Society for Ambulatory Assessment

Fourth quarter 2013 (October to December)

Abroms, L. C., Lee, W. J., Bontemps-Jones, J., Ramani, R., & Mellerson, J. (2013). A content analysis of popular smartphone apps for smoking cessation. Am.J.Prev.Med., 45, 732-736.

BACKGROUND: Smartphone applications (apps) are increasingly available for smoking cessation. PURPOSE: This study examined the content of popular apps for smoking cessation for both iPhone and Android operating systems in February 2012. METHODS: A total of 252 smoking-cessation apps were identified for the iPhone and 148 for the Android. Across both operating systems, the most popular apps were identified (n=47 for the iPhone and n=51 for the Android) and analyzed for their (1) approach to smoking cessation and (2) adherence to an index based on the U.S. Public Health Service’s Clinical Practice Guidelines for Treating Tobacco Use and Dependence. Where available, apps were coded for frequency of downloads. The analysis took place in 2012. RESULTS: Overall, popular apps have low levels of adherence, with an average score of 12.9 of a possible 42 on the Adherence Index. No apps recommended calling a quitline, and only a handful of apps recommended using approved medications (4.1%). Android apps in the sample were downloaded worldwide between 310,800 and 1,248,000 times per month. For both the iPhone and Android, user ratings were positively associated with scores on the Adherence Index. For the iPhone, display order was also positively associated with scores on the Adherence Index. CONCLUSIONS: Apps could be improved by better integration with the Clinical Practice Guidelines and other evidence-based practices

Adams, M. A., Johnson, W. D., & Tudor-Locke, C. (2013). Steps/day translation of the moderate-to-vigorous physical activity guideline for children and adolescents. The International Journal of Behavioral Nutrition and Physical Activity, 10.

Background: An evidence-based steps/day translation of U.S. federal guidelines for youth to engage in GëÑ60 minutes/day of moderate-to-vigorous physical activity (MVPA) would help health researchers, practitioners, and lay professionals charged with increasing youthGÇÖs physical activity (PA). The purpose of this study was to determine the number of free-living steps/day (both raw and adjusted to a pedometer scale) that correctly classified children (6GÇô11 years) and adolescents (12GÇô17 years) as meeting the 60-minute MVPA guideline using the 2005GÇô2006 National Health and Nutrition Examination Survey (NHANES) accelerometer data, and to evaluate the 12,000 steps/day recommendation recently adopted by the PresidentGÇÖs Challenge Physical Activity and Fitness Awards Program. Methods: Analyses were conducted among children (n = 915) and adolescents (n = 1,302) in 2011 and 2012. Receiver Operating Characteristic (ROC) curve plots and classification statistics revealed candidate steps/day cut points that discriminated meeting/not meeting the MVPA threshold by age group, gender and different accelerometer activity cut points. The Evenson and two Freedson age-specific (3 and 4 METs) cut points were used to define minimum MVPA, and optimal steps/day were examined for raw steps and adjusted to a pedometer-scale to facilitate translation to lay populations. Results: For boys and girls (6GÇô11 years) with GëÑ 60 minutes/day of MVPA, a range of 11,500GÇô13,500 uncensored steps/day for children was the optimal range that balanced classification errors. For adolescent boys and girls (12GÇô17) with GëÑ60 minutes/day of MVPA, 11,500GÇô14,000 uncensored steps/day was optimal. Translation to a pedometer-scaling reduced these minimum values by 2,500 step/day to 9,000 steps/day. Area under the curve was GëÑ84% in all analyses. Conclusions: No single study has definitively identified a precise and unyielding steps/day value for youth. Considering the other evidence to date, we propose a reasonable GÇÿrule of thumbGÇÖ value of GëÑ 11,500 accelerometer-determined steps/day for both children and adolescents (and both genders), accepting that more is better. For practical applications, 9,000 steps/day appears to be a more pedometer-friendly value.

Addy, C. L., Trilk, J. L., Dowda, M., Byun, W., & Pate, R. R. (2013). Assessing Preschool Children’s Physical Activity: How Many Days of Accelerometry Measurement. Pediatr.Exerc.Sci..

The purpose of this study was to determine the minimum number of days of accelerometry required to estimate accurately MVPA and total PA in 3- to 5-year-old children. The study examined these metrics for all days, weekdays, and in-school activities. Study participants were 204 children attending 22 preschools who wore accelerometers for at least six hour per day for up to 12 days during most waking hours. The primary analysis considered the intraclass correlation coefficient (ICC) for each metric to estimate the number of days required to attain a specified reliability. The ICC estimates are 0.81 for MVPA-all days, 0.78 for total PA-all days, 0.83 for MVPA-weekdays, 0.80 for total PA-weekdays, 0.81 for in-school MVPA, and 0.84 for in-school total PA. We recommend a full seven days of measurement whenever possible, but researchers can achieve acceptable reliability with fewer days as indicated by the Spearman-Brown prophecy: 3-4 days for any weekday measure and 5-6 days for the all-days measures

Alhassan, S., Lyden, K., Howe, C., Kozey, K. S., Nwaokelemeh, O., & Freedson, P. S. (2012). Accuracy of accelerometer regression models in predicting energy expenditure and METs in children and youth. Pediatr.Exerc.Sci., 24, 519-536.

Abstract: This study examined the validity of commonly used regression equations for the Actigraph and Actical accelerometers in predicting energy expenditure (EE) in children and adolescents. Sixty healthy (8-16 yrs) participants completed four treadmill (TM) and five self-paced activities of daily living (ADL). Four Actigraph (AG) and three Actical (AC) regression equations were used to estimate EE. Bias (+/- 95% CI) and root mean squared errors were used to assess the validity of the regression equations compared with indirect calorimetry. For children, the Freedson (AG) model accurately predicted EE for all activities combined and the Treuth (AG) model accurately predicted EE for TM activities. For adolescents, the Freedson model accurately predicted EE for TM activities and the Treuth model accurately predicted EE for all activities and for TM activities. No other equation accurately estimated EE. The percent agreement for the AG and AC equations were better for light and vigorous compared with moderate intensity activities. The Trost (AG) equation most accurately classified all activity intensity categories. Overall, equations yield inconsistent point estimates of EE

Aminian, S. & Hinckson, E. A. (2012). Examining the validity of the ActivPAL monitor in measuring posture and ambulatory movement in children. Int.J.Behav.Nutr.Phys.Act., 9, 119.

BACKGROUND: Decreasing sedentary activities that involve prolonged sitting may be an important strategy to reduce obesity and other physical and psychosocial health problems in children. The first step to understanding the effect of sedentary activities on children’s health is to objectively assess these activities with a valid measurement tool. PURPOSE: To examine the validity of the ActivPAL monitor in measuring sitting/lying, standing, and walking time, transition counts and step counts in children in a laboratory setting. METHODS: Twenty five healthy elementary school children (age 9.9 +/- 0.3 years; BMI 18.2 +/- 1.9; mean +/- SD) were randomly recruited across the Auckland region, New Zealand. Children were fitted with ActivPAL monitors and observed during simulated free-living activities involving sitting/lying, standing and walking, followed by treadmill and over-ground activities at various speeds (slow, normal, fast) against video observation (criterion measure). The ActivPAL sit-to-stand and stand-to-sit transition counts and steps were also compared with video data. The accuracy of step counts measured by the ActivPAL was also compared against the New Lifestyles NL-2000 and the Yamax Digi-Walker SW-200 pedometers. RESULTS: We observed a perfect correlation between the ActivPAL monitor in time spent sitting/lying, standing, and walking in simulated free-living activities with direct observation. Correlations between the ActivPAL and video observation in total numbers of sit-to-stand and stand-to-sit transitions were high (r = 0.99 +/- 0.01). Unlike pedometers, the ActivPAL did not misclassify fidgeting as steps taken. Strong correlations (r = 0.88-1.00) between ActivPAL step counts and video observation in both treadmill and over-ground slow and normal walking were also observed. During treadmill and over-ground fast walking and running, the correlations were low (r = 0.21-0.46). CONCLUSION: The ActivPAL monitor is a valid measurement tool for assessing time spent sitting/lying, standing, and walking, sit-to-stand and stand-to-sit transition counts and step counts in slow and normal walking. The device did not measure accurately steps taken during treadmill and over-ground fast walking and running in children

Andrews, N. E., Strong, J., Meredith, P. J., & D’Arrigo, R. G. (2013). Association Between Physical Activity and Sleep in Adults With Chronic Pain: A Momentary, Within-Persons Perspective. Phys.Ther..

BACKGROUND: Individuals with chronic pain consider improved sleep as one of the most important outcomes of treatment. Physical activity has been shown to have beneficial effects on sleep in the general population. Despite this, the physical activity-sleep relationship has not been directly examined in a chronic pain sample. OBJECTIVE: This study aimed to examine the association between objective daytime physical activity and subsequent objective sleep for individuals with chronic pain while controlling for pain and psychosocial variables. DESIGN: An observational prospective within-persons study design was employed. METHODS: A clinical sample of fifty adults with chronic pain was recruited. Participation involved completing a demographic questionnaire followed by five days of data collection. Over this period participants wore a tri-axial accelerometer to monitor their daytime activity and sleep. Participants also carried a Palm Hand Held Computer that administered a questionnaire measuring pain, mood, catastrophizing, and stress, six times throughout the day. RESULTS: Results demonstrated that higher fluctuations in daytime activity significantly predicted shorter sleep duration. Furthermore, higher mean daytime activity levels and a greater number of pain sites contributed significantly to the prediction of longer periods of wakefulness at night. LIMITATIONS: The small sample size used in this study limits the generalizability of findings. Missing data may have led to over- or under-estimations of effect sizes, and additional factors that may be associated with sleep (such as medication usage and environmental factors) were not measured. CONCLUSIONS: Results of this study suggest engagement in high intensity activity and high fluctuations in activity are associated with poorer sleep at night; hence, activity modulation may be a key treatment strategy to address sleep complaints in individuals with chronic pain

Antos, S. A., Albert, M. V., & Kording, K. P. (2013). Hand, belt, pocket or bag: Practical activity tracking with mobile phones. J.Neurosci.Methods.

For rehabilitation and diagnoses, an understanding of patient activities and movements is important. Modern smartphones have built in accelerometers which promise to enable quantifying minute-by-minute what patients do (e.g. walk or sit). Such a capability could inform recommendations of physical activities and improve medical diagnostics. However, a major problem is that during everyday life, we carry our phone in different ways, e.g. on our belt, in our pocket, in our hand, or in a bag. The recorded accelerations are not only affected by our activities but also by the phone’s location. Here we develop a method to solve this kind of problem, based on the intuition that activities change rarely, and phone locations change even less often. A hidden Markov model (HMM) tracks changes across both activities and locations, enabled by a static support vector machine (SVM) classifier that probabilistically identifies activity-location pairs. We find that this approach improves tracking accuracy on healthy subjects as compared to a static classifier alone. The obtained method can be readily applied to patient populations. Our research enables the use of phones as activity tracking devices, without the need of previous approaches to instruct subjects to always carry the phone in the same location

Azar, K. M., Lesser, L. I., Laing, B. Y., Stephens, J., Aurora, M. S., Burke, L. E. et al. (2013). Mobile applications for weight management: theory-based content analysis. Am.J.Prev.Med., 45, 583-589.

BACKGROUND: The use of smartphone applications (apps) to assist with weight management is increasingly prevalent, but the quality of these apps is not well characterized. PURPOSE: The goal of the study was to evaluate diet/nutrition and anthropometric tracking apps based on incorporation of features consistent with theories of behavior change. METHODS: A comparative, descriptive assessment was conducted of the top-rated free apps in the Health and Fitness category available in the iTunes App Store. Health and Fitness apps (N=200) were evaluated using predetermined inclusion/exclusion criteria and categorized based on commonality in functionality, features, and developer description. Four researchers then evaluated the two most popular apps in each category using two instruments: one based on traditional behavioral theory (score range: 0-100) and the other on the Fogg Behavioral Model (score range: 0-6). Data collection and analysis occurred in November 2012. RESULTS: Eligible apps (n=23) were divided into five categories: (1) diet tracking; (2) healthy cooking; (3) weight/anthropometric tracking; (4) grocery decision making; and (5) restaurant decision making. The mean behavioral theory score was 8.1 (SD=4.2); the mean persuasive technology score was 1.9 (SD=1.7). The top-rated app on both scales was Lose It! by Fitnow Inc. CONCLUSIONS: All apps received low overall scores for inclusion of behavioral theory-based strategies

Baddeley, J. L., Pennebaker, J. W., & Beevers, C. G. (2013). Everyday social behavior during a major depressive episode. Social Psychological and Personality Science, 4, 445-452.

Although social functioning deficits are believed to characterize major depressive disorder (MDD), few studies have examined the social behavior of individuals with MDD in everyday life. The current studyGÇÖs aim is to assess the everyday social behavior of individuals in a current major depressive episode. Participants with current MDD (n = 29) and healthy controls (n = 28) wore the electronically activated recorder (EAR), an ambulatory assessment device, for 3GÇô4 days. The EAR recorded 90-second sound clips from participantsGÇÖ immediate environments. ParticipantsGÇÖ conversations were transcribed and locations and activities coded. Indicators of social isolation and negative emotional expression were examined. Individuals with and without MDD spent similar amounts of time talking, laughing, and with another person. However, depressed people spent less time in groups and used more negative emotion words, particularly in reference to the self, and particularly around romantic partners. Findings suggest depressed peopleGÇÖs social interactions suffer in quality but not quantity.

Barrantes-Vidal, N., Chun, C. A., Myin-Germeys, I., & Kwapil, T. R. (2013). Psychometric schizotypy predicts psychotic-like, paranoid, and negative symptoms in daily life. Journal of Abnormal Psychology, 122, 1077-1087.

Positive and negative schizotypy exhibit differential patterns of impairment in social relations, affect, and functioning in daily life. However, studies have not examined the association of schizotypy with real-world expression of psychotic-like, paranoid, and negative symptoms. The present study employed experience-sampling methodology (ESM) to assess positive and negative schizotypy in daily life in a nonclinical sample of 206 Spanish young adults. Participants were prompted randomly 8 times daily for 1 week to complete assessments of their current symptoms and experiences. Positive schizotypy was associated with psychotic-like and paranoid symptoms in daily life. Negative schizotypy was associated with a subset of these symptoms and with negative symptoms in daily life. Momentary stress was associated with psychotic-like and paranoid symptoms, but only for those high in positive schizotypy. Social stress predicted momentary psychotic-like symptoms in both positive and negative schizotypy. Time-lagged analyses indicated that stress at the preceding signal predicted psychotic-like symptoms at the current assessment, but only for individuals high in positive schizotypy. The results are consistent with models linking stress sensitivity with the experience of psychotic symptoms. The findings provide cross-cultural support for the multidimensional model of schizotypy and schizophrenia. Furthermore, the findings demonstrate that ESM is an effective method for predicting the experience of psychotic-like symptoms, as well as their precursors, in daily life.

Becker, S., Kribben, A., Meister, S., Diamantidis, C. J., Unger, N., & Mitchell, A. (2013). User profiles of a smartphone application to support drug adherence-experiences from the iNephro project. PLoS.One., 8, e78547.

PURPOSE: One of the key problems in the drug therapy of patients with chronic conditions is drug adherence. In 2010 the initiative iNephro was launched ( A software to support regular and correct drug intake was developed for a smartphone platform (iOS). The study investigated whether and how smartphone users deployed such an application. METHODS: Together with cooperating partners the mobile application “Medikamentenplan” (“Medication Plan”) was developed. Users are able to keep and alter a list of their regular medication. A memory function supports regular intake. The application can be downloaded free of charge from the App Store by Apple. After individual consent of users from December 2010 to April 2012 2042338 actions were recorded and analysed from the downloaded applications. Demographic data were collected from 2279 users with a questionnaire. RESULTS: Overall the application was used by 11688 smartphone users. 29% (3406/11688) used it at least once a week for at least four weeks. 27% (3209/11688) used the application for at least 84 days. 68% (1554/2279) of users surveyed were male, the stated age of all users was between 6-87 years (mean 44). 74% of individuals (1697) declared to be suffering from cardiovascular disease, 13% (292) had a previous history of transplantation, 9% (205) were suffering from cancer, 7% (168) reported an impaired renal function and 7% (161) suffered from diabetes mellitus. 69% (1568) of users were on <6 different medications, 9% (201) on 6 - 10 and 1% (26) on more than 10. CONCLUSION: A new smartphone application, which supports drug adherence, was used regularly by chronically ill users with a wide range of diseases over a longer period of time. The majority of users so far were middle-aged and male

Bender, J. L., Yue, R. Y., To, M. J., Deacken, L., & Jadad, A. R. (2013). A Lot of Action, But Not in the Right Direction: Systematic Review and Content Analysis of Smartphone Applications for the Prevention, Detection, and Management of Cancer. J.Med.Internet.Res., 15, e287.

BACKGROUND: Mobile phones have become nearly ubiquitous, offering a promising means to deliver health interventions. However, little is known about smartphone applications (apps) for cancer. OBJECTIVE: The purpose of this study was to characterize the purpose and content of cancer-focused smartphone apps available for use by the general public and the evidence on their utility or effectiveness. METHODS: We conducted a systematic review of the official application stores for the four major smartphone platforms: iPhone, Android, Nokia, and BlackBerry. Apps were included in the review if they were focused on cancer and available for use by the general public. This was complemented by a systematic review of literature from MEDLINE, Embase, and the Cochrane Library to identify evaluations of cancer-related smartphone apps. RESULTS: A total of 295 apps from the smartphone app stores met the inclusion criteria. The majority of apps targeted breast cancer (46.8%, 138/295) or cancer in general (28.5%, 84/295). The reported app purpose was predominantly to raise awareness about cancer (32.2%, 95/295) or to provide educational information about cancer (26.4%, 78/295), followed by apps to support fundraising efforts (12.9%, 38/295), assist in early detection (11.5%, 34/295), promote a charitable organization (10.2%, 30/295), support disease management (3.7%, 11/295), cancer prevention (2.0%, 6/295), or social support (1.0%, 3/295). The majority of the apps did not describe their organizational affiliation (64.1%, 189/295). Apps affiliated with non-profit organizations were more likely to be free of cost (chi2 1=16.3, P<.001) and have a fundraising or awareness purpose (chi2 2=13.3, P=.001). The review of the health literature yielded 594 articles, none of which reported an evaluation of a cancer-focused smartphone application. CONCLUSIONS: There are hundreds of cancer-focused apps with the potential to enhance efforts to promote behavior change, to monitor a host of symptoms and physiological indicators of disease, and to provide real-time supportive interventions, conveniently and at low cost. However, there is a lack of evidence on their utility, effectiveness, and safety. Future efforts should focus on improving and consolidating the evidence base into a whitelist for public consumption

Berg, K. C., Peterson, C. B., Crosby, R. D., Cao, L., Crow, S. J., Engel, S. G. et al. (2013). Relationship between daily affect and overeating-only, loss of control eating-only, and binge eating episodes in obese adults. Psychiatry Research.

The two objectives of the current study were: (1) to identify daily patterns of negative affect (NA) in obese individuals; and (2) to determine whether daily affect patterns were related to overeating without loss of control (OE-only), loss of control eating without overeating (LOC-only), and binge eating (BE) episodes. Fifty obese (BMI=40.3-¦08.5) adults (84.0% female) completed a two-week ecological momentary assessment protocol during which they completed assessments of NA and indicated whether their eating episodes were characterized by OE and/or LOC. Latent growth mixture modeling (LGMM) was used to identify daily trajectories of NA. GEE analysis was used to determine whether daily affect trajectories were differentially related to the frequency of OE-only, LOC-only, and BE episodes. The LGMM analyses identified nine unique trajectories of NA. Significantly higher frequencies of OE-only and BE episodes occurred on days characterized by high or increasing levels of NA. There were no significant differences between classes for the frequency of LOC-only episodes. These data suggest that NA may act as an antecedent to OE-only and BE episodes and that targeting GÇ£problematic affect daysGÇØ may reduce the occurrence of OE-only and BE episodes among obese individuals.

Bohnert, A., Burdette, K., Dugas, L., Travers, L., Randall, E., Richards, M. et al. (2013). Multimethod analyses of discretionary time use and health behaviors among urban low-income African-American adolescents: A pilot study. Journal of Developmental and Behavioral Pediatrics, 34, 589-598.

Objective: The objective of this pilot study was to examine the relations between discretionary time (DT) social context, health behaviors (dietary intake and physical activity), and body mass index (BMI) in a sample of urban low-income African-American early adolescents. Methods: Multiple methods were used, including accelerometers, 24-hour dietary recalls, anthropometric measurements, and Experience Sampling Method (ESM). Participants included 9 boys (mean = 12.9 years) and 16 girls (mean = 12.9 years). Sixteen participants were at a healthy weight (10 girls and 6 boys), and 9 were overweight or obese (5 girls and 3 boys). Results: Eighth graders had higher BMI z scores, engaged in less healthful eating during DT, and spent less time in vigorous exercise in DT than sixth graders. Participants spent the majority of DT with siblings, which was associated with increased light physical activity as measured by accelerometers. The ESM data suggested that adolescents engaged in increased physical activity and decreased sedentary activity when with peers but increased sedentary activity when with parents. Increased percentage of DT spent with parents was associated with increased daily fat intake. Data also indicate high consumption of unhealthy foods across all DT social contexts and activities. Conclusions: Peers may provide a protective social context with regard to obesity-related health behaviors. Targeting changes in health behaviors during the middle school years may be an effective means of decreasing obesity risk among urban African-American adolescents. Interventions for urban African-American early adolescents may benefit from facilitating physical activity with peers and targeting change in family health behaviors.

Bonmati-Carrion, M. A., Middleton, B., Revell, V., Skene, D. J., Rol, M. A., & Madrid, J. A. (2013). Circadian phase asessment by ambulatory monitoring in humans: Correlation with dim light melatonin onset. Chronobiol.Int..

The increased prevalence of circadian disruptions due to abnormal coupling between internal and external time makes the detection of circadian phase in humans by ambulatory recordings a compelling need. Here, we propose an accurate practical procedure to estimate circadian phase with the least possible burden for the subject, that is, without the restraints of a constant routine protocol or laboratory techniques such as melatonin quantification, both of which are standard procedures. In this validation study, subjects (N = 13) wore ambulatory monitoring devices, kept daily sleep diaries and went about their daily routine for 10 days. The devices measured skin temperature at wrist level (WT), motor activity and body position on the arm, and light exposure by means of a sensor placed on the chest. Dim light melatonin onset (DLMO) was used to compare and evaluate the accuracy of the ambulatory variables in assessing circadian phase. An evening increase in WT: WTOnset (WTOn) and “WT increase onset” (WTiO) was found to anticipate the evening increase in melatonin, while decreases in motor activity (Activity Offset or AcOff), body position (Position Offset (POff)), integrative TAP (a combination of WT, activity and body position) (TAPOffset or TAPOff) and an increase in declared sleep propensity were phase delayed with respect to DLMO. The phase markers obtained from subjective sleep (R = 0.811), WT (R = 0.756) and the composite variable TAP (R = 0.720) were highly and significantly correlated with DLMO. The findings strongly support a new method to calculate circadian phase based on WT (WTiO) that accurately predicts and shows a temporal association with DLMO. WTiO is especially recommended due to its simplicity and applicability to clinical use under conditions where knowing endogenous circadian phase is important, such as in cancer chronotherapy and light therapy

Booth, J. N., Leary, S. D., Joinson, C., Ness, A. R., Tomporowski, P. D., Boyle, J. M. et al. (2014). Associations between objectively measured physical activity and academic attainment in adolescents from a UK cohort. Br.J.Sports Med., 48, 265-270.

BACKGROUND: To test for cross-sectional (at age 11) and longitudinal associations between objectively measured free-living physical activity (PA) and academic attainment in adolescents.Method Data from 4755 participants (45% male) with valid measurement of PA (total volume and intensity) by accelerometry at age 11 from the Avon Longitudinal Study of Parents and Children (ALSPAC) was examined. Data linkage was performed with nationally administered school assessments in English, Maths and Science at ages 11, 13 and 16. RESULTS: In unadjusted models, total volume of PA predicted decreased academic attainment. After controlling for total volume of PA, percentage of time spent in moderate-vigorous intensity PA (MVPA) predicted increased performance in English assessments in both sexes, taking into account confounding variables. In Maths at 16 years, percentage of time in MVPA predicted increased performance for males (standardised beta=0.11, 95% CI 0.00 to 0.22) and females (beta=0.08, 95% CI 0.00 to 0.16). For females the percentage of time spent in MVPA at 11 years predicted increased Science scores at 11 and 16 years (beta=0.14 (95% CI 0.03 to 0.25) and 0.14 (0.07 to 0.21), respectively). The correction for regression dilution approximately doubled the standardised beta coefficients. CONCLUSIONS: Findings suggest a long-term positive impact of MVPA on academic attainment in adolescence

Borujeny, G. T., Yazdi, M., Keshavarz-Haddad, A., & Borujeny, A. R. (2013). Detection of epileptic seizure using wireless sensor networks. J.Med.Signals Sens., 3, 63-68.

The monitoring of epileptic seizures is mainly done by means of electroencephalogram (EEG) monitoring. Although this method is accurate, it is not comfortable for the patient as the EEG-electrodes have to be attached to the scalp which hampers the patient’s movement. This makes long-term home monitoring not feasible. In this paper, the aim is to propose a seizure detection system based on accelerometry for the detection of epileptic seizure. The used sensors are wireless, which can improve quality of life for the patients. In this system, three 2D accelerometer sensors are positioned on the right arm, left arm, and left thigh of an epileptic patient. Datasets from three patients suffering from severe epilepsy are used in this paper for the development of an automatic detection algorithm. This monitoring system is based on Wireless Sensor Networks and can determine the location of the patient when a seizure is detected and then send an alarm to hospital staff or the patient’s relatives. Our wireless sensor nodes are MICAz Motes developed by Crossbow Technology. The proposed system can be used for patients living in a clinical environment or at their home, where they do only their daily routines. The analysis of the recorded data is done by an Artificial Neural Network and K Nearest-Neighbor to recognize seizure movements from normal movements. The results show that K Nearest Neighbor performs better than Artificial Neural Network for detecting these seizures. The results also show that if at least 50% of the signal consists of seizure samples, we can detect the seizure accurately. In addition, there is no need for training the algorithm for each new patient

Bowen, K. S., Uchino, B. N., Birmingham, W., Carlisle, M., Smith, T. W., & Light, K. C. (2013). The Stress-Buffering Effects of Functional Social Support on Ambulatory Blood Pressure. Health Psychology.

Objective: Social support is a reliable predictor of cardiovascular health. According to the buffering hypothesis, stress is 1 mechanism by which support is able to affect physiological processes. However, most of the experimental evidence for the hypothesis comes from laboratory studies. Ambulatory blood pressure (ABP) protocols examine participants in their natural environment, where they are more likely to encounter personally relevant real-world stressors. Furthermore, prior work shows that examining support by its specific functional components reveals additional independent links to health. Methods: The current study aimed to examine the stress-buffering effects of functional social support on ABP. One hundred eighty-eight participants completed a 1-day ABP assessment along with measures of functional social support and both global perceived stress and momentary stress at time of reading. Results: Results indicated main effects for both stress measures. Global support, emotional, tangible, and informational support only moderated the effects of momentary stress, but not global stress, in predicting ABP. Informational support was the most consistent stress-buffering predictor of ABP, predicting both ambulatory systolic and diastolic blood pressure. Conclusions: The predicted values in ABP for informational support achieved health-relevant differences, emphasizing the value of examining functional support beyond global support alone.

Brans, K., van Mechelen, I., Rim+®, B., & Verduyn, P. (2013). The relation between social sharing and the duration of emotional experience. Cognition and Emotion, 27, 1023-1041.

People often socially share their emotions to regulate them. Two-mode theory of social sharing states that cognitive sharing will contribute to emotional recovery, whereas socio-affective sharing will only temporarily alleviate emotional distress. Previous studies supporting this theory, measured emotional recovery in terms of residual emotional intensity. Until now, another important time-dynamic aspect of emotions, emotion duration, has been largely ignored. In two experience sampling studies we addressed this gap. In Study 1, participants reported on the duration of anger, fear, and sadness episodes; additionally time-varying information on the occurrence and mode of sharing was collected. This study revealed that sharing led to a shortening in emotion duration, in particular when it was socio-affective in nature. In Study 2 we investigated whether this result could be interpreted in terms of our measure of duration primarily reflecting emotional relief rather than recovery. In this study, the same method as in Study 1 was used; additionally, residual emotional intensity was measured three days after emotion onset. Study 2 largely replicated the findings from Study 1. Furthermore, duration appeared to be empirically distinct from residual intensity. Finally, no relation between sharing and residual intensity was found, even when considering the sharing mode.

Brodbeck, J., Bachmann, M. S., & Znoj, H. (2013). Distinct coping strategies differentially predict urge levels and lapses in a smoking cessation attempt. Addictive Behaviors, 38, 2224-2229.

This study analysed mechanisms through which stress-coping and temptation-coping strategies were associated with lapses. Furthermore, we explored whether distinct coping strategies differentially predicted reduced lapse risk, lower urge levels, or a weaker association between urge levels and lapses during the first week of an unassisted smoking cessation attempt. Participants were recruited via the internet and mass media in Switzerland. Ecological momentary assessment (EMA) with mobile devices was used to assess urge levels and lapses. Online questionnaires were used to measure smoking behaviours and coping variables at baseline, as well as smoking behaviour at the three-month follow-up. The sample consisted of 243 individuals, aged 20 to 40, who reported 4199 observations. Findings of multilevel regression analyses show that coping was mainly associated with a reduced lapse risk and not with lower urge levels or a weaker association between urge levels and lapses. GÇÿCalming downGÇÖ and GÇÿcommitment to changeGÇÖ predicted a lower lapse risk and also a weaker relation between urge levels and lapses. GÇÿStimulus controlGÇÖ predicted a lower lapse risk and lower urge levels. Conversely, GÇÿtask-orientationGÇÖ and GÇÿrisk assessmentGÇÖ were related to higher lapse risk and GÇÿrisk assessmentGÇÖ also to higher urge levels. Disengagement coping i.e. GÇÿeating or shoppingGÇÖ, GÇÿdistractionGÇÖ, and GÇÿmobilising social supportGÇÖ did not affect lapse risk. Promising coping strategies during the initial stage of smoking cessation attempt are targeted directly at reducing the lapse risk and are characterised by engagement with the stressor or one’s reactions towards the stressor and a focus on positive consequences instead of health risks.

Bromberg, M. H., Connelly, M., Anthony, K. K., Gil, K. M., & Schanberg, L. E. (2013). Self-Reported pain and disease symptoms persist in juvenile idiopathic arthritis despite treatment advances: An electronic diary study. Arthritis Rheum..

Objective: The present study used electronic (e-) diaries to determine whether pain, stiffness, and fatigue continue to be common, disabling symptoms in children with Juvenile Idiopathic Arthritis (JIA) despite aggressive contemporary medical management. Methods: Fifty-nine children with JIA (ages 8-18) provided ratings of pain, stiffness, and fatigue intensity and functional limitations using a smartphone e-diary three times each day for one month. Medication information was collected via parent report and checked for accuracy by chart review. Descriptive analyses were conducted to determine typical symptom intensity, frequency, and variability. Multilevel modeling was used to analyze associations between symptoms and functional outcomes and between medication use and symptom intensity. Results: Children reported pain on 66% of e-diary entries. No children were entirely pain-free across the reporting period. Children endorsed high pain intensity (VAS > 40) on 31% of all e-diaries with 86% reporting high pain at least once during the study period. Average pain, stiffness, and fatigue intensity ratings were in the mild to moderate range. Medication class did not reliably predict differences in symptom intensity even though 79% of children were prescribed a DMARD and 47% a biologic. In-the-moment, higher pain and stiffness intensities uniquely predicted higher concurrent functional limitations. Conclusion: Self-reported pain, stiffness, and fatigue continue to be common in children with JIA despite contemporary treatment advances including biologics. The findings are surprisingly consistent with previous results from paper daily diary research in the pre-biologic era. There remains a pressing ongoing need to optimize pain and symptom management in JIA. (c) 2013 American College of Rheumatology

Bryant, L., Coffey, A., Povinelli, D. J., & Pruett, J. R. J. (2013). Theory of mind experience sampling in typical adults. Consciousness and Cognition: An International Journal, 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 1GÇô3. 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.

Buller, D. B., Borland, R., Bettinghaus, E. P., Shane, J. H., & Zimmerman, D. E. (2013). Randomized Trial of a Smartphone Mobile Application Compared to Text Messaging to Support Smoking Cessation. Telemed.J.E.Health.

Background: Text messaging has successfully supported smoking cessation. This study compares a mobile application with text messaging to support smoking cessation. Materials and Methods: Young adult smokers 18-30 years old (n=102) participated in a randomized pretest-posttest trial. Smokers received a smartphone application (REQ-Mobile) with short messages and interactive tools or a text messaging system (onQ), managed by an expert system. Self-reported usability of REQ-Mobile and quitting behavior (quit attempts, point-prevalence, 30-day point-prevalence, and continued abstinence) were assessed in posttests. Results: Overall, 60% of smokers used mobile services (REQ-Mobile, 61%, mean of 128.5 messages received; onQ, 59%, mean of 107.8 messages), and 75% evaluated REQ-Mobile as user-friendly. A majority of smokers reported being abstinent at posttest (6 weeks, 53% of completers; 12 weeks, 66% of completers [44% of all cases]). Also, 37% (25%of all cases) reported 30-day point-prevalence abstinence, and 32% (22% of all cases) reported continuous abstinence at 12 weeks. OnQ produced more abstinence (p<0.05) than REQ-Mobile. Use of both services predicted increased 30-day abstinence at 12 weeks (used, 47%; not used, 20%; p=0.03). Conclusions: REQ-Mobile was feasible for delivering cessation support but appeared to not move smokers to quit as quickly as text messaging. Text messaging may work better because it is simple, well known, and delivered to a primary inbox. These advantages may disappear as smokers become more experienced with new handsets. Mobile phones may be promising delivery platforms for cessation services using either smartphone applications or text messaging

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. Annals of Behavioral Medicine, 46, 217-226.

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.

Butler, A. C., Hokanson, J. E., & Flynn, H. A. (1994). A comparison of self-esteem lability and low trait self-esteem as vulnerability factors for depression. Journal of personality and social psychology, 66, 166.

Self-esteem lability (SEL), defined as daily event-related variability in state self-esteem, and low trait self-esteem (TSE) were assessed among 205 male and female undergraduates who were currently depressed, previously depressed (PD), and never depressed (ND). SEL scores were derived for the effect of positive, negative, and combined events on state self-esteem over 30 days. Consistent with psychodynamic and cognitive theories, SEL was found to be a better index of depression proneness than TSE. PD Ss showed higher lability on all SEL scores than ND controls but did not differ from controls on TSE. Ss were reassessed 5 mo later, and new cases showed higher premorbid SEL than ND controls but did not differ from controls on premorbid TSE. SEL at Time 1 was found to increase risk for depression at Time 2 among Ss reporting high life stress at Time 2. Theoretical and methodological implications are discussed.

Chen, Y. W., Cordier, R., & Brown, N. (2013). A preliminary study on the reliability and validity of using experience sampling method in children with autism spectrum disorders. Dev.Neurorehabil..

Abstract Objective: This study investigated the feasibility of using experience sampling method (ESM) to study everyday experiences in children with autism spectrum disorders. Methods: Six boys, aged 8-12 years, with high-functioning autism or Asperger syndrome carried an iPod touch with a pre-installed ESM survey about what they were doing, where, with whom and the quality of their experiences and associated emotions. They were randomly signalled seven times daily for seven consecutive days to respond to the survey. Results: The average signal response rates (56.8%) was acceptable and the mean time of survey completion (1 minute 53 seconds) was within acceptable range. Split-week analysis supported the consistency of experiences reporting while correlations among theoretically linked quality of experiences and emotions showed the internal logic of participants’ responses; thus supporting internal reliability and validity, respectively. Conclusion: The study demonstrated the feasibility and usefulness of using ESM in exploring participants’ everyday life experiences

Cheung, V. H., Gray, L., & Karunanithi, M. (2011). Review of accelerometry for determining daily activity among elderly patients. Arch.Phys.Med.Rehabil., 92, 998-1014.

OBJECTIVES: To review studies that used accelerometers to classify human movements and to appraise their potential to determine the activities of older patients in hospital settings. DATA SOURCES: MEDLINE, CINAHL, and Web of Science electronic databases. A search constraint of articles published in English language between January 1980 and March 2010 was applied. STUDY SELECTION: All studies that validated the use of accelerometers to classify human postural movements and mobility were included. Studies included participants from any age group. All types of accelerometers were included. Outcome measures criteria explored within the studies were comparisons of derived classifications of postural movements and mobility against those made by using observations. Based on these criteria, 54 studies were selected for detailed review from 526 initially identified studies. DATA EXTRACTION: Data were extracted by the first author and included characteristics of study participants, accelerometers used, body positions of device attachment, study setting, duration, methods, results, and limitations of the validation studies. DATA SYNTHESIS: The accelerometer-based monitoring technique was investigated predominantly on a small sample of healthy adult participants in a laboratory setting. Most studies applied multiple accelerometers on the sternum, wrists, thighs, and shanks of participants. Most studies collected validation data while participants performed a predefined standardized activity protocol. CONCLUSIONS: Accelerometer devices have the potential to monitor human movements continuously to determine postural movements and mobility for the assessment of functional ability. Future studies should focus on long-term monitoring of free daily activity of a large sample of mobility-impaired or older hospitalized patients, who are at risk for functional decline. Use of a single waist-mounted triaxial accelerometer would be the most practical and useful option

Chow, S. M. & Zhang, G. (2013). Nonlinear regime-switching state-space (RSSS) models. Psychometrika., 78, 740-768.

Nonlinear dynamic factor analysis models extend standard linear dynamic factor analysis models by allowing time series processes to be nonlinear at the latent level (e.g., involving interaction between two latent processes). In practice, it is often of interest to identify the phases-namely, latent “regimes” or classes-during which a system is characterized by distinctly different dynamics. We propose a new class of models, termed nonlinear regime-switching state-space (RSSS) models, which subsumes regime-switching nonlinear dynamic factor analysis models as a special case. In nonlinear RSSS models, the change processes within regimes, represented using a state-space model, are allowed to be nonlinear. An estimation procedure obtained by combining the extended Kalman filter and the Kim filter is proposed as a way to estimate nonlinear RSSS models. We illustrate the utility of nonlinear RSSS models by fitting a nonlinear dynamic factor analysis model with regime-specific cross-regression parameters to a set of experience sampling affect data. The parallels between nonlinear RSSS models and other well-known discrete change models in the literature are discussed briefly

Chung, L. M., Law, Q. P., Fong, S. S., & Chung, J. W. (2014). Teledietetics improves weight reduction by modifying eating behavior: a randomized controlled trial. Telemed.J.E.Health, 20, 55-62.

Abstract Background: Weight reduction without behavioral modification is not sustainable. However, with a technology application such as teledietetics, the recording process could be a cognitive cue for individuals to change their eating behavior. This study tested obese participants to determine whether teledietetics shows better results in weight reduction. Study Design and Methods: We conducted a double-blinded randomized controlled trial. The participants in the food diary (FD) and electronic diary (ED) groups recorded their dietary intakes in logbooks and on an electronic diary system, respectively. The participants in the control group (CG) did nothing. Subjects were adults 20-60 years of age with a body mass index (BMI) of >/=25 kg/m(2). The ED and FD groups were the intervention groups and were compared with the CG group. The participants’ body weights, BMIs, fat percentages, waist-to-hip ratios (WHRs), and mean arterial pressures (MAPs) were measured before the study, at Week 6, and at Week 12. Demographic data were collected using self-administered questionnaires. A chi-squared test and descriptive statistics were used to describe the demographic and biomeasurement data. Repeated-measures analysis of variance was used to evaluate the effectiveness of the three groups over time. Results: Significant decreases in body weight (F1.705,86.950=20.508, p<0.001) and BMI (F1.657, 84.486=21.256, p<0.001) and insignificant decreases in fat percentage (F2,94=0.547, p=0.581), WHR (F1.785,91.052=2.888, p=0.067), and MAP (F2,94=7.542, p=0.0001) were observed among the three measurement times. Conclusions: Electronic dietary records were better than food diaries in terms of fat percentage reduction in our trials, indicating that teledietetics increases healthy-eating awareness

Cohen, M. D., Cutaia, M., Brehm, R., Brutus, V., Pike, V. C., & Lewendowski, D. (2012). Detecting motor vehicle travel in accelerometer data. COPD., 9, 102-110.

Chronic Obstructive Pulmonary Disease (COPD) frequently has a significant impact on patients’ everyday activity. Because of this, accurate measurement of daily activity is of particular interest. Although accelerometers are an objective means of measuring daily activity, these devices sense vibrations and erroneously score motor vehicle travel (MVT) as moderate physical activity. It is the objective of this study to develop a new method to analyze accelerometry data that would accurately classify MVT as non-acceleration, or sitting/standing. As sitting/standing has a different pattern of count-to-count variability than walking, we hypothesized that a rolling standard deviation (RSD), which is a measurement of volatility in the data, would more accurately classify periods of MVT than analysis based on activity counts alone. Twenty-two subjects with COPD were studied. A training set of 15% of the dataset was used to establish an RSD-threshold during MVT based on the upper 95%-confidence interval. The accuracy of the RSD thresholds were tested and presented as sensitivity, specificity and receiver operating curves. Results demonstrated high sensitivity and specificity suggesting that the RSD not only accurately classified MVT, but had a low rate of misclassification. The RSD analysis scored more MVT as sitting/standing than assessment by VMU alone. The accuracy of accelerometers to define the profile of daily activity in sedentary populations, such as those with COPD, is greatly improved

Connelly, M., Bromberg, M. H., Anthony, K. K., Gil, K. M., Franks, L., & Schanberg, L. E. (2012). Emotion regulation predicts pain and functioning in children with juvenile idiopathic arthritis: an electronic diary study. J.Pediatr.Psychol., 37, 43-52.

OBJECTIVES: This study utilized e-diaries to evaluate whether components of emotion regulation predict daily pain and function in children with juvenile idiopathic arthritis (JIA). METHODS: 43 children ages 8-17 years and their caregivers provided baseline reports of child emotion regulation. Children then completed thrice daily e-diary assessments of emotion, pain, and activity involvement for 28 days. E-diary ratings of negative and positive emotions were used to calculate emotion variability and to infer adaptive emotion modulation following periods of high or low emotion intensity. Hierarchical linear models were used to evaluate how emotion regulation related to pain and function. RESULTS: The attenuation of negative emotion following a period of high negative emotion predicted reduced pain; greater variability of negative emotion predicted higher pain and increased activity limitation. Indices of positive emotion regulation also significantly predicted pain. CONCLUSIONS: Components of emotion regulation as captured by e-diaries predict important health outcomes in children with JIA

Cook, D. J., Thompson, J. E., Prinsen, S. K., Dearani, J. A., & Deschamps, C. (2013). Functional recovery in the elderly after major surgery: assessment of mobility recovery using wireless technology. Ann.Thorac.Surg., 96, 1057-1061.

PURPOSE: Hospitalization and surgery in older patients often leads to a loss of strength, mobility, and functional capacity. We tested the hypothesis that wireless accelerometry could be used to measure mobility during hospital recovery after cardiac surgery. DESCRIPTION: We used an off-the-shelf fitness monitor to measure daily mobility in patients after surgery. Data were transmitted wirelessly, aggregated, and configured onto a provider-viewable dashboard. EVALUATION: Wireless monitoring of mobility after major surgery was easy and practical. There was a significant relationship between the number of steps taken in the early recovery period, length of stay, and dismissal disposition. CONCLUSIONS: Wireless monitoring of mobility after major surgery creates an opportunity for early identification and intervention in individual patients and could serve as a tool to evaluate and improve the process of care and to affect postdischarge outcomes

Cuddy, J. S., Reinert, A. R., Hailes, W. S., Slivka, D. R., & Ruby, B. C. (2013). Accelerometry and salivary cortisol response during Air Force Special Tactics Officer selection. Extrem.Physiol Med., 2, 28.

BACKGROUND: Special Tactics Officer (STO) selection is conducted to select officers to enter the combat controller training pipeline. The aims were to determine physical activity patterns, estimate energy expenditure, and identify whether return and/or unsuccessful candidates demonstrated differences in cortisol responses compared to non-selected and/or first-time attendees. METHODS: Participants completed the STO selection, consisting of 5 days of physical and mental challenges. Participants were equipped with ActiCals(R), and saliva samples were collected throughout the STO selection. RESULTS: Average activity counts were 684 +/- 200 countsmin-1, with no group differences. Estimated energy expenditure was 4,105 +/- 451 kcalday-1. Cortisol was elevated following extended physical training but returned to baseline during rest. Return candidates had significantly lower cortisol responses compared to first-timers, 0.43 +/- 0.06 mugdl-1 versus 0.76 +/- 0.18 mugdl-1, respectively, p < 0.05. CONCLUSIONS: An individual’s salivary cortisol response to the stresses incurred during the STO selection has the potential to be incorporated into the entire picture of a candidate’s performance and ability to handle stress

Dalton, A., Patel, S., Chowdhury, A. R., Welsh, M., Pang, T., Schachter, S. et al. (2012). Development of a body sensor network to detect motor patterns of epileptic seizures. IEEE Trans.Biomed.Eng, 59, 3204-3211.

The objective of this study was the development of a remote monitoring system to monitor and detect simple motor seizures. Using accelerometer-based kinematic sensors, data were gathered from subjects undergoing medication titration at the Beth Israel Deaconess Medical Center. Over the course of the study, subjects repeatedly performed a predefined set of instrumental activities of daily living (iADLs). During the monitoring sessions, EEG and video data were also recorded and provided the gold standard for seizure detection. To distinguish seizure events from iADLs, we developed a template matching algorithm. Considering the unique signature of seizure events and the inherent temporal variability of seizure types across subjects, we incorporated a customized mass-spring template into the dynamic time warping algorithm. We then ported this algorithm onto a commercially available internet tablet and developed our body sensor network on the Mercury platform. We designed several policies on this platform to compare the tradeoffs between feature calculation, raw data transmission, and battery lifetime. From a dataset of 21 seizures, the sensitivity for our template matching algorithm was found to be 0.91 and specificity of 0.84. We achieved a battery lifetime of 10.5 h on the Mercury platform

Debrot, A., Schoebi, D., Perrez, M., & Horn, A. B. (2013). Touch as an interpersonal emotion regulation process in couplesGÇÖ daily lives: The mediating role of psychological intimacy.  Personality and Social Psychology Bulletin, 39, 1373-1385.

Interpersonal touch seems to promote physical health through its effects on stress-sensitive parameters. However, less is known about the psychological effects of touch. The present study investigates associations between touch and romantic partnersGÇÖ affective state in daily life. We hypothesized that this association is established by promoting the recipientGÇÖs experience of intimacy. Both partners of 102 dating couples completed an electronic diary 4 times a day during 1 week. Multilevel analyses revealed that touch was associated with enhanced affect in the partner. This association was mediated by the partnerGÇÖs psychological intimacy. Touch was also associated with intimacy and positive affect in the actor. Finally, participants who were touched more often during the diary study week reported better psychological well-being 6 months later. This study provides evidence that intimate partners benefit from touch on a psychological level, conveying a sense of strengthened bonds between them that enhances affect and well-being.

Dedert, E. A., Dennis, P. A., Swinkels, C. M., Calhoun, P. S., Dennis, M. F., & Beckham, J. C. (2013). Ecological Momentary Assessment of Posttraumatic Stress Disorder Symptoms During a Smoking Quit Attempt. Nicotine.Tob.Res..

INTRODUCTION: Smokers with posttraumatic stress disorder (PTSD) tend to lapse more quickly following a quit attempt, which might be explained by changes in PTSD symptoms during a quit attempt. The present study examines changes in PTSD symptoms, negative affect, and craving before and during a quit attempt. METHODS: Participants in this study were 52 smokers with PTSD who completed random-alarm ecological momentary assessments of PTSD symptoms, negative affect, cigarette craving, and smoking behavior throughout a prequit phase of ad-hoc smoking, a phase of abstinence from smoking, and a postlapse phase. RESULTS: Relative to the prequit phase, the abstinent phase was marked by decreases in PTSD reexperiencing, avoidance, and numbing clusters (ps </= .01). The odds of PTSD symptom or negative affect variability from one reading in the ecological momentary assessment (EMA)to the next reading was decreased in PTSD reexperiencing, avoidance, and numbing clusters (ps </= .02). Smoking cravings were also mildly decreased in the abstinent and postlapse phases (ps < .01), although some cravings in both phases were rated at the maximum intensity. Increased craving was predicted by the previous EMA reading of PTSD symptoms. CONCLUSIONS: Results suggested that smoking abstinence is not associated with exacerbation of PTSD symptoms, but PTSD symptoms during abstinence were related to craving levels during the quit attempt

Ding, H., Karunanithi, M., Duncan, M., Ireland, D., Noakes, M., & Hooker, C. (2013). A mobile phone enabled health promotion program for middle-aged males. Conf.Proc.IEEE Eng Med.Biol.Soc., 2013, 1173-1176.

The prevalence of chronic diseases among middle aged males outweigh their female counterparts in developed countries. To prevent this, delivery of health promotion programs targeting lifestyle modifications of physical activity and nutrition in middle-aged males has been essential, but often difficult. ManUp health promotion program was a recent initiative that uses current advances in information and communication technology (ICT) to reach the middle-aged males. One of the key components of the ICT approach was the development of smartphone application to enable middle-aged men to uptake the program with their own mobile phone. The smart phone application was aimed at providing varied level of challenges towards physical activity and healthy eating behavior, with interactive and motivational feedback SMS messages. The ManUp program was recently implemented and trialed in a randomized control trial in Gladstone and Rockhampton, Queens. This paper describes the components of the smart phone application integrated within the ManUp health promotion program

Doane, L. D. & Zeiders, K. H. (2013). Contextual moderators of momentary cortisol and negative affect in adolescents’ daily lives. Journal of Adolescent Health.

PURPOSE: To use an ecological momentary assessment design to examine the links between momentary negative affect and cortisol in a sample of adolescents preparing to transition to college. Guided by a risk and resilience framework, we also explored whether important ecological factors, perceived discrimination and social support, moderated the momentary associations between negative affect and youths’ cortisol. METHODS: Adolescents (N = 77) provided salivary samples and diary reports of affect and experiences five times a day over 3 days. They also completed self-report questionnaires on perceived discrimination and social support from family and friends. RESULTS: Within-person increases in momentary negative affect were associated with increases in cortisol. Perceived discrimination and social support from friends moderated this association. Adolescents who reported average and high levels of perceived discrimination experienced exaggerated cortisol responses to negative affect, whereas adolescents who reported low levels of perceived discrimination did not experience significant reactivity to negative affect. In contrast, adolescents who reported high levels of social support from friends experienced attenuated cortisol responses to negative affect compared with adolescents who reported average or low levels of social support from friends. CONCLUSIONS: This study contributes to our understanding of youths’ daily socioemotional experiences and physiological reactivity by identifying how perceived discrimination and social support from friends amplified and attenuated, respectively, the effects of negative affect on cortisol reactivity. Examining these processes within adolescents’ naturalistic environments advances our understanding of the moderating role of ecological characteristics in adolescents’ everyday lives.

Dobkin, B. H., Xu, X., Batalin, M., Thomas, S., & Kaiser, W. (2011). Reliability and validity of bilateral ankle accelerometer algorithms for activity recognition and walking speed after stroke. Stroke, 42, 2246-2250.

BACKGROUND AND PURPOSE: Outcome measures of mobility for large stroke trials are limited to timed walks for short distances in a laboratory, step counters and ordinal scales of disability and quality of life. Continuous monitoring and outcome measurements of the type and quantity of activity in the community would provide direct data about daily performance, including compliance with exercise and skills practice during routine care and clinical trials. METHODS: Twelve adults with impaired ambulation from hemiparetic stroke and 6 healthy controls wore triaxial accelerometers on their ankles. Walking speed for repeated outdoor walks was determined by machine-learning algorithms and compared to a stopwatch calculation of speed for distances not known to the algorithm. The reliability of recognizing walking, exercise, and cycling by the algorithms was compared to activity logs. RESULTS: A high correlation was found between stopwatch-measured outdoor walking speed and algorithm-calculated speed (Pearson coefficient, 0.98; P=0.001) and for repeated measures of algorithm-derived walking speed (P=0.01). Bouts of walking >5 steps, variations in walking speed, cycling, stair climbing, and leg exercises were correctly identified during a day in the community. Compared to healthy subjects, those with stroke were, as expected, more sedentary and slower, and their gait revealed high paretic-to-unaffected leg swing ratios. CONCLUSIONS: Test-retest reliability and concurrent and construct validity are high for activity pattern-recognition Bayesian algorithms developed from inertial sensors. This ratio scale data can provide real-world monitoring and outcome measurements of lower extremity activities and walking speed for stroke and rehabilitation studies

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. Int.J.Behav.Nutr.Phys.Act., 10, 22.

BACKGROUND: Accelerometers can identify certain physical activity behaviours, but not the context in which they take place. This study investigates the feasibility of wearable cameras to objectively categorise the behaviour type and context of participants’ 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-synchronised. Participants engaged in free-living activities for 3 days. Actical data were cleaned and episodes of sedentary, lifestyle-light, lifestyle-moderate, and moderate-to-vigorous physical activity (MVPA) were identified. Actical episodes were categorised 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, behaviour 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 behaviour 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’t involved in direct engagement. CONCLUSION: Wearable camera images offer an objective method to capture a spectrum of activity behaviour types and context across 81% of accelerometer-identified episodes of activity. Wearable cameras represent the best objective method currently available to categorise the social and environmental context of accelerometer-defined episodes of activity in free-living conditions

Doherty, S. T. & Oh, P. (2012). A multi-sensor monitoring system of human physiology and daily activities. Telemed.J.E.Health, 18, 185-192.

OBJECTIVE: To present the design and pilot test results of a continuous multi-sensor monitoring system of real-world physiological conditions and daily life (activities, travel, exercise, and food consumption), culminating in a Web-based graphical decision-support interface. MATERIALS AND METHODS: The system includes a set of wearable sensors wirelessly connected to a “smartphone” with a continuously running software application that compresses and transmits the data to a central server. Sensors include a Global Positioning System (GPS) receiver, electrocardiogram (ECG), three-axis accelerometer, and continuous blood glucose monitor. A food/medicine diary and prompted recall activity diary were also used. The pilot test involved 40 type 2 diabetic patients monitored over a 72-h period. RESULTS: All but three subjects were successfully monitored for the full study period. Smartphones proved to be an effective hub for managing multiple streams of data but required attention to data compression and battery consumption issues. ECG, accelerometer, and blood glucose devices performed adequately as long as subjects wore them. GPS tracking for a full day was feasible, although significant efforts are needed to impute missing data. Activity detection algorithms were successful in identifying activities and trip modes but could benefit by incorporating accelerometer data. The prompted recall diary was an effective tool for augmenting algorithm results, although subjects reported some difficulties with it. The food and medicine diary was completed fully, although end times and medicine dosages were occasionally missing. CONCLUSIONS: The unique combination of sensors holds promise for increasing accuracy and reducing burden associated with collecting individual-level activity and physiological data under real-world conditions, but significant data processing issues remain. Such data will provide new opportunities to explore the impacts of human geography and daily lifestyle on health at a fine spatial/temporal scale

Edmondson, D., Shaffer, J. A., Chaplin, W. F., Burg, M. M., Stone, A. A., & Schwartz, J. E. (2013). Trait anxiety and trait anger measured by ecological momentary assessment and their correspondence with traditional trait questionnaires. J.Res.Pers., 47.

Ecological momentary assessments (EMA) of anxiety and anger/hostility were obtained every 25-30 minutes over two 24-hour periods, separated by a median of 6 months, from 165 employees at a university in the Northeast. We used a multilevel trait-state-error structural equation model to estimate: (1) the proportion of variance in EMA anxiety and anger/hostility attributable to stable trait-like individual differences; (2) the correspondence between these trait-like components of EMA anxiety and anger/hostility and traditional questionnaire measures of each construct; and (3) the test-retest correlation between two 24-hour averages obtained several months apart. After adjustment for measurement error, more than half the total variance in EMA reports of anxiety and anger/hostility is attributable to stable trait-like individual differences; however, the trait-like component of each construct is only modestly correlated with questionnaire measures of that construct. The 6-month “test-retest” correlations of latent variables representing the true 24-hour EMA average anxiety and average anger are quite high (r >/= 0.83). This study represents the longest follow-up period over which EMA-based estimates of traits have been examined. The results suggest that although the trait component (individual differences) of EMA momentary ratings of anxiety and anger is larger than the state component, traditional self-report questionnaires of trait anxiety and anger correspond only weakly with EMA-defined traits

Elavsky, S., Molenaar, P. C., Gold, C. H., Williams, N. I., & Aronson, K. R. (2012). Daily physical activity and menopausal hot flashes: applying a novel within-person approach to demonstrate individual differences. Maturitas, 71, 287-293.

BACKGROUND: Physical activity (PA) may be a useful tool in the management of menopausal hot flashes (HFs) but findings are generally inconsistent. There are few well-designed and sufficiently powered RCTs. Applying a longitudinal within-person approach offers an alternative way to examine the PA-HFs relationship which enables complete accommodation of inter-individual differences. OBJECTIVES: Aprospective daily diary study which applied experience sampling methods and time series modeling techniques investigated, at the within-person level, the relationship between objectively measured daily PA of varying intensities and self-reported menopausal HFs. METHODS: Twenty-four symptomatic middle-aged women (M age=50.4; SD=4.9) completed fitness, body composition and hormonal status screening, and reported on daily HFs using an electronic PDA device across one menstrual cycle or for 30 days (if postmenopausal). Daily PA and PA intensity was measured using accelerometry and subjects completed a battery of psychological measures. RESULTS: Within person analysis identified significant relations between PA and HFs in 50% of subjects, although the specific PA indicators that predicted HFs varied, both in terms of direction and magnitude. Perceived control over HFs was the variable that most consistently differentiated between women for whom more PA was associated with fewer HFs as compared to those for whom more PA was associated with more HFs, but other individual difference characteristics such as affect, depressive symptoms, and anxiety were identified. CONCLUSIONS: There is great individual variation in the way daily PA impacts self-reported HFs. Affective outcomes and perceived control may help potentially explain this variability

Epstein, D. H., Tyburski, M., Craig, I. M., Phillips, K. A., Jobes, M. L., Vahabzadeh, M. et al. (2014). Real-time tracking of neighborhood surroundings and mood in urban drug misusers: Application of a new method to study behavior in its geographical context. Drug Alcohol Depend., 134,  22-29.

BACKGROUND: Maladaptive behaviors may be more fully understood and efficiently prevented by ambulatory tools that assess people’s ongoing experience in the context of their environment. METHODS: To demonstrate new field-deployable methods for assessing mood and behavior as a function of neighborhood surroundings (geographical momentary assessment; GMA), we collected time-stamped GPS data and ecological momentary assessment (EMA) ratings of mood, stress, and drug craving over 16 weeks at randomly prompted times during the waking hours of opioid-dependent polydrug users receiving methadone maintenance. Locations of EMA entries and participants’ travel tracks calculated for the 12 before each EMA entry were mapped. Associations between subjective ratings and objective environmental ratings were evaluated at the whole neighborhood and 12-h track levels. RESULTS: Participants (N=27) were compliant with GMA data collection; 3711 randomly prompted EMA entries were matched to specific locations. At the neighborhood level, physical disorder was negatively correlated with negative mood, stress, and heroin and cocaine craving (ps<.0001-.0335); drug activity was negatively correlated with stress, heroin and cocaine craving (ps .0009-.0134). Similar relationships were found for the environments around respondents’ tracks in the 12h preceding EMA entries. CONCLUSIONS: The results support the feasibility of GMA. The relationships between neighborhood characteristics and participants’ reports were counterintuitive and counter-hypothesized, and challenge some assumptions about how ostensibly stressful environments are associated with lived experience and how such environments ultimately impair health. GMA methodology may have applications for development of individual- or neighborhood-level interventions

Farjadian, A. B., Sivak, M. L., & Mavroidis, C. (2013). SQUID: Sensorized shirt with smartphone interface for exercise monitoring and home rehabilitation. IEEE Int.Conf.Rehabil.Robot., 2013, 1-6.

Stroke is a leading cause of serious long-term disability in the United States. There is a need for new technological adjuncts to expedite patients’ scheduled discharge from hospital and pursue rehabilitation procedure at home. SQUID is a low-cost, smart shirt that incorporates a six-channel electromyography (EMG) and heart rate data acquisition module to deliver objective audiovisual and haptic biofeedback to the patient. The sensorized shirt is interfaced with a smartphone application, for the subject’s usage at home, as well as the online database, for the therapist’s remote supervision from hospital. A single healthy subject was recruited to investigate the system functionality during improperly performed exercise. The system can potentially be used in automated, remote monitoring of variety of physical therapy exercises, rooted in strength or coordination training of specific muscle groups

Fleury, A., Mourcou, Q., Franco, C., Diot, B., Demongeot, J., & Vuillerme, N. (2013). Evaluation of a Smartphone-based audio-biofeedback system for improving balance in older adults - A pilot study. Conf.Proc.IEEE Eng Med.Biol.Soc., 2013, 1198-1201.

This study was designed to assess the effectiveness of a Smartphone-based audio-biofeedback (ABF) system for improving balance in older adults. This so-called “iBalance-ABF” system that we recetly developed is “all-inclusive” in the sense that its three main components of a balance prosthesis, (i) the sensory input unit, (ii) the processing unit, and (iii) the sensory output unit, are entirely embedded into the Smartphone. The underlying principle of this system is to supply the user with supplementary information about the medial-lateral (ML) trunk tilt relative to a predetermined adjustable “dead zone” through sound generation in earphones. Six healthy older adults voluntarily participated in this pilot study. Eyes closed, they were asked to stand upright and to sway as little as possible in two (parallel and tandem) stance conditions executed without and with the use of the iBalance-ABF system. Results showed that, without any visual information, the use of the Smartphone-based ABF allowed the older healthy adults to significantly decrease their ML trunk sway in the tandem stance posture and to mitigate the destabilizing effect induced by this particular stance. Although an extended study including a larger number of participants is needed to confirm these data, the present results are encouraging. They do suggest that Smartphone-based ABF system could be used for balance training and rehabilitation therapy in older adults

Fontana, J. M. & Sazonov, E. S. (2012). A robust classification scheme for detection of food intake through non-invasive monitoring of chewing. Conf.Proc.IEEE Eng Med.Biol.Soc., 2012, 4891-4894.

Automatic methods for food intake detection are needed to objectively monitor ingestive behavior of individuals in a free living environment. In this study, a pattern recognition system was developed for detection of food intake through the classification of jaw motion. A total of 7 subjects participated in laboratory experiments that involved several activities of daily living: talking, walking, reading, resting and food intake while being instrumented with a wearable jaw motion sensor. Inclusion of such activities provided a high variability to the sensor signal and thus challenged the classification task. A forward feature selection process decided on the most appropriate set of features to represent the chewing signal. Linear and RBF Support Vector Machine (SVM) classifiers were evaluated to find the most suitable classifier that can generalize the high variability of the input signal. Results showed that an average accuracy of 90.52% can be obtained using Linear SVM with a time resolution of 15 sec

Gaggioli, A. (2012). Quality of experience in real and virtual environments: some suggestions for the development of positive technologies. Stud.Health Technol.Inform., 181, 177-181.

What does one feel when one uses virtual reality? How does this experience differ from the experience associated with “real life” activities and situations? To answer these questions, we used the Experience Sampling Method (ESM), a procedure that allows researchers to investigate the daily fluctuations in the quality of experience through on-line self reports that participants fill out during daily life. The investigation consisted in one-week ESM observation (N = 42). During this week, participants underwent two virtual reality sessions: Immediately after the exposure to virtual environments, they were asked to complete a ESM report. For data analysis, experiential variables were aggregated into four dimensions: Mood, Engagement, Confidence, and Intrinsic Motivation Intrinsic Motivation. Findings showed that virtual experience is characterized by a specific configuration, which comprises significantly positive values for affective and cognitive components. In particular, positive scores of Mood suggest that participants perceived VR as an intrinsically pleasurable activity, while positive values of Engagement indicate that the use of VR and the experimental task provided valid opportunities for action and high skill investment. Furthermore, results showed that virtual experience is associated with Flow, a state of consciousness characterized by narrowed focus of attention, deep concentration, positive affect and intrinsic reward. Implications for VR research and practice are discussed

Gao, L., Bourke, A. K., & Nelson, J. (2012). Activity recognition using dynamic multiple sensor fusion in body sensor networks. Conf.Proc.IEEE Eng Med.Biol.Soc., 2012, 1077-1080.

Multiple sensor fusion is a main research direction for activity recognition. However, there are two challenges in those systems: the energy consumption due to the wireless transmission and the classifier design because of the dynamic feature vector. This paper proposes a multi-sensor fusion framework, which consists of the sensor selection module and the hierarchical classifier. The sensor selection module adopts the convex optimization to select the sensor subset in real time. The hierarchical classifier combines the Decision Tree classifier with the Naive Bayes classifier. The dataset collected from 8 subjects, who performed 8 scenario activities, was used to evaluate the proposed system. The results show that the proposed system can obviously reduce the energy consumption while guaranteeing the recognition accuracy

Gladh, K., Ang, B. O., Lindholm, P., Nilsson, J., & Westman, A. (2013). Decelerations and muscle responses during parachute opening shock. Aviat.Space Environ.Med., 84, 1205-1210.

INTRODUCTION: Pain in the neck region among skydivers can be related to repeated parachute opening shocks (POS), but empirical data on ramair POS biomechanics is lacking in the literature. The aim of this study was to develop and evaluate a methodology for assessment of multidirectional accelerations and neck muscle activity during parachuting, and to describe preliminary data. METHODS: In an experimental design, four experienced skydivers made two consecutive skydives. Deceleration was recorded with two triaxial accelerometers, one placed on the skydiver’s cervicothoracic junction (acc-neck) and the other on the harness (acc-rig). Surface electromyography (EMG) was sampled from four sites bilaterally: anterior-neck, posterior upper and lower neck, and upper shoulder muscles. EMG activity was normalized against a premeasured maximum voluntarily produced electrical signal (MVE). RESULTS: The measuring equipment did not interfere with the parachute jumps. High-quality signals were recorded. The median peak POS deceleration for the acc-neck vs. acc-rig indicated differences (4.0 G vs. 5.1 G), in addition to significant differences emerging for medians of average and maximum onset rates of deceleration (avg: 1.2 G x s(-1) vs. 19.5 G x s(-1); max: 23.0 G x s(-1) vs. 80.0 G x s(-1)). The median of overall muscleactivity was as high as 87% MVE, but no differences in peak activity were found between muscles. Temporal activations of the posterior upper neck occurred less than 50 ms after deceleration initiation, indicating feedforward control of the neck. CONCLUSION: All instruments recorded data of good quality without impeding the skydiving activity. Triaxial accelerometry on the neck vs. the harness yielded dissimilar results, underlining the importance of correct accelerometer placement. Muscle activity was high during POS and neck muscles showed anticipatory tendencies

Goetz, T., Bieg, M., L++dtke, O., Pekrun, R., & Hall, N. C. (2013). Do girls really experience more anxiety in mathematics? Psychological Science, 24, 2079-2087.

Two studies were conducted to examine gender differences in trait (habitual) versus state (momentary) mathematics anxiety in a sample of students (Study 1: N = 584; Study 2: N = 111). For trait math anxiety, the findings of both studies replicated previous research showing that female students report higher levels of anxiety than do male students. However, no gender differences were observed for state anxiety, as assessed using experience-sampling methods while students took a math test (Study 1) and attended math classes (Study 2). The discrepant findings for trait versus state math anxiety were partly accounted for by studentsGÇÖ beliefs about their competence in mathematics, with female students reporting lower perceived competence than male students despite having the same average grades in math. Implications for educational practices and the assessment of anxiety are discussed.

Goetz, T., Frenzel, A. C., Hall, N. C., Nett, U. E., Pekrun, R., & Lipnevich, A. A. (2013). Types of boredom: An experience sampling approach. Motivation and Emotion.

The present study investigated different types of boredom as proposed in a four-categorical conceptual model by Goetz and Frenzel (2006; doi: 10.1026/0049-8637.38.4.149 ). In this model, four types of boredom are differentiated based on degrees of valence and arousal: indifferent, calibrating, searching, and reactant boredom. In two studies (Study 1: university students, N = 63, mean age 24.08 years, 66 % female; Study 2: high school students, grade 11, N = 80, mean age 17.05 years, 58 % female), real-time data were obtained via the experience-sampling method (personal digital assistants, randomized signals). Boredom experiences (N = 1,103/1,432 in Studies 1/2) were analyzed with respect to the dimensions of valence and arousal using multilevel latent profile analyses. Supporting the internal validity of the proposed boredom types, our results are in line with the assumed four types of boredom but suggest an additional, fifth type, referred to as GÇ£apathetic boredom.GÇØ The present findings further support the external validity of the five boredom types in showing differential relations between the boredom types and other affective states as well as frequency of situational occurrence (achievement contexts vs. non-achievement contexts). Methodological implications as well as directions for future research are discussed.

Goldschmidt, A. B., Wonderlich, S. A., Crosby, R. D., Engel, S. G., Lavender, J. M., Peterson, C. B. et al. (2013). Ecological Momentary Assessment of Stressful Events and Negative Affect in Bulimia Nervosa. Journal of Consulting and Clinical Psychology.

Objective: Negative affect precedes binge eating and purging in bulimia nervosa (BN), but little is known about factors that precipitate negative affect in relation to these behaviors. We aimed to assess the temporal relation among stressful events, negative affect, and bulimic events in the natural environment using ecological momentary assessment. Method: A total of 133 women with current BN recorded their mood, eating behavior, and the occurrence of stressful events every day for 2 weeks. Multilevel structural equation mediation models evaluated the relations among Time 1 stress measures (i.e., interpersonal stressors, work/environment stressors, general daily hassles, and stress appraisal), Time 2 negative affect, and Time 2 binge eating and purging, controlling for Time 1 negative affect. Results: Increases in negative affect from Time 1 to Time 2 significantly mediated the relations between Time 1 interpersonal stressors, work/environment stressors, general daily hassles, and stress appraisal and Time 2 binge eating and purging. When modeled simultaneously, confidence intervals for interpersonal stressors, general daily hassles, and stress appraisal did not overlap, suggesting that each had a distinct impact on negative affect in relation to binge eating and purging. Conclusions: Our findings indicate that stress precedes the occurrence of bulimic behaviors and that increases in negative affect following stressful events mediate this relation. Results suggest that stress and subsequent negative affect may function as maintenance factors for bulimic behaviors and should be targeted in treatment.

Gonzalez, R., Tamminga, C. A., Tohen, M., & Suppes, T. (2014). The relationship between affective state and the rhythmicity of activity in bipolar disorder. J.Clin.Psychiatry.

OBJECTIVE: The aim of this study was to test the relationships between mood state and rhythm disturbances as measured via actigraphy in bipolar disorder by assessing the correlations between manic and depressive symptoms as measured via Young Mania Rating Scale (YMRS) and 30-item Inventory for Depressive Symptomatology, Clinician-Rated (IDS-C-30) scores and the actigraphic measurements of rhythm, the 24-hour autocorrelation coefficient and circadian quotient. METHOD: The research was conducted at the University of Texas Southwestern Medical Center at Dallas from February 2, 2009, to March 30, 2010. 42 patients with a DSM-IV-TR diagnosis of bipolar I disorder were included in the study. YMRS and the IDS-C-30 were used to determine symptom severity. Subjects wore the actigraph continuously for 7 days. The 24-hour autocorrelation coefficient was used as an indicator of overall rhythmicity. The circadian quotient was used to characterize the strength of a circadian rhythm. RESULTS: A greater severity of manic symptoms correlated with a lower degree of rhythmicity and less robust rhythms of locomotor activity as indicated by lower 24-hour autocorrelation (r = -0.3406, P = .03) and circadian quotient (r = -0.5485, P = .0002) variables, respectively. No relationship was noted between the degree of depression and 24-hour autocorrelation scores (r = -0.1190, P = .45) or circadian quotient (r = 0.0083, P = .96). Correlation was noted between the 24-hour autocorrelation and circadian quotient scores (r = 0.6347, P < .0001). CONCLUSIONS: These results support the notion that circadian rhythm disturbances are associated with bipolar disorder and that these disturbances may be associated with clinical signatures of the disorder. Further assessment of rhythm disturbances in bipolar disorder is warranted

Granholm, E., Ben-Zeev, D., Fulford, D., & Swendsen, J. (2013). Ecological Momentary Assessment of social functioning in schizophrenia: impact of performance appraisals and affect on social interactions. Schizophr.Res., 145, 120-124.

Research concerning the complex interplay between factors that contribute to poor social functioning in schizophrenia has been hampered by limitations of traditional measures, most notably the ecological validity and accuracy of retrospective self-report and interview measures. Computerized Ecological Momentary Assessment (EMAc) permits the real-time assessment of relationships between daily life experiences, thoughts, feelings, and behaviors. In the current study, EMAc was used to record daily social interactions, subjective performance appraisals of these interactions (e.g., “I succeeded/failed”; “I was liked/rejected”), and affect in 145 individuals with schizophrenia or schizoaffective disorder. Participants completed electronic questionnaires on a personal digital assistant (PDA) four times per day for one week. Time-lagged multilevel modeling of the data revealed that more positive interaction appraisals at any point in a day were associated with greater positive affect which, in turn, was a strong predictor of more social interactions over subsequent hours. Social functioning, therefore, was linked to positive performance beliefs about social interactions that were associated with greater positive affect. The findings suggest a useful treatment target for cognitive behavioral therapy and other psychosocial interventions that can be used to challenge defeatist beliefs and increase positive affect to enhance social functioning in schizophrenia

Gruber, J., Kogan, A., Mennin, D., & Murray, G. (2013). Real-world emotion? An experience-sampling approach to emotion experience and regulation in bipolar I disorder. Journal of Abnormal Psychology, 122, 971-983.

Laboratory studies suggest that bipolar disorder is characterized by emotion dysregulation, yet emotion disturbance has not been systematically described using more ecologically valid methods. Using an experience-sampling approach, we therefore sought to investigate positive and negative emotionality, emotion regulation strategies, and functioning among remitted individuals with bipolar I disorder (BD; n = 31) compared with both healthy controls (CTL; n = 32) and remitted individuals with major depressive disorder (MDD; n = 21). Hierarchical linear modeling analyses of self-report data spanning a 6-day consecutive period revealed that the BD group aligned with the CTL group in reporting greater positive emotionality than the MDD group, but aligned with the MDD group in reporting greater negative emotionality than the CTL group. Furthermore, the BD and MDD groups reported greater general use of emotion regulation strategies than the CTL group. These findings suggest that BD is characterized by amplified emotionality as well as increased efforts to regulate emotions in everyday life. Discussion focuses on implications for BD, as well as identification of unique (disorder-specific) and shared (transdiagnostic) features of emotion disturbance.

Gyllensten, I. C. & Bonomi, A. G. (2011). Identifying types of physical activity with a single accelerometer: evaluating laboratory-trained algorithms in daily life. IEEE Trans.Biomed.Eng, 58, 2656-2663.

Accurate identification of physical activity types has been achieved in laboratory conditions using single-site accelerometers and classification algorithms. This methodology is then applied to free-living subjects to determine activity behavior. This study is aimed at analyzing the reproducibility of the accuracy of laboratory-trained classification algorithms in free-living subjects during daily life. A support vector machine (SVM), a feed-forward neural network (NN), and a decision tree (DT) were trained with data collected by a waist-mounted accelerometer during a laboratory trial. The reproducibility of the classification performance was tested on data collected in daily life using a multiple-site accelerometer augmented with an activity diary for 20 healthy subjects (age: 30 +/- 9; BMI: 23.0 +/- 2.6 kg/m(2)). Leave-one-subject-out cross validation of the training data showed accuracies of 95.1 +/- 4.3%, 91.4 +/- 6.7%, and 92.2 +/- 6.6% for the SVM, NN, and DT, respectively. All algorithms showed a significantly decreased accuracy in daily life as compared to the reference truth represented by the IDEEA and diary classifications (75.6 +/- 10.4%, 74.8 +/- 9.7%, and 72.2 +/- 10.3%; p < 0.05). In conclusion, cross validation of training data overestimates the accuracy of the classification algorithms in daily life

Hallman, D. M., Ekman, A. H., & Lyskov, E. (2013). Changes in physical activity and heart rate variability in chronic neck-shoulder pain: monitoring during work and leisure time. Int.Arch.Occup.Environ.Health.

OBJECTIVES: Neck-shoulder pain (NSP) is a common work-related musculoskeletal disorder with unclear mechanisms. Changes in physical activity and autonomic nervous system regulation may be involved in the pathogenesis of chronic NSP. The aim of the current study was to investigate autonomic regulation in relation to physical activity and perceived symptoms during work and leisure time among workers with chronic NSP (n = 29) as compared to a healthy control group (CON, n = 27). METHODS: Physical activity was objectively monitored for 7 days using accelerometry. Beat-to-beat heart rate was collected continuously for 72 h, with simultaneous momentary ratings of pain, stress, and fatigue. Duration of sitting/lying, standing and walking, number of steps, and energy expenditure were used as measures of physical activity. Heart rate variability (HRV) indices were extracted in time and frequency domains as reflecting autonomic regulation. Data were divided into work hours, leisure time, and sleep. RESULTS: The NSP group rated higher levels of stress and fatigue at work and leisure, and reduced sleep quality as compared to CON. Elevated heart rate and reduced HRV were found in NSP compared with CON, especially during sleep. The NSP group demonstrated a different pattern of physical activity than CON, with a lower activity level in leisure time. Higher physical activity was associated with increased HRV in both groups. CONCLUSION: Changes in HRV reflected an autonomic imbalance in workers with chronic musculoskeletal pain. This can be explained by reduced physical activity in leisure time. Intervention studies aimed at increasing physical activity may shed further light on the association between autonomic regulation and physical activity in work-related NSP

Haut, S. R., Hall, C. B., Borkowski, T., Tennen, H., & Lipton, R. B. (2013). Modeling seizure self-prediction: an e-diary study. Epilepsia, 54, 1960-1967.

PURPOSE: A subset of patients with epilepsy successfully self-predicted seizures in a paper diary study. We conducted an e-diary study to ensure that prediction precedes seizures, and to characterize the prodromal features and time windows that underlie self-prediction. METHODS: Subjects 18 or older with localization-related epilepsy (LRE) and >/=3 seizures per month maintained an e-diary, reporting a.m./p.m. data daily, including mood, premonitory symptoms, and all seizures. Self-prediction was rated by, “How likely are you to experience a seizure (time frame)?” Five choices ranged from almost certain (>95% chance) to very unlikely. Relative odds of seizure (odds ratio, OR) within time frames was examined using Poisson models with log normal random effects to adjust for multiple observations. KEY FINDINGS: Nineteen subjects reported 244 eligible seizures. OR for prediction choices within 6 h was as high as 9.31 (CI 1.92-45.23) for “almost certain.” Prediction was most robust within 6 h of diary entry, and remained significant up to 12 h. For nine best predictors, average sensitivity was 50%. Older age contributed to successful self-prediction, and self-prediction appeared to be driven by mood and premonitory symptoms. In multivariate modeling of seizure occurrence, self-prediction (2.84; CI 1.68-4.81), favorable change in mood (0.82; CI 0.67-0.99), and number of premonitory symptoms (1.11; CI 1.00-1.24) were significant. SIGNIFICANCE: Some persons with epilepsy can self-predict seizures. In these individuals, the odds of a seizure following a positive prediction are high. Predictions were robust, not attributable to recall bias, and were related to self-awareness of mood and premonitory features. The 6-h prediction window is suitable for the development of preemptive therapy

Henry, J. A., Galvez, G., Turbin, M. B., Thielman, E. J., McMillan, G. P., & Istvan, J. A. (2012). Pilot study to evaluate ecological momentary assessment of tinnitus. Ear Hear., 33, 179-290.

OBJECTIVES: Because audiometric evaluation, symptom histories, questionnaires, and similar standard assessment tools may not adequately sample the effects of chronic tinnitus on day-to-day activities, there is a need for alternative methodological approaches to study the impact of tinnitus on day-to-day life. An innovative methodological approach that has shown great promise in the study of chronic health problems characterized by reported temporal and/or situational variability in symptoms and distress is known as ecological momentary assessment (EMA). EMA involves the real-time measurement of states, situational factors, and symptoms by individuals as they go about their day-to-day activities. The objective of this pilot investigation was to explore the feasibility of using EMA methods to examine within- and between-day effects of tinnitus. DESIGN: This study was conducted in three phases: (1) design and development of an EMA methodology that could be used to assess effects of tinnitus; (2) refinement of the methodology through the use of two focus groups; and (3) field-test the methodology with individuals who experienced bothersome tinnitus. For Phase 3, each of the 24 participants wore, throughout their waking hours for 2 weeks, a personal digital assistant that produced alerts four times a day. The alerts prompted participants to respond to 19 questions, including 9 relating to situational and mood factors and 10 comprising the Tinnitus Handicap Inventory-Screening version (THI-S). To evaluate for potential reactive effects of performing the EMA protocol, each participant completed the paper-and-pencil version of the full 25-item THI before and after the 2-week EMA period. RESULTS: Participants responded to the alerts with a 90% compliance rate, providing a total of 1210 completed surveys. At the time of their response, participants indicated that they were in their house or apartment (67.7%), alone (50.2%), happy (50%), and calm (54.5%). Across most responses, participants could hear their tinnitus (97%), and the loudness of their tinnitus averaged 4.7 on a 7-point increasing-loudness scale. The mean THI-S index score (out of a possible maximum 40 points for greatest tinnitus severity) was 17.0 (moderate self-perceived tinnitus handicap). Repeated THI-S index scores varied considerably both within and between participants. Mean 25-item THI scores were not significantly different before and after the EMA period, suggesting little reactivity of the EMA. CONCLUSIONS: The high compliance rate, positive feedback from participants, lack of reactivity as a result of performing the EMA protocol, and data collected indicate that EMA methodology is feasible with patients who have tinnitus. Outcome data obtained with this methodology cannot be obtained any other way because retrospective questionnaires cannot capture the day-to-day reactions. This methodology has the potential to provide more in-depth and accurate assessments of patients receiving therapy for tinnitus

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 1-2 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 1-2 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

Hofmann, W., Vohs, K. D., & Baumeister, R. F. (2012). What people desire, feel conflicted about, and try to resist in everyday life. Psychol.Sci., 23, 582-588.

In the present study, we used experience sampling to measure desires and desire regulation in everyday life. Our analysis included data from 205 adults, who furnished a total of 7,827 reports of their desires over the course of a week. Across various desire domains, results revealed substantial differences in desire frequency and strength, the degree of conflict between desires and other goals, and the likelihood of resisting desire and the success of this resistance. Desires for sleep and sex were experienced most intensively, whereas desires for tobacco and alcohol had the lowest average strength, despite the fact that these substances are thought of as addictive. Desires for leisure and sleep conflicted the most with other goals, and desires for media use and work brought about the most self-control failure. In addition, we observed support for a limited-resource model of self-control employing a novel operationalization of cumulative resource depletion: The frequency and recency of engaging in prior self-control negatively predicted people’s success at resisting subsequent desires on the same day

Hohn, P., Menne-Lothmann, C., Peeters, F., Nicolson, N. A., Jacobs, N., Derom, C. et al. (2013). Moment-to-moment transfer of positive emotions in daily life predicts future course of depression in both general population and patient samples. PLoS.One., 8, e75655.

OBJECTIVE: Positive affect (PA) is closely linked to prevention of, and recovery from, depression. Previous studies have investigated PA reactivity to pleasant situations with respect to its protective properties in relation to mood disorder. The purpose of this study was to examine, and replicate, whether moment-to-moment transfer of PA in daily life (PA persistence) is relevant to the prediction of future course of depression. METHOD: Individuals from three different studies (one general population sample (n=540), and two patient samples (n=43 and n=50) with matching controls (n=39 and n=21, respectively)) participated in an Experience Sampling Method (ESM) study. Time-lagged multilevel analyses were used to assess the degree of transfer (or persistence) of momentary positive affective states over time, in relation to naturalistic outcome (study 1) or treatment outcome (studies 2 and 3). Depressive symptoms were measured using the Symptom Checklist (SCL-90R) in sample 1 and the Hamilton Depression Rating Scale (HDRS) in samples 2 and 3. RESULTS: In study 1, participants with greater momentary PA persistence were less likely to show depressive symptoms at follow-up. In study 2, patients were more likely to respond to treatment if they displayed greater momentary PA persistence, particularly in those with recurrent depression. In study 3, patients with greater momentary PA persistence were similarly more likely to respond to treatment, especially when treated with imipramine rather than placebo. CONCLUSION: The ability to transfer PA from one moment to the next is an important factor in the prevention of and recovery from depressive symptoms. Patients with recurrent depression and those who receive antidepressants rather than placebo may benefit most from this effect. The results suggest that treatment-induced improvement in depression is mediated by increased levels of momentary transfer of PA in daily life, acquisition of which may be contingent on duration of exposure to depressive experience

Houtveen, J. H. & Sorbi, M. J. (2013). Prodromal functioning of migraine patients relative to their interictal stateGÇöAn ecological momentary assessment study. PLoS ONE, 8.

Smartphones were used in an online Ecological Momentary Assessment (EMA) design to test prodromal functioning relative to the interictal state in migraine patients. Eighty-seven participants completed an electronic diary 4 times daily during 3-6 weeks to monitor their migraine attacks. Twice daily the diary additionally included 16 multi-answer questions covering physical symptoms (30 items), cognitive-affective functioning (25 items) and external factors (25 items). Eight clustered prodromal features were identified in the current study: sensory sensitivity, pain/stiffness, fatigue, cognitive functioning, positive affect, negative affect, effort spent and stressors encountered. Per feature, individual change scores with interictal control days - excluding 24-hour post-attack recovery - were computed for six 12-hour pre-attack time windows covering three prodromal days. Linear mixed model (fixed-effect) analysis established significant increases in sensory sensitivity, pain/stiffness and fatigue, and a tendency for increased negative affect, in the 12 hours prior to the attack. Positive affect and cognitive functioning were impaired both in the 25-36 hour and - more strongly - in the 12-hour time window before the attack. No effects were found for effort spent and stressors encountered. Exploratory (random effect) analysis revealed significant individual differences in the change scores in sensory sensitivity, pain/stiffness, fatigue and negative affect. It is concluded that the prodromal change in migraine - relative to interictal functioning - predominantly exists within the last 12 hours before attack onset. Individual diversity is large, however. Future research should zoom in to identify prodrome development within the 12 pre-attack hours as well as to isolate individual patterns.

Igic, I., Ryser, S., & Elfering, A. (2013). Does work stress make you shorter? An ambulatory field study of daily work stressors, job control, and spinal shrinkage. Journal of Occupational Health Psychology, 18, 469-480.

Body height decreases throughout the day due to fluid loss from the intervertebral disk. This study investigated whether spinal shrinkage was greater during workdays compared with nonwork days, whether daily work stressors were positively related to spinal shrinkage, and whether job control was negatively related to spinal shrinkage. In a consecutive 2-week ambulatory field study, including 39 office employees and 512 days of observation, spinal shrinkage was measured by a stadiometer, and calculated as body height in the morning minus body height in the evening. Physical activity was monitored throughout the 14 days by accelerometry. Daily work stressors, daily job control, biomechanical workload, and recreational activities after work were measured with daily surveys. Multilevel regression analyses showed that spinal disks shrank more during workdays than during nonworkdays. After adjustment for sex, age, body weight, smoking status, biomechanical work strain, and time spent on physical and low-effort activities during the day, lower levels of daily job control significantly predicted increased spinal shrinkage. Findings add to knowledge on how work redesign that increases job control may possibly contribute to preserving intervertebral disk function and preventing occupational back pain.

Janney, C. A., Fagiolini, A., Swartz, H. A., Jakicic, J. M., Holleman, R. G., & Richardson, C. R. (2014). Are adults with bipolar disorder active? Objectively measured physical activity and sedentary behavior using accelerometry. J.Affect.Disord., 152-154, 498-504.

BACKGROUND: Little is known about physical activity and sedentary behavior of adults with bipolar disorder (BP). Physical activity and sedentary behaviors may be modifiable factors associated with elevated rates of obesity, diabetes, cardiovascular disease, metabolic syndrome, and mortality in adults with BP. METHODS: Sixty adult outpatients treated for BP (>18yr) wore accelerometers for seven consecutive days. Each minute epoch was assigned an activity level based on the number of counts per minute; sedentary(<100 counts), light(101-1951 counts), or moderate/vigorous(>1952 counts). Adults with BP were matched 1:1 to users and non-users of mental health services (MHS) (NHANES 2003-2004) by gender, closest BMI, and age. RESULTS: On average, adults with BP wore actigraphs over 17h/day. The majority of monitoring time (78%) was classified as sedentary (approximately 13.5h/day). Light physical activity accounted for 21% of the monitoring time/day (215min/day). None achieved 150min/wk of moderate/vigorous activity as recommended by national guidelines. Adults with BP were significantly less active and more sedentary than MHS users and non-users in NHANES 2003-2004 (p<0.01). LIMITATIONS: Majority of the participants were relatively asymptomatic with most (87%) having no more than mild depressive symptoms and none experiencing severe manic symptoms. The sedating effects of medications on physical activity were not investigated. CONCLUSION: From clinical perspectives, these findings justify physical activity interventions targeting adults with BP as a possible means to improve their physical and mental health and to reduce the elevated risk of commonly observed medical comorbidities in this high-risk population

Jappe, L. M., Cao, L., Crosby, R. D., Crow, S. J., Peterson, C. B., Le, G. D. et al. (2013). Stress and eating disorder behavior in anorexia nervosa as a function of menstrual cycle status. Int.J.Eat.Disord. .

OBJECTIVE: Fluctuations in ovarian hormones during the menstrual cycle and psychosocial stress contribute to eating disorder (ED) behavior. METHOD: Using ecological momentary assessment techniques, this study examined relationships between stress and binge eating, self-induced vomiting, and dietary restriction based on menstrual cycle status in anorexia nervosa (AN). One hundred nine females with full and subthreshold AN (17-45 years old) recorded ED behavior and stress ratings over 2 weeks. Using hierarchical linear modeling, individuals with eumenorrhea and those with amenorrhea or oligomenorrhea were compared. RESULTS: Following episodes of meal skipping, momentary stress decreased in individuals with normal menstrual cycles and increased in those with irregular menstrual cycles. DISCUSSION: Results suggest that changes in stress severity in response to food restriction may differ based on ovarian hormonal status and may be a mechanism by which AN is maintained in individuals without menstrual disturbance. (c) 2013 Wiley Periodicals, Inc.(Int J Eat Disord 2013)

John, D., Staudenmayer, J., & Freedson, P. (2013). Simple to complex modeling of breathing volume using a motion sensor. Sci.Total Environ., 454-455, 184-188.

PURPOSE: To compare simple and complex modeling techniques to estimate categories of low, medium, and high ventilation (VE) from ActiGraph activity counts. METHODS: Vertical axis ActiGraph GT1M activity counts, oxygen consumption and VE were measured during treadmill walking and running, sports, household chores and labor-intensive employment activities. Categories of low (<19.3 l/min), medium (19.3 to 35.4 l/min) and high (>35.4 l/min) VEs were derived from activity intensity classifications (light <2.9 METs, moderate 3.0 to 5.9 METs and vigorous >6.0 METs). We examined the accuracy of two simple techniques (multiple regression and activity count cut-point analyses) and one complex (random forest technique) modeling technique in predicting VE from activity counts. RESULTS: Prediction accuracy of the complex random forest technique was marginally better than the simple multiple regression method. Both techniques accurately predicted VE categories almost 80% of the time. The multiple regression and random forest techniques were more accurate (85 to 88%) in predicting medium VE. Both techniques predicted the high VE (70 to 73%) with greater accuracy than low VE (57 to 60%). Actigraph cut-points for light, medium and high VEs were <1381, 1381 to 3660 and >3660 cpm. CONCLUSIONS: There were minor differences in prediction accuracy between the multiple regression and the random forest technique. This study provides methods to objectively estimate VE categories using activity monitors that can easily be deployed in the field. Objective estimates of VE should provide a better understanding of the dose-response relationship between internal exposure to pollutants and disease

Judge, T. A., Simon, L. S., Hurst, C., & Kelley, K. (2013). What I Experienced Yesterday Is Who I Am Today: Relationship of Work Motivations and Behaviors to Within-Individual Variation in the Five-Factor Model of Personality. Journal of Applied Psychology.

Historically, organizational and personality psychologists have ignored within-individual variation in personality across situations or have treated it as measurement error. However, we conducted a 10-day experience sampling study consistent with whole trait theory (Fleeson, 2012), which conceptualizes personality as a system of stable tendencies and patterns of intraindividual variation along the dimensions of the Big Five personality traits (Costa & McCrae, 1992). The study examined whether (a) internal events (i.e., motivation), performance episodes, and interpersonal experiences at work predict deviations from central tendencies in trait-relevant behavior, affect, and cognition (i.e., state personality), and (b) there are individual differences in responsiveness to work experiences. Results revealed that personality at work exhibited both stability and variation within individuals. Trait measures predicted average levels of trait manifestation in daily behavior at work, whereas daily work experiences (i.e., organizational citizenship, interpersonal conflict, and motivation) predicted deviations from baseline tendencies. Additionally, correlations of neuroticism with standard deviations in the daily personality variables suggest that, although work experiences influence state personality, people higher in neuroticism exhibit higher levels of intraindividual variation in personality than do those who are more emotionally stable.

Kam, H. J., Lee, K., Cho, S. M., Shin, Y. M., & Park, R. W. (2011). High-Resolution Actigraphic Analysis of ADHD: A Wide Range of Movement Variability Observation in Three School Courses - A Pilot Study. Healthc.Inform.Res., 17, 29-37.

OBJECTIVES: This study was conducted to determine whether or not newly proposed high-resolution activity features could provide a superior analytic foundation compared to those commonly used to assess transitions in children’s activities, under circumstances in which the types of courses attended exert different situational effects on activity levels. METHODS: From 153 children at a local elementary school, 10 subjects with attention deficit hyperactivity disorder (ADHD) and 7 controls were recruited. Their activity data was collected using an actigraph while they attended school. Ratios of partitioned activity ranges (0.5-2.8 G) during the entire activity were extracted during three classes: art, mathematics, and native language (Korean). Extracted activity features for each participant were compared between the two groups of children (ADHD and control) using graphs and statistical analysis. RESULTS: Activity distributions between ADHD and control groups for each class showed statistically significant differences spread through the entire range in art class compared to native language and mathematics classes. The ADHD group, but not the control group, experienced many significantly different intervals (> 50%) having low to very high activity acceleration regions during the art and languages courses. CONCLUSIONS: Class content appears to influence the activity patterns of ADHD children. Monitoring the actual magnitude and activity counts in a wide range of subjects could facilitate the examination of distributions or patterns of activities. Objective activity measurements made with an actigraph may be useful for monitoring changes in activities in children with ADHD in a timely manner

Kashdan, T. B., Yarbro, J., McKnight, P. E., & Nezlek, J. B. (2013). Laughter with someone else leads to future social rewards: Temporal change using experience sampling methodology. Personality and Individual Differences.

Prior research suggests that laughter is correlated with resilience and well-being. To date, there is little research on the subsequent social benefits following laughter with another person. We hypothesized that laughing with another person would be associated with greater social rewards in subsequent social interactions. Using a two-week daily diary study with 162 people (68% women), we collected data on 5510 face-to-face social interactions in everyday life. We found that laughing with another person during an interaction predicted greater intimacy, positive emotions, and enjoyment in the subsequent social interaction. There was no evidence for the reverse direction, as intimacy, positive emotions, and enjoyment failed to predict laughter in subsequent social interactions. As for specificity, laughter was associated with subsequent intimacy and positive emotions even after accounting for the variance attributable to enjoyment felt when socializing. As for robustness, laughter with another person had the same effect on subsequent interactions regardless of whether interacting with the same person or a new person. In summary, besides being immediately pleasurable, laughing with social interaction partners influences the likelihood of future social rewards. This study adds to theory and research suggesting that laughing is an important social bonding mechanism.

Kennedy, A. P., Epstein, D. H., Phillips, K. A., & Preston, K. L. (2013). Sex differences in cocaine/heroin users: Drug-use triggers and craving in daily life. Drug and Alcohol Dependence, 132, 29-37.

Background: Studies of sex differences have shown that men and women with drug-use disorders differ in course and outcome and in cue-induced activation of putative brain GÇ£control network GÇØ areas. We evaluated sex differences in daily functioning and subjective events related to drug use with ecological momentary assessment (EMA). Methods: EMA data were collected from cocaine- and heroin-using outpatients (72 men; 42 women) in methadone maintenance in 2GÇô5 randomly prompted (RP) entries per day and in participant-initiated entries for heroin or cocaine use or craving, for up to 25 weeks. Urine drug screens were conducted three times weekly. Data were analyzed via repeated-measures logistic regression, using sex as a predictor of responses. Results: In RP reports, women and men reported significantly different patterns of drug-cue exposure, with women significantly more likely to report having seen cocaine or been tempted to use in the past hour. Women also had higher craving after past-hour exposure to drug cues. In reports of drug use, women, compared to men, were more likely to report that they had used more cocaine than they had meant to, tended to feel guilty more often after drug use, and to have used despite trying not to use. Conclusions: These findings provide real-time behavioral evidence that women respond differently than men to exposure to drug cues and to drug use, consistent with laboratory and brain-imaging findings. This information may be useful for development of sex-specific treatment strategies.

Kerr, J., Marshall, S., Godbole, S., Neukam, S., Crist, K., Wasilenko, K. et al. (2012). The relationship between outdoor activity and health in older adults using GPS. Int.J.Environ.Res.Public Health, 9, 4615-4625.

Physical activity (PA) provides health benefits in older adults. Research suggests that exposure to nature and time spent outdoors may also have effects on health. Older adults are the least active segment of our population, and are likely to spend less time outdoors than other age groups. The relationship between time spent in PA, outdoor time, and various health outcomes was assessed for 117 older adults living in retirement communities. Participants wore an accelerometer and GPS device for 7 days. They also completed assessments of physical, cognitive, and emotional functioning. Analyses of variance were employed with a main and interaction effect tested for +/-30 min PA and outdoor time. Significant differences were found for those who spent >30 min in PA or outdoors for depressive symptoms, fear of falling, and self-reported functioning. Time to complete a 400 m walk was significantly different by PA time only. QoL and cognitive functioning scores were not significantly different. The interactions were also not significant. This study is one of the first to demonstrate the feasibility of using accelerometer and GPS data concurrently to assess PA location in older adults. Future analyses will shed light on potential causal relationships and could inform guidelines for outdoor activity

Khor, A. S., Gray, K. M., Reid, S. C., & Melvin, G. A. (2014). Feasibility and validity of ecological momentary assessment in adolescents with high-functioning autism and Asperger’s disorder. J.Adolesc., 37,  37-46.

Ecological Momentary Assessment (EMA) may increase accuracy of data compared with retrospective questionnaires by assessing behaviours as they occur, hence decreasing recall biases and increasing ecological validity. This study examined the feasibility and concurrent validity of an EMA tool for adolescents with High-Functioning Autism Spectrum Disorders (HFASD). Thirty-one adolescents with HFASD completed a mobile phone EMA application that assessed stressors and coping for two weeks. Parents and adolescents also completed retrospective measures of the adolescent’s coping/stressors. Moderate compliance with the EMA tool was achieved and some concurrent validity was established with the retrospective measure of coping. Concordance was found between the types of stressors reported by parents and adolescents but not the quantity. The results suggest adolescents with HFASD are capable of reporting on their stressors and coping via EMA. EMA has the potential to be a valuable research tool in this population

Kirchner, T. R. & Shiffman, S. (2013). Ecological momentary assessment. In J.MacKillop & H. de Wit (Eds.), The Wiley-Blackwell handbook of addiction psychopharmacology (pp. 541-565). Wiley-Blackwell.

(from the chapter) Ecological Momentary Assessment (EMA) is a method for collecting data in real time and in real-world settings. EMA is particularly well suited for studying substance use, because use patterns are highly complex and related to contextual factors like mood, setting, and cues. This chapter addresses the application of EMA to substance use research, outlining principles of EMA design and analysis, and illustrating them with examples from the literature. The chapter considers the way technological innovations are facilitating the rapid evolution of EMA systems, and provides recommendations on current best practices. It reviews data on methodological issues such as compliance and reactivity, and looks forward to the way emerging technologies will enable increasingly unobtrusive assessment of both individual- and systems-level processes over time and space. EMA methods reveal substance use patterns not captured by questionnaires or retrospective data, and hold great promise for substance use research and treatment.

Kirk, G. D., Linas, B. S., Westergaard, R. P., Piggott, D., Bollinger, R. C., Chang, L. W. et al. (2013). The exposure assessment in current time study: implementation, feasibility, and acceptability of real-time data collection in a community cohort of illicit drug users. AIDS Res.Treat., 2013, 594671.

Objective. We describe the study design and evaluate the implementation, feasibility, and acceptability of an ecological momentary assessment (EMA) study of illicit drug users. Design. Four sequential field trials targeting observation of 30 individuals followed for a four week period. Participants. Participants were recruited from an ongoing community-cohort of current or former injection drug users. Of 113 individuals enrolled, 109 completed study procedures during four trials conducted from November 2008 to May 2013. Methods. Hand-held electronic diaries used in the initial trials were transitioned to a smartphone platform for the final trial with identical data collection. Random-prompts delivered five times daily assessed participant location, activity, mood, and social context. Event-contingent data collection involved participant self-reports of illicit drug use and craving. Main Outcome Measures. Feasibility measures included participant retention, days of followup, random-prompt response rates, and device loss rate. Acceptability was evaluated from an end-of-trial questionnaire. Sociodemographic, behavioral, clinical, and trial characteristics were evaluated as correlates of weekly random-prompt response rates >/=80% using logistic regression with generalized estimating equations. Results. Study participants were a median of 48.5 years old, 90% African American, 52% male, and 59% HIV-infected with limited income and educational attainment. During a median followup of 28 days, 78% of 11,181 random-prompts delivered were answered (mean of 2.8 responses daily), while 2,798 participant-initiated events were reported (30% drug use events; 70% craving events). Self-reported acceptability to study procedures was uniformly favorable. Device loss was rare (only 1 lost device every 190 person-days of observation). Higher educational attainment was consistently associated with a higher response rate to random-prompts, while an association of HIV infection with lower response rates was not observed after accounting for differences in trial recruitment procedures. Conclusion. Near real-time EMA data collection in the field is feasible and acceptable among community-dwelling illicit drug users. These data provide the basis for future studies of EMA-informed interventions to prevent drug relapse and improve HIV treatment outcomes in this population

Kirste, T., Hoffmeyer, A., Koldrack, P., Bauer, A., Schubert, S., Schroder, S. et al. (2014). Detecting the effect of Alzheimer’s disease on everyday motion behavior. J.Alzheimers.Dis., 38, 121-132.

BACKGROUND: Early detection of behavioral changes in Alzheimer’s disease (AD) would help the design and implementation of specific interventions. OBJECTIVE: The target of our investigation was to establish a correlation between diagnosis and unconstrained motion behavior in subjects without major clinical behavior impairments. METHOD: We studied everyday motion behavior in 23 dyads with one partner suffering from AD dementia and one cognitively healthy partner in the subjects’ home, employing ankle-mounted three-axes accelerometric sensors. We determined frequency features obtained from the signal envelopes computed by an envelope detector for the carrier band 0.5 Hz to 5 Hz. Based on these features, we employed quadratic discriminant analysis for building models discriminating between AD patients and healthy controls. RESULTS: After leave-one-out cross-validation, the classification accuracy of motion features reached 91% and was superior to the classification accuracy based on the Cohen-Mansfield Agitation Inventory (CMAI). Motion features were significantly correlated with MMSE and CMAI scores. CONCLUSION: Our findings suggest that changes of everyday behavior are detectable in accelerometric behavior protocols even in the absence of major clinical behavioral impairments in AD

Kirwan, M., Vandelanotte, C., Fenning, A., & Duncan, M. J. (2013). Diabetes self-management smartphone application for adults with type 1 diabetes: randomized controlled trial. J.Med.Internet.Res., 15, e235.

BACKGROUND: Persistently poor glycemic control in adult type 1 diabetes patients is a common, complex, and serious problem initiating significant damage to the cardiovascular, renal, neural, and visual systems. Currently, there is a plethora of low-cost and free diabetes self-management smartphone applications available in online stores. OBJECTIVE: The aim of this study was to examine the effectiveness of a freely available smartphone application combined with text-message feedback from a certified diabetes educator to improve glycemic control and other diabetes-related outcomes in adult patients with type 1 diabetes in a two-group randomized controlled trial. METHODS: Patients were recruited through an online type 1 diabetes support group and letters mailed to adults with type 1 diabetes throughout Australia. In a 6-month intervention, followed by a three-month follow-up, patients (n=72) were randomized to usual care (control group) or usual care and the use of a smartphone application (Glucose Buddy) with weekly text-message feedback from a Certified Diabetes Educator (intervention group). All outcome measures were collected at baseline and every three months over the study period. Patients’ glycosylated hemoglobin levels (HbA1c) were measured with a blood test and diabetes-related self-efficacy, self-care activities, and quality of life were measured with online questionnaires. RESULTS: The mean age of patients was 35.20 years (SD 10.43) (28 male, 44 female), 39% (28/72) were male, and patients had been diagnosed with type 1 diabetes for a mean of 18.94 years (SD 9.66). Of the initial 72 patients, 53 completed the study (25 intervention, 28 control group). The intervention group significantly improved glycemic control (HbA1c) from baseline (mean 9.08%, SD 1.18) to 9-month follow-up (mean 7.80%, SD 0.75), compared to the control group (baseline: mean 8.47%, SD 0.86, follow-up: mean 8.58%, SD 1.16). No significant change over time was found in either group in relation to self-efficacy, self-care activities, and quality of life. CONCLUSIONS: In adjunct to usual care, the use of a diabetes-related smartphone application combined with weekly text-message support from a health care professional can significantly improve glycemic control in adults with type 1 diabetes. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry: ACTRN12612000132842; 2 (Archived by WebCite at

Kleim, B., Graham, B., Bryant, R. A., & Ehlers, A. (2013). Capturing intrusive re-experiencing in trauma survivors’ daily lives using ecological momentary assessment. J.Abnorm.Psychol., 122, 998-1009.

Intrusive memories are common following traumatic events and among the hallmark symptoms of posttraumatic stress disorder (PTSD). Most studies assess summarized accounts of intrusions retrospectively. We used an ecological momentary approach and index intrusive memories in trauma survivors with and without PTSD using electronic diaries. Forty-six trauma survivors completed daily diaries for 7 consecutive days recording a total of 294 intrusions. Participants with PTSD experienced only marginally more intrusions than those without PTSD, but experienced them with more “here and now quality,” and responded with more fear, helplessness, anger, and shame than those without PTSD. Most frequent intrusion triggers were stimuli that were perceptually similar to stimuli from the trauma. Individuals with PTSD experienced diary-prompted voluntary trauma memories with the same sense of nowness and vividness as involuntary intrusive trauma memories. The findings contribute to a better understanding of everyday experiences of intrusive reexperiencing in trauma survivors with PTSD and offer clinical treatment implications.

Kolodziejczyk, J. K., Norman, G. J., Barrera-Ng, A., Dillon, L., Marshall, S., Arredondo, E. et al. (2013). Feasibility and effectiveness of an automated bilingual text message intervention for weight loss: pilot study. JMIR.Res.Protoc., 2, e48.

BACKGROUND: Little is known about the feasibility and acceptability of tailored text message based weight loss programs for English and Spanish-language speakers. OBJECTIVE: This pilot study evaluated the feasibility, acceptability, and estimated impact of a tailored text message based weight loss program for English and Spanish-language speakers. The purpose of this pilot study was to inform the development of a full-scale randomized trial. METHODS: There were 20 overweight or obese participants (mean age 40.10, SD 8.05; 8/20, 40% male; 9/20, 45% Spanish-speakers) that were recruited in San Diego, California, from March to May 2011 and evaluated in a one-group pre/post clinical trial. For 8 weeks, participants received and responded to 3-5 text messages daily sent from a fully automated text messaging system. They also received printed weight loss materials and brief 10-15 minute weekly counseling calls. To estimate the impact of the program, the primary outcome was weight (kg) measured during face-to-face measurement visits by trained research staff. Pre and post differences in weight were analyzed with a one-way repeated measures analysis of variance. Differences by language preference at both time points were analyzed with t tests. Body mass index and weight management behaviors also were examined. Feasibility and acceptability were determined by recruitment success, adherence (ie, percentage of replies to interactive text messages and attrition), and participant satisfaction. RESULTS: Participants who completed the final assessment (N=18) decreased body weight by 1.85 kg (F1,17=10.80, P=.004, CI 0.66-3.03, eta(2)=0.39). At both time points, there were no differences in weight by language preference. Participants responded to 88.04% (986/1120) of interactive text messages, attrition rate was 10% (2/20), and 94% (19/20) of participants reported satisfaction with the program. CONCLUSIONS: This fully automated text message based weight program was feasible with English and Spanish-speakers and may have promoted modest weight loss over an 8-week period. TRIAL REGISTRATION: NCT01171586; (Archived by WebCite at

Koval, P., Ogrinz, B., Kuppens, P., Van den Bergh, O., Tuerlinckx, F., & Sutterlin, S. (2013). Affective instability in daily life is predicted by resting heart rate variability. PLoS.One., 8, e81536.

Previous research has shown that being affectively unstable is an indicator of several forms of psychological maladjustment. However, little is known about the mechanisms underlying affective instability. Our research aims to examine the possibility that being prone to extreme fluctuations in one’s feelings is related to maladaptive emotion regulation. We investigated this hypothesis by relating affective instability, assessed in daily life using the experience sampling method, to self-reported emotion regulation strategies and to parasympathetically mediated heart rate variability (HRV), a physiological indicator of emotion regulation capacity. Results showed that HRV was negatively related to instability of positive affect (as measured by mean square successive differences), indicating that individuals with lower parasympathetic tone are emotionally less stable, particularly for positive affect

Kramer, I., Simons, C. J., Hartmann, J. A., Menne-Lothmann, C., Viechtbauer, W., Peeters, F. et al. (2014). A therapeutic application of the experience sampling method in the treatment of depression: a randomized controlled trial. World Psychiatry, 13, 68-77.

In depression, the ability to experience daily life positive affect predicts recovery and reduces relapse rates. Interventions based on the experience sampling method (ESM-I) are ideally suited to provide insight in personal, contextualized patterns of positive affect. The aim of this study was to examine whether add-on ESM-derived feedback on personalized patterns of positive affect is feasible and useful to patients, and results in a reduction of depressive symptomatology. Depressed outpatients (n=102) receiving pharmacological treatment participated in a randomized controlled trial with three arms: an experimental group receiving add-on ESM-derived feedback, a pseudo-experimental group participating in ESM but receiving no feedback, and a control group. The experimental group participated in an ESM procedure (three days per week over a 6-week period) using a palmtop. This group received weekly standardized feedback on personalized patterns of positive affect. Hamilton Depression Rating Scale - 17 (HDRS) and Inventory of Depressive Symptoms (IDS) scores were obtained before and after the intervention. During a 6-month follow-up period, five HDRS and IDS assessments were completed. Add-on ESM-derived feedback resulted in a significant and clinically relevant stronger decrease in HDRS score relative to the control group (p<0.01; -5.5 point reduction in HDRS at 6 months). Compared to the pseudo-experimental group, a clinically relevant decrease in HDRS score was apparent at 6 months (B=-3.6, p=0.053). Self-reported depressive complaints (IDS) yielded the same pattern over time. The use of ESM-I was deemed acceptable and the provided feedback easy to understand. Patients attempted to apply suggestions from ESM-derived feedback to daily life. These data suggest that the efficacy of traditional passive pharmacological approach to treatment of major depression can be enhanced by using person-tailored daily life information regarding positive affect

Kristj+ínsd+¦ttir, +. B., Fors, E. A., Eide, E., Finset, A., Stensrud, T. L., van Dulmen, S. et al. (2013). A smartphone-based intervention with diaries and therapist feedback to reduce catastrophizing and increase functioning in women with chronic widespread pain. Part 2: 11-month follow-up results of a randomized trial. Journal of Medical Internet Research, 15, 152-170.

Background: Internet-based interventions are increasingly used to support self-management of individuals with chronic illnesses. Web-based interventions may also be effective in enhancing self-management for individuals with chronic pain, but little is known about long-term effects. Research on Web-based interventions to support self-management following participation in pain management programs is limited. Objective: The aim is to examine the long-term effects of a 4-week smartphone-intervention with diaries and therapist-written feedback following an inpatient chronic pain rehabilitation program, previously found to be effective at short-term and 5-month follow-ups. Methods: 140 women with chronic widespread pain, participating in a 4-week inpatient rehabilitation program, were randomized into two groups: with or without a smartphone intervention after the rehabilitation. The smartphone intervention consisted of one face-to-face individual session and 4 weeks of written communication via a smartphone, consisting of three diaries daily to elicit pain-related thoughts, feelings, and activities, as well as daily personalized written feedback based on cognitive behavioral principles from a therapist. Both groups were given access to an informational website to promote constructive self-management. Outcomes were measured with self-reported paper-and-pencil format questionnaires with catastrophizing as the primary outcome measure. Secondary outcomes included daily functioning and symptom levels, acceptance of pain, and emotional distress. Results: By the 11-month follow-up, the favorable between-group differences previously reported post-intervention and at 5-month follow-up on catastrophizing, acceptance, functioning, and symptom level were no longer evident (P > .10). However, there was more improvement in catastrophizing scores during the follow-up period in the intervention group (M = GêÆ2.36, SD 8.41) compared to the control group (M = .40, SD 7.20), P = .045. Also, per protocol within-group analysis showed a small positive effect (CohenGÇÖs d = .33) on catastrophizing in the intervention group (P = .04) and no change in the control group from the smartphone intervention baseline to 11-month follow-up. A positive effect (CohenGÇÖs d = .73) on acceptance was found within the intervention group (P < .001) but not in the control group. Small to large negative effects were found within the control group on functioning and symptom levels, emotional distress, and fatigue (P = .05) from the intervention baseline to the 11-month follow-up. Conclusion: The long-term results of this randomized trial are ambiguous. No significant between-group effect was found on the study variables at 11-month follow-up. However, the within-group analyses, comparing the baseline for the smartphone intervention to the 11-month data, indicated changes in the desired direction in catastrophizing and acceptance in the intervention group but not within the control group. This study provides modest evidence supporting the long-term effect of the intervention.

Kross, E., Verduyn, P., Demiralp, E., Park, J., Lee, D. S., Lin, N. et al. (2013). Facebook use predicts declines in subjective well-being in young adults. PLoS ONE, 8.

Over 500 million people interact daily with Facebook. Yet, whether Facebook use influences subjective well-being over time is unknown. We addressed this issue using experience-sampling, the most reliable method for measuring in-vivo behavior and psychological experience. We text-messaged people five times per day for two-weeks to examine how Facebook use influences the two components of subjective well-being: how people feel moment-to-moment and how satisfied they are with their lives. Our results indicate that Facebook use predicts negative shifts on both of these variables over time. The more people used Facebook at one time point, the worse they felt the next time we text-messaged them; the more they used Facebook over two-weeks, the more their life satisfaction levels declined over time. Interacting with other people “directly” did not predict these negative outcomes. They were also not moderated by the size of peopleGÇÖs Facebook networks, their perceived supportiveness, motivation for using Facebook, gender, loneliness, self-esteem, or depression. On the surface, Facebook provides an invaluable resource for fulfilling the basic human need for social connection. Rather than enhancing well-being, however, these findings suggest that Facebook may undermine it.

Kuntsche, E. & Labhart, F. (2013). ICAT: Development of an Internet-Based Data Collection Method for Ecological Momentary Assessment Using Personal Cell Phones. Eur.J.Psychol.Assess., 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 chi(2) 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

Kwapil, T. R., Brown, L. H., Silvia, P. J., Myin-Germeys, I., & Barrantes-Vidal, N. (2012). The expression of positive and negative schizotypy in daily life: an experience sampling study. Psychol.Med., 42, 2555-2566.

BACKGROUND: Psychometrically identified positive schizotypy and negative schizotypy are differentially related to psychopathology, personality and social functioning. However, little is known about the experience and expression of schizotypy in daily life and the psychological mechanisms that trigger psychotic-like experiences. METHOD: The present study employed experience sampling methodology (ESM) to assess positive and negative schizotypy in daily life in a non-clinical sample of 412 young adults. ESM is a structured diary technique in which participants are prompted at random times during the day to complete assessments of their current experiences. RESULTS: As hypothesized, positive schizotypy was associated with increased negative affect, thought impairment, suspiciousness, negative beliefs about current activities and feelings of rejection, but not with social disinterest or decreased positive affect. Negative schizotypy, on the other hand, was associated with decreased positive affect and pleasure in daily life, increased negative affect, and decreases in social contact and interest. Both positive schizotypy and negative schizotypy were associated with the desire to be alone when with others. However, this was moderated by anxiety in positive schizotypy and by diminished positive affect in negative schizotypy. CONCLUSIONS: The results support the construct validity of a multidimensional model of schizotypy and the ecological validity of the positive and negative schizotypy dimensions. ESM appears to be a promising method for examining the daily life experiences of schizotypic individuals

Lam, C. Y., Businelle, M. S., Aigner, C. J., McClure, J. B., Cofta-Woerpel, L., Cinciripini, P. M. et al. (2013). Individual and Combined Effects of Multiple High-Risk Triggers on Postcessation Smoking Urge and Lapse.  Nicotine.Tob.Res..

INTRODUCTION: Negative affect, alcohol consumption, and presence of others smoking have consistently been implicated as risk factors in smoking lapse and relapse. What is not known, however, is how these factors work together to affect smoking outcomes. This paper uses ecological momentary assessment (EMA) collected during the first 7 days of a smoking cessation attempt to test the individual and combined effects of high-risk triggers on smoking urge and lapse. METHODS: Participants were 300 female smokers who enrolled in a study that tested an individually tailored smoking cessation treatment. Participants completed EMA, which recorded negative affect, alcohol consumption, presence of others smoking, smoking urge, and smoking lapse, for 7 days starting on their quit date. RESULTS: Alcohol consumption, presence of others smoking, and negative affect were, independently and in combination, associated with increase in smoking urge and lapse. The results also found that the relationship between presence of others smoking and lapse and the relationship between negative affect and lapse were moderated by smoking urge. CONCLUSIONS: The current study found significant individual effect of alcohol consumption, presence of other smoking, and negative affect on smoking urge and lapse. Combing the triggers increased smoking urge and the risk of lapse to varying degrees and the presence of all 3 triggers resulted in the highest urge and lapse risk

Lambert, J., Chapman, J., & Lurie, D. (2013). Challenges to the four-channel model of flow: Primary assumption of flow support the moderate challenging control channel. The Journal of Positive Psychology, 8,  395-403.

Flow theory postulates that the psychological state of flow emerging when one engages in activities where skill level and challenge are both high, results in GÇÿoptimalGÇÖ subjective experiences relative to other psychological states, and is intrinsically motivated. The experience sampling method was used on a sample of college students to compare daily activities associated with flow (high skill, high challenge) to the psychological state of control (high skill, moderate challenge) in relation to the subjective experiences of enjoyment, happiness, intrinsic motivation, and cognitive involvement. Contrary to flow theory, enjoyment, happiness, and intrinsic motivation were characteristic of activities associated with being in GÇÿcontrol,GÇÖ as opposed to flow. Flow activities were associated with being cognitively involved in the task at hand. We believe such theoretically important findings have been masked when using the original four-channel model of flow, but are clarified with use of the revised experience fluctuation model.

Liu, X., Xu, W., Wang, Y., Williams, J. M., Geng, Y., Zhang, Q. et al. (2013). Can Inner Peace be Improved by Mindfulness Training: A Randomized Controlled Trial. Stress.Health.

This article reports a randomized controlled trial to investigate whether mindfulness training can successfully improve inner peace in participants with no known mental disorder. Fifty-seven participants were randomized to either mindfulness training (n = 29) or wait-list control (n = 28). The experience sampling method was used to measure the fleeting momentary experience of inner peace in participants. In addition, we used an experimental approach to assessing ability to focus attention: the Meditation Breath Attention Score, as well as the self-report Five-Facet Mindfulness Questionnaire (FFMQ). Compared with the wait-list control group, mindfulness training led to an increase in scores of inner peace, Meditation Breath Attention Score and FFMQ, using analysis of repeated measures analysis of variance. Change in inner peace was not, however, mediated by changes in self-rated mindfulness (FFMQ) nor by increased attentional focus. The findings provide first evidence suggesting that using mindfulness training improves the participants’ inner peace. The focus here was on the immediate effects and future studies need to use follow-up. (c) 2013 The Authors. Stress and Health published by John Wiley & Sons Ltd

Loeffler, S. N., Myrtek, M., & Peper, M. (2013). Mood-congruent memory in daily life: evidence from interactive ambulatory monitoring. Biol.Psychol., 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

Lyden, K., Kozey Keadle, S. L., Staudenmayer, J. W., & Freedson, P. S. (2012). Validity of two wearable monitors to estimate breaks from sedentary time. Med.Sci.Sports Exerc., 44, 2243-2252.

Investigations using wearable monitors have begun to examine how sedentary time behaviors influence health. PURPOSE: The objective of this study is to demonstrate the use of a measure of sedentary behavior and to validate the activPAL (PAL Technologies Ltd., Glasgow, Scotland) and ActiGraph GT3X (Actigraph, Pensacola, FL) for estimating measures of sedentary behavior: absolute number of breaks and break rate. METHODS: Thirteen participants completed two 10-h conditions. During the baseline condition, participants performed normal daily activity, and during the treatment condition, participants were asked to reduce and break up their sedentary time. In each condition, participants wore two ActiGraph GT3X monitors and one activPAL. The ActiGraph was tested using the low-frequency extension filter (AG-LFE) and the normal filter (AG-Norm). For both ActiGraph monitors, two count cut points to estimate sedentary time were examined: 100 and 150 counts per minute. Direct observation served as the criterion measure of total sedentary time, absolute number of breaks from sedentary time, and break rate (number of breaks per sedentary hour (brk.sed-h)). RESULTS: Break rate was the only metric sensitive to changes in behavior between baseline (5.1 [3.3-6.8] brk.sed-h) and treatment conditions (7.3 [4.7-9.8] brk.sed-h) (mean (95% confidence interval)). The activPAL produced valid estimates of all sedentary behavior measures and was sensitive to changes in break rate between conditions (baseline, 5.1 [2.8-7.1] brk.sed-h; treatment, 8.0 [5.8-10.2] brk.sed-h). In general, the AG-LFE and AG-Norm were not accurate in estimating break rate or the absolute number of breaks and were not sensitive to changes between conditions. CONCLUSION: This study demonstrates the use of expressing breaks from sedentary time as a rate per sedentary hour, a metric specifically relevant to free-living behavior, and provides further evidence that the activPAL is a valid tool to measure components of sedentary behavior in free-living environments

Marcano Belisario, J. S., Huckvale, K., Greenfield, G., Car, J., & Gunn, L. H. (2013). Smartphone and tablet self management apps for asthma. Cochrane.Database.Syst.Rev., 11, CD010013.

BACKGROUND: Asthma is one of the most common long-term conditions worldwide, which places considerable pressure on patients, communities and health systems. The major international clinical guidelines now recommend the inclusion of self management programmes in the routine management of patients with asthma. These programmes have been associated with improved outcomes in patients with asthma. However, the implementation of self management programmes in clinical practice, and their uptake by patients, is still poor. Recent developments in mobile technology, such as smartphone and tablet computer apps, could help develop a platform for the delivery of self management interventions that are highly customisable, low-cost and easily accessible. OBJECTIVES: To assess the effectiveness, cost-effectiveness and feasibility of using smartphone and tablet apps to facilitate the self management of individuals with asthma. SEARCH METHODS: We searched the Cochrane Airways Group Register (CAGR), the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, CINAHL, Global Health Library, Compendex/Inspec/Referex, IEEEXplore, ACM Digital Library, CiteSeer(x) and CAB abstracts via Web of Knowledge. We also searched registers of current and ongoing trials and the grey literature. We checked the reference lists of all primary studies and review articles for additional references. We searched for studies published from 2000 onwards. The latest search was run in June 2013. SELECTION CRITERIA: We included parallel randomised controlled trials (RCTs) that compared self management interventions for patients with clinician-diagnosed asthma delivered via smartphone apps to self management interventions delivered via traditional methods (e.g. paper-based asthma diaries). DATA COLLECTION AND ANALYSIS: We used standard methods expected by the Cochrane Collaboration. Our primary outcomes were symptom scores; frequency of healthcare visits due to asthma exacerbations or complications and health-related quality of life. MAIN RESULTS: We included two RCTs with a total of 408 participants. We found no cluster RCTs, controlled before and after studies or interrupted time series studies that met the inclusion criteria for this systematic review. Both RCTs evaluated the effect of a mobile phone-based asthma self management intervention on asthma control by comparing it to traditional, paper-based asthma self management. One study allowed participants to keep daily entries of their asthma symptoms, asthma medication usage, peak flow readings and peak flow variability on their mobile phone, from which their level of asthma control was calculated remotely and displayed together with the corresponding asthma self management recommendations. In the other study, participants recorded the same readings twice daily, and they received immediate self management feedback in the form of a three-colour traffic light display on their phones. Participants falling into the amber zone of their action plan twice, or into the red zone once, received a phone call from an asthma nurse who enquired about the reasons for their uncontrolled asthma.We did not conduct a meta-analysis of the data extracted due to the considerable degree of heterogeneity between these studies. Instead we adopted a narrative synthesis approach. Overall, the results were inconclusive and we judged the evidence to have a GRADE rating of low quality because further evidence is very likely to have an important impact on our confidence in the estimate of effect and is likely to change the estimate. In addition, there was not enough information in one of the included studies to assess the risk of bias for the majority of the domains. Although the other included study was methodologically rigorous, it was not possible to blind participants or personnel in the study. Moreover, there are concerns in both studies in relation to attrition bias and other sources of bias.One study showed that the use of a smartphone app for the delivery of an asthma self management programme had no statistically significant effect on asthma symptom scores (mean difference (MD) 0.01, 95% confidence interval (CI) -0.23 to 0.25), asthma-related quality of life (MD of mean scores 0.02, 95% CI -0.35 to 0.39), unscheduled visits to the emergency department (OR 7.20, 95% CI 0.37 to 140.76) or frequency of hospital admissions (odds ratio (OR) 3.07, 95% CI 0.32 to 29.83). The other included study found that the use of a smartphone app resulted in higher asthma-related quality of life scores at six-month follow-up (MD 5.50, 95% CI 1.48 to 9.52 for the physical component score of the SF-12 questionnaire; MD 6.00, 95% CI 2.51 to 9.49 for the mental component score of the SF-12 questionnaire), improved lung function (PEFR) at four (MD 27.80, 95% CI 4.51 to 51.09), five (MD 31.40, 95% CI 8.51 to 54.29) and six months (MD 39.20, 95% CI 16.58 to 61.82), and reduced visits to the emergency department due to asthma-related complications (OR 0.20, 95% CI 0.04 to 0.99). Both studies failed to find any statistical differences in terms of adherence to the intervention and occurrence of other asthma-related complications. AUTHORS’ CONCLUSIONS: The current evidence base is not sufficient to advise clinical practitioners, policy-makers and the general public with regards to the use of smartphone and tablet computer apps for the delivery of asthma self management programmes. In order to understand the efficacy of apps as standalone interventions, future research should attempt to minimise the differential clinical management of patients between control and intervention groups. Those studies evaluating apps as part of complex, multicomponent interventions, should attempt to tease out the relative contribution of each intervention component. Consideration of the theoretical constructs used to inform the development of the intervention would help to achieve this goal. Finally, researchers should also take into account: the role of ancillary components in moderating the observed effects, the seasonal nature of asthma and long-term adherence to self management practices

Martinez, S. & Guzman, S. (2013). Gender and racial/ethnic differences in self-reported levels of engagement in high school math and science courses. Hispanic Journal of Behavioral Sciences, 35, 407-427.

While gender and racial/ethnic performance gaps in math and science have been well documented, we know little about how students feel while they are in these courses. Using a sample of 793 high school students who participated in the Experience Sampling Method of the Study of Youth and Social Development, this study examines the gender and racial/ethnic differences in self-reported levels of challenge, a measure of student engagement, while students are in math and science courses. Results from multivariate regression analyses indicate that boys report similar levels of engagement while in math and science classes, but girls do not. While Black female students report lower levels of challenge in math classes, Latina girls report lower levels of challenge while in science class in comparison to other racial/ethnic groups.

Matsumura, K. & Yamakoshi, T. (2013). iPhysioMeter: A new approach for measuring heart rate and normalized pulse volume using only a smartphone. Behavior Research Methods, 45, 1272-1278.

Heart rate (HR) and normalized pulse volume (NPV) are physiological indices that have been used in a diversity of psychological studies. However, measuring these indices often requires laborious processes. We therefore developed a new smartphone program, named iPhysioMeter, that makes it possible to measure beat-by-beat HR and ln NPV using only a smartphone. We examined its accuracy against conventional laboratory measures. Mental stress tasks were used to alter HR and ln NPV in 12 participants. Bland-Altman analyses revealed negligible proportional bias for HR and ln NPV or for their change values, expressed as ΔHR and Δln NPV. However, a relatively large fixed bias did emerge for ln NPV, as well as a small one for Δln NPV, although both were within the limits of agreement. These findings suggest that iPhysioMeter can yield valid measures of the absolute level of HR and of relative changes in ln NPV.

McCormick, B. P., Snethen, G., & Lysaker, P. H. (2012). Emotional episodes in the everyday lives of people with schizophrenia: the role of intrinsic motivation and negative symptoms. Schizophr.Res., 142, 46-51.

Research on emotional experience has indicated that subjects with schizophrenia experience less positive, and more negative emotional experience than non-psychiatric subjects in natural settings. Differences in the experience of emotion may result from differences in experiences such that everyday activities may evoke emotions. The purpose of this study was to identify if everyday experience of competence and autonomy were related to positive and negative emotion. Adults with schizophrenia spectrum disorders were recruited from day treatment programs (N=45). Data were collected using experience-sampling methods. A number of subjects failed to meet data adequacy (N=13) but did not differ from retained subjects (N=32) in symptoms or cognition. Positive and negative emotion models were analyzed using hierarchical linear modeling Everyday activities were characterized by those reported as easily accomplished and requiring at most moderate talents. Positive emotional experiences were stronger than negative emotional experiences. The majority of variance in positive and negative emotion existed between persons. Negative symptoms were significantly related to positive emotion, but not negative emotion. The perception that motivation for activity was external to subjects (e.g. wished they were doing something else) was related to decreased positive emotion and enhanced negative emotion. Activities that required more exertion for activities was related to enhanced positive emotion, whereas activities that subjects reported they wanted to do was associated with reduced negative emotion. The implications of this study are that everyday experiences of people with schizophrenia do affect emotional experience and that management of experience to enhance positive emotion may have therapeutic benefits

McKee, S., Smith, H. J., Koch, A., Balzarini, R., Georges, M., & Callahan, M. P. (2013). Looking up and seeing green: Women’s everyday experiences with physical appearance comparisons. Psychology of Women Quarterly, 37, 351-365.

Psychological research documents the extent to which physical appearance comparisons are associated with negative emotional experiences, but researchers typically study physical appearance comparisons isolated from other comparison experiences. As part of a signal-contingent experience sampling design, 87 female undergraduate students recorded whether they had made any comparison about any topic after they received a text message at three randomly chosen times a day for 7 days. In contrast to other comparisons, physical appearance comparisons were more likely to be upward contrasts to dissimilar targets associated with increased envy, less inspiration, less pride, and less anxiety. Women who reported more demographically similar close friends reported more envy following physical appearance comparisons in contrast to women who reported more demographically diverse close friends. Women who associated their body with a better quality of life reported more inspiration and less envy following physical appearance comparisons. More demographically diverse close friends and a more positive body image may protect women from the negative emotional consequences associated with physical appearance comparisons. These data indicate that the positive benefits for interpersonal judgments associated with close cross-group friends extend to intrapersonal reactions to physical appearance comparisons.

Minami, H. (2013). Relations among affect, abstinence motivation and confidence, and daily lapse risk among smokers trying to quit. ProQuest Information & Learning, US.

Aims: This study prospectively tested the hypothesis that changes in momentary affect, abstinence motivation, and confidence would predict lapse risk over the next 12-48 hours using Ecological Momentary Assessment (EMA) data from smokers attempting to quit smoking. The moderating effects of high-risk contexts on relations between cognitions (motivation and confidence) and lapse risk were also tested. Method: 79 adult, daily smokers recorded their momentary affect, motivation to quit, abstinence confidence, and smoking behaviors in near real time with multiple EMA reports using electronic diaries post-quit. Results: Multilevel models indicated that increases in negative affect predicted greater lapse risk up to 12 hours, but not 24 hours later. Neither positive nor negative affect had significant effects on subsequent cognitions. High levels of motivation appeared to reduce increases in lapse risk that occur over hours. Momentary increases in confidence predicted greater lapse risk over 12 hours in high-risk situations, but not in the absence of potent smoking triggers. Conclusion: Momentary changes in negative affect, motivation, and confidence, during a quit attempt all had short-term effects on smoking lapse. Negative affect had short-lived effects on lapse risk, whereas high levels of motivation protected against the risk of lapsing that accumulates over hours. Contrary to expectations, an acute increase in confidence may increase vulnerability to lapse in the context of potent smoking triggers. Relations observed among affect, cognitions, and lapse seem to depend critically on the timing of assessments and the contexts in which the assessments occur.

Moore, T. M., Seavey, A., Ritter, K., McNulty, J. K., Gordon, K. C., & Stuart, G. L. (2013). Ecological Momentary Assessment of the Effects of Craving and Affect on Risk for Relapse During Substance Abuse Treatment. Psychology of Addictive Behaviors.

The primary goals of this study were to use ecological momentary assessment (EMA) to examine the extent to which proximal factors (cravings and affect) were temporally associated with relapse, and to assess the role of distal factors (e.g., coping styles) in moderating these associations. We also examined whether using EMA procedures impacted relapse rates. A sample of 100 male (n = 66) and female (n = 34) patients entering outpatient treatment for substance abuse completed a baseline assessment of substance dependence, stress, social support, coping styles, family history of substance abuse, and self-efficacy. Half of the participants were randomly assigned to receive training in using a handheld computer to respond to 3 random prompts each day for 4 months regarding cravings, affect, and substance use. All participants completed 2- and 4-month follow-up assessments of substance use. Results showed that using EMA procedures did not influence relapse rates. Hierarchical linear modeling showed that individuals who reported an increase in cravings on a given prompt were 14 times more likely to report relapse on the subsequent prompt than individuals who did not experience an increase in cravings. In addition, women, older individuals, and individuals who use distraction and disengagement as coping styles were at increased risk for relapse when experiencing an increase in cravings. Individuals who use acceptance as a coping style were at decreased risk for relapse when experiencing an increase in cravings. The study highlights the importance of tailoring treatments to address the needs of particular individuals and risk factors.

Mourcou, Q., Fleury, A., Dupuy, P., Diot, B., Franco, C., & Vuillerme, N. (2013). Wegoto: A Smartphone-based approach to assess and improve accessibility for wheelchair users. Conf.Proc.IEEE Eng Med.Biol.Soc., 2013, 1194-1197.

This paper proposes a description of a Smartphone-based approach to assess and improve accessibility for wheelchair users. The developed system employs a dedicated Smartphone application that records various complementary sensor measurements (acceleration, deceleration, inclination, orientation, speed, GPS position) and permits obstacle denunciation. Then, accessibility information are reported on maps in a Geographic Information System which can calculate the most accessible route for wheelchair users taking into account their profiles and capabilities. A case study involving a wheelchair-dependent paraplegic was performed to preliminary assess the feasibility of our Smartphone-based approach to provide an accessibility index for wheelchair users. Although preliminary, our results do suggest that the Wegoto system could be used as an innovative assistive navigation system for wheelchair users and ultimately could help to improve their autonomy and quality of life

Mulvaney, S. A., Ho, Y. X., Cala, C. M., Chen, Q., Nian, H., Patterson, B. L. et al. (2013). Assessing adolescent asthma symptoms and adherence using mobile phones. Journal of Medical Internet Research, 15, 85-94.

Background: Self-report is the most common method of measuring medication adherence but is influenced by recall error and response bias, and it typically does not provide insight into the causes of poor adherence. Ecological momentary assessment (EMA) of health behaviors using mobile phones offers a promising alternative to assessing adherence and collecting related data that can be clinically useful for adherence problem solving. Objective: To determine the feasibility of using EMA via mobile phones to assess adolescent asthma medication adherence and identify contextual characteristics of adherence decision making. Methods: We utilized a descriptive and correlational study design to explore a mobile method of symptom and adherence assessment using an interactive voice response system. Adolescents aged 12-18 years with a diagnosis of asthma and prescribed inhalers were recruited from an academic medical center. A survey including barriers to mobile phone use, the Illness Management Survey, and the Pediatric Asthma Quality of Life Questionnaire were administered at baseline. Quantitative and qualitative assessment of asthma symptoms and adherence were conducted with daily calls to mobile phones for 1 month. The Asthma Control Test (ACT) was administered at 2 study time points: baseline and 1 month after baseline. Results: The sample consisted of 53 adolescents who were primarily African American (34/53, 64%) and female (31/53, 58%) with incomes US$40K/year or lower (29/53, 55%). The majority of adolescents (37/53, 70%) reported that they carried their phones with them everywhere, but only 47% (25/53) were able to use their mobile phone at school. Adolescents responded to an average of 20.1 (SD 8.1) of the 30 daily calls received (67%). Response frequency declined during the last week of the month (b = GêÆ0.29, P < .001) and was related to EMA-reported levels of rescue inhaler adherence (r = 0.33, P = .035). Using EMA, adolescents reported an average of 0.63 (SD 1.2) asthma symptoms per day and used a rescue inhaler an average of 70% of the time (SD 35%) when they experienced symptoms. About half (26/49, 53%) of the instances of nonadherence took place in the presence of friends. The EMA-measured adherence to rescue inhaler use correlated appropriately with asthma control as measured by the ACT (r = GêÆ0.33, P = .034). Conclusions: Mobile phones provided a feasible method to assess asthma symptoms and adherence in adolescents. The EMA method was consistent with the ACT, a widely established measure of asthma control, and results provided valuable insights regarding the context of adherence decision making that could be used clinically for problem solving or as feedback to adolescents in a mobile or Web-based support system.

Munsch, S., Meyer, A. H., Quartier, V., & Wilhelm, F. H. (2012). Binge eating in binge eating disorder: a breakdown of emotion regulatory process? Psychiatry Res., 195, 118-124.

Current explanatory models for binge eating in binge eating disorder (BED) mostly rely on models for bulimia nervosa (BN), although research indicates different antecedents for binge eating in BED. This study investigates antecedents and maintaining factors in terms of positive mood, negative mood and tension in a sample of 22 women with BED using ecological momentary assessment over a 1-week. Values for negative mood were higher and those for positive mood lower during binge days compared with non-binge days. During binge days, negative mood and tension both strongly and significantly increased and positive mood strongly and significantly decreased at the first binge episode, followed by a slight though significant, and longer lasting decrease (negative mood, tension) or increase (positive mood) during a 4-h observation period following binge eating. Binge eating in BED seems to be triggered by an immediate breakdown of emotion regulation. There are no indications of an accumulation of negative mood triggering binge eating followed by immediate reinforcing mechanisms in terms of substantial and stable improvement of mood as observed in BN. These differences implicate a further specification of etiological models and could serve as a basis for developing new treatment approaches for BED

Nooijen, C. F., de, G. S., Postma, K., Bergen, M. P., Stam, H. J., Bussmann, J. B. et al. (2012). A more active lifestyle in persons with a recent spinal cord injury benefits physical fitness and health. Spinal Cord., 50, 320-323.

STUDY DESIGN: A prospective cohort study. OBJECTIVES: To study the longitudinal relationship between objectively measured everyday physical activity level, and physical fitness and lipid profile in persons with a recent spinal cord injury (SCI). SETTING: A rehabilitation centre in the Netherlands and the participant’s home environment. METHODS: Data of 30 persons with a recent SCI were collected at the start of active rehabilitation, 3 months later, at discharge from inpatient rehabilitation, and 1 year after discharge. Physical activity level (duration of dynamic activities as % of 24 h) was measured with an accelerometry-based activity monitor. Regarding physical fitness, peak oxygen uptake (VO(2)peak) and peak power output (POpeak) were determined with a maximal wheelchair exercise test, and upper extremity muscle strength was measured with a handheld dynamometer. Fasting blood samples were taken to determine the lipid profile. RESULTS: An increase in physical activity level was significantly related to an increase in VO(2)peak and POpeak, and an increase in physical activity level favourably affected the lipid profile. A nonsignificant relation was found with muscle strength. CONCLUSION: Everyday physical activity seems to have an important role in the fitness and health of persons with a recent SCI. An increase in physical activity level was associated with an increase in physical fitness and with a lower risk of cardiovascular disease

Nusbaum, E. C., Silvia, P. J., Beaty, R. E., Burgin, C. J., Hodges, D. A., & Kwapil, T. R. (2013). Listening Between the Notes: Aesthetic Chills in Everyday Music Listening. Psychology of Aesthetics, Creativity, and the Arts.

Who gets chillsGÇöa pleasurable feeling of goose bumpsGÇöin response to music, and why? The current study used experience sampling to examine within-person variability in aesthetic chills. For one week, 106 undergraduate participants responded to 10 daily surveys, delivered via their cell phones, about their momentary activities, emotions, and environment, with an emphasis on whether they were listening to music and were experiencing chills. At the within-person level, music listening context and emotional states during music listening influenced whether or not people got chills. Chills were more likely when people listened to music that they chose and that they were listening to closely. Chills were also more likely when people were listening to music while happy or while sad, but not while worried. Overall, the study illustrates how music listening context and other within-person differences contribute to aesthetic chills in peopleGÇÖs everyday environments.

Offer, S. (2013). Assessing the relationship between family mealtime communication and adolescent emotional well-being using the experience sampling method. Journal of Adolescence, 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 adolescentsGÇÖ 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 teensGÇÖ 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 adolescentsGÇÖ emotional well-being.

Olino, T. M., McMakin, D. L., Morgan, J. K., Silk, J. S., Birmaher, B., Axelson, D. A. et al. (2013). Reduced reward anticipation in youth at high-risk for unipolar depression: A preliminary study. Dev.Cogn Neurosci..

Offspring of depressed parents are at risk for depression and recent evidence suggests that reduced positive affect (PA) may be a marker of risk. We investigated whether self-reports of PA and fMRI-measured striatal response to reward, a neural correlate of PA, are reduced in adolescent youth at high familial risk for depression (HR) relative to youth at low familial risk for depression (LR). Functional magnetic resonance imaging assessments were conducted with 14 HR and 12 LR youth. All youth completed an ecological momentary assessment protocol to measure PA in natural settings and a self-report measure of depression symptomatology. Analyses found that HR youth demonstrated lower striatal response than LR youth during both reward anticipation and outcome. However, after controlling for youth self-reports of depression, HR youth demonstrated lower striatal response than LR youth only during reward anticipation. No significant differences were found between HR and LR youth on subjective ratings of PA or depressive symptoms. Results are consistent with previous findings that reduced reward response is a marker of risk for depression, particularly during reward anticipation, even in the absence of (or accounting for) disrupted subjective mood. Further examinations of prospective associations between reward response and depression onset are needed

Oorschot, M., Lataster, T., Thewissen, V., Wichers, M., & Myin-Germeys, I. (2012). Mobile assessment in schizophrenia: a data-driven momentary approach. Schizophr.Bull., 38, 405-413.

In this article, a data-driven approach was adopted to demonstrate how real-life diary techniques [ie, the experience sampling method (ESM)] could be deployed for assessment purposes in patients with psychotic disorder, delivering individualized and clinically relevant information. The dataset included patients in an acute phase of psychosis and the focus was on paranoia as one of the main psychotic symptoms (30 patients with high levels of paranoia and 34 with low levels of paranoia). Based on individual cases, it was demonstrated how (1) symptom and mood patterns, (2) patterns of social interactions or activities, (3) contextual risk profiles (eg, is being among strangers, as opposed to family, associated with higher paranoia severity?), and (4) temporal dynamics between mood states and paranoia (eg, does anxiety precipitate or follow the onset of increased paranoia severity?) substantially differ within individual patients and across the high vs low paranoid patient group. Most striking, it was shown that individual findings are different from what is found on overall group levels. Some people stay anxious after a paranoid thought came to mind. For others, paranoia is followed by a state of relaxation. It is discussed how ESM, surfacing the patient’s implicit knowledge about symptom patterns, may provide an excellent starting point for person-tailored psychoeducation and for choosing the most applicable therapeutic intervention

Ottaviani, C. & Couyoumdjian, A. (2013). Pros and cons of a wandering mind: A prospective study. Frontiers in Psychology, 4.

Mind wandering (MW) has recently been associated with both adaptive (e.g., creativity enhancement) and maladaptive (e.g., mood worsening) consequences. This study aimed at investigating whether proneness to MW was prospectively associated with negative health outcomes. At time 0, 21 women, 19 men; mean age = 24.5 (4.9) underwent a 5-min baseline electrocardiogram (ECG), a 20-min laboratory tracking task with thought probes, and personality questionnaires. At time 1 (1 year follow-up), the same participants underwent a 24-h Ecological Momentary Assessment characterized by ambulatory ECG recording and electronic diaries. First, we examined if the likelihood of being a GÇ£mind wandererGÇØ was associated with specific personality dispositions. Then, we tested if the occurrence of episodes of MW in the lab would be correlated with frequency of MW in daily life. Finally, multiple regression models were used to test if MW longitudinally acted as a risk factor for health, accounting for the effects of biobehavioral variables. Among dispositional traits, the frequency of MW episodes in daily life was inversely associated with the capacity of being mindful (i.e., aware of the present moment and non-judging). There was a positive correlation between frequency of MW in the lab and in daily life, suggesting that it is a stable disposition of the individual. When differentiated from perseverative cognition (i.e., rumination and worry), MW did not predict the presence of health risk factors 1 year later, however, a higher occurrence of episodes of MW was associated with short-term adverse consequences, such as increased 24-h heart rate (HR) on the same day and difficulty falling asleep the subsequent night. Present findings suggest that MW may be associated with short term GÇ£side effectsGÇØ but argue against a long term dysfunctional view of this cognitive process.

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, 34.

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

Peters, E., Lataster, T., Greenwood, K., Kuipers, E., Scott, J., Williams, S. et al. (2012). Appraisals, psychotic symptoms and affect in daily life. Psychol.Med., 42, 1013-1023.

BACKGROUND: Psychological models of psychosis were examined using Experience Sampling Methods (ESM) to explore relationships between dimensions and appraisals of key symptoms and affect. METHOD: Individuals were signalled to complete ESM booklets 10 times per day for six consecutive days; 534 data points were obtained from 12 out-patients with psychosis. RESULTS: Although only 3.6% of spontaneous thoughts were psychosis related, these predicted more negative and less positive affect. Delusions and hallucinations, when present, were rated at a moderate level of intensity, and intensity was associated with distress, interference and preoccupation. Symptom dimensions were related to each other, with weaker associations with delusional conviction, which, it is hypothesized, may represent a separate factor. Conviction and appraisals relating to insight and decentring (‘my problems are something to do with the way my mind works’) were highly variable. Decentring appraisals of delusions, but not insight, were associated with less distress. Appraisals about the power of voices were strong predictors of negative affect and symptom distress. CONCLUSIONS: This study demonstrates that ESM is a useful methodology to capture ‘online’ variability in psychotic phenomenology and provides evidence supporting cognitive models, which posit that psychotic symptoms are multi-dimensional phenomena, shaped by appraisals that, in turn, predict their emotional and behavioural sequelae

Phillips, K. A., Epstein, D. H., Mezghanni, M., Vahabzadeh, M., Reamer, D., Agage, D. et al. (2013). Smartphone Delivery of Mobile HIV Risk Reduction Education. AIDS Res.Treat., 2013, 231956.

We sought to develop and deploy a video-based smartphone-delivered mobile HIV Risk Reduction (mHIVRR) intervention to individuals in an addiction treatment clinic. We developed 3 video modules that consisted of a 10-minute HIVRR video, 11 acceptability questions, and 3 knowledge questions and deployed them as a secondary study within a larger study of ecological momentary and geographical momentary assessments. All 24 individuals who remained in the main study long enough completed the mHIVRR secondary study. All 3 videos met our a priori criteria for acceptability “as is” in the population: they achieved median scores of </=2.5 on a 5-point Likert scale; </=20% of the individuals gave them the most negative rating on the scale; a majority of the individuals stated that they would not prefer other formats over video-based smartphone-delivered one (all P < 0.05). Additionally, all of our video modules met our a priori criteria for feasibility: </=20% of data were missing due to participant noncompliance and </=20% were missing due to technical failure. We concluded that video-based mHIVRR education delivered via smartphone is acceptable, feasible and may increase HIV/STD risk reduction knowledge. Future studies, with pre-intervention assessments of knowledge and random assignment, are needed to confirm these findings

Piasecki, T. M., Cooper, M. L., Wood, P. K., Sher, K. J., Shiffman, S., & Heath, A. C. (2013). Dispositional Drinking Motives: Associations With Appraised Alcohol Effects and Alcohol Consumption in an Ecological Momentary Assessment Investigation. Psychological Assessment.

Alcohol use can be understood as a strategic behavior, such that people choose to drink based on the anticipated affective changes produced by drinking relative to those produced by alternative behaviors. This study investigated whether people who report drinking for specific reasons via the Drinking Motives QuestionnaireGÇôRevised (DMQ-R; Cooper, 1994) actually experience the alcohol effects they purportedly seek. As a secondary goal, we examined relations between drinking motives and indices of the amount of alcohol consumed. Data were drawn from 3,272 drinking episodes logged by 393 community-recruited drinkers during a 21-day Ecological Momentary Assessment investigation. After accounting for selected covariates, DMQ-R enhancement motives uniquely predicted real-time reports of enhanced drinking pleasure. DMQ-R coping motives were associated with reports of increased drinking-contingent relief and punishment. Enhancement motives uniquely predicted consuming more drinks per episode and higher peak intra-episode estimated blood alcohol concentration. The findings extend the evidence for the validity of the DMQ-R motive scores by demonstrating that internal drinking motives (enhancement and coping) are related to the experienced outcomes of drinking in the manner anticipated by theory.

Poerio, G. L., Totterdell, P., & Miles, E. (2013). Mind-wandering and negative mood: does one thing really lead to another? Conscious.Cogn, 22, 1412-1421.

Mind-wandering is closely connected with negative mood. Whether negative mood is a cause or consequence of mind-wandering remains an important, unresolved, issue. We sought to clarify the direction of this relationship by measuring mood before and after mind-wandering. We also measured the affective content, time-orientation and relevance of mind-wandering to current concerns to explore whether the link between mind-wandering and negative mood might be explained by these characteristics. A novel experience-sampling technique with smartphone application prompted participants to answer questions about mind-wandering and mood across 7 days. While sadness tended to precede mind-wandering, mind-wandering itself was not associated with later mood and only predicted feeling worse if its content was negative. We also found prior sadness predicted retrospective mind-wandering, and prior negative mood predicted mind-wandering to current concerns. Our findings provide new insight into how mood and mind-wandering relate but suggest mind-wandering is not inherently detrimental to well-being

Quinn, F., Johnston, M., & Johnston, D. W. (2013). Testing an integrated behavioural and biomedical model of disability in N-of-1 studies with chronic pain. Psychology & Health, 28, 1391-1406.

Background: Previous research has supported an integrated biomedical and behavioural model explaining activity limitations. However, further tests of this model are required at the within-person level, because while it proposes that the constructs are related within individuals, it has primarily been tested between individuals in large group studies. We aimed to test the integrated model at the within-person level. Method: Six correlational N-of-1 studies in participants with arthritis, chronic pain and walking limitations were carried out. Daily measures of theoretical constructs were collected using a hand-held computer (PDA), the activity was assessed by self-report and accelerometer and the data were analysed using time-series analysis. Results: The biomedical model was not supported as pain impairment did not predict activity, so the integrated model was supported partially. Impairment predicted intention to move around, while perceived behavioural control (PBC) and intention predicted activity. PBC did not predict activity limitation in the expected direction. Conclusions: The integrated model of disability was partially supported within individuals, especially the behavioural elements. However, results suggest that different elements of the model may drive activity (limitations) for different individuals. The integrated model provides a useful framework for understanding disability and suggests interventions, and the utility of N-of-1 methodology for testing theory is illustrated.

Ramirez, J. & Miranda, R., Jr. (2013). Alcohol craving in adolescents: bridging the laboratory and natural environment. Psychopharmacology (Berl).

RATIONALE: Initial lab studies suggest that adolescent drinkers crave alcohol when presented with alcohol cues. Whether this effect generalizes to the natural environment, however, remains unknown, and studies have not examined whether craving predicts drinking among youths. OBJECTIVES: This study builds on existing research by pairing controlled lab-based cue reactivity assessments (CRAs) with data collected in the natural environment using ecological momentary assessment (EMA) methods. We examined whether alcohol cues evoke craving among adolescent drinkers in the lab and natural environment, and tested the clinical relevance of craving during adolescence by examining the prospective association between craving and alcohol use. METHODS: Non-treatment-seeking adolescent drinkers (N = 42; ages 15 to 20 years) completed a lab-based CRA followed by a 1-week EMA monitoring period. During the EMA period, youth were prompted randomly throughout the day to record momentary data on craving and contextual factors (e.g., alcohol cues, peers present). RESULTS: Alcohol cues elicited craving in the lab, and this effect generalized to the natural environment, especially among adolescents with more alcohol problems. In addition, craving predicted subsequent drinking levels in the natural environment. CONCLUSIONS: This study demonstrates the utility of pairing lab paradigms with EMA methods to better characterize adolescents’ reactivity to alcohol cues. Results implicate craving as a clinically meaningful motivator for drinking among adolescents and highlight a potentially important target of pharmacological or behavioral intervention

Rauers, A., Blanke, E., & Riediger, M. (2013). Everyday empathic accuracy in younger and older couples: Do you need to see your partner to know his or her feelings? Psychological Science, 24, 2210-2217.

On average, older adults are less accurate than younger adults at recognizing emotions from faces or voices. We challenge the view that such differences in emotion-recognition tasks reflect differences in empathic accuracy (the ability to infer other peopleGÇÖs feelings): Empathic accuracy relies not only on sensory cues (e.g., emotional expressions) but also on knowledge about the target person. Using smartphone-based measures, we assessed empathic accuracy in younger and older couplesGÇÖ daily lives and found that younger adultsG ÇÖ empathic accuracy was higher than older adultsG ÇÖ empathic accuracy when their partners were visibly present. During the partnersGÇÖ absence, however, when judgments relied exclusively on knowledge of those partners, no age differences emerged, and performance in both age groups was still more accurate than chance. We conclude that across adulthood, sensory information and knowledge differentially support empathic accuracy. Laboratory emotion-recognition tasks may therefore underestimate older adultsGÇÖ empathic competencies.

Remacle, A., Morsomme, D., & Finck, C. (2013). Comparison of vocal loading parameters in kindergarten and elementary school teachers. J.Speech Lang Hear.Res..

PURPOSE: Although a global picture exists of teachers’ voice demands in general, few studies have compared specific groups of teachers to determine whether some are more at risk than others. This study compared vocal loading of kindergarten and elementary school teachers; professional and non-professional vocal load was determined for both groups. METHOD: Twelve kindergarten and twenty elementary school female teachers without voice problems were monitored during one workweek using the Ambulatory Phonation Monitor. Vocal loading parameters analyzed were F0, SPL, time dose, distance dose and cycle dose. RESULTS: Comparisons between the groups showed significantly higher cycle dose and distance dose for kindergarten teachers than for elementary school teachers, in both professional and non-professional environments. Professional and non-professional voice use comparisons showed significant differences for all parameters, indicating that vocal load was higher in the professional environment for both groups. CONCLUSIONS: The higher vocal doses measured in kindergarten teachers suggest that particular attention should be paid to this specific group of teachers. Although non-professional vocal load is lower than professional vocal load, it is important to take both into account because of their cumulative effects

Robusto, K. M. & Trost, S. G. (2012). Comparison of three generations of ActiGraph activity monitors in children and adolescents. J.Sports Sci., 30, 1429-1435.

In this study, we evaluated agreement among three generations of ActiGraph accelerometers in children and adolescents. Twenty-nine participants (mean age = 14.2 +/- 3.0 years) completed two laboratory-based activity sessions, each lasting 60 min. During each session, participants concurrently wore three different models of the ActiGraph accelerometers (GT1M, GT3X, GT3X+). Agreement among the three models for vertical axis counts, vector magnitude counts, and time spent in moderate-to-vigorous physical exercise (MVPA) was evaluated by calculating intraclass correlation coefficients and Bland-Altman plots. The intraclass correlation coefficient for total vertical axis counts, total vector magnitude counts, and estimated MVPA was 0.994 (95% CI = 0.989-0.996), 0.981 (95% CI = 0.969-0.989), and 0.996 (95% CI = 0.989-0.998), respectively. Inter-monitor differences for total vertical axis and vector magnitude counts ranged from 0.3% to 1.5%, while inter-monitor differences for estimated MVPA were equal to or close to zero. On the basis of these findings, we conclude that there is strong agreement between the GT1M, GT3X, and GT3X+ activity monitors, thus making it acceptable for researchers and practitioners to use different ActiGraph models within a given study

Schaffer, A., Kreindler, D., Reis, C., & Levitt, A. J. (2013). Use of mental health telemetry to enhance identification and predictive value of early changes during augmentation treatment of major depression. J.Clin.Psychopharmacol., 33, 775-781.

Standard clinical trial methodology in depression does not allow for careful examination of early changes in symptom intensity. The purpose of this study was to use daily “Mental Health Telemetry” (MHT) to prospectively record change in depressive and anxiety symptoms for depressed patients receiving augmentation treatment, and determine the extent and predictive capacity of early changes. We report results of a 6-week, open-label study of the addition of quetiapine XR (range, 50-300 mg) for adult patients (n = 26) with major depressive disorder who were nonresponsive to antidepressant treatment. In addition to regular study visits, all participants completed daily, wirelessly transmitted self-report ratings of symptoms on a Smartphone. Daily and 3-day moving average mean scores were calculated, and associations between early symptom change and eventual response to treatment were determined. Improvement in depressive and anxiety symptoms was identified as early as day 1 of treatment. Of the total decline in depression severity over 6 weeks, 9% was present at day 1, 28% at day 2, 39% at days 3 and 4, 65% at day 7, and 80% at day 10. Self-report rating of early improvement (>/=20%) in depressive symptoms at day 7 significantly predicted responder status at week 6 (P = 0.03). Clinician-rated depressive and anxiety symptoms only became significantly associated with responder status at day 14. In conclusion, very early changes in depressive symptoms were identified using MHT, early changes accounted for most of total change, and MHT-recorded improvement as early as day 7 significantly predicted response to treatment at study end point

Scheers, T., Philippaerts, R., & Lefevre, J. (2012). Patterns of physical activity and sedentary behavior in normal-weight, overweight and obese adults, as measured with a portable armband device and an electronic diary. Clin.Nutr., 31, 756-764.

BACKGROUND & AIMS: Accurate data on domain-specific physical activity and sedentary behavior among normal-weight, overweight and obese adults are scarce. This study described a comprehensive physical (in)activity profile and examined variations in activity across the week. METHODS: Physical activity was measured in 442 Flemish adults (41.4 +/- 9.8 years) for 7 days using the SenseWear Armband and an electronic diary. Differences in (in)activity between BMI subgroups were examined using one-way analyses of variance. RESULTS: Physical activity level decreased with increasing BMI in men (1.77-1.46 MET) and women (1.67-1.31 MET). Sedentary time was higher in obese than normal-weight men (+1.09 h/day) and overweight and obese than normal-weight women (+1.04 and +1.88 h/day). Total hours of moderate-to-vigorous activity and bouts of moderate-to-vigorous activity were lower in overweight and obese than normal-weight subjects. The average duration of a sedentary bout and the number of breaks in sedentary time were only different between female BMI groups. The intensity of domain-specific activities decreased with increasing BMI. Activity patterns across the week differed between subgroups, with the difference most pronounced on Saturday for the male BMI groups. CONCLUSIONS: This study described activity patterns among normal-weight, overweight and obese adults. The results should be used to design obesity prevention strategies

Scheers, T., Philippaerts, R., & Lefevre, J. (2013). Objectively-determined intensity- and domain-specific physical activity and sedentary behavior in relation to percent body fat. Clin.Nutr., 32, 999-1006.

BACKGROUND & AIMS: This study examined the independent and joint associations of overall, intensity-specific and domain-specific physical activity and sedentary behavior with bioelectrical impedance-determined percent body fat. METHODS: Physical activity was measured in 442 Flemish adults (41.4 +/- 9.8 years) using the SenseWear Armband and an electronic diary. Two-way analyses of covariance investigated the interaction of physical activity and sedentary behavior with percent body fat. Multiple linear regression analyses, adjusted for potential confounders, examined the associations of intensity-specific and domain-specific physical activity and sedentary behavior with percent body fat. RESULTS: Results showed a significant main effect for physical activity in both genders and for sedentary behavior in women, but no interaction effects. Light activity was positively (beta = 0.41 for men and 0.43 for women) and moderate (beta = -0.64 and -0.41), vigorous (beta = -0.21 and -0.24) and moderate-to-vigorous physical activity (MVPA) inversely associated with percent body fat, independent of sedentary time. Regarding domain-specific physical activity, significant associations were present for occupation, leisure time and household chores, irrespective of sedentary time. The positive associations between body fat and total and domain-specific sedentary behavior diminished after MVPA was controlled for. CONCLUSIONS: MVPA during leisure time, occupation and household chores may be essential to prevent fat gain

Schnall, R., Okoniewski, A., Tiase, V., Low, A., Rodriguez, M., & Kaplan, S. (2013). Using text messaging to assess adolescents’ health information needs: An ecological momentary assessment. Journal of Medical Internet Research, 15, 101-109.

Background: Use of mobile technology has made a huge impact on communication, access, and information/resource delivery to adolescents. Mobile technology is frequently used by adolescents. Objective: The purpose of this study was to understand the health information needs of adolescents in the context of their everyday lives and to assess how they meet their information needs. Methods: We gave 60 adolescents smartphones with unlimited text messaging and data for 30 days. Each smartphone had applications related to asthma, obesity, human immunodeficiency virus, and diet preinstalled on the phone. We sent text messages 3 times per week and asked the following questions: (1) What questions did you have about your health today? (2) Where did you look for an answer (mobile device, mobile application, online, friend, book, or parent)? (3) Was your question answered and how? (4) Anything else? Results: Our participants ranged from 13-18 years of age, 37 (62%) participants were male and 22 (37%) were female. Of the 60 participants, 71% (42/60) participants identified themselves as Hispanic and 77% (46/60) were frequent users of mobile devices. We had a 90% (1935/2150) response rate to our text messages. Participants sent a total of 1935 text messages in response to the ecological momentary assessment questions. Adolescents sent a total of 421 text messages related to a health information needs, and 516 text messages related to the source of information to the answers of their questions, which were related to parents, friends, online, mobile apps, teachers, or coaches. Conclusions: Text messaging technology is a useful tool for assessing adolescentsGÇÖ health behavior in real-time. Adolescents are willing to use text messaging to report their health information. Findings from this study contribute to the evidence base on addressing the health information needs of adolescents. In particular, attention should be paid to issues related to diet and exercise. These findings may be the harbinger for future obesity prevention programs for adolescents.

Scott, S. B., Sliwinski, M. J., & Blanchard-Fields, F. (2013). Age differences in emotional responses to daily stress: The role of timing, severity, and global perceived stress. Psychology and Aging, 28, 1076-1087.

Research on age differences in emotional responses to daily stress has produced inconsistent findings. Guided by recent theoretical advances in aging theory (S. T. Charles, 2010, Strength and vulnerability integration: A model of emotional well-being across adulthood, Psychological Bulletin, Vol. 136, pp. 1068GÇô1091) that emphasize the importance of context for predicting when and how age is related to affective well-being, the current study examined age differences in emotional responses to everyday stressors. The present study examined how three contextual features (e.g., timing of exposure, stressor severity, global perceived stress [GPS]) moderate age differences in emotional experience in an ecological momentary assessment study of adults (N = 190) aged 18GÇô81 years. Results indicated that older adultsGÇÖ negative affect (NA) was less affected by exposure to recent stressors than younger adults, but that there were no age differences in the effects of stressor exposure 3GÇô6 hr afterward. Higher levels of GPS predicted amplified NA responses to daily stress, and controlling for GPS eliminated age differences in NA responses to stressors. No age differences in NA responses as a function of stressor severity were observed. In contrast, older age was associated with less of a decrease in PA when exposed to recent stressors or with more severe recent stressors. There were no age differences in the effect of previous stressor exposure or severity on PA, or any interactions between momentary or previous stress and GPS on PA. Together, these results support the notion that chronic stress plays a central role in emotional experience in daily life. We discuss the implications of these results for emotion theories of aging.

Selby, E. A., Franklin, J., CarsonGÇÉWong, A., & Rizvi, S. L. (2013). Emotional cascades and selfGÇÉinjury: Investigating instability of rumination and negative emotion. Journal of Clinical Psychology, 69, 1213-1227.

Objective: Nonsuicidal self-injury (NSSI) is a public health concern and risk factor for suicide. The Emotional Cascade Model (ECM) proposes that NSSI partially functions as a distraction from cascades of negative affect and rumination. The purpose of this study was to examine the roles of trait rumination, and momentary instability of rumination and negative emotion, in NSSI. Method: Experience sampling methods were used to monitor thoughts, emotions, and behaviors in 47 individuals reporting dysregulated behaviors including NSSI. Instability indices were generated for rumination and negative emotion using the momentary assessments. Results: Twenty-five episodes of NSSI were reported during monitoring. Trait rumination prospectively predicted NSSI episodes, and the instability indices interacted to predict NSSI. Conclusions: Consistent with the ECM, the interaction between rumination instability and negative affect instability during monitoring significantly predicted NSSI, with the strongest effects occurring for sadness and rumination about past. These findings may enhance conceptualization and treatment of patients with NSSI.

Setodji, C. M., Martino, S. C., Scharf, D. M., & Shadel, W. G. (2013). Quantifying the Persistence of Pro-Smoking Media Effects on College Students’ Smoking Risk. J.Adolesc.Health.

PURPOSE: To quantify the persistence of pro-smoking media exposure effects on college students’ intentions to smoke and smoking refusal self-efficacy. METHOD: A total of 134 college students (ages 18-24 years) were enrolled in an ecological momentary assessment study in which they carried handheld data collection devices for 3 weeks and reported their exposures to pro-smoking media as they occurred in the real world. Smoking intentions and smoking refusal self-efficacy were assessed after each exposure to pro-smoking media and at random prompts during each day of the 3-week assessment period. A generalized additive model was used to determine how long the effect of an exposure to pro-smoking media persisted. RESULTS: The effect of pro-smoking media exposures persisted for 7 days. After exposure, smoking intentions immediately increased (.56; 95% confidence interval [CI]: [.26, .87]) and then steadily decreased (-.12; 95% CI: [-.19, -.05]) each day for 7 days, while smoking refusal self-efficacy immediately decreased (-.42; 95% CI: [-.75, -.10]) and then steadily increased (.09; 95% CI: [.02, .16]) each day for 7 days. Daily changes occurring after 7 days were not statistically significant, suggesting that smoking intentions and refusal self-efficacy had stabilized and were no longer affected by pro-smoking media exposure. CONCLUSIONS: Exposures to pro-smoking media may have strong implications for emerging young adults smoking risk as the impact of an individual exposure appears to persist for at least a week

Shiffman, S. (2013). Conceptualizing Analyses of Ecological Momentary Assessment Data. Nicotine.Tob.Res..

Ecological Momentary Assessment (EMA) methods, which involve collection of real-time data in subjects’ real-world environments, are particularly well suited to studying tobacco use. Analyzing EMA datasets can be challenging, as the datasets include a large and varied number of observations per subject and are relatively unstructured. This paper suggests that time is typically a key organizing principle in EMA data, and that conceptualizing the data as a timeline of events, behaviors, and experiences can help define analytic approaches. EMA datasets lend themselves to answering a diverse array of research questions, and the research question must drive how data are arranged for analysis, and the kinds of statistical models that are applied. The paper illustrates this with brief examples of diverse analyses applied to answer different questions from an EMA study of tobacco use and relapse

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-Injurous adolescents: An ecological momentary analysis. International Journal of Eating Disorders, 46, 684-689.

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. © 2013 Wiley Periodicals, Inc. (Int J Eat Disord 2013; 46:684-689)

Shiyko, M. P., Burkhalter, J., Li, R., & Park, B. J. (2013). Modeling Nonlinear Time-Dependent Treatment Effects: An Application of the Generalized Time-Varying Effect Model (TVEM). Journal of Consulting and Clinical Psychology.

Objective: The goal of this article is to introduce to social and behavioral scientists the generalized time-varying effect model (TVEM), a semiparametric approach for investigating time-varying effects of a treatment. The method is best suited for data collected intensively over time (e.g., experience sampling or ecological momentary assessments) and addresses questions pertaining to effects of treatment changing dynamically with time. Thus, of interest is the description of timing, magnitude, and (nonlinear) patterns of the effect. Method: Our presentation focuses on practical aspects of the model. A step-by-step demonstration is presented in the context of an empirical study designed to evaluate effects of surgical treatment on quality of life among early stage lung cancer patients during posthospitalization recovery (N = 59; 61% female, M age = 66.1 years). Frequency and level of distress associated with physical symptoms were assessed twice daily over a 2-week period, providing a total of 1,544 momentary assessments. Results: Traditional analyses (analysis of covariance [ANCOVA], repeated-measures ANCOVA, and multilevel modeling) yielded findings of no group differences. In contrast, generalized TVEM identified a pattern of the effect that varied in time and magnitude. Group differences manifested after Day 4. Conclusions: Generalized TVEM is a flexible statistical approach that offers insight into the complexity of treatment effects and allows modeling of nonnormal outcomes. The practical demonstration, shared syntax, and availability of a free set of macros aim to encourage researchers to apply TVEM to complex data and stimulate important scientific discoveries.

Sibon, I., Lassalle-Lagadec, S., Renou, P., & Swendsen, J. (2012). Evolution of depression symptoms following stroke: a prospective study using computerized ambulatory monitoring. Cerebrovasc.Dis., 33, 280-285.

BACKGROUND: Despite the high prevalence and impact of post-stroke depression (PSD), questions persist concerning the nature and stability of PSD over time. The current study uses state-of-the-art computerized ambulatory monitoring techniques to assess daily life depression symptoms following stroke and examines the evolution of depression levels over a three-month period. METHODS: 48 patients admitted to a university hospital neurology unit for ischemic or hemorrhagic stroke participated in ambulatory monitoring of DSM-IV depression symptoms for a one-week period after hospital discharge. Clinician-administered measures of depression were also obtained at discharge and again three months later. RESULTS: The percentage of the sample with elevated depression scores was the same at discharge and three months later, but consistency in depression profiles was low. Ambulatory monitoring revealed that elevated depression levels at hospital discharge were most strongly associated with anhedonia (t ratio = 4.840, p < 0.001) and fatigue (t ratio = 4.00, p < 0.001), whereas individuals with elevated scores at three months were predicted by daily life negative thoughts (t ratio = 4.051, p < 0.001), anxious mood (t ratio = 3.489, p < 0.01), sad mood (t ratio = 2.621, p < 0.05) and emotional reactivity (t ratio = 2.466, p < 0.05). CONCLUSIONS: The prevalence of depression may appear stable during the immediate weeks and months following stroke, but it is likely to be composed of very different symptom profiles. The immediate physical and psychological impact of stroke may induce somatic symptoms that explain elevated depression levels and which may not indicate a risk factor for later depression

Silvia, P. J., Kwapil, T. R., Eddington, K. M., & Brown, L. H. (2013). Missed beeps and missing data: Dispositional and situational predictors of nonresponse in experience sampling research. Social Science Computer Review, 31, 471-481.

Experience sampling research measures peopleGÇÖs thoughts, feelings, and actions in their everyday lives by repeatedly administering brief questionnaires throughout the day. NonresponseGÇöfailing to respond to these daily life questionnairesGÇöhas been a vexing source of missing data. The present research examined person-level, day-level, and signal-level predictors of nonresponse. We analyzed data from a sample of 450 young adults who were signaled 8 times a day for 7 days. At the person level, nonresponse was higher for men and for people high in positive schizotypy, depressive symptoms, and hypomania. At the day level, nonresponse increased over the first few days of the study and then declined toward the end. At the signal level, time of day strongly predicted nonresponse. Lagged signal-level analyses examined how emotions and experiences at a prior signal prospectively predicted the likelihood of ignoring the next signal. Only one variableGÇöfeelings of enthusiasmGÇöhad a significant lagged effect, which suggests that within-day experiences are not major sources of nonresponse. For the most part, the day of the study and the time of day had the most salient effects. Understanding the predictors of missing data allows researchers to implement methods to increase compliance and to handle missing data more effectively by including predictors of nonresponse.

Sokolovsky, A. W., Mermelstein, R. J., & Hedeker, D. (2013). Factors Predicting Compliance to Ecological Momentary Assessment Among Adolescent Smokers. Nicotine.Tob.Res..

INTRODUCTION: Ecological momentary assessments (EMAs) are increasingly used in smoking research to understand contextual and individual differences related to smoking and changes in smoking. To date, there has been little detailed research into the predictors of EMA compliance. However, patterns or predictors of compliance may affect key relationships under investigation and introduce sources of bias in results. The purpose of this study was to investigate predictors of compliance to random prompts among a sample of adolescents who had ever smoked. METHODS: Data for this study were drawn from a sample of 461 adolescents (9th and 10th graders at baseline) participating in a longitudinal study of smoking escalation. We examined 2 outcomes: subject-level EMA compliance (overall rate of compliance over a week-long EMA wave) and in-the-moment prompt-level compliance to the most proximal random prompt. We investigated several covariates including gender, race, smoking rate, alcohol use, psychological symptomatology, home composition, mood, social context, time in study, inter-prompt interval, and location. RESULTS: At the overall subject level, higher mean negative affect, smoking rate, alcohol use, and male gender predicted lower compliance with random EMA prompts. At the prompt level, after controlling for significant subject-level predictors of compliance, increased positive affect, being outside of the home, and longer inter-prompt interval predicted lower momentary compliance. CONCLUSIONS: This study identifies several factors associated with overall and momentary EMA compliance among a sample of adolescents participating in a longitudinal study of smoking. We also propose a conceptual framework for investigating the contextual and momentary predictors of compliance within EMA studies

Spicer, J., Werner, E., Zhao, Y., Choi, C. W., Lopez-Pintado, S., Feng, T. et al. (2013). Ambulatory assessments of psychological and peripheral stress-markers predict birth outcomes in teen pregnancy. J.Psychosom.Res., 75, 305-313.

OBJECTIVE: Pregnant adolescents have high rates of poor birth outcomes, but the causes are unclear. We present a prospective, longitudinal study of pregnant adolescents assessing associations between maternal psychobiological stress indices and offspring gestational age at birth and birthweight. METHOD: Healthy nulliparous pregnant adolescents were recruited (n=205) and followed during pregnancy. Ambulatory assessments over 24h of perceived psychological stress (collected every 30 min) and salivary cortisol (6 samples) and a summary questionnaire, the Perceived Stress Scale, were collected at three time points (13-16, 24-27, and 34-37 gestational weeks). Corticotropin-releasing hormone, C-reactive protein, and interleukin 6 were assayed from blood taken at the latter 2 sessions. A final sample of 119 participants was selected for analyses. RESULTS: The ambulatory assessment of perceived psychological stress was positively correlated with the Perceived Stress Scale (r=.20, p=.03) but neither was associated with any of the biological assays (all ps>.20). Based on backward selection regression models that included all stress variables and relevant covariates, the ambulatory assessments of perceived psychological stress and cortisol - though not the Perceived Stress Scale - were negatively associated with gestational age at birth (F(4, 107)=3.38, p=.01) while cortisol was negatively related to birthweight (F(5, 107)=14.83, p<.0001). CONCLUSIONS: Targeted interventions to reduce psychological and biological indicators of heightened stress during pregnancy may have positive public health benefits for the offspring given the associations of shortened gestation and lower birthweight with risk for poor mental and physical health outcomes

Stein, K. F., Chen, D. G., Corte, C., Keller, C., & Trabold, N. (2013). Disordered eating behaviors in young adult Mexican American women: Prevalence and associations with health risks. Eating Behaviors, 14,  476-483.

Recent research has shown that disordered eating behaviors are as prevalent in heterogenous samples of Latinas living in the U.S. as in non-Hispanic white women, yet less is known about the prevalence in women of Mexican origin. The primary purpose of this study is to report the prevalence and associations among DE behaviors and health risk of alcohol, tobacco use and obesity in a sample of N = 472 young adult college enrolled Mexican American (MA) women living in the United States. This report focuses on baseline data from a 12-month repeated measures longitudinal study. Ecological momentary assessment (EMA)was used to capture the prevalence of disordered eating and health risk behaviors in the context of everyday activities. Disordered eating behaviors including purging, binge eating, fasting and exercise were reported by approximately 15% of the sample. Food/calorie restricting, was the most prevalent behavior reported by 48% of the sample and along with binge eating was a positive predictor of BMI. Fasting was the only disordered eating behavior associated with tobacco use. These findings suggest that subclinical levels of DE behaviors are prevalent in a community sample of women of Mexican origin and are associated with health risks of tobacco use and higher BMI. Early identification of DE behaviors and community-based interventions targeting MA women may help reduce disparities associated with overweight and obesity in this population.

Stinson, J. N., Jibb, L. A., Nguyen, C., Nathan, P. C., Maloney, A. M., Lee Dupuis, L. et al. (2013). Development and testing of a multidimensional iPhone pain assessment application for adolescents with cancer. Journal of Medical Internet Research, 15, 137-151.

Background: Pain is one of the most common and distressing symptoms reported by adolescents with cancer. Despite advancements in pain assessment and management research, pain due to cancer and/or its treatments continues to be poorly managed. Our research group has developed a native iPhone application (app) called Pain Squad to tackle the problem of poorly managed pain in the adolescent with cancer group. The app functions as an electronic pain diary and is unique in its ability to collect data on pain intensity, duration, location, and the impact pain has on an adolescentGÇÖs life (ie, relationships, school work, sleep, mood). It also evaluates medications and other physical and psychological pain management strategies used. Users are prompted twice daily at configurable times to complete 20 questions characterizing their pain and the app transmits results to a database for aggregate reporting through a Web interface. Each diary entry represents a pain case filed by an adolescent with cancer and a reward system (ie, moving up through law-enforcement team ranks, built-in videotaped acknowledgements from fictitious officers) encourages consistent use of the diary. Objective: Our objective was to design, develop, and test the usability, feasibility, compliance, and satisfaction of a game-based smartphone pain assessment tool for adolescents with cancer. Methods: We used both low- and high-fidelity qualitative usability testing with qualitative semi-structured, audio-taped interviews and iterative cycles to design and refine the iPhone based Pain Squad app. Qualitative thematic analysis of interviews using constant comparative methodology captured emergent themes related to app usability. Content validity was assessed using question importance-rating surveys completed by participants. Compliance and satisfaction data were collected following a 2-week feasibility trial where users were alarmed to record their pain twice daily on the app. Results: Thematic analysis of usability interviews showed the app to be appealing overall to adolescents. Analyses of both low-and high-fidelity testing resulted in minor revisions to the app to refine the theme and improve its usability. Adolescents resoundingly endorsed the game-based nature of the app and its virtual reward system. The importance of app pain diary questions was established by content validity analysis. Compliance with the app, assessed during feasibility testing, was high (mean 81%, SD 22%) and adolescents from this phase of the study found the app likeable, easy to use, and not bothersome to complete. Conclusions: A multifaceted usability approach demonstrated how the Pain Squad app could be made more appealing to children and adolescents with cancer. The game-based nature and built-in reward system of the app was appealing to adolescents and may have resulted in the high compliance rates and satisfaction ratings observed during clinical feasibility testing.

Tabak, M., Vollenbroek-Hutten, M. M., van der Valk, P. D., van der Palen, J., & Hermens, H. J. (2013). A telerehabilitation intervention for patients with Chronic Obstructive Pulmonary Disease: a randomized controlled pilot trial. Clin.Rehabil..

Objective:First, to investigate the effects of a telerehabilitation intervention on health status and activity level of patients with Chronic Obstructive Pulmonary Disease (COPD), compared to usual care. Second, to investigate how patients comply with the intervention and whether compliance is related to treatment outcomes.Design:a randomized controlled pilot trialSubjects:Thirty-four patients diagnosed with COPD.Intervention:The telerehabilitation application consists of an activity coach (3D-accelerometer with smartphone) for ambulant activity registration and real-time feedback, complemented by a web portal with a symptom diary for self-treatment of exacerbations. The intervention group used the application for 4 weeks. The control group received usual care.Main measures:Activity level measured by a pedometer (in steps/day), health status by the Clinical COPD Questionnaire at baseline and after intervention. Compliance was expressed as the time the activity coach was worn.Results:Fourteen intervention and 16 control patients completed the study. Activity level (steps/day) was not significantly affected by the intervention over time. There was a non-significant difference in improvement in health status between the intervention (-0.34+/-0.55) and control group (0.02+/-0.57, p=0.10). Health status significantly improved within the intervention group (p=0.05). The activity coach was used more than prescribed (108%) and compliance was related to the increase in activity level for the first two feedback weeks (r=0.62, p=0.03).Conclusions:This pilot study shows the potential of the telerehabilitation intervention: compliance with the activity coach was high, which directly related to an improvement in activity levels

Takano, K., Sakamoto, S., & Tanno, Y. (2013). Repetitive thought impairs sleep quality: An experience sampling study. Behavior Therapy.

Although previous research has suggested that presleep negative cognitive activities are associated with poor sleep quality, there is little evidence regarding the association between negative thoughts and sleep in real-life settings. The present study used experience sampling and long-term sleep monitoring with actigraphy to investigate the relationships among negative repetitive thought, mood, and sleep problems. During a 1-week sampling period, 43 undergraduate students recorded their thought content and mood eight times a day at semirandom intervals. In addition to these subjective reports, participants wore actigraphs on their wrists in order to measure sleep parameters. Analyses using multilevel modeling showed that repetitive thought in the evening was significantly associated with longer sleep-onset latency, decreased sleep efficiency, and reduced total sleep time. Furthermore, impaired sleep quality was significantly associated with reduced positive affect the next morning, and decreased positive affect was indirectly associated with increased repetitive thought in the evening. These findings suggest the existence of a self-reinforcing cycle involving repetitive thought, mood, and impaired sleep quality, highlighting the importance of cognitive and emotional factors in enhancement and maintenance of good-quality sleep.

Tanantong, T., Nantajeewarawat, E., & Thiemjarus, S. (2014). Toward continuous ambulatory monitoring using a wearable and wireless ECG- recording system: a study on the effects of signal quality on arrhythmia detection. Biomed.Mater.Eng, 24, 391-404.

Five well-known arrhythmia classification algorithms were compared in this paper based on the recommendations in AAMI standard. They are C4.5, k-Nearest Neighbor, Multilayer Perceptron, PART, and Support Vector Machine, respectively, with inputs related to heartbeat intervals and ECG morphological features. They were evaluated on three independent datasets, including the MIT-BIH arrhythmia database, a collection of ECG signals acquired from healthy subjects by the wireless Body Sensor Network (BSN) nodes, and a third dataset captured also by the BSN nodes. Results showed the overall accuracy on the MIT-BIH arrhythmia database was approximately 99.04%, with high sensitivity, specificity, and selectivity. When tested with ECG signals acquired from the human subjects, which were partially deteriorated due to several factors, e.g., motion artifacts and data transmission problems, the overall accuracy of 94.19% and that of 81.22% were obtained for static activities and dynamic activities, respectively. In addition, the effects of the signal quality from these human subjects on false alarms were investigated. When false alarms occurring in signal segments with low quality were excluded, the number of false detections reduced from 14.17% to 8.65%. When evaluated on signals generated by the patient simulator, which included several types of premature ventricular contraction without artifacts from body movements, a high classification accuracy was also observed

Thomas, S. & Bacon, A. (2013). Stress and affective inductions in addiction research. In J.MacKillop & H. de Wit (Eds.), The Wiley-Blackwell handbook of addiction psychopharmacology (pp. 411-434). Wiley-Blackwell.

(from the chapter) That people take drugs and use alcohol to help alleviate stress or improve a bad mood is an assumed truth that seems too obvious to warrant scientific study. The very nature of drugs of abuseGÇöall of which induce pleasure and other desirable affective states (Leshner and Koob, 1999)GÇöseems to confirm that drugs and alcohol improve one’s affect and would therefore be especially sought when the individual is stressed. Theories to explain substance use and addiction, including the self-medication hypothesis (Khantzian, 1985) and the tension reduction theory of alcohol use (Cappell and Herman, 1972; Conger, 1956), posit that drugs and alcohol are consumed in part because they are negatively reinforcing. Certainly, retrospective reports support that the desire to drink or use drugs increases under stress (Brown et al., 1995; Fouquereau, Fernandez, Mullet, and Somm, 2003). It is perplexing, then, that there is only modest scientific evidence that alcohol and drugs actually relieve stress (Kassel, Stroud, and Paronis, 2003; Sayette et al., 2001), and as explained in the present chapter, prospective studies to examine whether stress increases urge to use drugs or alcohol are inconsistent. Two research methods have been employed in prospective clinical studies to examine whether acute stress motivates substance use. Ecological momentary assessment (EMA) is an approach that captures participants’ naturally occurring affective states and desire to use and/or actual use of substances in real time over several days or months (see Chapter 20). Alternatively, the other methodGÇöapplying a stressor in a clinical laboratory setting and measuring subsequent use or desire to use substancesGÇöaffords the ability to employ true experimental methods to determine not just temporal relationships but actual causal connections between stress and increased motivation to use drugs or alcohol. This chapter discusses ways to measure the effects of substance use on stress.

Tomko, R. L., Solhan, M. B., Carpenter, R. W., Brown, W. C., Jahng, S., Wood, P. K. et al. (2013). Measuring Impulsivity in Daily Life: The Momentary Impulsivity Scale. Psychological Assessment.

Impulsivity is a core feature of many psychiatric disorders. Traditionally, impulsivity has been assessed using retrospective questionnaires or laboratory tasks. Both approaches neglect intraindividual variability in impulsivity and do not capture impulsivity as it occurs in real-world settings. The goal of the current study was to provide a method for assessing impulsivity in daily life that provides both between-individual and within-individual information. Participants with borderline personality disorder (BPD; n = 67) or a depressive disorder (DD; n = 38) carried an electronic diary for 28 days and responded to 9 impulsivity items up to 6 times per day. Item distributions and iterative exploratory factor analysis (EFA) results were examined to select the items that best captured momentary impulsivity. A brief 4-item scale was created that can be used for the assessment of momentary impulsivity. Model fit was good for both within- and between-individual EFA. As expected, the BPD group showed significantly higher scores on our Momentary Impulsivity Scale than the DD group, and the resulting scale was moderately correlated with common trait impulsivity scales.

Uchino, B. N., Sanbonmatsu, D. M., & Birmingham, W. (2013). Knowing your partner is not enough: Spousal importance moderates the link between attitude familiarity and ambulatory blood pressure. Journal of Behavioral Medicine, 36, 549-555.

Close relationships have been linked to cardiovascular morbidity and mortality. More research is needed, however, on the social and biological processes responsible for such links. In this study, we examined the role of relationship-based attitudinal processes (i.e., attitude familiarity and partner importance) on ambulatory blood pressure during daily life. Forty-seven married couples completed a questionnaire regarding their own attitudes, perceptions of their partnerGÇÖs attitudes, and perceptions of partner importance. They also underwent a 1-day ambulatory assessments of daily spousal interactions and blood pressure. Partner importance was related to better interpersonal functioning (e.g., partner responsiveness) and lower ambulatory systolic blood pressure. More interestingly, partner importance moderated the links between attitude familiarity and both ambulatory systolic and diastolic blood pressure. This statistical interaction revealed that simply knowing a partnerGÇÖs attitudes was not enough as partner knowledge was primarily related to lower ambulatory blood pressure when they were also viewed as more important. These data are discussed in light of how attitude familiarity and spousal importance may jointly influence health outcomes and the social-cognitive mechanisms potentially responsible for such links.

van de Leemput, I. A., Wichers, M., Cramer, A. O., Borsboom, D., Tuerlinckx, F., Kuppens, P. et al. (2014). Critical slowing down as early warning for the onset and termination of depression. Proc.Natl.Acad.Sci.U.S.A, 111, 87-92.

About 17% of humanity goes through an episode of major depression at some point in their lifetime. Despite the enormous societal costs of this incapacitating disorder, it is largely unknown how the likelihood of falling into a depressive episode can be assessed. Here, we show for a large group of healthy individuals and patients that the probability of an upcoming shift between a depressed and a normal state is related to elevated temporal autocorrelation, variance, and correlation between emotions in fluctuations of autorecorded emotions. These are indicators of the general phenomenon of critical slowing down, which is expected to occur when a system approaches a tipping point. Our results support the hypothesis that mood may have alternative stable states separated by tipping points, and suggest an approach for assessing the likelihood of transitions into and out of depression

Van Ryckeghem, D. M., Crombez, G., Goubert, L., De, H. J., Onraedt, T., & Van, D. S. (2013). The predictive value of attentional bias towards pain-related information in chronic pain patients: a diary study. Pain, 154, 468-475.

Theoretical accounts of chronic pain hypothesize that attentional bias towards pain-related information is a maintaining or exacerbating factor, fuelling further pain, disability, and distress. However, empirical research testing this idea is currently lacking. In the present study, we investigated whether attentional bias towards pain-related information predicts daily pain-related outcomes in a sample of chronic pain patients (n=69; M(age)=49.64 years; 46 females). During an initial laboratory session, attentional bias to pain-related information was assessed using a modified spatial cueing task. In advance, patients completed a number of self-report measures assessing current pain intensity, current disability, and pain duration. Subsequently, daily pain outcomes (self-reported pain severity, disability, avoidance behaviour, and distractibility) were measured for 2 weeks by means of an electronic diary. Results indicated that, although an attentional bias towards pain-related information was associated with the current level of disability and pain severity, it had no additional value above control variables in predicting daily pain severity, avoidance, distractibility, and disability. Attentional bias towards pain-related information did, however, moderate the relationship between daily pain severity and both daily disability and distractibility, indicating that, particularly in those patients with a strong attentional bias, increases in pain were associated with increased disability and distractibility. The use of interventions that diminish attentional bias may therefore be helpful to reduce daily disability and the level of distraction from current tasks despite the presence of pain in chronic pain patients

van, O. J., Lataster, T., Delespaul, P., Wichers, M., & Myin-Germeys, I. (2014). Evidence that a psychopathology interactome has diagnostic value, predicting clinical needs: an experience sampling study. PLoS ONE, 9, e86652.

BACKGROUND: For the purpose of diagnosis, psychopathology can be represented as categories of mental disorder, symptom dimensions or symptom networks. Also, psychopathology can be assessed at different levels of temporal resolution (monthly episodes, daily fluctuating symptoms, momentary fluctuating mental states). We tested the diagnostic value, in terms of prediction of treatment needs, of the combination of symptom networks and momentary assessment level. METHOD: Fifty-seven patients with a psychotic disorder participated in an ESM study, capturing psychotic experiences, emotions and circumstances at 10 semi-random moments in the flow of daily life over a period of 6 days. Symptoms were assessed by interview with the Positive and Negative Syndrome Scale (PANSS); treatment needs were assessed using the Camberwell Assessment of Need (CAN). RESULTS: Psychotic symptoms assessed with the PANSS (Clinical Psychotic Symptoms) were strongly associated with psychotic experiences assessed with ESM (Momentary Psychotic Experiences). However, the degree to which Momentary Psychotic Experiences manifested as Clinical Psychotic Symptoms was determined by level of momentary negative affect (higher levels increasing probability of Momentary Psychotic Experiences manifesting as Clinical Psychotic Symptoms), momentary positive affect (higher levels decreasing probability of Clinical Psychotic Symptoms), greater persistence of Momentary Psychotic Experiences (persistence predicting increased probability of Clinical Psychotic Symptoms) and momentary environmental stress associated with events and activities (higher levels increasing probability of Clinical Psychotic Symptoms). Similarly, the degree to which momentary visual or auditory hallucinations manifested as Clinical Psychotic Symptoms was strongly contingent on the level of accompanying momentary paranoid delusional ideation. Momentary Psychotic Experiences were associated with CAN unmet treatment needs, over and above PANSS measures of psychopathology, similarly moderated by momentary interactions with emotions and context. CONCLUSION: The results suggest that psychopathology, represented as an interactome at the momentary level of temporal resolution, is informative in diagnosing clinical needs, over and above traditional symptom measures

van, R. E., Verhagen, M., Scholte, R. H., Kleinjan, M., Goossens, L., & Engels, R. C. (2013). The Oxytocin Receptor Gene (OXTR) in Relation to State Levels of Loneliness in Adolescence: Evidence for Micro-Level Gene-Environment Interactions. PLoS.One., 8, e77689.

Previous research has shown that the rs53576 variant of the oxytocin receptor gene (OXTR) is associated with trait levels of loneliness, but results are inconsistent. The aim of the present study is to examine micro-level effects of the OXTR rs53576 variant on state levels of loneliness in early adolescents. In addition, gene-environment interactions are examined between this OXTR variant and positive and negative perceptions of company. Data were collected in 278 adolescents (58% girls), by means of the Experience Sampling Method (ESM). Sampling periods consisted of six days with nine assessments per day. A relation was found between the OXTR rs53576 variant and state loneliness, in girls only. Girls carrying an A allele had higher levels of state loneliness than girls carrying the GG genotype. In addition, adolescents with an A allele were more affected by negative perceptions of company than GG carriers, on weekend days only. No significant gene-environment interactions were found with positive company. Adolescents carrying an A allele were more susceptible to negative environments during weekend days than GG carriers. Our findings emphasize the importance of operationalizing the phenotype and the environment accurately

Vanhelst, J., Fardy, P. S., Duhamel, A., & Beghin, L. (2013). How many days of accelerometer monitoring predict weekly physical activity behaviour in obese youth? Clin.Physiol Funct.Imaging.

The aim of this study was to determine the type and the number of accelerometer monitoring days needed to predict weekly sedentary behaviour and physical activity in obese youth. Fifty-three obese youth wore a triaxial accelerometer for 7 days to measure physical activity in free-living conditions. Analyses of variance for repeated measures, Intraclass coefficient (ICC) and regression linear analyses were used. Obese youth spent significantly less time in physical activity on weekends or free days compared with school days. ICC analyses indicated a minimum of 2 days is needed to estimate physical activity behaviour. ICC were 0.80 between weekly physical activity and weekdays and 0.92 between physical activity and weekend days. The model has to include a weekday and a weekend day. Using any combination of one weekday and one weekend day, the percentage of variance explained is >90%. Results indicate that 2 days of monitoring are needed to estimate the weekly physical activity behaviour in obese youth with an accelerometer. Our results also showed the importance of taking into consideration school day versus free day and weekday versus weekend day in assessing physical activity in obese youth

Vilardaga, R. (2013). An experience sampling study of psychological processes and their relation to functional outcome among individuals with severe psychopathology. ProQuest Information & Learning, US.

Background. The functional relations between daily contextual factors, psychological coping and functional outcome among individuals with severe psychopathology are still largely unexamined as compared to other aspects in this population, such as the genetic makeup of these individuals, their performance on cognitive tests, or their retrospective self-reports. Aims and method. To compare the role of cognitive and emotional regulation strategies versus contextual and behavioral regulation strategies in predicting different types of functional outcome after controlling for the occurrence of positive psychotic events and other negative stressors. A group of 31 individuals diagnosed with severe psychopathology from a Program for Assertive Community Treatment (PACT) of the Northern Nevada Adult Mental Health Services (NNAMHS) were recruited for this study. The study design was observational, with the added feature of an experience sampling method; 685 experience sampling moments were gathered during the course of six days. Additional psychological processes were examined in this study such as empathy, perspective taking ability and values. Results The study suggests that the occurrence of positive psychotic symptoms and stressful events had a negative impact on functional outcome, but not after accounting for the role of some contextual and behavioral regulation strategies. More specifically, behavioral regulation strategies such as experiential acceptance and overt avoidance had a superior association with functional outcome than emotional regulation strategies such as cognitive reappraisal. Moreover, data suggests that cognitive reappraisal tended to increase individual’s distress, although not after accounting for cognitive suppression and overt avoidance. Finally, due to small sample size and design considerations it was not possible to reliably explore the association between perspective taking, values and functional outcome, however, additional exploratory analysis were conducted in order to test the direction and strength of these associations. Conclusions. Behavioral and contextual regulation strategies seem to have a superior effect on functional outcome as compared to cognitive and emotional regulation strategies among individuals with severe psychopathology that regularly experience psychotic and/or negative experiences.

Voogt, C. V., Kuntsche, E., Kleinjan, M., Poelen, E. A., Lemmers, L. A., & Engels, R. C. (2013). Using ecological momentary assessment in testing the effectiveness of an alcohol intervention: a two-arm parallel group randomized controlled trial. PLoS.One., 8, e78436.

BACKGROUND: Alcohol consumption of college students has a fluctuating nature, which might impact the measurement of intervention effects. By using 25 follow-up time-points, this study tested whether intervention effects are robust or might vary over time. METHODS: Data were used from a two-arm parallel group randomized controlled trial applying ecological momentary assessment (EMA) with 30 data time-points in total. Students between 18 and 24 years old who reported heavy drinking in the past six months and who were ready to change their alcohol consumption were randomly assigned to the experimental (n = 456: web-based brief alcohol intervention) and control condition (n = 451: no intervention). Outcome measures were weekly alcohol consumption, frequency of binge drinking, and heavy drinking status. RESULTS: According to the intention-to-treat principle, regression analyses revealed that intervention effects on alcohol consumption varied when exploring multiple follow-up time-points. Intervention effects were found for a) weekly alcohol consumption at 1, 2, 3, 4, and 7 weeks follow-up, b) frequency of binge drinking at 1, 2, 7, and 12 weeks follow-up, and c) heavy drinking status at 1, 2, 7, and 16 weeks follow-up. CONCLUSIONS: This research showed that the commonly used one and six month follow-up time-points are relatively arbitrary and not using EMA might bring forth erroneous conclusions on the effectiveness of interventions. Therefore, future trials in alcohol prevention research and beyond are encouraged to apply EMA when assessing outcome measures and intervention effectiveness. TRIAL REGISTRATION: Netherlands Trial Register NTR2665

Vorwerg, Y., Petroff, D., Kiess, W., & Bluher, S. (2013). Physical activity in 3-6 year old children measured by SenseWear Pro(R): direct accelerometry in the course of the week and relation to weight status, media consumption, and socioeconomic factors. PLoS.One., 8, e60619.

BACKGROUND: Data on objectively measured physical activity (PA) in preschoolers are controversial. Direct accelerometry was performed in children aged 3-6 years, and differences in PA patterns over the course of the week were evaluated. Data were analyzed with gender, BMI, lifestyle, and socioeconomic parameters as covariates. METHODS: PA was measured in 119 children by the SensewearPro(R) accelerometer and analyzed in the 92 (40 girls) that wore it for at least 4 days including one day of the weekend. Median measuring time in this group was 7 consecutive days (median/mean daily measuring time: 23.5 h/d and 21.8 h/d, respectively), corresponding to 834,000 analyzed minutes. PA questionnaires were completed by 103 parents and 87 preschool teachers to collect anthropometric, lifestyle, and socioeconomic data. RESULTS: Median daily PA (MET>3) was 4.3 hours (mean: 4.4 hours). Boys spent an estimated 52 min/week more being very active (MET>6) than girls (95% CI [6, 96] min/week, p = 0.02). PA was lower during the weekend (3.7 h/d) compared to weekdays (4.5 h/d), p = 3 x 10(-6)), where a 95% CI for the difference is [0.5, 1.0] h/d. PA levels did not differ between overweight/obese children (median 4.7 h/d) and normal-weight peers (median 4.2 h/d). Daily media consumption increased with decreasing social class on weekdays (p = 0.05) and during the weekend (p = 0.01), but was not related to the amount of daily PA. A multivariate regression with BMI-SDS as independent variable and gender, age, amount of PA>6 MET, parental BMI, media time and socioeconomic status as explanatory variables revealed that only SES had a significant contribution. CONCLUSION: The negative impact of obesity-promoting factors in older children is rather low for preschoolers, but there is evidently a gradient in PA between weekdays and weekends already in this age group. Weight status of preschoolers is already considerably influenced by SES, but not physical activity levels

Walsh, M. A., Brown, L. H., Barrantes-Vidal, N., & Kwapil, T. R. (2013). The expression of affective temperaments in daily life. J.Affect.Disord., 145, 179-186.

BACKGROUND: Numerous validation studies have examined the TEMPS-A in both clinical and nonclinical samples. However, the majority of these studies utilized cross-sectional assessments in laboratory or clinical settings. The present study is the first to examine the expression of affective temperaments in daily life using experience sampling methodology (ESM). METHODS: 138 participants completed the TEMPS-A and received a personalized digital assistant that signaled them eight times daily for one week to complete questionnaires that assessed affect, cognition, behavior, sense of self, and social interaction. RESULTS: As expected, cyclothymic/irritable temperament was positively associated with negative affect, risky behavior, and restlessness, and was negatively associated with positive affect and preference to be with others in daily life. In contrast, hyperthymic temperament was associated with positive affect, fullness of thought, doing many and exciting things, grandiosity, and preference to be with others in daily life. Dysthymic temperament was modestly associated with worry, and was positively associated with trouble concentrating, fullness of thought, and a preference for social contact. Cross-level interactions indicated that cyclothymic/irritable temperament was associated with elevated stress reactivity in daily life. LIMITATIONS: ESM data collection was limited to one week. Longer assessment periods might better capture the cyclical nature of affective temperaments. CONCLUSIONS: This was the first study to examine affective temperaments in daily life. The findings offer further validation of the TEMPS-A, as well as the maladaptive nature of the cyclothymic/irritable temperament

Wegerer, M., Blechert, J., Kerschbaum, H., & Wilhelm, F. H. (2013). Relationship between Fear Conditionability and Aversive Memories: Evidence from a Novel Conditioned-Intrusion Paradigm. PLoS.One., 8, e79025.

Intrusive memories - a hallmark symptom of posttraumatic stress disorder (PTSD) - are often triggered by stimuli possessing similarity with cues that predicted or accompanied the traumatic event. According to learning theories, intrusive memories can be seen as a conditioned response to trauma reminders. However, direct laboratory evidence for the link between fear conditionability and intrusive memories is missing. Furthermore, fear conditioning studies have predominantly relied on standardized aversive stimuli (e.g. electric stimulation) that bear little resemblance to typical traumatic events. To investigate the general relationship between fear conditionability and aversive memories, we tested 66 mentally healthy females in a novel conditioned-intrusion paradigm designed to model real-life traumatic experiences. The paradigm included a differential fear conditioning procedure with neutral sounds as conditioned stimuli and short violent film clips as unconditioned stimuli. Subsequent aversive memories were assessed through a memory triggering task (within 30 minutes, in the laboratory) and ambulatory assessment (involuntary aversive memories in the 2 days following the experiment). Skin conductance responses and subjective ratings demonstrated successful differential conditioning indicating that naturalistic aversive film stimuli can be used in a fear conditioning experiment. Furthermore, aversive memories were elicited in response to the conditioned stimuli during the memory triggering task and also occurred in the 2 days following the experiment. Importantly, participants who displayed higher conditionability showed more aversive memories during the memory triggering task and during ambulatory assessment. This suggests that fear conditioning constitutes an important source of persistent aversive memories. Implications for PTSD and its treatment are discussed

Wenze, S. J., Gunthert, K. C., Ahrens, A. H., & Bos, T. C. T. (2013). Biases in short-term mood prediction in individuals with depression and anxiety symptoms. Individual Differences Research, 11, 91-101.

We used ecological momentary assessment to explore depressive and anxious biases in within-day negative and positive mood predictions. Participants (N = 120) who were higher in depression symptoms demonstrated stronger biases (i.e., were more pessimistically biased) in the prediction of negative mood and weaker biases (i.e., were less optimistically biased) in the prediction of positive mood (bGéÇGéü = .002, SE = .001, p = .031 and bGéÇGéü = GêÆ.008, SE = .002, p < .001, respectively). Anxiety symptoms were not associated with short-term mood prediction biases (p’s > .10). Such biases might influence daily decisions and experiences as well as impact longer-term outcomes. Limitations and future research directions are discussed.

Wichers, M., Simons, C. J., Kramer, I. M., Hartmann, J. A., Lothmann, C., Myin-Germeys, I. et al. (2011). Momentary assessment technology as a tool to help patients with depression help themselves. Acta Psychiatr.Scand., 124, 262-272.

OBJECTIVE: Given high relapse rates and residual symptoms in depression, new strategies to increase treatment effectiveness are required. A promising avenue is to investigate how electronic momentary assessment technology may contribute to clinical assessment and interventions in depression. METHOD: A literature search was conducted focusing on the potential contribution of momentary assessments to clinical applications in depression. RESULTS: Momentary assessments are able to reveal subtle, small but repetitive and relevant patterns of emotional expression that predict future course of depression. A momentary assessment tool may expose manageable pieces of daily life behaviour contributing to the depressive experience that patients can influence. The use of this explicit knowledge of daily life experience is understudied with regard to its contribution to diagnostic assessment, monitoring of treatment effects and feedback interventions in depressed patients. The clinical application of momentary assessments may stimulate a shift from passive consumption of treatment to an active role for patients in their recovery and increased patient ownership. CONCLUSION: The precise, prospective and fine-grained information that momentary assessment technology provides may contribute to clinical practice in various ways. Future studies should examine the clinical impact of its use and the feasibility of its implementation in mental health care

Wichers, M., Peeters, F., Rutten, B. P., Jacobs, N., Derom, C., Thiery, E. et al. (2012). A time-lagged momentary assessment study on daily life physical activity and affect. Health Psychol., 31, 135-144.

OBJECTIVE: Novel study designs using within-subject methodology and frequent and prospective measurements are required to unravel direction of causality and dynamic processes of behavior over time. The current study examined the effects of physical activity on affective state. A primary and within-study replication sample was derived from twin pairs. METHODS: Female twins (n = 504) participated in an experience sampling method study at baseline. Positive and negative affective changes were examined before and following daily life increases in physical activity. Neuroticism was measured at baseline and depressive symptoms were assessed at baseline and at each of four follow-up assessments. Diagnoses, derived by Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Health-IV axis I disorders, (A. P. A., 1994) were obtained at baseline. RESULTS: A significant increase in positive affect (PA) following the moment of increase in physical activity was replicated across both samples up to 180 min after physical activity. There was no effect of physical activity on negative affect (NA). Across the two samples, a history of fulfilling diagnostic criteria for depression at least once moderated the effect of physical activity on PA, in that the effect was lost more rapidly. CONCLUSIONS: The study supports a causal effect of physical activity on PA. However, people with past experience of clinical depression may benefit less from the PA-inducing effect of physical activity. These findings have implications for the use of physical exercise in clinical practice

Wigman, J. T. W., Os, J. v., 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.

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.

Wilcox, T. K., Chen, W. H., Howard, K. A., Wiklund, I., Brooks, J., Watkins, M. L. et al. (2013). Item selection, reliability and validity of the Shortness of Breath with Daily Activities (SOBDA) questionnaire: a new outcome measure for evaluating dyspnea in chronic obstructive pulmonary disease.  Health Qual.Life Outcomes., 11, 196.

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterized by irreversible, progressive obstruction of lung airflow. Dyspnea (shortness of breath [SOB]) is the COPD symptom which most negatively impacts patients’ daily activities. To assess how SOB affects daily activities, 37 items were drafted through focus group discussions and cognitive interviews with COPD patients to develop a patient-reported outcome instrument: the Shortness of Breath with Daily Activities questionnaire (SOBDA). Psychometric analysis was conducted to reduce the number of items and evaluate the measurement properties of the final SOBDA. METHODS: Prospective, observational study of 334 COPD patients, recruited from 24 pulmonology and internal medicine clinics in the United States. The 37-item SOBDA was administered to patients each evening for 28 days using an electronic diary. Patients answered every item and rated their level of SOB experienced that day during specific activities. Item selection was conducted by examining item characteristics, dimensionality, and Rasch model analysis results. The decision to delete an item was based on psychometric evidence, content validity, and expert clinical input. The final SOBDA instrument was evaluated for internal consistency, reproducibility, convergent validity, known-groups validity, and responsiveness. RESULTS: Twenty-four items from the 37-item pool were removed following the item selection process: nine items were removed due to high item-to-item correlations; five due to floor effects; three due to infrequent activity; one due to gender bias; two due to low factor loadings; three due to unordered response options; and one due to expert’s discretion. Internal consistency and reproducibility of the final SOBDA were demonstrated by Cronbach Alpha = 0.87, and intra-class correlation coefficient = 0.91. Convergent validity was demonstrated by high correlation with the CRQ-SAS (0.60) and SGRQ-C (0.61). Known groups validity was demonstrated by significant difference between ratings of the mMRC and clinical global rating of severity. Evaluation of the ability to detect change was not performed owing to too few responders at the end of the study. CONCLUSIONS: Through the empirical item reduction process, 13 items were selected from the 37-item pool generated during qualitative development. The final 13-item SOBDA is a reliable and valid instrument for use in clinical trials

Wilson, S. J., Smyth, J. M., & Maclean, R. R. (2013). Integrating Ecological Momentary Assessment and Functional Brain Imaging Methods: New Avenues for Studying and Treating Tobacco Dependence. Nicotine.Tob.Res..

INTRODUCTION: Ecological momentary assessment (EMA) and related methods typically entail repeatedly and intensively sampling behavior as it occurs over time and under naturalistic conditions. Although the methodological features of EMA make it a highly valuable research technique in its own right, EMA can also be a potent counterpart to other approaches. One methodological partnership with substantial, yet largely untapped, potential for the study of tobacco dependence is the pairing of EMA with functional brain imaging. METHODS: The goal of this review is to outline the promise of this approach, with a focus on the combined use of EMA and functional magnetic resonance imaging (fMRI). Due to the unique and complementary strengths of each method, the merger of EMA and fMRI methods has the potential to advance the understanding of tobacco dependence in ways difficult or impossible to achieve through the use of either method in isolation. RESULTS: In addition to describing a conceptual basis for combining EMA with fMRI, we provide a preliminary empirical illustration of this integrative approach using data from an ongoing study. CONCLUSIONS: EMA and fMRI have independently yielded important findings regarding the nature and treatment of tobacco dependence. The integration of these powerful research methods, however, holds even greater potential for the field of tobacco research. In addition, recent advances are paving the way for the synergistic use of fMRI and EMA-based methods to develop innovative approaches to tobacco cessation

Wrzus, C., Muller, V., Wagner, G. G., Lindenberger, U., & Riediger, M. (2013). Affective and cardiovascular responding to unpleasant events from adolescence to old age: complexity of events matters. Dev.Psychol., 49, 384-397.

Two studies investigated the overpowering hypothesis as a possible explanation for the currently inconclusive empirical picture on age differences in affective responding to unpleasant events. The overpowering hypothesis predicts that age differences in affective responding are particularly evident in highly resource-demanding situations that overtax older adults’ capacities. In Study 1, we used a mobile phone-based experience-sampling technology in 378 participants 14-86 years of age. Participants reported their momentary negative affect and occurrences of unpleasant events on average 54 times over 3 weeks. In Study 2, a subsample of 92 participants wore an ambulatory psycho-physiological monitoring system for 24 hr while pursuing their daily routines and additionally completed an average of 7 mobile phone-based experience-sampling reports. Affective responding was analyzed by comparing, within persons, affective states in situations without and with preceding unpleasant events. Results support the overpowering hypothesis: When dealing with complex unpleasant events that affected multiple life domains, both psychological (Study 1) and cardiovascular (Study 2) responding to unpleasant events were more pronounced the older the participants were. When dealing with circumscribed unpleasant events, however, no age differences in psychological responding were observed (Study 1), and cardiovascular responding was even less pronounced the older the participants were (Study 2). These findings are consistent with the notion of preserved affect regulation throughout adulthood, as long as the resource demands exerted by an event do not overtax the individual’s capacities. We conclude that the overpowering hypothesis can bridge previously opposing positions regarding age differences in affective responding

Xia, Y., Cheung, V., Garcia, E., Ding, H., & Karunaithi, M. (2011). Development of an automated physical activity classification application for mobile phones. Stud.Health Technol.Inform., 168, 188-194.

BACKGROUND: Physical activity classification is an objective approach to assess levels of physical activity, and indicates an individual’s degree of functional ability. It is significant for a number of the disciplines, such as behavioural sciences, physiotherapy, etc. Accelerometry is found to be a practical and low cost method for activity classification that could provide an objective and efficient measurement of people’s daily activities. METHODS: This paper utilises a mobile phone with a built-in tri-axial accelerometer sensor to automatically classify normal physical activities. A rule-based activity classification model, which can recognise 4 common daily activities (lying, walking, sitting, and standing) and 6 transitions between postural orientations, is introduced here. In this model, three types of statuses (walking/ transition, lying, and sitting/standing) are first classified based on the kinetic energy and upright angle. Transitions are then separated from walking and assigned to the corresponding type using upright angle algorithm. To evaluate the performance of this developed application, a trial is designed with 8 healthy adult subjects, who are required to perform a 6-minute activity routine with an iPhone fixed at the waist position. RESULTS: Based on the evaluation result, our application measures the length of time of each activity accurately and the achieved sensitivity of each activity classification exceeds 90% while the achieved specificity exceeds 96%. Meanwhile, regarding the transition identification, the sensitivities are high in stand-to-sit (80%) and low in sit-to-stand (56%)

Yeung, D. Y., Fung, H. H., & Chan, D. K. (2013). Positive Effect of Social Work-Related Values on Work Outcomes: The Moderating Role of Age and Work Situation. J.Gerontol.B Psychol.Sci.Soc.Sci..

Objectives. This study investigated the effect of social work-related values on job performance through job satisfaction and tested whether age and work situation would moderate such associations.Methods. This study consists of two parts: Part 1 is a cross-sectional survey among 299 Chinese clerical employees aged 19-60 years and Part 2 is a 14-day experience sampling study in a subsample of Part 1 (N = 67).Results and Discussion. Part 1 revealed that age moderated the effect of social work-related values on job performance through job satisfaction, with a stronger positive effect in older workers than in younger workers. Part 2 demonstrated that the moderating effect of age shown in Part 1 also varied across work situations. In particular, holding momentary social work-related values was beneficial to the task performance of older workers, and the effect was significantly stronger when they were in social situations than in nonsocial situations, whereas the effect remained weak among younger workers regardless of work context. Moreover, the moderating effect of age could be accounted for by future time perspective. This study supports socioemotional selectivity theory that goal orientation shifts toward the emphasis of interpersonal closeness when one perceives future time as increasingly limited

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