A procedure for evaluating sensitivity to within-person change: can mood measures in diary studies detect change reliably?

Sexually dimorphic and interactive effects of prenatal maternal cortisol and psychological distress on infant cortisol reactivity

In utero exposure to maternal psychological distress is a risk factor for developmental psychopathology, and these effects are believed to partially occur via dysregulation of the maternal and fetal hypothalamus-adrenal-pituitary axes. Nevertheless, only a few human studies have directly assessed the effects of prenatal cortisol exposure on infant cortisol reactivity, and none have investigated sex differences or potential interactions between prenatal cortisol and psychological distress. Here we report on a prospective longitudinal investigation (N = 236) of in utero exposure to maternal cortisol and distress in a relatively high socioeconomic status and low-risk population to determine whether these exposures interact in their effects on infant (M age = 3.0 months, range = 2.3-5.0 months, 51.9% male) cortisol reactivity and whether there are sex differences in these effects. Results revealed both sexually dimorphic and interactive effects of prenatal cortisol and distress, even after controlling for postnatal distress. In general, blunted reactivity in females was associated with exposure to high maternal distress and flattened patterns of diurnal maternal cortisol, whereas blunted reactivity in males was associated with exposure to steeper morning increases and daytime decreases in maternal cortisol. The findings suggest that sex differences in the effects of prenatal cortisol and distress on infant cortisol reactivity are a plausible mechanism by which maternal experiences during pregnancy contribute to sex differences in the development of psychopathology.

Applying generalizability theory methods to assess continuity and change on the Adolescent Quality of Life-Mental Health Scale (AQOL-MHS)

PURPOSE

The Adolescent Quality of Life-Mental Health Scale (AQOL-MHS) is designed to measure quality of life in clinical samples of Latino adolescents aged 12-18 years. Initial findings support its reliability, validity and conceptual model for use of its three domains (emotional regulation, self-concept and social context). Our current study tests the usefulness of the AQOL-MHS for tracking changes in HRQOL during the course of service use.

METHODS

Three waves of data were collected from 59 participants who were recruited from mental health clinics, where waves were spaced 4 months apart. Participants were receiving services at baseline assessment and were tracked for follow-up appointments regardless of treatment status. We analyze conventional reliability statistics for individual differences (e.g., Cronbach's alpha and test-retest correlations), and to estimate the reliability of change, we carried out a variance decomposition analysis.

RESULTS

The psychometric analyses from Chavez et al. (Qual Life Res 23(4):1327-1335, 2014) were replicated with comparable results. A generalizability theory (GT) analysis revealed that the AQOL-MHS domains can measure change reliably. The reliability estimates varied from .65 to .78. Although there was reliable change at the individual level, on the average the AQOL-MHS means improved only slightly over time.

CONCLUSIONS

The reliability of change for all three scales in the AQOL-MHS was acceptable, but consistently lower than the Cronbach's alpha values for each wave. Future work will use this approach to adapt our current measure to provide a better reliability of within-person change and thus broaden its applicability for prospective use.

Experiences With Parents and Youth Physical Health Symptoms and Cortisol: A Daily Diary Investigation

Using daily diary data, this study examined the associations between positive and negative parent-youth experiences and youth cortisol and physical health symptoms among a sample of adolescents (N=132, Mean Age = 13.39). On days when girls reported more negative experiences than usual, they exhibited more physical health symptoms and flatter evening cortisol slopes than usual. Negative experiences with mothers were associated with higher dinner and bedtime youth cortisol levels (between-person). Daily positive experiences with fathers were linked with lower dinner cortisol levels. Youth with high levels of negative experiences, on average, were less sensitive to daily variation in negative experiences than youth who experienced lower parental negativity. We discuss the benefits of a daily diary approach.

Both trait and state mindfulness predict lower aggressiveness via anger rumination: A multilevel mediation analysis

Trait mindfulness, or the capacity for nonjudgmental, present-centered attention, predicts lower aggression in cross-sectional samples, an effect mediated by reduced anger rumination. Experimental work also implicates state mindfulness (i.e., fluctuations around one's typical mindfulness) in aggression. Despite evidence that both trait and state mindfulness predict lower aggression, their relative impact and their mechanisms remain unclear. Higher trait mindfulness and state increases in mindfulness facets may reduce aggression-related outcomes by (1) limiting the intensity of anger, or (2) limiting rumination on anger experiences. The present study tests two hypotheses: First, that both trait and state mindfulness contribute unique variance to lower aggressiveness, and second, that the impact of both trait and state mindfulness on aggressiveness will be uniquely partially mediated by both anger intensity and anger rumination. 86 participants completed trait measures of mindfulness, anger intensity, and anger rumination, then completed diaries for 35 days assessing mindfulness, anger intensity, anger rumination, anger expression, and self-reported and behavioral aggressiveness. Using multilevel zero-inflated regression, we examined unique contributions of trait and state mindfulness facets to daily anger expression and aggressiveness. We also examined the mediating roles of anger intensity and anger rumination at both trait and state levels. Mindfulness facets predicted anger expression and aggressiveness indirectly through anger rumination after controlling for indirect pathways through anger intensity. Individuals with high or fluctuating aggression may benefit from mindfulness training to reduce both intensity of and rumination on anger.

Change in parent-child conflict and the HPA-axis: Where should we be looking and for how long?

OBJECTIVE

Salivary cortisol is increasingly used as a longitudinal indicator of change in neuroendocrine regulation and as a predictor of health outcomes in youth. The purpose of this study was to describe which indices of HPA-axis functioning are sensitive to changes in parent-child conflict over a three week period and to explore the time course under which these changes can be measured.

METHODS

Youth (n=47; ages 8-13) completed daily diaries of their conflict with parents for 56 days. On days 17-18 and 38-39, youth contributed saliva samples upon waking, 30-minutes post-waking, afternoon, and bedtime. We assessed change in average diurnal HPA-axis functioning between day 17-18 and day 38-39 as a function of the slopes of change in parent-child conflict over 3 weeks.

RESULTS

Increasing parent-child conflict was positively associated with concurrent increases in total cortisol output (AUCg), flattening of the diurnal slope, and increases in cortisol at bedtime, but not with change in the cortisol awakening response (CAR). Further, associations between parent-child conflict and both AUCg and bedtime cortisol were observed with at least 14 days of daily diary reporting, whereas any additional ratings of conflict beyond 3 days of daily diaries did not improve model fit for changes in diurnal slope.

CONCLUSIONS

This study demonstrates the within-subject up-regulation of the HPA-axis across three weeks in a healthy sample of youth exposed to natural increases in family conflict. In particular, cortisol at bedtime may be the HPA-axis index that is most sensitive to change over time in parent-child conflict, above and beyond conflict occurring that day. Further, when testing associations between family stressors and diurnal cortisol, the optimal schedule for assessing parent-child conflict varies for different indices of HPA-axis functioning.

Meta-analysis of DSM alcohol use disorder criteria severities: structural consistency is only 'skin deep'

BACKGROUND

Item response theory (IRT) analyses of alcohol use disorder (AUD) and other psychological disorders are a predominant method for assessing overall and individual criterion severity for psychiatric diagnosis. However, no investigation has established the consistency of the relative criteria severities across different samples.

METHOD

PubMed/Medline, PsycINFO, Web of Science and ProQuest databases were queried for entries relating to alcohol use and IRT. Study data were extracted using a standardized data entry sheet. Consistency of reported criteria severities across studies was analysed using generalizability theory to estimate generalized intraclass correlations (ICCs).

RESULTS

A total of 451 citations were screened and 34 papers (30 unique samples) included in the research synthesis. The AUD criteria set exhibited low consistency in the ordering of criteria using both traditional [ICC = 0.16, 95% confidence interval (CI) 0.06-0.56] and generalized (ICC = 0.18, 95% CI 0.15-0.21) approaches. These results were partially accounted for by previously studied factors such as age and type of sample (e.g. clinical v. community), but the largest source of unreliability was the diagnostic instrument employed.

CONCLUSIONS

Despite the robust finding of unidimensional structure of AUDs, inconsistency in the relative severities across studies suggests low replicability, challenging the generalizability of findings from any given study. Explicit modeling of well-studied factors like age and sample type is essential and increases the generalizability of findings. Moreover, while the development of structured diagnostic interviews is considered a landmark contribution toward improving psychiatric research, variability across instruments has not been fully appreciated and is substantial.

The interplay between sleep behavior and affect in elementary school children's daily life

Recent reviews raised the idea of a bidirectional relation between sleep behavior and affect in adults, but little is known about this interplay in general and especially regarding children. In this micro-longitudinal study, the interplay of sleep and affect was captured directly in children's daily life context in and out of school through ambulatory assessment. For 31 consecutive days, 110 elementary school children (8-11 years old) provided information about their last night's sleep and reported their current affect at four daily occasions in school and at home on smartphones. A multilevel approach was used to analyze the relation between sleep and affect the next day (morning, noon, and afternoon) and the relation between evening affect and subsequent sleep. At the within-person level, sleep quality was related to all observed facets of affect the next day and the strongest effects were found in the morning. The effect of sleep quality on positive affect was particularly pronounced for children who on average went to bed early and slept long. There were, however, no direct within-person effects of sleep quantity on affect. Furthermore, evening affect was related to subsequent sleep. The findings support the idea of a bidirectional relation between affect and sleep in children's daily life (including school). They suggest that good sleep provides a basis and resource for children's affective well-being the next day and demonstrate the importance of analyzing within-person variations of children's sleep. Micro-longitudinal findings can contribute to explain how macro-longitudinal relations between sleep and affect develop over time.

Happy all the time? Affect, resources, and time use

When examined at the level of activities, people spend more time in activities associated with more negative affect (NA), suggesting that affect may not influence time use. However, when the normal time frames of activities such as work or eating are considered, people may spend relatively more time in activities they find more enjoyable. The present study examined time use between and within activities, using multilevel models, to further explain time use. Working women (N = 98) reported on time use, affect, and resources associated with 18 different activities using the day reconstruction method. Across activities, higher NA was associated with more time spent in that activity, an effect driven partially by work. However, within activities, higher NA but especially higher positive affect and more resource growth was associated with more time spent in that activity by a particular woman. Individuals who derive more affective and resource value from an activity devote more time to it. (PsycINFO Database Record

Affect and Subsequent Physical Activity: An Ambulatory Assessment Study Examining the Affect-Activity Association in a Real-Life Context

Traditionally, cognitive, motivational, and volitional determinants have been used to explain and predict health behaviors such as physical activity. Recently, the role of affect in influencing and regulating health behaviors received more attention. Affects as internal cues may automatically activate unconscious processes of behavior regulation. The aim of our study was to examine the association between affect and physical activity in daily life. In addition, we studied the influence of the habit of being physically active on this relationship. An ambulatory assessment study in 89 persons (33.7% male, 25 to 65 years, M = 45.2, SD = 8.1) was conducted. Affect was assessed in the afternoon on 5 weekdays using smartphones. Physical activity was measured continuously objectively using accelerometers and subjectively using smartphones in the evening. Habit strength was assessed at the beginning of the diary period. The outcomes were objectively and subjectively measured moderate-to-vigorous physical activity (MVPA) performed after work. Multilevel regression models were used to analyze the association between affect and after work MVPA. In addition, the cross-level interaction of habit strength and affect on after work MVPA was tested. Positive affect was positively related to objectively measured and self-reported after work MVPA: the greater the positive affect the more time persons subsequently spent on MVPA. An inverse relationship was found for negative affect: the greater the negative affect the less time persons spent on MVPA. The cross-level interaction effect was significant only for objectively measured MVPA. A strong habit seems to strengthen both the positive influence of positive affect and the negative influence of negative affect. The results of this study confirm previous results and indicate that affect plays an important role for the regulation of physical activity behavior in daily life. The results for positive affect were consistent. However, in contrast to previous reports of no or an inverse association, negative affect decreased subsequent MVPA. These inconsistencies may be—in part—explained by the different measurements of affect in our and other studies. Therefore, further research is warranted to gain more insight into the association between affect and physical activity.

Disentangling Components of Flexibility via the Hexaflex Model: Development and Validation of the Multidimensional Psychological Flexibility Inventory (MPFI)

The current study developed the 60-item Multidimensional Psychological Flexibility Inventory (MPFI)—a scale assessing the 12 dimensions of the Hexaflex model. We created an exhaustive pool of 554 items including 22 of the most widely used measures from the acceptance and commitment therapy and mindfulness literatures. Exploratory and confirmatory factor analyses were used in combination with item response theory and responsiveness to change analyses in 3,040 online respondents across three studies ( NStudy 1 = 372; NStudy 2 = 2,150; NStudy 3 = 518) to create the MPFI. Associations between the MPFI subscales and an array of existing measures supported its convergent and discriminant validities. The MPFI offers acceptance and commitment therapy researchers new tools for elaborating treatment effects.

"You're on ten, where can you go from there?" Tufnel problems in repeated experiential judgments

We describe a set of Tufnel problems that arise when repeated use of a fixed-point scale precipitates failures to assess a full range of subjective experiences. As empirical evidence, participants in Study 1 periodically reported their depth of mind wandering on either 5- or 7-point Likert scales during a sustained attention task. The proportion of participants providing maximum scale ratings increased quickly over time-on-task and did so more quickly for the 5-point than for the 7-point group. Participants in Study 2 completed the same task using a 10-point scale before indicating whether and where they could have used a scale extended to "11" during the task. Slightly more than 20% of participants reported needing a scale extension. This Need for 11 was associated with differences in both reports of mind wandering depth and task performance. We conclude that Tufnel problems warrant methodological consideration and reflect interesting constraints on human judgment.

Ambulatory and diary methods can facilitate the measurement of patient-reported outcomes

PURPOSE

Ambulatory and diary methods of self-reported symptoms and well-being have received increasing interest in recent years. These methods are a valuable addition to traditional strategies for the assessment of patient-reported outcomes (PROs) in that they capture patients' recent symptom experiences repeatedly in their natural environments. In this article, we review ways that incorporating diary methods into PRO measurement can facilitate research on quality of life.

METHODS

Several diary methods are currently available, and they include "real-time" (Ecological Momentary Assessment) and "near-real-time" (end-of-day assessments, Day Reconstruction Method) formats. We identify the key benefits of these methods for PRO research.

RESULTS

(1) In validity testing, diary assessments can serve as a standard for evaluating the ecological validity and for identifying recall biases of PRO instruments with longer-term recall formats. (2) In research and clinical settings, diaries have the ability to closely capture variations and dynamic changes in quality of life that are difficult or not possible to obtain from traditional PRO assessments. (3) In test construction, repeated diary assessments can expand understanding of the measurement characteristics (e.g., reliability, dimensionality) of PROs in that parameters for differences between people can be compared with those for variation within people.

CONCLUSIONS

Diary assessment strategies can enrich the repertoire of PRO assessment tools and enhance the measurement of patients' quality of life.

Using Negative Emotions to Trace the Experience of Borderline Personality Pathology: Interconnected Relationships Revealed in an Experience Sampling Study

While emotional difficulties are highly implicated in borderline personality disorder (BPD), the dynamic relationships between emotions and BPD symptoms that occur in everyday life are unknown. The current paper examined the function of negative emotions as they relate to BPD symptoms in real time. Experience sampling methodology with 281 participants measured negative emotions and borderline symptoms, expressed as a spectrum of experiences, five times daily for two weeks. Overall, having a BDP diagnosis was associated with experiencing more negative emotions. Multilevel modeling supported positive concurrent relationships between negative emotions and BPD symptoms. Lagged models showed that even after 3 hours negative emotions and several symptoms continued to influence each other. Therefore, results indicated that negative emotions and BPD symptoms are intricately related; some evidenced long-lasting relationships. This research supports emotion-symptom contingencies within BPD and provides insight regarding the reactivity and functionality of negative emotions in borderline pathology.

Physical Activity, Affect, and Cognition in Children With Symptoms of ADHD

OBJECTIVE

To examine the role of physical activity in determining the affect and executive functioning of children with symptoms of ADHD.

METHOD

In Study 1, the association between physical activity and affect in the daily lives of children with varying degrees of hyperactivity was examined. In Study 2, children with ADHD were randomly assigned a physical activity or a sedentary task before working on a task requiring executive control.

RESULTS

Lack of physical activity was shown to relate to depressed affect, more strongly in participants with severe hyperactivity symptoms (Study 1). The physically active participants showed improved executive functioning after only 5 min of vigorous activity; the sedentary control participants showed no improvement (Study 2).

CONCLUSION

These results indicate that interventions to increase the level of physical activity in children with and without ADHD might improve affect and executive functioning.

Supervisor Support Buffers Daily Psychological and Physiological Reactivity to Work-to-Family Conflict

Using a daily diary design, the current study assessed within-person associations of work-to-family conflict with negative affect and salivary cortisol. Furthermore, we investigated whether supervisor support moderated these associations. Over eight consecutive days, 131 working parents employed by an information technology company answered telephone interviews about stressors and mood that occurred in the previous 24 hours. On Days 2-4 of the study protocol, they also provided five saliva samples throughout the day that were assayed for cortisol. Results indicated a high degree of day-to-day fluctuation in work-to-family conflict, with employed parents having greater negative affect and poorer cortisol regulation on days with higher work-to-family conflict compared to days when they experience lower work-to-family conflict. These associations were buffered, however, when individuals had supervisors who offered support. Discussion centers on the use of dynamic assessments of work-to-family conflict and employee well-being.

Within-Person Link between Depressed Affect and Moderate-to-Vigorous Physical Activity in Adolescence: An Intensive Longitudinal Approach

BACKGROUND

During adolescence, young women and men frequently show low physical activity and elevated depressed affect. This study aimed to examine the within-person link between moderate-to-vigorous physical activity (MVPA) and depressed affect in everyday life.

METHODS

Within an intensive longitudinal approach, adolescents (N = 72; 37% young women; M age = 17.36 years; age range: 12-26 years; mid-90% age range: 13-22 years) wore accelerometers to assess their daily MVPA and reported next-morning and same-evening depressed affect in diaries over eight consecutive days. The within-person link between MVPA and depressed affect on the next morning (time-lagged prediction) and the same evening (same-day link) was analyzed with mixed-effects models.

RESULTS

More-than-usual MVPA significantly predicted less next-morning depressed affect on weekdays in young women, to the extent that a 60-min increase in MVPA over the person mean significantly predicted 50 per cent lower next-morning depressed affect.

CONCLUSIONS

This study encourages the development of individually tailored physical activity interventions that could help adolescents enhance their daily amount of unstructured, self-initiated MVPA to reduce depressed affect. This approach may be particularly suitable for young women who have the highest risk for an inactive lifestyle and elevated depressed affect.

Micro-level processes of identity development: Intra-individual relations between commitment and exploration

We investigate intra-individual processes of identity at the micro level. With an intensive longitudinal design in the general context of higher education, we explore associations between changes in pivotal identity concepts: commitment and exploration and elaborate on how we conceptualize these concepts on a micro level. With our within-individual empirical approach, we revealed a large amount of variation between individuals with respect to the associations between exploration and commitment processes. At the same time, similarities were found amongst individuals, which help extend and clarify existing findings regarding identity development. Our findings highlight the necessity to, firstly, distinguish between micro- and macro-level identity processes. Secondly, and in the same vein, our findings emphasize the heterogeneous nature of micro-level identity processes, and the necessity to use a within individual approach to study these processes.

Perceived Partner Responsiveness Mediates the Association Between Sexual and Marital Satisfaction: A Daily Diary Study in Newlywed Couples

Sexuality is an integral part of intimate relationships, yet surprisingly little is known about how and for whom sexuality matters. The present research investigated the interplay of sexual and non-sexual factors that contribute to relationship satisfaction. Specifically, we tested the hypothesis that the association between sexual satisfaction and marital satisfaction is mediated by a non-sexual factor-namely, perceived partner responsiveness (PPR). Additionally, we tested the role of gender as a possible moderator of this mediated association. Thirty-four newlywed couples completed diaries with each spouse reporting their sexual satisfaction, marital satisfaction, and PPR every day for 30 days. We tested our predictions at both the person level (i.e., the mean level across 30 days) and the daily level. At the person level, we found that sexual satisfaction and PPR separately predicted marital satisfaction. Moreover, the effect of sexual satisfaction on marital satisfaction was partially mediated by PPR. No gender differences emerged at this level. At the daily level, we found similar support for partial mediation. However, at this level, gender did serve as a moderator. The stronger mediation found for women was driven by a stronger association between sexual satisfaction and PPR for women than for men. This study joins a growing literature highlighting the role of PPR in dyadic relationships.

Dynamics of Change and Change in Dynamics

A framework is presented for building and testing models of dynamic regulation by categorizing sources of differences between theories of dynamics. A distinction is made between the dynamics of change, i.e., how a system self-regulates on a short time scale, and change in dynamics, i.e., how those dynamics may themselves change over a longer time scale. In order to clarify the categories, models are first built to estimate individual differences in equilibrium value and equilibrium change. Next, models are presented in which there are individual differences in parameters of dynamics such as frequency of fluctuations, damping of fluctuations, and amplitude of fluctuations. Finally, models for within-person change in dynamics over time are proposed. Simulations demonstrating feasibility of these models are presented and OpenMx scripts for fitting these models have been made available in a downloadable archive along with scripts to simulate data so that a researcher may test a selected models' feasibility within a chosen experimental design.

Task-switching ability protects against the adverse effects of pain on health: A longitudinal study of older adults

OBJECTIVE

Ageing is often accompanied by increases in pain, which may threaten physical health. Successfully managing increased pain requires the ability to switch attention away from the pain and towards adaptive health cognitions and behaviours. However, no study to date has tested how pain interacts with task-switching ability to predict future health in older adults. Additionally, no study has tested whether objective (i.e., task-switching performance) or subjective measures of cognitive ability have a stronger impact on future health.

DESIGN/METHODS

The current study tested these interactions in community-dwelling older adults. Participants included 150 older adults who provided pain, task-switching ability, subjective cognitive functioning, and health data every 6 months for up to 5 years.

RESULTS

Multilevel modelling was used to analyse the data, yielding gammas (γ) analogous to unstandardized beta weights in regression. A significant interaction between task-switching and pain indicated that when task-switching ability was lower than usual, higher-than-usual pain predicted poorer health at the following wave (γ = 0.30, SE = 0.12, t(663) = 2.45, p = .009; 95% CI: 0.07-0.65). When task-switching ability was higher than usual, there was no effect of pain on health (γ = -0.13, t(663) = -0.85, p = .39; 95% CI: -0.44-0.17). No significant interaction was found for subjective cognitive functioning.

CONCLUSIONS

Objective task-switching ability, but not subjective cognitive functioning, may have health-protective effects when older adults experience increases in pain.

STATEMENT OF CONTRIBUTION

What is already known on the subject? As people age, they are more likely to experience pain. Increases in pain threaten health. Older adults are at particular risk for both increased pain and poor health. What does this study add? When pain levels are higher than usual, task-switching ability protects older adults from future declines in health. Within people, task-switching ability interacts with pain to promote healthy ageing.

The Everyday Implications of Ethnic-Racial Identity Processes: Exploring Variability in Ethnic-Racial Identity Salience Across Situations

Given the social and developmental relevance of ethnicity-race during adolescence, it is important to understand the meaning of ethnic-racial identity in adolescents' everyday lives. The current study considered how individual differences in ethnic-racial identity exploration (i.e., the extent to which individuals have explored their ethnicity-race), and commitment (i.e., the extent which they have a clear sense of what it means to them) influenced variability versus stability in the awareness of ethnicity-race in a given situation (i.e., salience), and how this variability is related to mood in that situation. Within an ethnic/racially diverse sample of 395 adolescents (M age = 15; 63 % female; 12 % Black, 26 % Latino, 34 % Asian, 23 % White), results indicated that ethnic-racial identity exploration was unrelated to variability in salience, while commitment promoted stability in salience across situations. Further, among adolescents who were generally very aware of their ethnicity-race, increases in situational salience were related to decreased negative and anxious mood. Among adolescents who were generally not aware of their ethnicity-race, increases in situational salience were related to increased positive and decreased negative mood. Implications for understanding the developmental and everyday experiences of ethnic-racial identity are discussed.

Fifth-grade children's daily experiences of peer victimization and negative emotions: moderating effects of sex and peer rejection

This study examined the relations of fifth-grade children's (181 boys and girls) daily experiences of peer victimization with their daily negative emotions. Children completed daily reports of peer victimization and negative emotions (sadness, anger, embarrassment, and nervousness) on up to eight school days. The daily peer victimization checklist was best represented by five factors: physical victimization, verbal victimization, social manipulation, property attacks, and social rebuff. All five types were associated with increased negative daily emotions, and several types were independently linked to increased daily negative emotions, particularly physical victimization. Girls demonstrated greater emotional reactivity in sadness to social manipulation than did boys, and higher levels of peer rejection were linked to greater emotional reactivity to multiple types of victimization. Sex and peer rejection also interacted, such that greater rejection was a stronger indicator of emotional reactivity to victimization in boys than in girls.

Reading Minds and Being Invisible

Recent research suggests that social support is more beneficial when it is provided invisibly (subtly and without recipient awareness); however, what is still unknown is who is most likely to provide invisible support. The hypothesis that support providers exhibiting greater empathic accuracy are more likely to provide invisible support is tested in two studies of committed romantic couples: a month-long diary study in a highly stressful situation (Study 1, n = 311 couples) and an in-lab social observation study in which one member discusses a mildly stressful personal goal (Study 2, n = 85 couples). In Study 1, providers exhibiting greater empathic accuracy on a given day were more likely to provide invisible practical support the same day. In Study 2, providers’ empathic accuracy was positively associated with their provision of invisible practical support during the interaction (both coded by trained observers). Similar findings did not emerge for emotional support.

Negative emotional responses to motherhood-related support receipt during pregnancy predict postpartum depressive symptoms

BACKGROUND AND OBJECTIVES

Prenatal stress increases risk for postpartum depression. While social support availability may attenuate this risk, little research has examined support receipt during pregnancy, which has been linked to increased distress in other domains. This study assesses the implications of motherhood-related and motherhood-unrelated support receipt for daily distress during pregnancy and tests whether negative responsiveness to motherhood-related support predicts postpartum depression risk.

DESIGN AND METHOD

Thirty-one pregnant women were recruited from the community for a 3-wave study (beginning at approximately 26 weeks gestation, 34 weeks gestation, and 4 weeks postpartum). Each wave included a survey of general characteristics (e.g. depressive symptoms) and a two-week diary period measuring mood, stress, and support.

RESULTS

A multilevel model analysis suggested that motherhood-related support predicted greater increases in daily distress than motherhood-unrelated support. Follow-up regression analysis showed that those who responded more negatively to motherhood-related support reported higher postpartum depressive symptoms.

CONCLUSIONS

Although preliminary due to the sample size, the results suggest that how women interpret and respond to support may contribute to postpartum depression risk. Future research should focus on how mothers can more positively construe the support they receive in addition to how to increase the support available to them.

Cognitive-behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women

This study evaluated a theory-guided cognitive-behavioral counseling (CBC) intervention for smoking cessation during pregnancy and postpartum. It also explored the mediating role of cognitive-affective variables on the impact of CBC. Underserved inner city pregnant women (N = 277) were randomized to the CBC or a best practice (BP) condition, each of which consisted of two prenatal and two postpartum sessions. Assessments were obtained at baseline, late pregnancy, and 1- and 5-months postpartum. An intent-to-treat analysis found no differences between the two groups in 7-day point-prevalence abstinence. However, a respondents-only analysis revealed a significantly higher cessation rate in the CBC (37.3 %) versus the BP (19.0 %) condition at 5-months postpartum follow-up. This effect was mediated by higher quitting self-efficacy and lower cons of quitting. CBC, based on the Cognitive-Social Health Information Processing model, has the potential to increase postpartum smoking abstinence by assessing and addressing cognitive-affective barriers among women who adhere to the intervention.

Weekly fluctuations in nonjudging predict borderline personality disorder feature expression in women

OBJECTIVES

Borderline personality disorder (BPD) features have been linked to deficits in mindfulness, or nonjudgmental attention to present-moment stimuli. However, no previous work has examined the role of fluctuations in mindfulness over time in predicting BPD features. The present study examines the impact of both between-person differences and within-person changes in mindfulness.

DESIGN

40 women recruited to achieve a flat distribution of BPD features completed 4 weekly assessments of mindfulness (Five Facet Mindfulness Questionnaire; FFMQ) and BPD features. Multilevel models predicted each outcome from both 1) a person's average levels of each facet and 2) weekly deviations from a person's average for each facet.

RESULTS

Average acting with awareness, nonjudging, and nonreactivity predicted lower BPD features at the between-person level, and weekly deviations above one's average (i.e., higher-than-usual) nonjudging predicted lower BPD feature expression at the within-person level.

CONCLUSIONS

Within-person fluctuations in the nonjudging facet of mindfulness may be relevant to the daily expression of BPD features over and above dispositional mindfulness.

Undifferentiated negative affect and impulsivity in borderline personality and depressive disorders: A momentary perspective

Individuals with borderline personality disorder (BPD) often report experiencing several negative emotions simultaneously, an indicator of "undifferentiated" negative affect. The current study examined the relationship between undifferentiated negative affect and impulsivity. Participants with a current BPD (n = 67) or depressive disorder (DD; n = 38) diagnosis carried an electronic diary for 28 days, reporting on emotions and impulsivity when randomly prompted (up to 6 times per day). Undifferentiated negative affect was quantified using momentary intraclass correlation coefficients, which indicated how consistently negative emotion items were rated across fear, hostility, and sadness subscales. Undifferentiated negative affect at the occasion-level, day-level, and across 28 days was used to predict occasion-level impulsivity. Multilevel modeling was used to test the hypothesis that undifferentiated negative emotion would be a significant predictor of momentary impulsivity above and beyond levels of overall negative affect. Undifferentiated negative affect at the occasion and day levels were significant predictors of occasion-level impulsivity, but undifferentiated negative affect across the 28-day study period was only marginally significant. Results did not differ depending on BPD or DD status, though individuals with BPD did report significantly greater momentary impulsivity and undifferentiated negative affect. Undifferentiated negative affect may increase risk for impulsivity among individuals with BPD and depressive disorders, and the current data suggest that this process can be relatively immediate as well as cumulative over the course of a day. This research supports the consideration of undifferentiated negative affect as a transdiagnostic construct, but one that may be particularly relevant for those with BPD.

A Contingency-Oriented Approach to Understanding Borderline Personality Disorder: Situational Triggers and Symptoms

This article tested a contingency-oriented perspective to examine the dynamic relationships between in-the-moment borderline personality disorder (BPD) symptom events and in-the-moment triggers. An experience sampling study with 282 adults, including 77 participants with BPD, obtained reports of situational triggers and BPD symptom events five times daily for 2 weeks. Triggers included being rejected, betrayed, abandoned, offended, and disappointed; having one's self-concept threatened; being in a boring situation; and being alone. BPD was associated with increased situational triggers. Multilevel models revealed significant within-person associations between situational triggers and BPD symptoms for the average participant in the study, with significant individual variance in the strength and direction of trigger-symptom contingencies. Most trigger-symptom contingencies were stronger for individuals with greater borderline symptomatology, suggesting that triggers are meaningfully related to BPD. These findings highlight possible proximal mechanisms that maintain BPD and help explain the course of a disorder often described as chaotic and unpredictable.

Mixed Expectations: Effects of Goal Ambivalence during Pregnancy on Maternal Well-Being, Stress, and Coping

BACKGROUND

We hypothesised that experiencing ambivalence toward the childbearing goal would be related to indicators of well-being, stress, and coping among women with planned pregnancies.

METHODS

Study 1 (N = 208) tested cross-sectional associations between goal ambivalence and measures of well-being, stress, and coping. It also included a postpartum measurement point (N = 71) to examine prospective effects of goal ambivalence. Study 2 (N = 109) extended the investigation to within-person effects in a three-week daily diary assessment.

RESULTS

In Study 1, goal ambivalence in pregnant women was positively associated with depressive symptoms, perceived stress, and pregnancy-specific avoidance-oriented coping, and negatively associated with coping self-efficacy. Goal ambivalence also predicted changes in life satisfaction, depressive symptoms, perceived stress, and coping self-efficacy postpartum. Study 2 revealed within-person effects of daily fluctuations in goal ambivalence on day-to-day changes in positive emotions, negative activation, and avoidance-oriented coping.

CONCLUSIONS

Ambivalence towards the childbearing goal is a source of significant distress to pregnant women with planned pregnancies and its effects seem to extend into the postpartum period. These findings may have important clinical implications for maternal and child well-being. Future studies should examine whether goal ambivalence during pregnancy affects the maternal-child relationship in the long term.

Briefly Assessing Repetitive Thought Dimensions: Valence, Purpose, and Total

Discrete forms of repetitive thought (RT), such as worry and reflection, can be characterized along basic dimensions of valence (positive vs. negative) and purpose (searching vs. solving). In addition, people can be characterized as high or low in their tendency to engage in RT. This dimensional model has been demanding to assess, and a smaller number of items that could stand in for a large battery would make measurement more accessible. Using four samples (N = 1,588), eight items that assess RT valence, purpose, and total in a circumplex model were identified. Across these and other samples, the dimensions were adequately reliable and valid with regard to assessment via large RT battery, other measures of RT, and depressive symptoms. The accessibility of dimensional assessment of RT using this smaller number of items should facilitate work on questions about the qualities of RT that predict mental and physical health.

Testing the Feasibility and Psychometric Properties of a Mobile Diary (myWHI) in Adolescents and Young Adults With Headaches

BACKGROUND

Headaches are prevalent among teens and young adults. Self-monitoring is essential for managing headaches and can be accomplished with the help of electronic headache diaries. An increasing number of electronic headache diaries exist, yet the absence of quality standards compromises their use for research and clinical purposes.

OBJECTIVE

Our goal was to develop and test the usability, feasibility, and psychometric properties of an electronic diary iPhone application for self-monitoring by adolescents and young adults with headaches.

METHODS

We used an iterative participatory design to develop and test our electronic headache diary. Participants aged 14-28 years old with recurrent headaches were recruited internationally. Screening and consent were conducted online. Following completion of an online pre-questionnaire, participants downloaded the diary to use in their natural environment for 14 days. An online post-questionnaire was completed following testing. The diary's usability and feasibility were tested first and determined to be complete when improvements to the diary did not result in a statistically significant impact on indicators of feasibility and adherence. Interviews were conducted with participants of usability and feasibility testing. The psychometric properties of the diary were then tested, and a case study analysis of one participant was completed.

RESULTS

Three cycles to test the usability and feasibility were conducted. Each cycle included 11-19 unique participants ranging in age from 16 to 28 years. Following the testing period for each cycle, 15% to 25% of participants took part in the post-cycle interview. Participants perceived the final version of the diary as useful, easy to learn, and efficient to use. Psychometric properties were then tested with a sample of 65 participants (6 aged 14-17 years old; 59 aged 18-28 years old). All items in the diary had substantial between- and within-subjects variability (percent of variance for the two participant groups ranged from 20.64 to 75.60 and 23.74 to 79.21, respectively). Moreover, the Migraine Disability Assessment (MIDAS) included in the diary had adequate between-subjects reliability (R1F=0.66, RKF=0.98), but low within-subjects reliability (RC=0.51). Critical elements of the diary demonstrated adequate convergent and concurrent validity, particularly in the older age group (18-28 years). The validity of some critical elements of the diary could not be explored in the younger age group due to the small subgroup size. The case study provides an example of the potential utility of the diary.

CONCLUSIONS

Our electronic headache diary was shown to be a usable and feasible self-monitoring tool when used by adolescents and young adults with headaches for 14 days. This study provides preliminary support of its psychometric properties. Our diary has the potential for helping users to better understand their headaches and, consequently, to change behaviors to improve self-management of their headaches. Its effectiveness as a component of an intervention will be the focus of future research.

Ovarian hormones and borderline personality disorder features: Preliminary evidence for interactive effects of estradiol and progesterone

Cyclical fluctuations in the ovarian hormones 17β-estradiol (E2; estrogen) and progesterone (P4) predict emotions, cognitive processes, and behaviors relevant to Borderline Personality Disorder (BPD); however, there are individual differences in sensitivity to normal hormone shifts. This study examined associations of naturally occurring hormonal changes with concurrent BPD feature expression. Forty women sampled for a flat distribution of the PAI-BOR (n=10 where T<50, n=10 where 50<T<60, n=10 where 60<T<70, and n=10 where T>70) provided four weekly saliva samples and psychological assessments. Across most outcomes (e.g., BPD features, felt rejection, anger rumination, negative urgency) P4 deviation (from one's person mean) moderated the effect of current E2 deviation (from one's person mean) among women high (+1 SD) in trait BPD features such that E2 deviation was negatively associated with symptoms only when P4 was higher-than-usual. Cyclical hormone changes (e.g., higher P4 in the luteal phase; E2 fluctuations at ovulation and in the luteal phase) may impact BPD feature expression among at-risk women.

Daily negative affect and smoking after a self-set quit attempt: The role of dyadic invisible social support in a daily diary study

OBJECTIVES

Social support receipt from one's partner is assumed to be beneficial for successful smoking cessation. However, support receipt can have costs. Recent research suggests that the most effective support is unnoticed by the receiver (i.e., invisible). Therefore, this study examined the association between everyday levels of dyadic invisible emotional and instrumental support, daily negative affect, and daily smoking after a self-set quit attempt in smoker-non-smoker couples.

METHODS

Overall, 100 smokers (72.0% men, mean age M = 40.48, SD = 9.82) and their non-smoking partners completed electronic diaries from a self-set quit date on for 22 consecutive days, reporting daily invisible emotional and instrumental social support, daily negative affect, and daily smoking.

RESULTS

Same-day multilevel analyses showed that at the between-person level, higher individual mean levels of invisible emotional and instrumental support were associated with less daily negative affect. In contrast to our assumption, more receipt of invisible emotional and instrumental support was related to more daily cigarettes smoked.

CONCLUSIONS

The findings are in line with previous results, indicating invisible support to have beneficial relations with affect. However, results emphasize the need for further prospective daily diary approaches for understanding the dynamics of invisible support on smoking cessation. Statement of contribution What is already known on this subject? Social support receipt from a close other has proven to have emotional costs. According to current studies, the most effective social support is unnoticed by the receiver (i.e., invisible). There is empirical evidence for beneficial effects of invisible social support on affective well-being. What does this study add? Confirming benefits of invisible social support for negative affect in a health behaviour change setting Providing first evidence for detrimental effects of invisible social support on smoking.

Ambulatory assessed implicit affect is associated with salivary cortisol

One of the presumed pathways linking negative emotions to adverse somatic health is an overactive HPA-axis, usually indicated by elevated cortisol levels. Traditionally, research has focused on consciously reported negative emotions. Yet, given that the majority of information processing occurs without conscious awareness, stress physiology might also be influenced by affective processes that people are not aware of. In a 24-h ambulatory study we examined whether cortisol levels were associated with two implicit measures. Implicit affect was assessed using the Implicit Positive and Negative Affect Test, and implicit negative memory bias was assessed with the word fragment completion tasks. In 55 healthy participants, we measured subjective stress levels, worries, implicit, and explicit affect each hour during waking hours. Also, saliva samples were collected at three fixed times during the day, as well as upon waking and 30 min thereafter (cortisol awakening response). Multilevel analyses of the daytime cortisol levels revealed that the presence of an implicit negative memory bias was associated with increased cortisol levels. Additionally, implicit PA and, unexpectedly, implicit NA were negatively associated with cortisol levels. Finally, participants demonstrating higher levels of implicit sadness during the first measurement day, had a stronger cortisol rise upon awakening at the next day. Contrary to previous research, no associations between explicit affect and cortisol were apparent. The current study was the first to examine the concurrent relation between implicit measures and stress physiology in daily life. The results suggest that the traditional focus on consciously reported feelings and emotions is limited, and that implicit measures can add to our understanding of how stress and emotions contribute to daily physiological activity and, in the long term, health problems.

The time-varying association between perceived stress and hunger within and between days

OBJECTIVE

Examine the association between perceived stress and hunger continuously over a week in free-living individuals.

METHODS

Forty five young adults (70% women, 30% overweight/obese) ages 18 to 24 years (Mean = 20.7, SD = 1.5), with BMI between 17.4 and 36.3 kg/m(2) (Mean = 23.6, SD = 4.0) provided between 513 and 577 concurrent ratings of perceived stress and hunger for 7 days via hourly, text messaging assessments and real-time eating records. Time-varying effect modeling was used to explore whether the within-day fluctuations in stress are related to perceived hunger assessed on a momentary basis.

RESULTS

A generally positive stress-hunger relationship was confirmed, but we found that the strength of the relationship was not linear. Rather, the magnitude of the association between perceived stress and hunger changed throughout the day such that only during specific time intervals were stress and hunger significantly related. Specifically, the strength of the positive association peaked during late afternoon hours on weekdays (β = 0.31, p < .05) and it peaked during evening hours on weekend days (β = 0.56, p < .05).

CONCLUSION

This is the first empirical study to demonstrate potentially maladaptive, nonlinear stress-hunger associations that peak in the afternoon or evening hours. While we are unable to infer causality from these analyses, our findings provide empirical evidence for a potentially high-risk time of day for stress-induced eating. Replication of these findings in larger, more diverse samples will aid with the design and implementation of real-time intervention studies aimed at reducing stress-eating.

Capitalizing on everyday positive events uniquely predicts daily intimacy and well-being in couples coping with breast cancer

Capitalization is the relational process of savoring positive life events by sharing them with responsive relationship partners. The purpose of the present study was to use dyadic intensive longitudinal methods to examine novel hypotheses regarding links between capitalization processes and daily intimacy and well-being in women with breast cancer and their intimate partners. Although couples coping with cancer often experience an increase in negative daily life events, we hypothesized that it would be important for them to share and capitalize on positive events in addition to sharing negative events. Female patients with early stage breast cancer and their intimate partners (99 couples) completed electronic daily diaries for 7 to 10 consecutive days tapping everyday processes of sharing negative and positive events with each other. Dyadic multilevel process modeling revealed that on days when capitalization attempts (i.e., sharing the best event of the day) occurred, daily feelings of intimacy in the sharer were higher for both patients and partners. Moreover, greater perceived partner responsiveness to capitalization attempts was associated with increases in the sharer's daily feelings of intimacy and decreases in the sharer's daily negative affect. When the patient's partner was the sharer, perceived partner responsiveness also was associated with increased daily positive affect. More important, all effects of capitalization were observed above and beyond the effects of event positivity and sharing negative events (i.e., social support attempts). Findings suggest that, even in the midst of significant life adversity, sharing daily good news with intimate partners enhances relationship well-being independently of sharing bad news.

Bidirectional-Compounding Effects of Rumination and Negative Emotion in Predicting Impulsive Behavior: Implications for Emotional Cascades

Influenced by chaos theory, the emotional cascade model proposes that rumination and negative emotion may promote each other in a self-amplifying cycle that increases over time. Accordingly, exponential-compounding effects may better describe the relationship between rumination and negative emotion when they occur in impulsive persons, and predict impulsive behavior. Forty-seven community and undergraduate participants who reported frequent engagement in impulsive behaviors monitored their ruminative thoughts and negative emotion multiple times daily for two weeks using digital recording devices. Hypotheses were tested using cross-lagged mixed model analyses. Findings indicated that rumination predicted subsequent elevations in rumination that lasted over extended periods of time. Rumination and negative emotion predicted increased levels of each other at subsequent assessments, and exponential functions for these associations were supported. Results also supported a synergistic effect between rumination and negative emotion, predicting larger elevations in subsequent rumination and negative emotion than when one variable alone was elevated. Finally, there were synergistic effects of rumination and negative emotion in predicting number of impulsive behaviors subsequently reported. These findings are consistent with the emotional cascade model in suggesting that momentary rumination and negative emotion progressively propagate and magnify each other over time in impulsive people, promoting impulsive behavior.

Differences in the Between–Person and Within–Person Structures of Affect Are A Matter of Degree

This study tested whether the structure of affect observed on the basis of between–person (BP) differences is equivalent to the affect structures that organize the variability of affective states within persons (WP) over time. Further aims were to identify individual differences in the degree of divergence between the WP and BP structure and examine its association to dispositional and contextual variables (neuroticism, extraversion, well–being and stress). In 100 daily sessions, 101 younger adults rated their mood on the Positive and Negative Affect Schedule. Variability of five negative affect items across time was so low that they were excluded from the analyses. We thus worked with a modified negative affect subscale. WP affect structures diverged reliably from the BP structure, with individual differences in the degree of divergence. Differences in the WP structural characteristics and the degree of divergence could be predicted by well–being and stress. We conclude that BP and WP structures of affect are not equivalent and that BP and WP variation should be considered as distinct phenomena. It would be wrong, for example, to conceive of positive and negative affect as independent at the WP level, as suggested by BP findings. Yet, individual differences in WP structural characteristics are related to stable BP differences, and the degree to which individuals’ affect structures diverge from the BP structure can provide important insights into intraindividual functioning. Copyright © 2014 European Association of Personality Psychology

Variability and reliability of diurnal cortisol in younger and older adults: implications for design decisions

The extant research is inconclusive regarding the best sampling methods to construct reliable measures of between-person differences in derived parameters of diurnal cortisol, and no study provides such recommendations for detecting within-person changes. These studies determined how many days of sampling are necessary to assess between-person differences and within-person changes over multiple occasions in diurnal mean, diurnal slope, and area under the curve (AUC). Generalizability and decision analyses were conducted on diurnal salivary cortisol data from two separate longitudinal studies, one with younger adults (N=124) and one with older adults (N=148). In both studies, results indicated that 3 days of data collection provided the minimal level of reliability in mean cortisol to detect between-person differences; 4-8 days were necessary to reliably assess AUC, and 10 days for cortisol slope. Similarly, in order to reliably characterize within-person changes across occasions, at least 3 days of data collection were needed for mean cortisol and AUC and 5-8 days for slope. Results also indicated that only two samples per day, taken morning and evening, could faithfully reproduce the diurnal slope calculated from 3 or 4 samples (r=.97-.99). Instead of having participants provide many samples per day over the course of a few days, we recommend collecting fewer samples per day over more days.

An idiographic approach to estimating models of dyadic interactions with differential equations

We present an idiographic approach to modeling dyadic interactions using differential equations. Using data representing daily affect ratings from romantic relationships, we examined several models conceptualizing different types of dyadic interactions. We fitted each model to each of the dyads and the resulting AICc values were used to classify the most likely configuration of interaction for each dyad. Additionally, the AICc from the different models were used in parameter averaging across models. Averaged parameters were used in models involving predictors of relationship dynamics, as indexed by these parameters, as well as models wherein the parameters predicted distal outcomes of the dyads such as relationship satisfaction and status. Results indicated that, within our sample, the most likely interaction style was that of independence, without evidence of emotional interrelations between the two individuals in the couple. Attachment-related avoidance and anxiety showed significant relations with model parameters, such that ideal levels of affect for males were negatively influenced by higher levels of avoidance from their partner while their own levels of anxiety had positive effects on their levels of dyadic coregulation. For females coregulation was negatively influenced by both time in the relationship and their partner's level of avoidance. Analysis involving distal outcomes showed modest influences from the individual's level of ideal affect.