Society for Ambulatory Assessment

Second quarter 2012 (April to June)

Aan Het, R. M., Hogenelst, K., & Schoevers, R. A. (2012). Mood disorders in everyday life: A systematic review of experience sampling and ecological momentary assessment studies. Clin.Psychol.Rev., 32, 510-523.

In the past two decades, the study of mood disorder patients using experience sampling methods (ESM) and ecological momentary assessment (EMA) has yielded important findings. In patients with major depressive disorder (MDD), the dynamics of their everyday mood have been associated with various aspects of their lives. To some degree similar studies have been conducted in patients with bipolar disorder (BD). In this paper we present the results of a systematic review of all ESM/EMA studies in MDD and BD to date. We focus not only on the correlates of patients’ everyday mood but also on the impact on treatment, residual symptoms in remitted patients, on findings in pediatric populations, on MDD/BD specificity, and on links with neuroscience. After reviewing these six topics, we highlight the benefits of ESM/EMA for researchers, clinicians, and patients, and offer suggestions for future studies

Agiovlasitis, S., Motl, R. W., Foley, J. T., & Fernhall, B. (2012). Prediction of energy expenditure from wrist accelerometry in people with and without Down syndrome. Adapt.Phys.Activ.Q., 29, 179-190.

This study examined the relationship between energy expenditure and wrist accelerometer output during walking in persons with and without Down syndrome (DS). Energy expenditure in metabolic equivalent units (METs) and activity-count rate were respectively measured with portable spirometry and a uniaxial wrist accelerometer in 17 persons with DS (age: 24.7+/-6.9 years; 9 women) and 21 persons without DS (age: 26.3+/-5.2 years; 12 women) during six over-ground walking trials. Combined groups regression showed that the relationship between METs and activity-count rate differed between groups (p<.001). Separate models for each group included activity-count rate and squared activity-count rate as significant predictors of METs (p</=.005). Prediction of METs appeared accurate based on Bland-Altman plots and the lack of between-group difference in mean absolute prediction error (DS: 17.07%; Non-DS: 18.74%). Although persons with DS show altered METs to activity-count rate relationship during walking, prediction of their energy expenditure from wrist accelerometry appears feasible

Alschuler, K. N., Hoodin, F., Murphy, S. L., Rice, J., & Geisser, M. E. (2011). Factors contributing to physical activity in a chronic low back pain clinical sample: A comprehensive analysis using continuous ambulatory monitoring. <em>Pain, 152, 2521-2527.

Back pain is one of the most common causes of disability in industrialized nations. Despite this, the variables that contribute to disability are not well understood and optimal measurement strategies of disability have not yet been determined. The present study sought to comprehensively assess the strongest predictors of physical activity as a proxy for disability. New patients in a chronic pain specialty clinic completed questionnaires to assess the predictors of physical activity and engaged in 5 days of home data collection wearing an accelerometer to assess physical activity in daily life, which is how disability was operationalized in this study. Analysis of repeated measures patient data revealed that, of 3 composite variables each representing a theoretical model, the model representative of operant factors significantly predicted physical activity. Subsequent analyses showed that pain sensitivity, fear avoidance, and solicitous spousal responses account for a significant amount of the variance in physical activity. These findings suggest that external sources of reinforcement or punishment may serve to influence physical behavior beyond that of internal cues such as fear avoidance or pain. Implications for treatment are discussed, including the potential benefits of specifically incorporating the patient’s sources of operant reinforcement or punishment into treatment.

Augustine, A. A. & Larsen, R. J. (2012). Is a trait really the mean of states? Similarities and differences between traditional and aggregate assessments of personality. Journal of Individual Differences, 33, 131-137.

Although several definitions exist, a personality trait can be defined as the average or expected value of personality-relevant behaviors. However, recent evidence suggests that, while trait questionnaires and aggregated momentary assessments of personality are highly related, they may also differ in meaningful ways. In this study, we examine the relationship between trait and mean state personality. Results indicate that these two assessment strategies, although highly related, do not show convergence (r = .39-.64) levels that would signify an equity of constructs. In line with this, these two assessment strategies show differential predictive utility. Although the pattern of this differential predictive utility suggests that measurement error may account for differences, the difference between trait and mean state personality predicts affect in a manner consistent with self-discrepancy theory. Thus, although these two constructs are highly related, the differences between trait and mean state personality are meaningful.

Ayabe, M., Aoki, J., Kumahara, H., & Tanaka, H. (2012). Age-related differences in daily physical activity divided by bout duration: Preliminary findings in female convenience samples. Journal of Sports Sciences, 30, 709-713.

The purpose of the present investigation was to clarify the relationship between age and bout duration of physical activity (PA) under free-living conditions in female adults. Forty-three females wore an accelerometer (Lifecorder) for seven consecutive days in order to determine the time spent in PA at light intensity (LPA), at moderate intensity (MPA), and at vigorous intensity (VPA). The PA was divided according to the bout duration, such as PA lasting longer than 16 s, 32 s, 60 s, 3 min, >5 min, and >10 min (PA16s, PA32s, PA1m, PA3m, PA5m, PA10m). The time for LPA32s, LPA1m, MPA16s, VPA16s, and the total time for MPA and VPA were significantly associated with age (P < 0.05). There were no significant associations between age and PA lasting >60 s, regardless of intensity category. The results of the present pilot study suggest that the age-associated differences in PA occur mainly in PA lasting 1 min or shorter duration.

Bak, M., Drukker, M., van Os, J., Delespaul, P., & Myin-Germeys, I. (2012). Daily life moment-to-moment variation in coping in people with a diagnosis of schizophrenia: State within trait psychosis. Psychosis: Psychological, Social and Integrative Approaches, 4, 115-125.

Introduction: Coping is a dynamic concept, associated with variability in stress and the individual’s response. It was hypothesized that coping responses vary from moment to moment in daily life in individuals diagnosed with schizophrenia. Methods: Patients diagnosed with schizophrenia (n = 25) were studied using the Experience Sampling Method to assess ongoing coping. Three subcategories of coping, social (interaction with environment), activity (behaviour to relief stress) and abuse (use of substances to deal with stress) were combined in a single coping variable expressed both dichotomously (present or not, representing frequency) and dimensionally (representing intensity). Results: The frequency of coping did not vary over the day with exception of abuse coping variance: 0.48; 95% CI 0.02-10.5). In contrast, the intensity of coping did vary during the day, except for abuse coping (coping combined variance = 0.05, 95% CI 0.01-0.20; social coping variance = 0.13, 95% CI 0.04GÇô0.39; and activity coping variance = 0.10, 95% CI 0.02GÇô0.51). Conclusion: In patients with schizophrenia, coping is stable from moment to moment, indicating a trait mechanism. However, coping varies in intensity, which refers to state properties of coping. Validity problems may arise if studies do not consider the partial variability of coping.

Bauer, S. & Moessner, M. (2012). Technology-enhanced monitoring in psychotherapy and e-mental health. J Ment.Health.

Advances in technology increasingly facilitate data collection in the context of psychosocial and psychotherapeutic care. Such technology-enhanced assessments (e.g. via Internet-based systems and mobile devices) open new perspectives for research into processes related to mental health and well-being. The use of this knowledge for the development and refinement of (online and face-to-face) therapeutic interventions promises to contribute to an optimization of care. The aim of this paper is to provide an overview on how information and communication technologies may be used (a) to improve our understanding of illness development and recovery through longitudinal technology-enhanced assessment of symptoms and behaviors (e.g. outcome monitoring and ecological momentary assessment) and (b) to optimize care for mental disorders by integrating such monitoring assessments in specific interventions (e.g. ecological momentary interventions and supportive monitoring) in face-to-face or e-mental health settings

Bergh, I. H., Grydeland, M., Bjelland, M., Lien, N., Andersen, L. F., Klepp, K.-I. et al. (2011). Personal and social-environmental correlates of objectively measured physical activity in Norwegian pre-adolescent children. Scandinavian Journal of Medicine & Science in Sports, 21, e315-e324.

The aim of this study was to examine modifiable biological, psychological, behavioral and social-environmental correlates of physical activity among 1129 Norwegian 11-year-old children within a cross-sectional sample from the HEalth In Adolescents study. Physical activity was assessed by accelerometer, and weight and height were measured objectively. Age- and gender-specific cut-off points proposed by the International Obesity Task Force were used to define body mass index. Social-environmental variables were self-reported by questionnaire. Hierarchical regression (linear mixed models) revealed that normal weight children scored higher on percentage daily moderate-to-vigorous physical activity [% daily moderate to vigorous physical activity (MVPA)] than overweight/obese children (P < 0.001). Self-efficacy (P < 0.01) and perceived social support from friends (P < 0.01) were positively associated with children’s % daily MVPA, and a negative association was found for computer/game-use on weekends (P < 0.01). A moderator effect of weight category (normal vs overweight/obese) in the relationship between computer/game-use on weekends and % daily MVPA was detected (P < 0.05), reflecting that higher computer/game-use on weekends was associated with lower % MVPA among the overweight/obese, but not among the normal weight. Modifiable correlates from multiple domains accounted for 14% of the variance in % daily MVPA. Prospective and intervention studies are needed to examine whether these factors act as mediators for physical activity change in pre-adolescent children.

Bexelius, C., Sandin, S., Lagerros, Y. T., Litton, J. E., & Löf, M. (2011). Estimation of physical activity levels using cell phone questionnaires: A comparison with accelerometry for evaluation of between-subject and within-subject variations. Journal of Medical Internet Research, 13, 186-191.

Background: Physical activity promotes health and longevity. Further elaboration of the role of physical activity for human health in epidemiological studies on large samples requires accurate methods that are easy to use, cheap, and possible to repeat. The use of telecommunication technologies such as cell phones is highly interesting in this respect. In an earlier report, we showed that physical activity level (PAL) assessed using a cell phone procedure agreed well with corresponding estimates obtained using the doubly labeled water method. However, our earlier study indicated high within-subject variation in relation to between-subject variations in PAL using cell phones, but we could not assess if this was a true variation of PAL or an artifact of the cell phone technique. Objective: Our objective was to compare within- and between-subject variations in PAL by means of cell phones with corresponding estimates using an accelerometer. In addition, we compared the agreement of daily PAL values obtained using the cell phone questionnaire with corresponding data obtained using an accelerometer. Methods: PAL was measured both with the cell phone questionnaire and with a triaxial accelerometer daily during a 2-week study period in 21 healthy Swedish women (20 to 45 years of age and BMI from 17.7 kg/m-¦ to 33.6 kg/m-¦). The results were evaluated by fitting linear mixed effect models and descriptive statistics and graphs. Results: With the accelerometer, 57% (95% confidence interval [CI] 40%-66%) of the variation was within subjects, while with the cell phone, within-subject variation was 76% (95% CI 59%-83%). The day-to-day variations in PAL observed using the cell phone questions agreed well with the corresponding accelerometer results. Conclusions: Both the cell phone questionnaire and the accelerometer showed high within-subject variations. Furthermore, day-to-day variations in PAL within subjects assessed using the cell phone agreed well with corresponding accelerometer values. Consequently, our cell phone questionnaire is a promising tool for assessing levels of physical activity. The tool may be useful for large-scale prospective studies.

Bowen, K. S., Birmingham, W., Uchino, B. N., Carlisle, M., Smith, T. W., & Light, K. C. (2012). Specific dimensions of perceived support and ambulatory blood pressure: Which support functions appear most beneficial and for whom? Int.J Psychophysiol..

Perceived support has been related to lower cardiovascular morbidity and mortality. However, little is known about the specific functional components of support responsible for such links. We tested if emotional, informational, tangible, and belonging support predicted ambulatory blood pressure (ABP) and interpersonal interactions (e.g., responsiveness), and if such links were moderated by gender. In this study, 94 married couples underwent 12h of ABP monitoring during daily life which included a night at home with their spouse. They completed a short-form of the interpersonal support evaluation list that provides information on total (global) support, as well as specific dimensions of support. Results revealed that global support scores did not predict ABP during daily life. However, separating out distinct support components revealed that emotional support was a significant predictor of lower ambulatory systolic and diastolic blood pressure, primarily for women. Finally, emotional support predicted greater partner responsiveness and self-disclosure, along with less perceived partner negativity although these results were not moderated by gender. These data are discussed in terms of the importance of considering specific support components and the contextual processes that might influence such links

Buchman, A. S., Boyle, P. A., Yu, L., Shah, R. C., Wilson, R. S., & Bennett, D. A. (2012). Total daily physical activity and the risk of AD and cognitive decline in older adults. Neurology, 78, 1323-1329.

OBJECTIVE: Studies examining the link between objective measures of total daily physical activity and incident Alzheimer disease (AD) are lacking. We tested the hypothesis that an objective measure of total daily physical activity predicts incident AD and cognitive decline. METHODS: Total daily exercise and nonexercise physical activity was measured continuously for up to 10 days with actigraphy (Actical(R); Philips Healthcare, Bend, OR) from 716 older individuals without dementia participating in the Rush Memory and Aging Project, a prospective, observational cohort study. All participants underwent structured annual clinical examination including a battery of 19 cognitive tests. RESULTS: During an average follow-up of about 4 years, 71 subjects developed clinical AD. In a Cox proportional hazards model adjusting for age, sex, and education, total daily physical activity was associated with incident AD (hazard ratio = 0.477; 95% confidence interval 0.273-0.832). The association remained after adjusting for self-report physical, social, and cognitive activities, as well as current level of motor function, depressive symptoms, chronic health conditions, and APOE allele status. In a linear mixed-effect model, the level of total daily physical activity was associated with the rate of global cognitive decline (estimate 0.033, SE 0.012, p = 0.007). CONCLUSIONS: A higher level of total daily physical activity is associated with a reduced risk of AD

Buckner, J. D., Crosby, R. D., Wonderlich, S. A., & Schmidt, N. B. (2012). Social anxiety and cannabis use: An analysis from ecological momentary assessment. Journal of Anxiety Disorders, 26, 297-304.

Individuals with elevated social anxiety appear especially vulnerable to cannabis-related problems, yet little is known about the antecedents of cannabis-related behaviors among this high-risk population. The present study used ecological momentary assessment (EMA) to examine the relations among social anxiety, cannabis craving, state anxiety, situational variables, and cannabis use in the natural environment during ad-lib cannabis use episodes. Participants were 49 current cannabis users. During the two-week EMA period, social anxiety significantly interacted with cannabis craving to predict cannabis use both cross-sectionally and prospectively. Specifically, individuals with higher social anxiety and craving were most likely to use cannabis. There was a significant social anxiety x state anxiety x others’ use interaction such that when others were using cannabis, those with elevations in both trait social anxiety and state anxiety were the most likely to use cannabis.

Catalino, L. I., Furr, R. M., & Bellis, F. A. (2012). A multilevel analysis of the self-presentation theory of social anxiety: Contextualized, dispositional, and interactive perspectives. Journal of Research in Personality.

According to self-presentation theory, social anxiety is determined by impression motivation and impression efficacy. However, researchers have not evaluated the theory’s applicability from contextual and dispositional perspectives in an integrated manner, nor have they examined a fundamental interactive facet of the theory. In three studies, we examined these issues using hypothetical situations and experience sampling methodology. Results demonstrated the theory’s applicability at the contextual and dispositional level, providing insight into people’s general tendencies to experience social anxiety and their momentary experiences of social anxiety. Results also revealed the predicted interaction between impression motivation and impression efficacy - high impression efficacy weakens the association between impression motivation and social anxiety. These studies expand understanding of the personological and situational factors that drive social anxiety.

Celis-Morales, C. A., Perez-Bravo, F., Ibanez, L., Salas, C., Bailey, M. E., & Gill, J. M. (2012). Objective vs. self-reported physical activity and sedentary time: effects of measurement method on relationships with risk biomarkers. PLoS One, 7, e36345.

PURPOSE: Imprecise measurement of physical activity variables might attenuate estimates of the beneficial effects of activity on health-related outcomes. We aimed to compare the cardiometabolic risk factor dose-response relationships for physical activity and sedentary behaviour between accelerometer- and questionnaire-based activity measures. METHODS: Physical activity and sedentary behaviour were assessed in 317 adults by 7-day accelerometry and International Physical Activity Questionnaire (IPAQ). Fasting blood was taken to determine insulin, glucose, triglyceride and total, LDL and HDL cholesterol concentrations and homeostasis model-estimated insulin resistance (HOMA(IR)). Waist circumference, BMI, body fat percentage and blood pressure were also measured. RESULTS: For both accelerometer-derived sedentary time (<100 counts.min(-1)) and IPAQ-reported sitting time significant positive (negative for HDL cholesterol) relationships were observed with all measured risk factors-i.e. increased sedentary behaviour was associated with increased risk (all p </= 0.01). However, for HOMA(IR) and insulin the regression coefficients were >50% lower for the IPAQ-reported compared to the accelerometer-derived measure (p<0.0001 for both interactions). The relationships for moderate-to-vigorous physical activity (MVPA) and risk factors were less strong than those observed for sedentary behaviours, but significant negative relationships were observed for both accelerometer and IPAQ MVPA measures with glucose, and insulin and HOMA(IR) values (all p<0.05). For accelerometer-derived MVPA only, additional negative relationships were seen with triglyceride, total cholesterol and LDL cholesterol concentrations, BMI, waist circumference and percentage body fat, and a positive relationship was evident with HDL cholesterol (p = 0.0002). Regression coefficients for HOMA(IR), insulin and triglyceride were 43-50% lower for the IPAQ-reported compared to the accelerometer-derived MVPA measure (all p</=0.01). CONCLUSION: Using the IPAQ to determine sitting time and MVPA reveals some, but not all, relationships between these activity measures and metabolic and vascular disease risk factors. Using this self-report method to quantify activity can therefore underestimate the strength of some relationships with risk factors

Choi, L., Ward, S. C., Schnelle, J. F., & Buchowski, M. S. (2012). Assessment of Wear/Nonwear Time Classification Algorithms for Triaxial Accelerometer. <em>Med.Sci.Sports Exerc..

PURPOSE: To assess performance of existing wear/nonwear time classification algorithms for accelerometry data collected in the free-living environment using a wrist-worn triaxial accelerometer and a waist-worn uniaxial accelerometer in older adults. METHODS: Twenty-nine adults aged 76 to 96 years wore wrist accelerometers for approximately 24-h per day and waist accelerometers during waking for approximately 7 days of free-living. Wear and nonwear times were classified by existing algorithms (Alg[Actilife], Alg[Troiano] and Alg[Choi]) and compared with wear and nonwear times identified by data plots and diary records. Using bias and probability of correct classification, performance of the algorithms, two time-windows (60- and 90-min), andvector magnitude (VM) vs. vertical axis (V) counts from a triaxial accelerometer, were compared. RESULTS: Automated algorithms (Alg[Choi] and Alg[Troiano]) classified wear/nonwear time intervals more accurately from VM than V counts. The use of 90-min time window improved wear/nonwear classification accuracy when compared with the 60-min window. The Alg[Choi] and Alg[Troiano] performed better than the manufacturer-provided algorithm (Alg[Actilife]), and Alg[Choi] performed better than Alg[Troiano] for wear/nonwear time classification using data collected by both accelerometers. CONCLUSIONS: Triaxial wrist-worn accelerometer can be used for an accurate wear/nonwear time classification in free-living older adults. The use of 90-min window and VM counts improves performance of commonly used algorithms for wear/nonwear classification for both uniaxial and triaxial accelerometers

Cohn, A. M., Hunter-Reel, D., Hagman, B. T., & Mitchell, J. (2011). Promoting behavior change from alcohol use through mobile technology: The future of ecological momentary assessment. Alcoholism: Clinical and Experimental Research, 35, 2209-2215.

Background: Interactive and mobile technologies (i.e., smartphones such as Blackberries, iPhones, and palm-top computers) show promise as an efficacious and cost-effective means of communicating health-behavior risks, improving public health outcomes, and accelerating behavior change. The present study was conducted as a “needs assessment” to examine the current available mobile smartphone applications (e.g., apps) that utilize principles of ecological momentary assessment (EMA)-daily self-monitoring or near real-time self-assessment of alcohol-use behavior-to promote positive behavior change, alcohol harm reduction, psycho-education about alcohol use, or abstinence from alcohol. Methods: Data were collected and analyzed from iTunes for Apple iPhone[sup]©[/sup]. An inventory assessed the number of available apps that directly addressed alcohol use and consumption, alcohol treatment, or recovery, and whether these apps incorporated empirically based components of alcohol treatment. Results: Findings showed that few apps addressed alcohol-use behavior change or recovery. Aside from tracking drinking consumption, a minority utilized empirically based components of alcohol treatment. Some apps claimed they could serve as an intervention; however, no empirical evidence was provided. Conclusions: More studies are needed to examine the efficacy of mobile technology in alcohol intervention studies. The large gap between availability of mobile apps and their use in alcohol treatment programs indicates several important future directions for research.

Coifman, K. G., Berenson, K. R., Rafaeli, E., & Downey, G. (2012). From Negative to Positive and Back Again: Polarized Affective and Relational Experience in Borderline Personality Disorder. J Abnorm.Psychol..

A core feature of borderline personality disorder (BPD) is the tendency to evaluate one’s experience with extreme polarity (i.e., feeling all good or all bad; Beck, Freeman, & Davis, 2004; Kernberg, 1975; Linehan, 1993). In this investigation, we examined the polarity of within-person reports of experience in individuals with BPD and healthy adults over the course of a 21-day, experience-sampling diary. We applied multilevel modeling techniques (Rafaeli, Rogers, & Ravelle, 2007) to capture the within-person covariance of momentary reports of negative and positive features of experience, either affective or relational. Our data indicated significantly greater polarity in reports of affective and relational experiences in BPD that increased during heightened interpersonal stress. We also examined the association of affective and relational polarity to reports of impulsive behaviors (e.g., self-injury, substance use, etc.) and found evidence that increased polarity in reports of affective (in low-stress contexts) and relational experiences (in high-stress contexts) predicted increased rate of reports of impulsive behaviors. Together, these data present strong evidence for the role of polarized experiences in BPD, and have implications for the treatment of individuals with this disorder.

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. Journal of Pediatric Psychology, 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 (J1A). 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.

Conner, T. S. & Barrett, L. F. (2012). Trends in ambulatory self-report: the role of momentary experience in psychosomatic medicine. Psychosom.Med., 74, 327-337.

In this article, we review the differences between momentary, retrospective, and trait self-report techniques and discuss the unique role that ambulatory reports of momentary experience play in psychosomatic medicine. After a brief historical review of self-report techniques, we discuss the latest perspective that links ambulatory self-reports to a qualitatively different conscious self-the “experiencing self”-which is functionally and neuroanatomically different from the “remembering” and “believing” selves measured through retrospective and trait questionnaires. The experiencing self functions to navigate current environments and is relatively more tied to the salience network and corporeal information from the body that regulates autonomic processes. As evidence, we review research showing that experiences measured through ambulatory assessment have stronger associations with cardiovascular reactivity, cortisol response, immune system function, and threat/reward biomarkers compared with memories or beliefs. By contrast, memories and beliefs play important roles in decision making and long-term planning, but they are less tied to bodily processes and more tied to default/long-term memory networks, which minimizes their sensitivity for certain research questions. We conclude with specific recommendations for using self-report questionnaires in psychosomatic medicine and suggest that intensive ambulatory assessment of experiences may provide greater sensitivity for connecting psychological with biologic processes

Crayen, C., Eid, M., Lischetzke, T., Courvoisier, D. S., & Vermunt, J. K. (2012). Exploring dynamics in mood regulation-mixture latent Markov modeling of ambulatory assessment data. Psychosom.Med., 74, 366-376.

OBJECTIVE: To illustrate how fluctuation patterns in ambulatory assessment data with features such as few categorical items, measurement error, and heterogeneity in the change pattern can adequately be analyzed with mixture latent Markov models. The identification of fluctuation patterns can be of great value to psychosomatic research concerned with dysfunctional behavior or cognitions, such as addictive behavior or noncompliance. In our application, unobserved subgroups of individuals who differ with regard to their mood regulation processes, such as mood maintenance and mood repair, are identified. METHODS: In an ambulatory assessment study, mood ratings were collected 56 times during 1 week from 164 students. The pleasant-unpleasant mood dimension was assessed by the two ordered categorical items unwell-well and bad-good. Mixture latent Markov models with different number of states, classes, and degrees of invariance were tested, and the best model according to information criteria was interpreted. RESULTS: Two latent classes that differed in their mood regulation pattern during the day were identified. Mean classification probabilities were high (>0.88) for this model. The larger class showed a tendency to stay in and return to a moderately pleasant mood state, whereas the smaller class was more likely to move to a very pleasant mood state and to stay there with a higher probability. CONCLUSIONS: Mixture latent Markov models are suitable to obtain information about interindividual differences in stability and change in ambulatory assessment data. Identified mood regulation patterns can serve as reference for typical mood fluctuation in healthy young adults

Dunton, G. F., Intille, S. S., Wolch, J., & Pentz, M. A. (2012). Children’s perceptions of physical activity environments captured through ecological momentary assessment: A validation study. Prev.Med..

OBJECTIVE: This study used ecological momentary assessment (EMA) to investigate whether children’s perceptions of physical activity (PA) settings correspond with (1) parents’ perceptions of neighborhood characteristics (convergent construct validity) and (2) children’s level of PA in those settings (concurrent criterion validity). METHODS: Low-to-middle income, ethnically-diverse children (N=108) (ages 9-13) living in Southern California participated in 8days of EMA during non-school time. EMA measured current activity type (e.g., sports/exercise, TV watching) and perceptions of the current setting (i.e., vegetation, traffic, safety). The Neighborhood Environment Walkability Survey (NEWS) assessed parents’ perceptions of neighborhood characteristics. EMA responses were time-matched to moderate-to-vigorous physical activity (MVPA) (measured by accelerometer) in the 30min before and after each EMA survey. Data were collected in 2009-2010. RESULTS: Children’s perceptions of vegetation and traffic in PA settings corresponded with parents’ perceptions of the aesthetics (OR=2.21, 95% CI=1.04-4.73) and traffic (OR=2.64, 95% CI=1.31-5.30) in neighborhood environment, respectively. MVPA minutes were higher in settings perceived by children to have less traffic (beta=3.47, p<.05). CONCLUSIONS: This work provides initial support for the construct and criterion validity of EMA-based measures of children’s perceptions of their PA environments

Ellis-Davies, K., Sakkalou, E., Fowler, N. C., Hilbrink, E. E., & Gattis, M. (2012). CUE: The continuous unified electronic diary method.  Behav.Res Methods.

In the present article, we introduce the continuous unified electronic (CUE) diary method, a longitudinal, event-based, electronic parent report method that allows real-time recording of infant and child behavior in natural contexts. Thirty-nine expectant mothers were trained to identify and record target behaviors into programmed handheld computers. From birth to 18 months, maternal reporters recorded the initial, second, and third occurrences of seven target motor behaviors: palmar grasp, rolls from side to back, reaching when sitting, pincer grip, crawling, walking, and climbing stairs. Compliance was assessed as two valid entries per behavior: 97 % of maternal reporters met compliance criteria. Reliability was assessed by comparing diary entries with researcher assessments for three of the motor behaviors: palmar grasp, pincer grip and walking. A total of 81 % of maternal reporters met reliability criteria. For those three target behaviors, age of emergence was compared across data from the CUE diary method and researcher assessments. The CUE diary method was found to detect behaviors earlier and with greater sensitivity to individual differences. The CUE diary method is shown to be a reliable methodological tool for studying processes of change in human development

Engeser, S. & Schiepe-Tiska, A. (2012). Historical lines and an overview of current research on flow. In S.Engeser (Ed.), Advances in flow research (pp. 1-22). New York, NY US: Springer Science + Business Media.

(from the chapter) This chapter introduces the flow concept by listing the components of flow as provided by Csikszentmihalyi. We will show that these components constitute the widely shared definitional ground of researchers in the field, with only minor variation between research groups and time periods. Next, we try to clarify some lingering ambiguities regarding the components of flow, and then talk about flow as an optimal experience as well as discussing flow and happiness. Subsequently, we trace the history of flow. We take time to describe the beginnings of flow research by Csikszentmihalyi and a similar research program by Rheinberg in Germany. Following the description of flow and qualitative analyses, the quantitative method of the experience sampling method (ESM), which has greatly influenced research on flow, will be presented. Creativity and well-being remain an important part of flow research and will be considered here, but flow research has entered many other areas, spanning from a strong emphasis on sport, learning, and flow at work to the emerging research on flow in teams and social interaction or psychophysiological correlates of flow. Finally, we complete this chapter by exploring methodological aspects of the research on flow.

Epstein, D. H. & Preston, K. L. (2012). TGI Monday?: drug-dependent outpatients report lower stress and more happiness at work than elsewhere. Am.J Addict., 21, 189-198.

In the general population, experience-sampling studies show that work is the aspect of daily life most associated with momentary unhappiness and a desire to be elsewhere. We assessed whether this holds true for urban outpatients in treatment for heroin and cocaine dependence. In a 25-week natural-history study, 79 employed methadone-maintained misusers of heroin and cocaine carried electronic diaries on which mood and behavior were assessed up to five times per day. Being at work was associated with lower stress, greater happiness, and lower drug craving. Work accounted for 14% of the variance in stress, 30% of the variance in happiness, and 50% of the variance in cocaine craving. Participants with skilled jobs reported more positive and less negative mood states (and lower cocaine craving) at all times compared to participants with semi/unskilled jobs, although the latter reported greater mood improvement at work. In all participants, mood improvements occurred specifically in the presence of coworkers (not other companions). Our seemingly unusual findings might be specific to substance-disorder patients (for whom work may be a respite from drug-using companions), but might also hold for other urban dwellers of similar socioeconomic backgrounds (for whom work may be a respite from environmental stressors)

Evans, C. C., Hanke, T. A., Zielke, D., Keller, S., & Ruroede, K. (2012). Monitoring community mobility with global positioning system technology after a stroke: a case study. J Neurol.Phys.Ther., 36, 68-78.

BACKGROUND: Stroke survivors often experience difficulty returning to activities and places they deem important to their social, leisure, and occupational aspirations. The extent to which stroke survivors return to community mobility and their ability to navigate and access locations they deem meaningful have not been objectively measured. PURPOSE: We used global positioning system technology (GPSt) to measure the community mobility of a person poststroke, and assess the relationship between GPSt measures and clinical measures of mobility. METHODS: : The participant was a 56-year-old man who sustained a right pontine stroke. At discharge from rehabilitation, his Six-Minute Walk Test distance was 73 m. He was fitted with a GPS unit and an accelerometer attached to a single belt and instructed to wear the devices at all times when out of bed. After identifying 10 locations that were important to his goals, he was monitored for 5 separate 1-week periods, on the first, fifth, and ninth weeks and at 6 and 12 months after discharge. RESULTS: During the first 10 weeks, he averaged 7.6 target visits (70%) and 26.7 trips per week. At 1 year, his Six-Minute Walk distance score was 287.5 m. Accelerometry data revealed that he remained primarily sedentary. Target visits and trips per week did not change substantially over the course of 1 year, and compliance wearing the GPS unit was variable. CONCLUSIONS: Given the limited correlation in gait speed and distance with target attainment and trips, these outcomes likely measure different constructs for this subject. GPSt may offer insights into participation for stroke survivors following rehabilitation

Faulkner, H. J., Arima, H., & Mohamed, A. (2012). Latency to first interictal epileptiform discharge in epilepsy with outpatient ambulatory EEG. Clin.Neurophysiol..

OBJECTIVE: The diagnosis and classification of epilepsy often relies upon the demonstration of interictal epileptiform discharges (IEDs). Routine 20-min EEG recording has low sensitivity, with multiple EEGs increasing sensitivity to a maximum of 77% (Doppelbauer et al., 1993). An alternate strategy is the use of prolonged continuous EEG; however, there are no data on the average latency to first IED with ambulatory monitoring. METHODS: In this retrospective study we reviewed 180 consecutive patients with epilepsy referred to a Specialist Epilepsy Unit who had undergone 96h outpatient ambulatory EEGs, without medication withdrawal, where IEDs were recorded. Latency to, and factors affecting first IED were analysed. RESULTS: Median latency to first IED was 316min, (interquartile range 70-772min, n=180). IEDs were recorded in 44% of patients within 4h, 58% within 8h, 85% within 24h and 95% within 48h. Recording for the full 96h period revealed only 5% further IEDs. Multivariate analysis showed the latencies to IEDs with generalised epilepsies were shorter than with focal epilepsies (p<0.0001). CONCLUSIONS: In 95% of patients showing scalp IEDs a 48h recording was sufficient for electro-clinical classification in this study. SIGNIFICANCE: Our data are the first to show the latency to recording interictal epileptiform discharges with prolonged outpatient EEG monitoring. These data are important in guiding diagnostic practice in Specialist Epilepsy Services

Finan, P. H., Tennen, H., Thoemmes, F., Zautra, A. J., & Davis, M. C. (2012). Ambulatory monitoring in the genetics of psychosomatic medicine. Psychosom.Med., 74, 349-355.

Psychosomatic disorders are composed of an array of psychological, biologic, and environmental features. The existing evidence points to a role for genetic factors in explaining individual differences in the development and maintenance of a variety of disorders, but studies to date have not shown consistent and replicable effects. As such, the attempt to uncover individual differences in the expression of psychosomatic disorders as a function of genetic architecture requires careful attention to their phenotypic architecture or the various intermediate phenotypes that make up a heterogeneous disorder. Ambulatory monitoring offers a novel approach to measuring time-variant and situation-dependent intermediate phenotypes. Recent examples of the use of ambulatory monitoring in genetic studies of stress reactivity, chronic pain, alcohol use disorders, and psychosocial resilience are reviewed in an effort to highlight the benefits of ambulatory monitoring for genetic study designs

Galland, B. C., Kennedy, G. J., Mitchell, E. A., & Taylor, B. J. (2012). Algorithms for using an activity-based accelerometer for identification of infant sleep-wake states during nap studies. Sleep Med., 13, 743-751.

OBJECTIVE: To determine the accuracy of using different algorithms on the output from an Actical accelerometer, a device normally used to measure physical activity, to distinguish sleep from wake states. METHODS: Thirty-one infants aged 10-22weeks wore the accelerometer on the shin for a daytime nap recording in tandem with polysomnography. Sleep-wake epochs were identified using four computations/algorithms: the zero-threshold computation, two common algorithms used for wrist-based devices (Sadeh and Cole), and a new algorithm developed for this study (count-scaled). Accuracy was examined in direct epoch comparison with polysomnography using 15-, 30- and 60-s sampling epochs. RESULTS: Overall agreements (accuracy) for sleep-wake states were >80% for all computations. The count-scaled algorithm sampling 15-s epochs gave the highest accuracy, with sensitivity (sleep agreement) at 86% and specificity (awake agreement) at 85%. Other computations yielded higher sensitivity at the expense of specificity. Another way to assess the accuracy of identification of sleep-wake states was to compare sleep parameter outputs. All computations and sampling epochs were significantly correlated with total sleep time (r=0.76-0.88), sleep latency (r=0.70-0.93), sleep efficiency (r=0.76-0.87), and wake time after sleep onset (r=0.41-0.53). The number of awakenings after sleep onset was overestimated by accelerometry. CONCLUSIONS: The Actical accelerometer, designed to measure physical activity, can reliably identify sleep in infants during napping, with the count-scaled algorithm showing some advantages over other methods for accurate identification of sleep-wake epochs

Galvez, G., Turbin, M. B., Thielman, E. J., Istvan, J. A., Andrews, J. A., & Henry, J. A. (2012). Feasibility of ecological momentary assessment of hearing difficulties encountered by hearing aid users. Ear Hear., 33, 497-507.

OBJECTIVES: : Measurement of outcomes has become increasingly important to assess the benefit of audiologic rehabilitation, including hearing aids, in adults. Data from questionnaires, however, are based on retrospective recall of events and experiences, and often can be inaccurate. Questionnaires also do not capture the daily variation that typically occurs in relevant events and experiences. Clinical researchers in a variety of fields have turned to a methodology known as ecological momentary assessment (EMA) to assess quotidian experiences associated with health problems. The objective of this study was to determine the feasibility of using EMA to obtain real-time responses from hearing aid users describing their experiences with challenging hearing situations. DESIGN: : This study required three phases: (1) develop EMA methodology to assess hearing difficulties experienced by hearing aid users; (2) make use of focus groups to refine the methodology; and (3) test the methodology with 24 hearing aid users. Phase 3 participants carried a personal digital assistant 12 hr per day for 2 weeks. The personal digital assistant alerted participants to respond to questions four times a day. Each assessment started with a question to determine whether a hearing problem was experienced since the last alert. If “yes,” then up to 23 questions (depending on contingent response branching) obtained details about the situation. If “no,” then up to 11 questions obtained information that would help to explain why hearing was not a problem. Each participant completed the Hearing Handicap Inventory for the Elderly (HHIE) both before and after the 2-week EMA testing period to evaluate for “reactivity” (exacerbation of self-perceived hearing problems that could result from the repeated assessments). RESULTS: : Participants responded to the alerts with a 77% compliance rate, providing a total of 991 completed momentary assessments (mean = 43.1 per participant). A substantial amount of data were obtained with the methodology. It is important to note that participants reported a “hearing problem situation since the last alert” 37.6% of the time (372 responses). The most common problem situation involved “face-to-face conversation” (53.8% of the time). The next most common problem situation was “telephone conversation” (17.2%) followed by “TV, radio, iPod, etc.” (15.3%), “environmental sounds” (9.7%), and “movies, lecture, etc.” (4.0%). Comparison of pre- and post-EMA mean HHIE scores revealed no significant difference (p > 0.05), indicating that reactivity did not occur for this group. It should be noted, however, that 37.5% of participants reported a greater sense of awareness regarding their hearing loss and use of hearing aids. CONCLUSIONS: : Results showed participants were compliant, gave positive feedback, and did not demonstrate reactivity based on pre- and post-HHIE scores. We conclude that EMA methodology is feasible with patients who use hearing aids and could potentially inform hearing healthcare (HHC) services. The next step is to develop and evaluate EMA protocols that provide detailed daily patient information to audiologists at each stage of HHC. The advantages of such an approach would be to obtain real-life outcome measures, and to determine within- and between-day variability in outcomes and associated factors. Such information at present is not available from patients who seek and use HHC services

Gass, J. C., Wray, J. M., Hawk, L. W., Mahoney, M. C., & Tiffany, S. T. (2012). Impact of varenicline on cue-specific craving assessed in the natural environment among treatment-seeking smokers. Psychopharmacology (Berl).

RATIONALE: Varenicline is believed to work, in part, by reducing craving responses to smoking cues and by reducing general levels of craving; however, these hypotheses have never been evaluated with craving assessed in the natural environments of treatment-seeking smokers. OBJECTIVES: Ecological momentary assessment procedures were used to assess the impact of varenicline on cue-specific and general craving in treatment-seeking smokers prior to quitting. METHODS: For 5 weeks prior to quitting, 60 smokers carried personal digital assistants that assessed their response to smoking or neutral cues. During week 1 (baseline), participants did not receive medication; during weeks 2-4 (drug manipulation), participants were randomized to receive varenicline or placebo; during week 5 (standard therapy), all participants received varenicline. Craving was assessed before each cue; cue-specific craving and attention to cue were assessed after each cue. RESULTS: During all phases, smoking cues elicited greater craving than neutral cues; the magnitude of this effect declined after the first week. General craving declined across each phase of the study. Relative to the placebo condition, varenicline was associated with a greater decline in general craving over the drug manipulation phase. Varenicline did not significantly attenuate cue-specific craving during any phase of the study. CONCLUSIONS: Smoking cues delivered in the natural environment elicited strong craving responses in treatment-seeking smokers, but cue-specific craving was not affected by varenicline administered prior to the quit attempt. These findings suggest that the clinical efficacy of varenicline is not mediated by changes in cue-specific craving during the pre-quit period of treatment-seeking smokers

Hendrix, Y., Reelick, M. F., van Mierlo, P., & Rikkert, M. O. (2012). Activity in older people with and without a major depressive disorder. International Journal of Geriatric Psychiatry, 27.

Psychomotor disturbances are an essential feature of major depressive disorders. Many studies have been carried out to investigate these psychomotor disturbances, except in the geriatric population. This may be caused by their frailty and intrinsic problems in including depressive geriatric subjects in studies that ask compliance to protocols that require physical activity, for which depressive subjects are often not motivated. In the present pilot study, we compared the physical activity in patients with a major depressive disorder (DSM-IV), before and after treatment with a Selective Serotonin Reuptake Inhibitor, with older subjects without an affective disorder as controls. Similar to younger patients, there is less activity in patients with a major depressive disorder, compared with controls. Although depressive symptoms improve after treatment with a Selective Serotonin Reuptake Inhibitor, there was no improvement in activity. The use of an accelerometer in the geriatric depressed population is complicated: it encountered low acceptance. A proper validation study in a larger subject sample is warranted for confirmation. Next, older depressed patients probably need specific mobility training and activation during antidepressive drug treatment to sufficiently regain their former activity level and prevent sarcopenia and malnutrition.

Hensel, D. J., Harezlak, J., Craig, D., & Fortenberry, J. D. (2012). The feasibility of cell phone based electronic diaries for STI/HIV research. BMC.Med.Res Methodol., 12, 75.

BACKGROUND: Self-reports of sensitive, socially stigmatized or illegal behavior are common in STI/HIV research, but can raise challenges in terms of data reliability and validity. The use of electronic data collection tools, including ecological momentary assessment (EMA), can increase the accuracy of this information by allowing a participant to self-administer a survey or diary entry, in their own environment, as close to the occurrence of the behavior as possible. In this paper, we evaluate the feasibility of using cell phone-based EMA as a tool for understanding sexual risk and STI among adult men and women. METHODS: As part of a larger prospective clinical study on sexual risk behavior and incident STI in clinically recruited adult men and women, using study-provided cell phones, participants (N= 243) completed thrice daily EMA diaries monitoring individual and partner-specific emotional attributes, non-sexual activities, non-coital or coital sexual behaviors, and contraceptive behaviors. Using these data, we assess feasibility in terms of participant compliance, behavior reactivity, general method acceptability and method efficacy for capturing behaviors. RESULTS: Participants were highly compliant with diary entry protocol and schedule: over the entire 12 study weeks, participants submitted 89.7% (54,914/61,236) of the expected diary entries, with an average of 18.86 of the 21 expected diaries (85.7%) each week. Submission did not differ substantially across gender, race/ethnicity and baseline sexually transmitted infection status. A sufficient volume and range of sexual behaviors were captured, with reporting trends in different legal and illegal behaviors showing small variation over time. Participants found the methodology to be acceptable, enjoyed and felt comfortable participating in the study. CONCLUSION: Achieving the correct medium of data collection can drastically improve, or degrade, the timeliness and quality of an individual’s self-reported sexual risk behavior, which in turn, is a key factor in the success of intervention or education programs relying on this information. Our findings demonstrate that completion of electronic diaries via cellular phone is feasible way to describe STI/HIV risk among clinically recruited adult men and women

Heron, K. E. (2012). Ecological momentary intervention {emi}: Incorporating mobile technology into a disordered eating treatment program for college women. ProQuest Information & Learning, US.

Psychosocial and health behavior treatments can be extended beyond research and clinical settings by using mobile technology to provide Ecological Momentary Interventions [EMI] to individuals as they go about their daily lives. This study integrates the assessment (i.e., Ecological Momentary Assessment; EMA) and intervention (i.e., EMI) capacities of palmtop computers to provide individually tailored EMI to participants in real time. The feasibility and efficacy of using EMI to augment a disordered eating treatment intervention for college women was evaluated. Participants were randomized to view psychoeducational videos on a computer (attention control), complete an interactive CD-ROM-based intervention aimed at reducing body dissatisfaction and disordered eating behaviors (CD), or receive the CD-ROM supplemented with EMI (CD+EMI). The content and timing of EMI was individually tailored in real time and provided on palmtop computers for one week following the CD intervention. Very high compliance rates with the EMA/EMI protocol were demonstrated and women were generally satisfied with the intervention, suggesting it is feasible to implement tailored EMI. An evaluation of treatment efficacy revealed the computerized CD-ROM intervention did not reliably produce significant improvements in body-related constructs and there was no unique or added benefit of EMI. This study was innovative in that it used palmtop computers to combine ambulatory assessment and intervention strategies to provide tailored and contextually sensitive EMI. As such, it adds to the relatively young, but growing EMI literature by identifying challenges and opportunities for ambulatory assessment and intervention methods in psychosocial and health behavior treatments.

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

Inal, S., Karakoc, M. A., Kan, E., Ebinc, F. A., Toruner, F. B., & Aslan, M. (2012). The effect of overt and subclinical hypothyroidism on the development of non-dipper blood pressure. Endokrynol.Pol., 63, 97-103.

INTRODUCTION: ‘Non-dippers’ are individuals without the anticipated nocturnal decrease in blood pressure. An increased incidence of target organ damage and a worse outcome in terms of cardiovascular events have been reported in this group of people. The pathogenesis of non-dipper hypertension is not clear at present. We aimed to investigate the effects of overt and subclinical hypothyroidism on the development of a non-dipper blood pressure pattern via 24-hour ambulatory blood pressure monitoring. MATERIAL AND METHODS: 109 normotensive patients with overt and subclinical hypothyroidism were evaluated, and 95 of these patients without reverse dipping and masked hypertension were included in the study. The control group consisted of 75 gender- and age-matched, normotensive, euthyroid healthy individuals. RESULTS: Median serum TSH levels were 7.61 and 1.59 mUmL in patient and control groups, respectively. The number of non-dippers according to systolic, diastolic and mean blood pressure was significantly higher in the patients with hypothyroidism compared to the control group. In linear regression analysis, TSH had a negative effect on the night/day ratio of the systolic, diastolic and mean blood pressures. CONCLUSION: Despite the fact that the effect of hypothyroidism on non-dipper blood pressure pattern is not known, the present study has revealed that elevated TSH levels are likely to increase the risk of non-dipping in normotensive patients with either overt or subclinical hypothyroidism

Jacobs, N., van Os, J., Derom, C., Thiery, E., Delespaul, P., & Wichers, M. (2011). Neuroticism explained? From a non-informative vulnerability marker to informative person-context interactions in the realm of daily life. British Journal of Clinical Psychology, 50, 19-32.

Objectives: Despite the well-replicated finding that neuroticism is associated with increased susceptibility for psychopathology, it remains unclear what vulnerability as indexed by neuroticism’ represents in terms of everyday life emotional processes. This study examined the association between neuroticism and six phenotypes of daily life emotional responses: positive affect (PA), negative affect (NA), PA variability, NA variability, stress sensitivity, and reward experience, and investigated the contribution of genetic and environmental factors to these associations. Design: A prospective cohort study in a population-based sample of 416 adult female twins. Method. A momentary assessment approach (experience sampling method) was used to collect multiple assessments of affect in daily life. Neuroticism was assessed with the Eysenck Personality Scale. Multi-level regression analyses were carried out to examine the association between neuroticism and the phenotypes of daily life emotional responses. Cross-twin, cross-trait analyses, and bivariate structural equation modelling (SEM) were performed in order to investigate the nature of these associations. Results: A high neuroticism score was associated with lower momentary PA levels and increased NA variability, independent of momentary NA, PA variability, stress sensitivity, and reward experience. Both the cross-twin, cross-trait analyses, and the bivariate SEM showed that unique, non-shared environmental factors drive the association between neuroticism and PA and that the association between neuroticism and increased NA variability is based on shared genetic factors as well as individual-specific environmental factors. Conclusions: Neuroticism as measured by Eysenck questionnaire may index an environmental risk for decreased daily life PA levels and a genetic as well as an environmental risk for increased NA variability. Decomposing the broad measure of neuroticism into measurable persons-context interactions increases its ‘informative’ value in explaining psychopathology.

Jason, L. A. & Brown, M. M. (2012). Sub-typing daily fatigue progression in chronic fatigue syndrome. J Ment.Health.

Background Activity logs involve patients writing down their activities and symptoms over 1 or more days. Aims This study sought to classify daily fatigue patterns among patients with chronic fatigue syndrome (CFS) using activity logs. Method Fatigue intensity was self-reported every 30 min in a sample of 90 patients with CFS over 1 day. A cluster analysis using fatigue intensity, variability and slope was conducted. Results Three clusters emerged involving patients with different trajectories. One group evidenced high fatigue intensity, low variability, and fatigue intensity stayed the same over time. A second group had moderate fatigue intensity, high variability, and fatigue intensity decreased over time. A third group had moderate fatigue intensity, high variability, but fatigue intensity increased over time. The three clusters of patients differed on measures of actigraphy, pain and immune functioning. Conclusions Activity logs can provide investigators and clinicians with valuable sources of data for understanding patterns of fatigue and activity among patients with CFS

Jose, P. E., Lim, B. T., & Bryant, F. B. (2012). Does savoring increase happiness? A daily diary study. The Journal of Positive Psychology, 7, 176-187.

Bryant and Veroff (2007, Savoring: A new model of positive experience. Mahwah, NJ: Lawrence Erlbaum Associates) have proposed that savoring, namely, regulating the emotional impact of positive events by one’s cognitive or behavioral responses, increases happiness. The present study was designed to determine whether and how savoring influences daily happiness. Experience sampling methodology was used with 101 participants, who provided self-reports of their momentary positive events, savoring responses, and positive affect daily over a period of 30 days. Multilevel modeling analyses verified that (a) these three constructs were positively related to each other within a given day, (b) momentary savoring both mediated and moderated the impact of daily positive events on momentary happy mood, and (c) levels of trait savoring moderated the observed mediational pattern. These results provide support for the hypothesis that savoring is an important mechanism through which people derive happiness from positive events.

Kamarck, T. W., Shiffman, S., Sutton-Tyrrell, K., Muldoon, M. F., & Tepper, P. (2012). Daily psychological demands are associated with 6-year progression of carotid artery atherosclerosis: the Pittsburgh Healthy Heart Project. Psychosom.Med., 74, 432-439.

OBJECTIVE: We examine associations between the perception of ongoing psychological demands by ecological momentary assessment (EMA) and 6-year changes in carotid artery atherosclerosis by ultrasonography. METHODS: A total of 270 initially healthy participants collected ambulatory blood pressure (ABP) and recorded their daily experiences, using electronic diaries, during two 3-day periods. Mean intima-media thickness (IMT) and plaque were assessed in the carotid arteries using B-mode ultrasound at baseline and again during a 6-year follow-up (mean follow-up duration = 73 months). RESULTS: Among those who had no exposure to antihypertensive medications during the course of follow-up (n = 192), daily psychological demands were associated with greater progression of IMT as well as plaque, after adjusting for demographic and risk factor covariates. Associations between demands and plaque change were partially accounted for by ABP differences among those reporting high demands. Among those who were employed at baseline (n = 117), 6-year IMT changes were more strongly associated with ratings of daily demands than with traditional measures of occupational stress. CONCLUSIONS: These data support the role of psychological demands as a correlate of subclinical atherosclerotic progression, they point to ABP as a potential mechanism facilitating these effects, and they highlight the utility of EMA measures for capturing daily psychological demands with potential effects on health

Kanning, M., Ebner-Priemer, U., & Brand, R. (2012). Autonomous regulation mode moderates the effect of actual physical activity on affective States: an ambulant assessment approach to the role of self-determination. J Sport Exerc.Psychol., 34, 260-269.

Studies have shown that physical activity influences affective states. However, studies have seldom depicted these associations in ongoing real-life situations, and there is no investigation showing that motivational states (i.e., more or less autonomously regulated) would moderate these effects in situ. To investigate the interaction of autonomous regulation and actual physical activity (aPA) with affective states, we use an ambulatory assessment approach. The participants were 44 university students (mean age: 26.2 +/- 3.2 years). We assessed aPA through 24-hr accelerometry and affective states and autonomous regulation via electronic diaries. Palmtop devices prompted subjects every 45 min during a 14-hr daytime period. We performed hierarchical multilevel analyses. Both aPA and autonomous regulation significantly influenced affective states. The interaction was significant for two affects. The higher the volume of aPA and thereby the more autonomously regulated the preceding bout of aPA was, the more our participants felt energized (r = .16) but agitated (r = -.18)

Koster, A., Caserotti, P., Patel, K. V., Matthews, C. E., Berrigan, D., Van Domelen, D. R. et al. (2012). Association of sedentary time with mortality independent of moderate to vigorous physical activity. PLoS One, 7, e37696.

BACKGROUND: Sedentary behavior has emerged as a novel health risk factor independent of moderate to vigorous physical activity (MVPA). Previous studies have shown self-reported sedentary time to be associated with mortality; however, no studies have investigated the effect of objectively measured sedentary time on mortality independent of MVPA. The objective our study was to examine the association between objectively measured sedentary time and all-cause mortality. METHODS: 7-day accelerometry data of 1906 participants aged 50 and over from the U.S. nationally representative National Health and Nutrition Examination Survey (NHANES) 2003-2004 were analyzed. All-cause mortality was assessed from the date of examination through December 31, 2006. RESULTS: Over an average follow-up of 2.8 years, there were 145 deaths reported. In a model adjusted for sociodemographic factors, lifestyle factors, multiple morbidities, mobility limitation, and MVPA, participants in third quartile (hazard ratio (HR):4.05; 95%CI:1.55-10.60) and fourth quartile (HR:5.94; 95%CI: 2.49-14.15) of having higher percent sedentary time had a significantly increased risk of death compared to those in the lowest quartile. CONCLUSIONS: Our study suggests that sedentary behavior is a risk factor for mortality independent of MVPA. Further investigation, including studies with longer follow-up, is needed to address the health consequences of sedentary behavior

Kudielka, B. M., Gierens, A., Hellhammer, D. H., Wust, S., & Schlotz, W. (2012). Salivary cortisol in ambulatory assessment-some dos, some don’ts, and some open questions. Psychosom.Med., 74, 418-431.

The impact of stress on health and disease is an important research topic in psychosomatic medicine. Because research on hypothalamic-pituitary-adrenal (HPA) axis regulation under controlled laboratory studies lacks ecological validity, it needs to be complemented by a research program that includes momentary ambulatory assessment. The measurement of salivary cortisol offers the possibility to trace the free steroid hormone concentrations in ambulant settings. Therefore, in this article, we first discuss the role of salivary cortisol in ambulatory monitoring. We start with a brief description of HPA axis regulation, and we then consider cortisol assessments in other organic materials, followed by a presentation of common salivary markers of HPA axis regulation suitable for ambulatory assessment. We further provide an overview on assessment designs and sources of variability within and between subjects (intervening variables), acknowledge the issue of (non)compliance, and address statistical aspects. We further give an overview of associations with psychosocial and health-related variables relevant for ambulatory assessment. Finally, we deal with preanalytical aspects of laboratory salivary cortisol analysis. The relative simplicity of salivary cortisol assessment protocols may lead to an overoptimistic view of the robustness of this method. We thus discuss several important issues related to the collection and storage of saliva samples and present empirical data on the stability of salivary cortisol measurements over time

Kusserow, M., Candia, V., Amft, O., Hildebrandt, H., Folkers, G., & Troster, G. (2012). Monitoring stage fright outside the laboratory: an example in a professional musician using wearable sensors. Med.Probl.Perform.Art., 27, 21-30.

We implemented and tested a wearable sensor system to measure patterns of stress responses in a professional musician under public performance conditions. Using this sensor system, we monitored the cellist’s heart activity, the motion of multiple body parts, and their gradual changes during three repeated performances of a skill-demanding piece in front of a professional audience. From the cellist and her teachers, we collected stage fright self-reports and performance ratings that were related to our sensor data analysis results. Concomitant to changes in body motion and heart rate, the cellist perceived a reduction in stage fright. Performance quality was objectively improved, as technical playing errors decreased throughout repeated renditions. In particular, from performance 1 to 3, the wearable sensors measured a significant increase in the cellist’s bowing motion dynamics of approximately 6% and a decrease in heart rate. Bowing motion showed a marginal correlation to the observed heart rate patterns during playing. The wearable system did not interfere with the cellist’s performance, thereby allowing investigation of stress responses during natural public performances

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., 1-12.

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.MethodThe 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

Lassalle-Lagadec, S., Allard, M., Dilharreguy, B., Schweitzer, P., Swendsen, J., & Sibon, I. (2012). Linking MRI to daily life experience: The example of poststroke depression. Neurology, 78, 322-325.

Objective: The state-of-the-art tools of neurology, in particular modern neuroimaging techniques, have yet to benefit from the revolution in mobile technologies that provide new insights into the mechanisms underlying clinical syndromes. This study demonstrates the manner in which mobile technologies may provide information that is complementary to MRI data, using the illustration of poststroke depression. Methods: MRI examinations were provided to 15 stroke patients, followed by computerized ambulatory monitoring of daily life experiences over 1 week. Results: The occurrence of daily life events was significantly associated with the intensity of positive affect during the ambulatory monitoring period. This emotional reactivity was also significantly associated with functional connectivity in brain regions linked with the risk of depression 3 months following stroke. Conclusions: Novel mobile technologies provide information that is inaccessible to hospital-based tests, and allow for more complete investigations of disorder expression and etiology.

LePage, M. L., Price, M., O Neil, P., & Crowther, J. H. (2012). The effect of exercise absence on affect and body dissatisfaction as moderated by obligatory exercise beliefs and eating disordered beliefs and behaviors. Psychology of Sport and Exercise, 13, 500-508.

Aim: Research suggests that exercise absence is frequently associated with greater guilt and negative affect, particularly when obligatory exercise beliefs and eating disordered psychopathology are considered. Two separate studies used ecological momentary assessment (EMA) to examine differences in mood on exercise and non-exercise days and the moderating impact of obligatory exercise beliefs and eating disordered beliefs and behaviors. Method: Both studies recruited female university students who endorsed frequent exercise behavior and study two also recruited based on level of eating disordered psychopathology. Participants completed the Obligatory Exercise Questionnaire at baseline and EMA measures of affect and exercise behavior for approximately one week. Study two participants also completed measures of body dissatisfaction and cognitions. Results: Results of study one suggest that obligation to exercise appears to have a greater impact on general level of affect than does exercise absence or the interaction of these two. In addition, in study two, eating disorder symptomatology was significantly associated with affect and cognition while exercise absence and obligatory exercise beliefs were not. Conclusions: The present studies suggest that the absence of exercise is not associated with significant changes in affect or cognitions. However, obligation to exercise and eating disorder symptomatology do impact affect and cognitions.

Lin, B. A., Thomas, P., Spiezia, F., Loppini, M., & Maffulli, N. (2012). Changes in daily physical activity before and after total hip arthroplasty. A pilot study using accelerometry. Surgeon..

The present single-centre prospective follow-up study assessed the objective changes in physical activity undertaken before and after total hip arthroplasty (THA) using accelerometry. We enrolled 12 female patients who underwent home-based accelerometry assessment one month before and six months after the THA procedure. We assessed the daily amount of physical activity and energy expenditure related to physical activities. We also recorded the intensity of the physical activity, and pre- and post-operative clinical evaluation with the Harris Hip Score (HHS). At 6 months after surgery, we found a statistically significant increase of the total energy cost of physical activity (DA) (P=0.02), without significant increase of activity time (P>0.05). The energy cost of moderate/vigorous activity was statistically significant increased after surgery (P=0.008). Finally, HHS improved form 53.9+/-15.3 pre-operatively to 78.1+/-12.2 post-operatively (P=0.03). In our patients, the improvement was significant only for the total energy cost of daily activity. Thus, although patients did not exhibit a more active lifestyle, as shown by the slight increase of the activity time, they significantly increased the amount of moderate or vigorous activities performed after surgery

Maddern-Leserer, D. (2012). Stopping the downward spiral: Real-time monitoring of stress with cell phones as a self-help tool for relapse prevention. ProQuest Information & Learning, US.

This study investigated the relationship between awareness of stress-as a result of monitoring stress levels multiple times a day-and its impact on relapse to addiction. The sample included 17 participants enrolled in an outpatient drug rehabilitation clinic. Participants recorded their stress levels with their cell phones four times a day for a 3-week period. Three month post-participation relapse rates of individuals who voluntarily opted to participate in the study were compared to those who did not participate to determine whether participation in the study would confer differential success in the rehabilitation program. This study used a methodology similar to the Ecological Momentary Assessment (EMA). Results of this study showed that participants were twice as likely to remain in treatment compared to nonparticipants. Data analysis showed that participants’ actual moment-to-moment stress remained fairly constant, however, participants reported a decrease in the perception of their stress. Furthermore, participants reported that they found it useful to participate and 100% of the participants reported that they would use this form of data collection again. The results of this study mirror the results of a study conducted by this researcher with a non-clinical sample. Reporting one’s stress 4 times a day might help participants to become more mindful of their experience, thus becoming more tolerant of their affective states over time. Using cell phones to record stress levels multiple times a day may be a highly cost effective way to increase mindfulness, awareness, self-control as well as social support, and might increase the likelihood of program completion. These results are consistent with the literature on mindfulness training, suggesting that mindfulness may disrupt the spiral of stress precipitated by alcohol relapse, and thus, enhance clinical outcomes in substance-abusing populations.

McLellan, C. P. & Lovell, D. I. (2012). Neuromuscular responses to impact and collision during elite rugby league match play. J Strength.Cond.Res, 26, 1431-1440.

The purpose of this study was to investigate the relationship between the prematch and short-term postmatch neuromuscular responses to the intensity, number, and distribution of impacts associated with collisions during elite Rugby League match play. Twenty-two elite male Rugby League players were monitored during 8 regular season competition matches using portable global positioning system (GPS) technology. The intensity, number, and distribution of impact forces experienced by players during match play were recorded using integrated accelerometry. Peak rate of force development (PRFD), peak power (PP), and peak force (PF) were measured during a countermovement jump on a force plate 24 hours prematch, 30 minutes prematch, 30 minutes postmatch and then at 24-hour intervals for a period of 5 days postmatch. The change in the dependent variables at each sample collection time was compared with that at 24 hours prematch and 30-minute prematch measures. There were significant (p < 0.05) decreases in PRFD and PP up to 24 hours postmatch with PF significantly (p < 0.05) being decreased 30 minutes postmatch. Significant (p < 0.05) correlations were found between the total number of impacts and PRFD and PP 30 minutes postmatch. Impact zones 4 (7.1-8.0 G), 5 (>8.1-10.0 G), and 6 (>10.1 G) were significantly (p < 0.05) correlated to PRFD and PP 30 minutes postmatch with the number of zone 5 and 6 impacts significantly (p < 0.05) correlated to PRFD and PP 24 hours postmatch. Elite Rugby League match play resulted in significant neuromuscular fatigue and was highly dependent on the number of heavy collisions >7.1G. Results demonstrate that neuromuscular function is compromised for up to 48 hours postmatch indicating that at least 2 days of modified activity is required to achieve full neuromuscular recovery after elite Rugby League match play. Position-specific demands on energy systems and the influence of repeated blunt force trauma during collisions during elite Rugby League match play should be considered when planning postmatch recovery protocols and training activities to optimize subsequent performance

Mehl, M. R., Robbins, M. L., & Deters, F. G. (2012). Naturalistic observation of health-relevant social processes: the electronically activated recorder methodology in psychosomatics. Psychosom.Med., 74, 410-417.

This article introduces a novel observational ambulatory monitoring method called the electronically activated recorder (EAR). The EAR is a digital audio recorder that runs on a handheld computer and periodically and unobtrusively records snippets of ambient sounds from participants’ momentary environments. In tracking moment-to-moment ambient sounds, it yields acoustic logs of people’s days as they naturally unfold. In sampling only a fraction of the time, it protects participants’ privacy and makes large observational studies feasible. As a naturalistic observation method, it provides an observer’s account of daily life and is optimized for the objective assessment of audible aspects of social environments, behaviors, and interactions (e.g., habitual preferences for social settings, idiosyncratic interaction styles, subtle emotional expressions). This article discusses the EAR method conceptually and methodologically, reviews prior research with it, and identifies three concrete ways in which it can enrich psychosomatic research. Specifically, it can (a) calibrate psychosocial effects on health against frequencies of real-world behavior; (b) provide ecological observational measures of health-related social processes that are independent of self-report; and (c) help with the assessment of subtle and habitual social behaviors that evade self-report but have important health implications. An important avenue for future research lies in merging traditional self-report-based ambulatory monitoring methods with observational approaches such as the EAR to allow for the simultaneous yet methodologically independent assessment of inner, experiential aspects (e.g., loneliness) and outer, observable aspects (e.g., social isolation) of real-world social processes to reveal their unique effects on health

Michielsen, M. E., Selles, R. W., Stam, H. J., Ribbers, G. M., & Bussmann, J. B. (2012). Quantifying Nonuse in Chronic Stroke Patients: A Study Into Paretic, Nonparetic, and Bimanual Upper-Limb Use in Daily Life. Arch.Phys.Med.Rehabil..

Michielsen ME, Selles RW, Stam HJ, Ribbers GM, Bussmann JB. Quantifying nonuse in chronic stroke patients: a study into paretic, nonparetic, and bimanual upper-limb use in daily life. OBJECTIVE: To quantify uni- and bimanual upper-limb use in patients with chronic stroke in daily life compared with healthy controls. DESIGN: Cross-sectional observational study. SETTING: Outpatient rehabilitation center. PARTICIPANTS: Patients with chronic stroke (n=38) and healthy controls (n=18). INTERVENTION: Not applicable. MAIN OUTCOME MEASURES: Upper-limb use in daily life was measured with an accelerometry-based upper-limb activity monitor, an accelerometer based measurement device. Unimanual use of the paretic and the nonparetic side and bimanual upper-limb use were measured for a period of 24 hours. Outcomes were expressed in terms of both duration and intensity. RESULTS: Patients used their unaffected limb much more than their affected limb (5.3h vs 2.4h), while controls used both limbs a more equal amount of time (5.4h vs 5.1h). Patients used their paretic side less than controls used their nondominant side and their nonparetic side more than controls their dominant side. The intensity with which patients used their paretic side was lower than that with which controls used their nondominant side, while that of the nonparetic side was higher than that of the dominant side of controls. Finally, patients used their paretic side almost exclusively in bimanual activities. During bimanual activities, the intensity with which they used their affected side was much lower than that of the nonaffected side. CONCLUSION: Our data show considerable nonuse of the paretic side, both in duration and in intensity, and both during unimanual and bimanual activities in patients with chronic stroke. Patients do compensate for this with increased use of the nonparetic side

Miller, G. D., Jakicic, J. M., Rejeski, W. J., Whit-Glover, M. C., Lang, W., Walkup, M. P. et al. (2012). Effect of Varying Accelerometry Criteria on Physical Activity: The Look AHEAD Study. Obesity (Silver.Spring).

The importance of physical activity in weight management is widely documented. Although accelerometers offer an objective measure of activity that provide a valuable tool for intervention research, considerations for processing these data need further development. This study tests the effects of using different criteria for accelerometry data reduction. Data were obtained from 2,240 overweight and obese individuals with type 2 diabetes mellitus (T2DM) from the Look AHEAD study, with 2,177 baseline accelerometer files used for analysis. Number, duration, and intensity of moderate (>/=3 metabolic equivalents (METS)) and vigorous (>/=6 METS) activity bouts were compared using various data reduction criteria. Daily wear time was identified as 1,440 min/day minus non-wear time. Comparisons of physical activity patterns for non-wear time (using either 20, 30, or 60 min of continuous zeros), minimal daily wear time (8, 10, and 12 h), number of days with available data (4, 5, and 6 days), weekdays vs. weekends, and 1- or 2-min time interruptions in an activity bout were performed. In this mostly obese population with T2DM (BMI = 36.4 kg/m(2); mean age = 59.0 years), there were minimal differences in physical activity patterns using the different methods of data reduction. Altering criteria led to differences in the number of available data (sample size) meeting specific criteria. Although our results are likely directly applicable only to obese individuals with T2DM, an understudied population with regards to physical activity, the systematic analysis for data reduction employed can be more generalizable and provide guidance in this area in the absence of standard procedures

Morris, M. E., Kathawala, Q., Leen, T. K., Gorenstein, E. E., Guilak, F., Labhard, M. et al. (2010). Mobile therapy: Case study evaluations of a cell phone application for emotional self-awareness. Journal of Medical Internet Research, 12, 33-50.

Background: Emotional awareness and self-regulation are important skills for improving mental health and reducing the risk of cardiovascular disease. Cognitive behavioral therapy can teach these skills but is not widely available. Objective: This exploratory study examined the potential of mobile phone technologies to broaden access to cognitive behavioral therapy techniques and to provide in-the-moment support. Methods: We developed a mobile phone application with touch screen scales for mood reporting and therapeutic exercises for cognitive reappraisal (ie, examination of maladaptive interpretations) and physical relaxation. The application was deployed in a one-month field study with eight individuals who had reported significant stress during an employee health assessment. Participants were prompted via their mobile phones to report their moods several times a day on a Mood Map-a translation of the circumplex model of emotion-and a series of single-dimension mood scales. Using the prototype, participants could also activate mobile therapies as needed. During weekly open-ended interviews, participants discussed their use of the device and responded to longitudinal views of their data. Analyses included a thematic review of interview narratives, assessment of mood changes over the course of the study and the diurnal cycle, and interrogation of this mobile data based on stressful incidents reported in interviews. Results: Five case studies illustrate participants’ use of the mobile phone application to increase self-awareness and to cope with stress. One example is a participant who had been coping with longstanding marital conflict. After reflecting on his mood data, particularly a drop in energy each evening, the participant began practicing relaxation therapies on the phone before entering his house, applying cognitive reappraisal techniques to cope with stressful family interactions, and talking more openly with his wife. His mean anger, anxiety and sadness ratings all were lower in the second half of the field study than in the first (P ? .01 for all three scales). Similar changes were observed among other participants as they used the application to negotiate bureaucratic frustrations, work tensions and personal relationships. Participants appeared to understand the mood scales developed for this experience sampling application and responded to them in a way that was generally consistent with self-reflection in weekly interviews. Interview accounts of mood changes, associated with diurnal cycles, personal improvement over the course of the study, and stressful episodes, could be seen in the experience sampling data. Discrepancies between interview and experience-sampling data highlighted the ways that individuals responded to the two forms of inquiry and how they calibrated mood ratings over the course of the study. Conclusions: Participants quickly grasped the Mood Mapping and therapeutic concepts, and applied them creatively in order to help themselves and empathize with others. Applications developed for mobile phones hold promise for delivering state-of-the-art psychotherapies in a nonstigmatizing fashion to many people who otherwise would not have access to therapy.

Muller, A., Mitchell, J. E., Crosby, R. D., Cao, L., Johnson, J., Claes, L. et al. (2012). Mood states preceding and following compulsive buying episodes: an ecological momentary assessment study. Psychiatry Res.

This study examined the extent to which patterns of mood and daily stress experienced by individuals with compulsive buying (CB) are associated with CB episodes by using Ecological Momentary Assessment. The comparison of mood and the impact of daily stress on days on which CB occurred to those days on which CB episodes did not occur did not reveal any significant differences. Within-day analysis indicated that negative affect increased significantly and positive affect decreased significantly prior to a CB episode. There was also evidence of a significant decrease in negative affect following a CB episode. Positive affect did not change significantly after a CB episode. The findings suggest that CB episodes hold negative reinforcing properties for individuals with CB. Treatment of patients with CB should focus on functional assessment of the affective antecedents and consequences of CB episodes and the identification of alternative, more functional behaviors to deal with these affective states

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

Mutschler, J., von, Z. F., Rossler, W., & Grosshans, M. (2012). Application of electronic diaries in patients with schizophrenia and bipolar disorders. Psychiatr.Danub., 24, 206-210.

BACKGROUND: Despite the dissemination of second generation antipsychotics for schizophrenia and bipolar disorder, outcomes remain suboptimal, largely due to poor treatment and drug adherence. The primary aim of the current study was to assess the tolerability, validity and feasibility of the pocket-sized electronic diary Medicus(R). SUBJECTS AND METHODS: Our case observations attempted to evaluate eighteen patients suffering from schizophrenia and bipolar disorder. All of the patients were treated with the second generation antipsychotic quetiapine. We followed them up in two German medical centers over two years. RESULTS: The present results display an improvement of mood-stability in all patients treated with quetiapine. All patients were in regular contact to their psychiatrist over a period of 24 months. A complete description of the coherences between the symptoms was essential for estimation, which was conducted by Medicus(R). Moreover, Medicus(R) seem to be useful for improving compliance within a medication regimen. CONCLUSIONS: Although uncontrolled case observations can only be interpreted with caution, Medicus(R) seems to deserve further investigation and may hold the potential to optimize treatment and drug adherence in patients suffering from schizophrenia and bipolar disorders

Myers, T. A., Ridolfi, D. R., Crowther, J. H., & Ciesla, J. A. (2012). The impact of appearance-focused social comparisons on body image disturbance in the naturalistic environment: The roles of thin-ideal internalization and feminist beliefs. Body Image, 9, 342-351.

Drawing on Festinger’s (1954) social comparison theory and its modern applications, this research investigated the relationship between upward appearance-focused social comparisons and body image disturbance using ecological momentary assessment, which allows for examination of these phenomena in their natural context. Participants were 91 undergraduate women who answered questionnaires five times per day for five days using Palm Personal Data Assistant (PDA) devices. Analyses were conducted using hierarchical linear modeling, which allows for examination of longitudinal data both within and across participants. Results revealed a positive relationship between upward appearance-focused social comparisons and body image disturbance. Upward appearance-focused social comparisons were associated with greater body image disturbance for those with higher levels of thin-ideal internalization and with greater body checking for women with lower levels of feminist beliefs. These findings further illuminate the nature of the relationship between social comparisons and body image disturbance

Neustifter, B., Rathbun, S. L., & Shiffman, S. (2012). Mixed-Poisson Point Process with Partially-Observed Covariates: Ecological Momentary Assessment of Smoking. J Appl.Stat., 39, 883-899.

Ecological Momentary Assessment is an emerging method of data collection in behavioral research that may be used to capture the times of repeated behavioral events on electronic devices, and information on subjects’ psychological states through the electronic administration of questionnaires at times selected from a probability-based design as well as the event times. A method for fitting a mixed Poisson point process model is proposed for the impact of partially-observed, time-varying covariates on the timing of repeated behavioral events. A random frailty is included in the point-process intensity to describe variation among subjects in baseline rates of event occurrence. Covariate coefficients are estimated using estimating equations constructed by replacing the integrated intensity in the Poisson score equations with a design-unbiased estimator. An estimator is also proposed for the variance of the random frailties. Our estimators are robust in the sense that no model assumptions are made regarding the distribution of the time-varying covariates or the distribution of the random effects. However, subject effects are estimated under gamma frailties using an approximate hierarchical likelihood. The proposed approach is illustrated using smoking data

Nicaise, V., Marshall, S., & Ainsworth, B. E. (2011). Domain-specific physical activity and self-report bias among low-income Latinas living in San Diego County. Journal of Physical Activity & Health, 8, 881-890.

Background: Evidence suggests that Latina women appear to be less physically active than women of other racial/ethnic groups. This study evaluated how different domains of physical activity (PA) contributed to overall levels of PA among low-income Latinas, the validity of Latinas’ self-reported PA, and potential moderators of self-report bias in PA. Methods: A community sample of 105 Latinas (mean age = 35.9 ± 9.0 years; mean body mass index = 31.6 ± 7.2) completed the long form Spanish-language version of the International Physical Activity Questionnaire (IPAQ), wore an accelerometer for seven days, and completed self-reported measures of acculturation and socioeconomic status. Results: Ninety-six percent of IPAQ-reported moderate-intensity PA (MPA) was accrued during household activities, with only 4% accrued during leisure time. Seventy-two percent of participants met national recommendations for PA using IPAQ data, but only 20% met recommendations when measured by accelerometer. When bouts of MPA lasting >10 min were included, 0% met recommendations. Age appeared to moderate self-report bias of vigorous PA, and there were nonsignificant trends for acculturation and income to moderate MPA and vigorous-intensity PA, respectively. Conclusions: Data suggest that it is important to measure household activity of Latinas, and that the IPAQ yield overestimates of self-report PA.

Oorschot, M., Lataster, T., Thewissen, V., Lardinois, M., van, O. J., Delespaul, P. A. et al. (2012). Symptomatic remission in psychosis and real-life functioning. Br.J Psychiatry.

BACKGROUND: In 2005 Andreasen proposed criteria for remission in schizophrenia. It is unclear whether these criteria reflect symptom reduction and improved social functioning in daily life. AIMS: To investigate whether criteria for symptomatic remission reflect symptom reduction and improved functioning in real life, comparing patients meeting remission criteria, patients not meeting these criteria and healthy controls. METHOD: The Experience Sampling Method (ESM), a structured diary technique, was used to explore real-life symptoms and functioning in 177 patients with (remitted and non-remitted) schizophrenia spectrum disorders and 148 controls. RESULTS: Of 177 patients, 70 met criteria for symptomatic remission. These patients reported significantly fewer positive and negative symptoms and better mood states compared with patients not in remission. Furthermore, patients in remission spent more time in goal-directed activities and had less preference for being alone when they were with others. However, the patient groups did not differ on time spent in social company and doing nothing, and both the remission and non-remission groups had lower scores on functional outcome measures compared with the control group. CONCLUSIONS: The study provides an ecological validation for the symptomatic remission criteria, showing that patients who met the criteria reported fewer positive symptoms, better mood states and partial recovery of reward experience compared with those not in remission. However, remission status was not related to functional recovery, suggesting that the current focus on symptomatic remission may reflect an overly restricted goal

Palmier-Claus, J. E., Dunn, G., & Lewis, S. W. (2012). Emotional and symptomatic reactivity to stress in individuals at ultra-high risk of developing psychosis. Psychological Medicine, 42, 1003-1012.

Background: The stress-vulnerability model of psychosis continues to be influential. The aim of this study was to compare emotional and symptomatic responses to stress in individuals at ultra-high risk (UHR) of developing psychosis, in age- and gender-matched healthy controls, and in patients with non-affective psychosis. Method: A total of 27 UHR, 27 psychotic and 27 healthy individuals completed the experience sampling method, an ambulant diary technique, where they were required to fill in self-assessment questions about their emotions, symptoms and perceived stress at semi-random times of the day for 6 days. Questionnaire and interview assessments were also completed. Results: Multilevel regression analyses showed that individuals at UHR of developing psychosis reported greater negative emotions in response to stress than the healthy individuals. Against the initial hypotheses, the UHR individuals also experienced greater emotional reactivity to stress when compared with the patient group. No significant differences were observed between the patients and the non-clinical sample. Stress measures significantly predicted the intensity of psychotic symptoms in UHR individuals and patients, but the extent of this did not significantly differ between the groups. Conclusions: Individuals at UHR of developing psychosis may be particularly sensitive to everyday stressors. This effect may diminish after transition to psychosis is made and in periods of stability. Subtle increases in psychotic phenomena occur in response to stressful events across the continuum of psychosis.

Pasipanodya, E. C., Parrish, B. P., Laurenceau, J. P., Cohen, L. H., Siegel, S. D., Graber, E. C. et al. (2012). Social Constraints on Disclosure Predict Daily Well-Being in Couples Coping With Early-Stage Breast Cancer. J Fam.Psychol..

According to the social-cognitive processing model (Lepore, 2001), social constraints on disclosure can limit an individual’s ability to communicate openly with others and consequently have negative effects on psychological adjustment, especially in the context of stressful experiences such as the diagnosis and treatment of cancer. The goal of the present study was to examine the influence of social constraints on daily event sharing, individual well-being, and relationship well-being in couples coping with breast cancer. Forty-five patients recently diagnosed and treated for early stage breast cancer and their spouses reported perceptions of spousal constraints on patient disclosure and completed a 7-day electronic diary. Analyses revealed that patient-reported social constraints, independent of the spouse’s report, were linked to reduced patient sharing of both cancer-related and other important daily events. Patient and spouse perceptions of social constraints, independent of their shared consensus, predicted reduced daily individual well-being indexed by self-esteem and negative affect, as well as reduced daily relationship well-being indexed by relationship happiness and intimacy. Moreover, many of the aforementioned effects on daily well-being remained after controlling for global marital quality. Overall, these findings reveal that individual perceptions of social constraints have a negative influence on both patient and spouse daily well-being outcomes.

Peters, E., Lataster, T., Greenwood, K., Kuipers, E., Scott, J., Williams, S. et al. (2012). Appraisals, psychotic symptoms and affect in daily life. Psychological Medicine, 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.

Piasecki, T. M., Wood, P. K., Shiffman, S., Sher, K. J., & Heath, A. C. (2012). Responses to alcohol and cigarette use during ecologically assessed drinking episodes. Psychopharmacology (Berl).

RATIONALE: Tobacco and alcohol are frequently used together, and this may be partly explained by a distinct profile of subjective effects associated with co-administration. Ecological momentary assessment studies have examined effects of naturally occurring co-use, but, to date, have not assessed differing effects as alcohol levels rise and fall. OBJECTIVES: The objective of the study was to describe subjective states and appraisals of cigarette and alcohol effects reported during the entirety of real-world drinking episodes. METHODS: Currently-smoking frequent drinkers (N = 255) carried electronic diaries for 21 days. Analyses focused on reports made during 2,046 drinking episodes. Signaled prompts intensively oversampled moments in the hours following consumption of the first drink in an episode. Multilevel regression analyses were used to predict ratings of buzz, dizziness, excitement, and sluggishness as a function of person-level and contextual covariates, estimated blood alcohol concentration (eBAC) level, ascending vs. descending eBAC, smoking, and their interactions. Appraisals of cigarette and alcohol effects were also examined within this framework. RESULTS: Buzz, excitement, and pleasure from alcohol and cigarettes were prominent features of real-world drinking episodes. Smoking was associated with enhanced buzz and excitement when eBAC was high and descending. Smoking slightly accentuated the relation between eBAC and ratings of drinking pleasure among women, but this relation was somewhat weakened by smoking among men. CONCLUSIONS: Smoking during drinking episodes may be partly explained by a persistence of stimulant alcohol effects beyond the blood alcohol concentration peak. Acute effects of nicotine and tobacco use on the descending limb deserve further scrutiny in experimental alcohol challenge research

Possemato, K., Kaier, E., Wade, M., Lantinga, L. J., Maisto, S. A., & Ouimette, P. (2012). Assessing daily fluctuations in posttraumatic stress disorder symptoms and substance use with interactive voice response technology: Protocol compliance and reactions. Psychol.Serv., 9, 185-196.

PTSD symptoms and substance use commonly co-occur, but information is limited regarding their interplay. We used ecological momentary assessment (EMA) to capture fluctuations in PTSD symptoms and drinking within and across days. Fifty Iraq and Afghanistan War veterans completed four daily Interactive Voice Response (IVR) assessments of PTSD and substance use with cell phones for 28 days. The aims of this study were to (1) describe participant compliance and reactions to the protocol and (2) identify participant characteristics and protocol reactions that predict compliance. Protocol compliance was high, with participants completing an average of 96 out of a total of 112 IVR assessments (86%). While some participants perceived that the IVR assessments increased their drinking (21%) and PTSD symptoms (60%), self-report measures showed significant decreases in PTSD symptoms and nonsignificant decreases in drinking over the assessment period. Analyses revealed demographic (e.g., older than 24, full-time employment, more education), clinical (e.g., less binge drinking, less avoidance symptoms), and perceived benefit from participation predicted better protocol compliance. Results can guide future research on participant predictors of compliance with intensive EMA methods.

Rose, M., Bjorner, J. B., Fischer, F., Anatchkova, M., Gandek, B., Klapp, B. F. et al. (2012). Computerized adaptive testing-ready for ambulatory monitoring? Psychosom.Med., 74, 338-348.

BACKGROUND: Computerized adaptive tests (CATs) have abundant theoretical advantages over established static instruments, which could improve ambulatory monitoring of patient-reported outcomes (PROs). However, an empirical demonstration of their practical benefits is warranted. METHODS: We reviewed the literature and evaluated existing data to discuss the potential of CATs for use in ambulatory monitoring outside clinical facilities. RESULTS: Computerized adaptive tests are not being used for ambulatory monitoring, but initial results from their use in health care research allow for discussion of some issues relevant to ambulatory care. Evidence shows that CATs can capture the most relevant health outcomes as well as established static tools, with substantially decreased respondent burden. They can be more precise than static tools of similar length and can reduce floor and ceiling effects. Computerized adaptive tests can reliably measure a construct over time with different items, which yields the potential of introducing item exposure control in ambulatory monitoring. Studies have shown that CATs can be at least as valid as well-designed static tools in group comparisons, but further investigation is needed to determine whether psychometric advantages lead to increased responsiveness of CATs. CONCLUSIONS: Ambulatory monitoring of PROs demands short, yet very precise measurements, which can be repeated up to many times a day. Computerized adaptive tests may address several present shortcomings in ambulatory monitoring of PROs efficiently. However, most CAT developments have primarily focused on psychometric improvements. To use the full potential of CATs for ambulatory monitoring purposes, content must also be carefully considered

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..

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. (2012). Assessment of physical activity and inactivity in multiple domains of daily life: a comparison between a zomputerized questionnaire and the SenseWear Armband complemented with an electronic diary. Int.J Behav.Nutr.Phys.Act., 9, 71.

BACKGROUND: Although differences between paper-and-pencil questionnaires and accelerometers have been reported for overall physical activity and time spent in moderate and vigorous activity, few studies have looked at domain-specific behavior. This study compared estimates of domainspecific physical (in)activity obtained with the Flemish physical activity computerized questionnaire (FPACQ) with those obtained from a combination of the SenseWear Armband and an electronic diary. Furthermore, it was investigated whether the correspondence between the two methods varied with gender and age METHODS: Data were obtained from 442 Flemish adults (41.4+/-9.8 years). Physical activity was questioned with the FPACQ and measured for seven consecutive days using the SenseWear Armband together with an electronic activity diary (SWD). Analogous variables were calculated from the FPACQ and SWD. Mean differences and associations between FPACQ and SWD outcomes were examined with paired t-tests and Pearson correlations. The BlandAltman method was used to assess the level of agreement between the two methods. Main effects and interaction of gender and age groups (20-34; 35-49; 50-64 years) on differences between FPACQ and SWD outcomes were analyzed using two-way ANOVAs. RESULTS: All parameters of the FPACQ were significantly correlated with SWD assessments (r = 0.21 to 0.65). Reported activity was significantly different from SWD-obtained values for all parameters, except screen time. Physical activity level, total energy expenditure and time spent in vigorous activities were significantly higher (+0.14 MET, +25.09 EThours.week-1and +1.66 hours.week-1, respectively), and moderate activities and sedentary behavior significantly lower (-5.20 and -25.01 hours.week-1, respectively) with the FPACQ compared to SWD. Time and energy expenditure of job activities and active transport were significantly higher, while household chores, motorized transport, eating and sleeping were significantly lower with the FPACQ. Time spent in sports was lower (-0.54 hours.week-1), but energy expenditure higher (+4.18 METhours.week-1) with the FPACQ. The correspondence between methods varied with gender and age, but results differed according to the intensity and domain of activity. CONCLUSIONS: Despite the moderate correlations, significant differences between the two methods were found. In general, physical activity was higher and sedentary behavior lower as calculated from the FPACQ compared to SWD

Seppälä, P., Mauno, S., Kinnunen, M. L., Feldt, T., Juuti, T., Tolvanen, A. et al. (2012). Is work engagement related to healthy cardiac autonomic activity? Evidence from a field study among Finnish women workers. The Journal of Positive Psychology, 7, 95-106.

The present study investigated whether work engagement is related to and can explain healthy cardiac autonomic activity as indicated by decreased heart rate (HR; i.e., sympathetic and parasympathetic activity) and increased high-frequency power (HFP) of heart rate variability (i.e., parasympathetic activity). A total of 30 healthy Finnish female cleaning workers underwent an ambulatory monitoring period of two nights and two regular workdays, and mean values of work period HR and HFP were utilized as dependent variables. Correlations revealed that work engagement was, as hypothesized, negatively related to HR and positively to HFP. Furthermore, in hierarchical linear regression analysis, work engagement accounted for an additional 19% of the variance explained in HFP, independent of individual baseline, age, Body Mass Index, physical fitness, and medication. However, the explanation rate for HR did not reach statistical significance. The findings suggest that work engagement is associated with healthy, adaptable cardiac autonomic activity, particularly increased parasympathetic activity.

Serre, F., Fatseas, M., Debrabant, R., Alexandre, J. M., Auriacombe, M., & Swendsen, J. (2012). Ecological momentary assessment in alcohol, tobacco, cannabis and opiate dependence: A comparison of feasibility and validity. Drug Alcohol Depend..

BACKGROUND: Despite growing use of computerized ambulatory monitoring in substance dependence research, little is known about the comparative feasibility and validity of these novel methods by substance type. This study compares the feasibility and validity of computerized ambulatory monitoring in outpatients seeking treatment for alcohol, tobacco, cannabis or opiate dependence. METHODS: A total of 109 participants were recruited from an outpatient treatment center and completed standard clinical instruments followed by 2 weeks of computerized ambulatory monitoring of daily life experiences and substance use. RESULTS: Individuals with cannabis dependence had the lowest rates of study acceptance (31%) as well as compliance with the repeated electronic interviews (79.9%), while those with tobacco dependence had the highest rates (62% and 91.0%, respectively). Concurrent validity was found between scores from standard clinical instruments and similar constructs assessed in daily life, with no difference by substance group. While no fatigue effects were detected, change in some variables was observed as a function of time in the study. CONCLUSIONS: Computerized ambulatory protocols are feasible and provide valid data in individuals with diverse forms of dependence, but compliance to repeated sampling methodology may vary by substance type

Setodji, C. M., Martino, S. C., Scharf, D. M., & Shadel, W. G. (2012). Friends Moderate the Effects of Pro-Smoking Media on College Students’ Intentions to Smoke. Psychol.Addict.Behav..

Exposure to prosmoking media (e.g., smoking in movies, advertising in magazines) contributes to smoking in young people. However, the extent to which the impact of exposure depends on the social context in which those exposures occur has not been investigated. This study used ecological momentary assessment to examine the moderating role of social context in the relationship between college students’ exposure to prosmoking media and their smoking refusal self-efficacy and intention to smoke. College students (n = 134) carried handheld computers for 21 days, recording their exposure to all forms of prosmoking media during the assessment period. They also responded to three investigator-initiated control prompts (programmed to occur randomly) each day of the assessment. After each exposure to prosmoking media and after each control prompt, participants answered questions about smoking refusal self-efficacy and their intentions to smoke; they also indicated whether they were with friends, with family, with a romantic partner, or alone (i.e., their social context). When participants were with friends, prosmoking media exposures were associated with stronger smoking intentions and lower smoking refusal self-efficacy; these associations were not present when participants were alone. Being with family members or with a romantic partner did not moderate the impact of prosmoking media exposure on either dependent variable. These results suggest a new role for peers in the development of youth smoking.

Shiffman, S., Ferguson, S. G., Dunbar, M. S., & Scholl, S. M. (2012). Tobacco Dependence Among Intermittent Smokers. Nicotine Tob.Res.

INTRODUCTION: Intermittent smokers (ITS) are an increasingly prevalent segment of smokers, yet it is unknown whether or how dependence severity may vary across ITS. METHODS: Participants were 217 ITS (70 never daily ITS [NITS], 138 converted ITS [CITS], and 9 unknown), who smoked 4-27 days per month, and 197 daily smokers (DS), recruited for a study on smoking patterns. Participants completed questionnaires on dependence (time to first cigarette after waking, Fagerstrom Test of Nicotine Dependence [FTND], Nicotine Dependence Syndrome Scale [NDSS], Wisconsin Inventory of Smoking Dependence Motives [WISDM], and Hooked on Nicotine Checklist [HONC]) and recorded each cigarette in real time over 3 weeks using Ecological Momentary Assessment. Logistic regression assessed differences in dependence between groups (DS vs. ITS; CITS vs. NITS), and least squares regression examined associations between dependence and smoking behavior (mean, maximum cigarettes per day; proportion of days smoked; longest period of abstinence) within ITS. RESULTS: As expected, DS were significantly more dependent than ITS: FTND, NDSS, and WISDM discriminated between ITS and DS with greater than 90% accuracy. Similarly, among ITS, NITS demonstrated lower dependence than CITS. Within ITS, dependence measures also correlated with observed smoking rate and duration of abstinence.Conclusions:The study confirmed that DS are more dependent than ITS and that CITS are more dependent than NITS. Importantly, ITS exhibit features of dependence, and there is meaningful variation in dependence within ITS, suggesting that some aspects of dependence may appear with very infrequent smoking. Future work should examine implications for ITS’ potential progression to daily smoking and cessation outcome

Skoglund, P. H., Ostergren, J., & Svensson, P. (2012). Ambulatory pulse pressure predicts cardiovascular events in patients with peripheral arterial disease. Blood Press.

Background. Patients with peripheral arterial disease (PAD) are at high risk of cardiovascular (CV) events and often have hypertension with a high pulse pressure (PP). We studied the prognostic value of ambulatory blood pressure (ABP) in PAD patients with special reference to PP. Methods. 98 consecutive males with PAD had 24-h ABP measurements. The mean age was 68 years and CV comorbidity was prevalent. The outcome variable was CV events defined as CV mortality or any hospitalization for myocardial infarction, stroke or coronary revascularization. The predictive value of ABP variables was assessed by Cox regression. 90 age-matched men free of CV disease served as controls. Results. During follow-up (median 71 months), 36 patients and seven controls had at least one CV event. In PAD patients, 24-h PP (hazard ratios, HR, 1.48 (95% confidence interval, CI, 1.14-1.92), p < 0.01) predicted CV events. Office PP did not predict events in PAD patients (HR 1.15 (0.97-1.38), ns). In multivariate analysis, 24-h PP (HR 1.48 (1.12-1.95), p < 0.01) remained a predictor of CV events. Conclusions. Ambulatory PP predicts CV events in patients with PAD. ABP measurement may be indicated for better risk stratification in PAD patients

Stamatakis, E., Hamer, M., Tilling, K., & Lawlor, D. A. (2012). Sedentary time in relation to cardio-metabolic risk factors: differential associations for self-report vs accelerometry in working age adults. Int.J Epidemiol..

BACKGROUND: Sedentary behaviour has been proposed to be detrimentally associated with cardio-metabolic risk independently of moderate to vigorous physical activity (MVPA). However, it is unclear how the choice of sedentary time (ST) indicator may influence such associations. The main objectives of this study were to examine the associations between ST and a set of cardio-metabolic risk factors [waist, body mass index (BMI), systolic and diastolic blood pressure, total and high-density lipoprotein cholesterol, glycated haemoglobin] and whether these associations differ depending upon whether ST is assessed by self-report or objectively by accelerometry. METHODS: Multiple linear regression was used to examine the above objectives in a cross-sectional study of 5948 adults (2669 men) aged 16-65 years with self-reported measures of television time, other recreational sitting and occupational sitting or standing. In all, 1150 (521 men) participants had objective (accelerometry) data on ST as well. RESULTS: Total self-reported ST showed multivariable-adjusted (including for MVPA) associations with BMI [(unstandardized beta coefficients corresponding to the mean difference per 10 min/day greater ST: 0.035 kg/m(2); 95% CI: 0.027-0.044), waist circumference (0.083 cm; 0.062-0.105), systolic (0.024 mmHg; 0.000-0.049) and diastolic blood pressure (0.023 mmHg; 0.006-0.040) and total cholesterol (0.004 mmol/l; 0.001-0.006)]. Similar associations were observed for TV time, whereas non-TV self-reported ST showed consistent associations with the two adiposity proxies (BMI/waist circumference) and total cholesterol. Accelerometry-assessed ST was only associated with total cholesterol (0.010 mmol/l; 0.001-0.018). CONCLUSIONS: In this study, ST was associated consistently with cardio-metabolic risk only when it was measured by self-report

Sugiyama, T., Okely, A. D., Masters, J. M., & Moore, G. T. (2012). Attributes of child care centers and outdoor play areas associated with preschoolers’ physical activity and sedentary behavior. Environment and Behavior, 44, 334-349.

This study examined characteristics of child care centers associated with preschoolers’ moderate-to-vigorous physical activity and sedentary behavior while in child care (MVPA-C, SB-C), and attributes of outdoor play areas associated with the same behaviors during outdoor time (MVPA-O, SB-O). Participants were 89 children (3 -5 years) recruited from 10 child care centers in Brisbane, Australia. Children’s activity was measured by accelerometer over a 3-day period. Center characteristics and outdoor play area attributes were identified through survey and observation. We found that children were mostly sedentary while in child care. Lower child-staff ratios and using indoor play areas for motor activity were associated with more MVPA-C and less SB-C. Fixed play equipment in outdoor areas was conducive to more MVPA-O and less SB-O. This study suggests the possibility of enhancing preschoolers’ activity levels through changing these attributes. Further research with more centers from diverse settings is needed to test these findings.

Tang, N. K., Goodchild, C. E., Sanborn, A. N., Howard, J., & Salkovskis, P. M. (2012). Deciphering the temporal link between pain and sleep in a heterogeneous chronic pain patient sample: a multilevel daily process study. Sleep, 35, 675-87A.

OBJECTIVES: Because insomnia is a common comorbidity of chronic pain, scientific and clinical interest in the relationship of pain and sleep has surged in recent years. Although experimental studies suggest a sleep-interfering property of pain and a pain-enhancing effect of sleep deprivation/fragmentation, the temporal association between pain and sleep as experienced by patients is less understood. The current study was conducted to examine the influence of presleep pain on subsequent sleep and sleep on pain reports the next day, taking into consideration other related psychophysiologic variables such as mood and arousal. DESIGN: A daily process study, involving participants to monitor their pain, sleep, mood, and presleep arousal for 1 wk. Multilevel modeling was used to analyze the data. SETTING: In the patients’ natural living and sleeping environment. PATIENTS: One hundred nineteen patients (73.9% female, mean age = 46 years) with chronic pain and concomitant insomnia. MEASUREMENT: An electronic diary was used to record patients’ self-reported sleep quality/efficiency and ratings of pain, mood, and arousal at different times of the day; actigraphy was also used to provide estimates of sleep efficiency. RESULTS: Results indicated that presleep pain was not a reliable predictor of subsequent sleep. Instead, sleep was better predicted by presleep cognitive arousal. Although sleep quality was a consistent predictor of pain the next day, the pain-relieving effect of sleep was only evident during the first half of the day. CONCLUSIONS: These findings challenge the often-assumed reciprocal relationship between pain and sleep and call for a diversification in thinking of the daily interaction of these 2 processes

Taraldsen, K., Chastin, S. F. M., Riphagen, I. I., Vereijken, B., & Helbostad, J. L. (2012). Physical activity monitoring by use of accelerometer-based body-worn sensors in older adults: A systematic literature review of current knowledge and applications. Maturitas, 71, 13-19.

Objectives: To systematically review the literature on physical activity variables derived from body-worn sensors during long term monitoring in healthy and in-care older adults. Methods: Using pre-designed inclusion and exclusion criteria, a PubMed search strategy was designed to trace relevant reports of studies. Last search date was March 8, 2011. Study selection: Studies that included persons with mean or median age of >65 years, used accelerometer-based body-worn sensors with a monitoring length of >24 h, and reported values on physical activity in the samples assessed. Results: 1403 abstracts were revealed and 134 full-text papers included in the final review. A variety of variables derived from activity counts or recognition of performed activities were reported in healthy older adults as well as in in-care older adults. Three variables were possible to compare across studies, level of Energy Expenditure in kcal per day and activity recognition in terms of total time in walking and total activity. However, physical activity measured by these variables demonstrated large variation between studies and did not distinguish activity between healthy and in-care samples. Conclusion: There is a rich variety in methods used for data collection and analysis as well as in reported variables. Different aspects of physical activity can be described, but the variety makes it challenging to compare across studies. There is an urgent need for developing consensus on activity monitoring protocols and which variables to report.

Telford, C., McCarthy-Jones, S., Corcoran, R., & Rowse, G. (2012). Experience sampling methodology studies of depression: The state of the art. Psychological Medicine, 42, 1119-1129.

Background: Experience Sampling Methodology (ESM) is ideally suited to test the predictions, and inform the development of contemporary cognitive models of depression. Yet there has been no systematic examination of ESM in depression research. Method: A search of databases (PsychARTICLES, PsycINFO, AMED, Ovid Medline and CINAHL) was conducted to identify studies published within the last 25 years investigating major depressive disorder (MDD) using ESM. Results: Altogether, 19 studies using ESM, or comparable methodologies, with clinically depressed individuals were identified and critically reviewed. The identified studies examined six aspects of MDD: methodological issues ; positive and negative affect ; cortisol secretion ; antidepressant treatment ; work performance; genetic risk factors. Conclusions: Despite some methodological limitations of existing studies, ESM has made a significant contribution to our current understanding of depression by consolidating existing theories, uncovering new and clinically relevant findings and identifying questions for future research. This review concludes by introducing the possibility of using ESM as an intervention tool in clinical practice and proposing that ESM could be useful for furthering knowledge of the causes of MDD.

Thewissen, V., Bentall, R. P., Oorschot, M., á Campo, J., van Lierop, T., van Os, J. et al. (2011). Emotions, self-esteem, and paranoid episodes: An experience sampling study. British Journal of Clinical Psychology, 50, 178-195.

Objectives: The evidence to date for a causal role of emotions in the generation of paranoid symptoms is scarce, mainly because of a lack of studies investigating the longitudinal association between emotional processes and paranoia. The primary aim of this study was to investigate whether momentary emotional experiences (anxiety, depression, anger/irritability) and self-esteem predicted the onset and duration of a paranoid episode. We also studied whether levels of emotional experiences and self-esteem were respectively higher and lower during a paranoid episode. Design: A 1-week, prospective momentary assessment study. Methods: Data were collected using the experience sampling method, a structured self-assessment diary technique. The sample consisted of 158 individuals who ranged across the paranoia continuum. Participants with a psychotic disorder were recruited from in-patient and out-patient mental health services. Participants without psychotic disorder were sampled from the general population. Results: Specific aspects of emotional experience were implicated in the onset and persistence of paranoid episodes. Both an increase in anxiety and a decrease in self-esteem predicted the onset of paranoid episodes. Cross-sectionally, paranoid episodes were associated with high levels of all negative emotions and low level of self-esteem. Initial intensity of paranoia and depression was associated with longer, and anger/irritability with shorter duration of paranoid episodes. Conclusions: Paranoid delusionality is driven by negative emotions and reductions in self-esteem, rather than serving an immediate defensive function against these emotions and low self-esteem. Clinicians need to be aware of the central role of emotion-related processes and especially self-esteem in paranoid thinking.

Thomas, J. G., Doshi, S., Crosby, R. D., & Lowe, M. R. (2011). Ecological Momentary Assessment of obesogenic eating behavior: Combining person-specific and environmental predictors. Obesity, 19, 1574-1579.

Obesity has been promoted by a food environment that encourages excessive caloric intake. An understanding of how the food environment contributes to obesogenic eating behavior in different types of individuals may facilitate healthy weight control efforts. In this study, Ecological Momentary Assessment (EMA) via palmtop computers was used to collect real-time information about participants’ environment and eating patterns to predict overeating (i.e., greater than usual intake during routine meals/snacks, and eating outside of a participant’s normal routine) that could lead to weight gain. Thirty-nine women (BMI = 21.6 -¦ 1.8; age = 20.1 -¦ 2.0 years; 61 % white) of normal weight (BM 118.5-25) completed the Three Factor Eating Questionnaire and the Power of Food Scale (PFS), and carried a palmtop computer for 7-10 days, which prompted them to answer questions about eating events, including a count of the types of good tasting high-calorie foods that were available. None of the self-report measures predicted overeating, but BMI interacted with the number of palatable foods available to predict overeating (P = 0.035). Compared to leaner individuals who reported a relatively low frequency of overeating regardless of the availability of palatable food, the probability of overeating among heavier individuals was very low in the absence of palatable food, but quickly increased in proportion to the number of palatable foods available. Our findings suggest that the eating behavior of those with higher relative weights is susceptible to the presence of palatable foods in the environment. Individuals practicing weight control may benefit from limiting their exposure to good tasting high-calorie food in their immediate environment.

Tseng, W. C. (2010). The quality of subjective experience in daily lives of college students: The effect of perceived challenges and skills. Chinese Journal of Psychology, 52, 133-153.

This study conducted two major examinations. First, the present study examined whether varying ratios of perceived challenge and skill can explain the range of negative to positive variations in daily experience. Second, the article investigated the effects that perceived challenges and skills in activities have on the quality of everyday life experience. The design of the study involved an experience sampling methodology; 101 college students completed experience surveys at eight times during the day for a period of one week, resulting in a total 5,640 observations. The experience surveys measure daily variations in five dimensions of experience (concentration, control, interest, enjoyment, and involvement) in four contexts. Findings showed that the quality of experience in high-challenge/high-skill conditions was characterized by high concentration, control, interest, and involvement of the situation. Results from hierarchical linear modeling analyses showed that prediction of flow theory that the interaction of challenges and skills has a positive effect on the quality of experience. Yet some differences of parameter estimates were found between dimensions of experience and between social contexts of activity. The perceived challenges, skills, and their interaction explained 11%-39% of the with-individual variance in dimensions of experience. These findings suggest implications for improving the quality of Taiwanese college students’ life and call for a further improvement of the flow model.

Tudor-Locke, C., Camhi, S. M., & Troiano, R. P. (2012). A catalog of rules, variables, and definitions applied to accelerometer data in the national health and nutrition examination survey, 2003-2006. Prev.Chronic.Dis., 9, E113.

INTRODUCTION: The National Health and Nutrition Examination Survey (NHANES) included accelerometry in the 2003-2006 data collection cycles. Researchers have used these data since their release in 2007, but the data have not been consistently treated, examined, or reported. The objective of this study was to aggregate data from studies using NHANES accelerometry data and to catalogue study decision rules, derived variables, and cut point definitions to facilitate a more uniform approach to these data. METHODS: We conducted a PubMed search of English-language articles published (or indicated as forthcoming) from January 2007 through December 2011. Our initial search yielded 74 articles, plus 1 article that was not indexed in PubMed. After excluding 21 articles, we extracted and tabulated details on 54 studies to permit comparison among studies. RESULTS: The 54 articles represented various descriptive, methodological, and inferential analyses. Although some decision rules for treating data (eg, criteria for minimal wear-time) were consistently applied, cut point definitions used for accelerometer-derived variables (eg, time spent in various intensities of physical activity) were especially diverse. CONCLUSION: Unique research questions may require equally unique analytical approaches; some inconsistency in approaches must be tolerated if scientific discovery is to be encouraged. This catalog provides a starting point for researchers to consider relevant and/or comparable accelerometer decision rules, derived variables, and cut point definitions for their own research questions

Uchino, B. N., Sanbonmatsu, D. M., & Birmingham, W. (2012). Knowing your partner is not enough: spousal importance moderates the link between attitude familiarity and ambulatory blood pressure. J Behav.Med..

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 partner’s 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 partner’s 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

Vallance, J. K., Winkler, E. A. H., Gardiner, P. A., Healy, G. N., Lynch, B. M., & Owen, N. (2011). Associations of objectively-assessed physical activity and sedentary time with depression: NHANES (2005-2006). Preventive Medicine: An International Journal Devoted to Practice and Theory, 53, 284-288.

Background: Studies provide conflicting evidence for the protective effects of moderate-to-vigorous-intensity physical activity on depression. Recent evidence suggests that sedentary behaviors may also be associated with depression. Purpose: To examine the associations of accelerometer-derived moderate-to-vigorous-intensity physical activity and sedentary time with depression among a population-based sample. Methods: Cross-sectional study using 2,862 adults from the 2005-2006 US National Health and Nutrition Examination Survey. ActiGraph accelerometers were used to derive both moderate-to-vigorous-intensity physical activity and sedentary time. Results: Depression occurred in 6.8% of the sample. For moderate-to-vigorous-intensity physical activity, compared with those in quartile 1 (least active), significantly lower odds of depression were observed for those participants in quartiles 2 (OR=0.55, 95% CI, 0.34 to 0.89), 3 (OR=0.49, 95% CI, 0.26 to 0.93), and 4 (most active) (OR=0.37, 95% CI, 0.20 to 0.70) (p for trend pb0.01). In overweight/obese participants only, those in quartile 4 (most sedentary) had significantly higher odds for depression than those in quartile 1 (least sedentary) [quartile 3 vs 1 (OR=1.94, 95% CI, 1.01 to 3.68) and 4 vs 1 (OR=3.09, 95% CI, 1.25 to 7.68)]. Conclusion: The current study identified lower odds of depression were associated with increasing moderate-to-vigorous-intensity physical activity and decreasing sedentary time, at least within overweight/obese adults.

Van Zundert, R. M., Kuntsche, E., & Engels, R. C. (2012). In the heat of the moment: Alcohol consumption and smoking lapse and relapse among adolescents who have quit smoking. Drug Alcohol Depend..

BACKGROUND: The present study tested the co-occurrence of alcohol use and the first lapse and relapse into smoking among daily smoking adolescents who quit smoking. METHODS: In this ecological momentary assessment study, participants completed web-based questionnaires three times a day during one week prior to and three weeks after a quit attempt in their own natural environments. Participants were 134 daily smoking adolescents in the aged 15-19. Hierarchical linear modeling was applied to test whether alcohol use was related to the first lapse and relapse. Lapse was defined as the first incidence of smoking after achieving 24-h abstinence, relapse was defined as smoking at least five cigarettes on three consecutive days. RESULTS: The first lapse was strongly associated with alcohol use. Individual characteristics (age, sex, and baseline smoking status) did not predict the first lapse nor did they moderate the association between alcohol use and the first lapse. Progression from lapse to relapse did not seem to be associated with alcohol consumption, although this association appeared to be moderated by baseline smoking status. More specifically, alcohol use only posed a significant risk factor for relapse among those who smoked less frequently before the start of the study than others who relapsed. Intermittent smoking between the first lapse and relapse (or end of data) was strongly associated with alcohol use. CONCLUSIONS: Adolescent drinking during smoking cessation seems to be associated with the first lapse into smoking after quitting and subsequent intermittent smoking and should be targeted in adolescent smoking cessation interventions

Warner, E. T., Wolin, K. Y., Duncan, D. T., Heil, D. P., Askew, S., & Bennett, G. G. (2012). Differential accuracy of physical activity self-report by body mass index. American Journal of Health Behavior, 36, 168-178.

Objectives: To examine whether agreement between self-reported and accelerometer-measured physical activity varies by BMI category in a low-income black sample. Methods: Participants completed a questionnaire and wore an accelerometer for 4-6 days. Using one- and 10-minute bouts, accelerometers measured light, moderate, and vigorous physical activity time. Results: Correlations varied by obesity (nonobese: one-minute r = 0.41; 10-minute r = 0.47; obese: one-minute r = 0.21; 10-minute r = 0 .14). Agreement was highest among nonobese persons (one-minute kappa = 0.48, 10-minute kappa = 0.023; obese: one-minute kappa = -0.024, 10-minute kappa = -0.020). Conclusions: We found compromised questionnaire performance among obese participants.

Wenze, S. J., Gunthert, K. C., & German, R. E. (2012). Biases in affective forecasting and recall in individuals with depression and anxiety symptoms. Pers.Soc.Psychol.Bull., 38, 895-906.

The authors used experience sampling to investigate biases in affective forecasting and recall in individuals with varying levels of depression and anxiety symptoms. Participants who were higher in depression symptoms demonstrated stronger (more pessimistic) negative mood prediction biases, marginally stronger negative mood recall biases, and weaker (less optimistic) positive mood prediction and recall biases. Participants who were higher in anxiety symptoms demonstrated stronger negative mood prediction biases, but positive mood prediction biases that were on par with those who were lower in anxiety. Anxiety symptoms were not associated with mood recall biases. Neither depression symptoms nor anxiety symptoms were associated with bias in event prediction. Their findings fit well with the tripartite model of depression and anxiety. Results are also consistent with the conceptualization of anxiety as a “forward-looking” disorder, and with theories that emphasize the importance of pessimism and general negative information processing in depressive functioning

Wichers, M., Lothmann, C., Simons, C. J., Nicolson, N. A., & Peeters, F. (2012). The dynamic interplay between negative and positive emotions in daily life predicts response to treatment in depression: a momentary assessment study. Br.J Clin.Psychol., 51, 206-222.

OBJECTIVES: Although the treatment of depressive illness aims to restore the imbalance between an excess of negative affect (NA) and a shortage of positive affect (PA), no study has examined how NA and PA may influence each other in depression. This study examines how NA and PA dynamically influence each other in depression and how this may impact on treatment response. DESIGN: Depressed help-seeking individuals participated in the Experience Sampling Method (ESM), which enables visualization of subtle dynamic alterations of momentary affective states over time. Thereafter, participants received a combination of antidepressant treatment and psychotherapy, and were followed up each month. METHODS: NA and PA were assessed during ESM at 10 random moments per day for 6 days. Depressive symptoms were assessed at baseline and at monthly intervals during treatment. RESULTS: Future response to treatment was associated with altered baseline NA-PA dynamics in individuals with previous depressive episodes. Their daily life boosts of PA were followed by a stronger suppression of NA over subsequent hours than in other depressed groups or controls. CONCLUSIONS: Subtle individual differences in daily life emotional dynamics predict future treatment outcome in depression

Willett, L. L., Estrada, C. A., Wall, T. C., Coley, H. L., Ngu, J., Curry, W. et al. (2011). Use of ecological momentary assessment to guide curricular change in graduate medical education. J Grad.Med.Educ., 3, 162-167.

PURPOSE: To assess whether a novel evaluation tool could guide curricular change in an internal medicine residency program. METHOD: The authors developed an 8-item Ecological Momentary Assessment tool and collected daily evaluations from residents of the relative educational value of 3 differing ambulatory morning report formats (scale: 8 = best, 0 = worst). From the evaluations, they made a targeted curricular change and used the tool to assess its impact. RESULTS: Residents completed 1388 evaluation cards for 223 sessions over 32 months, with a response rate of 75.3%. At baseline, there was a decline in perceived educational value with advancing postgraduate (PGY) year for the overall mean score (PGY-1, 7.4; PGY-2, 7.2; PGY-3, 7.0; P < .01) and for percentage reporting greater than 2 new things learned (PGY-1, 77%; PGY-2, 66%; PGY-3, 50%; P < .001). The authors replaced the format of a lower scoring session with one of higher cognitive content to target upper-level residents. The new session’s mean score improved (7.1 to 7.4; P = .03); the adjusted odds ratios before and after the change for percentage answering, “Yes, definitely” to “Area I need to improve” was 2.53 (95% confidence interval [CI], 1.45-4.42; P = .001) and to “Would recommend to others,” it was 2.08 (95% CI, 1.12-3.89; P = .05). CONCLUSIONS: The Ecological Momentary Assessment tool successfully guided ambulatory morning report curricular changes and confirmed successful curricular impact. Ecological Momentary Assessment concepts of multiple, frequent, timely evaluations can be successfully applied in residency curriculum redesign

Wolfenstetter, A., Simonetti, G. D., Poschl, J., Schaefer, F., & Wuhl, E. (2012). Altered Cardiovascular Rhythmicity in Children Born Small for Gestational Age. Hypertension.

Low birth weight is frequently associated with a disproportionately high incidence of cardiovascular disease, diabetes mellitus, and kidney disease in adulthood. Epidemiological studies have identified an inverse association between low birth weight or being small for gestational age and hypertension in adulthood. We hypothesized that children born with low birth weight might have altered circadian and ultradian cardiovascular rhythmicity independent of the prevailing blood pressure level. Twenty-four-hour ambulatory blood pressure and heart rate rhythmicity was prospectively evaluated by Fourier analysis in a cohort of healthy children born with low birth weight and compared with normative pediatric data. Seventy-five children born small for gestational age (mean age, 8.1+/-2.2 years) and 139 controls matched for age and sex were investigated. In addition to increased 24-hour, daytime, and especially nighttime blood pressure levels (P<0.05), children born small for gestational age exhibited blunted circadian (24-hour) and ultradian (12-, 8-, and 6-hour) blood pressure rhythmicity (P<0.05). In a multivariate analysis including children born with low birth weight and controls, being born with low birth weight independently influenced ultradian blood pressure rhythmicity, whereas in a multivariate analysis including children born with low birth weight only, circadian and ultradian rhythms were independently influenced by catch-up growth, gestational age, and blood pressure level. This study demonstrates blunted circadian and ultradian cardiovascular rhythmicity in prepubertal children born small for gestational age, independent from the presence of arterial hypertension. Circadian and ultradian rhythms may be sensitive indicators for detecting subtle early abnormalities of cardiovascular regulation

Wright, L. B., Gregoski, M. J., Tingen, M. S., Barnes, V. A., & Treiber, F. A. (2011). Impact of Stress Reduction Interventions on Hostility and Ambulatory Systolic Blood Pressure in African American Adolescents. J Black.Psychol., 37, 210-233.

This study examined the impact of breathing awareness meditation (BAM), life skills (LS) training, and health education (HE) interventions on self-reported hostility and 24-hour ambulatory blood pressure (ABP) in 121 African American (AA) ninth graders at increased risk for development of essential hypertension. They were randomly assigned to BAM, LS, or HE and engaged in intervention sessions during health class for 3 months. Before, after, and 3 months following intervention cessation, self-reported hostility and 24-hour ABP were measured. Results indicated that between pre- and postintervention, BAM participants displayed significant reductions in self-reported hostility and 24-hour systolic ABP. Reductions in hostility were significantly related to reductions in 24-hour systolic ABP. Between postintervention and follow-up, participants receiving LS showed a significant reduction in hostility but not in 24-hour ABP. Significant changes were not found for the HE group in 24-hour ABP or self-reported hostility, but these change scores were significantly correlated. The implications of the findings are discussed with regard to behavioral stress reduction programs for the physical and emotional health of AAs

Wrzus, C., Muller, V., Wagner, G. G., Lindenberger, U., & Riediger, M. (2012). Affective and Cardiovascular Responding to Unpleasant Events From Adolescence to Old Age: Complexity of Events Matters. Dev.Psychol..

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.

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