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Background: Investigating the effects of breaking up sedentary behavior with short bouts of Yoga and Tai-Chi on glycemic control, concentration, and well-being in healthy individuals. Methods: In this randomized balanced incomplete block study, 15 adults (age = 26 [2.50] y, 8 females) completed 2 of 3 protocols: uninterrupted sitting (Control), sitting interrupted with 3 minutes of Yoga every 30 minutes, or with 3 minutes of Tai-Chi every 30 minutes. Protocols lasted 7.5 hours and included a standardized diet. Glucose was measured every 30 minutes with a glucometer (Abbott FreeStyle Libre). Concentration and well-being were recorded with self-reported ecological momentary assessment. Area under the curve was calculated for glucose data. Statistical analyses were performed as a hierarchical repeated-measures model. Results: Glucose area under the curve for the Yoga intervention (34.55 [3.12] mmol/L) was significantly lower than the Control (38.14 [3.18] mmol/L; P <.05). There was a trend toward lower glucose in the Tai-Chi group compared with the Control, but no significant differences were found (AUCTai-Chi = 36.64 [3.11] mmol/L; P =.57). Mean concentration in all groups decreased throughout the day, with the largest decrease in the Control. Well-being for the Yoga and Control groups decreased but increased with Tai-Chi. Concentration and well-being responses were not statistically significant between intervention groups. Conclusions: Breaking up sedentary behavior using 3-minute bouts of Yoga significantly lowers blood glucose in healthy individuals without compromising concentration or well-being. Tai-Chi did not provide the same significant effect on glucose levels but allowed better maintenance of concentration and well-being. These interventions provide effective ways to combat the deleterious effects of prolonged sedentary time while maintaining concentration and well-being. [ABSTRACT FROM AUTHOR]

The goal of the present study was to examine naturalistic associations between body satisfaction and physical activity (PA) among women in midlife. Women 40–60 years of age with cardiovascular risk factors (e.g., hypertension; N = 75; Mage = 51.63) responded to five surveys per day for 10 days while accelerometer-derived PA measurements were collected continuously. PA parameters included cognitive determinants (PA motivation and intentions) and accelerometer-measured PA behavior (sedentary behavior, light-intensity PA, and moderate to vigorous PA). Multilevel models indicated that associations between body satisfaction and everyday PA differed across PA determinants, time frames (concurrent and prospective), and levels (momentary, daily, and person). For example, positive bidirectional associations were identified between women's daily body satisfaction and PA motivation, whereas greater momentary light-intensity PA (but not moderate to vigorous PA) was unidirectionally associated with greater body satisfaction at a subsequent prompt. These findings provide insight into how associations between body satisfaction and PA unfold in the daily lives of women in midlife and highlight the complexities of these associations. [ABSTRACT FROM AUTHOR]

ABSTRACT Few studies have measured components of stress responses in real time—an essential step in designing just‐in‐time interventions targeting moments of risk. Using ecological momentary assessment (EMA), we characterised stress response components to everyday stressors, including reactivity (the response following a stressor), recovery (the return towards baseline), and pile‐up (the accumulation of stressors) (RRPs) by quantifying the dynamics of response indicators (i.e., subjective stress, negative affect, and perseverative cognition). To determine the utility of these novel measures in capturing and characterising acute moments of the stress response, this study evaluated the proportion of variance in RRPs attributed to (1) between‐person, (2) between‐days, and (3) within‐day (momentary) levels. Healthy adults (n = 123; aged 35–65, 79% women, 91% non‐Hispanic White) participated in a 14‐day study assessing stress response via EMA 6 times a day. RRPs were constructed from 10,065 EMA reports. Multilevel models with moments nested within days nested within persons were used to partition variance in the RRPs. Reactivity and recovery indicators captured the most variation within‐days (i.e., across moments; range 76%–80% and 87%–89%, respectively), with small amounts of variance between‐person. For pile‐up, variation was mostly observed between‐days (range 60%–63%) and between‐persons (range 27%–31%). In contrast, raw measures of stress response reflected substantial between‐person (range 32%–54%) and within‐day (range 34%–53%) variance. These results demonstrated that a person‐specific approach to measuring stress response components (i.e., RRPs) can capture the dynamic within‐person variation in stress response, as it occurs in real time, making it well‐suited for use in novel just‐in‐time interventions targeting moments of risk. [ABSTRACT FROM AUTHOR]

AbstractFirearm availability is correlated with increased risk of suicide but its link with suicidal ideation remains unclear. Previous studies are limited by retrospective reports and prospective designs with lengthy gaps between assessments that are ill-suited for measuring fluctuations in suicidal ideation. This study used ecological momentary assessment (EMA) to repeatedly assess suicidal ideation in a sample of 138 U.S. adults (81 handgun owners, 57 non-owners). Participants received six EMA prompts per day for 28 consecutive days. Results revealed no group differences in the frequency, maximum amplitude, or variability of suicidal ideation across male and female handgun owners and non-owners. Stability of suicidal ideation significantly differed across groups, however (F(1,132) = 4.5, p = 0.036); male handgun owners had the strongest stability and male non-owners had the weakest stability. Stability of suicidal ideation was significantly lower when participants reported a firearm was nearby as compared to when no firearm was nearby (F(4,17732) = 5.6, p < 0.001). Results suggest firearm availability increases reactivity to the environment, slows recovery from acutely elevated risk states, and may increase vulnerability to sudden shifts to higher risk states characterized by increased probability of suicidal behavior. Although these effects were observed in both handgun owners and non-owners, they disproportionately impact handgun owners because they report being near firearms more often. [ABSTRACT FROM AUTHOR]

Acute stressors (e.g., time pressure) can provoke psychological and physiological stress responses, and the magnitude of such responses is called stress reactivity. However, stress reactivity levels can differ considerably among individuals, with exaggerated levels being associated with adverse outcomes (e.g., emotional exhaustion). Previous studies have primarily investigated psychological stress reactivity or physiological stress reactivity induced in the laboratory. Physiological stress reactivity, especially concerning heart rate variability (HRV), has rarely been examined so far in real life. We addressed this research gap in a sample of 394 adults who participated in 2- to 4-day ecological momentary assessments. Individuals answered self-reports on perceived time pressure and emotional exhaustion multiple times a day and simultaneously wore electrocardiogram sensors. Based on 4,009 total situations and 3–16 situations per participant, individual differences in HRV reactivity to time pressure were computed as random slopes from multilevel models. Consistent with preregistered hypotheses, increased time pressure was associated with reduced HRV, and increased stress reactivity was associated with increased emotional exhaustion. The findings highlight the detrimental effects of everyday demands and physiological reactivity and emphasize the relevance of practical coping strategies. This study contributes to research on dynamic inter- and intraindividual stress regulation using ambulatory, psychophysiological methods. [ABSTRACT FROM AUTHOR]

Introduction: Investigations on emotion regulation strategies (ERS) primarily focus on the influence of instructed emotion regulation (ER) on outcomes. However, recent work has shown that selection of ERS is dependent on, e.g., situational demands and personal resources. Methods: In this current investigation, we used an online diary to investigate ERS used by free choice and their association with ER-success, stress and rumination. We identified four factors of ERS: cognitive perspective change, cognitive-behavioral problem-solving, suppression-distraction and body-social ERS. Associations of ERS with stress, state-rumination and ER-success were investigated using multilevel-mixed-models, allowing to separate within- and between-subject effects. Results: Our results show that, on a within-subject level, all adaptive ERS were positively associated with ER-success, while maladaptive ERS as well as higher stress and state rumination were negatively associated with ER-success. On the other hand, only within-subject cognitive ERS were associated with higher self-efficacy. Maladaptive ERS-use was consequently positively associated with stress and state rumination. Surprisingly, only cognitive perspective change ERS were negatively associated with state rumination. Cognitive-behavioral problem-solving was positively associated with stress and success of emotion regulation. Discussion: We interpret these results in the light of situational constraints of ERS-use and the importance of the assessment of these in future studies. [ABSTRACT FROM AUTHOR]

Background: Limited research considers the quantity and potency of cannabis products along with social context on the subjective effects of real-world cannabis use. Aims: This study examined the subjective effects of acute use as a function of Δ9-tetrahydrocannabinol (THC) and cannabidiol (CBD) doses and social context during cannabis use episodes. Method: Ninety-six participants (43.75% male, M age = 35.73) reporting weekly cannabis use completed a baseline self-report battery assessing cannabis use. Then, THC and CBD potency and quantity of the cannabis product, social context, and subjective experience were assessed through self-initiated surveys after cannabis use episodes during a 14-day ecological momentary assessment (EMA). Results: Greater feeling high and liking were significantly associated with a higher THC dose than one's average (b = 0.03, p < 0.001; b = 0.02, p < 0.001) and social use (b = 0.38, p < 0.001; b = 0.20, p = 0.01). A higher CBD dose than one's average (b = 0.01, p = 0.04) was significantly associated with greater liking. A significant interaction effect of THC dose and social context (b = 0.01, p = 0.02) was observed such that solitary use had a negative association between THC dose and disliking (b = −0.01, p = 0.04), and social use had a null association (b = 0.003, p = 0.25). Individuals with greater cannabis problems reported lower liking (b = −0.18, p = 0.03) and higher disliking (b = 0.08, p = 0.02), but not feeling high, on average, across the EMA protocol. Conclusion: Social context plays an important role in the subjective experience of cannabis use. Interventions targeting cannabis problems could highlight the evidence that individuals with greater cannabis problems might experience less liking but more disliking in general across use episodes to effectively challenge expectancies/motives of use. [ABSTRACT FROM AUTHOR]

Sleep and biological rhythms are integral to mood regulation across the lifespan, particularly in bipolar disorder (BD), where alterations in sleep phase, structure, and duration occur in all mood states. These disruptions are linked to poorer quality of life, heightened suicide risk, impaired cognitive function, and increased relapse rates. This review highlights the pathophysiology of sleep disturbances in BD and aims to consolidate understanding and clinical applications of these phenomena. It also summarizes the evolution of sleep and biological rhythms assessment methods, including ecological momentary assessment (EMA) and digital phenotyping. It underscores the importance of recognizing circadian rhythm involvement in mood regulation, suggesting potential therapeutic targets. Future research directions include elucidating circadian clock gene mechanisms, understanding environmental impacts on circadian rhythms, and investigating the bidirectional relationship between sleep disturbances and mood regulation in BD. Standardizing assessment methods and addressing privacy concerns related to EMA technology and digital phenotyping are essential for advancing research. Collaborative efforts are crucial for enhancing clinical applicability and understanding the broader implications of biological rhythms in BD diagnosis and treatment. Overall, recognizing the significance of sleep and biological rhythms in BD offers promise for improved outcomes through targeted interventions and a deeper understanding of the disorder's underlying mechanisms. [ABSTRACT FROM AUTHOR]

AbstractObjectiveDesign and study sampleResultsConclusionsThe aim of this study was to use Ecological Momentary Assessment (EMA) to capture how stigma-induced identity threat is experienced by adults with hearing loss and how they respond to such threats in daily life.Twenty adults with hearing loss from 53 to 88 years (mean age of 69.4 years) completed a range of demographic and stigma questionnaires in the laboratory and, over a two-week period, answered daily EMA surveys.A total of 633 EMA surveys were collected. Five participants reported 13 listening events in which they experienced stigma. These events were typically when conversing with family or friends who were aware of the adults’ hearing loss.The number of individual stigma experiences captured by EMA were low, when viewed across a large number of social interactions. However, as a group, a quarter of the participants in this study experienced stigma over a two-week period, typically from others close to them. This suggests that stigma experiences may be a regular occurrence for some adults with hearing loss. [ABSTRACT FROM AUTHOR]

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]

Introduction Subjective experience of e-cigarettes may be an important factor in helping people who use combustible cigarettes switch completely to e-cigarettes to reduce harm from smoking. This paper describes a novel two-stage analysis using pleasure and satisfaction responses from ecological momentary assessments (EMA) of both cigarette and e-cigarette use to predict future cigarette and e-cigarette tobacco use. Aims and Methods This observational study included adult users of cigarettes and e-cigarettes who provided 7 days of EMA, capturing cigarette and e-cigarette use, followed by biweekly reports of cigarette and e-cigarette use over 1 year. Participants were 279 adults who provided both cigarette and e-cigarette responses during the EMA. We employed a two-stage analytic approach in which EMA data were used to predict subsequent levels of cigarette and e-cigarette use. In the first stage, EMA responses to cigarette and e-cigarette events were modeled via a mixed-effects location scale model to yield summaries of participants' means and variability on event-related ratings of pleasure and satisfaction. These EMA summaries served as predictors in the second stage analysis of the biweekly post-EMA longitudinal cigarette and e-cigarette use data. Results EMA pleasure and satisfaction ratings were similar for both products and predicted both longitudinal cigarette and e-cigarette use, even after controlling for baseline cigarette and e-cigarette dependence. Relatively higher levels of satisfaction with e-cigarettes were associated with greater decreases in cigarette use over time. Conclusions Pleasure and satisfaction are important predictors of subsequent cigarette and e-cigarette use. Implications Experienced subjective pleasure and satisfaction from e-cigarettes relative to cigarettes may be an important factor in helping individuals who smoke to switch completely to e-cigarettes as a harm reduction approach. In order to help sustain complete product switching and reduce dual use or relapse to smoking, e-cigarettes may need to deliver more satisfaction to the user compared to that experienced from cigarettes. [ABSTRACT FROM AUTHOR]

Introduction Addressing cigarette and e-cigarette use in China is key to reducing the global tobacco epidemic. Marketing exposure is one causal factor for adolescent smoking and e-cigarette use. Currently, China restricts cigarette and e-cigarette ads in public places and online; however, there may not be full policy compliance. We collected real-time data in the natural environment to estimate how much and where Chinese adolescents—a group susceptible to smoking and e-cigarette use—are exposed to cigarette and e-cigarette marketing to inform policy responses. Aims and Methods In June 2022, we conducted a 7-day ecological momentary assessment (EMA) study with 15–16-year-olds (n  = 96) across eight Chinese cities. Participants completed up to 42 EMA surveys (six per day), sent at random intervals outside of school hours. In each survey, participants reported whether they saw (1) displays and (2) ads in the past hour (none, cigarette, e-cigarette, both) in the past hour. We also captured the source of cigarette/e-cigarette ad exposure. Results Most participants were exposed to cigarette and/or e-cigarette displays (89.6%) or ads (79.2%) more than 7 days. On average, participants reported past-hour exposure to displays 12.7 times and past-hour exposure to ads 10.8 times over the week. The most common sources of cigarette ads were public places (eg, kiosks, supermarkets); the most common sources of e-cigarette ad exposure were social media/internet or e-cigarette stores. Conclusions Findings highlight the need to enhance enforcement of restrictions on cigarette and e-cigarette ads in public places and online in China and extend restrictions to ban displays. Implications Marketing exposure is a causal factor in youth smoking and e-cigarette use. We used EMA to estimate cigarette and e-cigarette display and ad exposure among Chinese adolescents. On average, participants reported past-hour exposure to cigarette and/or e-cigarette displays 13 times and past-hour exposure to cigarette and/or e-cigarette ads 11 times more than 1 week. Most saw ads in public places and online. Results suggest strengthening implementation of China's ban on cigarette and e-cigarette ads in public places and online and banning product displays. These are policy responses that can contribute to reducing adolescent cigarette and e-cigarette uptake in China. [ABSTRACT FROM AUTHOR]

Although survivors of childhood cancer are at an increased risk, little is known about the prevalence of chronic pain, associated interference, and daily pain experiences. Survivors (N 5 233; mean age 5 40.8 years, range 22-64 years; mean time since diagnosis 5 32.7 years) from the Childhood Cancer Survivor Study completed pain and psychosocial measures. Survivors with chronic pain completed 2-week, daily measures assessing pain and psychological symptoms using mHealth-based ecological momentary assessment. Multivariable-modified Poisson and linear regression models estimated prevalence ratio estimates (PR) and mean effects with 95% confidence intervals (CI) for associations of key risk factors with chronic pain and pain interference, respectively. Multilevel mixed models examined outcomes of daily pain and pain interference with prior day symptoms. Ninety-six survivors (41%) reported chronic pain, of whom 23 (24%) had severe interference. Chronic pain was associated with previous intravenous methotrexate treatment (PR 5 1.6, 95% CI 1.1-2.3), respiratory (PR 5 1.8, 95% CI 1.2-2.5), gastrointestinal (PR 5 1.6, 95% CI 11.0-2.3), and neurological (PR 5 1.5, 95% CI 1.0-2.1) chronic health conditions, unemployment (PR 5 1.4, 95% CI 1.0-1.9) and clinically significant depression and anxiety (PR 5 2.9, 95% CI 2.0-4.2), as well as a diagnosis of childhood Ewing sarcoma or osteosarcoma (PR 5 1.9, 95% CI 1.0-3.5). Higher pain interference was associated with cardiovascular and neurological conditions, unemployment and clinical levels of depression and/or anxiety, and fear of cancer recurrence. For male, but not female survivors, low sleep quality, elevated anxiety, and elevated depression predicted high pain intensity and interference the next day. A substantial proportion of childhood cancer survivors experience chronic pain and significant associated interference. Chronic pain should be routinely evaluated, and interventions are needed. [ABSTRACT FROM AUTHOR]

Feeling loved by one's caregiver is essential for individual flourishing (i.e., high levels of psychological well‐being in multiple dimensions). Although similar constructs are found to benefit adolescent well‐being, research that directly tests parental love as a feeling from the recipient's perspective is rare. Historically, parental love has been measured using single‐assessment methods and assumed to be a stable, trait‐like characteristic; yet, like any feeling, it may fluctuate in meaningful ways on a day‐to‐day basis—the implications of which are unknown. Using a sample of 150 adolescents (59.3% female; ages 14–16), this study estimated level (person's mean level across days) and instability (fluctuations across days) of feeling loved by a caregiver across 21 days for each adolescent, and then examined their prospective effects on adolescent flourishing 1 year later. After controlling for demographics (adolescent age, gender, family income, and parent's sex) and variable baseline levels, feeling more loved by one's caregiver in daily life significantly predicted higher levels of flourishing in two global measures 1 year later. Moreover, level and instability of feeling loved by one's caregiver played different roles for different dimensions of flourishing: higher levels significantly predicted higher levels of autonomy, purpose in life, and personal growth, whereas higher instability significantly predicted lower levels of positive relations with others and environmental mastery. Findings emphasized the importance of considering daily dynamics of feeling loved by one's caregiver and demonstrated that level (of feeling loved) is particularly important for intrapersonal aspects while instability is particularly important for interpersonal aspects of flourishing. Research Highlights: Adolescents feeling more loved by their caregiver in daily life had higher levels of overall flourishing 1 year later.Level (of feeling loved) is particularly important for intrapersonal aspects of adolescent flourishing, including autonomy, purpose in life, and personal growth.Stability (of feeling loved) is particularly important for interpersonal aspects of adolescent flourishing, including positive relations with others and environmental mastery. [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]

Objective: Self-efficacy is associated with positive mental health outcomes. We developed and tested a digital self-efficacy training for daily recall of autobiographical self-efficacy memories (e.g., memories of successfully overcoming a personal challenge). Method: In this randomized controlled trial, we investigated the effects of the week-long digital self-efficacy training on key mental health outcomes, including anxiety, stress, and hopelessness, and on self-efficacy in 93 university students (mean age 23.3 years, SD: 3.49) with elevated self-reported stress levels. Participants completed either the self-efficacy training combined with ecological momentary assessment (EMA) (training group) or EMA only (control group). Results: We found significantly reduced hopelessness and trait anxiety in the training group compared to the control group at post-assessment (one day post intervention). Effects on ratings of self-efficacy at post-assessment were also significant when controlling for baseline self-efficacy. Conclusions: This stand-alone digital self-efficacy training was significantly associated with a number of positive effects on outcomes compared to a control condition, including reduced hopelessness, trait anxiety, and increased self-efficacy. Future work is needed to replicate and investigate the long-term effects of the training and explore its implementation in clinical populations. Trial registration: ClinicalTrials.gov Identifier: NCT05617248 [ABSTRACT FROM AUTHOR]

Background : Management of type 1 diabetes (T1D) requires the use of insulin, which can cause hypoglycaemia (low blood glucose levels). While most hypoglycaemic episodes can be self-treated, all episodes can be sudden, inconvenient, challenging to prevent or manage, unpleasant and/or cause unwanted attention or embarrassment. Severe hypoglycaemic episodes, requiring assistance from others for recovery, are rare but potentially dangerous. Repeated exposure to hypoglycaemia can reduce classic warning symptoms ('awareness'), thereby increasing risk of severe episodes. Thus, fear of hypoglycaemia is common among adults with T1D and can have a negative impact on how they manage their diabetes, as well as on daily functioning, well-being and quality of life. While advances in glycaemic technologies and group-based psycho-educational programmes can reduce fear, frequency and impact of hypoglycaemia, they are not universally or freely available, nor do they fully resolve problematic hypoglycaemia or associated worries. This study aims to determine the effectiveness of a fully online, self-directed, scalable, psycho-educational intervention for reducing fear of hypoglycaemia: the Hypoglycaemia Prevention, Awareness of Symptoms, and Treatment (HypoPAST) programme. Methods: A 24-week, two-arm, parallel-group, hybrid type 1 randomised controlled trial, conducted remotely (online and telephone). Australian adults (≥ 18 years) with self-reported T1D and fear of hypoglycaemia will be recruited, and allocated at random (1:1) to HypoPAST or control (usual care). The primary outcome is the between-group difference in fear of hypoglycaemia (assessed using HFS-II Worry score) at 24 weeks. A sample size of N = 196 is required to detect a 9-point difference, with 90% power and allowing for 30% attrition. Multiple secondary outcomes include self-reported psychological, behavioural, biomedical, health economic, and process evaluation data. Data will be collected at baseline, 12 and 24 weeks using online surveys, 2-week ecological momentary assessments, website analytics and semi-structured interviews. Discussion: This study will provide evidence regarding the effectiveness, cost-effectiveness and acceptability of a novel, online psycho-educational programme: HypoPAST. Due to the fully online format, HypoPAST is expected to provide an inexpensive, convenient, accessible and scalable solution for reducing fear of hypoglycaemia among adults with T1D. Trial registration: Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN12623000894695 (21 August 2023). [ABSTRACT FROM AUTHOR]

Objective: People commonly cope with chronic low back pain (cLBP) by ignoring and distraction. Can mindful interoceptive exposure to the pain sensation itself and its phenomenological components be an alternative approach? Methods: Single-arm feasibility study in patients with cLBP using a 2-minute attention exercise guided by a smartphone app several times per day over 8 weeks. We assessed feasibility, pre/post pain, function, and psychological parameters using mixed methods: standard questionnaires, ecological momentary assessment, and exit interviews that included micro-phenomenology technique and subsequent reflexive thematic qualitative analysis. Results: We enrolled 31 participants, mostly female, mean age 48, the majority had pain for >5 years; 29 completed. Mean pain intensity [0–10] improved from 4.8 ±1.7 to 3.1 ±1.9 (p <.0001); mean PEG scores (intensity and interference with daily life; range 0–30) improved from 13.7 ±6.2 to 8.4 ±6.6 (p <.0001); pain impact (9 items incl physical function) 22.3 ±8.7 to 19.7 ±8.1 (p =.0010). Twenty-one of 29 improved PEG score ≥30%. There were significant improvements in PCS Rumination and MAIA Not-Worrying. Participants became aware of their usual habit of avoidance and the challenge of and resistance to focusing on pain. They were surprised how pain sensations varied over time, and that pain intensity and the threat value of pain could diminish by focusing on it. They described a variety of 3D pain shapes (e.g., football, pool ball, rod, nail, brick, stars) with a range of colors, transparency, temperature, and density that for some changed with mindful attention. Most struggled to find appropriate words for sensory awareness and attention regulation and found that the threat value of their pain diminished. Conclusions: Mindful interoceptive exposure to the sensations of their cLBP using a 2-minute attention exercise with a phone app—rather than ignoring and distracting from it—may be a beneficial intervention for cLBP. Trial registration: ClinicalTrials.gov #NCT06186193. [ABSTRACT FROM AUTHOR]

ABSTRACT Self‐monitoring with support, lifestyle modifications, and emotion management improves blood pressure (BP). Patients with hypertension need continual support to modify behaviors, but time pressures limit lifestyle education in primary care settings. Using mixed methods, we aimed to study the feasibility and acceptability of an innovative 6‐week program that combined self‐monitoring with coping skills and lifestyle education for patients with uncontrolled hypertension. Patients with uncontrolled hypertension interested in lifestyle modifications before intensifying medications were enrolled from primary care clinics. Patients self‐monitored emotions, behaviors, and BPs and received education from medical providers and mind‐body therapists through shared medical appointments (SMAs) with an option of weekly printed materials. Over 6 months, 31 eligible participants completed the program with higher uptake (21/41) from physician referrals (74.2% women, 41.9% Black, median household income $100 000). Fourteen participants opted for weekly educational materials due to upcoming SMA sessions being fully booked or personal schedules. Pre‐ to post‐intervention paired t‐test showed improvement in systolic BP of 11.6 mmHg (95% CI, 6.6–16.6, p < 0.0001), and hypertension control rate improved by 36% (11/31) post‐intervention. Higher baseline systolic BP was associated with higher BP reduction (p < 0.001). Thematic analysis showed the perceived benefit of self‐awareness, education, and peer support, whereas time constraints were perceived as challenges. Self‐monitoring with education on coping skills and lifestyle modification is feasible and improved BP and hypertension control across diverse primary care patients interested in lifestyle modifications; however, few low‐income patients enrolled. Less burdensome and community‐based interventions may improve participation in low‐income patients. [ABSTRACT FROM AUTHOR]

In this perspective paper, we propose a novel tech-driven method to evaluate body representations (BRs) in autistic individuals. Our goal is to deepen understanding of this complex condition by gaining continuous and real-time insights through digital phenotyping into the behavior of autistic adults. Our innovative method combines cross-sectional and longitudinal data gathering techniques to investigate and identify digital phenotypes related to BRs in autistic adults, diverging from traditional approaches. We incorporate ecological momentary assessment and time series data to capture the dynamic nature of real-life events for these individuals. Statistical techniques, including multivariate regression, time series analysis, and machine learning algorithms, offer a detailed comprehension of the complex elements that influence BRs. Ethical considerations and participant involvement in the development of this method are emphasized, while challenges, such as varying technological adoption rates and usability concerns, are acknowledged. This innovative method not only introduces a novel vision for evaluating BRs but also shows promise in integrating traditional and dynamic assessment approaches, fostering a more supportive atmosphere for autistic individuals during assessments compared to conventional methods. [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]

ABSTRACT Background Study Objectives Methods Results Conclusions The introduction of a smartphone‐based ecological momentary assessment (EMA) approach has allowed achieving data on the frequency of different awake bruxism (AB) behaviours (i.e., teeth contact, teeth clenching, teeth grinding, and mandible bracing) reported by an individual in the natural environment.The fluctuation of AB reports over time has a certain degree of variability that has never been investigated. Therefore, the aim of this investigation was to assess the long‐term fluctuation of AB behaviours in a population of young adults.A smartphone application was used to assess a real‐time report on five specific oral conditions related to AB in a sample of 77 young adults, aged 24.0 ± 0.8 years. Data were recorded over three periods of 7 days, with a three‐month interval for a total of 6 months.The average frequency of the relaxed condition was 72.9%, 78.2%, and 80.8% at the end of the first, second, and third sessions, respectively. On average, teeth contact and mandible bracing were the most frequently reported conditions, with a mean prevalence of 12.9% and 7%, respectively, whilst the frequency of teeth clenching and teeth grinding was less than 3%. The ANOVA test showed an absence of significant differences (p < 0.05) between the three recording periods, and the frequency was in general only moderately variable from day‐to‐day (e.g., the coefficient of variation (CV) for the condition “relaxed jaw muscles” was 0.3). No gender differences were detected either.Findings suggest that in a population of healthy individuals, the frequency of AB behaviours over a six‐month monitoring period is quite constant. This investigation represents a standpoint for future comparisons on the study of natural fluctuations of AB behaviours as well as on AB frequency in populations with risk/associated factors and possible clinical consequences. [ABSTRACT FROM AUTHOR]

Background and Aims Methods Results Conclusions Studies show that higher levels of positive affect (PA) and lower levels of negative affect (NA) are related to craving and alcohol consumption at a daily level in men, but little is known on these associations at a momentary level, and whether they are present in women. This study measured the dynamics of within‐person NA and PA surrounding craving, non‐heavy alcohol use and binge drinking in women with alcohol use disorder (AUD) and female controls without AUD.53 female patients with AUD and 75 female controls, all recruited in Belgium, were included in an experience sampling study where they reported on momentary NA, PA, craving and alcohol use in daily life over a period of 12 months. Assessments occurred eight times a day on Thursdays, Fridays and Saturdays in seven bursts of three weeks.Within‐person NA at a previous assessment (t−1) predicted craving at the current assessment (t0) in patients with AUD in a positive linear [β = 0.043; 95% confidence interval (CI) = 0.002, 0.057; P = 0.041] and quadratic fashion (β = 0.034; CI = 0.011, 0.057; P = 0.004). Within‐person PA at t−1 predicted craving at t0 in patients with AUD with a positive quadratic relation (β = 0.042; CI = 0.08, 0.065; P < 0.001). Within‐person NA at t−1 negatively predicted non‐heavy alcohol use at t0 in a linear fashion in controls (β = −0.495; CI = ‐0.677, ‐0.312; P < 0.001) and patients with AUD (β = −0.276; CI = ‐0.421, ‐0.132; P < 0.001). Within‐person PA at t−1 significantly predicted non‐heavy alcohol use at t0 with a positive linear term (β = 0.470; CI = 0.329, 0.610; P < 0.001) in controls, but with a positive linear term (β = 0.399; CI = 0.260, 0.454; P < 0.001) and a positive quadratic term (β = 0.203; CI = 0.060, 0.347; P = 0.003) in patients with AUD. Within‐person NA at t−1 predicted binge drinking at t0 in patients with AUD with a significant quadratic term (β = 0.236; CI = 0.060, 0.412; P = 0.008), but not for controls. Within‐person PA at t−1 predicted binge drinking at t0 in patients with AUD with a significant quadratic term (β = 0.378; CI = 0.215, 0.542; P < 0.001), and this was also the case for controls (β = 0.487; CI = 0.158, 0.770; P < 0.001). Non‐heavy alcohol use at t0 predicted lower levels of NA at t+1 in both patients with AUD (β = −0.161; SE = 0.044; CI = ‐0.248, 0.074; P = 0.001) and controls (β = −0.114; CI = ‐0.198, ‐0.029; P = 0.010). Non‐heavy alcohol use at t0 also predicted higher levels of PA at t+1 in both patients with AUD (β = 0.181; CI = 0.088, 0.274; P < 0.001) and controls (β = 0.189; CI = 0.101, 0.278; P < 0.001).The momentary relation between affect and craving or alcohol use seems to be non‐linear in female patients with alcohol use disorder, whereby a worse mood predicts subsequent alcohol use, though more for binge drinking than for non‐heavy alcohol use. [ABSTRACT FROM AUTHOR]

Previous studies have implied that stress is a risk factor for depression, but relatively little is known about how healthy individuals' stress dynamically affects depression as a mood in daily life. Therefore, an ecological momentary assessment study was conducted among 141 college students to test the temporal dynamic effect of daily perceived stress on depression and the underlying mediating and moderating role of rumination. Perceived stress, state rumination, and depression were measured using self‐compiled questionnaire three times a day over 12 days. Trait rumination was measured with the Nolen‐Hoeksema Ruminative Response Scale. Hierarchical linear models with HLM 7.0 were adopted to examine the mediation and moderation effects. In the mediation model, the greater the daily perceived stress at time t, the higher the state rumination at time t + 1, and state rumination at t + 1 positively predicted college students' depression at t + 2. In the moderation model, trait rumination significantly facilitated perceived stress‐induced depression. These results verified that daily perceived stress could affect college students' depression directly or indirectly through the critical mediating mechanism of state rumination, and this effect would be exacerbated with a higher level of trait rumination. [ABSTRACT FROM AUTHOR]

Objective: This study tested a highly individualized cognitive-behavioral coping skills treatment for alcohol use disorder (AUD). Recent studies have indicated that coping skills training programs are not always effective. A possible explanation is that the training provided in these programs may not address the specific needs of the patient. The Individualized Assessment and Treatment Program (IATP) was intended to provide a highly individualized approach to the training of skills most relevant for each individual. Method: Men and women with AUD (N = 173) were randomly assigned to one of three, manualized, 12-session treatments: IATP, a conventional (Packaged) cognitive-behavioral program (PCBT), or a Case Management control condition (CaseM). An experience sampling (ES) procedure was employed prior to, and during, treatment to record alcohol use and coping behaviors in all patients. In IATP, this information was used by therapists to plan treatment that would address the specific strengths and weaknesses of each patient in alcohol-use situations. ES data were collected at multiple time points and patients were followed every 3 months out to 21 months posttreatment. Results: Multilevel model analyses indicated that IATP yielded better drinking outcomes than the CaseM or PCBT conditions. Mediation analyses indicated that the effects of IATP versus the other treatments on outcomes were accounted for at least partly by changes in active coping with high-risk situations. Conclusion: Due to the limited diversity of the sample, generalizability of the results may be limited. Results are discussed in terms of the importance of tailoring treatment for the individual patient. What is the public health significance of this article?: This study indicates that a highly individualized coping skills program is an effective treatment for alcohol use disorder. Additionally, results of the study suggests that coping skills acquisition may be a mechanism of treatment for alcohol use disorder. The use of ecological momentary assessment may provide an effective means to individualize treatments for a variety of disorders. [ABSTRACT FROM AUTHOR]

According to SAMHSA (2023), approximately 16,600,000 American adults and teens reported having serious thoughts of suicide in 2022. While suicide prevention has primarily focused on suicide deaths and attempts, we contend that suicidal ideation (SI) deserves more in-depth investigation and should be an essential intervention target on its own. In support of this point, we provide three examples of ways to improve specificity in understanding of SI through the study of controllability of SI, the language used to assess SI, and measuring SI in real time. We also consider qualitative work on the content of SI, its treatment, and definitional considerations. We thus call for an increased general focus on SI within research, clinical care, and policy. [ABSTRACT FROM AUTHOR]

College counseling centers are seeing increasing rates of suicidal thoughts and behaviors, and nonsuicidal self-injury (NSSI) among students. The high degree of need and limited resources underscores the need for novel approaches to identify at-risk students. We used latent profile analysis (LPA) to identify subgroups of students (n = 371) with different patterns of interpersonal factors and examine whether these subgroups differed by risk for self-injurious thoughts and behaviors. The best-fitting LPA had three profiles, which differed in urges to die by suicide and engage in NSSI. The profile with low average social support and higher instability (greater day-to-day fluctuations of self-reported social support and rejection) was associated with greatest risk, suggesting that this combination leaves individuals more vulnerable to suicide and NSSI. [ABSTRACT FROM AUTHOR]

Creative ideation constitutes an important human skill to develop innovative solutions in science and technology and to overcome daily challenges. Although creative ideation takes place in everyday life situations, the moment-to-moment dynamics of creative ideation performance has not been intensively investigated so far. Fortunately, well-developed methods exist to assess creative ideation performance in controlled settings that can be adopted for assessments in real-life contexts. In the present field-study, a novel Ambulatory Battery of Creativity (ABC) was applied to a sample of 77 participants for 5 days. Each day, participants had to complete 12 randomly presented items of two divergent thinking tasks—half in the verbal and half in the figural domain. Psychometric analyses indicated good between-person (≥.84) and within-person (≥.70) reliability. Furthermore, between-person and within-person validity evidence of the ABC was obtained. This study constitutes a first attempt to develop a reliable and valid ABC to measure both individual differences and moment-to-moment fluctuations of creative ideation performance in everyday life. [ABSTRACT FROM AUTHOR]

Social support is a key predictor of well‐being, but not everyone experiences mental health benefits from receiving it. However, given that a growing number of interventions are based on social support, it is crucial to identify the features that make individuals more likely to benefit from social ties. Emerging evidence suggests that neural responses to positive social feedback (i.e., social reward) might relate to individual differences in social functioning, but potential mechanisms linking these neural responses to psychological outcomes are yet unclear. This study examined whether neural correlates of social reward processing, indexed by the reward positivity (RewP), relate to individuals' affective experience following self‐reported real‐world positive social support events. To this aim, 193 university students (71% females) underwent an EEG assessment during the Island Getaway task and completed a 10‐day ecological momentary assessment where participants reported their positive and negative affects (PA, NA) nine times a day and the count of daily positive and negative events. Experiencing a higher number of social support positive events was associated with higher PA. The RewP moderated this association, such that individuals with greater neural response to social feedback at baseline had a stronger positive association between social support positive events count and PA. Individual differences in the RewP to social feedback might be one indicator of the likelihood of experiencing positive affect when receiving social support. Social support is key to well‐being and, as such, it is typically implemented in various intervention programs for several mental disorders. However, not everyone benefits from social support in the same way. This study integrated laboratory and ecological momentary assessment measures to elucidate the role of neural responses to social rewards in determining whether an individual will experience positive affect when exposed to social support events. [ABSTRACT FROM AUTHOR]

Introduction: Suicidal ambivalence is increasingly understood as the result of the interplay of two conflicting motivational orientations, the wish to die (WTD) and wish to live (WTL). However, research is scarce regarding the nature of their relationship, their temporal structure, and their relevance in predicting suicidal desire. Methods: Fifty psychosomatic/psychiatric inpatients (17 reporting suicide attempts) took part in an intensive longitudinal design with 10 signal‐contingent prompts per day over 10 days; assessing WTD, WTL, and suicidal desire. We calculated mean values and variability of WTD, WTL, suicidal ambivalence, and suicidal desire and tested mixed‐effects models of suicidal desire. Results: The mean number of answered prompts was 40.98 (SD = 21.68). Repeated‐measures correlation of WTD and WTL was r = −0.60. Patients with a history of suicide attempts reported higher WTD, lower WTL, more suicidal ambivalence, stronger suicidal desire, and showed higher variability in all constructs. At the same assessment, WTD was the strongest statistical predictor of suicidal desire. Only WTL and the interaction of WTD and WTL predicted suicidal desire prospectively. Conclusion: Wish to die and WTL are likely two distinct (although correlated) constructs that should not be reduced to a single ambivalence score. A stronger focus on WTL holds potential for suicide research and practice. [ABSTRACT FROM AUTHOR]

Objective: Suicide risk is highly fluctuating. There is a need for predictors of short‐term change in suicide risk to optimize risk assessment and treatment, especially among individuals who already attempted suicide. Methods: Based on 1776 daily assessments of 16 former psychiatric inpatients with a history of suicide attempts, we examined how suicidal ambivalence and, respectively, wish to die (WTD) and wish to live (WTL) predicted same‐day and change in perceived suicide risk (i.e., next‐day perceived suicide risk, controlled for same‐day perceived suicide risk) in multilevel regression models. Additionally, based on the assumptions of nonlinear dynamics, we examined the associations between levels of fluctuations in the WTD/WTL and perceived suicide risk within the same time period. Results: Suicidal ambivalence, WTD, and a WTL significantly correlated with same‐day suicide risk. Suicidal ambivalence and WTD significantly predicted change in suicide risk. Fluctuations in WTD were significantly associated with concurrent suicide risk. Conclusion: The results suggest that suicidal ambivalence and WTD are drivers of suicide risk among individuals who already attempted suicide. The association between fluctuations in WTD and suicide risk was small and warrants further investigation on the practical utility as a warning sign. [ABSTRACT FROM AUTHOR]

Few studies have investigated how older people's daily activities and characteristics of the surrounding urban environment affect their emotions and daily satisfaction. This study fills the research gap by using a paper-based survey and a smartphone ecological momentary assessment (EMA) application (with GPS tracking and pop-up surveys about activities) to study older people's well-being in Hong Kong. Three hundred and two older adults completed the paper survey and forty-two of them further completed a six- to seven-day EMA survey. Based on a total of 1,530 activity episodes, generalized estimating equation models were developed to examine the relationship between older people's socioeconomic background, activity participation, urban environment characteristics, and their feelings of happiness and calmness. Results show that older people's daily life satisfaction is affected by the emotions they experienced throughout the day. In particular, a higher level of happiness was associated with socializing, leisure, and recreation activities taking place outside of the immediate neighborhood, and calmness was best achieved during passive relaxation and resting activities within the residential neighborhood. Furthermore, characteristics of the environment at activity locations are statistically significant in explaining momentary well-being. The findings support the planning for age-friendly cities and communities through encouraging older people to engage in activities outside their residential neighborhoods and designing activity locations with more leisure facilities, lower road density, and higher exposure to water bodies. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the feasibility and acceptability of using EMA questionnaires and physiological data via wristbands to measure day-to-day occupational stress, musculoskeletal pain, and mental health among university employees (N = 23), across 10 work days. Adherence to the study protocol as well as participant experiences (via semi-structured interviews) with the protocol were used to assess feasibility and acceptability of the method. Results: Adherence to the study protocol was excellent. Participants wore the wristband for a mean of 9.7 days. Participants completed a mean of 24.5 EMAs (out of 30). Semi-structured interviews with participants revealed that a small number of participants had difficulties uploading data from the wristband. The timing of EMAs was challenging for some participants, resulting in missed EMAs, raising questions about whether EMA frequency and timing could be changed to improve adherence. Some EMA items were difficult to answer due to the nature of participants' roles and the work undertaken. Overall, the protocol was feasible and acceptable but highlighted future potential changes including using a different physiological data collection tool, reducing the number of EMAs, adjusting EMA timings, and reviewing EMA items. [ABSTRACT FROM AUTHOR]

Ecological momentary assessment (EMA), a structured diary assessment technique, has shown feasibility to capture psychotic(-like) symptoms across different study groups. We investigated whether EMA combined with unsupervised machine learning can distinguish groups on the continuum of genetic risk toward psychotic illness and identify individuals with need for extended healthcare. Individuals with psychotic disorder (PD, N = 55), healthy individuals (HC, N = 25) and HC with first-degree relatives with psychosis (RE, N = 20) were assessed at two sites over 7 days using EMA. Cluster analysis determined subgroups based on similarities in longitudinal trajectories of psychotic symptom ratings in EMA, agnostic of study group assignment. Psychotic symptom ratings were calculated as average of items related to hallucinations and paranoid ideas. Prior to EMA we assessed symptoms using the Positive and Negative Syndrome Scale (PANSS) and the Community Assessment of Psychic Experience (CAPE) to characterize the EMA subgroups. We identified two clusters with distinct longitudinal EMA characteristics. Cluster 1 (NPD = 12, NRE = 1, NHC = 2) showed higher mean EMA symptom ratings as compared to cluster 2 (NPD = 43, NRE = 19, NHC = 23) (p < 0.001). Cluster 1 showed a higher burden on negative (p < 0.05) and positive (p < 0.05) psychotic symptoms in cross-sectional PANSS and CAPE ratings than cluster 2. Findings indicate a separation of PD with high symptom burden (cluster 1) from PD with healthy-like rating patterns grouping together with HC and RE (cluster 2). Individuals in cluster 1 might particularly profit from exchange with a clinician underlining the idea of EMA as clinical monitoring tool. [ABSTRACT FROM AUTHOR]

Objective: Individuals with type 1 diabetes (T1D) have increased risk for cognitive dysfunction and high rates of sleep disturbance. Despite associations between glycemia and cognitive performance using cross-sectional and experimental methods few studies have evaluated this relationship in a naturalistic setting, or the impact of nocturnal versus daytime hypoglycemia. Ecological Momentary Assessment (EMA) may provide insight into the dynamic associations between cognition, affective, and physiological states. The current study couples EMA data with continuous glucose monitoring (CGM) to examine the within-person impact of nocturnal glycemia on next day cognitive performance in adults with T1D. Due to high rates of sleep disturbance and emotional distress in people with T1D, the potential impacts of sleep characteristics and negative affect were also evaluated. Methods: This pilot study utilized EMA in 18 adults with T1D to examine the impact of glycemic excursions, measured using CGM, on cognitive performance, measured via mobile cognitive assessment using the TestMyBrain platform. Multilevel modeling was used to test the within-person effects of nocturnal hypoglycemia and hyperglycemia on next day cognition. Results: Results indicated that increases in nocturnal hypoglycemia were associated with slower next day processing speed. This association was not significantly attenuated by negative affect, sleepiness, or sleep quality. Conclusions: These results, while preliminary due to small sample size, showcase the power of intensive longitudinal designs using ambulatory cognitive assessment to uncover novel determinants of cognitive fluctuation in real world settings, an approach that may be utilized in other populations. Findings suggest reducing nocturnal hypoglycemia may improve cognition in adults with T1D. [ABSTRACT FROM AUTHOR]

Background: Despite impressive dissemination programs of best-practice therapies, clinical psychology faces obstacles in developing more efficacious treatments for mental disorders. In contrast to other medical disciplines, psychotherapy has made only slow progress in improving treatment outcomes. Improvements in the classification of mental disorders could enhance the tailoring of treatments to improve effectiveness. We introduce a multimodal dynamical network approach, to address some of the challenges faced by clinical research. These challenges include the absence of a comprehensive meta-theory, comorbidity, substantial diagnostic heterogeneity, violations of ergodicity assumptions, and a limited understanding of causal processes. Methods: Through the application of multimodal dynamical network analysis, we describe how to advance clinical research by addressing central problems in the field. By utilizing dynamic network analysis techniques (e.g., Group Iterative Multiple Model Estimation, multivariate Granger causality), multimodal measurements (i.e., psychological, psychopathological, and neurobiological data), intensive longitudinal data collection (e.g., Ecological Momentary Assessment), and causal inference methods (e.g., GIMME), our approach could improve the comprehension and treatment of mental disorders. Under the umbrella of the systems approach and utilizing e.g., graph theory and control theory, we aim to integrate data from longitudinal, multimodal measurements. Results: The multimodal dynamical network approach enables a comprehensive understanding of mental disorders as dynamic networks of interconnected symptoms. It dismantles artificial diagnostic boundaries, facilitating a transdiagnostic view of psychopathology. The integration of longitudinal data and causal inference techniques enhances our ability to identify influential nodes, prioritize interventions, and predict the impact of therapeutic strategies. Conclusion: The proposed approach could improve psychological treatment by providing individualized models of psychopathology and by suggesting individual treatment angles. [ABSTRACT FROM AUTHOR]

Purpose: Research and clinical attention in psychology has focused heavily on negative automatic thoughts and their role in symptoms of psychopathology and maladaptive behavior; however, the role of thoughts that appear to be overly positive in content has received much less attention. Recent work in the cognitive-behavioral treatment of Attention-Deficit/Hyperactivity Disorder (ADHD) has identified overly positive thoughts that may be associated with avoidance and functional impairment. Method: We defined, described, and measured Avoidant Automatic Thoughts (AAT) in the daily lives of 101 undergraduate students using ecological momentary assessment and tested hypotheses about the association of these thoughts with ADHD symptoms and in-the-moment avoidance and negative emotion. Data were collected at baseline and up to three times per day for six days and analyzed using multilevel modeling. Results: We found that AAT were frequent daily occurrences for the undergraduates in our sample and that recent presence of AAT was associated with greater task avoidance and inattentive symptoms at the momentary level. AAT were not, however, associated with momentary negative emotion. Participants' general level of ADHD symptoms predicted greater momentary AAT, task avoidance, negative emotion and negative thoughts and less positive emotion. Conclusions: This study introduces AAT as a construct with potential research and clinical utility for understanding, predicting, and intervening in problematic avoidance behaviors that reduce people's quality of life and prevent them from reaching their meaningful goals. [ABSTRACT FROM AUTHOR]

Emotion-related impulsivity—the engagement in impulsive reactions specifically in response to emotions—is considered a transdiagnostic factor underlying psychopathology. The reflexive responding to emotion (RRE) model of emotion-related impulsivity (Carver et al., 2008) suggests that sensitivities to reward and threat in combination with control over emotion are factors that result in internalizing and externalizing psychopathology. In the current study, we adapt the trait-based RRE model to momentary states by evaluating how within-person fluctuations in affect combine with perceptions of momentary emotional control to predict impulsive, rash action and inaction in daily life. Participants (college students and adults recruited from the community: N = 197) completed 8 days of ecological momentary assessment, where we assessed current affect, perceptions of momentary emotional control (via distress intolerance and willpower), and urges for rash action and inaction (5,353 momentary prompts completed). We also assessed subsequent engagement in rash action and inaction. Using multilevel modeling, we found that when people feel greater positive affect and lower negative affect, they also report greater subjective willpower and lower distress intolerance, replicating past ecological momentary assessment findings. Furthermore, we found that momentary perceptions of momentary emotional control moderated the relationship between (a) affect and urges for rash action and (b) affect and engagement in rash action at follow-up. Findings support a dynamic model of the RRE model, confirming that perceptions of momentary emotional control are relevant for both rash action and inaction, particularly when occurring alongside shifts in affect. General Scientific Summary: The tendency to respond impulsively to emotion is associated with a broad range of psychopathology. To better understand when and for whom emotion-related impulsivity is problematic, we investigated how fluctuations in people's ability to manage emotions are linked to rash behavior throughout the day. Our findings highlight how momentary shifts in affect and emotional control play an important role in people's engagement in rash behavior. [ABSTRACT FROM AUTHOR]

We developed three machine learning models that predict hour-by-hour probabilities of a future lapse back to alcohol use with increasing temporal precision (i.e., lapses in the next week, next day, and next hour). Model features were based on raw scores and longitudinal change in theoretically implicated risk factors collected through ecological momentary assessment. Participants (N = 151, 51% male, Mage = 41, 87% White, 97% non-Hispanic) in early recovery (1–8 weeks of abstinence) from alcohol use disorder provided 4 × daily ecological momentary assessment for up to 3 months. We used grouped, nested cross-validation to select the best models and evaluate the performance of those best models. Models yielded median areas under the receiver operating curves of 0.89, 0.90, and 0.93 in the 30 held-out test sets for week-, day-, and hour-level models, respectively. Some feature categories consistently emerged as being globally important to lapse prediction across our week-, day-, and hour-level models (i.e., past use, future self-efficacy). However, most of the more punctate, time-varying constructs (e.g., craving, past stressful events, arousal) appear to have a greater impact within the next-hour prediction model. This research represents an important step toward the development of a smart (machine learning guided) sensing system that can both identify periods of peak lapse risk and recommend specific supports to address factors contributing to this risk. General Scientific Summary: This study suggests that densely sampled self-report data can be used to predict lapses back to alcohol use with varying degrees of temporal precision. Additionally, the contextual features contributing to the risk of lapse may offer important insight for treatment matching through a digital therapeutic. [ABSTRACT FROM AUTHOR]

Research examining initiation and outcomes of ER has primarily examined when people regulate their own emotions. In the present study, we investigated what predicts the initiation and outcomes of interpersonal emotion regulation (IER). We also examined whether the associations varied by major depressive disorder (MDD), which is characterized by several emotion regulation challenges, including in IER. Adults with and without MDD (N = 215) completed a 14-day EMA protocol, reporting on their emotional experience, recent events, and recent IER interactions. For IER initiation, we examined two features of subjective emotional experiences: participants' affect (negative affect, positive affect) and emotional awareness (attention to emotion, emotional clarity), and two situational characteristics: event unpleasantness and goal interruption. For IER outcomes, we focused on sharing partners' characteristics. Analyses utilized multilevel modeling. We focus on reporting within-person findings. Participants were more likely to initiate IER when the situation was more unpleasant and when goals were interrupted. Regarding IER outcomes, the extent to which participants experienced improved feelings about the problem and relational closeness varied depending on who was the sharing partner. Additionally, perceived warmth of sharing partner was associated with better IER outcomes. Initiating IER did not differ by MDD status, whereas associations between perceived warmth and IER outcomes did. Findings elucidate factors relevant to the IER process and serve to provide important insight into the contexts in which individuals might seek others to support their regulation and when the sharing partner were the most helpful in IER. [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]

Traditionally, behavioral, social, and health science researchers have relied on global/retrospective survey methods administered cross-sectionally (i.e., on a single occasion) or longitudinally (i.e., on several occasions separated by weeks, months, or years). More recently, social and health scientists have added daily life survey methods (also known as intensive longitudinal methods or ambulatory assessment) to their toolkit. These methods (e.g., daily diaries, experience sampling, ecological momentary assessment) involve dense repeated assessments in everyday settings. To facilitate research using daily life survey methods, we present SEMA3 (http://www.SEMA3.com), a platform for designing and administering intensive longitudinal daily life surveys via Android and iOS smartphones. SEMA3 fills an important gap by providing researchers with a free, intuitive, and flexible platform with basic and advanced functionality. In this article, we describe SEMA3's development history and system architecture, provide an overview of how to design a study using SEMA3 and outline its key features, and discuss the platform's limitations and propose directions for future development of SEMA3. [ABSTRACT FROM AUTHOR]

Social interactions, spending time together, and relationships are important for individuals' well-being, with people feeling happier when they spend more time with others. So far, most information about the frequency and duration of spending time together is based on self-report questionnaires. Although recent technological innovations have stimulated the development of objective approaches for measuring physical proximity in humans in everyday life, these methods still have substantial limitations. Here we present a novel method, using Bluetooth low-energy beacons and a smartphone application, to measure the frequency and duration of dyads being in close proximity in daily life. This method can also be used to link the frequency and duration of proximity to the quality of interactions, by using proximity-triggered questionnaires. We examined the use of this novel method by exploring proximity patterns of family interactions among 233 participants (77 Dutch families, with 77 adolescents [Mage = 15.9] and 145 parents [Mage = 48.9]) for 14 consecutive days. Overall, proximity-based analyses indicated that adolescents were more often and longer in proximity to mothers than to fathers, with large differences between families in frequency and duration. Proximity-triggered evaluations of the interactions and parenting behavior were generally positive for both fathers and mothers. This innovative method is a promising tool that can be broadly used in other social contexts to yield new and more detailed insights into social proximity in daily life. [ABSTRACT FROM AUTHOR]

Organizational researchers are now making widespread use of ecological momentary assessments but have not yet taken the logical next step to ecological momentary interventions, also called Just-in-Time Adaptive Interventions (JITAIs). JITAIs have the potential to test within-person causal theories and maximize practical benefits to participants through two developmental phases: The microrandomized trial and the randomized controlled trial, respectively. In the microrandomized trial design, within-person randomization and experimental manipulation maximize internal validity at the within-person level. In the randomized controlled trial design, interventions are delivered in a timely and ecological manner while avoiding unnecessary and ill-timed interventions that potentially increase participant fatigue and noncompliance. Despite these potential advantages, the development and implementation of JITAIs require consideration of many conceptual and methodological factors. Given the benefits of JITAIs, but also the various considerations involved in using them, this review introduces organizational behavior and human resources researchers to JITAIs, provides guidelines for JITAI design, development, and evaluation, and describes the extensive potential of JITAIs in organizational behavior and human resources research. [ABSTRACT FROM AUTHOR]

There are profound methodological challenges facing microdosing research. One way we can address some of these methodological issues is by understanding how psilocybin microdosing fits in the broader existential context of people’s lives. We recruited participants who underwent psilocybin microdosing on their own and consented to being monitored for harm mitigation purposes. We combined momentary ecological assessment and detailed retrospective interviews. Participants reported loosening of mental structures (i.e., less intense strength of thoughts, tangential stream of consciousness), increased salience of external stimuli (varyingly associated with greater interest in otherwise mundane activities, as well as sensory overload), an increase in flexible cognition, a decrease in stable cognition, and various ego-dystonic contents. Highly structured environments were conducive to positive appraisal of experiences and vice versa. Momentary ecological assessment and retrospective interviews yielded differing accounts of microdosing experience. We relate our findings to stable and flexible cognition, as well as the notion of salience. We point out the necessity for systematic mixed methods studies to better characterize the lived experience of taking low doses of psilocybin. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective Method Results Discussion Although social media use, such as Instagram, has been associated with ED pathology, mechanisms connecting social media use to disordered eating behaviors (DEBs) remain largely unevaluated. Based on Dual Process, Tripartite, and Affect Regulation models of ED pathology, we proposed a moderated mediation model evaluating impacts of exposure to fitspiration/thinspiration on Instagram.We evaluated a hypothesized pathway from exposure to fitspiration/thinspiration (i.e., ED‐salient content) on Instagram to disordered eating mediated by negative affect and tested individual differences in weight bias internalization, trait self‐esteem, and trait self‐comparison as moderators. We recruited 173 undergraduate women who reported engaging in DEBs on average at least once per week over the past 3 months. Participants completed a seven‐day ecological momentary assessment protocol, during which they reported their ED‐salient content exposure on Instagram, affect, and engagement in DEBs.Multilevel modeling was used to assess moderated mediation. Negative affect partially mediated associations between viewing ED‐salient content and subsequent engagement in objective binge eating and restricting but did not mediate the pathway to purging or excessive exercise. Higher weight bias internalization intensified the association between viewing ED‐salient content and negative affect.The association between viewing ED‐salient content and engaging in objective binge eating and restricting may be a partial consequence of elevated negative affect; however, effects were small. Individuals with higher weight bias internalization may be more vulnerable to negative consequences from viewing ED‐salient content. Findings suggested that reducing negative affect responses (e.g., via emotion regulation) could reduce negative consequences of viewing ED‐salient content. [ABSTRACT FROM AUTHOR]

The effects of heat exposure on negative affect are thought to be central to the observed relationships between hot summer days and deleterious outcomes, such as violent crime or mental health crises. As these relationships are likely to be magnified by the effects of climate change, a better understanding of how consistent or variable the effects of hot weather on affective states is required. The current work combines data gathered from an ecological momentary assessment (EMA) study on individuals' thermal perceptions, comfort, and affective states in outdoor environments during their daily lives with high spatiotemporal resolution climate-modeled weather variables. Using these data, associations between objective weather variables (temperature, humidity, etc.), perceived heat (thermal perception and comfort), and affective states are examined. Overall, objective weather data reasonably predicted perception and comfort, but only comfort predicted negative affective states. The variance explained across individuals was generally very low in predicting negative affect or comfort, but within-person variance explained was high. In other words, while there may be a relatively consistent relationship between temperature and psychological experience for any given person, there are significant individual differences across people. Age and gender were examined as moderators of these relationships, and while gender had no impact, participant age showed several significant interactions. Specifically, while older adults tended to experience more thermal discomfort and perceived higher temperatures as hotter, the relationship between discomfort and negative affect was lower in older adults. Taken together, these results emphasize the importance of thermal discomfort specifically in predicting negative affect, as well as the high inter-individual variability in thermal perceptions and comfort for the same ambient temperatures. [ABSTRACT FROM AUTHOR]