Society for Ambulatory Assessment

Second quarter 2013 (April to June)

Ainsworth, J., Palmier-Claus, J. E., Machin, M., Barrowclough, C., Dunn, G., Rogers, A. et al. (2013). A Comparison of two delivery modalities of a mobile phone-based assessment for serious mental illness: native smartphone application vs text-messaging only implementations. J Med Internet Res, 15, e60.

BACKGROUND: Mobile phone-based assessment may represent a cost-effective and clinically effective method of monitoring psychotic symptoms in real-time. There are several software options, including the use of native smartphone applications and text messages (short message service, SMS). Little is known about the strengths and limitations of these two approaches in monitoring symptoms in individuals with serious mental illness. OBJECTIVE: The objective of this study was to compare two different delivery modalities of the same diagnostic assessment for individuals with non-affective psychosis-a native smartphone application employing a graphical, touch user interface against an SMS text-only implementation. The overall hypothesis of the study was that patient participants with sewrious mental illness would find both delivery modalities feasible and acceptable to use, measured by the quantitative post-assessment feedback questionnaire scores, the number of data points completed, and the time taken to complete the assessment. It was also predicted that a native smartphone application would (1) yield a greater number of data points, (2) take less time, and (3) be more positively appraised by patient participant users than the text-based system. METHODS: A randomized repeated measures crossover design was employed. Participants with currently treated Diagnostic and Statistical Manual (Fourth Edition) schizophrenia or related disorders (n=24) were randomly allocated to completing 6 days of assessment (four sets of questions per day) with a native smartphone application or the SMS text-only implementation. There was then a 1-week break before completing a further 6 days with the alternative delivery modality. Quantitative feedback questionnaires were administered at the end of each period of sampling. RESULTS: A greater proportion of data points were completed with the native smartphone application in comparison to the SMS text-only implementation (beta = -.25, SE=.11, P=.02), which also took significantly less time to complete (beta =.78, SE= .09, P<.001). Although there were no significant differences in participants’ quantitative feedback for the two delivery modalities, most participants reported preferring the native smartphone application (67%; n=16) and found it easier to use (71%; n=16). 33% of participants reported that they would be willing to complete mobile phone assessment for 5 weeks or longer. CONCLUSIONS: Native smartphone applications and SMS text are both valuable methods of delivering real-time assessment in individuals with schizophrenia. However, a more streamlined graphical user interface may lead to better compliance and shorter entry times. Further research is needed to test the efficacy of this technology within clinical services, to assess validity over longer periods of time and when delivered on patients’ own phones

al’Absi, M., Khalil, N. S., Habori, M. A., Hoffman, R., Fujiwara, K., & Wittmers, L. (2013). Effects of chronic khat use on cardiovascular, adrenocortical, and psychological responses to stress in men and women. The American Journal on Addictions, 22, 99-107.

Background: Khat is a psychostimulant plant widely used in Africa and its use has been growing rapidly in Europe and North America. Objectives:We investigated effects of chronic khat (Catha edulis) use on cardiovascular, adrenocortical, and psychological responses to acute stress. Methods: Chronic khat users and nonusers were compared on physiological measures and mood reports in a crossΓÇÉsectional, mixed design. Measurements were conducted during 24ΓÇÉhour ambulatory monitoring and during a laboratory session. A total of 152 participants (58 women) were recruited by flyers posted around SanaΓÇÖa University campus and the surrounding community in SanaΓÇÖa, Yemen. Salivary cortisol and selfΓÇÉreport measures were collected during a 24ΓÇÉhour ambulatory period prior to a lab testing session. In addition, blood pressures (BP), salivary cortisol, and mood measures were assessed during rest and in response to acute mental stress. Results: Khat users exhibited enhanced evening and attenuated morning cortisol levels, reflecting a blunted diurnal pattern of adrenocortical activity compared to nonusers. Khat users reported greater negative affect during the ambulatory period and during the laboratory session. In addition, they exhibited attenuated BP responses to stress. Conclusions and Scientific Significance: These novel results demonstrate altered adrenocortical activity and increased dysphoric mood among khat users. The extent to which these associations are due to effects of chronic khat use per se or instead reflect predisposing risk factors for khat use is yet to be determined.

Albert, M. V., McCarthy, C., Valentin, J., Herrmann, M., Kording, K., & Jayaraman, A. (2013). Monitoring Functional Capability of Individuals with Lower Limb Amputations Using Mobile Phones. PLoS One, 8, e65340.

To be effective, a prescribed prosthetic device must match the functional requirements and capabilities of each patient. These capabilities are usually assessed by a clinician and reported by the Medicare K-level designation of mobility. However, it is not clear how the K-level designation objectively relates to the use of prostheses outside of a clinical environment. Here, we quantify participant activity using mobile phones and relate activity measured during real world activity to the assigned K-levels. We observe a correlation between K-level and the proportion of moderate to high activity over the course of a week. This relationship suggests that accelerometry-based technologies such as mobile phones can be used to evaluate real world activity for mobility assessment. Quantifying everyday activity promises to improve assessment of real world prosthesis use, leading to a better matching of prostheses to individuals and enabling better evaluations of future prosthetic devices

Bakker, A. B. & Daniels, K. (2013). A day in the life of a happy worker. New York, NY US: Psychology Press.

(from the cover) This edited collection brings together some of the leading researchers in the study of the daily experience of work and well-being. The book covers both theoretical and methodological issues involved in studying workers’ well-being as it evolves on an everyday basis. Interest in the topic of daily fluctuations in worker well-being has grown rapidly over the past ten years. This is partly because of advances in research methods and statistical interests, but also because researchers have found that the psychological processes that influence well-being play out from moment to moment, and from day to day. Topics covered in this book include: (1) the theoretical basis of studying work as a series of daily episodes; (2) assessment of different components of daily well-being; (3) factors involved in the regulation of well-being at work; (4) qualitative and quantitative diary experience sampling and event reconstruction methods; and (5) latent growth curve modeling of diary data. The final chapter of the book includes a preview of how daily methods may evolve in the future. Intended as a guide for researchers with good knowledge of field research methods, the book will be particularly useful to researchers of work-related phenomena that seek to expand their knowledge of dynamic methods in field contexts, and those that want to start using these methods. It will also be of interest to students of work psychology and organizational behavior, and related disciplines.

Bastawrous, A. & Armstrong, M. J. (2013). Mobile health use in low- and high-income countries: an overview of the peer-reviewed literature. J R Soc.Med, 106, 130-142.

The evolution of mobile phone technology has introduced new possibilities to the field of medicine. Combining technological advances with medical expertise has led to the use of mobile phones in all healthcare areas including diagnostics, telemedicine, research, reference libraries and interventions. This article provides an overview of the peer-reviewed literature, published between 1 August 2006 and 1 August 2011, for the application of mobile/cell phones (from basic text-messaging systems to smartphones) in healthcare in both resource-poor and high-income countries. Smartphone use is paving the way in high-income countries, while basic text-messaging systems of standard mobile phones are proving to be of value in low- and middle-income countries. Ranging from infection outbreak reporting, anti-HIV therapy adherence to gait analysis, resuscitation training and radiological imaging, the current uses and future possibilities of mobile phone technology in healthcare are endless. Multiple mobile phone based applications are available for healthcare workers and healthcare consumers; however, the absolute majority lack an evidence base. Therefore, more rigorous research is required to ensure that healthcare is not flooded with non-evidence based applications and is maximized for patient benefit

Baumler, D., Kirschbaum, C., Kliegel, M., Alexander, N., & Stalder, T. (2013). The cortisol awakening response in toddlers and young children. Psychoneuroendocrinology.

The cortisol awakening response (CAR) is frequently assessed in psychoneuroendocrinological research on adult participants. However, knowledge on the development of the CAR during early life is scarce and characterized by inconsistent findings. We have recently shown that a positive CAR is readily observable in young infants under conditions of strict methodological control. However, it still remains unknown whether a significant CAR is maintained consistently throughout toddler- and childhood. Here, we report data from 150 toddlers and young children aged 12-87 months in whom salivary cortisol levels were assessed 0 and 30min post-awakening over three non-consecutive study days. High quality of data was ensured by the use of objective measures to verify children’s awakening times (wrist actigraphy) and sampling times (electronic monitoring containers). Results revealed the presence of a significant CAR (>1.5nmol/L) in 142 (out of 150) children and on a total of 82% of study days. A marked CAR was consistently observed throughout all examined age groups (mean increase: 8.73nmol/L). In addition, the level of cortisol on awakening was found to increase linearly with children’s age (r=.17, p=.04). Overall, the current findings strongly suggest that, contrary to previous propositions, the CAR is maintained consistently throughout toddler- and childhood

Behar, J., Roebuck, A., Domingos, J. S., Gederi, E., & Clifford, G. D. (2013). A review of current sleep screening applications for smartphones. Physiol Meas., 34, R29-R46.

Sleep disorders are a common problem and contribute to a wide range of healthcare issues. The societal and financial costs of sleep disorders are enormous. Sleep-related disorders are often diagnosed with an overnight sleep test called a polysomnogram, or sleep study involving the measurement of brain activity through the electroencephalogram. Other parameters monitored include oxygen saturation, respiratory effort, cardiac activity (through the electrocardiogram), as well as video recording, sound and movement activity. Monitoring can be costly and removes the patients from their normal sleeping environment, preventing repeated unbiased studies. The recent increase in adoption of smartphones, with high quality on-board sensors has led to the proliferation of many sleep screening applications running on the phone. However, with the exception of simple questionnaires, no existing sleep-related application available for smartphones is based on scientific evidence. This paper reviews the existing smartphone applications landscape used in the field of sleep disorders and proposes possible advances to improve screening approaches

Bekman, N. M., Winward, J. L., Lau, L. L., Wagner, C. C., & Brown, S. A. (2013). The Impact of Adolescent Binge Drinking and Sustained Abstinence on Affective State. Alcohol Clin.Exp.Res.

BACKGROUND: While it is clear that affect is negatively impacted by heavy drinking in adulthood and that it improves with abstinence, little is known about effects of heavy drinking on mood during adolescence. METHODS: This study examined negative mood states among 2 groups of 16- to 18-year-old high school students; youth with a history of recent heavy episodic drinking (HED; n = 39) and comparison youth with limited lifetime drinking experience (CON; n = 26). Affect was assessed at 3 time points during a 4- to 6-week period of monitored abstinence using the Hamilton Rating Scales for Anxiety and Depression; self-reports were obtained with the state portion of the State-Trait Anxiety Inventory, and experience sampling of current affect was assessed via daily text messages sent at randomly determined times in the morning, afternoon, and evening. RESULTS: Youth with a recent history of HED reported more negative affect compared with nondrinking youth during early stages of abstinence (days since last HED at assessment 1: M = 6.46; SD = 5.06); however, differences in affect were not observed after 4 to 6 weeks of abstinence. Sex differences were evident, with HED girls reporting greater depression and anxiety than HED male peers. Although not significant, response patterns indicated that boys may experience faster resolution of negative emotional states than girls with sustained abstinence. CONCLUSIONS: Findings suggest that high-dose drinking is associated with elevated negative affect for adolescents and that negative mood states may take longer to resolve for girls than for boys following heavy drinking episodes. Future research clarifying naturally occurring changes in affective response during early and sustained abstinence is necessary for improving programs designed to promote adolescent decision-making and to reduce risk for relapse
Bolger, N. & Laurenceau, J. P. (2013). Intensive longitudinal methods: An introduction to diary and experience sampling research. New York, NY US: Guilford Press.

(from the cover) A complete, practical guide to planning and executing an intensive longitudinal study, this book provides the tools for understanding within-subject social, psychological, and physiological processes in everyday contexts. Intensive longitudinal studies involve many repeated measurements taken on individuals, dyads, or groups, and include diary and experience sampling studies. A range of engaging, worked-through research examples with datasets are featured. Coverage includes how to: select the best intensive longitudinal design for a particular research question, model within-subject change processes for continuous and categorical outcomes, distinguish within-subject from between-subjects effects, assess the reliability of within-subject changes, assure sufficient statistical power, and more. Several end-of-chapter write-ups illustrate effective ways to present study findings for publication.

Bond, D. S., Thomas, J. G., Ryder, B. A., Vithiananthan, S., Pohl, D., & Wing, R. R. (2013). Ecological momentary assessment of the relationship between intention and physical activity behavior in bariatric surgery patients. International Journal of Behavioral Medicine, 20, 82-87.

Background: Performing habitual physical activity (PA) is challenging for many bariatric surgery patients. Purpose: We used electronic ecological momentary assessment to naturalistically examine whether insufficient PA among bariatric surgery patients was due to infrequent PA intentions or inadequate follow through on PA intentions. Method: Twenty-one patients 6-months post-bariatric surgery were recruited from multiple clinics in Providence, Rhode Island, USA. Participants used a palmtop computer upon waking for 6 days to indicate whether they intended to be active, and if so, the amount of PA they intended to perform in bouts ëÑ10 min. Each evening, participants reported PA minutes and barriers encountered that day. Results: All 21 participants reported intending to be active on at least 1 day but only 9 (42%) intended to be active on ëÑ70% of days. Twelve (57%) participants performed PA on each of the days they intended, but none achieved the amount of PA they intended on all of these days. Overall, participants had PA intentions on 81 of 123 days (66%); these were partially implemented (ëÑ10 PA minutes) on 49 days, but fully implemented on only 15 days. Participants spent 34 min in PA, or 20 fewer minutes than intended. Ç£Lack of timeÇØ was the only frequently cited barrier, particularly on days that PA was neither intended nor performed. Conclusion: Few patients intended to be active on a near daily basis and all patients had difficulty in implementing their intentions. Interventions that target planning strategies may help facilitate PA intentions and limit discrepancy between intended and actual PA.

Bossmann, T., Kanning, M., Koudela-Hamila, S., Hey, S., & Ebner-Priemer, U. (2013). The Association between Short Periods of Everyday Life Activities and Affective States: A Replication Study Using Ambulatory Assessment. Front Psychol., 4, 102.

Regularly conducted exercise programs effectively influence affective states. Studies suggest that this is also true for short bouts of physical activity (PA) of 10 min or less. Accordingly, everyday life activities of short duration might be used to regulate affective states. However, this association has rarely been studied in reference to unstructured activities in ongoing real-life situations. The current study examined the influence of various everyday life activities on three dimensions of mood (valence, calmness, energetic arousal) in a predominantly inactive sample. Ambulatory Assessment (AA) was used to investigate the association between actual PA and affective states during the course of 1 day. Seventy-seven students ages 19-30 participated in the study. PA was assessed with accelerometers, and affective state assessments were conducted hourly using an e-diary with a six-item mood scale that was specially designed for AA. Multilevel analyses indicated that the mood dimensions energetic arousal (p = 0.001) and valence (p = 0.005) were positively influenced by the intensity of the activity carried out in the 10-min prior to the assessment. As their activity increased, the participants’ positive feelings and energetic arousal increased. However, the students’ calmness was not affected by their activity levels. The findings highlight the importance of integrating short activity intervals of 10 min or less into everyday life routines to improve affective states

Bringmann, L. F., Vissers, N., Wichers, M., Geschwind, N., Kuppens, P., Peeters, F. et al. (2013). A network approach to psychopathology: new insights into clinical longitudinal data. PLoS One, 8, e60188.

In the network approach to psychopathology, disorders are conceptualized as networks of mutually interacting symptoms (e.g., depressed mood) and transdiagnostic factors (e.g., rumination). This suggests that it is necessary to study how symptoms dynamically interact over time in a network architecture. In the present paper, we show how such an architecture can be constructed on the basis of time-series data obtained through Experience Sampling Methodology (ESM). The proposed methodology determines the parameters for the interaction between nodes in the network by estimating a multilevel vector autoregression (VAR) model on the data. The methodology allows combining between-subject and within-subject information in a multilevel framework. The resulting network architecture can subsequently be analyzed through network analysis techniques. In the present study, we apply the method to a set of items that assess mood-related factors. We show that the analysis generates a plausible and replicable network architecture, the structure of which is related to variables such as neuroticism; that is, for subjects who score high on neuroticism, worrying plays a more central role in the network. Implications and extensions of the methodology are discussed

Broderick, J. E., Schneider, S., Junghaenel, D. U., Schwartz, J. E., & Stone, A. A. (2013). Validity and reliability of patient-reported outcomes measurement information system (PROMIS) instruments in osteoarthritis. Arthritis Care Res (Hoboken.).

OBJECTIVE.: Evaluation of known group validity, ecological validity, and test-retest reliability of four domain instruments from the Patient Reported Outcomes Measurement System (PROMIS) in osteoarthritis (OA) patients. METHODS.: Recruitment of an osteoarthritis sample and a comparison general population (GP) through an Internet survey panel. Pain intensity, pain interference, physical functioning, and fatigue were assessed for 4 consecutive weeks with PROMIS short forms on a daily basis and compared with same-domain Computer Adaptive Test (CAT) instruments that use a 7-day recall. Known group validity (comparison of OA and GP), ecological validity (comparison of aggregated daily measures with CATs), and test-retest reliability were evaluated. RESULTS.: The recruited samples matched (age, sex, race, ethnicity) the demographic characteristics of the U.S. sample for arthritis and the 2009 Census for the GP. Compliance with repeated measurements was excellent: > 95%. Known group validity for CATs was demonstrated with large effect sizes (pain intensity: 1.42, pain interference: 1.25, and fatigue: .85). Ecological validity was also established through high correlations between aggregated daily measures and weekly CATs (>/= .86). Test-retest validity (7-day) was very good (>/= .80). CONCLUSION.: PROMIS CAT instruments demonstrated known group and ecological validity in a comparison of osteoarthritis patients with a general population sample. Adequate test-retest reliability was also observed. These data provide encouraging initial data on the utility of these PROMIS instruments for clinical and research outcomes in osteoarthritis patients. (c) 2013 by the American College of Rheumatology
Brooke, M. J. & Thompson, B. M. (2013). Food and Drug Administration regulation of diabetes-related mHealth technologies. J Diabetes Sci Technol., 7, 296-301.

mHealth smartphone applications (apps) offer great promise for managing people with diabetes, as well as those with prediabetes. But to realize that potential, industry needs to get clarity from the U.S. Food and Drug Administration (FDA) regarding the scope of its regulatory oversight. Certain smartphone apps, when properly understood, simply help people live healthier lives, assisting with dietary choices, monitoring exercise, and recording other factors important to overall health. The manufacturers of such apps, in an effort to promote their products but also to educate customers, might wish to explain how using the app can help reduce the risk of developing diabetes. Right now, though, the mere mention of the disease “diabetes” would cause the app to be regulated by the FDA. Such regulation, we submit, discourages the kind of education and motivational messages that our country needs to stem the tide of this disease. Further, should the app simply receive data from a blood glucose meter and graph that data for easier comprehension by the patient, the app would become a class II medical device that requires FDA clearance. Again, we submit that such simple software functionality should not be so discouraged. In this article, we identify the issues that we believe need to be clarified by the FDA in order to unleash the potential of mHealth technology in the diabetes space

Bryant, L., Coffey, A., Povinelli, D. J., & Pruett, J. R., Jr. (2013). Theory of Mind experience sampling in typical adults. Conscious.Cogn, 22, 697-707.

We explored the frequency with which typical adults make Theory of Mind (ToM) attributions, and under what circumstances these attributions occur. We used an experience sampling method to query 30 typical adults about their everyday thoughts. Participants carried a Personal Data Assistant (PDA) that prompted them to categorize their thoughts as Action, Mental State, or Miscellaneous at approximately 30 pseudo-random times during a continuous 10-h period. Additionally, participants noted the direction of their thought (self versus other) and degree of socializing (with people versus alone) at the time of inquiry. We were interested in the relative frequency of ToM (mental state attributions) and how prominent they were in immediate social exchanges. Analyses of multiple choice answers suggest that typical adults: (1) spend more time thinking about actions than mental states and miscellaneous things, (2) exhibit a higher degree of own- versus other-directed thought when alone, and (3) make mental state attributions more frequently when not interacting (offline) than while interacting with others (online). A significant 3-way interaction between thought type, direction of thought, and socializing emerged because action but not mental state thoughts about others occurred more frequently when participants were interacting with people versus when alone; whereas there was an increase in the frequency of both action and mental state attributions about the self when participants were alone as opposed to socializing. A secondary analysis of coded free text responses supports findings 1-3. The results of this study help to create a more naturalistic picture of ToM use in everyday life and the method shows promise for future study of typical and atypical thought processes

Burford, T. I., Low, C. A., & Matthews, K. A. (2013). Night/Day Ratios of Ambulatory Blood Pressure Among Healthy Adolescents: Roles of Race, Socioeconomic Status, and Psychosocial Factors. Ann.Behav.Med.

BACKGROUND: Elevated nighttime blood pressure (BP) predicts hypertension and its complications in adulthood. PURPOSE: This study aimed to assess the independent effects of race and family income on night/day BP among adolescents and to examine whether negative emotions, low positive resources, and unpleasant interactions during the day are also related. METHODS: Healthy African American and Caucasian high school students (N = 239) wore an ambulatory BP monitor for 48 h, recorded quality of ongoing interpersonal interactions, and completed questionnaires. RESULTS: African Americans and those with lower family income had higher night/day BP ratios. African Americans reporting greater negative emotions, lower positive resources, and more unpleasant interactions had higher night/day BP ratios. CONCLUSIONS: Racial differences in night BP emerge by adolescence, independent of family income. African Americans, especially those high in negative emotions and low in positive resources, may be at higher relative risk for hypertension later in life in part due to elevated night BP

Carter, M. C., Burley, V. J., Nykjaer, C., & Cade, J. E. (2013). Adherence to a smartphone application for weight loss compared to website and paper diary: pilot randomized controlled trial. J Med Internet Res, 15, e32.

BACKGROUND: There is growing interest in the use of information communication technologies to treat obesity. An intervention delivered by smartphone could be a convenient, potentially cost-effective, and wide-reaching weight management strategy. Although there have been studies of texting-based interventions and smartphone applications (apps) used as adjuncts to other treatments, there are currently no randomized controlled trials (RCT) of a stand-alone smartphone application for weight loss that focuses primarily on self-monitoring of diet and physical activity. OBJECTIVE: The aim of this pilot study was to collect acceptability and feasibility outcomes of a self-monitoring weight management intervention delivered by a smartphone app, compared to a website and paper diary. METHODS: A sample of 128 overweight volunteers were randomized to receive a weight management intervention delivered by smartphone app, website, or paper diary. The smartphone app intervention, My Meal Mate (MMM), was developed by the research team using an evidence-based behavioral approach. The app incorporates goal setting, self-monitoring of diet and activity, and feedback via weekly text message. The website group used an existing commercially available slimming website from a company called Weight Loss Resources who also provided the paper diaries. The comparator groups delivered a similar self-monitoring intervention to the app, but by different modes of delivery. Participants were recruited by email, intranet, newsletters, and posters from large local employers. Trial duration was 6 months. The intervention and comparator groups were self-directed with no ongoing human input from the research team. The only face-to-face components were at baseline enrollment and brief follow-up sessions at 6 weeks and 6 months to take anthropometric measures and administer questionnaires. RESULTS: Trial retention was 40/43 (93%) in the smartphone group, 19/42 (55%) in the website group, and 20/43 (53%) in the diary group at 6 months. Adherence was statistically significantly higher in the smartphone group with a mean of 92 days (SD 67) of dietary recording compared with 35 days (SD 44) in the website group and 29 days (SD 39) in the diary group (P<.001). Self-monitoring declined over time in all groups. In an intention-to-treat analysis using baseline observation carried forward for missing data, mean weight change at 6 months was -4.6 kg (95% CI -6.2 to -3.0) in the smartphone app group, -2.9 kg (95% CI -4.7 to -1.1) in the diary group, and -1.3 kg (95% CI -2.7 to 0.1) in the website group. BMI change at 6 months was -1.6 kg/m(2) (95% CI -2.2 to -1.1) in the smartphone group, -1.0 kg/m(2) (95% CI -1.6 to -0.4) in the diary group, and -0.5 kg/m(2) (95% CI -0.9 to 0.0) in the website group. Change in body fat was -1.3% (95% CI -1.7 to -0.8) in the smartphone group, -0.9% (95% CI -1.5 to -0.4) in the diary group, and -0.5% (95% CI -0.9 to 0.0) in the website group. CONCLUSIONS: The MMM app is an acceptable and feasible weight loss intervention and a full RCT of this approach is warranted. TRIAL REGISTRATION: ClinicalTrials.gov NCT01744535; http://clinicaltrials.gov/ct2/show/NCT01744535 (Archived by WebCite at http://www.webcitation.org/6FEtc3PVB)

Cohen, D. L., Bowler, A., Fisher, S. A., Norris, A., Newberg, A., Rao, H. et al. (2013). Lifestyle Modification in Blood Pressure Study II (LIMBS): Study protocol of a randomized controlled trial assessing the efficacy of a 24week structured yoga program versus lifestyle modification on blood pressure reduction. Contemp.Clin.Trials, 36, 32-40.

Hypertension is a major public health issue affecting 68million adults in the United States. Lifestyle modifications including complementary therapies such as the movement based mind body practice of yoga have become increasingly popular in the United States and have been considered as a potential alternative to medication in blood pressure reduction. We completed a pilot study in 2009 which showed meaningful decreases in 24-hour ambulatory blood pressure readings after a 12week period of yoga participation. Based on data from our pilot study we are now completing The Lifestyle Modification and Blood Pressure Study (LIMBS II) which is a phase 2 randomized controlled trial designed to determine the effects of yoga therapy and enhanced lifestyle modification on lowering blood pressure in pre-hypertensive and stage 1 hypertensive subjects. Using 24-hour ambulatory blood pressure monitoring, LIMBS II aims to compare the effects on blood pressure reduction in subjects randomized for 24weeks to one of the three following groups: yoga therapy versus blood pressure education program (sodium restriction and walking program) versus a combination program that involves components of both groups. LIMBS II will also examine the impact that changes in blood pressure have on cerebral blood flow. If successful, the LIMBS study will determine if yoga therapy combined with enhanced lifestyle modification will result in clinically meaningful decreases in blood pressure and thus can be implemented as an alternative to drug therapy for patients with prehypertension and stage 1 hypertension

Collings, P. J., Brage, S., Ridgway, C. L., Harvey, N. C., Godfrey, K. M., Inskip, H. M. et al. (2013). Physical activity intensity, sedentary time, and body composition in preschoolers. Am J Clin.Nutr., 97,  1020-1028.

BACKGROUND: Detailed associations between physical activity (PA) subcomponents, sedentary time, and body composition in preschoolers remain unclear. OBJECTIVE: We examined the magnitude of associations between objectively measured PA subcomponents and sedentary time with body composition in 4-y-old children. DESIGN: We conducted a cross-sectional study in 398 preschool children recruited from the Southampton Women’s Survey. PA was measured by using accelerometry, and body composition was measured by using dual-energy X-ray absorptiometry. Associations between light physical activity, moderate physical activity (MPA), vigorous physical activity (VPA), and moderate-to-vigorous physical activity (MVPA) intensity; sedentary time; and body composition were analyzed by using repeated-measures linear regression with adjustment for age, sex, birth weight, maternal education, maternal BMI, smoking during pregnancy, and sleep duration. Sedentary time and PA were also mutually adjusted for one another to determine whether they were independently related to adiposity. RESULTS: VPA was the only intensity of PA to exhibit strong inverse associations with both total adiposity [P < 0.001 for percentage of body fat and fat mass index (FMI)] and abdominal adiposity (P = 0.002 for trunk FMI). MVPA was inversely associated with total adiposity (P = 0.018 for percentage of body fat; P = 0.022 for FMI) but only because of the contribution of VPA, because MPA was unrelated to fatness (P >/= 0.077). No associations were shown between the time spent sedentary and body composition (P >/= 0.11). CONCLUSIONS: In preschoolers, the time spent in VPA is strongly and independently associated with lower adiposity. In contrast, the time spent sedentary and in low-to-moderate-intensity PA was unrelated to adiposity. These results indicate that efforts to challenge pediatric obesity may benefit from prioritizing VPA

Collip, D., Wigman, J. T., Myin-Germeys, I., Jacobs, N., Derom, C., Thiery, E. et al. (2013). From epidemiology to daily life: linking daily life stress reactivity to persistence of psychotic experiences in a longitudinal general population study. PLoS One, 8, e62688.

Subclinical psychotic experiences at the level of the general population are common, forming an extended psychosis phenotype with clinical psychosis. Persistence of subclinical experiences is associated with transition to later mental disorder. Increased daily life stress reactivity is considered an endophenotype for psychotic disorders. We examined, in a longitudinal framework, whether baseline momentary assessment markers of stress reactivity would predict persistence of subclinical psychotic experiences over time. In a general population sample of female twins (N = 566), the Experience Sampling Method (ESM; repetitive random sampling of momentary emotions, psychotic experiences and context) was used to assess (emotional and psychotic) daily life stress reactivity. Persistence of subclinical psychotic experiences was based on the Community Assessment of Psychic Experiences (CAPE), assessed three times over 14 months post-baseline. It was investigated whether baseline daily life emotional and psychotic stress reactivity predicted persistence of psychotic experiences over time. Higher levels of emotional stress reactivity (a decrease in positive and an increase in negative affect in response to stress), and increased psychotic reactivity to daily stress was found in individuals with persistent psychotic experiences over time compared to individuals with transient psychotic experiences. The results suggest that markers of daily life stress reactivity may predict “macro-level” persistence of normally transient expression of psychotic liability over time. Linking daily life markers of altered reactivity in terms of emotions and psychotic experiences to longitudinal persistence of psychotic experiences, associated with increased risk of transition to overt mental disorder, may contribute to earlier and more accurate diagnosis of risk

Collip, D., Wigman, J. T., van, O. J., Oorschot, M., Jacobs, N., Derom, C. et al. (2013). Positive emotions from social company in women with persisting subclinical psychosis: lessons from daily life. Acta Psychiatr.Scand..

OBJECTIVE: Altered social reward functioning is associated with psychosis irrespective of stage and severity. Examining the role of social reward functioning prospectively in relation to psychotic experiences before these become persistent and potentially disabling can aid in elucidating social mechanisms that induce shifts toward more severe psychotic states, without the confounding effects of clinical disorder. METHOD: In a longitudinal general population sample (N = 566), the experience sampling method (repetitive random sampling of momentary emotions and social context) was used to assess daily life social functioning at baseline. Persistence of subclinical psychotic experiences was based on the Community Assessment of Psychic Experiences assessed three times over 14 months. Analyses examined to what degree i) social context and ii) appreciation thereof differentiated between those who did and did not develop persistent psychotic experiences. RESULTS: Although individuals with persistent psychotic experiences did not differ in overall level of positive effect, the amount of time spent alone or the level of social satisfaction compared to individuals without persistent psychotic experiences, they were more sensitive to the rewarding effects of social company. CONCLUSION: Alterations in social reward experience may form one of the mechanisms that precede the development of the extended psychosis phenotype over time

Crooke, A. H. D., Reid, S. C., Kauer, S. D., McKenzie, D. P., Hearps, S. J. C., Khor, A. S. et al. (2013). Temporal mood changes associated with different levels of adolescent drinking: Using mobile phones and experience sampling methods to explore motivations for adolescent alcohol use. Drug and Alcohol Review, 32, 262-268.

Introduction and Aims: Alcohol use during adolescence is associated with the onset of alcohol use disorders, mental health disorders, substance abuse as well as socially and physically damaging behaviours, the effects of which last well into adulthood. Nevertheless, alcohol use remains prevalent in this population. Understanding motivations behind adolescent alcohol consumption may help in developing more appropriate and effective interventions. This study aims to increase this understanding by exploring the temporal relationship between mood and different levels of alcohol intake in a sample of young people. Design and Methods: Forty-one secondary school students used a purpose-designed mobile phone application to monitor their daily mood and alcohol use for 20 random days within a 31 day period. Generalised estimating equations were used to examine the relationship between differing levels of alcohol consumption (light, intermediate and heavy) and positive and negative mood three days before and after drinking episodes. Results: While there was no relationship between light and heavy drinking and positive mood, there was an increase in positive mood before and after the drinking event for those that drank intermediate amounts. No statistically significant relationships were found between negative mood and any of the three drinking categories. Discussion and Conclusion: Adolescents who drank in intermediate amounts on a single drinking occasion experienced an increase in positive mood over the three days leading up to and three days following a drinking event. These findings contribute to an understanding of the motivations that underpin adolescent alcohol use, which may help inform future interventions.

Daniels, K., Wimalasiri, V., Beesley, N., & Cheyne, A. (2012). Affective well-being and within-day beliefs about job demands’ influence on work performance: An experience sampling study. Journal of Occupational and Organizational Psychology, 85, 666-674.

Affective well-being is influenced by individuals’ momentary beliefs concerning events’ impact on goals. We examined within-day beliefs concerning problem-solving demands’ adverse impact on an important work goal (work performance). Participants (N = 68) provided data up to four times per day for one working week. Hourly beliefs about problem-solving demands’ adverse impact on performance were associated with end-of-hour anxious affect and inversely associated with end-of-hour motivated pleasant affect.

Daniels, K. (2013). Job characteristics and problem-solving. In A.B.Bakker & K. Daniels (Eds.), A day in the life of a happy worker (pp. 58-71). New York, NY US: Psychology Press.

(from the chapter) Many theories of job design treat job characteristics as stable, independent of the person performing the job, and as an “objective” determinant of workplace health, well-being, and performance. Drawing on the job crafting and coping literatures, in this chapter, I portray job characteristics as dynamic phenomena which are enacted by people for specific purposes. I show how this approach to job design can be used to help understand how some job characteristics can protect and enhance daily levels of well-being, learning, creativity, innovation, and cognitive performance through facilitating the generation and implementation of solutions to workplace problem-solving demands. Next, I will review how traditional approaches to job design have furthered our understanding of what makes for good and productive work. I will also review some of the unstated assumptions of this approach that are inherent to the methodologies used in this stream of literature. Following from this, I will examine some of the major principles from the emerging literature on job crafting. Together with some of the literature on coping, I will show how the literature on job design can be extended to examine how workers shape their work over the short-term for specific purposes. These purposes include solving problems at work. I will then outline how experience-sampling and diary methods can add to our understanding of job design and its consequences because they allow researchers to look at job design in a new way. Before concluding the chapter with implications for job design theories, I will review research that indicates the importance of examining how workers shape their work over the short-term for specific purposes. This research indicates implications for well-being and different facets of work performance, such as learning, creativity, innovation, and cognitive performance.

Dayer, L., Heldenbrand, S., Anderson, P., Gubbins, P. O., & Martin, B. C. (2013). Smartphone medication adherence apps: potential benefits to patients and providers. J Am Pharm.Assoc.(2003.), 53, 172-181.

OBJECTIVES: To provide an overview of medication adherence, discuss the potential for smartphone medication adherence applications (adherence apps) to improve medication nonadherence, evaluate features of adherence apps across operating systems (OSs), and identify future opportunities and barriers facing adherence apps. PRACTICE DESCRIPTION: Medication nonadherence is a common, complex, and costly problem that contributes to poor treatment outcomes and consumes health care resources. Nonadherence is difficult to measure precisely, and interventions to mitigate it have been largely unsuccessful. PRACTICE INNOVATION: Using smartphone adherence apps represents a novel approach to improving adherence. This readily available technology offers many features that can be designed to help patients and health care providers improve medication-taking behavior. MAIN OUTCOME MEASURES: Currently available apps were identified from the three main smartphone OSs (Apple, Android, and Blackberry). In addition, desirable features for adherence apps were identified and ranked by perceived importance to user desirability using a three-point rating system: 1, modest; 2, moderate; or 3, high. The 10 highest-rated apps were installed and subjected to user testing to assess app attributes using a standard medication regimen. RESULTS 160 adherence apps were identified and ranked. These apps were most prevalent for the Android OS. Adherence apps with advanced functionality were more prevalent on the Apple iPhone OS. Among all apps, MyMedSchedule, MyMeds, and RxmindMe rated the highest because of their basic medication reminder features coupled with their enhanced levels of functionality. CONCLUSION: Despite being untested, medication apps represent a possible strategy that pharmacists can recommend to nonadherent patients and incorporate into their practice

de Groot, J. F., de Jong, A. S., Visser, T., & Takken, T. (2013). Validation of the Actical and Actiheart monitor in ambulatory children with Spina Bifida. J Pediatr.Rehabil.Med, 6, 103-111.

BACKGROUND: Ambulatory children with Spina Bifida (SB) often show a decline in physical activity leading to deconditioning and functional decline. Therefore, assessment and promotion of physical activity is important. Because energy expenditure during activities is higher in these children, the use of existing pediatric equations to predict physical activity energy expenditure (PAEE) may not be valid. AIMS: (1) To evaluate criterion validity of existing predictions converting accelerocounts into PAEE in ambulatory children with SB and (2) to establish new disease-specific equations for PAEE. METHODS: Simultaneous measurements using the Actical, the Actiheart, and indirect calorimetry took place to determine PAEE in 26 ambulatory children with SB. DATA ANALYSIS: Paired T-tests, Intra-class correlations limits of agreement (LoA), and explained variance (R<formula>^2</formula>) were used to analyze validity of the prediction equations using true PAEE as criterion. New equations were derived using regression techniques. RESULTS: While T-tests showed no significant differences for some models, the predictions developed in healthy children showed moderate ICC’s and large LoA with true PAEE. The best regression models to predict PAEE were: PAEE=174.049+3.861 x H

de, G. S. & Nieuwenhuizen, M. G. (2013). Validity and reliability of measuring activities, movement intensity and energy expenditure with the DynaPort MoveMonitor. Med Eng Phys..

The purpose of this study was to evaluate the validity and reliability of assessing activities, movement intensity (MI) and energy expenditure (EE) measured by accelerometry. 28 Able-bodied participants performed standardized tasks while an accelerometer was worn and oxygen uptake was measured. After uploading the accelerometer data to the manufacturer’s website, a report was received that gave minute-by-minute MI and EE of the performed activities. Validity was assessed by comparing reported activities and EE with the actual performed activities and calculated EE from the oxygen uptake, and by testing whether MI differed between walking velocities and cycling resistances. Reliability was assessed by performing the protocol twice. Except for standing (classified predominantly (82%) as sitting), most activities were categorized mainly correctly (93-100%). A difference in MI was detected between walking speeds but not between cycling resistances. EE was overestimated for walking (ICC=0.54) and underestimated for cycling (ICC=0.03). Reliability of MI was high (ICC=0.91) but reliability for the relative time spent in activities or the step count was weak to moderate. In conclusion, most activities were categorized correctly, MI seemed to be valid and reliable but reliability is low for relative time spent in activities and EE cannot be estimated well

Dennison, L., Morrison, L., Conway, G., & Yardley, L. (2013). Opportunities and challenges for smartphone applications in supporting health behavior change: qualitative study. J Med Internet Res, 15, e86.

BACKGROUND: There is increasing interest from academics and clinicians in harnessing smartphone applications (apps) as a means of delivering behavioral interventions for health. Despite the growing availability of a range of health-related apps on the market, academic research on the development and evaluation of such apps is in the relatively early stages. A few existing studies have explored the views of various populations on using mobile phones for health-related issues and some studies are beginning to report user feedback on specific apps. However, there remains little in depth research on users’ (and potential users’) experiences and views on a wide range of features and technologies that apps are, or will soon be, capable of. In particular, research on young adults is lacking, which is an unfortunate omission considering that this group comprises of a good number of mobile technology adoptors. OBJECTIVE: The current study sought to explore young adults’ perspectives on apps related to health behavior change. It sought their experiences and views of features that might support health behavior change and issues that contribute to interest in and willingness to use such apps. METHODS: Four focus groups were conducted with 19 students and staff at a University in the United Kingdom. Participants included 13 females and 6 males with a mean age of 23.79 (SD 7.89). The focus group discussions centred on participants’ experiences of using smartphone apps to support a healthy lifestyle, and their interest in and feelings about features and capabilities of such apps. The focus groups were recorded, transcribed, and analyzed using inductive thematic analysis. RESULTS: Study findings suggested that young, currently healthy adults have some interest in apps that attempt to support health-related behavior change. Accuracy and legitimacy, security, effort required, and immediate effects on mood emerged as important influences on app usage. The ability to record and track behavior and goals and the ability to acquire advice and information “on the go” were valued. Context-sensing capabilities and social media features tended to be considered unnecessary and off-putting. CONCLUSIONS: This study provided insight into the opportunities and challenges involved in delivering health-related behavioral interventions through smartphone apps. The findings suggested a number of valued features and characteristics that app developers may wish to consider when creating health behavior apps. Findings also highlighted several major challenges that appeared to need further consideration and research to ensure the development of effective and well-accepted behavior change apps

Dhingra, L. K., Homel, P., Grossman, B., Chen, J., Scharaga, E., Calamita, S. et al. (2013). Ecological Momentary Assessment of Smoking Behavior in Persistent Pain Patients. Clin.J Pain.

OBJECTIVES:: Smoking is associated with chronic pain and pain-related functional impairment. Some studies suggest that pain activates smoking urges and others suggest that smoking is analgesic. We evaluated these associations using ecological momentary assessment, a method for real-time measurement of health-related phenomena. METHODS:: For 1 week, 36 chronic pain patients who smoked a mean of 17.5 (SD=9.4) cigarettes per day completed multiple daily assessments on a handheld computer. RESULTS:: The sample included 67% women and 39% whites; 67% had back pain, with an average (SD) worst pain severity during the past week of 8.6 (1.5) on a 0 to 10 numeric rating scale. Patients completed an average (SD) of 44 (24) random assessments. At each assessment, the patient recorded pain “right now” on a 0 to 10 scale, whether he/she was “about to smoke,” and if he/she had “just smoked in the past 30 minutes,” pain before smoking. After controlling for other significant correlates of pain, patients who were about to smoke had more pain than at other times [M (SD)=6.5 (2.3) vs. 5.2 (2.4); P<0.01], but pain before and after smoking was not different [M (SD)=6.1 (2.2) vs. 5.9 (2.3); P=0.18]. DISCUSSION:: These findings support the hypothesis that smoking behavior is triggered by pain, but smoking is not analgesic. Future studies should clarify potential explanatory mechanisms for this pain-related trigger and evaluate tailored cessation strategies for pain patients

Dimotakis, N. & Ilies, R. (2013). Experience-sampling and event-sampling research. In A.B.Bakker & K. Daniels (Eds.), A day in the life of a happy worker (pp. 85-99). New York, NY US: Psychology Press.

(from the chapter) In recent years, an emerging focus on studying within-person processes and phenomena has started to complement traditional between-person research streams that explain how and why construct scores co-vary among individuals (Ilies, Schwind, & Heller, 2007; Ilies et al., 2010). Recent innovations and improvements in technological, analytical, and conceptual areas have helped the field expand rapidly, spurring a greatly increased interest in this research approach. One of the most important of these innovations has been the introduction of the Experience-Sampling Method (ESM; Larson & Csikszentmihalyi, 1983). ESM, in broad terms, aims to utilize a multiple measurement schedule over a set period of time in order to explain fluctuations in episodic experiences (e.g. affective states) and the dynamic antecedents and outcomes of these fluctuations. More specifically, ESM approaches include using a random- or fixed-event or signal-contingent schedule in order to measure the dependent and independent variables at multiple points during an individual’s day, typically over a period of multiple days. Data from ESM designs are then commonly used as input in within-person or cross-level multivariate, mediational, or moderational multilevel regression models, using statistical techniques such as Hierarchical Linear Modeling (Raudenbush & Bryk, 2002). In order to contribute to this emerging stream of research, this chapter aims to outline and discuss the basic features of ESM and to examine the advantages and disadvantages of implementing these features in ESM research designs. Moreover, we provide illustrative examples of various types of these designs. We also provide suggestions for future research utilizing ESM in various ways to examine within-person research questions.

Doherty, A. R., Kelly, P., Kerr, J., Marshall, S., Oliver, M., Badland, H. et al. (2013). Using wearable cameras to categorise type and context of accelerometer-identified episodes of physical activity. The International Journal of Behavioral Nutrition and Physical Activity, 10.

Background: Accelerometers can identify certain physical activity behaviors, but not the context in which they take place. This study investigates the feasibility of wearable cameras to objectively categorize the behavior type and context of participantsÇÖ accelerometer-identified episodes of activity. Methods: Adults were given an Actical hip-mounted accelerometer and a SenseCam wearable camera (worn via lanyard). The onboard clocks on both devices were time-synchronized. Participants engaged in free-living activities for 3 days. Actical data were cleaned and episodes of sedentary, lifestyle-light, lifestyle-moderate, and moderate-tovigorous physical activity (MVPA) were identified. Actical episodes were categorized according to their social and environmental context and Physical Activity (PA) compendium category as identified from time-matched SenseCam images. Results: There were 212 days considered from 49 participants from whom SenseCam images and associated Actical data were captured. Using SenseCam images, behavior type and context attributes were annotated for 386 (out of 3017) randomly selected episodes (such as walking/transportation, social/not-social, domestic/leisure). Across the episodes, 12 categories that aligned with the PA Compendium were identified, and 114 subcategory types were identified. Nineteen percent of episodes could not have their behavior type and context categorized; 59% were outdoors versus 39% indoors; 33% of episodes were recorded as leisure time activities, with 33% transport, 18% domestic, and 15% occupational. 33% of the randomly selected episodes contained direct social interaction and 22% were in social situations where the participant wasnÇÖt involved in direct engagement. Conclusion: Wearable camera images offer an objective method to capture a spectrum of activity behavior types and context across 81% of accelerometer-identified episodes of activity. Wearable cameras represent the best objective method currently available to categorize the social and environmental context of accelerometer-defined episodes of activity in free-living conditions.

Dunton, G. F., Huh, J., Leventhal, A. M., Riggs, N., Hedeker, D., Spruijt-Metz, D. et al. (2013). Momentary Assessment of Affect, Physical Feeling States, and Physical Activity in Children. Health Psychology .
Objective: Most research on the interplay of affective and physical feelings states with physical activity in children has been conducted under laboratory conditions and fails to capture intraindividual covariation. The current study used Ecological Momentary Assessment (EMA) to bidirectionally examine how affective and physical feeling states are related to objectively measured physical activity taking place in naturalistic settings during the course of children’s everyday lives. Methods: Children (N = 119, ages 9Çô13 years, 52% male, 32% Hispanic) completed 8 days of EMA monitoring, which measured positive affect (PA), negative affect (NA), feeling tired, and feeling energetic up to 7 times per day. EMA responses were time-matched to accelerometer assessed moderate-to-vigorous physical activity (MVPA) in the 30 min before and after each EMA survey. Results: Higher ratings of feeling energetic and lower ratings of feeling tired were associated with more MVPA in the 30 min after the EMA prompt. More MVPA in the 30 min before the EMA prompt was associated with higher ratings of PA and feeling energetic and lower ratings of NA. Between-subjects analyses indicated that mean hourly leisure-time MVPA was associated with less intraindividual variability in PA and NA. Conclusions: Physical feeling states predict subsequent physical activity levels, which in turn, predict subsequent affective states in children. Active children demonstrated higher positive and negative emotional stability. Although the strength of these associations were of modest magnitude and their clinical relevance is unclear, understanding the antecedents to and consequences of physical activity may have theoretical and practical implications for the maintenance and promotion of physical activity and psychological well-being in children.

Fazio, P., Granieri, G., Casetta, I., Cesnik, E., Mazzacane, S., Caliandro, P. et al. (2013). Gait measures with a triaxial accelerometer among patients with neurological impairment. Neurological Sciences, 34, 435-440.

The purpose of the present study is to evaluate accelerometric parameters of gait in different neurological conditions with pathological gait impairment compared to healthy subjects. We studied 17 patients affected by ParkinsonÇÖs disease, 24 with ataxic gait due to different diseases and 24 healthy subjects supplied with a triaxial accelerometer with a portable datalogger which measures acceleration and deceleration on an anteriorÇôposterior, mediolateral and vertical plane at an approximate level of the center of mass (back sacral localization) and in other two positions (sternal and frontal sacral region) during a steady-state walking. Analyses of the basic accelerometric parameters associated with a jerk analysis allowed us to differentiate between the population groups. We observed a significant reduction of acceleration parameters in neurological patients when compared with healthy subjects, with a reduction of the mean acceleration of 0.30 m/s-¦ for ataxic and 0.64 m/s-¦ for parkinsonian patients (t test, p < 0.01). The root-mean square of the accelerations was used to quantify the attenuations of accelerations. This study suggests that a triaxial accelerometer is a good practical and an economic tool for assessing the alteration of perambulation. Moreover, it is plausible to use these data to obtain objective parameters in the evaluation of the progression of the disease and the efficacy of therapeutic tools.

Geisler, F. C. M., Kubiak, T., Siewert, K., & Weber, H. (2013). Cardiac vagal tone is associated with social engagement and self-regulation. Biological Psychology, 93, 279-286.

The polyvagal theory (Porges, 2007) represents a biobehavioral model that relates autonomic functioning to self-regulation and social engagement. The aim of the two presented studies was to test the proposed association of cardiac vagal tone (CVT), assessed via resting high-frequency heart rate variability (respiratory sinus arrhythmia, RSA), with coping, emotion-regulation, and social engagement in young adults. In Study 1 (retrospective self-report), RSA was positively associated with engagement coping (situation control, response control, positive self-instructions, social-support seeking) and aspects of social wellbeing. In Study 2 (ecological momentary assessment), for 28 days following the initial assessment, RSA predicted less use of disengagement strategies (acceptance and avoidance) for regulating negative emotions and more use of socially adaptive emotion-regulation strategies (i.e., social-support seeking as a reaction to sadness and making a concession as a reaction to anger caused by others). Furthermore, RSA was higher in participants who reported no anger episodes compared to those who reported at least one anger episode and was positively associated with reported episodes of negative emotions. Results support the association proposed by the PVT between CVT and self-regulatory behavior, which promotes social bonds.

Giesbrecht, G. F., Campbell, T., Letourneau, N., & Kaplan, B. J. (2013). Advancing gestation does not attenuate biobehavioural coherence between psychological distress and cortisol. Biological Psychology, 93, 45-51.

Background: Despite little evidence to suggest that HPA axis responses to psychological provocation are attenuated during pregnancy, it is widely held that dampening of the HPA axis response to psychological distress serves a protective function for the mother and fetus. The current study was designed to assess changes in biobehavioral coherence between psychological distress and cortisol over the course of pregnancy. Methods: Ambulatory assessment of ecologically relevant psychological distress and salivary cortisol were repeated in all three trimesters for 82 pregnant women. Samples were collected 5 times per day over the course of 2 days in each trimester. Results: Psychological distress and cortisol were positively associated, +¦ = .024, p < .01, indicating that increases in psychological distress were associated with increases in cortisol. Gestational age did not moderate this association, +¦ = .0009, p = .13, suggesting that negative psychological experiences remain potent stimuli for the HPA axis during pregnancy. Conclusion: Biobehavioral coherence between ecologically relevant experiences of psychological distress and cortisol is not attenuated with advancing gestation.

Goldschmidt, A. B., Peterson, C. B., Wonderlich, S. A., Crosby, R. D., Engel, S. G., Mitchell, J. E. et al. (2013). Trait-level and momentary correlates of bulimia nervosa with a history of anorexia nervosa. International Journal of Eating Disorders, 46, 140-146.

Objective: Some investigators have suggested subtyping bulimia nervosa (BN) by anorexia nervosa (AN) history. We examined trait-level and momentary eating- related and psychosocial factors in BN with and without an AN history. Method: Interview, questionnaire, and ecological momentary assessment data of eating-related and psychological symptoms were collected from 122 women with BN, including 43 with (BN+) and 79 without an AN history (BNêÆ). Results: Body mass index (kg/m-¦) was lower in BN+ than BNêÆ (p = 0.001). Groups did not differ on trait-level anxiety, shape/weight concerns, psychiatric comorbidity, or dietary restraint; or on momentary anxiety, dietary restriction, binge eating, purging, or exercise frequency, or affective patterns surrounding binge/purge behaviors. Negative affect increased prior to exercise and decreased thereafter in BN+ but not BNêÆ, although groups did not statistically differ. Discussion: Results do not support formally subtyping BN by AN history. Exercise in BN+ may modulate negative affect, which could have important treatment implications.

Goldstein, A. L., Stewart, S. H., Hoaken, P. N. S., & Flett, G. L. (2013). Mood, Motives, and Gambling in Young Adults: An Examination of Within- and Between-Person Variations Using Experience Sampling. Psychology of Addictive Behaviors.

It is well established that young adults are a population at risk for problem gambling and that young adults gamble for various reasons, including positive mood enhancement and negative mood reduction. Although these motives have been identified as important proximal predictors of gambling, the research to date has focused on between-subjects relationships. What is missing is a process-level understanding of the specific within-subjects relations between mood-regulation motives for gambling, mood states, and gambling behaviors. The current study used experience sampling to assess the specific link between gambling motives, mood states, and gambling behavior. Participants were 108 young adults (ages 19Çô24 years), who completed baseline measures of gambling motives and gambling problems and then reported on their mood states and gambling behavior three times a day for 30 days. Multilevel modeling analyses revealed a significant positive moderating effect for enhancement motives on the relationship between positive mood and amount of time spent gambling and number of drinks consumed while gambling. In addition, problem gambling status was associated with consuming fewer drinks while gambling at higher levels of positive mood, and spending more money than intended at higher levels of negative mood. Unexpectedly, there was only one moderating effect for coping motives on the mood-gambling relationship; low coping motivated gamblers consumed more alcohol while gambling at higher levels of positive mood, whereas high coping motivated gamblers did not change their drinking in response to positive mood. The current findings highlight enhancement motives as risky motives for young adult gambling, particularly in the context of positive mood, and suggest that gambling interventions should include strategies to address positive mood management.

Hansen, A. L., Carstensen, B., Helge, J. W., Johansen, N. B., Gram, B., Christiansen, J. S. et al. (2013). Combined Heart Rate- and Accelerometer-Assessed Physical Activity Energy Expenditure and Associations With Glucose Homeostasis Markers in a Population at High Risk of Developing Diabetes: The ADDITION-PRO Study. Diabetes Care.

OBJECTIVERegular physical activity (PA) reduces the risk of developing type 2 diabetes, and different subtypes of dysglycemia have shown different associations with PA. To better understand the associations of PA and glucose homeostasis, we examined the association of objectively measured PA energy expenditure (PAEE) with detailed measures of glucose homeostasis.RESEARCH DESIGN AND METHODSIn 1,531 men and women, with low to high risk of developing type 2 diabetes, we measured 7 days of PAEE using a combined accelerometry and heart rate monitor (ActiHeart). Measures and indices of glucose homeostasis were derived from a 3-point oral glucose tolerance test in addition to measures of long-term glycemia (glycated hemoglobin A1c and advanced glycation end products). Associations of PAEE with glucose homeostasis markers were examined using linear regression models.RESULTSMedian age (IQR) was 66.6 years (62.1-71.6) (54% men) with a median ActiHeart wear time of 6.9 days (6.0-7.1) and PAEE level of 33.0 kJ/kg/day (23.5-46.1). In fully adjusted models, we found higher levels of PAEE to be positively associated with insulin sensitivity and negatively with insulin 2 h after glucose load (P < 0.05).CONCLUSIONSEven in an elderly population with low levels of PA, we found higher objectively measured PAEE levels to be associated with a more beneficial glucose metabolic profile. Although our findings are cross-sectional, they indicate that even without high-intensity exercise, increasing the overall level of PAEE slightly in an entire population at risk for developing type 2 diabetes may be a realistic and worthwhile goal to reach in order to achieve beneficial effect in terms of glucose metabolism

Hayakawa, M., Uchimura, Y., Omae, K., Waki, K., Fujita, H., & Ohe, K. (2013). A Smartphone-based Medication Self-management System with Realtime Medication Monitoring. Appl.Clin.Inform., 4, 37-52.

BACKGROUND: Most patients cannot remember their entire medication regimen and occasionally forget to take their medication. OBJECTIVES: The objective of the study was to design, develop, and demonstrate the feasibility of a new type of medication self-management system using smartphones with real-time medication monitoring. METHODS: We designed and developed a smartphone-based medication self-management system (SMSS) based on interviews of 116 patients. The system offered patients two main functions by means of smartphones: (1) storage and provision of an accurate, portable medication history and medication-taking records of patients; and (2) provision of a reminder to take medication only when the patient has forgotten to take his/her medication. These functions were realized by two data input methods: (a) reading of prescription data represented in two-dimensional barcodes using the smartphone camera and getting the photographic images of the pills; and (b) real-time medication monitoring by novel user-friendly wireless pillboxes. RESULTS: Interviews suggested that a pocket-sized pillbox was demanded to support patient’s medication-taking outside the home and pillboxes for home use should be adaptable to the different means of pillbox storage. In accordance with the result, we designed and developed SMSS. Ten patients participated in the feasibility study. In 17 out of 47 cases (36.2%), patients took their medication upon being presented with reminders by the system. Correct medication-taking occurrence was improved using this system. CONCLUSIONS: The SMSS is acceptable to patients and has the advantage of supporting ubiquitous medication self-management using a smartphone. We believe that the proposed system is feasible and provides an innovative solution to encourage medication self-management

Heathers, J. A. (2013). Smartphone-enabled pulse rate variability: An alternative methodology for the collection of heart rate variability in psychophysiological research. Int.J Psychophysiol..

Heart rate variability (HRV) is widely used to assess autonomic nervous system (ANS) function. It is traditionally collected from a dedicated laboratory electrocardiograph (ECG). This presents a barrier to collecting the large samples necessary to maintain the statistical power of between-subject psychophysiological comparisons. An alternative to ECG involves an optical pulse sensor or photoplethysmograph run from a smartphone or similar portable device: smartphone pulse rate variability (SPRV). Experiment 1 determined the simultaneous accuracy between ECG and SPRV systems in n=10 participants at rest. Raw SPRV values showed a consistent positive bias, which was successfully attenuated with correction. Experiment 2 tested an additional n=10 participants at rest, during attentional load, and during mild stress (exercise). Accuracy was maintained, but slightly attenuated during exercise. The best correction method maintained an accuracy of +/-2% for low-frequency spectral power, and +/-5% for high-frequency spectral power over all points. Thus, the SPRV system records a pulse-to-pulse approximation of an ECG-derived heart rate series that is sufficiently accurate to perform time- and frequency-domain analysis of its variability, as well as accurately reflecting change in autonomic output provided by typical psychophysiological stimuli. This represents a novel method by which an accurate approximation of HRV may be collected for large-sample or naturalistic cardiac psychophysiological research

Hermida, R. n. C., Ayala, D. E., Moj+¦n, A., & Fern+índez, J. R. (2013). Blunted sleep-time relative blood pressure decline increases cardiovascular risk independent of blood pressure level – The ‘normotensive non-dipper’ paradox. Chronobiology International, 30, 87-98.

Numerous studies have consistently shown an association between blunted sleep-time relative blood pressure (BP) decline (non-dipping) and increased cardiovascular disease (CVD) risk in hypertension. Normotensive persons with a non-dipper BP profile also have increased target organ damage, namely, increased left ventricular mass and relative wall thickness, reduced myocardial diastolic function, increased urinary albumin excretion, increased prevalence of diabetic retinopathy, and impaired glucose tolerance. It remains a point of contention, however, whether the nondipper BP pattern or just elevated BP, alone, is the most important predictor of advanced target organ damage and future CVD events. Accordingly, we investigated the role of dipping status and ambulatory BP level as contributing factors for CVD morbidity and mortality in the MAPEC (Monitorizaci+¦n Ambulatoria para Predicci+¦n de Eventos Cardiovasculares, i.e., Ambulatory Blood Pressure Monitoring for Prediction of Cardiovascular Events) study. We prospectively studied 3344 individuals (1718 men/1626 women), 52.6 -¦ 14.5 (mean -¦ SD) yrs of age, during a median follow-up of 5.6 yrs. BP was measured by ambulatory monitoring (ABPM) for 48 h at baseline, and again annually or more frequently (quarterly) if treatment adjustment was required in treated hypertensive patients. At baseline, those with ABPM-substantiated hypertension were randomized to one of two treatment-time regimen groups: (i) ingestion of all prescribed hypertension medications upon awakening or (ii) ingestion of the entire dose of ëÑ 1 of them at bedtime. Those found to be normotensive at baseline were untreated but followed and evaluated by repeated ABPM like the hypertensive patients. Participants were divided into four investigated categories on the basis of dipping status and ambulatory BP: (i) dipper vs. non-dipper, and (ii) normal ambulatory BP if the awake systolic (SBP)/diastolic (DBP) BP means were < 135/85 mm Hg and the asleep SBP/DBP means were < 120/70 mm Hg, and elevated ambulatory BP otherwise. Cox survival analyses, adjusted for significant confounding variables, documented that non-dippers had significantly higher CVD risk than dippers, whether they had normal (p = .017) or elevated ambulatory BP (p < .001). Non-dippers with normal awake and asleep SBP and DBP means, who accounted for 21% of the studied population, had similar hazard ratio (HR) of CVD events (1.61 [95% confidence interval, CI: 1.09Çô2.37]) as dippers with elevated ambulatory BP (HR: 1.54 [95% CI: 1.01Çô2.36]; p = .912 between groups). These results remained mainly unchanged for treated and untreated patients analyzed separately. Our findings document that the risk of CVD events is influenced not only by ambulatory BP elevation, but also by blunted nighttime BP decline, even within the normotensive range, thus supporting ABPM as a requirement for proper CVD risk assessment in the general population. The elevated CVD risk in “normotensive” individuals with a non-dipper BP profile represents a clear paradox, as those persons do not have “normal BP” or low CVD risk. Our findings also indicate the need to redefine the concepts of normotension/hypertension, so far established on the unique basis of BP level, mainly if not exclusively measured at the clinic, independently of circadian BP pattern.

Heron, K. E. & Smyth, J. M. (2013). Is intensive measurement of body image reactive? A two-study evaluation using Ecological Momentary Assessment suggests not. Body Image, 10, 35-44.

Intensive assessment methods (e.g., Ecological Momentary Assessment [EMA]) are increasingly used to capture body image experiences in daily life. One concern with EMA is multiple assessments may increase reactivity to internal or external cues, potentially biasing measurement. Reactivity to EMA was evaluated in two studies (Study 1: N = 63 female undergraduates, Study 2: N = 131 women with high body dissatisfaction/disordered eating). Participants completed five daily surveys on handheld computers for 1Çô2 weeks and body image-related questionnaires at the start and end of each study. Results showed no systematic changes in pre- and post-EMA measures or momentary EMA reports, suggesting women were not reactive to the EMA protocols. Completing 1Çô2 weeks of EMA does not appear to affect body dissatisfaction, mood, or attitudes in non-clinical or at-risk samples of women. These studies provide evidence that EMA methods can be used to assess real-world body image experiences without undue concern about measurement reactivity.

Heron, K. E. & Smyth, J. M. (2013). Body image discrepancy and negative affect in women’s everyday lives: An ecological momentary assessment evaluation of self discrepancy theory. Journal of Social and Clinical Psychology, 32, 276-295.

Discrepancies in self-image occur when individuals hold conflicting beliefs about personal characteristics and those one would ideally like to have (actual:ideal [A:I] discrepancy) or believes one should possess (actual:ought [A:O] discrepancy). Self-discrepancy Theory (SDT; Higgins, 1987) predicts A:I and A:O discrepancies are uniquely associated with depressed and anxious affect, respectively. This study provided the first empirical test of these relationships within individuals in daily life. Body image discrepancy and depressed and anxious affect were assessed in college women (n = 63) using Ecological Momentary Assessment. Women were signaled by, and completed assessments on, a palmtop computer five times daily for one week. The predictions of SDT were supported; momentary A:I and A:O discrepancies differentially predicted concurrent depressed and anxious affect in women’s everyday lives. These findings are the first to evaluate the predictions of SDT as within-person processes using a real-time assessment methodology. This study investigated the real world experience of body dissatisfaction and negative mood, and thus, also has implications for understanding the development, maintenance, and treatment of body dissatisfaction and clinical and subclinical eating disorders.

Hinton, E. C., Brunstrom, J. M., Fay, S. H., Wilkinson, L. L., Ferriday, D., Rogers, P. J. et al. (2013). Using photography in ‘The Restaurant of the Future’. A useful way to assess portion selection and plate cleaning? Appetite, 63, 31-35.

Laboratory-based studies of human dietary behaviour benefit from highly controlled conditions; however, this approach can lack ecological validity. Identifying a reliable method to capture and quantify natural dietary behaviours represents an important challenge for researchers. In this study, we scrutinised cafeteria-style meals in the ‘Restaurant of the Future.’ Self-selected meals were weighed and photographed, both before and after consumption. Using standard portions of the same foods, these images were independently coded to produce accurate and reliable estimates of (i) initial self-served portions, and (ii) food remaining at the end of the meal. Plate cleaning was extremely common; in 86% of meals at least 90% of self-selected calories were consumed. Males ate a greater proportion of their self-selected meals than did females. Finally, when participants visited the restaurant more than once, the correspondence between selected portions was better predicted by the weight of the meal than by its energy content. These findings illustrate the potential benefits of meal photography in this context. However, they also highlight significant limitations, in particular, the need to exclude large amounts of data when one food obscures another.

Hofmann, W., Adriaanse, M., Vohs, K. D., & Baumeister, R. F. (2013). Dieting and the self-control of eating in everyday environments: An experience sampling study. Br.J Health Psychol..

OBJECTIVE: The literature on dieting has sparked several debates over how restrained eaters differ from unrestrained eaters in their self-regulation of healthy and unhealthy food desires and what distinguishes successful from unsuccessful dieters. We addressed these debates using a four-component model of self-control that was tested using ecological momentary assessment, long-term weight change, and a laboratory measure of inhibitory control. DESIGN: A large sample of adults varying in dietary restraint and inhibitory control (as measured by a Stroop task) were equipped with smartphones for a week. They were beeped on random occasions and provided information on their experience and control of healthy and unhealthy food desires in everyday environments. MAIN OUTCOME MEASURES: The main outcome measures were desire strength, experienced conflict, resistance, enactment of desire, and weight change after a 4-month follow-up. RESULTS AND CONCLUSIONS: Dietary restraint was unrelated to desire frequency and strength, but associated with higher conflict experiences and motivation to use self-control with regard to food desires. Most importantly, relationships between dietary restraint and resistance, enactment of desire, and long-term weight change were moderated by inhibitory control: Compared with dieters low in response inhibition, dieters high in response inhibition were more likely to attempt to resist food desires, not consume desired food (especially unhealthy food), and objectively lost more weight over the ensuing 4 months. These results highlight the combinatory effects of aspects of the self-control process in dieters and highlight the value in linking theoretical process frameworks, experience sampling, and laboratory-based assessment in health science. STATEMENT OF CONTRIBUTION: What is already known on this subject? Dieting is a multifaceted process that can be viewed from the lens of self-control. Dietary restraint measures can be used to capture dieting status, but it is relatively unclear what differentiates successful from unsuccessful dieters (e.g., differences in desire frequency, desire strength, motivation, executive functions). What does this study add? A novel four-step conceptual model of self-control is applied to eating behaviour in everyday life. This model allows a fine-grained look at the self-control process in restrained eaters (dieters) as compared to non-dieters. Dieters and non-dieters do not differ in desire frequency and strength (they are not simply more tempted). Dieters high (as compared to low) in inhibitory control are more likely to engage in self-control. Dieters high (as compared to low) in inhibitory control are more likely to resist unhealthy food desires. Dieters high (as compared to low) in inhibitory control are more likely to loose weight over a 4-month period. Together, the study shows clear differences among successful and unsuccessful dieters that can be linked to differences in executive functioning (inhibitory control). The present article is one of the first studies combining a conceptual model with smartphone experience sampling to study weight control and thus paradigmatic from a methodological perspective

Hofmann, W., Fisher, R. R., Luhmann, M., Vohs, K. D., & Baumeister, R. F. (2013). Yes, But Are They Happy? Effects of Trait Self-Control on Affective Well-Being and Life Satisfaction. J Pers..

OBJECTIVE: Does trait self-control (TSC) predict affective well-being and life satisfaction -positively, negatively, or not? METHOD: We conducted three studies (Study 1: n=414; 64.0% female; Mage =35.0 years; Study 2: n=208; 66.0% female; Mage =25.24 years; Study 3: n=234; 61.0% female; Mage =34.53 years). The key predictor was TSC, with affective well-being and life satisfaction ratings as key outcomes. Potential explanatory constructs including goal conflict, goal balancing, and emotional distress also were investigated. RESULTS: TSC is positively related to affective well-being and life satisfaction, and managing goal conflict is a key as to why. All studies, moreover, showed that the effect of TSC on life satisfaction was at least partially mediated by affect. Study 1′s correlational study established the effect. Study 2′s experience sampling study demonstrated that compared to those low in TSC, those high in TSC experience higher levels of momentary affect even as they experience desire, an effect partially mediated through experiencing lower conflict and emotional distress. Study 3 found evidence for the proposed mechanism-that TSC may boost well-being by helping people to avoid frequent conflict and balance vice-virtue conflicts by favoring virtues. CONCLUSION: Self-control positively contributes to happiness through avoiding and dealing with motivational conflict

Hofmann, W., Kotabe, H., & Luhmann, M. (2013). The spoiled pleasure of giving in to temptation. Motivation and Emotion.

Satisfying one’s desires is typically a pleasurable experience and thus a source of momentary happiness. Getting happy in the here and now, however, may be more complicated when people yield to temptations-desires that conflict with personal self-regulatory goals so that they have reason to resist them. Using data from a large experience sampling study on everyday desire, we show that people receive considerably smaller gains in momentary happiness from enacting tempting as compared to nontempting desires. We further demonstrate that this “spoiled pleasure” effect can largely be explained by self-conscious emotions, as statistically accounting for guilt, pride, and regret as mediators reduced the observed hedonic gap to nonsignificance. The present findings challenge the assumption that the costs associated with temptation lie only in the future.

Huffziger, S., Ebner-Priemer, U., Eisenbach, C., Koudela, S., Reinhard, I., Zamoscik, V. et al. (2013). Induced ruminative and mindful attention in everyday life: An experimental ambulatory assessment study. Journal of Behavior Therapy and Experimental Psychiatry, 44, 322-328.

Background and objectives: Rumination has been proposed as a risk factor for depression, while mindful attention might be protective. Differential effects of these attention foci have so far only been examined in the laboratory. Therefore, we conducted an experimental ambulatory assessment study using ruminative and mindful attention inductions in everyday life to examine their effects in a natural context. Methods: Fifty young adults carried palmtops over three weekdays (rumination induction day, mindful attention induction day, noninduction day; randomized cross-over design). Ten times a day, participants rated ruminative self-focus and mood. On the induction days, they were additionally subjected to 3-min inductions of ruminative or mindful attention at each assessment. Results: The two induction modes exhibited differential immediate effects on ruminative self-focus and mood. While induced rumination immediately deteriorated valence and calmness, induced mindful attention specifically enhanced calmness. Depressive symptoms did not moderate these effects. While overall longer term effects of the inductions were missing, the mindful attention day was associated with slightly increasing positive valence over the day. Limitations: The results need to be replicated in high-risk and patient samples to demonstrate the clinical significance of identified effects. Conclusions: Results confirm the emotional relevance of rumination and mindful attention in real world settings. Future work may test whether adaptive attention-focusing instructions delivered in daily life can support clinical interventions.

Huffziger, S., Ebner-Priemer, U., Zamoscik, V., Reinhard, I., Kirsch, P., & Kuehner, C. (2013). Effects of mood and rumination on cortisol levels in daily life: An ambulatory assessment study in remitted depressed patients and healthy controls. Psychoneuroendocrinology.

The influence of naturally occurring emotional and cognitive experiences on hypothalamic-pituitary-adrenal axis (HPAA) activity is still underinvestigated, particularly in clinical populations. The present study examined effects of mood and rumination on cortisol levels in daily life in remitted depressed patients with recurrent episodes or a chronic precourse (n=31) and healthy controls (n=32). Ambulatory assessment of subjective variables (valence, calmness, energetic-arousal, ruminative self-focus), daily stressors, and saliva cortisol samples was performed five times a day on two consecutive workdays, whereby cortisol was collected 20min after the subjective assessments. In addition, depressive symptoms and trait rumination (brooding, reflection) were measured retrospectively. Multilevel models revealed that remitted depressed patients showed lower cortisol activity compared to healthy controls. Depressive symptoms and trait rumination did not predict HPAA activity, whereas, by controlling for daily stressors, higher daily means of ruminative self-focus and lower daily means of valence, energetic arousal and calmness were associated with higher daily cortisol levels. Separate analyses per group revealed that mean daily ruminative self-focus predicted higher cortisol in both samples. In contrast, lower daily means of calmness, but also of valence and energetic arousal, were significantly linked to higher cortisol output only in healthy controls, but not in the patient sample. These findings indicate that naturally occurring rumination and low mood are associated with increased activation of the HPAA in daily life. Moreover, our data revealed a potentially reduced mood-cortisol coupling in remitted recurrent depression, possibly indicating that during the course of recurrent depression HPAA activation might become less responsive toward subtle emotional experiences in natural contexts.

Humber, N., Emsley, R., Pratt, D., & Tarrier, N. (2013). Anger as a predictor of psychological distress and self-harm ideation in inmates: A structured self-assessment diary study. Psychiatry Res.

Suicidal ideation and behaviour are common among inmates. Anger is found at exaggerated levels and has been associated with suicidal ideation and behaviour in inmate samples suggesting its possible salience in the prediction of suicide. The study investigated relationships between anger, psychological distress, and self-harm/suicidal ideation among inmates. The principles of Ecological Momentary Assessment were considered and a structured self-assessment diary was utilised to examine relationships between the variables of interest. Participants completed a structured self-assessment diary for six consecutive days which included momentary ratings of items describing psychological states of concurrent affects, thoughts, and appraisals related to anger, psychological distress, and self-harm/suicidal ideation. Psychometric assessment measures were also conducted. Temporal associations between predictors and outcomes were investigated. Multilevel modelling analyses were performed. Increased anger was significantly associated with concurrent high levels of self-harm ideation in inmates, when controlling for depression and hopelessness. Temporal analyses also revealed that anger at one time point did not predict suicidal ideation at the next time point. Elucidating the temporal nature of the relationship between anger, psychological distress, and self-harm/suicidal ideation has advanced understanding of the mechanisms of suicidal behaviour, by demonstrating an increased risk of suicide when a male inmate is angry

Hundt, N. E., Brown, L. H., Kimbrel, N. A., Walsh, M. A., Nelson-Gray, R., & Kwapil, T. R. (2013). Reinforcement sensitivity theory predicts positive and negative affect in daily life. Personality and Individual Differences, 54, 350-354.

Laboratory studies of Reinforcement Sensitivity Theory have associated sensitivity to punishment (SP) with negative affect and sensitivity to reward (SR) with positive affect. However, few studies have examined the expression of these systems and their response to cues of reward in daily life. The current study employed experience sampling methodology (ESM) to assess the association of SP and SR with affect and perceptions of situations in daily life. SP was positively associated with negative affect and negatively associated with positive affect in daily life, whereas SR was associated with positive affect and one aspect of negative affect, irritability/anger. Furthermore, high SP participants experienced smaller increases in positive affect and smaller decreases in negative affect in some situations that were perceived as positive, in comparison to low SP participants. In contrast, high SR participants experienced greater decreases in negative affect in some situations that were perceived as positive, in comparison to low SR participants.

Kanning, M. K., Ebner-Priemer, U. W., & Schlicht, W. M. (2013). How to Investigate Within-Subject Associations between Physical Activity and Momentary Affective States in Everyday Life: A Position Statement Based on a Literature Overview. Front Psychol., 4, 187.

Several meta-analyses have investigated the association between physical activity and affective states and have found evidence suggesting that exercise exerts a positive effect on affective state. However, in this field of research, most studies have conducted between-subject analyses. Nonetheless, there is more and more interest in the within-subject associations between physical activity and momentary affective states in everyday life. This position statement pertains to this up-and-coming field of research and provides methodological recommendations for further studies. The paper is divided into three parts: first, we summarize and evaluate three methodological requirements necessary for the proper evaluation of within-subject associations between physical activity and momentary affective states in everyday life. We propose that the following issues should be considered: (a) to address the dynamic nature of such relationships, repeated assessments are necessary; (b) as activities performed in everyday life are mostly spontaneous and unconscious, an objective assessment of physical activity is useful; (c) given that recall of affective states is often affected by systematic distortions, real-time assessment is preferable. In sum, we suggest the use of ambulatory assessment techniques, and more specifically the combination of accelerometer-assessment of physical activity with an electronic diary assessment of the momentary affective state and additional context information. Second, we summarize 22 empirical studies published between 1980 and 2012 using ambulatory assessment to investigate within-subject associations between momentary affective states and physical activity in everyday life. Generally, the literature overview detects a positive association, which appears stronger among those studies that were of high methodological quality. Third, we propose the use of ambulatory assessment intervention (AAIs) strategies to change people’s behavior and to enable people to be active as often as possible during the day (e.g., reducing sitting time, taking more steps per day)

Kemps, E. & Tiggemann, M. (2013). Hand-held dynamic visual noise reduces naturally occurring food cravings and craving-related consumption. Appetite, 68, 152-157.

This study demonstrated the applicability of the well-established laboratory task, dynamic visual noise, as a technique for reducing naturally occurring food cravings and subsequent food intake. Dynamic visual noise was delivered on a hand-held computer device. Its effects were assessed within the context of a diary study. Over a 4-week period, 48 undergraduate women recorded their food cravings and consumption. Following a 2-week baseline, half the participants watched the dynamic visual noise display whenever they experienced a food craving. Compared to a control group, these participants reported less intense cravings. They were also less likely to eat following a craving and consequently consumed fewer total calories following craving. These findings hold promise for curbing unwanted food cravings and craving-driven consumption in real-world settings

Kim, J., Kikuchi, H., & Yamamoto, Y. (2013). Systematic comparison between ecological momentary assessment and day reconstruction method for fatigue and mood states in healthy adults. British Journal of Health Psychology, 18, 155-167.

Objectives: While both ecological momentary assessment (EMA) and the day reconstruction method (DRM) have been used to overcome recall bias, a full systematic comparison of these methods has not been conducted. This study was aimed to investigate the differences and correlations between momentary fatigue and mood states recorded by EMA and reconstructed ones recorded by simultaneous DRM in healthy adults. Design: Each of two different designs (time-based and episode-based) of EMA and DRM were simultaneously conducted. Methods: Twenty-five healthy adults recorded momentary fatigue and mood states with EMA, and then, reconstructed them with DRM. Differences between the mean and the variability of momentary and reconstructed recordings, and the correlations between them, are analysed for different EMA designs. Results: No significant differences are found between the mean or the variability of EMA and DRM estimated over the monitoring period. However, correlations between EMA and DRM are low, albeit statistically significant. Conclusions: Although the overall mean and variability of EMA recordings may be accessible with DRM, detailed changes over time of momentary fatigue and mood states are not retrieved by DRM.

Kim, J., Tanabe, K., Yokoyama, N., Zempo, H., & Kuno, S. (2013). Objectively measured light-intensity lifestyle activity and sedentary time are independently associated with metabolic syndrome: A cross-sectional study of Japanese adults. The International Journal of Behavioral Nutrition and Physical Activity, 10.

Background: Reducing sedentary time and increasing lifestyle activities, including light-intensity activity, may be an option to help prevent metabolic syndrome (MetS). The purpose of the present study was to examine whether objectively measured light-intensity lifestyle activity and sedentary time is associated with MetS, independent of moderateÇôvigorous intensity physical activity (MVPA). Methods: The participants in this cross-sectional study were 483 middle-aged Japanese adults, aged 30Çô64 years. The participants were divided into those with or without MetS according to the Japanese criteria for MetS. A triaxial accelerometer was used to measure light-intensity lifestyle activity [1.6Çô2.9 metabolic equivalents (METs)] and sedentary time (ëñ1.5 METs). Logistic regression was used to predict MetS from the levels of light-intensity lifestyle activity and sedentary time with age, sex, smoking, calorie intake, accelerometer wear time, and MVPA as covariates. Results: The odds ratios (OR) for MetS in the highest and middle tertiles of light-intensity lifestyle activity were 0.44 [95% confidence interval (CI): 0.24 to 0.81] and 0.51 (95% CI: 0.29 to 0.89) relative to the lowest tertile, after adjustment for age, sex, smoking, calorie intake, accelerometer wear time and MVPA (P[sub]trend[/sub] = 0.012). Sedentary time was also associated with the risk of MetS (P[sub]trend[/sub] = 0.018). Among participants in the highest tertile of sedentary time, the risk of MetS was 2.27-times greater than that in the lowest tertile (95% CI: 1.25 to 4.11). The risk of MetS was not significantly increased in subjects in the middle tertile of sedentary time. Conclusions: We found that light-intensity lifestyle activity and sedentary time were significantly associated with the risk of MetS, independent of MVPA. The results of our study suggest that public health messages and guidelines should be refined to include increases in light-intensity lifestyle activity and/or decreases in sedentary time, alongside promoting MVPA, to prevent MetS.

Knatz, S. (2013). Ecological momentary assessment of shame trends and subtypes throughout the binge-purge cycle. ProQuest Information & Learning, US.

Despite extensive research documenting the role of negative affect in bulimic behaviors, little is known about the specific role that shame plays in relation to these behaviors. The present study examined temporal patterns of shame related to characterological and behavioral features over the course of a binge-purge episode. Thirty women with bulimic symptoms provided momentary self-reports of shame and other negative affect levels during a binge-purge episode. A multi-level factor analysis revealed three distinct subtypes of shame emerging on a momentary basisÇöshame about the body, and self-judgment (internal shame) and perceived judgment by others (external shame) about engaging in bulimic behaviors. Repeated measures ANOVA was used to identify changes in shame over the course of a bulimic episode. Analysis revealed changes in shame levels throughout a binge-purge episode and distinctive temporal trends for shame subtypes. These findings support the notion that shame is intimately tied to bulimic behaviors and that levels of shame vary depending on the feature or event to which they are tied.

Kubiak, T., Zahn, D., Siewert, K., Jonas, C., & Weber, H. (2013). Positive Beliefs about Rumination Are Associated with Ruminative Thinking and Affect in Daily Life: Evidence for a Metacognitive View on Depression. Behav.Cogn Psychother, 1-9.

Background: Self-regulatory executive function theory (Wells and Matthews, 1994; Wells, 2008) stresses the role of metacognitions in the development of emotional disorders. Within this metacognitive model, positive beliefs about ruminative thinking are thought to be a risk factor for engaging in rumination and subsequently for depression. However, most of the existing research relies on retrospective self-report trait measures. Aims: The aim of the present study was to examine the theory’s predictions with an Ecological Momentary Assessment approach capturing rumination as it occurs in daily life. Method: Non-clinical participants (N = 93) were equipped with electronic diaries and completed four signal-contingent momentary self-reports per day for 4 weeks. A multilevel mediation model was computed to examine associations between positive beliefs about rumination and ruminative thinking and negative affect in daily life. Results: Positive beliefs about rumination were significantly associated with ruminative thinking as it occurs in daily life. We further found evidence for a negative association with positive affect that was completely mediated via ruminative thinking in daily life occurring in response to negative emotions. Conclusions: Our results add ecologically valid corroborating evidence for the metacognitive model of emotional disorders within the framework of self-regulatory executive function theory

Kuntsche, E. & Labhart, F. (2013). Using personal cell phones for ecological momentary assessment: An overview of current developments. European Psychologist, 18, 3-11.

Ecological Momentary Assessment (EMA) is a way of collecting data in people’s natural environments in real time and has become very popular in social and health sciences. The emergence of personal digital assistants has led to more complex and sophisticated EMA protocols but has also highlighted some important drawbacks. Modern cell phones combine the functionalities of advanced communication systems with those of a handheld computer and offer various additional features to capture and record sound, pictures, locations, and movements. Moreover, most people own a cell phone, are familiar with the different functions, and always carry it with them. This paper describes ways in which cell phones have been used for data collection purposes in the field of social sciences. This includes automated data capture techniques, for example, geolocation for the study of mobility patterns and the use of external sensors for remote health-monitoring research. The paper also describes cell phones as efficient and user-friendly tools for prompt manual data collection, that is, by asking participants to produce or to provide data. This can either be done by means of dedicated applications or by simply using the web browser. We conclude that cell phones offer a variety of advantages and have a great deal of potential for innovative research designs, suggesting they will be among the standard data collection devices for EMA in the coming years.

Kuntsche, E. & Labhart, F. (2013). ICAT: Development of an Internet-based data collection method for ecological momentary assessment using personal cell phones. European Journal of Psychological Assessment, 29, 140-148.

Rapid advances in mobile data-transfer technologies offer new possibilities in the use of cell phones to conduct assessments of a person’s natural environment in real time. This paper describes features of a new Internet-based, cell phone-optimized assessment technique (ICAT), which consists of a retrospective baseline assessment combined with text messages sent to the participants’ personal cell phones providing a hyperlink to an Internet-stored cell phone-optimized questionnaire. Two participation conditions were used to test variations in response burden. Retention rates, completion rates, and response times in different subgroups were tested by means of x2 tests, Cox regression, and logistic regression. Among the 237 initial participants, we observed a retention rate of 90.3% from the baseline assessment to the cell-phone part, and 80.4% repeated participation in the 30 daily assessments. Each day, 40-70% of the questionnaires were returned, a fourth in less than 3 minutes. Qualitative interviews underscored the ease of use of ICAT. This technique appears to be an innovative, convenient, and cost-effective way of collecting data on situational characteristics while minimizing recall bias. Because of its flexibility, ICAT can be applied in various disciplines, whether as part of small pilot studies or large-scale, crosscultural, and multisite research projects.

Lassalle-Lagadec, S., Catheline, G., Mayo, W., Dilharreguy, B., Renou, P., Fleury, O. et al. (2013). Cerebellum involvement in post-stroke mood: A combined ecological and MRI study. Psychiatry Research: Neuroimaging, 212, 158-160.

This study evaluated a new approach combining magnetic resonance imaging and the experience sampling method in the understanding of post-stroke mood pathophysiology. Findings revealed that emotional cognition after stroke may be related to phenotypic characteristics such as cerebellar volume, thereby suggesting that this combined approach could provide new insights into the pathophysiology of post-stroke mood disorders as well as other forms of comorbidity.

Lavender, J. M., Wonderlich, S. A., Crosby, R. D., Engel, S. G., Mitchell, J. E., Crow, S. J. et al. (2013). Personality-based subtypes of anorexia nervosa: Examining validity and utility using baseline clinical variables and ecological momentary assessment. Behav.Res Ther., 51, 512-517.

OBJECTIVE: This study sought to empirically derive and validate clinically relevant personality-based subtypes of anorexia nervosa (AN). METHODS: Women (N = 116) with full or subthreshold AN completed baseline measures of personality, clinical variables, and eating disorder (ED) symptoms, followed by two weeks of ecological momentary assessment (EMA). A latent profile analysis was conducted to identify personality subtypes, which were compared on baseline clinical variables and EMA variables. RESULTS: The best-fitting model supported three subtypes: underregulated, overregulated, and low psychopathology. The underregulated subtype (characterized by high Stimulus Seeking, Self-Harm, and Oppositionality) displayed greater baseline ED symptoms, as well as lower positive affect and greater negative affect, self-discrepancy, and binge eating in the natural environment. The overregulated subtype (characterized by high Compulsivity and low Stimulus Seeking) was more likely to have a lifetime obsessive-compulsive disorder diagnosis and exhibited greater perfectionism; levels of negative affect, positive affect, and self-discrepancy in this group were intermediate between the other subtypes. The low psychopathology subtype (characterized by normative personality) displayed the lowest levels of baseline ED symptoms, co-occurring disorders, and ED behaviors measured via EMA. CONCLUSIONS: Findings support the validity of these personality-based subtypes, suggesting the potential utility of addressing within-diagnosis heterogeneity in the treatment of AN

Lavender, J. M., Wonderlich, S. A., Crosby, R. D., Engel, S. G., Mitchell, J. E., Crow, S. et al. (2013). A naturalistic examination of body checking and dietary restriction in women with anorexia nervosa. Behav.Res Ther., 51, 507-511.

Body checking has been conceptualized as a behavioral manifestation of the core overvaluation of eating, shape, and weight concerns underlying eating disorder psychopathology. Cognitive-behavioral theories suggest that body checking behaviors may function to maintain dietary restriction. The current study examined the association between body checking frequency and dietary restriction among women with anorexia nervosa (AN) in the natural environment. Women (N = 118) with full or partial AN completed baseline clinical interviews and a two-week ecological momentary assessment protocol, during which they reported on body checking behaviors (i.e., checking whether one’s thighs touch; checking joints/bones for fat) and dietary restriction (i.e., 8 waking hours without eating; consuming less than 1200 calories per day). Average daily body checking frequency was positively associated with baseline eating disorder symptoms and body mass index. Daily body checking frequency was associated with both forms of dietary restriction on the same day, as well as the following day. Results support the theorized association between body checking and overvaluation of shape and weight, and suggest that targeting such behaviors in treatment may have utility in reducing dietary restriction

Lavender, J. M., De Young, K. P., Wonderlich, S. A., Crosby, R. D., Engel, S. G., Mitchell, J. E. et al. (2013). Daily Patterns of Anxiety in Anorexia Nervosa: Associations With Eating Disorder Behaviors in the Natural Environment. Journal of Abnormal Psychology.

The role of anxiety has been emphasized in etiological/maintenance models of anorexia nervosa. This study identified daily patterns of anxiety in anorexia nervosa and examined the likelihood of the occurrence of eating disorder behaviors in each trajectory, the daily temporal distribution of eating disorder behaviors in each trajectory, and the extent to which the tendency to exhibit particular anxiety trajectories was associated with baseline diagnostic and trait-level personality variables. Women with full or subthreshold anorexia nervosa (N = 118) completed a 2-week ecological momentary assessment (EMA) protocol during which they reported on a variety of behavioral and affective variables, including anxiety and eating disorder behaviors. Using latent growth mixture modeling to classify EMA days (N = 1,526) based on anxiety ratings, we identified 7 distinct daily anxiety trajectories. Overall differences between trajectories were found for rates of binge eating, self-induced vomiting, body checking, skipping meals, and dietary restriction. Furthermore, distinct daily temporal distributions of eating disorder behaviors were found across the trajectories, with peaks in the probability of behaviors frequently coinciding with high levels of anxiety. Finally, traits of personality pathology (affective lability, self-harm, social avoidance, and oppositionality) and the presence of a co-occurring mood disorder were found to be associated with the tendency to experience particular daily anxiety trajectories (e.g., stable high anxiety). Findings support the presence of within-person variability in daily anxiety patterns in anorexia nervosa and also provide evidence for an association between these anxiety patterns and eating disorder behaviors.

Le Grange, D., Crosby, R. D., Engel, S. G., Cao, L., Ndungu, A., Crow, S. J. et al. (2013). DSM-IV-defined anorexia nervosa versus subthreshold anorexia nervosa (EDNOS-AN). European Eating Disorders Review, 21, 1-7.

Objectives: Eating disorder not otherwise specified (EDNOS) is the most prevalent eating disorder, yet its heterogeneity begs less reliance on this broad diagnostic category. The purpose of this study was to compare women with anorexia nervosa (AN) and EDNOS, AN type (EDNOS-AN) from a multisite study on eating-related and general psychopathology measures. Methods: One hundred eighteen participants (n = 59 with DSM-IV AN, n = 59 with EDNOS-AN) completed structured interviews, questionnaires and a physical examination at baseline. In addition, participants carried a handheld palm pilot computer for 2 weeks to provide ecological momentary assessment (EMA) information about mood and eating disorder behaviours. Results: No significant differences between AN and EDNOS-AN were found on the self-report and interview measures, or on the EMA mood assessments. The only differences to emerge were that participants with AN reported higher rates of binge eating and purging on EMA compared with those with EDNOS-AN, whereas EDNOS-AN reported higher rates of checking thighs and joints on EMA compared with those with AN. For the physiological parameters, AN presented with lower white blood cell counts compared with EDNOS-AN. Conclusions: Findings highlight the clinical significance of EDNOS-AN and support a closer look at the definition of AN as proposed by the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition.

Lee, P. H. (2013). Data imputation for accelerometer-measured physical activity: the combined approach. Am J Clin.Nutr., 97, 965-971.

BACKGROUND: Accelerometers are gaining popularity for the assessment of the physical activity level; however, compliance is a problem that results in missing data. Data from study days in which the accelerometer is not worn for a number of hours that are sufficient to reach a predetermined cutoff value are considered invalid and discarded. The problem of missing data is commonly handled by imputation; however, all traditional imputation methods ignore the available information from invalid days. OBJECTIVE: In this study, I propose a new approach to the imputation of missing accelerometer data that takes into account the data available from invalid days. DESIGN: A total of 4069 participants in NHANES waves 2003-2004 and 2005-2006 who provided 7 d of valid accelerometer data were used to illustrate this new approach. The method of imputation was a combined approach that combined the available data from valid days and invalid days to impute missing values. Simulation studies were carried out to compare this new combined approach with the traditional imputation method for 1) accuracy and 2) effect-size estimation of the sex-physical activity relation by using the root mean squared error (RMSE). RESULTS: The combined approach performed significantly better than traditional imputation method (all t tests P < 0.001), with the percentage reduction of the RMSE for accuracy and effect-size estimation that ranged from 12.4% to 17.3% and 19.8% to 32.9%, respectively. CONCLUSION: The combined approach significantly outperforms the traditional imputation algorithm

Loeffler, S. N., Myrtek, M., & Peper, M. (2013). Mood-congruent memory in daily life: Evidence from interactive ambulatory monitoring. Biological Psychology, 93, 308-315.

Evidence from the psychological laboratory indicates that emotional states tend to facilitate the encoding and retrieval of stimuli of the same emotional valence. To explore mood-congruent memory and the role of arousal in daily life, we applied a new interactive ambulatory technique. Psychophysiological arousal as indexed by non-metabolic heart rate, self-reported emotions and situational information were assessed during 24-h recordings in 70 healthy participants. The emotional state was used to trigger word list presentations on a minicomputer. Our results show that psychophysiological arousal at the time of encoding enhanced the recall of negative words in negative emotional conditions, whereas low psychophysiological arousal facilitated recall of positive words. In positive contexts, mood congruency was more prominent when arousal was low. These results demonstrate how automated experimentation with an ambulatory technique may help to assess emotional memory in real-world contexts, thus providing new methods for diverse fields of application.

Mace, C. J., Maddison, R., Olds, T., & Kerse, N. (2013). Validation of a Computerised Use of Time Recall for Activity Measurement in Advanced Aged Adults. J Aging Phys.Act..

BACKGROUND: The Multimedia Activity Recall for Children and Adults (MARCA) is a computerised recall instrument recording use of time during 24-hours the previous day that has been developed to address limitations of current self-report physical activity measures for those in advanced age. METHODS: Test-retest reliability and convergent validity of the adult MARCA were assessed in a sample of 45 advanced aged adults (aged 84.9 SD+/-1.62 y) as a subsample of the Life and Living in Advanced Age Cohort Study New Zealand (LiLACS NZ). Test-retest methods required participants to recall the previous day’s activity using the MARCA twice within the same day. Convergent validity was assessed against accelerometry. RESULTS: Test-retest reliability was high, with ICCs greater than 0.99 for moderate to vigorous physical activity (MVPA) and physical activity level (PAL). Compared to accelerometry, the MARCA demonstrated validity comparable to other self-report instruments with Spearman’s coefficients of 0.34 and 0.59 for time spent in non-sedentary physical activity and PAL. CONCLUSION: The MARCA is a valid and reliable self-report tool for physical activity behaviours in advanced aged adults

McClernon, F. J. & Roy, C. R. (2013). I Am Your Smartphone and I Know You Are About to Smoke: The Application of Mobile Sensing and Computing Approaches to Smoking Research and Treatment. Nicotine Tob.Res.

Much is known about the immediate and predictive antecedents of smoking lapse, which include situations (e.g., presence of other smokers), activities (e.g., alcohol consumption), and contexts (e.g., outside). This commentary suggests smartphone-based systems could be used to infer these predictive antecedents in real time and provide the smoker with just-in-time intervention. The smartphone of today is equipped with an array of sensors, including GPS, cameras, light sensors, barometers, accelerometers, and so forth, that provide information regarding physical location, human movement, ambient sounds, and visual imagery. We propose that libraries of algorithms to infer these antecedents can be developed and then incorporated into diverse mobile research and personalized treatment applications. While a number of challenges to the development and implementation of such applications are recognized, our field benefits from a database of known antecedents to a problem behavior, and further research and development in this exciting area are warranted

McKinstry, B., Hanley, J., Wild, S., Pagliari, C., Paterson, M., Lewis, S. et al. (2013). Telemonitoring based service redesign for the management of uncontrolled hypertension: multicentre randomised controlled trial.  BMJ, 346, f3030.

OBJECTIVE: To determine if an intervention consisting of telemonitoring and supervision by usual primary care clinicians of home self measured blood pressure and optional patient decision support leads to clinically important reductions in daytime systolic and diastolic ambulatory blood pressure in patients with uncontrolled blood pressure. DESIGN: Multicentre randomised controlled trial. SETTING: 20 primary care practices in south east Scotland. PARTICIPANTS: 401 people aged 29-95 years with uncontrolled blood pressure (mean daytime ambulatory measurement >/=135/85 mm Hg but </=210/135 mm Hg). INTERVENTION: Self measurement and transmission of blood pressure readings to a secure website for review by the attending nurse or doctor and participant, with optional automated patient decision support by text or email for six months. MAIN OUTCOME MEASURES: Blinded assessment of mean daytime systolic ambulatory blood pressure six months after randomisation. RESULTS: 200 participants were randomised to the intervention and 201 to usual care; primary outcome data were available for 90% of participants (182 and 177, respectively). The mean difference in daytime systolic ambulatory blood pressure adjusted for baseline and minimisation factors between intervention and usual care was 4.3 mm Hg (95% confidence interval 2.0 to 6.5; P=0.0002) and for daytime diastolic ambulatory blood pressure was 2.3 mm Hg (0.9 to 3.6; P=0.001), with higher values in the usual care group. The intervention was associated with a mean increase of one general practitioner (95% confidence interval 0.5 to 1.6; P=0.0002) and 0.6 (0.1 to 1.0; P=0.01) practice nurse consultations during the course of the study. CONCLUSIONS: Supported self monitoring by telemonitoring is an effective method for achieving clinically important reductions in blood pressure in patients with uncontrolled hypertension in primary care settings. However, it was associated with increase in use of National Health Service resources. Further research is required to determine if the reduction in blood pressure is maintained in the longer term and if the intervention is cost effective. TRIAL REGISTRATION: Current Controlled Trials ISRCTN72614272

Mitchell, E., Monaghan, D., & O’Connor, N. E. (2013). Classification of sporting activities using smartphone accelerometers. Sensors.(Basel), 13, 5317-5337.

In this paper we present a framework that allows for the automatic identification of sporting activities using commonly available smartphones. We extract discriminative informational features from smartphone accelerometers using the Discrete Wavelet Transform (DWT). Despite the poor quality of their accelerometers, smartphones were used as capture devices due to their prevalence in today’s society. Successful classification on this basis potentially makes the technology accessible to both elite and non-elite athletes. Extracted features are used to train different categories of classifiers. No one classifier family has a reportable direct advantage in activity classification problems to date; thus we examine classifiers from each of the most widely used classifier families. We investigate three classification approaches; a commonly used SVM-based approach, an optimized classification model and a fusion of classifiers. We also investigate the effect of changing several of the DWT input parameters, including mother wavelets, window lengths and DWT decomposition levels. During the course of this work we created a challenging sports activity analysis dataset, comprised of soccer and field-hockey activities. The average maximum F-measure accuracy of 87% was achieved using a fusion of classifiers, which was 6% better than a single classifier model and 23% better than a standard SVM approach

Nolan, M., Mitchell, J. R., & Doyle-Baker, P. K. (2013). Validity of the Apple iPhone/iPod Touch(R) as an Accelerometer-Based Physical Activity Monitor: A Proof-of-Concept Study. J Phys.Act.Health.

BACKGROUND: The popularity of smartphones has led researchers to ask if they can replace traditional tools for assessing free-living physical activity. Our purpose was to establish proof-of-concept that a smartphone could record acceleration during physical activity, and those data could be modeled to predict activity type (walking or running), speed (km.h-1), and energy expenditure (METs). METHODS: An application to record and email accelerations was developed for the Apple iPhone/iPod Touch(R). Twenty-five healthy adults performed treadmill walking (4.0 km.h-1 to 7.2 km.h-1) and running (8.1 km.h-1 to 11.3 km .h-1) wearing the device. Criterion energy expenditure measurements were collected via metabolic cart. RESULTS: Activity type was classified with 99% accuracy. Speed was predicted with a bias of 0.02 km h-1 (SEE: 0.57 km.h-1) for walking, -0.03 km.h-1 (SEE: 1.02 km.h-1) for running. Energy expenditure was predicted with a bias of 0.35 METs (SEE: 0.75 METs) for walking, -0.43 METs (SEE: 1.24 METs) for running. CONCLUSION: Our results suggest that an iPhone/iPod Touch(R) can predict aspects of locomotion with accuracy similar to other accelerometer-based tools. Future studies may leverage this and the additional features of smartphones to improve data collection and compliance

Offer, S. (2013). Assessing the relationship between family mealtime communication and adolescent emotional well-being using the experience sampling method. J Adolesc., 36, 577-585.

While most prior research has focused on the frequency of family meals the issue of which elements of family mealtime are most salient for adolescents’ well-being has remained overlooked. The current study used the experience sampling method, a unique form of time diary, and survey data drawn from the 500 Family Study (N = 237 adolescents with 8122 observations) to examine the association between family mealtime communication and teens’ emotional well-being. Results showed that in approximately half of the time spent on family meals (3 h per week on average) adolescents reported talking to their parents. Hierarchical linear model analyses revealed that controlling for the quality of family relationships family mealtime communication was significantly associated with higher positive affect and engagement and with lower negative affect and stress. Findings suggest that family meals constitute an important site for communication between teens and parents that is beneficial to adolescents’ emotional well-being

Oorschot, M., Lataster, T., Thewissen, V., Lardinois, M. l., Wichers, M., van Os, J. et al. (2013). Emotional experience in negative symptoms of schizophrenia–No evidence for a generalized hedonic deficit. Schizophrenia Bulletin, 39, 217-225.

Background: Deficits in emotion processing are thought to underlie the key negative symptoms flat affect and anhedonia observed in psychotic disorders. This study investigated emotional experience and social behavior in the realm of daily life in a sample of patients with schizophrenia and schizoaffective disorder, stratified by level of negative symptoms. Methods: Emotional experience and behavior of 149 patients with schizophrenia and schizoaffective disorder and 143 controls were explored using the Experience Sampling Method. Results: Patients reported lower levels of positive and higher levels of negative affect compared with controls. High negative symptom patients reported similar emotional stability and capacity to generate positive affect as controls, whereas low negative symptom patients reported increased instability. All participants displayed roughly comparable emotional responses to the company of other people. However, in comparison with controls, patients showed more social withdrawal and preference to be alone while in company, particularly the high negative symptom group. Conclusions: This study revealed no evidence for a generalized hedonic deficit in patients with psychotic spectrum disorders. Lower rather than higher levels of negative symptoms were associated with a pattern of emotional processing which was different from healthy controls.

Palmier-Claus, J. E., Rogers, A., Ainsworth, J., Machin, M., Barrowclough, C., Laverty, L. et al. (2013). Integrating mobile-phone based assessment for psychosis into people’s everyday lives and clinical care: A qualitative study. BMC Psychiatry, 13.

Background: Over the past decade policy makers have emphasised the importance of healthcare technology in the management of long-term conditions. Mobile-phone based assessment may be one method of facilitating clinically- and cost-effective intervention, and increasing the autonomy and independence of service users. Recently, text-message and smartphone interfaces have been developed for the real-time assessment of symptoms in individuals with schizophrenia. Little is currently understood about patients’ perceptions of these systems, and how they might be implemented into their everyday routine and clinical care. Method: 24 community based individuals with non-affective psychosis completed a randomised repeated-measure cross-over design study, where they filled in self-report questions about their symptoms via text-messages on their own phone, or via a purpose designed software application for Android smartphones, for six days. Qualitative interviews were conducted in order to explore participants’ perceptions and experiences of the devices, and thematic analysis was used to analyse the data. Results: Three themes emerged from the data: i) the appeal of usability and familiarity, ii) acceptability, validity and integration into domestic routines, and iii) perceived impact on clinical care. Although participants generally found the technology non-stigmatising and well integrated into their everyday activities, the repetitiveness of the questions was identified as a likely barrier to long-term adoption. Potential benefits to the quality of care received were seen in terms of assisting clinicians, faster and more efficient data exchange, and aiding patient-clinician communication. However, patients often failed to see the relevance of the systems to their personal situations, and emphasised the threat to the person centred element of their care. Conclusions: The feedback presented in this paper suggests that patients are conscious of the benefits that mobile-phone based assessment could bring to clinical care, and that the technology can be successfully integrated into everyday routine. However, it also suggests that it is important to demonstrate to patients the personal, as well as theoretical, benefits of the technology. In the future it will be important to establish whether clinical practitioners are able to use this technology as part of a personalised mental health regime.

Palmier-Claus, J. E., Dunn, G., Taylor, H., Morrison, A. P., & Lewis, S. W. (2013). Cognitive-self consciousness and metacognitive beliefs: Stress sensitization in individuals at ultra-high risk of developing psychosis. British Journal of Clinical Psychology, 52, 26-41.

Objective: Metacognitive beliefs (MCB) may guide information and attention processes, increasing affective and symptomatic reactions to stressful events. Cognitive self-consciousness (CSC; i.e., a preoccupation with one s thoughts) may increase awareness of MCB, potentially triggering the onset of psychotic symptoms. This study tested the hypotheses that (1), MCB would moderate affective and symptomatic reactions to stress in individuals at ultra-high risk (UHR) of developing psychosis, and (2), greater CSC would precede worsening in psychotic symptoms in individuals with strong MCB. Method: Twenty-seven individuals at UHR of developing psychosis completed a self-report diary when prompted by an electronic wristwatch several times each day for 6 days (experience sampling). Results: MCB moderated the association between affective, but not symptomatic, responses to social stress. CSC preceded the subsequent occurrence of hallucinations in individuals who reported strong beliefs about the need to control their thoughts. Conclusions: The data suggest that MCB sensitize an individual to social stressors. CSC may represent times where an individual is aware that their thoughts are uncontrollable, and therefore contradicting their MCB, motivating them to make an external attribution. The findings have implications for improving the effectiveness of interventions for people experiencing hallucinations.

Pan, W., Kwak, S., Li, F., Wu, C., Chen, Y., Yamamoto, Y. et al. (2013). Actigraphy monitoring of symptoms in patients with Parkinson’s disease. Physiol Behav..

Although the Unified Parkinson’s Disease Rating Scale (UPDRS) is the “gold-standard” tool in assessing the severity of symptoms in patients with Parkinson’s disease (PD), not all activity-related disease symptoms can be accurately captured by the well-established clinical rating scale. Using an alternative approach, this study examined the level of physical activity measured by actigraphy over time and whether change in physical activity was associated with disease severity assessed by UPDRS. We used a longitudinal design in which physical activity and disease severity were assessed repeatedly during a 4-month interval, over a 3-year observational period, in a sample of 61 patients with idiopathic PD and a control group of 32 neurologically intact individuals. Physical activity data during awake-time were analyzed using the power-law exponent (PLE) method. Correlational relationships between changes in maxima values of PLE and scores of total UPDRS, UPDRS-part II (Activities of Daily Living), and UPDRS-part III (Motor Examination) in patients with PD were examined. Results show an increase in maxima values of PLE and the UPDRS total score in PD patients and that there is a positive association between changes in maxima values and total UPDRS score (r=0.746, p=0.032), UPDRS-part II score (r=0.687, p=0.027), and UPDRS-part III score (r=0.893, p=0.018). There was no significant change in the level of physical activity over time for the controls. Findings from this study indicate that change in physical activity, as captured by actigraphy, is associated with increased severity in patients’ clinical symptoms of PD over time. Thus, these data suggest that, when used in conjunction with the conventional UPDRS measure, an actigraphic measure of physical activity may provide clinicians an adjunct measurement approach to monitor patients’ activity-based disease progression or responses to treatment in outpatient clinic settings

Pollak, J. P. (2013). The Photographic Affect Meter: A novel application to measure momentary emotional states. ProQuest Information & Learning, US.

Emotion plays an ever-present role in human existence, impacting nearly every behavior and decision in some way. Research in the behavioral sciences is rife with exploration of emotion and the role it plays in everything from business decision making to health-related behavior. However, affect, the feeling or experience of emotion, is complex and presents many challenges to those interested in measuring it, often resulting in a disconnect between the way emotion is experienced and felt and the way that researchers measure it. This dissertation addresses the challenges of measuring emotion through the presentation of the design, development, and validation of a novel measure of affect. The Photographic Affect Meter, PAM, is a digital measure of affect in which subjects choose from a grid of photos the one that best represents their current emotional state. The objective of PAM is to provide researchers with a means of measuring affect that is brief, reliable, and effective when used in situ. PAM was developed through an extensive iterative design process anchored in Human-Computer Interaction research, drawing inspiration from Affective Computing and Design literature. PAM was then rigorously validated via three separate studies. In the first two studies, subjects were assessed using both PAM and one of three widely accepted measure of affect (PANAS, Russell ÇÖs Affect Grid, or the Self Assessment Manikin). In the third study, subjects were induced with negative, neutral, or positive affect and then assessed using PAM. In each of the studies, PAM results were found to be consistent with expectation, establishing the validity and reliability of the measure. While the success of this approach has implications for researchers in Affective Computing, Emotion, Design, and Ecological Momentary Assessment, the primary contribution of this work is the introduction of a novel measure of affect that is ready to be deployed in a wide variety of studies.

Prioreschi, A., Hodkinson, B., Avidon, I., Tikly, M., & McVeigh, J. A. (2013). The clinical utility of accelerometry in patients with rheumatoid arthritis. Rheumatology.(Oxford).

Objectives. To assess habitual physical activity levels in patients with RA compared with healthy control participants and to compare these measures with health-related quality of life and disease activity in the RA patients.Methods. Fifty RA patients [age 48 (13) years] and 22 BMI, sex and geographically matched control participants were recruited. Habitual physical activity was measured using an Actical accelerometer worn on the hip for 2 consecutive weeks. Patients completed the Short Form-36 (SF-36) and modified Health Assessment Questionnaires (HAQ-DI). Disease activity was assessed using the Simplified Disease Activity Index (SDAI). RA patients were further categorized as more physically active (n = 25) and less physically active (n = 25) according to their average activity counts.Results. The RA group spent more time in sedentary activity than the control group (71% vs 62% of the day respectively, P = 0.002) and had bimodal decreases in diurnal physical activity compared with the control group in the morning (P < 0.001) and late afternoon (P < 0.001). HAQ-DI, when adjusted for age and disease duration, was negatively correlated with physical activity in the RA group (r = -0.343, P = 0.026). The more physically active patients scored better than the less physically active patients on every component of the SF-36.Conclusion. Patients with RA lead a significantly more sedentary lifestyle than healthy controls and show diurnal differences in physical activity due to morning stiffness and fatigue. Higher levels of habitual physical activity may be protective of functional capacity and are highly associated with improved health-related quality of life in RA patients

Rabbitts, J. A., Holley, A. L., Karlson, C. W., & Palermo, T. M. (2013). Bidirectional Associations Between Pain and Physical Activity in Adolescents. Clin.J Pain.

OBJECTIVES:: The objectives were to: (1) examine temporal relationships between pain and activity in youth, specifically, whether physical activity affects pain intensity and whether intensity of pain affects subsequent physical activity levels on a daily basis, and (2) examine clinical predictors of this relationship. METHODS:: Participants were 119 adolescents (59 with chronic pain and 60 healthy) aged 12 to 18 years, 71% female. Adolescents completed 10 days of actigraphic monitoring of physical activity and daily electronic diary recordings of pain intensity, medication use, sleep quality, and mood. Linear mixed models assessed daily associations among physical activity and pain. Daily mean (average count/min) and peak (highest daily level) activity were used for analyses. Medication use, sleep quality, and mood ratings were included as covariates, and age, sex, and body mass index percentile were adjusted for. RESULTS: Higher pain intensity was associated with lower peak physical activity levels on the next day (t641=-2.25, P=0.03) and greater medication use predicted lower mean physical activity levels the same day (t641=-2.10, P=0.04). Higher mean physical activity levels predicted lower pain intensity ratings at the end of the day (t705=-2.92, P=0.004), but only in adolescents with chronic pain. DISCUSSION:: Youth experiencing high pain intensity limit their physical activity level on a day-to-day basis. Activity was related to subsequent pain intensity, and may represent an important focus in chronic pain treatment. Further study of the effect of medications on subsequent activity is needed

Rathbun, S. L., Song, X., Neustifter, B., & Shiffman, S. (2013). Survival Analysis with Time-Varying Covariates Measured at Random Times by Design. J R Stat.Soc.Ser.C.Appl.Stat., 62, 419-434.

Ecological momentary assessment (EMA) is a method for collecting real-time data in subjects’ environments. It often uses electronic devices to obtain information on psychological state through administration of questionnaires at times selected from a probability-based sampling design. This information can be used to model the impact of momentary variation in psychological state on the lifetimes to events such as smoking lapse. Motivated by this, a probability-sampling framework is proposed for estimating the impact of time-varying covariates on the lifetimes to events. Presented as an alternative to joint modeling of the covariate process as well as event lifetimes, this framework calls for sampling covariates at the event lifetimes and at times selected according to a probability-based sampling design. A design-unbiased estimator for the cumulative hazard is substituted into the log likelihood, and the resulting objective function is maximized to obtain the proposed estimator. This estimator has two quantifiable sources of variation, that due to the survival model and that due to sampling the covariates. Data from a nicotine patch trial are used to illustrate the proposed approach

Scharf, D. M., Martino, S. C., Setodji, C. M., Staplefoote, B. L., & Shadel, W. G. (2013). Middle and High School Students’ Exposure to Alcohol- and Smoking-Related Media: A Pilot Study Using Ecological Momentary Assessment. Psychology of Addictive Behaviors.

The goals of this study were to assess the feasibility of using Ecological Momentary Assessment (EMA) to measure adolescents’ exposure to alcohol and smoking-related media. A sample of 20 middle and high school students completed a 2-week EMA protocol in which they monitored exposures to alcohol and smoking-related media. Results showed that adolescents were highly compliant with the study protocol. A total of 255 exposures to alcohol (67%) and smoking (33%) were captured, representing an average of 8.50 (SD = 5.82) alcohol-related media exposures and 4.25 (SD = 3.67) smoking-related media exposures per participant, during the study period. Exposures tended to occur in the afternoon (52% alcohol; 54% smoking), at point of sale (44% alcohol; 65% smoking), and on days leading up to the weekend (57% alcohol; 57% smoking). Exposures were also likely in the presence of family (69% alcohol; 56% smoking). Overall, results of this small pilot provide preliminary evidence that EMA is a useful tool for tracking and characterizing middle and high school students’ real-world exposures to alcohol- and smoking-related media. Future studies may suggest mechanisms by which media exposures lead to youth uptake of drinking and smoking behaviors.

Shingleton, R. M., Eddy, K. T., Keshaviah, A., Franko, D. L., Swanson, S. A., Yu, J. S. et al. (2013). Binge/purge thoughts in nonsuicidal self-injurious adolescents: An ecological momentary analysis. Int.J Eat.Disord..

OBJECTIVE: Adolescents who self-injure often engage in bingeing/purging (BP). Ecological momentary assessment (EMA) has potential to offer insight into the relationship between self-injury and BP. The aims of this study were to examine the frequency and context of BP using EMA in a sample of nonsuicidal self-injurious (NSSI) adolescents. METHOD: Thirty adolescents with a history of NSSI responded to questions regarding self-destructive thoughts/behaviors using a palm-pilot device. Descriptive analyses compared thought/behavior contexts during reports of BP and NSSI thoughts/behaviors (occurring together vs. individually). RESULTS: BP thoughts were present in 22 (73%) participants, occurring on 32% of the person-days recorded; 59% of these participants actually engaged in BP behavior. Seventy-nine percent of BP thoughts co-occurred with other self-destructive thoughts. Adolescents were more often with friends/peers than alone or with family when having BP thoughts. Worry and pressure precipitated both BP and NSSI thoughts, but perceived criticism and feelings of rejection/hurt were associated more often with BP thoughts than with NSSI thoughts. DISCUSSION: BP thoughts and behaviors were common in this sample, often occurring with other self-destructive thoughts. Future EMA research is needed to address the function of BP symptoms, the contextual variables that increase risk for BP thoughts, and the factors that predict the transition of thoughts into behaviors in adolescents with and without self-injury. (c) 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2013)

Silvia, P. J., Kwapil, T. R., Walsh, M. A., & Myin-Germeys, I. (2013). Planned missing-data designs in experience-sampling research: Monte Carlo simulations of efficient designs for assessing within-person constructs.  Behav.Res Methods.

Experience-sampling research involves trade-offs between the number of questions asked per signal, the number of signals per day, and the number of days. By combining planned missing-data designs and multilevel latent variable modeling, we show how to reduce the items per signal without reducing the number of items. After illustrating different designs using real data, we present two Monte Carlo studies that explored the performance of planned missing-data designs across different within-person and between-person sample sizes and across different patterns of response rates. The missing-data designs yielded unbiased parameter estimates but slightly higher standard errors. With realistic sample sizes, even designs with extensive missingness performed well, so these methods are promising additions to an experience-sampler’s toolbox

Sotgiu, I. & Rusconi, M. L. (2013). Investigating emotions in Parkinson’s disease: what we know and what we still don’t know. Front Psychol., 4, 336.

Over the last decade, there has been an increasing attention to the role played by emotional processes in Parkinson’s disease (PD). However, most of what is known in this area is based on research conducted in laboratory or clinical settings. In this article, the authors underline the need to expand our current knowledge of the psychological correlates of PD by investigating patients’ everyday emotions in natural contexts. Specifically, the authors illustrate new research avenues based on the implementation of experience sampling methods. It is argued that these methods could permit future researchers to ecologically assess the frequency and intensity with which parkinsonian patients experience specific emotions (either negative or positive) during their everyday life, providing at the same time precious information on what are the most typical situations in which these emotions occur and on how patients behave in these circumstances. Potential practical implications associated with investigating these issues are discussed

Steger, M. F. & Kashdan, T. B. (2013). The unbearable lightness of meaning: Well-being and unstable meaning in life. The Journal of Positive Psychology, 8, 103-115.

Psychological theories prioritize developing enduring sources of meaning in life. As such, unstable meaning should be detrimental to well-being. Two daily experience sampling studies were conducted to test this hypothesis. Across the studies, people with greater instability of daily meaning reported lower daily levels of meaning in life, and lower global levels of life satisfaction, positive affect, social connectedness and relationship satisfaction, along with higher global levels of negative affect and depression. In addition, instability of meaning interacted with average daily levels of meaning to account for significant variance in meaning in life scores. Relative to people with more stable meaning, people with unstable meaning tended to score near the middle of the distribution of well-being, whether they reported high or low levels of daily meaning. Results are discussed with an eye toward a better understanding of meaning in life and developing interventions to stabilize and maximize well-being.

Tay, L., Chan, D., & Diener, E. (2013). The metrics of societal happiness. Social Indicators Research.

Growing interest in the measurement of subjective well-being (SWB) has also been accompanied by scientific debate on the optimal method for measuring SWB. The momentary perspective, which is represented by the ecological momentary assessment (EMA) and day reconstruction method (DRM), emphasizes the momentary experiences and aims to measure SWB in an objective manner via the aggregation of happiness levels over time and activities. The global reporting perspective emphasizes the subjective evaluation of life experiences and aims to capture the overall evaluation using retrospection or global evaluations. We discuss the strengths and weaknesses of these different perspectives and methods by examining conceptual, methodological, and practical issues. We propose adopting a multi-method assessment approach to SWB that uses both perspectives and the corresponding methods in a theory-driven and complementary manner. For the purposes of measuring and tracking SWB of societies, we also call for more research on the reliability and validity of EMA and DRM

te Lindert, B. H. W. & Van Someren, E. J. W. (2013). Sleep estimates using microelectromechanical systems (MEMS). Sleep: Journal of Sleep and Sleep Disorders Research, 36, 781-789.

Study Objectives: Although currently more affordable than polysomnography, actigraphic sleep estimates have disadvantages. Brand-specific differences in data reduction impede pooling of data in large-scale cohorts and may not fully exploit movement information. Sleep estimate reliability might improve by advanced analyses of three-axial, linear accelerometry data sampled at a high rate, which is now feasible using microelectromechanical systems (MEMS). However, it might take some time before these analyses become available. To provide ongoing studies with backward compatibility while already switching from actigraphy to MEMS accelerometry, we designed and validated a method to transform accelerometry data into the traditional actigraphic movement counts, thus allowing for the use of validated algorithms to estimate sleep parameters. Design: Simultaneous actigraphy and MEMS-accelerometry recording. Setting: Home, unrestrained. Participants: Fifteen healthy adults (23-36 y, 10 males, 5 females). Interventions: None. Measurements: Actigraphic movement counts/15-sec and 50-Hz digitized MEMS-accelerometry. Analyses: Passing-Bablok regression optimized transformation of MEMS-accelerometry signals to movement counts. Kappa statistics calculated agreement between individual epochs scored as wake or sleep. Bland-Altman plots evaluated reliability of common sleep variables both between and within actigraphs and MEMS-accelerometers. Results: Agreement between epochs was almost perfect at the low, medium, and high threshold (kappa = 0.87 -¦ 0.05, 0.85 -¦ 0.06, and 0.83 -¦ 0.07). Sleep parameter agreement was better between two MEMS-accelerometers or a MEMS-accelerometer and an actigraph than between two actigraphs. Conclusions: The algorithm allows for continuity of outcome parameters in ongoing actigraphy studies that consider switching to MEMS-accelerometers. Its implementation makes backward compatibility feasible, while collecting raw data that, in time, could provide better sleep estimates and promote cross-study data pooling.

Tossell, C. C., Kortum, P., Shepard, C. W., Rahmati, A., & Zhong, L. (2012). Getting real: A naturalistic methodology for using smartphones to collect mediated communication. Advances in Human-Computer Interaction, 2012.

This paper contributes an intentionally naturalistic methodology using smartphone logging technology to study communications in the wild. Smartphone logging can provide tremendous access to communications data from real environments. However, researchers must consider how it is employed to preserve naturalistic behaviors. Nine considerations are presented to this end. We also provide a description of a naturalistic logging approach that has been applied successfully to collecting mediated communications from iPhones. The methodology was designed to intentionally decrease reactivity and resulted in data that were more accurate than self-reports. Example analyses are also provided to show how data collected can be analyzed to establish empirical patterns and identify user differences. Smartphone logging technologies offer flexible capabilities to enhance access to real communications data, but methodologies employing these techniques must be designed appropriately to avoid provoking naturally occurring behaviors. Functionally, this methodology can be applied to establish empirical patterns and test specific hypotheses within the field of HCI research. Topically, this methodology can be applied to domains interested in understanding mediated communications such as mobile content and systems design, teamwork, and social networks.

Unsworth, N., McMillan, B. D., Brewer, G. A., & Spillers, G. J. (2013). Individual differences in everyday retrospective memory failures.  Journal of Applied Research in Memory and Cognition, 2, 7-13.

The present study examined individual differences in everyday retrospective memory failures. Undergraduate students completed various cognitive ability measures in the laboratory and recorded everyday retrospective memory failures in a diary over the course of a week. The majority of memory failures were forgetting information pertaining to exams and homework, forgetting names, and forgetting login and ID information. Using latent variable techniques the results also suggested that individual differences in working memory capacity and retrospective memory were related to some but not all everyday memory failures. Furthermore, everyday memory failures predicted SAT scores and partially accounted for the relation between cognitive abilities and SAT scores. These results provide important evidence for individual differences in everyday retrospective memory failures as well as important evidence for the ecological validity of laboratory measures of working memory capacity and retrospective memory.

van Dijk, A. E., van, L. R., van, E. M., Gemke, R. J., Vrijkotte, T. G., & de Geus, E. J. (2013). Measuring cardiac autonomic nervous system (ANS) activity in children. J Vis.Exp., e50073.

The autonomic nervous system (ANS) controls mainly automatic bodily functions that are engaged in homeostasis, like heart rate, digestion, respiratory rate, salivation, perspiration and renal function. The ANS has two main branches: the sympathetic nervous system, preparing the human body for action in times of danger and stress, and the parasympathetic nervous system, which regulates the resting state of the body. ANS activity can be measured invasively, for instance by radiotracer techniques or microelectrode recording from superficial nerves, or it can be measured non-invasively by using changes in an organ’s response as a proxy for changes in ANS activity, for instance of the sweat glands or the heart. Invasive measurements have the highest validity but are very poorly feasible in large scale samples where non-invasive measures are the preferred approach. Autonomic effects on the heart can be reliably quantified by the recording of the electrocardiogram (ECG) in combination with the impedance cardiogram (ICG), which reflects the changes in thorax impedance in response to respiration and the ejection of blood from the ventricle into the aorta. From the respiration and ECG signals, respiratory sinus arrhythmia can be extracted as a measure of cardiac parasympathetic control. From the ECG and the left ventricular ejection signals, the preejection period can be extracted as a measure of cardiac sympathetic control. ECG and ICG recording is mostly done in laboratory settings. However, having the subjects report to a laboratory greatly reduces ecological validity, is not always doable in large scale epidemiological studies, and can be intimidating for young children. An ambulatory device for ECG and ICG simultaneously resolves these three problems. Here, we present a study design for a minimally invasive and rapid assessment of cardiac autonomic control in children, using a validated ambulatory device (1-5), the VU University Ambulatory Monitoring System (VU-AMS, Amsterdam, the Netherlands, www.vu-ams.nl)

Van Voorhees, E. E., Dennis, M. F., McClernon, F. J., Calhoun, P. S., Buse, N. A., & Beckham, J. C. (2013). The Association of Dehydroepiandrosterone and Dehydroepiandrosterone Sulfate With Anxiety Sensitivity and Electronic Diary Negative Affect Among Smokers With and Without Posttraumatic Stress Disorder. J Clin.Psychopharmacol..

Posttraumatic stress disorder (PTSD) is associated with increased smoking initiation, maintenance, and relapse. Dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS) are neurosteroids that have been associated with mood measures as well as smoking status, and nicotine is associated with increased DHEA and DHEAS levels. Given the difficulties with mood experienced by smokers with PTSD, the purpose of the current study was to evaluate the association between negative affect and anxiety sensitivity with DHEA and DHEAS levels. Ninety-six smokers with and without PTSD provided blood samples for neurosteroid analyses and completed self-report measures of anxiety sensitivity and electronic diary ratings of negative affect. As expected, PTSD smokers reported higher levels of anxiety sensitivity (F1,94 = 20.67, partial eta = 0.18, P < 0.0001) and negative affect (F1,91 = 7.98, partial eta = 0.08, P = 0.006). After accounting for age and sex, DHEAS was significantly inversely associated with both anxiety sensitivity (F3,92 = 6.97, partial eta = 0.07, P = 0.01) and negative affect (F3,87 = 10.52, partial eta = 0.11, P = 0.002) across groups. Effect sizes indicated that these effects are moderate to high. No significant interactions of diagnosis and DHEA(S) levels with mood measures were detected. Given that nicotine is known to elevate DHEA(S) levels, these results suggest that DHEAS may serve as a biomarker of the association between mood and nicotine among smokers. Implications for the results include (1) the use of DHEAS measurement across time and across quit attempts and (2) the potential for careful use of DHEA supplementation to facilitate abstinence during smoking cessation

Vansteelandt, K., Claes, L., Muehlenkamp, J., De Cuyper, K., Lemmens, J., Probst, M. et al. (2013). Variability in affective activation predicts non-suicidal self-injury in eating disorders. European Eating Disorders Review, 21, 143-147.

We examined whether affective variability can predict non-suicidal self-injury (NSSI) in eating disorders. Affect was represented by valence (positive versus negative) and activation (high versus low). Twenty-one patients with anorexia nervosa-restricting type, 18 patients with anorexia nervosa-binge-purging type and 20 patients with bulimia nervosa reported their momentary affect at nine random times a day during a one week period using a hand-held computer. Affective variability was calculated as the within-person standard deviation of valence and activation over time. Results indicate that patients displaying greater variability in activation and using selective serotonin reuptake inhibitors have a higher probability to engage in lifetime NSSI after adjustment for depression and borderline personality disorder. Neither variability of valence nor mean level of valence and activation had any predictive association with engaging in NSSI. It is suggested that the treatment of NSSI should focus on affect stabilization rather than reducing negative affect.

Ver, C., Hofgart, G., Szima, G., Kovacs, G., Nyisztor, Z., Kardos, L. et al. (2013). [Experiences with a self developed accelerometer]. Ideggyogy.Sz, 66, 29-34.

OBJECTIVE: In neurology the objective evaluation of improvement of paresis on every-day practice. The aim of this study was to develop and test a small 3-d acceleration measuring device and validate its usefulness. PATIENTS AND METHODS: We collected data from 17 mild and medium severity hemiparetic, bedridden acute ischaemic and hemorrhagic stroke patients and compared with data of 22 control subjects. The devices were attached to the paretic and non-paretic extremities and any movements (m/s2) and movement-durations were registered (24h). The data of movement-monitors were compared also with the changes of National Institute of Health Stroke Scale and European Stroke Scale. The electromyograph-sensor of polysomnograph was used for validation. RESULTS: Mild differences could be found in the use of dominant and non-dominant upper extremities of control persons. The control persons used their upper extremities more frequently than the stroke patients. Our data showed significant correlation with National Institute of Health Stroke Scale. Higher values on the scores were accompanied with less intensive use of extremities. We found a correlation between the consiousness level of patients and their activity of upper extremities. If the patients had severe consiousness disturbances they used significantly less their upper extremities. CONCLUSION: Our device sensitively detected the movement-differences between paretic and non-paretic extremities and can be used for quantitative evaluation of patient’s neurological and consciousness status

Wigman, J. T., van, O. J., Thiery, E., Derom, C., Collip, D., Jacobs, N. et al. (2013). Psychiatric diagnosis revisited: towards a system of staging and profiling combining nomothetic and idiographic parameters of momentary mental states. PLoS One, 8, e59559.

BACKGROUND: Mental disorders may be reducible to sets of symptoms, connected through systems of causal relations. A clinical staging model predicts that in earlier stages of illness, symptom expression is both non-specific and diffuse. With illness progression, more specific syndromes emerge. This paper addressed the hypothesis that connection strength and connection variability between mental states differ in the hypothesized direction across different stages of psychopathology. METHODS: In a general population sample of female siblings (mostly twins), the Experience Sampling Method was used to collect repeated measures of three momentary mental states (positive affect, negative affect and paranoia). Staging was operationalized across four levels of increasing severity of psychopathology, based on the total score of the Symptom Check List. Multilevel random regression was used to calculate inter- and intra-mental state connection strength and connection variability over time by modelling each momentary mental state at t as a function of the three momentary states at t-1, and by examining moderation by SCL-severity. RESULTS: Mental states impacted dynamically on each other over time, in interaction with SCL-severity groups. Thus, SCL-90 severity groups were characterized by progressively greater inter- and intra-mental state connection strength, and greater inter- and intra-mental state connection variability. CONCLUSION: Diagnosis in psychiatry can be described as stages of growing dynamic causal impact of mental states over time. This system achieves a mode of psychiatric diagnosis that combines nomothetic (group-based classification across stages) and idiographic (individual-specific psychopathological profiles) components of psychopathology at the level of momentary mental states impacting on each other over time

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