Psychological distress and trajectories of sleep duration among Australian adolescents: a prospective cohort study.

OBJECTIVES: This study investigated the association between indicators of psychological distress and well-being and trajectories of sleep duration among a cohort of Australian adolescents. DESIGN: A prospective cohort of adolescents was followed over 27 weeks (8 November 2019-14 May 2020). Data on sleep duration and psychological distress were collected via smartphones, based on ecological momentary assessments. SETTING: Sydney population catchment, Australia. PARTICIPANTS: Young people aged 13-19 years were recruited via social media (Instagram or Facebook). PRIMARY OUTCOME MEASURE: Self-reported sleep duration in the past 24 hours. Sleep duration was dichotomised into 'less than 8 hours' and 'at least 8 hours', to represent those participants not meeting the recommended minimum amount of daily sleep. RESULTS: Participants with high psychological distress had higher odds of sleeping less than 8 hours (OR 1.51 (95% CI 1.17 to 1.96)), compared with those with low psychological distress. Social media use (OR 1.34 (95% CI 1.01 to 1.79)) and longer periods spent on homework (OR 1.37, (95% CI 1.07 to 1.75)) were also associated with a sleep duration of less than 8 hours. Also, decreasing sleep trajectories were associated with increased psychological distress (ß=0.069, (95% CI -0.010 to 0.149)) and increased homework hours (ß=0.078 (95% CI 0.036 to 0.120)). CONCLUSION: Findings highlight the adverse impact of psychological distress and high levels of social media use on sleep duration among adolescents. Longitudinal studies with longer follow-up periods are warranted to further explore the temporal associations between sleep duration and different health outcomes among varying populations.

Tracking Well-Being: A Comprehensive Analysis of Physical Activity and Mental Health in College Students Across COVID-19 Phases Using Ecological Momentary Assessment.

Physical activity (PA) is a critical factor in maintaining mental health, particularly among college students who are vulnerable to stress, anxiety, and mood disturbances. The COVID-19 pandemic introduced unprecedented disruptions to daily routines. The purpose of this cohort study was to examine the longitudinal PA behaviors before and during COVID-19 using device-based assessment in a sample of college students. The participants were a convenience sample of 1-year college students from the University of Vermont Wellness Environment study. A daily survey was distributed to the participants every night on a study app measured three mental health outcomes of mood, anxiety, and stress for 16 weeks. Participants wore Apple Watches to monitor PA. A total of 167 participants completed at least 50% of daily surveys and had 20 days of valid Apple Watch data, which resulted in 11 387 participant-days' of observations. Changes in average daily moderate-to-vigorous physical activity (MVPA) and step counts were examined week-over-week from an 8-week period before COVID to an 8-week period during COVID using cluster-robust piecewise regression (16-weeks total). Linear mixed models examined the association between PA and mental health outcomes, while also examining the moderating influence of COVID phase. Significantly lower MVPA was observed from the end of pre-COVID to start of COVID by -18.2 min/day (p < 0.001) and significantly fewer steps/day was observed from end of pre-COVID to start of COVID by -3277 steps/day (p < 0.001). An MVPA "catch-up" effect was observed as there were small but positive week-over-week improvements during COVID for MVPA (b = 1.32 min/day, p < 0.001). The influence of COVID-19 phases had a notable impact on the relationships between PA/exercise and mental health outcomes. A discernible trend emerged, indicating stronger connections during the COVID period for anxiety and stress compared to the pre-COVID era. Interestingly, the moderating effect of COVID was opposite for mood and exercise. The COVID-19 pandemic led to a dramatic decline in PA among college students, coinciding with a period of heightened stress and anxiety. Despite a slight recovery in PA levels during the pandemic, the strengthened association between exercise and anxiety/stress during this time underscores the vital role of PA in promoting mental health. These findings highlight the importance of implementing behavior change strategies to maintain and promote student wellbeing.

Moderating Role of Self-Regulation Difficulties in the Momentary Associations Between Depressive Symptoms and Participation Poststroke.

IMPORTANCE: Because depressive symptoms are momentarily associated with lower levels of participation poststroke, it is crucial to investigate what moderates such associations to identify a potential intervention target to reduce the momentary links between depressive symptoms and participation poststroke. Self-regulation seems to be a potential moderator of such associations. OBJECTIVE: To investigate the extent to which difficulties in self-regulation moderate the momentary associations between depressive symptoms and participation poststroke. DESIGN: This study uses a real-time, repeated-measures design using smartphone-based ecological momentary assessment surveys five times a day for 10 days. We performed multilevel modeling to uncover the momentary associations among the study variables. SETTING: Community. PARTICIPANTS: 39 people with stroke. OUTCOMES AND MEASURES: We obtained real-time data for difficulties in self-regulation (total, cognitive, behavioral, and emotion regulation), depressive symptoms, and participation in daily activities (performance in daily activities and satisfaction with performing daily activities). RESULTS: We included 1,612 survey responses in the analysis. Higher depressive symptoms were momentarily associated with lower levels of performance (ß = -0.05 to -0.07, p < .001) and satisfaction (ß = -0.04 to -0.06, p < .05), regardless of adjusting for self-regulation variables and other covariates. Difficulties in total self-regulation (ß = -0.01, p < .001) and emotion regulation (ß = -0.02, p < .001) magnified the negative associations between depressive symptoms and satisfaction with performing daily activities. CONCLUSIONS AND RELEVANCE: Using self-regulation and emotion regulation strategies may be a target for just-in-time intervention for reducing the momentary associations between depressive symptoms and satisfaction with performing daily activities poststroke. Plain-Language Summary: Depressive symptoms have immediate and real-time associations with lower levels of participation in daily activities in people with stroke. Self-regulation, including cognitive regulation (e.g., goal setting, planning strategies), behavioral regulation (e.g., controlling impulsive behaviors), and emotion regulation (e.g., managing negative feelings), may be an intervention target for reducing the immediate associations between depressive symptoms and lower levels of participation poststroke. Thus, we investigated whether difficulties in self-regulation variables magnify the negative real-time associations between depressive symptoms and participation poststroke. To obtain real-time data on difficulties in self-regulation variables, depressive symptoms, and participation (i.e., performance and satisfaction), we asked 39 community-dwelling people with stroke to answer smartphone surveys. The results showed that difficulties in total self-regulation and emotion regulation magnified the negative associations between depressive symptoms and satisfaction with performing daily activities. Our findings suggest that self-regulation and emotion regulation strategies may be a target for real-time intervention for reducing the momentary associations between depressive symptoms and satisfaction with performing daily activities poststroke.

A control theoretic approach to evaluate and inform ecological momentary interventions.

OBJECTIVES: Ecological momentary interventions (EMI) are digital mobile health interventions administered in an individual's daily life to improve mental health by tailoring intervention components to person and context. Experience sampling via ecological momentary assessments (EMA) furthermore provides dynamic contextual information on an individual's mental health state. We propose a personalized data-driven generic framework to select and evaluate EMI based on EMA. METHODS: We analyze EMA/EMI time-series from 10 individuals, published in a previous study. The EMA consist of multivariate psychological Likert scales. The EMI are mental health trainings presented on a smartphone. We model EMA as linear dynamical systems (DS) and EMI as perturbations. Using concepts from network control theory, we propose and evaluate three personalized data-driven intervention delivery strategies. Moreover, we study putative change mechanisms in response to interventions. RESULTS: We identify promising intervention delivery strategies that outperform empirical strategies in simulation. We pinpoint interventions with a high positive impact on the network, at low energetic costs. Although mechanisms differ between individuals - demanding personalized solutions - the proposed strategies are generic and applicable to various real-world settings. CONCLUSIONS: Combined with knowledge from mental health experts, DS and control algorithms may provide powerful data-driven and personalized intervention delivery and evaluation strategies.

Development of a web-based ecological momentary assessment tool to measure day-to-day variability of the symptoms in patients with Sjögren's disease.

OBJECTIVES: To develop and validate a web-based ecological momentary assessment (EMA) tool to enhance symptoms monitoring among patients with Sjögren's disease (SjD). METHODS: Consecutive adults with SjD were enrolled in this pilot observational study. Participants used the WebApp over a 3-month period, for the daily collection of individual EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI) scales and separate assessment of eyes and mouth dryness, using 0-10 numerical scales. Primary outcome was the measure of the interdaily variability of symptoms. Data collected through the WebApp were compared with those obtained with paper-based questionnaires administered during a final visit, using distinct approaches (predicted error, maximum negative error and maximum positive error). User experience was assessed using the System Usability Scale (SUS) score. RESULTS: Among the 45 participants, 41 (91.1%) were women. Median age was 57 years (IQR: 49-66). Daily variability of symptoms ranged between 0.5 and 0.8 points across the scales. Over the 3-month period, the predicted error ranged between -1.2 and -0.3 points of the numerical scales. The greatest differences were found for fatigue (-1.2 points (IQR: -2.3 to -0.2)) and ESSPRI score (-1.2 points (IQR: -1.7 to -0.3)). Over the last 2 weeks, the predicted error ranged between - 1.2 and 0.0 points. Maximum negative error ranged between -2.0 and -1.0 points, and maximum positive error between -0.3 and 0.0 points. Median SUS score was 90 (IQR: 85-95). CONCLUSION: Our results demonstrate the usability and the relevance of our web-based EMA tool for capturing data that closely reflects daily experiences of patients with SjD.

Temporal generative models for learning heterogeneous group dynamics of ecological momentary assessment data.

One of the goals of precision psychiatry is to characterize mental disorders in an individualized manner, taking into account the underlying dynamic processes. Recent advances in mobile technologies have enabled the collection of ecological momentary assessments that capture multiple responses in real-time at high frequency. However, ecological momentary assessment data are often multi-dimensional, correlated, and hierarchical. Mixed-effect models are commonly used but may require restrictive assumptions about the fixed and random effects and the correlation structure. The recurrent temporal restricted Boltzmann machine (RTRBM) is a generative neural network that can be used to model temporal data, but most existing RTRBM approaches do not account for the potential heterogeneity of group dynamics within a population based on available covariates. In this paper, we propose a new temporal generative model, the HDRBM, to learn the heterogeneous group dynamics and demonstrate the effectiveness of this approach on simulated and real-world ecological momentary assessment datasets. We show that by incorporating covariates, HDRBM can improve accuracy and interpretability, explore the underlying drivers of the group dynamics of participants, and serve as a generative model for ecological momentary assessment studies.

Using Biosensor Devices and Ecological Momentary Assessment to Measure Emotion Regulation Processes: Pilot Observational Study With Dialectical Behavior Therapy.

Background: Novel technologies, such as ecological momentary assessment (EMA) and wearable biosensor wristwatches, are increasingly being used to assess outcomes and mechanisms of change in psychological treatments. However, there is still a dearth of information on the feasibility and acceptability of these technologies and whether they can be reliably used to measure variables of interest. Objective: Our objectives were to assess the feasibility and acceptability of incorporating these technologies into dialectical behavior therapy and conduct a pilot evaluation of whether these technologies can be used to assess emotion regulation processes and associated problems over the course of treatment. Methods: A total of 20 adults with borderline personality disorder were enrolled in a 6-month course of dialectical behavior therapy. For 1 week out of every treatment month, participants were asked to complete EMA 6 times a day and to wear a biosensor watch. Each EMA assessment included measures of several negative affect and suicidal thinking, among other items. We used multilevel correlations to assess the contemporaneous association between electrodermal activity and 11 negative emotional states reported via EMA. A multilevel regression was conducted in which changes in composite ratings of suicidal thinking were regressed onto changes in negative affect. Results: On average, participants completed 54.39% (SD 33.1%) of all EMA (range 4.7%-92.4%). They also wore the device for an average of 9.52 (SD 6.47) hours per day and for 92.6% of all days. Importantly, no associations were found between emotional state and electrodermal activity, whether examining a composite of all high-arousal negative emotions or individual emotional states (within-person r ranged from -0.026 to -0.109). Smaller changes in negative affect composite scores were associated with greater suicidal thinking ratings at the subsequent timepoint, beyond the effect of suicidal thinking at the initial timepoint. Conclusions: Results indicated moderate overall compliance with EMA and wearing the watch; however, there was no concurrence between EMA and wristwatch data on emotions. This pilot study raises questions about the reliability and validity of these technologies incorporated into treatment studies to evaluate emotion regulation mechanisms.

ECO-MIND: enhancing pro-environmental behaviours and mental health through nature contact for urban youth - a research protocol for a multi-country study using geographic ecological momentary assessment and mental models.

INTRODUCTION: Urban youth are experiencing increasing mental health problems due to diverse personal, social and environmental concerns. Youths' detachment from natural environments, including green and blue spaces, may intensify such issues further. Contact with nature can benefit mental health and promote pro-environmental behaviour (PEB). Yet, only a few studies assess these relationships among the youth usually ignoring effects of living in diverse urban contexts, and everyday nature experiences. ECO-MIND will investigate whether urban youth's dynamic greenspace exposure and their mental models about nature connectedness explain the associations between greenspace exposure, mental health and PEB in multiple urban contexts. METHODS AND ANALYSIS: We will collect data from university students from the Global South (ie, Dhaka, Kampala) and Global North cities (ie, Utrecht). Participants aged 18-24 will be recruited through stratified random sampling. We will use geographic ecological momentary assessment to assess respondents' everyday experiences and exposure to greenspaces. Our definition of greenspace exposure will be based on the availability, accessibility and visibility of greenspaces extracted from satellite and street view images. We will administer a baseline questionnaire to participants about mental health, nature connectedness and PEB characteristics. Further, we will ask participants to build mental models to show their perception of nature connectedness. Finally, we will fit partial least square structural equation models and multi-level models to our longitudinal geographic momentary assessment data. ETHICS AND DISSEMINATION: The study was approved by the Ethical Review Board of the Utrecht University (Geo S-23221). Informed consent must be given freely, without coercion and based on a clear understanding of the participation in the study. Findings will be disseminated in peer-reviewed journals and at conferences. Furthermore, we will implement public engagement activities (eg, panel discussion) to share results among local stakeholders and policymakers and cocreate policy briefs.

Development and Initial Evaluation of a Digital Phenotype Collection System for Adolescents: Proof-of-Concept Study.

BACKGROUND: The growing concern on adolescent mental health calls for proactive early detection and intervention strategies. There is a recognition of the link between digital phenotypes and mental health, drawing attention to their potential use. However, the process of collecting digital phenotype data presents challenges despite its promising prospects. OBJECTIVE: This study aims to develop and validate system concepts for collecting adolescent digital phenotypes that effectively manage inherent challenges in the process. METHODS: In a formative investigation (N=34), we observed adolescent self-recording behaviors and conducted interviews to develop design goals. These goals were then translated into system concepts, which included planners resembling interfaces, simplified data input with tags, visual reports on behaviors and moods, and supportive ecological momentary assessment (EMA) prompts. A proof-of-concept study was conducted over 2 weeks (n=16), using tools that simulated the concepts to record daily activities and complete EMA surveys. The effectiveness of the system was evaluated through semistructured interviews, supplemented by an analysis of the frequency of records and responses. RESULTS: The interview findings revealed overall satisfaction with the system concepts, emphasizing strong support for self-recording. Participants consistently maintained daily records throughout the study period, with no missing data. They particularly valued the recording procedures that aligned well with their self-recording goal of time management, facilitated by the interface design and simplified recording procedures. Visualizations during recording and subsequent report viewing further enhanced engagement by identifying missing data and encouraging deeper self-reflection. The average EMA compliance reached 72%, attributed to a design that faithfully reflected adolescents' lives, with surveys scheduled at convenient times and supportive messages tailored to their daily routines. The high compliance rates observed and positive feedback from participants underscore the potential of our approach in addressing the challenges of collecting digital phenotypes among adolescents. CONCLUSIONS: Integrating observations of adolescents' recording behavior into the design process proved to be beneficial for developing an effective and highly compliant digital phenotype collection system.

Everyday helping is associated with enhanced mood but greater stress when it is more effortful.

Our affective states can influence whether we help others and after helping we often experience improved affect. One important factor determining whether we help, is the amount of effort involved. Using an ecological momentary assessment approach across two measurement bursts (N = 803; N = 303), we investigated the affective antecedents and consequences of everyday helping in terms of participants' self-reported momentary stress and mood valence, with a specific focus on the perceived amount of effort involved. Regardless of the amount of effort involved in helping, participants reported more positive mood valence after helping across both measurement bursts. In burst 2, this mood boosting effect of helping was strongest in those reporting lower mood prior to helping. In burst 1, we found a bidirectional relationship between stress and helping effort: the greater the effort involved in helping, the greater the perceived stress both before and after helping. Contrary to our preregistered hypotheses, changes in stress or mood valence did not precede helping regardless of the amount of effort involved. Our results support previous work linking helping to enhanced mood but suggest that when helping is more effortful it is both preceded and followed by greater stress. These findings have important implications for fostering and sustaining prosocial behaviours, especially when effort is involved.

Time course of kratom effects via ecological momentary assessment, by product type, dose amount, and assayed alkaloid content.

BACKGROUND AND AIMS: Using ecological momentary assessment (EMA), we undertook a natural experiment wherein kratom-product variability was a tool to assess kratom dose-response relationships based on product form and alkaloid level. METHODS: Between July-November 2022, 357 US kratom consumers (56.6 % male, 90.2 % non-Hispanic white) completed 15 days of EMA; 348 participants submitted samples of the products used most often during EMA. These were assayed for ten alkaloids using ultra-performance liquid chromatography-tandem mass spectrometry. Self-reported kratom effects were modeled as a function of kratom amount and alkaloid content. RESULTS: Participants used over 220 brands. The most-reported product forms were loose powder (55.8 %) and encapsulated powder (26.8 %); extracts were used less (419 uses across 9.48 % of participants). Of the 12,244 use-event entries, 7726 had follow-up data (15-180minutes after use) on felt effects. Effects were stronger in participants with a higher average amount per use. Within-person dose-response relationships were obscured by highly-consistent within-person dosages. Effects of loose powder decreased over three hours; effects of extracts started higher but decreased more rapidly. Dose-response relationships for specific alkaloids could not be reliably established because total alkaloid content and relative levels of specific alkaloids showed limited variability between products. Higher levels of corynoxine alkaloids were associated with slightly stronger effects, possibly an artifact of modeling data with low alkaloid variability. CONCLUSIONS: Alkaloid content was surprisingly consistent across kratom products, and participants were consistent in the amount they used across events. Firm conclusions about alkaloid-effect relationships for kratom will require experimenter-controlled manipulations of agent and dose.

Emptiness and negative affect changes related to binge eating and borderline personality traits.

Borderline personality disorder (BPD) is characterized by unstable self-image, conflictual interpersonal relationships, emotional dysregulation, and marked impulsivity. One form of impulsivity commonly seen in BPD is binge eating; however, little is known about this maladaptive behavior in the context of BPD. In the eating disorder (ED) literature, multiple theories suggest binge eating occurs as a result of heightened levels of negative affect. Given that BPD and EDs share emotional dysregulation and impulsivity as maintaining mechanisms of each respective disorder, these theories of binge eating may provide a model for binge eating in BPD. Existing literature suggests feelings of emotional emptiness may precede binge episodes in those with EDs. The current study sought to explore feelings of emptiness as antecedents to binge eating behaviors in those with BPD traits. Using ecological momentary assessment, binge episodes, affect, and feelings of emptiness were tracked throughout the day for 14 days in undergraduate students with BPD traits (n = 55). The current study found momentary feelings of emptiness at the time of the binge eating episode significantly predicted increased odds of a binge episode occurring. Additionally, momentary feelings of emptiness, as well as other negative affects, increase following a binge episode. Results suggest treatment of binge eating within BPD should include elements of acceptance of negative affects including emptiness, such as in dialectical behavior therapy distress tolerance skills training. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

First-person thought is associated with body awareness in daily life.

Sensations from the body are thought to play a critical role in many aspects of conscious experience, including first-person thought. In the present set of studies, we examined within-person relationships between in-the-moment subjective awareness of sensations from the body and self-reported first-person thought in real-world settings using ecological momentary assessment (EMA) protocols. In Study 1, participants reported experiencing greater first-person thoughts in moments when they also reported heightened awareness of sensations from their body, and this relationship was stable over a 4-week period even with mean-level changes in body awareness and first-person thought. In Study 2, we replicated this association in a 1-week EMA protocol using both self-report measures and measures derived from participants' open-ended descriptions of their ongoing thoughts using a natural language processing approach. Taken together, findings shed light on the role of subjective body awareness in other facets of conscious experience.

Integrating Real-Time Air Quality Monitoring, Ecological Momentary Assessment, and Spirometry to Evaluate Asthma Symptoms: Usability Study.

BACKGROUND: Individuals are exposed to a variety of indoor residential toxins including volatile organic compounds and particulates. In adults with asthma, such exposures are associated with asthma symptoms, asthma exacerbations, and decreased lung function. However, data on these exposures and asthma-related outcomes are generally collected at different times and not in real time. The integration of multiple platforms to collect real-time data on environmental exposure, asthma symptoms, and lung function has rarely been explored. OBJECTIVE: This paper describes how adults with asthma perceive the acceptability and usability of three integrated devices: (1) residential indoor air quality monitor, (2) ecological momentary assessment (EMA) surveys delivered via a smartphone app, and (3) home spirometry, over 14 days. METHODS: Participants (N=40) with uncontrolled asthma were mailed the Awair Omni indoor air quality monitor, ZEPHYRx home spirometer, and detailed instructions required for the in-home monitoring. The air quality monitor, spirometer, and EMA app were set up and tested during a videoconference or phone orientation with a research team member. Midway through the 14-day data collection period, participants completed an interview about the acceptability of the study devices or apps, instructional materials provided, and the setup process. At the end of the 14-day data collection period, participants completed a modified System Usability Scale. A random sample of 20 participants also completed a phone interview regarding the acceptability of the study and the impact of the study on their asthma. RESULTS: Participants ranged in age from 26 to 77 (mean 45, SD 13.5) years and were primarily female (n=36, 90%), White (n=26, 67%), college graduates (n=25, 66%), and residing in a single-family home (n=30, 75%). Most indicated that the air quality monitor (n=23, 58%), the EMA (n=20, 50%), and the spirometer (n=17, 43%) were easy to set up and use. Challenges with the EMA included repetitive surveys, surveys arriving during the night, and technical issues. While the home spirometer was identified as a plausible means to evaluate lung function in real time, the interpretation of the readings was unclear, and several participants reported side effects from home spirometer use. Overall, the acceptability of the study and the System Usability Scale scores were high. CONCLUSIONS: The study devices were highly acceptable and usable. Participant feedback was instrumental in identifying technical challenges that should be addressed in future studies.

Variable and dynamic associations between hot weather, thermal comfort, and individuals' emotional states during summertime.

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.

Examining the Impact of Simultaneous Alcohol and Cannabis Use on Alcohol Consumption and Consequences: Protocol for an Observational Ambulatory Assessment Study in Young Adults.

BACKGROUND: There is significant conflicting evidence as to how using cannabis while drinking alcohol (ie, simultaneous alcohol and cannabis use) impacts alcohol volume consumed, patterns of drinking, and alcohol-related consequences. The impact of simultaneous use on drinking outcomes may be influenced by several within-person (eg, contextual) and between-person (individual) factors. OBJECTIVE: This study was designed to examine naturalistic patterns of alcohol and cannabis use to understand how simultaneous use may impact drinking outcomes. The primary aims were to understand the following: (1) if simultaneous use is associated with increased alcohol consumption and riskier patterns of drinking, (2) if simultaneous use leads to increased alcohol consequences, and (3) how contextual circumstances moderate the impact of simultaneous use on consumption and consequences. METHODS: Data collection involves a 28-day ambulatory assessment protocol in which a sample of non-treatment-seeking young adults who report simultaneous use of alcohol and cannabis complete ecological momentary assessments (random, event-contingent, and time-contingent surveys) of alcohol and cannabis use, contexts, motives, and consequences on their personal smartphones while continuously wearing an alcohol biosensor bracelet. Participants also complete a baseline assessment, brief internet-based check-in on day 14, and a final session on day 28. Community-based recruitment strategies (eg, social media and flyers) were used to enroll 95 participants to obtain a target sample of 80, accounting for attrition. RESULTS: Recruitment and data collection began in May 2021 and continued through June 2024. Initial results for primary aims are expected in October 2024. As of March 2024, the project had recruited 118 eligible participants, of whom 94 (79.7%) completed the study, exceeding initial projections for the study time frame. Remaining recruitment will provide the capacity to probe cross-level interactions that were not initially statistically powered. Strengths of the project include rigorous data collection, good retention and compliance rates, faster-than-expected enrollment procedures, use of a novel alcohol biosensor, and successful adaptation of recruitment and data collection procedures during the COVID-19 pandemic. CONCLUSIONS: This is the first investigation to assess the key momentary predictors and outcomes of simultaneous use as well as self-reported and objective (via alcohol biosensor) measures of alcohol consumption and patterns. The results of this study will inform prevention efforts and studies of individuals who use cannabis who are engaged in alcohol treatment. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/58685.

Daily stress and emotions in relation to fear of negative and positive evaluation.

Fear of negative (FNE) and positive (FPE) evaluation constitute distinct components of social anxiety and relate to altered affectivity. It is unclear whether individuals with strong FNE/FPE overreact to social stressors only or to more unspecific ones as well. The present set of three studies (n = 109 and n = 97 healthy individuals in study 1/2, n = 49 patients with social anxiety disorder in study 3) assessed whether reactivity to various daily stressors and non-specific momentary stress/emotions assessed through ecological momentary assessment depend on individuals' level of FPE/FNE. Almost all relationships with FPE/FNE were explained by depressive symptoms, except for a unique association of FNE with reactivity to stressors from the distant social network. Relationships of FNE with momentary global stress and emotions were mixed, but again explained by depressive symptoms. More depressive symptoms were associated with higher stress, negative affect, and most stressor types as well as lower positive affect in all studies. These results show that for social stressors from the distant social network, FNE has explanatory power. They further document the role of depressive affect for reactivity to a wide range of everyday stressors and question the need for specific instruments assessing FPE/FNE unless stressors are explicitly social-evaluative in nature.

Evidence for a vicious socioemotional cycle of negative emotions and interpersonal conflict.

Objective: Interpersonal and emotional functioning are closely linked and reciprocally influence one another. Contemporary integrative interpersonal theory (CIIT) offers a useful framework to conceptualize these patterns and guide interventions in cases where these patterns result in dysfunction. Stress processes offer several dynamic frameworks to guide empirical investigations using methods that allow for fine-grained analyses in the context of daily life. METHOD: Four samples of adults (Sample 1, N = 145; Sample 2, N = 160; Sample 3, N = 297; Sample 4 = 89 dyads, 178 individuals) completed ecological momentary assessment protocols focused on a variety of interpersonal and emotional experiences. Samples were enriched for aggressive and self-harming behavior (Sample 1), trait hostility (Sample 2), interpersonal problems (Sample 3), and personality disorder features (Sample 4). RESULTS: Using multilevel dynamic structural equation modeling, we investigated how emotions and interpersonal functioning operate over brief timescales in daily life. We found evidence for a vicious socioemotional cycle across all four samples, whereby negative emotions related to interpersonal conflict (i.e., perceptions of and enacting cold, antagonistic, or quarrelsome behavior; components that contribute to the interpersonal situation from the perspective of CIIT) which in turn related to increased negative emotions. Although individuals differed in the strength of this process, it was unrelated to trait negative affectivity. CONCLUSIONS: Viewing these results through the lens of CIIT, we discuss multiple intervention points highlighted by these dynamic results whereby the vicious cycle might be changed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Outcome prediction in psychological therapy with continuous time dynamic modeling of affective states and emotion regulation.

OBJECTIVE: To date, many prediction studies in psychotherapy research have used cross-sectional data to predict treatment outcome. The present study used intensive longitudinal assessments and continuous time dynamic modeling (CTDM) to investigate the temporal dynamics of affective states and emotion regulation in the early phase of therapy and their ability to predict treatment outcome. METHOD: Ninety-one patients undergoing psychological treatment at a university outpatient clinic took part in a 2-week ecological momentary assessment (EMA) period. Participants answered self-report measures on positive affect (PA), negative affect, and emotion regulation (ER) four times a day. Hierarchical Bayesian CTDM was conducted to identify temporal effects within (autoregressive) and between (cross-regressive) PA, negative affect, and ER. The resulting CTDM parameters, simple EMA parameters (e.g., mean), and cross-sectional predictors were entered into a LASSO model to be examined as predictors of treatment outcome at Session 15. RESULTS: Two significant predictors were identified: initial impairment and the continuous time cross-effect of PA on ER. The final model explained 40% of variance in treatment outcome, with the cross-effect (PA-ER) accounting for 4% of variance beyond initial impairment. CONCLUSIONS: The results demonstrate that temporal patterns of affective EMA data are valuable for the mapping of individual differences and the prediction of treatment outcome. This information can be used to provide therapists with feedback to personalize treatments. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Characterizing the dynamics, reactivity and controllability of moods in depression with a Kalman filter.

BACKGROUND: Mood disorders involve a complex interplay between multifaceted internal emotional states, and complex external inputs. Dynamical systems theory suggests that this interplay between aspects of moods and environmental stimuli may hence determine key psychopathological features of mood disorders, including the stability of mood states, the response to external inputs, how controllable mood states are, and what interventions are most likely to be effective. However, a comprehensive computational approach to all these aspects has not yet been undertaken. METHODS: Here, we argue that the combination of ecological momentary assessments (EMA) with a well-established dynamical systems framework-the humble Kalman filter-enables a comprehensive account of all these aspects. We first introduce the key features of the Kalman filter and optimal control theory and their relationship to aspects of psychopathology. We then examine the psychometric and inferential properties of combining EMA data with Kalman filtering across realistic scenarios. Finally, we apply the Kalman filter to a series of EMA datasets comprising over 700 participants with and without symptoms of depression. RESULTS: The results show a naive Kalman filter approach performs favourably compared to the standard vector autoregressive approach frequently employed, capturing key aspects of the data better. Furthermore, it suggests that the depressed state involves alterations to interactions between moods; alterations to how moods responds to external inputs; and as a result an alteration in how controllable mood states are. We replicate these findings qualitatively across datasets and explore an extension to optimal control theory to guide therapeutic interventions. CONCLUSIONS: Mood dynamics are richly and profoundly altered in depressed states. The humble Kalman filter is a well-established, rich framework to characterise mood dynamics. Its application to EMA data is valid; straightforward; and likely to result in substantial novel insights both into mechanisms and treatments.