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Hyperarousal is a key symptom of anxiety, stress-related disorders, and insomnia. However, it has been conceptualized in many different ways, ranging from various physiological markers (e.g. cortisol levels, high-frequency EEG activity) to personality traits, or state assessments of subjective anxiety and tension. This approach resulted in partly inconsistent evidence, complicating unified interpretations. Crucially, no previous studies addressed the likely variability of hyperarousal within and across days, nor the relationship of such variability in hyperarousal with the night-by-night variability in sleep quality characteristic of insomnia. Here, we present a novel data-driven approach to understanding dynamics of state hyperarousal in insomnia. Using ecological momentary assessment, we tracked fluctuations in a wide range of emotions across 9 days in 169 people with insomnia disorders and 38 controls without sleep problems. Exploratory factor analysis identified a hyperarousal factor, comprised of items describing tension and distress. People with insomnia scored significantly higher on this factor than controls at all timepoints. In both groups, the hyperarousal factor score peaked in the morning and waned throughout the day, pointing to a potential contributing role of sleep or other circadian processes. Importantly, the overnight increase in hyperarousal was stronger in people with in insomnia than in controls. Subsequent adaptive LASSO regression analysis revealed a stronger overnight increase in hyperarousal across nights of worse subjective sleep quality. These findings demonstrate the relationship between subjective sleep quality and overnight modulations of hyperarousal. Disorders in which hyperarousal is a predominant complaint might therefore benefit from interventions focused on improving sleep quality. [ABSTRACT FROM AUTHOR]

Strategies to detect the presence of suicidal ideation (SI) or characteristics of ideation that indicate marked suicide risk are critically needed to guide interventions and improve care during care transition periods. Some studies indicate that machine learning can be applied to momentary data to improve classification of SI. This study examined whether the classification accuracy of these models varies as a function of type of training data or characteristics of ideation. A total of 257 psychiatric inpatients completed a 3-week battery of ecological momentary assessment and measures of suicide risk factors. The accuracy of machine learning models in classifying the presence, duration, or intensity of ideation was compared across models trained on baseline and/or momentary suicide risk data. Relative feature importance metrics were examined to identify the risk factors that were most important for outcome classification. Models including both baseline and momentary features outperformed models with only one feature type, providing important information in both correctly classifying and differentiating individual characteristics of SI. Models classifying SI presence, duration, and intensity performed similarly. Results of this study may not generalize beyond a high-risk, psychiatric inpatient sample, and additional work is needed to examine temporal ordering of the relationships identified. Our results support using machine learning approaches for accurate identification of SI characteristics and underscore the importance of understanding the factors that differentiate and drive different characteristics of SI. Expansion of this work can support use of these models to guide intervention strategies. • Strategies to detect suicide ideation are needed for timely intervention. • Machine learning models are relevant for accurately identifying suicide ideation. • Different risk factors are useful for classifying ideation characteristics. • Both baseline and momentary risk factor training data are essential. [ABSTRACT FROM AUTHOR]

Major depressive disorder (MDD) and borderline personality disorder (BPD) often co-occur, with 20 % of adults with MDD meeting criteria for BPD. While MDD is typically diagnosed by symptoms persisting for several weeks, research suggests a dynamic pattern of symptom changes occurring over shorter durations. Given the diagnostic focus on affective states in MDD and BPD, with BPD characterized by instability, we expected heightened instability of MDD symptoms among depressed adults with BPD traits. The current study examined whether BPD symptoms predicted instability in depression symptoms, measured by ecological momentary assessments (EMAs). The sample included 207 adults with MDD (76 % White, 82 % women) recruited from across the United States. At the start of the study, participants completed a battery of mental health screens including BPD severity and neuroticism. Participants completed EMAs tracking their depression symptoms three times a day over a 90-day period. Using self-report scores assessing borderline personality disorder (BPD) traits along with neuroticism scores and sociodemographic data, Bayesian and frequentist linear regression models consistently indicated that BPD severity was not associated with depression symptom change through time. Diagnostic sensitivity and specificity may be restricted by use of a self-report screening tool for capturing BPD severity. Additionally, this clinical sample of depressed adults lacks a comparison group to determine whether subclinical depressive symptoms present differently among individuals with BPD only. The unexpected findings shed light on the interplay between these disorders, emphasizing the need for further research to understand their association. • Depression symptoms were measured through ecological momentary assessments (EMAs) three times a day over a ninety-day period. • Borderline personality disorder traits were not linked to instability of overall or individual depressive symptoms across time. • Findings diverged from expectations and highlight the need for further research on the relationship between BPD and MDD. [ABSTRACT FROM AUTHOR]

Rates of suicide in United States Marines are among the highest in the military, and sleep disorder symptoms are a known risk factor for suicide in the military. Intensive ecological momentary assessments (EMA) might improve the ability to detect periods that are characterized by increased suicidal ideation. Marines who were at high risk for suicide were intensively assessed for one month on sleep, suicidal urges, posttraumatic stress disorder (PTSD) and depression symptoms. U.S. Marines (N = 40) who had a past month suicide attempt or suicidal urges with intent were sent EMA for 28 days. Mixed effects models explored associations among daily sleep, suicidal urges, PTSD, and depression symptoms. Worsened sleep indicators on a given night significantly predicted higher maximum values of suicide urges the following day. Worse sleep quality the prior night was moderately associated with more severe PTSD symptoms and depression symptoms. Greater severity of PTSD symptoms and depression symptoms were strongly associated with both the maximum value and the range of suicide urges. PTSD and depression symptoms mediated the relationship between sleep quality and suicidal urges. Participants reported that 0000–0300 had the greatest elevation in endorsement of highest suicide urges. This study had a small sample size may not generalize beyond active duty Marines. Poor sleep quality and other sleep markers were an important risk factor for suicidal urges among U.S. Marines. This relationship was mediated by exacerbations in PTSD and depression symptoms. Interventions are needed to interrupt suicide risk during and following nights with poor sleep. [ABSTRACT FROM AUTHOR]

The Interpersonal Psychological Theory of Suicide (IPTS) states that thwarted belongingness (TB), perceived burdensomeness (PB), and hopelessness are risk factors for suicidal ideation. This ecological momentary assessment (EMA) study aimed to (1) demonstrate that there is substantial between-person variability in the association between IPTS predictors and suicidal ideation, (2) identify clusters of patients for which the predictors differently predict suicidal ideation, and (3) examine whether identified clusters are characterized by specific patient characteristics. EMA data were collected ten times per day for six days in 74 psychiatric inpatients and was analyzed with dynamic structural equation modelling. Idiographic associations were obtained and clustered using k-means clustering. We found substantial between-person variability in associations between IPTS predictors and suicidal ideation. Four distinct clusters were identified and different risk factors were relevant for different clusters. In the largest cluster (n = 36), none of the IPTS predictors predicted suicidal ideation. Clusters in which associations between IPTS variables and suicidal ideation were stronger showed higher suicidal ideation, depression, and lower positive affect. These findings suggest that a one-size-fits-all model may not adequately reflect idiosyncratic processes leading to suicidal ideation. A promising avenue might be to use idiographic approaches to personalize prediction and interventions. • We found substantial variability in the degree to which PB, TB, hopelessness predict SI. • In about half of the sample, none of the IPTS factors was predictive for SI. • Different predictors were relevant for different clusters of patients. • Associations were stronger for patients with more symptoms and less positive affect. • Group models may insufficiently reflect heterogeneity in processes leading to SI. [ABSTRACT FROM AUTHOR]

Restrained eating has been related to psychological distress like anxiety and eating disorder symptomatology, but little is known about this relationship in daily life in non-clinical populations. We aimed to understand concurrent and temporal associations between momentary anxiety and restrained eating in everyday life within and across persons in a non-clinical sample, and examined whether this association remains after controlling for eating disorder symptomatology. We used a 10-day ecological momentary assessment (EMA) protocol. Participants (n = 123) completed a baseline survey with demographics and eating disorder symptomatology questions, and three EMA surveys per day reporting anxiety and restrained eating intentions. We applied mixed-effects and random intercept cross-lagged models to analyze the data. Momentary anxiety and restrained eating were concurrently significantly positively associated within and between persons. When participants had more anxiety than was typical for them, they were more likely to intend to restrain eating, and people with overall higher anxiety symptoms tended to report greater restrained eating over the study period. These associations remained significant after adjusting for eating disorder symptomatology. There were no significant temporal cross-lagged effects. Anxiety-restrained eating association did not spill over into the next assessment window. The time window between prompts may have been too long to capture potential temporal effects, and we did not examine actual behavioral food restrictions. Daily-life anxiety may be related to concurrent restrained eating intentions, above and beyond baseline eating disorder symptomatology. Research is needed exploring daily-life anxiety as a potential intervention target to address restrained eating. • We examined the associations between anxiety and restrained eating in everyday life. • Momentary anxiety was related to restrained eating intentions within and across persons. • These associations were robust beyond the effect of eating disorder symptomatology. • Anxiety and restrained eating association showed no temporal carry-over effects. • Momentary anxiety is an important aspect to consider in the context of restrained eating. [ABSTRACT FROM AUTHOR]

Dimensional frameworks of psychopathology call for multivariate approaches to map co-occurring disorders to index what symptoms emerge when and for whom. Ecological momentary assessment (EMA) offers a method for assessing and differentiating the dynamics of co-occurring symptoms with greater temporal granularity and naturalistic context. The present study used multivariate mixed effects location-scale modeling to characterize the time-varying dynamics of depressed mood and anxiety for women diagnosed with social anxiety disorder (SAD) and major depression (MDD). Women completed five daily EMA surveys over 30 days (150 EMA surveys/woman, T ≈ 5250 total observations) and two clinical diagnostic and retrospective self-report measures administered approximately two months apart. There was evidence of same-symptom lagged effects (bs = 0.08–0.09), but not cross-symptom lagged effects (b s < 0.01) during EMA. Symptoms co-varied such that momentary spikes from one's typical level of anxiety were associated with increases in momentary depressed mood (b = 0.19) and greater variability of depressed mood (b = 0.06). Similarly, spikes from one's typical levels of depressed mood were associated with increases in momentary anxiety (b = 0.19). Furthermore, the presence and magnitude of effects demonstrated person-specific heterogeneity. Our findings are constrained to the dynamics of depressed and anxious mood among cisgender women with primary SAD and current or past MDD. Findings from this work help to characterize how daily experiences of co-occurring mood and anxiety fluctuate and offer insight to aid the development of momentary, person-specific interventions designed to regulate symptom fluctuations. • The nature of covariation in mood and anxiety varies from person to person. • Multivariate mixed effects location-scale modeling was used. • Momentary spikes in one symptom were associated with increases in the other. • The presence and magnitude of effects demonstrated person-specific heterogeneity. • Findings inform the design of momentary, person-specific interventions. [ABSTRACT FROM AUTHOR]

Appraisal theory posits that emotions result from cognitive appraisals of events and situations. Experimental work suggests that sleep influences cognitive processes and event appraisal, which the present study examines in real life. Poor sleep influences brain regions involved in the appraisal-to-emotion process, and tired participants showed more conservative appraisal and reported less positive and more negative affect. In the present study, we tested whether sleep duration and/or quality predicted more pleasant event appraisal and whether sleep moderated the association between event appraisal and affect. Participants (N = 892) from the general Dutch population reported thrice daily on event appraisal and various emotions for 30 days and once daily on sleep duration and quality. We constructed multilevel models to account for the nested structure of our data (observations within participants). Multilevel regression analyses showed that on days when participants reported having slept longer and better than their average, their event appraisal was more positive. Subjective sleep duration and quality did not influence the relationship between event appraisal and affect. Hence, poor sleep predicted changes in cognitive functioning, as people appraised situations as more unpleasant. We measured subjective sleep duration and quality with two single items and focused on only pleasantness dimension of event appraisal. Results match perspectives on emotions as multicomponent systems involving appraisal processes. Understanding the elements of event appraisal may help unravel the detrimental effects of poor sleep on mental health and well-being. • Individuals appraise daytime events as more pleasant after waking up from a longer and higher quality night of sleep. • Individuals experience more positive and less negative affect after appraising their recent events to be more pleasant. • Previous night's duration and quality of sleep do not influence the relationship between daytime affect and event appraisal. [ABSTRACT FROM AUTHOR]

Social anhedonia is a hallmark symptom of schizophrenia. Discrepancies in anticipated versus consummatory pleasure for non-social stimuli are well-documented. Thus, a similar emotional paradox may underlie social anhedonia. If so, our understanding of social anhedonia—including how to treat it in schizophrenia—could be enhanced. This project used a 5-day experience sampling method (ESM) to measure discrepancies between anticipated and consummatory pleasure for real-world social activities in people with schizophrenia and healthy controls (n = 30/group). ESM results were compared to laboratory assessments of negative symptoms and neurocognition. The schizophrenia group exhibited similar levels of anticipated and consummatory social pleasure as controls throughout daily life, and both groups were accurate in their short-term predictions of pleasure. Clinical interviews revealed those with schizophrenia showed significant deficits in long-term social pleasure prediction (i.e., a 1-week timeframe). Thus, people with schizophrenia may exhibit differences in ability to predict pleasure in the short-term versus the long-term. Negative symptoms and neurocognition were related to anticipated, but not consummatory, social pleasure, suggesting anhedonia is driven by deficits in thinking about pleasure, rather than inability to experience pleasure. Clinical implications include focusing on building upon short-term ability to predict pleasure in therapy to increase social motivation in schizophrenia. • People with schizophrenia report as much social pleasure in daily life as controls. • Those with schizophrenia can accurately predict social pleasure in the short-term. • Those with schizophrenia show deficits in long-term social pleasure prediction. • Cognitive impairment is implicated in ability to predict social pleasure. [ABSTRACT FROM AUTHOR]

Paranoia is a common delusion type found in clinical and non-clinical populations. A hierarchical, dimensional model of paranoia in the general population has been proposed, with four categories representing increasing levels of paranoia: interpersonal sensitivity (IP), mistrust (M), ideas of reference (IR), persecutory ideas (PI). What is currently lacking and could provide insights into etiology is a comprehensive clinical characterization of the lower end of the paranoia spectrum, psychological domains that are associated with symptom severity, and how paranoia and its structure fluctuate over time. This study conducted both cross-sectional and longitudinal surveys with 802 participants from the German population assessing paranoia and general psychopathology. Data was collected through Ecological Momentary Assessment (EMA). Several statistical approaches were used including confirmatory factor analysis (CFA), latent class analysis (LCA) and mixed modelling analyses (ME). Paranoid experiences appear to be a common phenomenon that occur in people with and without mental illness. Subjects clustered into four paranoia severity subgroups (IP, M, IR, PI) and showed significant associations in various psychological domains like increased psychiatric symptoms and maladaptive coping. Paranoia fluctuates over time in all four severity subgroups, but the hierarchical subgrouping was stable. Both persecutory ideations and interpersonal sensitivity were significant predictors of paranoia. Findings provide important insights into the architecture of paranoia in the German population by characterizing their hierarchical, dimensional, and dynamic structure and its link to psychopathology. [ABSTRACT FROM AUTHOR]

• Mealtime anxiety predicted increased emotional avoidance at the next meal. • When considering concurrent guilt, anxiety did not predict emotional avoidance. • Mealtime guilt and physical discomfort predicted emotional avoidance. • These affective processes may differentially relate to eating disorder symptoms. • Guilt should be considered in conceptualizing the anxiety–avoidance cycle. The relationship between negative emotions and avoidance is widely theorized as a bidirectional cycle implicated in a range of psychopathology. Historically, research on this cycle has examined one type of negative emotion: anxiety. Yet, a broader range of internal experiences may be implicated in the maintenance of unhealthy avoidance cycles in psychopathology. This study examines prospective relationships among anxiety, guilt, physical discomfort, and experiential avoidance during mealtimes for individuals with eating disorders (EDs). Participants (N = 108) completed ecological momentary assessments four times a day for 25 days. We computed multilevel models to examine between- and within-person effects of negative emotions and physical discomfort on experiential avoidance. When including guilt and anxiety in one model, guilt, but not anxiety, explained the significant variance in experiential avoidance at the next meal. Mealtime physical discomfort and experiential avoidance evidenced reciprocal prospective relationships. Future research should test whether interventions targeting experiential avoidance and physical discomfort at mealtimes disrupt guilt. [ABSTRACT FROM AUTHOR]

[Display omitted] • First ecological momentary assessment study to examine emotion dysregulation in OCD. • More avoidance-oriented strategies in OCD vs. healthy controls. • Less positive affect and regulatory effectiveness in OCD vs. healthy controls. • Results remain significant controlling for symptoms, negative affect or depression. • Negative affect is related to more avoidance, less effectiveness, and acceptance. Emotion dysregulation is a central process implicated in the genesis and maintenance of obsessive-compulsive disorder (OCD). However, past research on OCD has examined emotion regulation with a trait-level approach, thereby neglecting important situational and temporal dynamics. The present study is the first one to examine moment-to-moment emotion regulation in individuals with OCD. A 6-day ecological momentary assessment was used to assess affect, emotion regulation strategies, perceived effectiveness of emotion regulation strategies, and acceptance of emotional experiences in n = 72 individuals with OCD and n = 54 psychologically healthy controls. As expected, individuals with OCD reported more negative and less positive affect. Group differences in positive (but not negative) affect did remain significant when controlling for baseline depression. Furthermore, the OCD group reported to use a higher momentary number of avoidance-oriented regulation strategies and less perceived effectiveness of emotion regulation, even when controlling for current symptoms and negative affect or baseline depression scores. Further, irrespective of group, more momentary negative affect amplified use of avoidance-oriented strategies and diminished perceived effectiveness and emotional acceptance. Contrary to expectations, these effects were not more pronounced in the OCD group. Possible explanations for unexpected findings and implications for future research, particularly regarding more holistic emotion regulation treatments, are discussed. [ABSTRACT FROM AUTHOR]

Recent research shows that sleep disturbances are linked to increased suicidal ideation. In the present longitudinal cohort study, we used subjective (ecological momentary assessment, EMA) and objective (actigraphy) measures to examine the effects of sleep parameters on next-day suicidal ideation. Further, we examined hopelessness as a mediator between insufficient sleep and increased suicidal ideation. Individuals with current suicidal ideation (N = 82) completed 21 days of EMA and actigraphy to estimate suicidal ideation, hopelessness and sleep parameters. Multilevel linear-mixed models were used to examine the effects of sleep parameters on next-day suicidal ideation, as well as for the mediating effect of hopelessness (in the morning) on the association between previous night's sleep and suicidal ideation levels the next day. Significant concordance existed between subjective and objective sleep measures, with moderate-to-large correlations (r = 0.44–0.58). Lower subjective sleep quality and efficiency, shorter total sleep time and increased time awake after sleep onset were significantly associated with increased next-day suicidal ideation (controlling for previous-day suicidal ideation). Actigraphy-measured sleep fragmentation was also a significant predictor of next-day ideation. Hopelessness mediated the effects of the subjective sleep parameters on suicidal ideation, but did not account for the association with sleep fragmentation. Therefore, individuals' psychological complaints (hopelessness, suicidal ideation) were better predicted by subjective sleep complaints than by objective sleep indices. Increased hopelessness following from perceived insufficient sleep appears an important explanatory factor when considering the link between sleep disturbances and suicidal ideation. • Interrupted sleep at night is linked to increased next-day suicidal ideation, using both subjective and objective measures. • Hopelessness is a significant explanatory factor in the association between sleep and next-day suicidal ideation. • Sleep disturbances may represent an important warning sign for increased suicide risk. [ABSTRACT FROM AUTHOR]

Clinician collaboration can help high-risk individuals to manage their suicidal crises. However, limited research has directly examined how higher patient-clinician collaboration during assessment and intervention can effectively reduce suicidal ideation. This novel randomized clinical trial compared a high vs. low level of patient-clinician collaboration by pairing commonly used assessment (Structured Interview vs. Narrative Assessment) and intervention approaches (Safety Planning Intervention vs. Crisis Response Planning). We hypothesized that the interventions involving higher (than lower) patient-clinician collaboration during assessment (Narrative Assessment) or intervention (Crisis Response Planning) would lead to larger reductions in suicidal ideation. Eighty-two participants with a history of suicide ideation and/or attempts were randomly assigned to one of the four interventions varying in patient-clinician collaboration. After attrition, sixty-six participants completed the study. Suicidal ideation via ecological momentary assessment was measured 14 days before and 14 days after treatment. Although the severity of suicidal ideation decreased in all groups, the two groups that included highly collaborative assessment had larger pre-post reductions in suicidal ideation (Narrative Assessment+Safety Plan; d within = 0.26, and Narrative Assessment+Crisis Response Plan; d within = 0.19) than the groups that included a checklist-based assessment (Structured Interview). Longer follow-up periods with a larger sample would have provided an understanding of the durability of intervention effects. Results suggest that the inclusion of higher patient-clinician collaboration techniques during suicide risk assessment can effectively reduce suicidal thoughts. Thus, clinician-led collaborative risk assessment approaches can enhance the effects of safety planning-type interventions among patients with elevated risk for suicide versus checklist-based assessment approaches. • Higher clinician-led collaboration via Narrative assessment reduces suicide risk. • Narrative assessment paired with Safety Plan Intervention reduces suicidal thoughts. • Narrative assessment paired with a Crisis Response Plan reduces suicidal thoughts. • Collaborative risk assessments can enhance safety planning-type interventions. [ABSTRACT FROM AUTHOR]

Evidence suggests that loneliness causes people to feel more depressed. It is unknown, however, why this association occurs and whether momentary versus chronic experiences of loneliness are implicated. Theoretical accounts suggest that momentary feelings of loneliness produce two competing motivations: social reaffiliation and social withdrawal. Social affiliation is protective against depression; social withdrawal, in contrast, is a risk factor. Thus, engaging in frequent and high-quality interactions following experiences of loneliness may protect against subsequent depression. We tested this hypothesis using a random-interval experience sampling design (5x/day/day, 14 days; Nobs = 6568) with a racially/ethnically diverse sample of adults with elevated depression symptoms (N = 102). Momentary loneliness was associated with depressed mood at the same time point and ∼2.5h and ∼5h later. Frequency and quality of social interaction did not moderate these associations. Findings suggest that momentary feelings of loneliness may be an important target for clinical intervention. • Evidence suggests that loneliness is causally associated with depression. • It is unclear whether momentary vs. chronic feelings of loneliness cause depression. • Features of social interactions (e.g., quantity) may buffer against subsequent depression. • Results showed that loneliness was associated with depression at the same time point and ∼2.5 and ∼5 hours later. • Neither social interaction quantity, satisfaction, self- and other-disclosure, nor responsiveness moderated this association. [ABSTRACT FROM AUTHOR]

Ecological Momentary Assessment (EMA) holds promise for providing insights into daily life experiences when studying mental health phenomena. However, commonly used mixed-effects linear statistical models do not fully utilize the richness of the ultidimensional time-varying data that EMA yields. Recurrent Neural Networks (RNNs) provide an alternative data analytic method to leverage more information and potentially improve prediction, particularly for non-normally distributed outcomes. As part of a broader research study of suicidal thoughts and behavior in people with borderline personality disorder (BPD), eighty-four participants engaged in EMA data collection over one week, answering questions multiple times each day about suicidal ideation (SI), stressful events, coping strategy use, and affect. RNNs and mixed-effects linear regression models (MEMs) were trained and used to predict SI. Root mean squared error (RMSE), mean absolute percent error (MAPE), and a pseudo-R2 accuracy metric were used to compare SI prediction accuracy between the two modeling methods. RNNs had superior accuracy metrics (full model: RMSE = 3.41, MAPE = 42 %, pseudo-R2 = 26 %) compared with MEMs (full model: RMSE = 3.84, MAPE = 56 %, pseudo-R2 = 16 %). Importantly, RNNs showed significantly more accurate prediction at higher values of SI. Additionally, RNNs predicted, with significantly higher accuracy, the SI scores of participants with depression diagnoses and of participants with higher depression scores at baseline. In this EMA study with a moderately sized sample, RNNs were better able to learn and predict daily SI compared with mixed-effects models. RNNs should be considered as an option for EMA analysis. • Recurrent Neural Networks had superior predictive ability for Suicidal Ideation compared to Mixed-Effects Models • Both methods were less accurate in the higher range of Suicidal Ideation values • Recurrent Neural Networks performed better for high values than Mixed-Effects Models, and for those with depression symptoms • Proposed extensions of Recurrent Neural Network modeling further improved prediction accuracy in the high ideation range [ABSTRACT FROM AUTHOR]

Although suicide is complex and heterogeneous, most suicide theories assume that suicidal urges occur primarily in the context of extreme emotional distress. Newer models of suicide based on complex systems theory propose greater heterogeneity in suicidal experiences across individuals and groups, such that some, but not all, suicidal thoughts, urges, and behaviors are associated with extreme negative affect. The present study investigated individual differences in affective states experienced during suicidal urges among 138 adults recruited from the community; 81 (59.1 %) owned handguns and 57 (41.6 %) did not. Participants self-reported their current affect and urge to kill themselves 6 times per day for 28 consecutive days via ecological momentary assessment. Positive and negative affect ratings varied significantly during suicidal urges. The association of positive and negative affect with suicidal urges significantly varied within and between handgun owners and non-owners. Results suggest suicidal urges are characterized by high affective heterogeneity. • Little is known about the range of affect experienced during suicidal states • Affect and suicidal urges were assessed repeatedly using ecological momentary assessment • Affect during suicidal urges ranged considerably across individuals • The relationship of affect and suicidal urges also ranged considerably • The relationship of affect and suicidal urges was weaker among handgun owners [ABSTRACT FROM AUTHOR]

Understanding the biological processes that underlie individual differences in emotion regulation and stress responsivity is a key challenge for translational neuroscience. The gene FKBP5 is a core regulator in molecular stress signaling that is implicated in the development of psychiatric disorders. However, it remains unclear how FKBP5 DNA methylation in peripheral blood is related to individual differences in measures of neural structure and function and their relevance to daily-life stress responsivity. Here, we characterized multimodal correlates of FKBP5 DNA methylation by combining epigenetic data with neuroimaging and ambulatory assessment in a sample of 395 healthy individuals. First, we showed that FKBP5 demethylation as a psychiatric risk factor was related to an anxiety-associated reduction of gray matter volume in the ventromedial prefrontal cortex, a brain area that is involved in emotion regulation and mental health risk and resilience. This effect of epigenetic upregulation of FKBP5 on neuronal structure is more pronounced where FKBP5 is epigenetically downregulated at baseline. Leveraging 208 functional magnetic resonance imaging scans during a well-established emotion-processing task, we found that FKBP5 DNA methylation in peripheral blood was associated with functional differences in prefrontal-limbic circuits that modulate affective responsivity to daily stressors, which we measured using ecological momentary assessment in daily life. Overall, we demonstrated how FKBP5 contributes to interindividual differences in neural and real-life affect regulation via structural and functional changes in prefrontal-limbic brain circuits. [ABSTRACT FROM AUTHOR]

Depression is linked to cognitive biases towards more negative and less positive self-relevant information. Rumination, perseverative negative thinking about the past and the self, may contribute to these biases. 159 adolescents (12–18 years), with a range of depression symptoms, completed the SRET during fMRI. Multiple regressions tested associations between conventional self-report and ecological momentary assessment (EMA) measured rumination, and neural and behavioral responses during a self-referent encoding task (SRET). Higher rumination (conventional self-report and EMA) was associated with more negative and fewer positive words endorsed and recalled. Higher self-reported (but not EMA) rumination was associated with higher accuracy in recognizing negative words and greater insula and dorsal anterior cingulate activity to negative versus positive words. The sample included mostly non-Hispanic White participants with household incomes above the national average, highlighting the need for replication in more diverse samples. Word endorsement discrepancies required fMRI analyses to model neural response to viewing negative versus positive words. Adolescents with higher rumination endorsed and recalled more negative and fewer positive words and recognized more negative words during the SRET. Higher insula reactivity, a key region for modulating externally-oriented attention and internally-oriented self-referential processes, may contribute to links between rumination and negative memory biases. These findings provide insight into neurocognitive mechanisms underlying depression. • Rumination may contribute to negative cognitive biases in depression. • Rumination is linked to more negative memory biases on a self-referential task. • Rumination is linked to more insula activity to negative self-referential words. • Brain response to negative self-referential content may facilitate rumination. [ABSTRACT FROM AUTHOR]

A diagnostic criterion for Major Depressive Disorder (MDD) is difficulty concentrating and increased distractibility. One form of distraction that occurs in everyday life is mind-wandering. The current study aims to test how individuals with MDD and healthy controls differ in their mind-wandering in everyday life. Adults diagnosed with MDD (n = 53) and healthy controls (n = 53) completed a week of experience sampling, with prompts administered up to eight times per day. At each prompt, participants reported the occurrence and characteristics of their mind-wandering. They also reported levels of momentary negative affect (NA), positive affect (PA), and rumination. MDD participants reported mind-wandering almost twice as often as healthy control participants. Compared to healthy participants, MDD participants rated their mind-wandering as more negative, but did not differ in terms of temporal orientation. Higher NA and lower PA predicted mind-wandering in the MDD group but not healthy controls, even after controlling for rumination. Time-lagged analyses revealed that current mind-wandering predicted future levels of PA in MDD participants but not in healthy controls; in contrast, current NA and PA did not predict future mind-wandering. Limitations include our examination of specific forms of mind-wandering (i.e., we did not sample the full spectrum of this construct). Individuals with MDD frequently report engaging in mind-wandering in everyday life, and this appears to be coupled with affect. Mind-wandering may have maladaptive effects in MDD and could serve as a target for intervention. • Individuals with major depressive disorder (MDD) may have difficulties concentrating and may find that their mind wanders. • This study compared rates of mind-wandering in individuals with MDD to healthy controls over a week of experience sampling. • Mind-wandering was higher in MDD and was associated with subsequent changes in affect. • This research highlights that mind-wandering in MDD is common and suggests a potential target for intervention. [ABSTRACT FROM AUTHOR]

Disrupted sleep has been linked to suicidal thoughts and behavior. Less is known, however, about the underlying mechanisms of this relationship. A more nuanced understanding of the link between sleep and suicide may help inform treatment decisions and the development of prevention and intervention strategies. The present study examined daily average sleepiness as a moderator to the relation between same-day passive and active suicide ideation (SI). Fifty-nine young adults (mean age = 21.04; SD = 2.22) endorsing SI at least twice in the two weeks prior to baseline completed 3–5 daily surveys of sleepiness and SI over 2 weeks as part of a broader study. Across several indicators of sleepiness (desire to stay awake, desire to fall asleep), passive SI (desire to die, desire to live), and active SI (occurrence, intensity, duration, and controllability), the overall findings demonstrated that daily average sleepiness magnified the relation between same-day passive SI and active SI severity. These findings indicate that being sleepier than usual may increase the likelihood that passive SI transitions to active SI. Future research is needed to test the causal influence of sleepiness on this transition. • Sleepiness is related to both passive and active suicide ideation. • Sleepiness moderates the relation between passive and active suicide ideation. • Results are consistent across various indicators of sleepiness and passive ideation. [ABSTRACT FROM AUTHOR]

• People with schizophrenia spectrum disorders report normal quantity of mental imagery. • Mental imagery vividness is reduced in people with schizophrenia spectrum disorders. • Reduced vividness is related to low anticipatory pleasure, motivation, and activity. • Reduced vividness may cause a lack of incentive to seek pleasurable experiences. Many people with schizophrenia spectrum disorders (SSDs) experience profound amotivation, which is strongly related to anticipatory anhedonia. Yet, the neuropsychological fundamentals of anticipatory anhedonia and amotivation are barely understood, resulting in a lack of effective treatments for these patients. Aberrancies in positive mental imagery may interfere with the anticipation of pleasure and could thus explain anticipatory anhedonia and amotivation. However, the nature of mental imagery and its relationship with amotivational psychopathology in SSD is largely unknown. In this preregistered study, we therefore examined mental imagery characteristics and their relation to anticipatory anhedonia, amotivation, and daily life activity in SSD. The N = 86 participants included individuals with SSD (n = 43) and demographically matched healthy controls (n = 43). Mental imagery, anticipatory pleasure, amotivation, and activity engagement were assessed with structured interviews and self-report questionnaires. Ecological momentary assessment was used to measure state anticipatory pleasure and activity engagement in daily life (n = 81). Compared to the control group, the SSD group showed comparable quantity, but less vividness of mental imagery. Reduced vividness of mental imagery in SSD was significantly associated with higher anticipatory anhedonia, amotivation, and low activity engagement in cross-sectional and prospective analyses. Reduced mental imagery vividness may cause a lack of internal incentive to seek pleasurable experiences and could explain amotivation. Interventions aiming to improve mental imagery vividness and related anticipatory pleasure responses in SSD may be effective in targeting amotivation. [ABSTRACT FROM AUTHOR]

This study uses time-intensive, item-level assessment to examine individual depressive and co-occurring symptom dynamics. Participants experiencing moderate-severe depression (N = 31) completed ecological momentary assessment (EMA) four times per day for 20 days (total observations = 2480). We estimated idiographic networks using MDD, anxiety, and ED items. ED items were most frequently included in individual networks relative to depression and anxiety items. We built ridge and logistic regression ensembles to explore how idiographic network centrality metrics performed at predicting between-subject depression outcomes (PHQ-9 change score and clinical deterioration, respectively) at 6-months follow-up. For predicting PHQ-9 change score, R 2 ranged between 0.13 and 0.28. Models predicting clinical deterioration ranged from no better than chance to 80 % accuracy. This pilot study shows how co-occurring anxiety and ED symptoms may contribute to the maintenance of depressive symptoms. Future work should assess the predictive utility of psychological networks to develop understanding of how idiographic models may inform clinical decisions. • Eating disorder, anxiety, and depressive symptoms were central in depressed sample. • Each participant had a unique network structure. • Central symptoms accounted for change in depressive symptoms at 6-months follow-up. • Central symptoms with high means and variability predicted clinical deterioration. • The structure of co-occurring psychopathology may relate to depression outcomes. [ABSTRACT FROM AUTHOR]

Examining the daily experiences of older adults with depression facilitates the development and application of personalized effective treatments for them. In previous clinical research on depression, traditional mean-based approaches have mainly been employed. However, the within-person residual variance as a random effect provides greater insight into the heterogeneity of daily experiences among geriatric samples. This study aimed to examine the relationship between depression and daily vitality in older adults. Specifically, it focused on the mean and residual variance of daily vitality measured by the Ecological Momentary Assessment (EMA). Data from 64 older adults aged 65 years or more, who participated in community welfare centers or retirees' associations, were used. Daily vitality was examined using EMA surveys for seven consecutive days (four random surveys per day). The data were analyzed using a location-scale model. The intraclass correlation computed from the empty model for the EMA data was 0.488, indicating significant variances in daily vitality across time between individuals. Older adults with higher levels of depressive symptoms showed low mean levels of daily vitality and a large log-residual variance of daily vitality. The findings from the current study suggest that individuals experiencing depression not only exhibit low vitality in their daily lives but also struggle to maintain stable levels of vitality in their lives. These insights could contribute to the facilitation and advancement of personalized interventions tailored for older adults. • Individuals experiencing depression exhibit low vitality in their daily lives. • Depressed individuals struggle to maintain stable levels of vitality in their lives. • The multilevel location-scale model was used for data analysis. [ABSTRACT FROM AUTHOR]

Childhood trauma is experienced by approximately one third of young people in the United Kingdom and has been shown to confer an increased risk for mental health difficulties in adulthood. Understanding the associations between these factors before negative health outcomes manifest in adulthood is imperative to help inform the development of interventions. The aims of this study were two-fold; first, to investigate the effects of childhood trauma on daily stress-related vulnerability factors over a period of 7 days and to test whether any observed relationships were moderated by protective or risk factors. Second, to explore the indirect effects of childhood trauma on reasons for living, optimism, daily suicide ideation, defeat and entrapment through the daily stress-related vulnerability factors. 212 participants were recruited to an ecological momentary assessment study to complete three diaries per day for a 7-day period. Participants completed daily measures of stress, hassles, executive functioning, impulsivity, sleep quality (stress-related vulnerability factors) as well as measures of reasons for living, optimism, daily thoughts of suicide, defeat and entrapment. The Childhood Trauma Questionnaire was also completed at baseline. Analyses found that childhood trauma was significantly associated with higher scores on the daily stress-related vulnerability factors and positively related to each of the daily indicators of suicide risk. The study also uncovered key pathways whereby trauma had indirect effects on reasons for living, optimism, daily thoughts of suicide, defeat and entrapment through executive functioning, impulsivity, sleep quality and stress. The measures of executive function and sleep were self-reported and future research ought to replicate the current findings using more objective methods. The findings from this study highlight the complexity of childhood trauma and its damaging effects on stress-related vulnerability factors and poorer mental health outcomes. Greater understanding of pathways by which trauma may impact later health outcomes is essential for development of interventions. • Childhood trauma was associated with higher daily stress and impulsivity. • Childhood trauma was related to poorer sleep quality and executive functioning. • Childhood trauma was associated with suicide risk factors. • Childhood trauma had indirect effects on suicide risk through stress-related variables. [ABSTRACT FROM AUTHOR]

Low average affect, measured using ecological momentary assessment (EMA), has been consistently linked with depression, generalized anxiety, and social anxiety, supporting trait-like negative affect as a shared underlying feature. However, while theoretical models of emotion regulation would also implicate greater variability in daily affect in these conditions, empirical evidence linking EMA of mood variability with affective disorders is mixed. We used multilevel modeling to test relationships of daily mood and mood variability with depression, generalized anxiety, and social anxiety symptoms. Participants (N = 1004; 72.31 % female; M age = 40.85) responded to EMA of mood 2-3×/day and completed measures of depression (PHQ-8), generalized anxiety (GAD-7), and social anxiety (SPIN) every three weeks. Lower mean affect predicted all symptoms at both the between-person (PHQ-8: β = −0.486, p < 0.001; GAD-7: β = −0.429, p < 0.001; SPIN: β = −0.284, p < 0.001) and within-person (PHQ-8: β = −0.219, p < 0.001; GAD-7: β = −0.196, p < 0.001; SPIN: β = −0.049, p < 0.001) levels. Similarly, at the between-person level, greater affective variability was linked with all three clinical symptoms (PHQ-8: β = 0.617, p < 0.001; GAD-7: β = 0.703, p < 0.001; SPIN: β = 0.449, p < 0.001). However, within-person, affective variability related to depression (β = 0.144, p < 0.001) and generalized anxiety (β = 0.150, p < 0.001), but not social anxiety (β = 0.006, p = 0.712). The COVID-19 pandemic lockdown period occurred midway through the study. Findings point to common and specific emotion dynamics that characterize affective symptoms severity, with implications for affective monitoring in a clinical context. • Low in-vivo daily affect predicts depression, generalized anxiety, and social anxiety. • Variability in daily affect differentially relates to mood and anxiety symptoms. • Distinct daily affect patterns may signal within-person changes in a clinical context. • Multilevel modeling captures within-person affective processes over time. [ABSTRACT FROM AUTHOR]

Affective dynamics have been identified as a correlate of a broad span of mental health issues, making them key candidate transdiagnostic factors. However, there remains a lack of knowledge about which aspects of affective dynamics – especially as they manifest in the course of daily life – relate to a general risk for mental health issues versus specific symptoms. We leverage an ecological momentary assessment (EMA) study design with four measures per day over a two-week period to explore how negative affect levels, inertia, lability, and reactivity to provocation and stress in the course of daily life relate to mental health symptoms in young adults (n = 256) in the domains of anxiety, depression, psychosis-like symptoms, behaviour problems, suicidality, and substance use. Dynamic structural equation modelling (DSEM) suggested that negative affect levels in daily life were associated with depression, anxiety, indirect and proactive aggression, psychosis, anxiety, and self-injury; negative affective lability was associated with depression, physical aggression, reactive aggression, suicidal ideation, and ADHD symptoms; negative affective inertia was associated with depression, anxiety, physical aggression, and cannabis use; and emotional reactivity to provocation was related to physical aggression. The cross-sectional design, the limited span of mental health issues included, and the convenience nature and small size of the sample are limitations. Findings suggest that a subset of mental health symptoms have shared negative affective dynamics patterns. Longitudinal research is needed to rigorously examine the directionality of the effects underlying the association between affective dynamics and mental health issues. • This study used EMA to assess affective dynamics and examined their association with a range of mental health issues. • No affective dynamics component was found to be associated with all of the mental health symptoms included in this study. • Findings imply that dysfunctional affective processes may be makers for mental health symptoms. [ABSTRACT FROM AUTHOR]

Patients with depression often require inpatient treatment due to their high suicide risk. Ecological momentary assessment (EMA) studies have shown that suicidal ideation (SI) fluctuates over time. As affective instability and psychological pain (PP) are common experiences in borderline personality disorder (BPD), often comorbid with depression, we examined factors predicting short-term changes of SI in depressive inpatients with or without BPD. Psychiatric inpatients with depression with (N = 30) or without (N = 37) comorbid BPD assessed their anxiety, PP, severity of depression, SI, and hopelessness three times daily using visual analogue scales. Multilevel regression models were estimated. Altogether 4320 EMA observations, spanning on average 3.4 successive days, were collected. Only severity of depression (β = 0.19; [95 % CI = 0.06, 0.32]) and previous SI (β = 0.32; [95 % CI = 0.23, 0.41]) predicted near-future SI within several hours. PP predicted near-future SI in inpatients with depression and BPD (β = 0.28; [95 % CI = 0.11, 0.46]), but not in patients without BPD. The follow-up data represents only the first days of hospitalization. The context of the EMA is the acute psychiatric ward, affecting generalizability to outpatients. Short-terms changes in SI are predicted by changes in severity of depression and previous SI in depressed inpatients without BPD, and also by changes in PP in depressed inpatients with BPD. As SI and its risk factors may oscillate within a time scale of hours, frequent monitoring of momentary severity of depression, PP, and SI may be warranted in inpatient settings. • Suicidal ideation (SI) oscillates over time in patients with depression with and without borderline personality disorder (BPD) • Severity of depression and psychological pain (PP) are more temporally instable in depressed inpatients with BPD • Changes in depression in inpatients without BPD, and in PP in inpatients with BPD predict short-term changes of SI • Frequent monitoring of momentary severity of depression, PP, and SI may be warranted in inpatient settings [ABSTRACT FROM AUTHOR]

People with serious mental illness (SMI; schizophrenia, schizoaffective disorder, bipolar disorder) are at increased risk of suicidal ideation (SI). Over-attribution of social threat, or attributing threatening emotions to neutral faces, may contribute to social isolation through increased social avoidance and decreased social approach motivation. These factors are related to suicide, as well as perceived burdensomeness (PB) and thwarted belongingness (TB). This study examined how over-attribution of threat relates to PB, TB, and social motivations. N = 273 participants with SMI were assessed for current SI and behavior, and were stratified into SI (N = 130) vs. non-SI (N = 143) groups. Participants completed smartphone surveys (via ecological momentary assessments [EMA]) 3×/day for 10 days. They also completed the Mobile Ecological Test of Emotion Recognition (METER) 1×/day. Linear mixed models and multi-level mediation tested the relationships between over-attribution of threat, METER performance, PB/TB, and social motivations. Participants with and without SI did not significantly differ in over-attribution of threat or METER performance. In separate models, there was a relationship of over-attribution of threat with increased PB (B = 1.00, SE = 0.21, t = 4.72, p <.001), reduced social approach motivation (B = -0.74, SE = 0.22, t = −3.33, p <.001), and increased social avoidance (B = 0.90, SE = 0.24, t = 3.70, p <.001), all significant when adjusting for facial affect recognition ability. A model examining social motivations as a mediator between over-attribution of threat and PB/TB was not significant. These results suggest that over-attribution of threat relates to interpersonal constructs related to SI irrespective of facial affect abilities. This study may inform understanding of social cognitive processes related to suicide in SMI. [ABSTRACT FROM AUTHOR]

Despite the importance of positive emotions for affective psychopathology, prior research primarily focused on negative emotion regulation. To address this gap, this ecological momentary assessment study compared a broad set of emotion regulation strategies in the context of positive versus negative emotions regarding their effectiveness and associations with depressive symptoms. We analyzed data from 1066 participants who were notified five times daily for seven consecutive days to complete a smartphone survey assessing their predominant emotions, strategies to regulate them, and subsequent emotional outcomes. Findings show that the effectiveness of most regulation strategies depended on whether the emotional context was positive or negative. While acceptance and savoring predicted improved emotional outcomes across emotional contexts, reappraisal and problem-solving were associated with deteriorated emotional outcomes and increased depressive symptoms when regulating positive but not negative emotions. Future studies should replicate our findings in demographically and culturally diverse clinical samples to improve generalizability. These results emphasize that strategies effective for regulating negative emotions may be less helpful in the context of positive emotions. Thus, context-specific interventions may be a promising approach to improve the treatment of affective disorders. • Disturbances in positive emotions are central for affective psychopathology. • Most prior studies have examined negative emotion regulation relying on retrospective self-reports. • This study investigated how positive versus negative emotion regulation in daily life predicts depressive symptoms. • Unfavorable patterns of positive emotion regulation were associated with more severe depressive symptoms. • Targeting disturbances in positive emotion regulation within affective disorders is crucial for enhancing public health. [ABSTRACT FROM AUTHOR]

Hallucinations have been linked to failures in metacognitive reflection suggesting an association between hallucinations and overestimation of performance, although the cross-sectional findings are inconsistent. This inconsistency may relate to the fluctuating hallucinatory experiences that are not captured in cross-sectional studies. Ecological Momentary Assessment (EMA) captures in-the-moment experiences over time so can identify causal relationships between variables such as the associations between metacognition and hallucinatory experience in daily life and overcome problems in cross-sectional designs. Participants (N = 41) experiencing daily hallucinations completed baseline questionnaires and smartphone surveys 7 times per day for 14 days. They were prompted to identify a task they would complete in the next 4 h and to make metacognitive predictions around the likelihood of completing the task, the difficulty of the task, and how well they would complete it (standard of completion). 76 % finished the 14-days of assessment with an average of 42.2 % survey completion. Less accurate metacognition was associated with more hallucinations, but less accurate likelihood and standard of completion was associated with fewer hallucinations. Using a cross-lagged analysis, metacognitive predictions around the likelihood of completion (p <.001) and standard of completion (p =.01) predicted hallucination intensity at the following timepoint, and metacognitive predictions regarding likelihood of completion (p =.02) predicted hallucination control at the following timepoint. Interventions that aim to improve metacognitive ability in-the-moment may serve to reduce the intensity and increase the control of hallucinations. [ABSTRACT FROM AUTHOR]

Differentiating major depressive episodes (MDEs) of major depressive disorder (MDD), bipolar disorder (MDE/BD) and the MDEs comorbid with borderline personality disorder (MDE/BPD) is crucial for appropriate treatment, and knowledge of phenomenological differences may aid this. However, studies comparing affect experiences of these three patient groups and healthy subjects are scarce. In our study, participants (N = 114), including patients with MDD (n = 34), MDE/BD (n = 27), and MDE/BPD (n = 24), and healthy controls (HC, n = 29) responded to ecological momentary assessment (EMA) with ten circumplex model affect items ten times daily for seven days (7709 recordings). Explorative factor analysis resulted in two affect dimensions. The positive dimension included active, excited, cheerful (high arousal), and content (low arousal) affects, and the negative dimension irritated, angry, and nervous (high arousal) affects. Relative to HC, patients reported 3.5-fold negative affects (mean MDD 1.36 (SD 0.92), MDE/BD 1.43 (0.76), MDE/BPD 1.81 (0.95) vs. HC 0.44 (0.49) (p < 0.01)) but 0.5-fold positive affects (2.01 (0.90), 1.95 (0.89), 2.24 (1.03), vs. 3.2 (0.95), respectively (p < 0.01)). We used multilevel modelling. Negative-affect within-individual stability was lowest in MDE/BPD and highest in MDD. Negative affect predicted concurrent positive affect more in MDE/BPD than in MDD. Moderate size of subcohorts and no inpatients were limitations. Despite apparently similar MDEs, affective experiences may differ between BPD, BD, and MDD patients. Clinical subgroups of patients with depression may vary in affective instability and concurrent presence of negative and positive affects during depression. • Differentiating depression, bipolar and borderline personality disorders is pivotal. • We assessed MDD, MDE/BD and MDE/BPD patients plus controls' momentary affects. • The patient groups differed from controls more in negative than positive affect. • Negative affect's stability was lowest in MDE/BPD, highest in MDD patients. [ABSTRACT FROM AUTHOR]

• The objective was to use contingency management to reduce cannabis use. • Participants typically used cannabis on 94% of the days (1.42 grams daily). • During the 6-week reduction phase, participants reduced use days by 47%. • Participants reduced daily grams use to.61 grams daily. Many interventions for cannabis use disorder (CUD) are associated with decreases in frequency and quantity of use but fail to increase overall rates of sustained abstinence. It is currently unknown whether reductions in use (in the absence of sustained abstinence) result in clinically significant improvements in functioning. The objective of this study was to refine a mobile contingency management approach to reduce cannabis use to ultimately evaluate whether reductions in frequency and quantity of cannabis are related to improvements in functional and mental health status. Three cohorts of participants (n = 18 total, n = 10 women) were enrolled and completed 2 weeks of ecological momentary assessment (EMA) during a baseline ad lib cannabis use period, followed by a 6-week reduction period. Participants completed EMA assessments multiple times per day and were prompted to provide videotaped saliva cannabis testing 2–3 times daily. Data from participants who were at least 80% adherent to all EMA prompts were analyzed (13 out of 18). During the ad lib phase, participants were using cannabis on 94% of the days and reported using a mean of 1.42 grams daily. The intervention was a mobile application that participants used to record cannabis use by saliva tests to bioverify abstinence and participants completed electronic diaries to report their grams used. During the 6-week intervention phase, participants reported reducing their use days to 47% of the days with a reported mean of.61 grams daily. In the last cohort, at least 50% of the heavy users were able to reduce their cannabis use by at least 50%. The effect of cannabis reduction (versus abstinence) is largely unknown. Observations suggest that it is possible to develop a mobile intervention to reduce cannabis use among heavy users, and this paradigm can be utilized in future work to evaluate whether reductions in cannabis use among heavy users will result in improvements in functional and mental health status. [ABSTRACT FROM AUTHOR]

The reward/circadian rhythm model of bipolar spectrum disorders (BSDs) posits that when individuals with hypersensitive reward systems encounter reward-relevant events, they experience social and circadian rhythm disruption, leading to mood symptoms. The aim of the current study is to test an element of this theoretical model by investigating changes in social rhythms during and after an ecologically-valid reward-relevant event and evaluating whether the strength of these associations differ by trait reward sensitivity and BSD diagnostic group. Young adults from three groups (low BSD risk with moderate reward sensitivity [MRew], high BSD risk with high reward sensitivity [HRew], and high reward sensitivity with BSD [HRew+BSD]) completed a reward responsiveness task and 20-day ecological momentary assessment study structured around a participant-specific goal occurring on day 15. Social rhythm disruption (SRD) and social rhythm regularity (SRR) were assessed daily. Multilevel models examined whether reward sensitivity and group moderated associations between study phase (baseline [days 1–5], goal-striving [days 16–20], or outcome [days 16–20]) and social rhythms. Participants experienced greater SRD after the goal-striving event during the outcome phase, compared to the baseline phase. The HRew+BSD group had significant decreases in SRR during the outcome phase, and this pattern differed significantly from the low-risk and high-risk groups. Greater task reward responsiveness also was associated with significant decreases in SRR during the outcome phase. This study did not test whether social rhythm irregularity was associated with subsequent mood change. Participants exhibited social rhythm changes over the course of this ecologically valid goal-striving period, providing evidence for the interplay between reward-activating events and social rhythms. The HRew+BSD group showed a distinct pattern in which their social rhythms were more irregular after completing reward-relevant goal-striving that was not observed for the low-BSD risk or high-BSD risk groups. These findings provide additional support for Interpersonal and Social Rhythms Therapy. • Young adults exhibited changes in social rhythms over the course of an ecologically valid goal-striving period. • All participants had increased social rhythm disruptions in the days following a reward-relevant event. • Individuals with bipolar spectrum disorder had more social rhythm irregularity compared to the low-risk and high-risk groups. • High behavioral reward responsiveness also was associated with more social rhythm irregularity. [ABSTRACT FROM AUTHOR]

Consumer sleep trackers issue daily guidance on 'readiness' without clear empirical basis. We investigated how self-rated mood, motivation, and sleepiness (MMS) levels are affected by daily fluctuations in sleep duration, timing, and efficiency and overall sleep regularity. We also determined how temporally specific these associations are. 119 healthy university students (64 female, mean age = 22.54 ± 1.74 years) wore a wearable sleep tracker and undertook twice-daily smartphone-delivered ecological momentary assessment of mood, motivation, and sleepiness at post-wake and pre-bedtime timings for 2–6 weeks. Naps and their duration were reported daily. Nocturnal sleep on 2471 nights were examined using multilevel models to uncover within-subject and between-subject associations between sleep duration, timing, efficiency, and nap duration on following day MMS ratings. Time-lagged analyses examined the temporal specificity of these associations. Linear regression models investigated associations between MMS ratings and sleep variability, controlling for sleep duration. Nocturnal sleep durations were short (6.03 ± 0.71 h), and bedtimes were late (1:42AM ± 1:05). Within-subjects, nocturnal sleep longer than a person's average was associated with better mood, higher motivation, and lower sleepiness after waking. Effects of such longer sleep duration lingered for mood and sleepiness till the pre-bedtime window (all P s <.005) but did not extend to the next day. Between-subjects, higher intraindividual sleep variability, but not sleep duration, was associated with poorer mood and lower motivation after waking. Longer average sleep duration was associated with less sleepiness after waking and lower motivation pre-bedtime (all P s <.05). Longer naps reduced post-nap sleepiness and improved mood. Controlling for nocturnal sleep duration, longer naps also associated with lower post-waking sleepiness on the following day. Positive connections between nocturnal sleep and nap duration with MMS are temporally circumscribed, lending credence to the construction of sleep-based, daily 'readiness' scores. Higher sleep duration variability lowers an individual's post waking mood and motivation. ClinicalTrials.gov NCT04880629. [Display omitted] • Longer nocturnal sleep within-subjects was associated with better mood and motivation, and less sleepiness after waking. • Effects for mood and sleepiness lingered till the pre-bedtime window but did not extend into the next day. • Greater sleep variability, but not mean sleep duration, associated with poorer mood and lower motivation after waking. • Longer naps reduced post-nap sleepiness and improved mood. [ABSTRACT FROM AUTHOR]

Emotion processing deficits of alexithymia are a transdiagnostic risk factor. While such deficits are malleable, the differential efficacy of brief scalable digital mental trainings remains understudied. This randomized controlled trial probed the efficacy of mindfulness-based (MB) and partner-based socio-emotional Affect Dyad (SE) practice, both supported by weekly coaching sessions, in reducing alexithymia in 285 adult participants. We investigated the predictive role of interoceptive awareness assessed a) before and after daily practice, b) in ecological momentary assessment (EMA) before and after the intervention, and c) weekly during the 10-week intervention. Both interventions reduced emotion processing difficulties on the Toronto Alexithymia Scale (TAS-20). Similarly, both interventions improved interoceptive awareness immediately after daily practice and after the intervention period, yet SE outperformed MB training in EMA assessments. Further, only Dyad practice led to increases in body listening and self-regulatory aspects of the Multidimensional Assessment of Interoceptive Awareness (MAIA) over time, with the latter explaining a decrease in alexithymia. Given the subclinical study sample, findings are limited in their generalizability to clinical samples. Findings suggest that app-based socio-emotional and mindfulness-based practices, supported by online coaching sessions, are effective in reducing emotion processing deficits. Dyad training showed advantages on some measures of body awareness, which predicted observed changes in alexithymia. This highlights the potential of using app-based dyadic approaches in the development of emotion awareness and regulation. • Mindfulness and socio-emotional practice is effective in reducing alexithymia. • The two app-based trainings differentially promote interoceptive awareness. • Body awareness practiced in the Affect Dyad informs affect awareness and regulation. [ABSTRACT FROM AUTHOR]

Posttraumatic Stress Disorder is associated with emotion regulation difficulties. However, our understanding of these difficulties has been limited by the reliance of previous work on retrospective trait self-reports, which are unable to capture dynamic, ecologically-valid use of emotion regulation strategies. To address this issue, this study used an ecological momentary assessment (EMA) design to understand the impact of PTSD on emotion regulation in daily life. We conducted an EMA study in a trauma exposed sample with varying levels of PTSD severity (N = 70; 7 days; 423 observations). We found that PTSD severity was linked to greater use of disengagement and perseverative-based strategies to manage negative emotions, regardless of emotional intensity. Study design did not allow investigation into the temporal use of emotion regulation strategies and small sample size. This pattern of responding to emotions may interfere with engaging with the fear structure and thus impair emotion processing in current frontline treatments; clinical implications are discussed. • Used ecological momentary assessment to investigate emotion regulation in PTSD • Results indicate a preference for rumination, suppression, and distraction in daily life. • Cognitive reappraisal and relaxation were not associated with PTSD severity. [ABSTRACT FROM AUTHOR]

We present a novel ambulatory method, the Graz Ambulatory Interoception Task (GRAIT), to assess the accuracy of interoceptive beliefs (AccIB). This method captures both between- and within-person variations of AccIB by having participants counting perceived heartbeats in daily life. Reliability analyses showed high between-person (R kR = 0.99) and moderate within-person reliability (R Cn = 0.62). Validity was supported by associations with an established laboratory task (r = 0.87). Within-person associations revealed that interoceptive sensibility, heart rate variability, and states of low arousal coupled with positive affect were linked to AccIB. Study 2 replicated these findings and showed a relationship between AccIB and self-control in everyday life, highlighting the importance of cardiac interoception and its relevance for health. • Reliable and valid cardiac interoception measure in the field • Accuracy of interoceptive beliefs (AccIB) was associated with HRV. • AccIB was associated with positive deactivating affect. • Study 2 replicates this. • Self-control capacity was associated with the fluctuations of AccIB. [ABSTRACT FROM AUTHOR]

Social anhedonia is considered a key feature of schizophrenia that leads to impaired social functioning. Although traditional laboratory measures assess non-current social pleasure, researchers have begun using experience sampling methods (ESM) to measure current, or consummatory, experiences of social pleasure in daily life. A recent meta-analysis examined deficits in consummatory social pleasure in schizophrenia and found vast heterogeneity in effect sizes across ESM studies. Thus, this meta-analysis aimed to extend those results by testing moderators of this effect. Meta-analysis of 14 ESM studies suggests those with psychotic disorders exhibit a moderate deficit in consummatory social pleasure compared to healthy controls. Yet, this effect was significantly moderated by the type of measure used to assess social pleasure. Measures that directly assessed positive emotional experience during socialization yielded small effects that failed to reach significance; indirect measures of other social factors related to pleasure yielded large, significant effects. This suggests daily social anhedonia observed in psychotic disorders is not due to reduced experience of positive emotion. Instead, social anhedonia may be driven by other elements of social functioning. Most clinical variables did not influence effects, but there was a trend such that patient groups with lower cognitive functioning exhibited greater pleasure deficits. Inconsistent reporting across studies limited our ability to examine other real-world variables that may contribute to deficits in social pleasure. Yet, results show different ESM items used to measure social pleasure do not assess the same construct. Future research is needed to validate ESM measures and standardize protocols across studies. [ABSTRACT FROM AUTHOR]

Anhedonia and amotivation are symptoms of many different mental health disorders that are frequently associated with functional disability, but it is not clear whether the same processes contribute to motivational impairments across disorders. This study focused on one possible factor, the willingness to exert cognitive effort, referred to as cognitive effort–cost decision making. We examined performance on the deck choice task as a measure of cognitive effort–cost decision making, in which people choose to complete an easy task for a small monetary reward or a harder task for larger rewards, in 5 groups: healthy control (n = 80), schizophrenia/schizoaffective disorder (n = 50), bipolar disorder with psychosis (n = 58), current major depression (n = 60), and past major depression (n = 51). We examined cognitive effort–cost decision making in relation to clinician and self-reported motivation symptoms, working memory and cognitive control performance, and life function measured by ecological momentary assessment and passive sensing. We found a significant diagnostic group × reward interaction (F 8,588 = 4.37, p <.001, η p 2 = 0.056). Compared with the healthy control group, the schizophrenia/schizoaffective and bipolar disorder groups, but not the current or past major depressive disorder groups, showed a reduced willingness to exert effort at the higher reward values. In the schizophrenia/schizoaffective and bipolar disorder groups, but not the major depressive disorder groups, reduced willingness to exert cognitive effort for higher rewards was associated with greater clinician-rated motivation impairments, worse working memory and cognitive control performance, and less engagement in goal-directed activities measured by ecological momentary assessment. These findings suggest that the mechanisms contributing to motivational impairments differ among individuals with psychosis spectrum disorders versus depression. [ABSTRACT FROM AUTHOR]

• Reward processing was observed by real-life self-reports of depressed patients. • Within-participant means of all reward paths did not relate to depression course. • Reward Paths 1 and 2 had opposite effects on depression course. • Link between real-life reward processes and depression may be studied best separately. • Strong reward paths may not be adaptive under all circumstances. Engagement in activities increases positive affect (Reward Path 1), which subsequently reinforces motivation (Reward Path 2), and hence future engagement in activities (Reward Path 3). Strong connections between these three reward loop components are considered adaptive, and might be disturbed in depression. Although some ecological nomentary assessment (EMA) studies have investigated the cross-sectional association between separate reward paths and individuals' level of depression, no EMA study has looked into the association between individuals' reward loop strength and depressive symptom course. The present EMA study assessed reward loop functioning (5x/day, 28 days) of 46 outpatients starting depression treatment at secondary mental health services and monitored with the Inventory of Depressive Symptomatology—Self-Report (IDS-SR) during a 7-month period. Results of multilevel regression analyses showed significant within-person associations for Reward Path 1 (b = 0.21, p <.001), Reward Path 2 (b = 0.43, p <.001), and Reward Path 3 (b = 0.20, p <.001). Stronger average reward loops (i.e., within-person mean of all reward paths) did not relate to participants' improvement in depressive symptoms over time. Path-specific results revealed that Reward Paths 1 and 2 may have partly opposite effects on depressive symptom course. Together, our findings suggest that reward processes in daily life might be best studied separately and that further investigation is warranted to explore under what circumstances strong paths are adaptive or not. [ABSTRACT FROM AUTHOR]

Auditory verbal hallucinations (AVH) are experienced by approximately 70 % of patients with schizophrenia and are frequently associated with high levels of distress. Therefore, alleviating hallucinations is an important therapeutic challenge. However, for prescribing a personalized treatment adapted to the patient, an accurate and detailed assessment of AVH is necessary. Until now, there have been no self-evaluations; instead, only scales based on observer ratings have been used to assess AVH. Nevertheless, self-assessments may enhance patient symptom awareness and increase their insight and involvement in the treatment, promoting empowerment (Eisen et al., 2000). In this context, a mobile app called MIMO was devised in order to monitor AVHs assessed by the patients themselves. This app, including the Self-assessment of Auditory verbal Hallucinations (SAVH- https://sns-dollfus.com/), was devised as an ecological momentary assessment tool. The present study aimed to demonstrate the feasibility and acceptability of this app. [ABSTRACT FROM AUTHOR]

Abnormalities in positive and negative emotional experience have been identified in laboratory-based studies in schizophrenia (SZ) and associated with poorer clinical outcomes. However, emotions are not static in daily life–they are dynamic processes that unfold across time and are characterized by temporal interactions. Whether these temporal interactions are abnormal in SZ and associated with clinical outcomes is unclear (i.e., whether the experience of positive/negative emotions at time t increases or decreases the intensity of positive/negative emotions at time t+1). In the current study, participants with SZ (n = 48) and healthy controls (CN; n = 52) completed 6 days of ecological momentary assessment (EMA) surveys that sampled state emotional experience and symptoms. The EMA emotional experience data was submitted to Markov chain analysis to evaluate transitions among combined positive and negative affective states from time t to t+1. Results indicated that: (1) In SZ, the emotion system is more likely to stay in moderate or high negative affect states, regardless of positive affect level; (2) SZ transition to co-activated emotional states more than CN, and once emotional co-activation occurs, the range of emotional states SZ transition to is more variable than CN; (3) Maladaptive transitions among emotional states were significantly correlated with greater positive symptoms and poorer functional outcome in SZ. Collectively, these findings clarify how emotional co-activation occurs in SZ and its effects on the emotion system across time, as well as how negative emotions dampen the ability to sustain positive emotions across time. Treatment implications are discussed. [ABSTRACT FROM AUTHOR]

Experience sampling studies into daily-life affective reactivity indicate that depressed individuals react more strongly to both positive and negative stimuli than non-depressed individuals, particularly on negative affect (NA). Given the different mean levels of both positive affect (PA) and NA between patients and controls, such findings may be influenced by floor/ceiling effects, leading to violations of the normality and homoscedasticity assumptions underlying the used statistical models. Affect distributions in prior studies suggest that this may have particularly influenced NA-reactivity findings. Here, we investigated the influence of floor/ceiling effects on the observed PA- and NA-reactivity to both positive and negative events. Data came from 346 depressed, non-depressed, and remitted participants from the Netherlands Study of Depression and Anxiety (NESDA). In PA-reactivity analyses, no floor/ceiling effects and assumption violations were observed, and PA-reactivity to positive events, but not negative events, was significantly increased in the depressed and remitted groups versus the non-depressed group. However, NA-scores exhibited a floor effect in the non-depressed group and naively estimated models violated model assumptions. When these violations were accounted for in subsequent analyses, group differences in NA-reactivity that had been present in the naive models were no longer observed. In conclusion, we found increased PA-reactivity to positive events but no evidence of increased NA-reactivity in depressed individuals when accounting for violations of assumptions. The results indicate that affective-reactivity results are very sensitive to modeling choices and that previously observed increased NA-reactivity in depressed individuals may (partially) reflect unaddressed assumption violations resulting from floor effects in NA. • Non-depressed participants report very low values of negative affect. • Statistical modeling choices affect results on group differences in affective reactivity to daily events. • Prior findings of increased negative affect reactivity in depressed individuals did not replicate. [ABSTRACT FROM AUTHOR]

• We developed a brief mindfulness-based digital intervention for anorexia nervosa. • The intervention had excellent acceptability and feasibility. • Use of mindfulness skills was high and associated with higher state mindfulness. • We found large, significant improvements in trait mindfulness and emotion regulation. • We found medium-to-large significant reductions in eating disorder symptoms. Anorexia nervosa (AN) is a chronic and debilitating psychiatric disorder. Unfortunately, current treatments are lacking, with only 30-50% of individuals with AN recovering after treatment. We developed a beta-version of a digital mindfulness-based intervention for AN called Mindful Courage-Beta , which includes: (a) one foundational multimedia module; (b) 10 daily meditation mini-modules; (c) emphasis on a core skill set called the BOAT (Breathe, Observe, Accept, Take a Moment); and (d) brief phone coaching for both technical and motivational support. In this open trial, we aimed to evaluate (1) acceptability and feasibility; (2) intervention skill use and its association with state mindfulness in daily life; and (3) pre-to-post changes in target mechanisms and outcomes. Eighteen individuals with past-year AN or past-year atypical AN completed Mindful Courage-Beta over 2 weeks. Participants completed measures of acceptability, trait mindfulness, emotion regulation, eating disorder symptoms, and body dissatisfaction. Participants also completed ecological momentary assessment of skill use and state mindfulness. Acceptability ratings were good (ease-of-use: 8.2/10, helpfulness: 7.6/10). Adherence was excellent (100% completion for foundational module and 96% for mini-modules). Use of the BOAT in daily life was high (1.8 times/day) and was significantly associated with higher state mindfulness at the within-person level. We also found significant, large improvements in the target mechanisms of trait mindfulness (d =.96) and emotion regulation (d =.76), as well as significant, small-medium to medium-large reductions in eating disorder symptoms (ds =.36–.67) and body dissatisfaction (d =.60). Changes in trait mindfulness and emotion regulation had medium-large size correlations with changes in global ED symptoms and body dissatisfaction (rs =.43 –.56). Mindful Courage-Beta appears to be promising and further research on a longer, refined version is warranted. [ABSTRACT FROM AUTHOR]

Emotional reactivity predicts poor health and psychopathology. Despite its theoretical importance, little research has tested whether coping predicts emotional reactivity to stressors. We analyse three studies to test this hypothesis for negative (NA) and positive affect (PA) reactivity to daily stressors. 422 Participants (72.5 % females, M age = 22.79 ± 5.36) came from three longitudinal, ecological momentary assessment (EMA) studies across 7–15 days (ACES N = 190; DESTRESS N = 134; SHS N = 98). Coping was measured at baseline. NA, PA, and daily stressors were assessed via EMA. Mixed effects linear models tested whether coping predicted NA and PA reactivity, defined as their slope on within- and between-person daily stressors. Behavioural disengagement and mental disengagement coping predicted greater within-person NA reactivity across all studies (all p <.01, all f 2 = 0.01). Denial coping predicted greater within-person NA reactivity in ACES and DESTRESS (both p <.01, f 2 from 0.02‐0.03) and between-person in ACES and SHS (both p <.01, f 2 from 0.02 to 0.03). For approach-oriented coping, only active planning coping predicted lower within-person NA reactivity and only in DESTRESS (p <.01, f 2 = 0.02). Coping did not predict PA reactivity (all p >.05). Our findings cannot be generalised to children or older adults. Emotional reactivity to daily stressors may differ from severe or traumatic stressors. Although data were longitudinal, the observational design precludes establishing causality. Avoidance-oriented coping strategies predicted greater NA reactivity to daily stressors with small effect sizes. Few and inconsistent results emerged for approach-oriented coping and PA reactivity. Clinically, our results suggest that reducing reliance on avoidance-oriented coping may reduce NA reactivity to daily stressors. • Emotional reactivity to stressors was measured with ecological momentary assessment. • Avoidance-oriented coping predicted greater negative affect reactivity in 3 studies. • Active planning coping predicted lower negative affect reactivity in 1 study. • No coping strategy predicted positive affect reactivity. [ABSTRACT FROM AUTHOR]

We examined relationships between the serotonin system and stress in major depression and suicidal behavior. Twenty-five medication-free depressed participants (13 suicide attempters) underwent same-day [11C]DASB and [11C]CUMI-101 positron emission tomography (PET) imaging. Binding potential (BP ND) to the serotonin transporter (5-HTT) and serotonin 1A (5-HT 1A) receptor, respectively, was quantified using the NRU 5-HT atlas, reflecting distinct spatial distributions of multiple serotonin targets. Ecological momentary assessment (EMA) measured current stress over one week proximal to imaging. EMA stress did not differ between attempters and non-attempters. In all depressed participants, 5-HTT and 5-HT 1A BP ND were unrelated to EMA stress. There were region-specific effects of 5-HTT (p=0.002) and 5-HT 1A BP ND (p=0.03) in attempters vs. nonattempters. In attempters, region-specific associations between 5-HTT (p=0.03) and 5-HT 1A (p=0.005) BP ND and EMA stress emerged. While no post-hoc 5-HTT BP ND correlations were significant, 5-HT 1A BP ND correlated positively with EMA stress in attempters in 9/10 regions (p-values<0.007), including the entire cortex except the largely occipital region 5. Brodmann-based regional analyses found diminished effects for 5-HTT and subcortically localized positive corrrelations between 5-HT 1A and EMA stress, in attempters only. Given comparable depression severity and childhood and current stress between attempters and nonattempters, lower 5-HTT binding in attempters vs. nonattempters may suggest a biological risk marker. Localized lower 5-HTT and widespread higher 5-HT 1A binding with stress among attempters specifically may suggest that a serotonergic phenotype might be a key determinant of risk or resiliency for suicidal behavior. [ABSTRACT FROM AUTHOR]

A recent environmental theory of negative symptoms posits that environmental contexts (e.g., location, social partner) play a significant—yet often unaccounted for—role in negative symptoms of schizophrenia (SZ). "Gold-standard" clinical rating scales offer limited precision for evaluating how contexts impact symptoms. To overcome some of these limitations, Ecological Momentary Assessment (EMA) was used to determine whether there were state fluctuations in experiential negative symptoms (anhedonia, avolition, and asociality) in SZ across contexts (locations, activities, social interaction partner, social interaction method). Outpatients with SZ (n = 52) and healthy controls (CN: n = 55) completed 8 daily EMA surveys for 6 days assessing negative symptom domains (anhedonia, avolition, and asociality) and contexts. Multilevel modeling demonstrated that negative symptoms varied across location, activity, social interaction partner, and social interaction method. For the majority of contexts, SZ and CN did not report significantly different levels of negative symptoms, with SZ only reporting higher negative symptoms than CN while eating, resting, interacting with a significant other, or being at home. Further, there were several contexts where negative symptoms were similarly reduced (e.g., recreation, most social interactions) or elevated (e.g., using the computer, working, running errands) in each group. Results demonstrate that experiential negative symptoms dynamically change across contexts in SZ. Some contexts may "normalize" experiential negative symptoms in SZ, while other contexts, notably some used to promote functional recovery, may increase experiential negative symptoms. [ABSTRACT FROM AUTHOR]

Wrist-worn transdermal alcohol concentration (TAC) sensors have the potential to provide detailed information about day-level features of alcohol use but have rarely been used in field-based research or in early adulthood (i.e., 26–40 years) alcohol users. This pilot study assessed the acceptability, user burden, and validity of using the BACtrack Skyn across 28 days in individuals' natural settings. Adults aged 26–37 (N = 11, M age = 31.2, 55% female, 73% non-Hispanic white) participated in a study including retrospective surveys, a 28-day field protocol wearing Skyn and SCRAM sensors and completing ecological momentary assessments (EMA) of alcohol use and duration (daily morning reports and participant-initiated start/stop drinking EMAs), and follow-up interviews. Day-level features of alcohol use extracted from self-reports and/or sensors included drinks consumed, estimated Blood Alcohol Concentration (eBAC), drinking duration, peak TAC, area under the curve (AUC), rise rate, and fall rate. Repeated-measures correlations (r rm) tested within-person associations between day-level features of alcohol use from the Skyn versus self-report or the SCRAM. Participants preferred wearing the Skyn over the SCRAM [ t (10) = −6.79, p <.001, d = 2.74]. Skyn data were available for 5614 (74.2%) out of 7566 h, with 20.7% of data lost due to syncing/charging issues and 5.1% lost due to device removal. Skyn agreement for detecting drinking days was 55.5% and 70.3% when compared to self-report and the SCRAM, respectively. Correlations for drinking intensity between self-report and the Skyn were 0.35 for peak TAC, 0.52 for AUC, and 0.30 for eBAC, which were smaller than correlations between self-report and SCRAM, at 0.78 for peak TAC, 0.79 for AUC, and 0.61 for eBAC. Correlations for drinking duration were larger when comparing self-report to the Skyn (r rm = 0.36) versus comparing self-report to the SCRAM (r rm = 0.31). The Skyn showed moderate-to-large, significant correlations with the SCRAM for peak TAC (r rm = 0.54), AUC (r rm = 0.80), and drinking duration (r rm = 0.63). Our findings support the acceptability and validity of using the Skyn for assessing alcohol use across an extended time frame (i.e., 28 days) in individuals' natural settings, and for providing useful information about day-level features of alcohol use. • Individuals reported high acceptability for using the Skyn across 28 days. • Participants preferred using the Skyn versus the SCRAM in natural settings. • The Skyn showed similar probability to the SCRAM for detecting drinking days. • Skyn day-level alcohol use features correlated with self-report and the SCRAM. • The Skyn provided useful information about day-level features of alcohol use. [ABSTRACT FROM AUTHOR]

Social network changes are common as individuals transition from homeless to Supportive Housing. Egocentric approaches to elicit network members have been utilized with young adults experiencing homelessness to better understand such socio-environmental contexts; however, such approaches are subject to recall bias. Momentary measurements of one's social network via Ecological Momentary Assessment (EMA) can support in understanding the accuracy of egocentric elicitation methods. To examine who is elicited using an interaction-based approach in egocentric social network analysis among currently homeless and formerly homeless young adults residing in Supportive Housing and explore which alters are reported in interactions and how often are they reported when egocentric network analysis is embedded in EMA. The present study utilizes interaction-based elicitation embedded within Ecological Momentary Assessment (EMA) in two sub-samples: currently homeless young adults (n = 72) and formerly homeless young adults residing in Supportive Housing (n = 118). Most egos interacted with three of their top five alters, while only 8.9% interacted with all five. Conversely, only 2% of egos reported that they did not interact with any of their top five. Several differences in alter characteristics were identified by housing status. Alters indicated as being more supportive are elicited first and alters elicited first are interacted with the most. EMA findings suggest that a cross-sectional social network survey of top five alters will results in an ordered list, with the most important/frequent alter being named first and trend downward. Results have implications for future study design involving egocentric network analyses. Present findings indicate qualities of alters present and thus, offer plausible "best practices" when utilizing network elicitation methods, particularly interaction-based methods. • Findings suggest housed youth have more traditionally "pro-social" networks. • Differences in network characteristics in the baseline were like network differences that emerged during the EMA week. • The baseline survey accurately measured the social network present in the week following the baseline. • A cross-sectional survey of top five alters will result in an ordered list, with those more frequently interacted with named first. • Use of the interaction-based name generator appears to be a useful elicitation method, specifically if coupled with EMA. [ABSTRACT FROM AUTHOR]