in neurotypical adults.

In: Consciousness and cognition 51, S. 268–278. DOI: 10.1016/j.concog.2017.02.012.

Joint attention (JA) is hypothesized to have a close relationship with developing theory of mind (ToM) capabilities. We tested the co-occurrence of ToM and JA in social interactions between adults with no reported history of psychiatric illness or neurodevelopmental disorders. Participants engaged in an experimental task that encouraged nonverbal communication, including JA, and also ToM activity. We adapted an in-lab variant of experience sampling methods (Bryant et al., 2013) to measure ToM during JA based on participants’ subjective reports of their thoughts while performing the task. This experiment successfully elicited instances of JA in 17/20 dyads. We compared participants’ thought contents during episodes of JA and non-JA. Our results suggest that, in adults, JA and ToM may occur independently.


Shernoff, David J.; Sannella, Alexander J.; Schorr, Roberta Y.; Sanchez-Wall, Lina; Ruzek, Erik A.; Sinha, Suparna; Bressler, Denise M. (2017): Separate worlds. The influence of seating location on student engagement, classroom experience, and performance in the large university lecture hall.

In: J Environ Psychol 49, S. 55–64. DOI: 10.1016/j.jenvp.2016.12.002.

The purpose of this study was to examine the influence of students’ seating location in a large, lecture-style university course on student engagement, attention, classroom learning experience, and course performance. Participants (N = 407) were students in two cohorts of an undergraduate financial accounting course at a large university in the United States. They participated in the Experience Sampling Method measuring their self-reported seating location, engagement, attention, and other experiential dimensions throughout the one-semester course. Results showed that students reported lower engagement, attention, and quality of classroom experience when sitting in the back of the classroom than when sitting in the middle or front. Those sitting in the back of the classroom most of the time also received lower course grades. Engagement, attention, and other experiential factors mediated the influence of seating location on course grade. Multilevel models revealed both within-student and between-student effects of seating on classroom experience. (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 29 (7), S. 926–934. 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


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


Smiley, Sabrina L.; Elmasry, Hoda; Webb Hooper, Monica; 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: JMIR research protocols 6 (2), e9. DOI: 10.2196/resprot.6520.

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 (rho 0.84, P<.001) as well as sexts sent and received queries (rho 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.


Smyth, Joshua M.; Zawadzki, Matthew J.; Juth, Vanessa; Sciamanna, Christopher N. (2017): Global life satisfaction predicts ambulatory affect, stress, and cortisol in daily life in working adults.

In: Journal of behavioral medicine 40 (2), S. 320–331. DOI: 10.1007/s10865-016-9790-2.

Global life satisfaction has been linked with long-term health advantages, yet how life satisfaction impacts the trajectory of long-term health is unclear. This paper examines one such possible mechanism—that greater life satisfaction confers momentary benefits in daily life that accumulate over time. A community sample of working adults (n = 115) completed a measure of life satisfaction and then three subsequent days of ecological momentary assessment surveys (6 times/day) measuring affect (i.e., emotional valence, arousal), and perceived stress, and also provided salivary cortisol samples. Multilevel models indicated that people with higher (vs. lower) levels of life satisfaction reported better momentary affect, less stress, marginally lower momentary levels and significantly altered diurnal slopes of cortisol. Findings suggest individuals with high global life satisfaction have advantageous daily experiences, providing initial evidence for potential mechanisms through which global life satisfaction may help explain long-term health benefits. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Snippe, Evelien; Jeronimus, Bertus F.; Aan Het Rot, Marije; Bos, Elisabeth H.; Jonge, Peter; 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.


Snippe, Evelien; Viechtbauer, Wolfgang; Geschwind, Nicole; Klippel, Annelie; Jonge, Peter; Wichers, Marieke (2017): The Impact of Treatments for Depression on the Dynamic Network Structure of Mental States. Two Randomized Controlled Trials.

In: Scientific reports 7, S. 46523. DOI: 10.1038/srep46523.

Evidence is growing that vulnerability to depression may be characterized by strong negative feedback loops between mental states. It is unknown whether such dynamics between mental states can be altered by treatment. This study examined whether treatment with imipramine or treatment with Mindfulness-Based Cognitive Therapy (MBCT) reduces the connectivity within dynamic networks of mental states in individuals with depressive symptoms. In the Imipramine trial, individuals diagnosed with major depression were randomized to imipramine treatment or placebo-pill treatment (n = 50). In the Mind-Maastricht trial, individuals with residual depressive symptoms were randomized to Mindfulness-Based Cognitive Therapy (MBCT) or to a waiting-list control condition (n = 119). Lagged associations among mental states, as assessed with the Experience Sampling Method (ESM), were estimated at baseline and post-intervention. The results show that few of the dynamic network connections changed significantly over time and few of the changes after MBCT and imipramine treatment differed significantly from the control groups. The decrease in average node connectivity after MBCT did not differ from the decrease observed in the waiting-list control group. Our findings suggest that imipramine treatment and MBCT do not greatly change the dynamic network structure of mental states, even though they do reduce depressive symptomatology.


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.


Sosnowska, Joanna; Hofmans, Joeri; Fruyt, Filip (2017): Relating emotional arousal to work vigour. A dynamic systems perspective.

In: Pers Individ Dif. DOI: 10.1016/j.paid.2017.06.040.

We examined the emotional basis of work engagement by focusing on the relationship between arousal and work vigour. Drawing on the DynAff model of Kuppens, Oravecz, and Tuerlinckx (2010), we looked at three elements underlying the temporal dynamics of arousal: (1) the level of baseline arousal (i.e., the attractor state around which arousal fluctuates), (2) the amount of variability in arousal around this baseline, and (3) the swiftness with which people return to their arousal baseline once they deviated from it. We conducted a five-day experience sampling study, in which 88 employees reported on their momentary core affect (i.e., their momentary level of valence and arousal), while vigour was measured at the end of the study. Results showed that higher levels of baseline arousal were related to increased levels of vigour. Furthermore, we found that baseline arousal interacted with arousal variability in the sense that only people with low levels of baseline arousal and low levels of arousal variability experienced lower levels of vigour. Together, our findings suggest that, if we want to advance our understanding of the emotional basis of work engagement, we need to look into the temporal dynamics underlying it. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


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.


Steffens, Jochen; Steele, Daniel; Guastavino, Catherine (2017): Situational and person-related factors influencing momentary and retrospective soundscape evaluations in day-to-day life.

In: The Journal of the Acoustical Society of America 141 (3), S. 1414. DOI: 10.1121/1.4976627.

Soundscape research draws on both experiments conducted in laboratory settings and studies in the field to explore peoples’ perception and understanding of their acoustic environments. One opportunity to combine the strength of both approaches is the so-called Experience Sampling Method (ESM). This method was used to investigate the influence of situational and person-related variables on soundscape evaluations. Further, the relationship between momentary and retrospective soundscape judgments was explored. In the course of the 7-day ESM study, 32 participants were prompted ten times per day by a smartphone application to evaluate their soundscape and report on situational factors. Additionally, they performed summary retrospective judgments evaluating the whole of each day and their whole week. Upon completion, an exit interview probed personality traits (e.g., Big Five, information processing styles). Results revealed that both situational and person-related factors significantly contributed to the judgments of three soundscape dimensions (pleasantness, eventfulness, familiarity). Retrospective judgments of soundscape pleasantness were not only the average of the momentary judgments, but were also affected by the peak moment, the linear trend of the experience, and a person’s mood while performing the judgment. Hence, the study provides valuable insights into the complex structure of momentary and retrospective soundscape evaluations.


Stein, Jeffrey S.; Sze, Yan Yan; Athamneh, Liqa; Koffarnus, Mikhail N.; Epstein, Leonard H.; Bickel, Warren K. (2017): Think fast. Rapid assessment of the effects of episodic future thinking on delay discounting in overweight/obese participants.

In: Journal of behavioral medicine. DOI: 10.1007/s10865-017-9857-8.

Accumulating laboratory-based evidence indicates that reducing delay discounting (devaluation of delayed outcomes) with the use of episodic future thinking (EFT; mental simulation of future events) improves dietary decision-making and other maladaptive behaviors. Recent work has adapted EFT for use in the natural environment to aid in dietary and weight control by engaging participants in EFT repeatedly throughout the day. These efforts may benefit from minimizing the amount of time required for measurement and implementation of EFT. Using Amazon Mechanical Turk in the present study, we show that EFT effectively reduces delay discounting in overweight/obese participants (N = 131) using the recently developed 5-trial, adjusting-delay discounting task, which can be completed rapidly (25 s) and is therefore ideally suited for ecological momentary assessment. Moreover, measures of delay discounting from this task were strongly correlated with those from the commonly used adjusting-amount task (r = .859). Significant effects of EFT on discounting, however, depended on the number of future events participants generated and imagined. Use of a range of events and future time frames (as is typical in the literature) significantly reduced delay discounting, whereas use of only a single event did not.


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 5x/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.


Sultson, Hedvig; Kukk, Katrin; Akkermann, Kirsti (2017): Positive and negative emotional eating have different associations with overeating and binge eating. Construction and validation of the Positive-Negative Emotional Eating Scale.

In: Appetite 116, S. 423–430. DOI: 10.1016/j.appet.2017.05.035.

Research on emotional eating mostly focuses on negative emotions. Much less is known about how positive emotions relate to overeating and binge eating (BE). The aim of the current study was to construct a scale for positive and negative emotional eating and to assess its predictive validity. In study 1, the Positive-Negative Emotional Eating Scale (PNEES) was constructed and tested on 531 women, who also completed Eating Disorders Assessment Scale (EDAS). Results showed that a two-factor model constituting Positive emotional eating (PNEES-P) and Negative emotional eating (PNEES-N) fit the data well. PNEES-N also showed good convergent validity in assessing binge eating, correlating highly with EDAS subscale Binge eating. Further, a path analysis showed that after controlling for the mediating effect of PNEES-N, PNEES-P continued to significantly predict binge eating. In study 2 (N = 60), experience sampling method was used to assess overeating and BE in the natural environment. Palmtop computers were given to participants for a three-day study period that prompted them with questions regarding emotional experience, overeating, and BE. Results indicated that PNEES-P significantly predicted overeating, whereas PNEES-N predicted overeating and BE episodes only in a subsample of women who had experienced at least one overeating or BE episode. Thus, positive and negative emotional eating might have different relations with overeating and BE, with the latter being more characteristic of the severity/frequency of overeating and BE. New assessment tools that in addition to negative emotional eating also address positive emotional eating could be of potential help in planning intervention. Further, the tendency to overeat in response to positive emotions could be integrated into current models of eating disorders, especially when addressing relapse prevention.


Tarantola, Melissa E.; Heath, Andrew C.; Sher, Kenneth J.; Piasecki, Thomas M. (2017): WISDM Primary and Secondary Dependence Motives. Associations With Smoking Rate, Craving, and Cigarette Effects in the Natural Environment.

In: Nicotine & tobacco research : official journal of the Society for Research on Nicotine and Tobacco. DOI: 10.1093/ntr/ntx027.

Introduction: The Wisconsin Inventory of Smoking Dependence Motives (WISDM) is a multidimensional measure of smoking motives that was developed to facilitate research aiming to refine the nomological network surrounding tobacco dependence. Recent evidence suggests that a composite of four subscales, termed the Primary Dependence Motives (PDM), may represent core features of advanced addiction, while the remaining nine subscales (Secondary Dependence Motives; SDM) represent instrumental motives for cigarette use that may be relevant at any stage of smoking. Methods: A sample of 255 smokers (all regular alcohol users) participated in an ecological momentary assessment study in which they monitored smoking behavior and related experiences for 21 days. Multilevel regression analyses tested how PDM and SDM predicted daily smoking rate, cigarette craving, and appraisals of pleasure and relief of unpleasant feelings from smoking. Results: When PDM and SDM were entered simultaneously, only PDM was related to daily cigarette count, and only SDM predicted reports of craving and relief from unpleasant feelings from smoking. SDM was associated with reports of greater pleasure from smoking and PDM was associated with lower pleasure ratings. The Fagerstrom Test for Nicotine Dependence (FTND) was related to daily smoking rate and craving, but WISDM composites contributed incremental prediction. Conclusions: The findings confirm that PDM indexes heavier use that is relatively unrelated to immediate consequences of smoking. SDM is not uniquely related to smoking heaviness, but is associated with craving and reports of pleasure and relief of unpleasant feelings derived from smoking during ad lib use. Implications: This study extends the evidence for the distinction between the WISDM PDM and SDM. PDM scores are associated with heavier smoking and are relatively unrelated to immediate consequences of smoking. SDM is more strongly related to craving and reports of smoking-derived pleasure and relief of unpleasant feelings during ongoing use in daily life.


Taylor, Hugh S.; Giudice, Linda C.; Lessey, Bruce A.; Abrao, Mauricio S.; Kotarski, Jan; Archer, David F. et al. (2017): Treatment of Endometriosis-Associated Pain with Elagolix, an Oral GnRH Antagonist.

In: The New England journal of medicine 377 (1), S. 28–40. DOI: 10.1056/NEJMoa1700089.

BACKGROUND: Endometriosis is a chronic, estrogen-dependent condition that causes dysmenorrhea and pelvic pain. Elagolix, an oral, nonpeptide, gonadotropin-releasing hormone (GnRH) antagonist, produced partial to nearly full estrogen suppression in previous studies. METHODS: We performed two similar, double-blind, randomized, 6-month phase 3 trials (Elaris Endometriosis I and II [EM-I and EM-II]) to evaluate the effects of two doses of elagolix – 150 mg once daily (lower-dose group) and 200 mg twice daily (higher-dose group) – as compared with placebo in women with surgically diagnosed endometriosis and moderate or severe endometriosis-associated pain. The two primary efficacy end points were the proportion of women who had a clinical response with respect to dysmenorrhea and the proportion who had a clinical response with respect to nonmenstrual pelvic pain at 3 months. Each of these end points was measured as a clinically meaningful reduction in the pain score and a decreased or stable use of rescue analgesic agents, as recorded in a daily electronic diary. RESULTS: A total of 872 women underwent randomization in Elaris EM-I and 817 in Elaris EM-II; of these women, 653 (74.9%) and 632 (77.4%), respectively, completed the intervention. At 3 months, a significantly greater proportion of women who received each elagolix dose met the clinical response criteria for the two primary end points than did those who received placebo. In Elaris EM-I, the percentage of women who had a clinical response with respect to dysmenorrhea was 46.4% in the lower-dose elagolix group and 75.8% in the higher-dose elagolix group, as compared with 19.6% in the placebo group; in Elaris EM-II, the corresponding percentages were 43.4% and 72.4%, as compared with 22.7% (P<0.001 for all comparisons). In Elaris EM-I, the percentage of women who had a clinical response with respect to nonmenstrual pelvic pain was 50.4% in the lower-dose elagolix group and 54.5% in the higher-dose elagolix group, as compared with 36.5% in the placebo group (P<0.001 for all comparisons); in Elaris EM-II, the corresponding percentages were 49.8% and 57.8%, as compared with 36.5% (P=0.003 and P<0.001, respectively). The responses with respect to dysmenorrhea and nonmenstrual pelvic pain were sustained at 6 months. Women who received elagolix had higher rates of hot flushes (mostly mild or moderate), higher levels of serum lipids, and greater decreases from baseline in bone mineral density than did those who received placebo; there were no adverse endometrial findings. CONCLUSIONS: Both higher and lower doses of elagolix were effective in improving dysmenorrhea and nonmenstrual pelvic pain during a 6-month period in women with endometriosis-associated pain. The two doses of elagolix were associated with hypoestrogenic adverse effects. (Funded by AbbVie; Elaris EM-I and EM-II numbers, NCT01620528 and NCT01931670 .).


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.


Thai, Sabrina; Page-Gould, Elizabeth (2017): ExperienceSampler. An Open-Source Scaffold for Building Smartphone Apps for Experience Sampling.

In: Psychological methods. DOI: 10.1037/met0000151.

Experience sampling methods allow researchers to examine phenomena in daily life and provide various advantages that complement traditional laboratory methods. However, existing experience sampling methods may be costly, require constant Internet connectivity, may not be designed specifically for experience sampling studies, or require a custom solution from a computer programming consultant. In this article, we present ExperienceSampler, an open-source scaffold for creating experience-sampling smartphone apps designed for Android and iOS devices. We designed ExperienceSampler to address the common barriers to using experience sampling methods. First, there is no cost to the user. Second, ExperienceSampler apps make use of local notifications to let participants know when to complete surveys and store the data locally until Internet connection is available. Third, our app scaffold was designed with experience sampling methodological issues in mind. We also demonstrate how researchers can easily customize ExperienceSampler even if they have no programming skills. Furthermore, we evaluate the utility of ExperienceSampler apps with results from one social psychological study conducted using ExperienceSampler (N = 168). Mean response rates averaged 84%, and the median response latency was 9 minutes. Taken together, ExperienceSampler creates cost-effective smartphone apps that can be easily customized by researchers to examine experiences in daily life. (PsycINFO Database Record


Thornton, Mark A.; Tamir, Diana I. (2017): Mental models accurately predict emotion transitions.

In: Proceedings of the National Academy of Sciences of the United States of America 114 (23), S. 5982–5987. DOI: 10.1073/pnas.1616056114.

Successful social interactions depend on people’s ability to predict others’ future actions and emotions. People possess many mechanisms for perceiving others’ current emotional states, but how might they use this information to predict others’ future states? We hypothesized that people might capitalize on an overlooked aspect of affective experience: current emotions predict future emotions. By attending to regularities in emotion transitions, perceivers might develop accurate mental models of others’ emotional dynamics. People could then use these mental models of emotion transitions to predict others’ future emotions from currently observable emotions. To test this hypothesis, studies 1-3 used data from three extant experience-sampling datasets to establish the actual rates of emotional transitions. We then collected three parallel datasets in which participants rated the transition likelihoods between the same set of emotions. Participants’ ratings of emotion transitions predicted others’ experienced transitional likelihoods with high accuracy. Study 4 demonstrated that four conceptual dimensions of mental state representation-valence, social impact, rationality, and human mind-inform participants’ mental models. Study 5 used 2 million emotion reports on the Experience Project to replicate both of these findings: again people reported accurate models of emotion transitions, and these models were informed by the same four conceptual dimensions. Importantly, neither these conceptual dimensions nor holistic similarity could fully explain participants’ accuracy, suggesting that their mental models contain accurate information about emotion dynamics above and beyond what might be predicted by static emotion knowledge alone.


Timm, Christina; Ubl, Bettina; Zamoscik, Vera; Ebner-Priemer, Ulrich; Reinhard, Iris; Huffziger, Silke et al. (2017): Cognitive and affective trait and state factors influencing the long-term symptom course in remitted depressed patients.

In: PloS one 12 (6), e0178759. DOI: 10.1371/journal.pone.0178759.

BACKGROUND: Major depressive disorder (MDD) is characterized by a high risk for relapses and chronic developments. Clinical characteristics such as residual symptoms have been shown to negatively affect the long-term course of MDD. However, it is unclear so far how trait repetitive negative thinking (RNT) as well as cognitive and affective momentary states, the latter experienced during daily-life, affect the long-term course of MDD. METHOD: We followed up 57 remitted depressed (rMDD) individuals six (T2) and 36 (T3) months after baseline. Clinical outcomes were time to relapse, time spent with significant symptoms as a marker of chronicity, and levels of depressive symptoms at T2 and T3. Predictors assessed at baseline included residual symptoms and trait RNT. Furthermore, momentary daily life affect and momentary rumination, and their variation over the day were assessed at baseline using ambulatory assessment (AA). RESULTS: In multiple models, residual symptoms and instability of daily-life affect at baseline independently predicted a faster time to relapse, while chronicity was significantly predicted by trait RNT. Multilevel models revealed that depressive symptom levels during follow-up were predicted by baseline residual symptom levels and by instability of daily-life rumination. Both instability features were linked to a higher number of anamnestic MDD episodes. CONCLUSIONS: Our findings indicate that trait RNT, but also affective and cognitive processes during daily life impact the longer-term course of MDD. Future longitudinal research on the role of respective AA-phenotypes as potential transdiagnostic course-modifiers is warranted.


Touitou, Yvan; Touitou, David; Reinberg, Alain (2017): Disruption of adolescents’ circadian clock. The vicious circle of media use, exposure to light at night, sleep loss and risk behaviors.

In: Journal of physiology, Paris. DOI: 10.1016/j.jphysparis.2017.05.001.

Although sleep is a key element in adolescent development, teens are spending increasing amounts of time online with health risks related to excessive use of electronic media (computers, smartphones, tablets, consoles…) negatively associated with daytime functioning and sleep outcomes. Adolescent sleep becomes irregular, shortened and delayed in relation with later sleep onset and early waking time due to early school starting times on weekdays which results in rhythm desynchronization and sleep loss. In addition, exposure of adolescents to the numerous electronic devices prior to bedtime has become a great concern because LEDs emit much more blue light than white incandescent bulbs and compact fluorescent bulbs and have therefore a greater impact on the biological clock. A large number of adolescents move to evening chronotype and experience a misalignment between biological and social rhythms which, added to sleep loss, results in e.g. fatigue, daytime sleepiness, behavioral problems and poor academic achievement. This paper on adolescent circadian disruption will review the sensitivity of adolescents to light including LEDs with the effects on the circadian system, the crosstalk between the clock and the pineal gland, the role of melatonin, and the behavior of some adolescents(media use, alcohol consumption, binge drinking, smoking habits, stimulant use…). Lastly, some practical recommendations and perspectives are put forward. The permanent social jet lag resulting in clock misalignment experienced by a number of adolescents should be considered as a matter of public health.


Treloar, Hayley; Miranda, Robert (2017): Craving and Acute Effects of Alcohol in Youths’ Daily Lives. Associations With Alcohol Use Disorder Severity.

In: Experimental and clinical psychopharmacology. DOI: 10.1037/pha0000133.

Identifying factors associated with the progression from recreational to pathological drinking in youth holds high clinical and theoretical importance. The present study tested cross-sectional associations of alcohol use disorder (AUD) severity with putative mechanisms of AUD progression among youth ages 15-24 years, namely acute subjective effects of alcohol and craving. Male (n = 44) and female (n = 42) youth completed ecological momentary assessments when not drinking, just before drinking, and while drinking in the natural environment via handheld wireless devices. Youth were recruited from the community and were frequent and heavy drinkers, the majority (93%) with at least 1 AUD symptom (M = 3.4, SD = 2.4). Findings from youths’ daily lives suggested that how youth feel while they drink depends, in part, on their severity of AUD pathology. In support of hypotheses, youths with more progressed drinking pathology (i.e., those with more symptoms of AUD) reported greater reductions in craving and tension while drinking, relative to nondrinking times. In partial support of hypotheses, males with greater AUD symptomatology reported marginally attenuated increases in stimulatory states while drinking; however, contrary to hypotheses, females with greater AUD symptomatology reported enhanced increases in stimulation while drinking. This research leveraged ecological momentary assessment methods to study subjective responses to alcohol and craving in youths’ daily lives and to cross-sectionally test putative associations with AUD etiology. This work adds to literature supporting subjective responses to alcohol in the pathogenesis of alcoholism, specifically by highlighting their importance during the period in life when alcohol problems typically first emerge. (PsycINFO Database Record


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, Brianna J.; Wakefield, Matthew A.; Gratz, Kim L.; Chapman, Alexander L. (2017): Characterizing Interpersonal Difficulties Among Young Adults Who Engage in Nonsuicidal Self-Injury Using a Daily Diary.

In: Behavior therapy 48 (3), S. 366–379. DOI: 10.1016/j.beth.2016.07.001.

Compared to people who have never engaged in nonsuicidal self-injury (NSSI), people with a history of NSSI report multiple interpersonal problems. Theories propose that these interpersonal difficulties play a role in prompting and maintaining NSSI. The cross-sectional nature of most studies in this area limits our understanding of how day-to-day interpersonal experiences relate to the global interpersonal impairments observed among individuals with NSSI, and vice versa. This study compared young adults with (n=60) and without (n=56) recent, repeated NSSI on baseline and daily measures of interpersonal functioning during a 14-day daily diary study. Groups differed in baseline social anxiety, excessive reassurance seeking, and use of support seeking relative to other coping strategies, but did not differ in self-perceived interpersonal competence. In terms of day-to-day functioning, participants with (vs. without) NSSI had significantly less contact with their families and friends, perceived less support following interactions with friends, and were less likely to seek support to cope, regardless of level of negative affect. With the exception of contact with family members, these group differences in daily interpersonal functioning were accounted for by baseline levels of social anxiety and use of support seeking. Contrary to expectations, participants with NSSI had more frequent contact with their romantic partners, did not differ in perceptions of support in romantic relationships, and did not report more intense negative affect following negative interpersonal interactions. This study provides a novel test of recent interpersonal theories of NSSI using daily reports.


Udachina, A.; Bentall, R. P.; Varese, F.; Rowse, G. (2017): Stress sensitivity in paranoia. Poor-me paranoia protects against the unpleasant effects of social stress.

In: Psychological medicine, S. 1–10. DOI: 10.1017/S0033291717001362.

BACKGROUND: The attributional theory of paranoia suggests that paranoid beliefs may protect individuals from low self-esteem and distress (Bentall et al. 2001). The current study tested this theory by investigating a hypothesis that paranoid beliefs in combination with low perceived deservedness of persecution (poor-me beliefs) confer protection against the distress caused by social but not activity related stress. METHODS: Paranoid symptoms, perceived deservedness of persecution, self-esteem, mood, and stress levels of individuals diagnosed with schizophrenia spectrum disorders (N = 91) and healthy controls (N = 52) were assessed in the context of daily life using the experience sampling method. RESULTS: Individuals holding poor-me beliefs (poor-me individuals) showed blunted sensitivity to social but not activity stress. In contrast, individuals holding paranoid beliefs in combination with high perceived deservedness of persecution (bad-me individuals) showed heightened sensitivity to social stress. No consistent differences in reactions to activity stress emerged. Although both poor-me and bad-me individuals reported low self-esteem, this disturbance was particularly characteristic of bad-me individuals. CONCLUSIONS: The results suggest that poor-me paranoid beliefs may protect individuals against the distress associated with unpleasant social situations. The specificity of reactions to social stress is discussed in the context of wider literature. Future directions for research are suggested.


van den Akker, Karolien; Havermans, Remco C.; Jansen, Anita (2017): Appetitive conditioning to specific times of day.

In: Appetite 116, S. 232–238. DOI: 10.1016/j.appet.2017.05.014.

Human laboratory studies have shown that eating desires are easily learned through classical conditioning: after a few pairings of an initially neutral stimulus (e.g., a box) with the intake of palatable food (e.g., chocolate), the stimulus elicits increased eating expectancies and eating desires (acquisition). After repeated non-reinforced presentations of the chocolate-associated stimulus, eating expectancies and desires decrease again (extinction). It is commonly assumed that eating desires in daily life are acquired and extinguished in a similar manner, but to date, this has not been empirically tested. In two studies, we examined whether the repeated consumption of chocolate at a specific time of day elicits increased eating expectancies and eating desires over a period of 5 days (study 1) or 15 days (study 2), and relative to a time of day not paired with chocolate intake. Further, it was tested whether acquired responding diminishes again during extinction (study 1). Ecological momentary assessment was used to carry out the studies in daily life. Results showed that eating expectancies were acquired in both studies. Only in study 2, eating desires were also successfully learned. It is concluded that eating expectancies and eating desires can be conditioned to ecologically valid cues and under real-life circumstances. This highlights the importance of associative learning processes in the experience of eating desires in daily life.


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 136 (1), S. 63–73. 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.; 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.


van Os, Jim; Verhagen, Simone; Marsman, Anne; Peeters, Frenk; Bak, Maarten; Marcelis, Machteld et al. (2017): The experience sampling method as an mHealth tool to support self-monitoring, self-insight, and personalized health care in clinical practice.

In: Depression and anxiety 34 (6), S. 481–493. DOI: 10.1002/da.22647.

BACKGROUND: The experience sampling method (ESM) builds an intensive time series of experiences and contexts in the flow of daily life, typically consisting of around 70 reports, collected at 8-10 random time points per day over a period of up to 10 days. METHODS: With the advent of widespread smartphone use, ESM can be used in routine clinical practice. Multiple examples of ESM data collections across different patient groups and settings are shown and discussed, varying from an ESM evaluation of a 6-week randomized trial of mindfulness, to a twin study on emotion dynamics in daily life. RESULTS: Research shows that ESM-based self-monitoring and feedback can enhance resilience by strengthening the capacity to use natural rewards. Personalized trajectories of starting or stopping medication can be more easily initiated and predicted if sensitive feedback data are available in real time. In addition, personalized trajectories of symptoms, cognitive abilities, symptoms impacting on other symptoms, the capacity of the dynamic system of mental health to “bounce back” from disturbance, and patterns of environmental reactivity yield uniquely personal data to support shared decision making and prediction in clinical practice. Finally, ESM makes it possible to develop insight into previous implicit patterns of thought, experience, and behavior, particularly if rapid personalized feedback is available. CONCLUSIONS: ESM enhances clinical practice and research. It is empowering, providing co-ownership of the process of diagnosis, treatment evaluation, and routine outcome measurement. Blended care, based on a mix of face-to-face and ESM-based outside-the-office treatment, may reduce costs and improve outcomes.


van Roekel, Eeske; Verhagen, Maaike; Engels, Rutger C. M. E.; Kuppens, Peter (2017): Variation in the Serotonin Transporter Polymorphism (5-HTTLPR) and Inertia of Negative and Positive Emotions in Daily Life.

In: Emotion (Washington, D.C.). DOI: 10.1037/emo0000336.

An important element of understanding the genotype–phenotype link in psychiatric disorders lies in identifying the psychological mechanisms through which genetic variation impacts mental health. Here we examined whether emotional inertia, the tendency for a person’s emotions to carry over from 1 moment to the next and a prospective predictor of the development of depression, is associated with a known genetic risk factor for emotional dysregulation, a polymorphism in the serotonin transporter gene (5-HTTLPR). Two hundred thirty-six adolescents recorded their positive and negative emotions in daily life 9 times a day for 6 consecutive days using smartphones, completed a depression questionnaire, and were genotyped for the 5-HTTLPR polymorphism. Carriers of the short 5-HTTLPR were characterized by higher inertia for negative emotions, even after controlling for depressive symptoms. These findings suggest a possible psychological pathway how the serotonin transporter gene contributes to risk for depression. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


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.


Vogel, Nina; Ram, Nilam; Conroy, David E.; Pincus, Aaron L.; Gerstorf, Denis (2017): How the social ecology and social situation shape individuals’ affect valence and arousal.

In: Emotion (Washington, D.C.) 17 (3), S. 509–527. DOI: 10.1037/emo0000244.

Many theories highlight the role social contexts play in shaping affective experience. However, little is known about how individuals’ social environments influence core affect on short time-scales (e.g., hours). Using experience sampling data from the iSAHIB, wherein 150 adults aged 18 to 89 years reported on 64,213 social interactions (average 6.92 per day, SD = 2.85) across 9 weeks of daily life, we examined how 4 features of individuals’ social ecology (between-person differences) and immediate social situations (within-person changes) were associated with core affect—valence and arousal—and how those associations differ with age. Results from multilevel models revealed that familiarity, importance, type of social partner, and gender composition of the social context were associated with affect valence and/or affect arousal. Higher familiarity, higher importance, and same-gender composition were associated with more positive affect valence and higher arousal. Interactions with family and friends were linked to more positive valence whereas nonfamily social partners were linked to higher arousal. Age moderated the associations between importance and affect arousal, and between type of social partner and both dimensions of core affect. Findings align with theoretical propositions, contributing to but also suggesting need for further precision regarding how development shapes the interplay between social context and moment-to-moment affective experience. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Weinstein, Netta; Legate, Nicole; Ryan, William S.; Sedikides, Constantine; Cozzolino, Philip J. (2017): Autonomy Support for Conflictual and Stigmatized Identities. Effects on Ownership and Psychological Health.

In: Journal of counseling psychology. DOI: 10.1037/cou0000224.

Important others’ perceptions influence self-perceptions. This presents a challenge for the critical developmental task of integrating all aspects of identity, as identities that are devalued or stigmatized by society are harder to own than valued ones. Across 3 studies, we tested the idea that conflictual or stigmatized identities are harder to own, or integrate into the self, than are nonconflictual ones, and we examine how receiving autonomy support for an identity-support for authentic identity exploration and expression-can facilitate ownership of that identity. Cross-sectional (n = 543), experience-sampling (n = 66), and experimental methods (n = 209) tested the dynamics of autonomy-supportive others on identity ownership. Data from these studies converge to show that conflictual identities are indeed harder to own than nonconflictual ones, but that autonomy support predicts greater ownership and psychological health, especially for conflictual identities. In the final study, we replicate these dynamics in 3 identities stigmatized by society: sexual minority, ethnic minority, and gender minority identities. Findings reveal the importance of integrating all aspects of identity-particularly those that are conflictual or stigmatized-into one’s self-concept. We consider implications for counseling and clinical practice, as well as broadly for the psychological health of stigmatized individuals. (PsycINFO Database Record


Weiss, Matthias; Razinskas, Stefan; Backmann, Julia; Hoegl, Martin (2017): Authentic leadership and leaders’ mental well-being. An experience sampling study.

In: Leadersh Q. DOI: 10.1016/j.leaqua.2017.05.007.

Research on authentic leadership has yielded important insights about its effects on subordinates. However, its consequences for the leaders themselves remain largely unexamined. This is problematic, as organizations require their leaders to provide guidance and leaders’ mental well-being is a prerequisite for this. Drawing on the theories of ego-depletion and authentic leadership, we investigate the role of authentic leadership in predicting leaders’ mental well-being. In an experience sampling study, we apply hierarchical linear modeling to analyze 396 observations from 44 executives. Our multilevel moderated mediation analyses reveal that authentic leadership reduces leaders’ stress and increases their work engagement and that these effects are mediated by leader mental depletion. Moreover, we show that the indirect effects are contingent on the extent to which leaders interact with their subordinates: authentic leaders deplete less with increasing follower interaction, while inauthentic leaders deplete less with decreasing follower interaction. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


Wen, Cheng K. Fred; Schneider, Stefan; Stone, Arthur A.; Spruijt-Metz, Donna (2017): Compliance With Mobile Ecological Momentary Assessment Protocols in Children and Adolescents. A Systematic Review and Meta-Analysis.

In: Journal of medical Internet research 19 (4), e132. DOI: 10.2196/jmir.6641.

BACKGROUND: Mobile device-based ecological momentary assessment (mobile-EMA) is increasingly used to collect participants’ data in real-time and in context. Although EMA offers methodological advantages, these advantages can be diminished by participant noncompliance. However, evidence on how well participants comply with mobile-EMA protocols and how study design factors associated with participant compliance is limited, especially in the youth literature. OBJECTIVE: To systematically and meta-analytically examine youth’s compliance to mobile-EMA protocols and moderators of participant compliance in clinical and nonclinical settings. METHODS: Studies using mobile devices to collect EMA data among youth (age </=18 years old) were identified. A systematic review was conducted to describe the characteristics of mobile-EMA protocols and author-reported factors associated with compliance. Random effects meta-analyses were conducted to estimate the overall compliance across studies and to explore factors associated with differences in youths’ compliance. RESULTS: This review included 42 unique studies that assessed behaviors, subjective experiences, and contextual information. Mobile phones were used as the primary mode of EMA data collection in 48% (20/42) of the reviewed studies. In total, 12% (5/42) of the studies used wearable devices in addition to the EMA data collection platforms. About half of the studies (62%, 24/42) recruited youth from nonclinical settings. Most (98%, 41/42) studies used a time-based sampling protocol. Among these studies, most (95%, 39/41) prompted youth 2-9 times daily, for a study length ranging from 2-42 days. Sampling frequency and study length did not differ between studies with participants from clinical versus nonclinical settings. Most (88%, 36/41) studies with a time-based sampling protocol defined compliance as the proportion of prompts to which participants responded. In these studies, the weighted average compliance rate was 78.3%. The average compliance rates were not different between studies with clinical (76.9%) and nonclinical (79.2%; P=.29) and studies that used only a mobile-EMA platform (77.4%) and mobile platform plus additional wearable devices (73.0%, P=.36). Among clinical studies, the mean compliance rate was significantly lower in studies that prompted participants 2-3 times (73.5%) or 4-5 times (66.9%) compared with studies with a higher sampling frequency (6+ times: 89.3%). Among nonclinical studies, a higher average compliance rate was observed in studies that prompted participants 2-3 times daily (91.7%) compared with those that prompted participants more frequently (4-5 times: 77.4%; 6+ times: 75.0%). The reported compliance rates did not differ by duration of EMA period among studies from either clinical or nonclinical settings. CONCLUSIONS: The compliance rate among mobile-EMA studies in youth is moderate but suboptimal. Study design may affect protocol compliance differently between clinical and nonclinical participants; including additional wearable devices did not affect participant compliance. A more consistent compliance-related result reporting practices can facilitate understanding and improvement of participant compliance with EMA data collection among youth.


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


Wiese, Christopher W.; Tay, Louis; Duckworth, Angela L.; D’Mello, Sidney; Kuykendall, Lauren; Hofmann, Wilhelm et al. (2017): Too much of a good thing? Exploring the inverted-U relationship between self-control and happiness.

In: Journal of personality. DOI: 10.1111/jopy.12322.

OBJECTIVE: Can having too much self-control make people unhappy? Researchers have increasingly questioned the unilateral goodness of self-control and proposed that it is beneficial only up to a certain point, after which it becomes detrimental. The little empirical research on the issue shows mixed results. Hence, we tested whether a curvilinear relationship between self-control and subjective well-being exists. METHOD: We used multiple metrics (questionnaires, behavioral ratings), sources (self-report, other-report), and methods (cross-sectional measurement, dayreconstruction method, experience sampling method) across six studies (Ntotal = 5,318). RESULTS: We found that self-control positively predicted subjective well-being (cognitive and affective), but there was little evidence for an inverted U-shaped curve. The results held after statistically controlling for demographics and other psychological confounds. CONCLUSION: Our main finding is that self-control enhances subjective well-being with little to no apparent downside of too much self-control.


Wiinberg, Stig; Samuelsson, Goran; Larsson, Stefan; Nilsson, Barbro; Jonsson, Patrik X.; Ivarsson, Bodil; Olofsson, Per-Ake (2017): Questionnaire-based evaluation of mobile phone interference with medical-electrical equipment in Swedish hospitals.

In: Technology and health care : official journal of the European Society for Engineering and Medicine. DOI: 10.3233/THC-170810.

National recommendations in Sweden recommend a safety distance of 3 m between mobile phones and medical-electrical (ME) equipment in hospitals. A questionnaire was used to investigate how often mobile phones were reported to interfere with ME products in clinical practice across Sweden. The results confirmed that ME equipment can be affected by mobile phone use but, the risk of the patient’s outcome being affected were minimal; no cases were identified which led to injury or death. In conclusion, the results support recommendations for a general safety distance of 0.5 m between mobile phones and ME equipment in care environments.


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.


Wright, Cassandra Jc; Dietze, Paul M.; Agius, Paul A.; Kuntsche, Emmanuel; Room, Robin; Livingston, Michael et al. (2017): An Ecological Momentary Intervention to Reduce Alcohol Consumption in Young Adults Delivered During Drinking Events. Protocol for a Pilot Randomized Controlled Trial.

In: JMIR research protocols 6 (5), e95. DOI: 10.2196/resprot.6760.

BACKGROUND: Risky drinking is a significant public health issue in young Australian adults. Brief interventions are one of few effective methods of reducing risky drinking but are time and cost intensive; innovative methods of delivery are therefore of interest. Mobile phones offer new opportunities to collect data and intervene during risky drinking events. Mobile phones have successfully been used for delivery of alcohol-related brief interventions and data collection but not in combination with or during drinking events. OBJECTIVE: This pilot study will investigate the efficacy of an ecological momentary intervention (EMI), with combined ecological momentary assessment (EMA) and brief intervention delivered by mobile phones to young adults during risky drinking events. METHODS: We will use a 3-armed randomized controlled trial to investigate the efficacy of the intervention for reducing peak single occasion drinking. Our sample is recruited from an observational cohort study of young, risky drinkers. Participants will be randomized into 1 of 3 intervention arms. On 6 nights across a 12-week study period, EMI and EMA groups will complete hourly EMA surveys on their mobile phone. EMI participants will receive tailored feedback short message service (SMS) texts corresponding to their EMA survey responses. The EMI participants will not receive feedback SMS. A third group will have no contact (no-contact control). All groups will then be contacted for a follow-up interview within 4 weeks of the 12-week study period ending. RESULTS: The primary outcome is mean reduction in standard drinks consumed during their most recent heavy drinking occasion as measured at follow-up. Secondary outcomes include alcohol consumption over the previous 6 months, experiences of alcohol-related harms, attitudes toward drinking and drunkenness, hazardous drinking and use of tobacco and illicit drugs. A random effects mixed modelling approach using maximum likelihood estimation will be used to provide estimates of differences in mean drinking levels between those receiving the intervention and control participants. CONCLUSIONS: This study is novel in that, unlike previous work, it will intervene repeatedly during single occasion drinking events. Further, it extends previous research in this area, which has applied limited tailoring of message content for SMS-based brief interventions. The findings of this study will contribute to the growing body of evidence to inform the use of mobile health interventions for reducing alcohol consumption and harms. TRIAL REGISTRATION: Australian New Zealand Clinical Trials ACTRN12616001323415; Trial/Registration/TrialReview.aspx?id=369534 (Archived by WebCite at 6qDqBZV9b).


Zenk, Shannon N.; Horoi, Irina; Jones, Kelly K.; Finnegan, Lorna; Corte, Colleen; Riley, Barth; Wilbur, JoEllen (2017): Environmental and personal correlates of physical activity and sedentary behavior in African American women. An ecological momentary assessment study.

In: Women Health 57 (4), S. 446–462. DOI: 10.1080/03630242.2016.1170093.

The authors of this study examined within-person associations of environmental factors (weather, built and social environmental barriers) and personal factors (daily hassles, affect) with moderate-to-vigorous physical activity (MVPA) and sedentary behavior (SB) in African American women aged 25–64 years living in metropolitan Chicago (n = 97). In 2012–13, for seven days, women wore an accelerometer and were signaled five times per day to complete a survey covering environmental and personal factors on a study-provided smartphone. Day-level measures of each were derived, and mixed regression models were used to test associations. Poor weather was associated with a 27.3% reduction in daily MVPA. Associations between built and social environmental barriers and daily MVPA or SB were generally not statistically significant. Negative affect at the first daily signal was associated with a 38.6% decrease in subsequent daily MVPA and a 33.2-minute increase in subsequent daily SB. Each one-minute increase in MVPA during the day was associated with a 2.2% higher likelihood of positive affect at the end of the day. SB during the day was associated with lower subsequent positive affect. Real-time interventions that address overcoming poor weather and negative affect may help African American women increase MVPA and/or decrease SB. (PsycINFO Database Record (c) 2017 APA, all rights reserved)


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