Higher emotion regulation flexibility predicts more stable negative emotions and faster affective recovery in early psychosis: an experience sampling study.

BACKGROUND: While evidence shows that people with early psychosis are flexible in using different emotion regulation (ER) strategies to manage the varying contextual demands, no studies have examined the effectiveness of such regulatory flexibility in this population. We addressed this issue by investigating whether and how ER flexibility relate to different dynamic aspects (variability, instability, inertia, and recovery) of negative affect (NA) in a combined early psychosis sample, consisting of both individuals at high clinical risk for psychosis and those diagnosed with first-episode psychosis. METHODS: Participants were 148 individuals from the INTERACT project, a multi-center randomized controlled trial on the efficacy of acceptance and commitment therapy in early psychosis. We utilized data from the baseline assessment, during which all participants completed six days of experience sampling assessment of momentary NA, as well as end-of-day assessments of ER strategy use. RESULTS: Multilevel models of within-person associations showed that greater ER flexibility was associated with more stable NA, and quicker recovery of NA from stressors during the day. Linear regression analyses of between-person associations showed that people who had more variable and unstable NA reported greater ER flexibility generally. No evidence was found for associations with NA inertia. CONCLUSIONS: The current study identified unique within-person and between-person links between ER flexibility and dynamics of NA in early psychosis. These findings further provide evidence for ER flexibility in early psychosis, emphasizing the adaptive nature of regulatory flexibility in relation to reduced instability in NA and faster recovery from NA in everyday life.

The temporal association between social isolation, distress, and psychotic experiences in individuals at clinical high-risk for psychosis.

BACKGROUND: Psychotic experiences (PEs) and social isolation (SI) seem related during early stages of psychosis, but the temporal dynamics between the two are not clear. Literature so far suggests a self-perpetuating cycle wherein momentary increases in PEs lead to social withdrawal, which, subsequently, triggers PEs at a next point in time, especially when SI is associated with increased distress. The current study investigated the daily-life temporal associations between SI and PEs, as well as the role of SI-related and general affective distress in individuals at clinical high risk (CHR) for psychosis. METHODS: We used experience sampling methodology in a sample of 137 CHR participants. We analyzed the association between SI, PEs, and distress using time-lagged linear mixed-effects models. RESULTS: SI did not predict next-moment fluctuations in PEs, or vice versa. Furthermore, although SI-related distress was not predictive of subsequent PEs, general affective distress during SI was a robust predictor of next-moment PEs. CONCLUSIONS: Our results suggest that SI and PEs are not directly related on a moment-to-moment level, but a negative emotional state when alone does contribute to the risk of PEs. These findings highlight the role of affective wellbeing during early-stage psychosis development.

Changes in adolescents' daily-life solitary experiences during the COVID-19 pandemic: an experience sampling study.

BACKGROUND: Adolescent solitude was drastically impacted by the COVID-19 pandemic. As solitude is crucial for adolescent development through its association with both positive and negative developmental outcomes, it is critical to understand how adolescents' daily-life solitary experiences changed as a result of the pandemic. METHODS: Using three waves of Experience Sampling Method data from a longitudinal study, we compared adolescents' daily-life solitary experiences in the early (nT1=100; MAge=16.1; SDAge=1.9; 93% girls) and mid-pandemic (nT2=204; MAge=16.5; SDAge=2.0; 79% girls) to their pre-pandemic experiences. RESULTS: We found that adolescents with lower levels of pre-pandemic social support and social skills reported wanting to be alone less and feeling like an outsider more at both time points during the pandemic. In the mid-pandemic wave, adolescents with higher levels of pre-pandemic social support and social skills reported decreases in positive affect compared to the pre-pandemic wave. CONCLUSION: This study shows that adolescents' daily-life solitary experiences worsened throughout the COVID-19 pandemic. There should be continued concern for the wellbeing of all adolescents, not only those already at risk, as effects of the pandemic on mental health might only manifest later.

Pressure to not feel bad among (different-sex) romantic partners: prevalence, and correlates.

Western society generally highly values happiness. As a result, people sometimes experience pressure not to feel negative emotions. In this study, we comprehensively investigated this pressure, and how it manifests itself, in adult romantic relationships. Specifically, we first examined when, how often and how intensely people experience pressure not to feel bad from their romantic partners (94 different-sex couples). Additionally, we investigated (both between- and within-person) how this pressure is related to context (presence of, contact and or conflict with a partner), emotional processes (i.e. experienced sadness and anxiety, emotion suppression, and how their partner perceived their affect), and relationship well-being. Using experience sampling methodology data (6/14 reports per day over one week) we found that although participants generally did not experience strong pressure from their partner, they experienced some feelings of pressure about 50% of the time. Furthermore, within-person predictors associated with negative processes/emotions (i.e. negative emotions, conflict, emotion suppression) were related to the momentary frequency (odds) and/or intensity of perceived pressure not to feel bad. At the between-person level, individuals who experience more sadness, anxiety and reported suppressing their emotions more often tended to experience more and/or stronger pressure. Only weak associations with relationship well-being were found.

Oxytocin and state attachment responses to secure base support after stress in middle childhood.

We tried to replicate the finding that receiving care increases children's oxytocin and secure state attachment levels, and tested whether secure trait attachment moderates the oxytocin and state attachment response to care. 109 children (9-11 years old; M = 9.59; SD = 0.63; 34.9% boys) participated in a within-subject experiment. After stress induction (Trier Social Stress Test), children first remained alone and then received maternal secure base support. Salivary oxytocin was measured eight times. Secure trait and state attachment were measured with questionnaires, and Secure Base Script knowledge was assessed. Oxytocin levels increased after receiving secure base support from mother after having been alone. Secure state attachment changed less. Trait attachment and Secure Base Script knowledge did not moderate oxytocin or state attachment responses to support. This might mean that, regardless of the attachment history, in-the-moment positive attachment experiences might have a beneficial effect on trait attachment development in middle childhood.

Enabling analytical power calculations for multilevel models with autocorrelated errors through deriving and approximating the precision matrix.

To unravel how within-person psychological processes fluctuate in daily life, and how these processes differ between persons, intensive longitudinal (IL) designs in which participants are repeatedly measured, have become popular. Commonly used statistical models for those designs are multilevel models with autocorrelated errors. Substantive hypotheses of interest are then typically investigated via statistical hypotheses tests for model parameters of interest. An important question in the design of such IL studies concerns the determination of the number of participants and the number of measurements per person needed to achieve sufficient statistical power for those statistical tests. Recent advances in computational methods and software have enabled the computation of statistical power using Monte Carlo simulations. However, this approach is computationally intensive and therefore quite restrictive. To ease power computations, we derive simple-to-use analytical formulas for multilevel models with AR(1) within-person errors. Analytic expressions for a model family are obtained via asymptotic approximations of all sample statistics in the precision matrix of the fixed effects. To validate this analytical approach to power computation, we compare it to the simulation-based approach via a series of Monte Carlo simulations. We find comparable performances making the analytic approach a useful tool for researchers that can drastically save them time and resources.

A new sample-size planning approach for person-specific VAR(1) studies: Predictive accuracy analysis.

Researchers increasingly study short-term dynamic processes that evolve within single individuals using N = 1 studies. The processes of interest are typically captured by fitting a VAR(1) model to the resulting data. A crucial question is how to perform sample-size planning and thus decide on the number of measurement occasions that are needed. The most popular approach is to perform a power analysis, which focuses on detecting the effects of interest. We argue that performing sample-size planning based on out-of-sample predictive accuracy yields additional important information regarding potential overfitting of the model. Predictive accuracy quantifies how well the estimated VAR(1) model will allow predicting unseen data from the same individual. We propose a new simulation-based sample-size planning method called predictive accuracy analysis (PAA), and an associated Shiny app. This approach makes use of a novel predictive accuracy metric that accounts for the multivariate nature of the prediction problem. We showcase how the values of the different VAR(1) model parameters impact power and predictive accuracy-based sample-size recommendations using simulated data sets and real data applications. The range of recommended sample sizes is smaller for predictive accuracy analysis than for power analysis.

Coping and sleep quality in youth: An Experience Sampling study.

INTRODUCTION: Sleep quality is closely linked with mental health. Two factors that influence sleep are coping style and locus of control, yet these have not been investigated in daily life. In this study, we examined associations between coping styles and sleep quality in daily life and the potential mediating effect of daily locus of control in a sample of youth, a group particularly vulnerable to developing psychopathology. METHODS: Three hundred and seventy-nine youths from the TwinssCan study participated in an Experience Sampling study, assessing sleep quality as well as state locus of control over the most negative event from the previous day. Participants also completed the Utrecht Coping List, which assessed engagement, disengagement, and emotion-focused coping. RESULTS: Disengagement, "passive reaction," and emotion-focused coping were associated with lower daily sleep quality. State locus of control did not mediate any effects of coping styles on quality of sleep. CONCLUSIONS: Disengagement, "passive reaction," and emotion-focused coping were associated with decreased sleep quality during several consecutive days, which may put youths at risk for developing future insomnia, and strain their mental well-being over time. Thus, there may be value in asking about coping when a young individual presents with sleep problems; however, impaired coping when sleeping poorly should also be considered.

Efficacy of Acceptance and Commitment Therapy in Daily Life in Early Psychosis: Results from the Multi-Center INTERACT Randomized Controlled Trial.

INTRODUCTION/OBJECTIVE: This study aimed to investigate efficacy of Acceptance and Commitment Therapy in Daily Life (ACT-DL), combining face-to-face therapy with an Ecological Momentary Intervention (EMI), in addition to treatment as usual (TAU) for psychotic distress, in comparison to TAU. METHODS: Individuals aged 15-65 years with clinically established ultra-high risk or first episode of psychosis were randomly assigned to TAU or ACT-DL+TAU. ACT-DL+TAU consisted of 8 ACT-sessions augmented with an EMI-app. The primary outcome was psychotic distress assessed with the Comprehensive Assessment scale of At Risk Mental State (CAARMS) at post-intervention and 6- and 12-month follow-up. Secondary outcomes were functioning, symptom severity, and momentary psychotic distress. We performed multivariate mixed models according to intent-to-treat principles. RESULTS: Between June 1, 2015 and December 31, 2018, 668 participants were referred, of whom 148 were randomized to ACT-DL+TAU (n = 71) or TAU (n = 77). One hundred and fifteen (78%) provided primary outcome data at least at one follow-up assessment. There was no evidence of greater reduction in the primary outcome measure CAARMS distress in ACT-DL+TAU compared to TAU (χ2(3) = 2.36; p = 0.50). However, out of the tested secondary outcomes, global functioning (χ2(3) = 9.05; p = 0.033), and negative symptoms (χ2(3) = 19.91; p<0.001) improved in ACT-DL+TAU compared to TAU, as did momentary psychotic distress (χ2(3) = 21.56; p < 0.001). CONCLUSIONS: INTERACT did not support a significant effect of ACT-DL over TAU on the primary outcome measure of psychotic distress as assessed with the CAARMS. Although significant improvements were found for some secondary outcome measures, further replication studies are needed to confirm the strength and specificity of these effects.

Identifying Clusters of Adolescents Based on Their Daily-Life Social Withdrawal Experience.

Social withdrawal is often presented as overall negative, with a focus on loneliness and peer exclusion. However, social withdrawal is also a part of normative adolescent development, which indicates that groups of adolescents potentially experience social withdrawal differently from one another. This study investigated whether different groups of adolescents experienced social withdrawal in daily life as positive versus negative, using experience sampling data from a large-scale study on mental health in general population adolescents aged 11 to 20 (n = 1913, MAge = 13.8, SDAge = 1.9, 63% female) from the Flemish region in Belgium. Two social withdrawal clusters were identified using model-based cluster analysis: one cluster characterized by high levels of positive affect and one cluster characterized by high levels of negative affect, loneliness and exclusion. Logistic regression showed that boys had 66% decreased odds of belonging to the negative cluster. These results show that daily-life social withdrawal experiences are heterogeneous in adolescence, which strengthens the view that, both in research and clinical practice, social withdrawal should not be seen as necessarily maladaptive.

Applying multiverse analysis to experience sampling data: Investigating whether preprocessing choices affect robustness of conclusions.

The experience sampling method (ESM) has revolutionized our ability to conduct psychological research in the natural environment. However, researchers have a large degree of freedom when preprocessing ESM data, which may hinder scientific progress. This study illustrates the use of multiverse analyses regarding preprocessing choices related to data exclusion (i.e., based on various levels of compliance and exclusion of the first assessment day) and the calculation of constructs (i.e., composite scores calculated as the mean, median, or mode) by reanalyzing established group differences in negative affect, stress reactivity, and emotional inertia between individuals with and without psychosis. Data came from five studies and included 233 individuals with psychosis and 223 healthy individuals (in total, 26,892 longitudinal assessments). Preprocessing choices related to data exclusion did not affect conclusions. For both stress reactivity and emotional inertia of negative affect, group differences were affected when negative affect was calculated as the mean compared to the median or mode. Further analyses revealed that this could be attributed to considerable differences in the within- and between-factor structure of negative affect. While these findings show that observed differences in affective processes between individuals with and without psychosis are robust to preprocessing choices related to data exclusion, we found disagreement in conclusions between different central tendency measures. Safeguarding the validity of future experience sampling research, scholars are advised to use multiverse analysis to evaluate the robustness of their conclusions across different preprocessing scenarios.

The Impact of COVID-19 on Adolescents' Daily Lives: The Role of Parent-Child Relationship Quality.

COVID-19 lockdown measures have profoundly impacted adolescent' daily life, with research suggesting an increase in irritability, stress, loneliness, and family conflict. A potential protective factor is parent-child relationship quality; however, no studies have investigated this. We used data from SIGMA, a longitudinal, experience sampling cohort study, in which N = 173 adolescents aged 11 to 20 were tested before and during COVID-19. Multilevel analyses showed decreased daily-life irritability and increased loneliness from pre- to mid-pandemic. Daily-life stress levels were unchanged. Relationship quality was negatively associated with irritability and loneliness and buffered against the increase in loneliness. Effect sizes were small and do not support a strong effect of the first lockdown on irritability, stress, loneliness, and family conflict in adolescents.

Idiographic analyses of motivation and related processes in participants with schizophrenia following a therapeutic intervention for negative symptoms.

BACKGROUND: Motivational negative symptoms hinder quality of life and daily functioning of individuals with schizophrenia spectrum disorders. A recently developed intervention, Switch, has shown promising effects on negative symptoms and functional outcomes. Switch targets multiple cognitive, emotional and behavioural processes associated with motivation and goal directed behaviours. We aimed to investigate its effects on motivation and associated processes in a naturalistic setting, and to explore the dynamics between the processes. METHODS: We used a single case approach (n = 3), with a pre-post and follow-up assessment design, which also included ambulatory assessments (experience sampling method, ESM; and step count). We computed autoregressive lag 1 models to evaluate the effects of the intervention on daily motivation levels and related processes, descriptive pie-charts, and vector autoregressive modelling to reveal the dynamics of the processes over time. RESULTS: The intervention was beneficial for each participant according to traditional evaluations of motivational negative symptoms, apathy, daily functioning and quality of life. The effects on the ESM variables revealed distinct outcomes for each individual. The dynamics between the various processes differed between participants, and fluctuated within participants (when comparing baseline, intervention phase, and follow-up). CONCLUSIONS: This study used an innovative approach to look at the effectiveness of an intervention. The intervention seems to lead to meaningful improvements in motivational negative symptoms and functional outcomes. The mechanisms of change need to be further investigated. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov, NCT04325100 . Registered 27 March 27, 2020 -retrospectively registered. REPORTING: Guidelines from the Transparent Reporting of Evaluations with Non-randomized Designs (TREND) statement were followed.

Investigating real-time social interaction in pairs of adolescents with the Perceptual Crossing Experiment.

The study of real-time social interaction provides ecologically valid insight into social behavior. The objective of the current research is to experimentally assess real-time social contingency detection in an adolescent population, using a shortened version of the Perceptual Crossing Experiment (PCE). Pairs of 148 adolescents aged between 12 and 19 were instructed to find each other in a virtual environment interspersed with other objects by interacting with each other using tactile feedback only. Across six rounds, participants demonstrated increasing accuracy in social contingency detection, which was associated with increasing subjective experience of the mutual interaction. Subjective experience was highest in rounds when both participants were simultaneously accurate in detecting each other's presence. The six-round version yielded comparable social contingency detection outcome measures to a ten-round version of the task. The shortened six-round version of the PCE has therefore enabled us to extend the previous findings on social contingency detection in adults to an adolescent population, enabling implementation in prospective research designs to assess the development of social contingency detection over time.

The Role of Childhood Trauma in Affective Stress Recovery in Early Psychosis: An Experience Sampling Study.

BACKGROUND AND HYPOTHESES: Affective recovery, operationalized as the time needed for affect to return to baseline levels after daily stressors, may be a putative momentary representation of resilience. This study aimed to investigate affective recovery in positive and negative affect across subclinical and clinical stages of psychosis and whether this is associated with exposure to childhood trauma (sexual, physical, and emotional abuse). STUDY DESIGN: We used survival analysis to predict the time-to-recovery from a daily event-related stressor in a pooled sample of 3 previously conducted experience sampling studies including 113 individuals with first-episode psychosis, 162 at-risk individuals, and 94 controls. STUDY RESULTS: Negative affective recovery (ie, return to baseline following an increase in negative affect) was longer in individuals with first-episode psychosis compared with controls (hazard ratio [HR] = 1.71, 95% confidence interval [CI; 1.03, 2.61], P = .04) and in at-risk individuals exposed to high vs low levels of emotional abuse (HR = 1.31, 95% CI [1.06, 1.62], P = .01). Positive affective recovery (ie, return to baseline following a decrease in positive affect) did not differ between groups and was not associated with childhood trauma. CONCLUSIONS: Our results give first indications that negative affective recovery may be a putative momentary representation of resilience across stages of psychosis and may be amplified in at-risk individuals with prior experiences of emotional abuse. Understanding how affective recovery contributes to the development of psychosis may help identify new targets for prevention and intervention to buffer risk or foster resilience in daily life.

Not just emotion regulation, but cognition: An experience sampling study testing the relations of ecological interpretation biases and use of emotion regulation strategies with momentary affective states during daily life functioning.

BACKGROUND: Current research is moving from studying cognitive biases and maladaptive emotion regulation (ER) as relatively stable phenomena contributing to affective disturbances, adopting ecological methodologies, such as Experience Sampling Methods (ESM). However, there is still limited ESM evidence on the interactions between stress and ER strategies' use, and negative interpretation biases, regarding their relations with momentary affective states. In this study, we used a new ESM design to disentangle the contextual, regulatory and cognitive processes implicated in daily affective experiences. METHOD: A sample of 103 participants completed an ESM study (3 times a day for 10 days) that included self-reports of momentary affect, stress intensity, ER strategies' use and a cognitive task measuring momentary negative interpretation biases. RESULTS: Multilevel analyses supported significant interactions of both rumination and worry with stress intensity, to account for momentary higher negative and lower positive affect levels. Furthermore, higher state negative interpretation bias levels uniquely predicted both higher negative and lower positive momentary affect levels. CONCLUSION: This study implemented a novel online cognitive task within an ESM procedure, which helped to disentangle how contextual ER strategies' use and momentary cognitive biases uniquely relate to affective experiences in daily life.

Childhood Adversity and Emerging Psychotic Experiences: A Network Perspective.

BACKGROUND AND HYPOTHESIS: Childhood adversity is associated with a myriad of psychiatric symptoms, including psychotic experiences (PEs), and with multiple psychological processes that may all mediate these associations. STUDY DESIGN: Using a network approach, the present study examined the complex interactions between childhood adversity, PEs, other psychiatric symptoms, and multiple psychological mediators (ie, activity-related and social stress, negative affect, loneliness, threat anticipation, maladaptive cognitive emotion regulation, attachment insecurity) in a general population, adolescent sample (n = 865, age 12-20, 67% female). STUDY RESULTS: Centrality analyses revealed a pivotal role of depression, anxiety, negative affect, and loneliness within the network and a bridging role of threat anticipation between childhood adversity and maladaptive cognitive emotion regulation. By constructing shortest path networks, we found multiple existing paths between different categories of childhood adversity and PEs, with symptoms of general psychopathology (ie, anxiety, hostility, and somatization) as the main connective component. Sensitivity analyses confirmed the robustness and stability of the networks. Longitudinal analysis in a subsample with Wave 2 data (n = 161) further found that variables with higher centrality (ie, depression, negative affect, and loneliness) better predicted follow-up PEs. CONCLUSIONS: Pathways linking childhood adversity to PEs are complex, with multifaceted psychological and symptom-symptom interactions. They underscore the transdiagnostic, heterotypic nature of mental ill-health in young people experiencing PEs, in agreement with current clinical recommendations.

Facial Regulation During Dyadic Interaction: Interpersonal Effects on Cooperation.

This study investigated interpersonal effects of regulating naturalistic facial signals on cooperation during an iterative Prisoner's Dilemma (IPD) game. Fifty pairs of participants played ten IPD rounds across a video link then reported on their own and their partner's expressed emotion and facial regulation in a video-cued recall (VCR) procedure. iMotions software allowed us to auto-code actors' and partners' facial activity following the outcome of each round. We used two-level mixed effects logistic regression to assess over-time actor and partner effects of auto-coded facial activity, self-reported facial regulation, and perceptions of the partner's facial regulation on the actor's subsequent cooperation. Actors were significantly less likely to cooperate when their partners had defected on the previous round. None of the lagged scores based on auto-coded facial activity were significant predictors of cooperation. However, VCR variables representing partner's positive regulation of expressions and actor's perception of partner's positive regulation both significantly increased the probability of subsequent actor cooperation after controlling for prior defection. These results offer preliminary evidence about interpersonal effects of facial regulation in interactive contexts and illustrate how dynamic dyadic emotional processes can be systematically investigated in controlled settings. Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-023-00208-y.

Is daily-life stress reactivity a measure of stress recovery? An investigation of laboratory and daily-life stress.

Typical measures of laboratory reactivity (i.e. difference between control and stress) and recovery (i.e. difference between stress and post-stress) were compared with a conventional measure of daily-life reactivity, best known as event-related stress. Fifty-three healthy individuals between 19 and 35 years of age took part in a laboratory session where stress was induced using the repeated Montreal Imaging Stress Task and 8 days of experience sampling method. Measures of negative affect, heart rate (HR), HR variability, and skin conductance level were collected. Findings show no strong associations between laboratory and daily life measures with the exception of laboratory affective recovery and daily life reactivity. Findings and their implications are discussed.

A mixed-method investigation into measurement reactivity to the experience sampling method: The role of sampling protocol and individual characteristics.

Since the introduction of the experience sampling method (ESM), there have been concerns that the repeated assessments typically related to this method may alter the behavior, thoughts, or feelings of participants. Previous studies have offered mixed results with some studies reporting reactive changes, while others failed to find such effects. Our aim was to investigate under which circumstances ESM induces reactive effects. Students (N = 151) were randomly assigned to receive a questionnaire containing 30 or 60 items three, six, or nine times per day for 14 days. A random sample of 50 participants took part in qualitative interviews after the end of the data collection. We investigated changes over time in the data, while taking into account the sampling protocol and characteristics of participants, and analyzed qualitative reports of measurement reactivity. Decreases in completion time, within-person variance of ratings and subjective reports of habituation point toward the existence of a habituation period. While participants reported increases in emotional awareness in interviews, ESM measures indicated a decrease in emotional awareness over time. Changes in behavior were rare in quantitative and qualitative reports. Positive affect was decreasing over time in the ESM data, and various changes in affect, emotion regulation, and thoughts were reported in interviews. Individual characteristics and sampling protocol had inconsistent effects on changes over time. The results suggest that ESM induces changes in within-person variability, completion times, affect, or emotional awareness over time. Further research is needed to explore whether observed changes affect the validity of ESM data. (PsycInfo Database Record (c) 2023 APA, all rights reserved).