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

Five indices of emotion regulation in participants with a history of nonsuicidal self-injury: a daily diary study

Theory has proposed that nonsuicidal self-injury (NSSI) is a response to intense frequent negative affect (NA) that is difficult to control. Therefore, individual differences that are related to emotion dysregulation should be higher in individuals who engage in NSSI compared to healthy controls. Though current research supports this prediction, this research could be strengthened by corroborating evidence from daily diary studies. The current study used a daily diary protocol to thoroughly examine the emotional correlates of NSSI. Individuals with and without a history of NSSI rated their affect daily for 14 days. This information was used to score multiple indices of emotionality (e.g., mean level, within-person variation, reactivity). The results showed that compared to controls, individuals who engaged in NSSI had higher mean levels, within-person variation, and lower emotional differentiation of NA, but groups did not differ on inertia of NA or reactivity of NA. Moreover, individuals with a history of NSSI reported lower levels of positive affect and lower inertia of positive affect. These results are discussed in terms of affect regulation models of NSSI and treatment implications.

Incivility from patients and their families: can organisational justice protect nurses from burnout?

AIM

To determine whether interpersonal and informational justice influence the association between daily experiences of incivility and burnout among nurses.

BACKGROUND

Research has suggested that incivility is a concern for managers. Nurses regularly experience incivility, particularly from their patients and patients' families. Incivility, in turn, can increase symptoms of burnout.

METHOD

Seventy-five nurses provided data on interpersonal and informational justice within their organisation. During five working days, nurses completed a twice-daily survey assessing incivility and burnout. Hierarchical linear modelling analyses examined the main effects and interaction effects of the three variables on burnout.

RESULT

Incivility was positively associated with burnout. In addition, interpersonal justice strengthened the incivility-burnout relationship. Informational justice did not significantly affect the incivility-burnout relationship.

CONCLUSION

Incivility is associated with more burnout. The work environment also influences burnout; when organisations provide informational justice, nurses experience less burnout. In organisations where interpersonal justice is high, nurses are more likely to experience burnout.

IMPLICATIONS FOR NURSING MANAGEMENT

Nursing managers can help employees by ensuring that management's decisions are transparent. In addition, managers should be aware that in organisations with higher interpersonal justice, nurses might be more likely to experience symptoms of burnout as a result of incivility from patients and their families.

When You Think Your Partner Is Holding Back

Do people benefit when they think their partner has made a sacrifice for the relationship? In a multimethod study of 80 couples, we examined whether people can detect when their partner suppresses their emotions and if perceived partner suppression is costly for the recipient of sacrifice. When people listened to their partner recall an important sacrifice in the lab and when people thought their partner sacrificed in daily life, they thought that their partner was less authentic the more they perceived them to have suppressed their emotions. In turn, perceived partner inauthenticity during sacrifice was associated with poorer personal well-being and relationship quality. These effects persisted over time with perceived partner suppression predicting poorer relationship quality 3 months later. The results were independent from the influence of an actor’s projection of their own suppression and their partner’s actual suppression. Implications for research on emotion regulation and close relationships are discussed.

Loneliness trajectories

This special section brings together five studies using group-based modeling to capture developmental trajectories of loneliness from age 7 through age 20. Together, the findings from these studies provide further evidence that developmental trajectories of loneliness are likely not best understood at a continuum but reflect distinct subpopulations that differ both where they start out and how they change over time in terms of mean levels of loneliness. Furthermore, adolescents who show chronically high loneliness or increasing loneliness over time exhibit poorer psychological and physical health, including greater incidence of depressive symptoms and more frequent suicide attempts. The findings from these studies also suggest that individuals experiencing increases in loneliness with age fare worse as well in terms of both physical and psychological health.

Detecting improvements in acute psychotic symptoms using experience sampling methodology

This study aimed to explore the feasibility and validity of using experience sampling methodology (ESM, or ecological momentary assessment or mobile device signaling) to measure temporal changes and fluctuations in psychotic symptoms in patients with acute psychosis at the start of antipsychotic treatment. Twenty-six in-patients with delusions were assessed within 2 weeks of starting antipsychotic treatment using ESM on a personal digital assistant (PDA), seven times a day for 14 consecutive days. They were also interviewed at baseline, 1 week and 2 weeks after using standardized symptom measures. Sixteen patients (61.5%) completed at least one-third of the entries, with a compliance rate of 70.7%. Responses to the ESM items were internally consistent. At baseline, ESM and clinical ratings converged on suspiciousness and images, but not on voices and most of the delusion dimensions. Conducting ESM with patients in an acute episode was found to be feasible and internally valid. There is some divergence in symptom data obtained by ESM and standard symptom interviews, but ESM captures rich information about change that may not be represented by observer ratings.

Ecological momentary assessment for chronic pain in fibromyalgia using a smartphone: a randomized crossover study

BACKGROUND

Daily diaries are a useful way of measuring fluctuations in pain-related symptoms. However, traditional diaries do not assure the gathering of data in real time, not solving the problem of retrospective assessment. Ecological momentary assessment (EMA) by means of electronic diaries helps to improve repeated assessment. However, it is important to test its feasibility in specific populations in order to reach a wider number of people who could benefit from these procedures.

METHODS

The present study compares the compliance and acceptability of an electronic diary running on a smartphone using a crossover design for a sample with a specific pain condition, fibromyalgia and low familiarity with technology. Forty-seven participants were randomly assigned to one of two conditions: (1) paper diary - smartphone diary and (2) smartphone diary - paper diary, using each assessment method for 1 week.

RESULTS

The findings of this study showed that the smartphone diary made it possible to gather more accurate and complete ratings. Besides, this method was well accepted by a sample of patients with fibromyalgia referred by a public hospital, with an important proportion of participants with low level of education and low familiarity with technology.

CONCLUSIONS

The findings of this study support the use of smartphones for EMA even in specific populations with a specific pain condition, fibromyalgia and with low familiarity with technology. These methods could help clinicians and researchers to gather more accurate ratings of relevant pain-related variables even in populations with low familiarity with technology.

The role of locus of control in daily life

Conceived of as a stable trait, locus of control has been linked with psychological and physical health outcomes. We investigated whether locus of control operates as a state variable, whether variation in daily locus of control is associated with anxiety and stressful events, and whether it predicts daily health behaviors and symptoms. Using a daily diary study of pregnant couples, we found daily variation in locus of control was predicted by daily hassles and anxiety such that high same-day and previous-day anxiety and hassles were associated with reports of lower levels of control. Furthermore, daily locus of control was positively associated with positive health behaviors and predicted negative health symptoms. These results provide evidence for a social learning perspective on the development and maintenance of individuals' sense of control and suggest that locus of control should be considered both a state- and trait-level construct in future research.

Spouses' involvement in their partners' diabetes management: associations with spouse stress and perceived marital quality

Spouses frequently attempt to influence (control) or support their chronically ill partners' adherence behaviors. Studies have documented effects of spousal control and support on chronically ill individuals, but little is known about how these two forms of involvement in a partner's disease management may be associated with spouses' stress or the quality of their interactions with their ill partners. The current study sought to address this gap by examining spouses' day-to-day involvement in their marital partner's management of type 2 diabetes (n = 129). Multilevel analyses of daily diary data revealed that on days when spouses exerted control, they reported more stress and more tense marital interactions, although these associations were more pronounced when patients exhibited poor adherence, had been ill for a longer period of time, and had more comorbid health conditions. On days when spouses provided support, in contrast, they reported less stress and more enjoyable marital interactions. The findings from the current study suggest that spouses' day-to-day stress and quality of interactions with their partners are associated with spouses' involvement in their partners' disease management, with health-related social control and support exhibiting distinctive associations.

Monitoring dietary intake and physical activity electronically: feasibility, usability, and ecological validity of a mobile-based Ecological Momentary Assessment tool

BACKGROUND

Despite the growing body of research on complex lifestyle behaviors (eg, Dietary Intake [DI] and Physical Activity [PA]), monitoring of these behaviors has been hampered by a lack of suitable methods. A possible solution to this deficiency is mobile-based Ecological Momentary Assessment (mEMA), which enables researchers to collect data on participants' states in real-time by means of a smartphone application. However, feasibility, usability, and ecological validity need to be anticipated and managed in order to enhance the validity of mEMA.

OBJECTIVE

To examine the feasibility, usability, and ecological validity of a mEMA application (app) with regard to DI and PA among Dutch vocational education students.

METHODS

The students (n=30) participated in the mEMA study for seven consecutive days. They downloaded the mEMA app on their smartphone. Feasibility and usability of the mEMA app were evaluated by completing an online evaluation after seven days of participation. Ecological validity was measured by assessing the degree to which the content of the mEMA app approximated the real-world setting that was being examined, through several multiple-choice questions.

RESULTS

Compliance rates, as registered by the mEMA app, declined 46% over a seven-day period, while self-reported compliance, as measured with an online evaluation questionnaire afterwards, indicated a smaller decrease in compliance (29%). The students evaluated the mEMA app as feasible and usable. Ecological validity analyses showed that all DI and almost all PA multiple-choice options were covered with the compound response categories.

CONCLUSIONS

The mEMA app offers the opportunity to assess complex health behaviors (eg, DI and PA) in real-time settings, in which specifically routinized behaviors are involved. However, the mEMA app faced several challenges that needed to be overcome in order to improve its validity. Overall, the present study showed that the mEMA app is a usable and ecologically valid tool to measure DI and PA behaviors among vocational education students, but compliance is still limited.

Emotion differentiation as a protective factor against nonsuicidal self-injury in borderline personality disorder

Evidence that nonsuicidal self-injury (NSSI) serves a maladaptive emotion regulation function in borderline personality disorder (BPD) has drawn attention to processes that may increase risk for NSSI by exacerbating negative emotion, such as rumination. However, more adaptive forms of emotion processing, including differentiating broad emotional experiences into nuanced emotion categories, might serve as a protective factor against NSSI. Using an experience-sampling diary, the present study tested whether differentiation of negative emotion was associated with lower frequency of NSSI acts and urges in 38 individuals with BPD who reported histories of NSSI. Participants completed a dispositional measure of rumination and a 21-day experience-sampling diary, which yielded an index of negative emotion differentiation and frequency of NSSI acts and urges. A significant rumination by negative emotion differentiation interaction revealed that rumination predicted higher rates of NSSI acts and urges in participants with difficulty differentiating their negative emotions. The results extend research on emotion differentiation into the clinical literature and provide empirical support for clinical theories that suggest emotion identification and labeling underlie strategies for adaptive self-regulation and decreased NSSI risk in BPD.

Psychometric characteristics of daily diaries for the Patient-Reported Outcomes Measurement Information System (PROMIS®): a preliminary investigation

PURPOSE

The Patient-Reported Outcomes (PRO) Measurement Information System (PROMIS(®)) has developed assessment tools for numerous PROs, most using a 7-day recall format. We examined whether modifying the recall period for use in daily diary research would affect the psychometric characteristics of several PROMIS measures.

METHODS

Daily versions of short-forms for three PROMIS domains (pain interference, fatigue, depression) were administered to a general population sample (n = 100) for 28 days. Analyses used multilevel item response theory (IRT) models. We examined differential item functioning (DIF) across recall periods by comparing the IRT parameters from the daily data with the PROMIS 7-day recall IRT parameters. Additionally, we examined whether the IRT parameters for day-to-day within-person changes are invariant to those for between-person (cross-sectional) differences in PROs.

RESULTS

Dimensionality analyses of the daily data suggested a single dimension for each PRO domain, consistent with PROMIS instruments. One-third of the daily items showed uniform DIF when compared with PROMIS 7-day recall, but the impact of DIF on the scale level was minor. IRT parameters for within-person changes differed from between-person parameters for 3 depression items, which were more sensitive for measuring change than between-person differences, but not for pain interference and fatigue items. Notably, mean scores from daily diaries were significantly lower than the PROMIS 7-day recall norms.

CONCLUSIONS

The results provide initial evidence supporting the adaptation of PROMIS measures for daily diary research. However, scores from daily diaries cannot be directly interpreted on PROMIS norms established for 7-day recall.

Affect and self-rated health: a dynamic approach with older adults

OBJECTIVE

Self-rated health (SRH) predicts mortality above and beyond objective health risks and, as such, comprises an important aspect of health. Established contributors to SRH include affect, age, and disease, but neither their dynamic nor their synergistic contributions to SRH have been comprehensively tested.

METHOD

The present study employed older adults (N = 150; Mage = 75 years) and a longitudinal design with 6-month waves over a period up to 5 years. Positive (PA) and negative affect (NA), chronic disease, and SRH were assessed at each wave.

RESULTS

In multilevel models with single predictors, older age, more chronic disease, and higher NA predicted worse SRH, whereas higher PA predicted better SRH. Affect predicted SRH both between and within people. In multilevel models with interactions between affect and age or disease, individual differences in NA predicted worse SRH primarily in older people. Within people, changes in NA were associated with changes in SRH, but more so in younger than in older people. Within people, changes in PA were associated with changes in SRH, but only when health was better than usual.

CONCLUSION

There were both dynamic and synergistic relationships between affect and SRH that could only emerge in a multilevel, multivariable design. In the case of NA, between-person, trait NA had the opposite relationship to SRH and age compared to within-person, state NA. Which component of this relationship predicts mortality is an important question for future research.

Social partners and momentary affect in the oldest-old: the presence of others benefits affect depending on who we are and who we are with

Links between social relationships and emotional well-being in old age are well documented, but little is known about daily life fluctuations in momentary affective experiences of the oldest-old while interacting with specific social partners. We examined associations between the presence of different types of social partners and moment-to-moment fluctuations in affect in the oldest-old, taking into account individual differences in gender, neuroticism, depressive symptoms, chronic health conditions, and loneliness. Participants (N = 74, M age = 88.7 years, range = 84-102 years, 68% women) provided self-reports concurrently on the presence of social partners and subjective affective states 6 times a day for each of 7 consecutive days (3,071 occasions, in total). Relative to being with other people, time spent alone was associated with lower positive affect in the oldest-old. Being with other family members and friends was associated with more positive affective experiences. Compared with men, women reported more negative affective experiences when they were with their spouses than when their spouses were not present. Individuals with more chronic health problems reported more negative affective experiences when they were with their spouses than not. Participants higher in neuroticism reported more positive affective experiences when they were with their friends, compared with times when their friends were not present. Finally, lonelier individuals reported more positive affective experiences when they were with their spouses than when they were not. These findings suggest that affective experience is a function of individual differences and the type of social partners oldest-old adults interact with in everyday life. We discuss how our findings can be generalized to oldest-olds of different marital statuses, taking into account the proportion of widows in our sample as well as measurement specifics.

Touch as an interpersonal emotion regulation process in couples' daily lives: the mediating role of psychological intimacy

Interpersonal touch seems to promote physical health through its effects on stress-sensitive parameters. However, less is known about the psychological effects of touch. The present study investigates associations between touch and romantic partners' affective state in daily life. We hypothesized that this association is established by promoting the recipient's experience of intimacy. Both partners of 102 dating couples completed an electronic diary 4 times a day during 1 week. Multilevel analyses revealed that touch was associated with enhanced affect in the partner. This association was mediated by the partner's psychological intimacy. Touch was also associated with intimacy and positive affect in the actor. Finally, participants who were touched more often during the diary study week reported better psychological well-being 6 months later. This study provides evidence that intimate partners benefit from touch on a psychological level, conveying a sense of strengthened bonds between them that enhances affect and well-being.

Depressive symptoms are a vulnerability factor for heavy episodic drinking: a short-term, four-wave longitudinal study of undergraduate women

Heavy episodic drinking is increasingly common among undergraduate women. Cross-sectional research suggests that depressive symptoms and heavy episodic drinking are related. Nonetheless, surprisingly little is known about whether depressive symptoms are an antecedent of heavy episodic drinking, a consequence of heavy episodic drinking, or both. Such knowledge is essential to the accurate conceptualization of heavy episodic drinking, depressive symptoms, and their interrelations. In the present short-term longitudinal study, depressive symptoms and heavy episodic drinking were proposed to reciprocally influence each other over time, with depressive symptoms predicting changes in heavy episodic drinking over 1 week and vice versa. This reciprocal relations model was tested in 200 undergraduate women using a 4-wave, 4-week longitudinal design. Structural equation modeling was used to conduct cross-lagged analyses testing reciprocal relations between depressive symptoms and heavy episodic drinking. Consistent with hypotheses, both depressive symptoms and heavy episodic drinking were temporally stable, and depressive symptoms predicted changes in heavy episodic drinking over 1 week. Contrary to hypotheses, heavy episodic drinking did not predict changes in depressive symptoms over 1 week. Results are consistent with a vulnerability model suggesting depressive symptoms leave undergraduate women vulnerable to heavy episodic drinking. For undergraduate women who are struggling with feelings of sadness, worthlessness, and hopelessness, heavy episodic drinking may provide a temporary yet maladaptive means of avoiding or alleviating depressive symptoms.

The wear and tear of daily stressors on mental health

Researchers assert that affective responses to seemingly minor daily events have long-term implications for mental health, yet this phenomenon has rarely been investigated. In the current study, we examined how levels of daily negative affect and affective reactivity in response to daily stressors predicted general affective distress and self-reported anxiety and depressive disorders 10 years after they were first assessed. Across eight consecutive evenings, participants (N = 711; age = 25 to 74 years) reported their daily stressors and their daily negative affect. Increased levels of negative affect on nonstressor days were related to general affective distress and symptoms of an affective disorder 10 years later. Heightened affective reactivity to daily stressors predicted greater general affective distress and an increased likelihood of reporting an affective disorder. These findings suggest that the average levels of negative affect that people experience and how they respond to seemingly minor events in their daily lives have long-term implications for their mental health.

Biased and Accurate

Are depressive symptoms associated with more biased or more accurate interpersonal perceptions? Both members of committed heterosexual couples ( N = 78) reported on their perceptions of their partner’s commitment and behavior daily across a 3-week period. Using the partner’s reports as the benchmark, participants who reported more depressive symptoms not only underestimated their partner’s commitment and overestimated their partner’s negative behavior (greater directional bias) but were also more accurate in tracking changes in their partner’s commitment and behavior across days (greater tracking accuracy). More negative perceptions of the partner’s commitment and behavior was also associated with increases in relationship insecurity and depressed mood, particularly when the partner also reported lower commitment and more negative behavior. These results indicate that depressive symptoms are associated with both more accurate and more biased interpersonal perceptions and suggest that more accurate detection and more biased magnification of interpersonal threat has important implications for the maintenance of depressed mood.

Disentangling sources of individual differences in diurnal salivary α-amylase: reliability, stability and sensitivity to context

In the present study, we employ a longitudinal design and a generalizability framework to examine the sources of variance in the diurnal rhythm of salivary α-amylase (sAA). The sample consisted of 122 first-year law students (55% male, mean age=23.9 years), who collected five saliva samples on each of three consecutive days at each of five data collection waves. In total, over 6900 saliva samples were collected, which allowed us to examine the properties of diurnal variation in sAA in great detail. Systematic individual differences accounted for 15-29% of the variability in the awakening response and diurnal slope, and for 61-65% of the variation in overall daily levels (i.e., diurnal mean, area under the curve with respect to ground [AUCg]). Although less than 1% of the variation was due to differences between waves and between days, the generalizability analyses revealed that between 16% and 17% of the variance in the diurnal mean, slope and AUCg is due to person by wave interactions, indicating that individuals vary in their biological sensitivity to environmental influences. In sum, this study documents sufficient stability and variation in diurnal sAA to warrant future studies on the origins and consequences of alterations in the diurnal rhythm of sAA worthwhile, and proposes guidelines on obtaining reliable measures.

Affective experience in ecologically relevant contexts is dynamic and not progressively attenuated during pregnancy

Pregnancy is thought to diminish a woman's appraisal of and affective response to stressors. To examine this assumption, we used an electronic diary and an ecological momentary assessment strategy to record women's (n = 85) experiences of positive and negative affect five times each day over 2 days within each trimester of pregnancy. The women also completed the Edinburgh Postnatal Depression Scale in each trimester. Multilevel modeling indicated nonlinear patterns for both positive and negative affect that differed by the level of depressive symptoms. The findings suggest that changes in the psychological experience over the course of pregnancy are dynamic and not progressively attenuated.

Daily mood and out-of-home mobility in older adults: does cognitive impairment matter?

This study explores the relationship between out-of-home behavior and daily mood of community-dwelling older adults with different levels of cognitive impairment across four consecutive weeks. The sample included 16 persons with early stage Alzheimer's disease (AD), 30 persons with mild cognitive impairment (MCI), and 95 cognitively healthy persons (CH). Using a multi-method approach, GPS tracking and daily-diary data were combined on a day-to-day basis. AD and MCI adults showed lower mood than the CH group. Whereas stronger positive links between mood and out-of-home behavior were found for AD compared to the total sample on an aggregate level, predicting daily mood by person (i.e., cognition) and occasion-specific characteristics (i.e., mobility and weekday), using multilevel regression analysis revealed no corresponding effect. In conclusion, cognitive status in old age appears to impact on mobility and mood as such, rather than on the mood and out-of-home behavior connection.

Negative moods correlate with craving in female methamphetamine users enrolled in compulsory detoxification

Background

Methamphetamine (METH) use, especially in females, has become a growing public health concern in China. In this study, we aimed to characterize the factors that contributed to drug craving in female METH users under isolated compulsory detoxification. We characterized factors contributing to craving such as duration of detoxification, history of drug use and self-reported mood state.

Methods

Subjects (N=113) undergoing a 1- to 3-year METH detoxification program were recruited from the Zhejiang Compulsory Detoxification Center for Women. The Questionnaire of METH-use Urge (QMU) was used to evaluate the level of craving for METH. The Abbreviate Profile of Mood States (A-POMS) was applied as an assessment for the negative mood disturbances.

Results

The participants were at a mean age of 25.2, primarily lowly educated and unemployed, and single. Smoking was the only route of METH administration at an average dose of 0.5 g/day, and 4 times/week. The reported craving level was positively correlated with the negative mood disturbances and the weekly dose of METH, but independent of the duration of detoxification. Furthermore, all five aspects of negative mood disturbances, including fatigue, bewilderment, anxiety, depression and hostility, were shown to positively correlate to the self-reported craving level after controlling for weekly dose of METH.

Conclusions

The data demonstrate a robust correlation between mood distress and craving for METH. Our results call for close evaluation of mood distress in treatment of METH users in China.

Vulnerability, distress, and immune response to vaccination in older adults

Psychological distress and biobehavioral vulnerability (e.g., arising from being older or sedentary) have independently predicted immune responses to influenza vaccination in older adults. Recent research examining basal inflammatory markers suggests that, rather than having additive effects, distress and vulnerability interact with each other. The present study tested the interactions between distress and age, sex, education, BMI, sleep quality, and physical activity over up to 8 years in older adults (N=134; M age=74 years) who received annual influenza vaccinations. Measured vaccination responses were changes from baseline in antibody to the three vaccine components, interleukin (IL)-6, and β2-microglobulin. As predicted, the most robust effects were interactions between distress and vulnerability. BMI interacted with stable individual differences in distress to predict antibody response (t(132)=3.09, p<0.003), such that only the combination of low BMI and low distress was associated with a more robust antibody response. Likewise, changes in physical activity over time interacted with changes in distress (t(156)=2.96, p<0.004), such that only the combination of increased physical activity and decreased distress was associated with a more robust antibody response. Finally, there was a smaller tendency for age to interact with stable individual differences in distress (t(130)=2.46, p<0.015), such that distress was more strongly associated with post-vaccination IL-6 at older ages. The synergistic effects of distress and other forms of vulnerability are an important direction for future research and a target for interventions to improve immunological health in older adults.

Vitamin C status and perception of effort during exercise in obese adults adhering to a calorie-reduced diet

OBJECTIVE

Moderate energy restriction and exercise are recommended for effective weight loss. Obese individuals oxidize less fat and report a higher perceived exertion during exercise, characteristics that may negatively influence exercise behavior. Because vitamin C status has been linked to fatigability, we compared the effects of vitamin C supplementation on self-reported fatigue and on the respiratory exchange ratio and the Ratings of Perceived Exertion scale during moderate exercise in healthy obese adults adhering to a hypocaloric diet.

METHODS

Twenty adults (4 men and 16 women) were stratified and randomly assigned to receive 500 mg of vitamin C (VC) or placebo (CON) daily for 4 wk while adhering to a vitamin C-controlled, calorie-restricted diet. Feelings of general fatigue as assessed by the Profile of Mood States questionnaire were recorded on a separate day from the exercise session at weeks 0 and 4. Participants walked on a treadmill at an intensity of 50% predicted maximal oxygen consumption for 60 min at weeks 0 and 4, and heart rate, respiratory exchange ratio, and Ratings of Perceived Exertion were recorded.

RESULTS

After 4 wk, the two groups lost similar amounts of weight (≈ 4 kg), and the respiratory exchange ratio was not altered by group. Heart rate and the Ratings of Perceived Exertion during exercise were significantly decreased in the VC versus the CON group (-11 versus -3 beats/min, P = 0.022, and -1.3 versus +0.1 U, P = 0.001, respectively), and the general fatigue score was decreased 5.9 U for the VC group versus a 1.9 U increase for the CON group (P = 0.001).

CONCLUSION

These data provide preliminary evidence that vitamin C status may influence fatigue, heart rate, and perceptions of exertion during moderate exercise in obese individuals.

Friendship trumps ethnicity (but not sexual orientation): comfort and discomfort in inter-group interactions

An experience sampling study tested the degree to which interactions with out-group members evoked negative affect and behavioural inhibition after controlling for level of friendship between partners. When friendship level was statistically controlled, neither White nor Black participants reported feeling more discomfort interacting with ethnic out-group members compared to ethnic in-group members. When partners differed in sexual orientation, friendship level had a less palliating effect. Controlling for friendship, both gay and straight men - but not women - felt more behaviourally inhibited when interacting with someone who differed in sexual orientation, and heterosexual participants of both genders continued to report more negative affect with gay and lesbian interaction partners. However, gay and lesbian participants reported similar levels of negative affect interacting with in-group (homosexual) and out-group (heterosexual) members after friendship level was controlled. Results suggest that much of the discomfort observed in inter-ethnic interactions may be attributable to lower levels of friendship with out-group partners. The discomfort generated by differences in sexual orientation, however, remains a more stubborn barrier to comfortable inter-group interactions.

The role of perfectionism in daily self-esteem, attachment, and negative affect

This study of university students (64 men, 99 women) examined the role of self-critical (SC) and personal standards (PS) higher order dimensions of perfectionism in daily self-esteem, attachment, and negative affect. Participants completed questionnaires at the end of the day for 7 consecutive days. Trait and situational influences were found in the daily reports of self-esteem, attachment, and affect. In contrast to PS perfectionism, SC perfectionism was strongly related to aggregated daily reports of low self-esteem, attachment fears (fear of closeness, fear of dependency, fear of loss), and negative affect as well as instability indexes of daily self-esteem, attachment, and negative affect. Multilevel modeling indicated that both SC and PS perfectionists were emotionally reactive to decreases in self-esteem, whereas only SC perfectionists were emotionally reactive to increases in fear of closeness with others. These results demonstrate the dispositional and moderating influences of perfectionism dimensions on daily self-esteem, attachment, and negative affect.

Salivary alpha-amylase during pregnancy: diurnal course and associations with obstetric history, maternal demographics, and mood

Diurnal patterns of salivary alpha amylase (sAA) in pregnant women have not previously been described. The current study employed ecological momentary assessment to examine the association between the diurnal sAA, obstetric history, maternal demographics, and mood during pregnancy. Saliva was self-collected by 83 pregnant women (89% White, age 25.3-43.0 years; mean gestational age 21.9 weeks, range 6-37 weeks; gravida 1-6) at home over three days. Results indicated that current pregnancy (gestational age and fetal sex) and maternal demographics were not related to diurnal sAA. In contrast, a history of previous miscarriage (Parameter = -.17; SE = .05; p < .05) was associated with an atypical diurnal pattern. Even after accounting for obstetric history, trait anxiety (Parameter = .16; SE = .04; p < .001) was associated with increased sAA over the day while chronic levels of fatigue (Parameter = -.06; SE = .03; p < .05) were associated with decreased sAA. In a separate model, we also tested the time varying covariation of sAA and mood. The effects of momentary mood were in contrast to those for trait mood. Both momentary depression (Parameter = .22; SE = .09; p < .01) and vigour/positive mood (Parameter = .12; SE = .04; p < .001) were associated with momentary increases in sAA while momentary anxiety and fatigue were not related to sAA. The findings suggest that basal sAA during pregnancy is sensitive to emotional arousal. Evaluating diurnal patterns of sAA holds promise for advancing understanding of how emotional arousal during pregnancy may affect fetal development.

Cognitive and Interpersonal Moderators of Daily Co-Occurrence of Anxious and Depressed Moods in Generalized Anxiety Disorder

Anxiety and depression co-occur, both at the disorder and symptom levels, and within anxiety disorders, fluctuations in daily anxious mood correspond temporally to fluctuations in depressed mood. However, little is known about the factors or conditions under which anxiety and depressive symptoms are most likely to co-occur. The current study investigated the role of cognitive factors (daily rumination and cognitive attributions about anxiety symptoms) and interpersonal functioning (daily perceived rejection, support, criticism, and interpersonal problems) as moderators of the daily association between anxious and depressed moods. Fifty-five individuals with generalized anxiety disorder completed a 21-day diary assessing daily mood and cognitive and interpersonal functioning. Ratings of anxious and depressed mood were more closely associated on days when participants ruminated about their anxiety or viewed anxiety symptoms more negatively. Furthermore, anxious mood predicted later depressed mood on days when participants reported greater interpersonal problems and more perceived rejection. Results suggest that cognitive and interpersonal factors may elevate the likelihood of anxiety-depression co-occurrence.

Psychological distress and salivary cortisol covary within persons during pregnancy

The mechanisms whereby maternal stress during pregnancy exerts organizational effects on fetal development require elaboration. The aim of this study was to assess the plausibility of cortisol as a biological link between maternal psychological distress during pregnancy and fetal development. Previous research has resulted in equivocal findings for between-persons differences in stress and cortisol. Ecological momentary assessment was used to simultaneously assess mood and cortisol 5 times daily for 3 days in 83 women (gestational ages 6-37 weeks). Results from multilevel analysis indicated a robust within-person association between negative mood and cortisol. For each 1.0% increase in negative mood there was a corresponding 1.9% increase in cortisol. This association was unaffected by advancing gestational age. The results suggest that cortisol is a plausible biological mechanism for transducing the effects of maternal psychological distress during pregnancy to fetal development.

The rejection-rage contingency in borderline personality disorder

Though long-standing clinical observation reflected in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.) suggests that the rage characteristic of borderline personality disorder (BPD) often appears in response to perceived rejection, the role of perceived rejection in triggering rage in BPD has never been empirically tested. Extending basic personality research on rejection sensitivity to a clinical sample, a priming-pronunciation experiment and a 21-day experience-sampling diary examined the contingent relationship between perceived rejection and rage in participants diagnosed with BPD compared with healthy controls. Despite the differences in these 2 assessment methods, the indices of rejection-contingent rage that they both produced were elevated in the BPD group and were strongly interrelated. They provide corroborating evidence that reactions to perceived rejection significantly explain the rage seen in BPD.

Latent Differential Equation Modeling of Self-Regulatory and Coregulatory Affective Processes

We examine emotion self-regulation and coregulation in romantic couples using daily self-reports of positive and negative affect. We fit these data using a damped linear oscillator model specified as a latent differential equation to investigate affect dynamics at the individual level and coupled influences for the 2 partners in each couple. Results indicate an absence of damping of relationship-specific affect within individuals in the sample. When both positive and negative affect are modeled at the individual level, the influence of positive affect is greater than that of negative affect. At the dyad level, the findings indicate coupled influences in both positive and negative affect between partners. With regard to positive affect, females are sensitive to their partners' overall displacement from average as well as their rate of change; males are sensitive only to their partners' displacement from average. For negative affect both partners are sensitive to each other's displacement from average, yet there are no coupled influences for rates of change in this dimension. We interpret the influence of the parameters on the system by examining the expected behavior of the system as a function of varying parameter values.

Depression and Empathic Accuracy in Couples

We examine the link between depression and empathic accuracy, the ability to infer other people’s thoughts and feelings, as a possible mechanism underlying gender differences in the association between depression and interpersonal difficulties within intimate relationships. Fifty-one heterosexual couples completed questionnaires assessing depressive symptoms and participated in both a lab and a daily diary procedure assessing empathic accuracy. In the lab measures, women’s (but not men’s) higher levels of depressive symptoms were associated with lower empathic accuracy regarding partners’ thoughts and feelings. In the daily diary data, women’s depressive symptoms were specifically associated with lower levels of empathic accuracy for negative feelings but not for positive feelings, and with lower levels of their partners’ empathic accuracy for the women’s negative feelings. Men’s depressive symptoms were again unrelated to levels of empathic accuracy. Our findings suggest that depressive symptoms may have a stronger impact on interpersonal perception in intimate relationships among women than among men.

Intraindividual coupling of daily stressors and cognitive interference in old age

OBJECTIVES

The current study examined emotional and cognitive reactions to daily stress. We examined the psychometric properties of a short cognitive interference measure and how cognitive interference was associated with measures of daily stress and negative affect (NA) between persons and within persons over time.

METHODS

A sample of 87 older adults (M(age) = 83, range = 70-97, 28% male) completed measures of daily stress, cognitive interference, and NA on 6 days within a 14-day period.

RESULTS

The measure yielded a single-factor solution with good reliability both between and within persons. At the between-person level, NA accounted for the effects of daily stress on individual differences in cognitive interference. At the within-person level, NA and daily stress were unique predictors of cognitive interference. Furthermore, the within-person effect of daily stress on cognitive interference decreased significantly with age.

DISCUSSION

These results support theoretical work regarding associations among stress, NA, and cognitive interference, both across persons and within persons over time.

The effect of feeling stereotyped on social power and inhibition

An experience sampling study examined the degree to which feeling stereotyped predicts feelings of low power and inhibition among stigmatized and nonstigmatized individuals. For 7 days, participants with a concealable (gay and lesbian), a visible (African American), or no identifiable stigma recorded feelings of being stereotyped, of powerlessness, and of inhibition immediately following social interactions. For members of all three groups, feeling stereotyped was associated with more inhibition, and this relation was partially mediated by feeling low in power. Although stigmatized participants reported feeling stereotyped more often than nonstigmatized participants, they reacted less strongly to the experience, consistent with the presence of buffering mechanisms developed by those living with stigma. African Americans appeared to buffer the impact of feeling stereotyped more effectively than gay and lesbian participants, an effect that was partly attributable to African Americans' higher identity centrality.

Getting in Under the Radar

There are many ways in which the provision of social support can be ineffective. Recent research suggests that the benefits of support may be maximized when it is provided invisibly. What remains unknown, however, is whether invisible support reflects the skillful behavior of support providers or recipients’ blissful unawareness, as well as how invisible support is delivered during spontaneous social interactions. We hypothesized that both providers’ skillful behavior and recipients’ unawareness are necessary for invisible support to be effective, and we sought to document what effective invisible support looks like. Eighty-five couples engaged in a videotaped support interaction in the lab. Support recipients whose partners provided more invisible practical and emotional support (coded by observers) but who reported receiving less support experienced the largest preinteraction-to-postinteraction declines in negative emotions. In the case of practical invisible support, the combination of more support and less awareness of that support also predicted increases in self-efficacy. These results indicate that invisible support is a dyadic phenomenon.

Feeling vigorous and the risks of all-cause mortality, ischemic heart disease, and diabetes: a 20-year follow-up of healthy employees

OBJECTIVE

To investigate prospectively the effects of vigor at work on the end points of mortality and the prevalence of ischemic heart disease (IHD) and diabetes.

METHODS

We tested the hypothesized beneficial effects of feeling vigorous at work at baseline on the risks of all-cause mortality, IHD, and diabetes during a 20-year follow-up. Participants were healthy employees (n = 968) who underwent a routine health check at baseline. We calculated the risk of all-cause mortality, IHD, and diabetes, with days as the time scale, using the Cox proportional hazard model. In our analyses, we predicted the above end points by baseline vigor, age, gender, and educational level, adjusting for the physiological risk factors of total cholesterol, glucose, and body mass index, the behavioral risk factors of smoking, alcohol intake, and physical activity, and the psychological risk factors of depressive and anxiety symptoms.

RESULTS

As hypothesized, we found that, after the above adjustments, baseline vigor decreased the risk of follow-up mortality by 26% (hazard ratio, 0.74; 95% confidence interval, 0.58-0.95) and the risk of diabetes by 17% (hazard ratio, 0.83; 95% confidence interval, 0.68-0.98). However, vigor did not have a significant effect on the risk of IHD.

CONCLUSIONS

Independently of physiological, behavioral, and psychological risk factors, feeling vigorous at work protected the participants from diabetes and reduced their risk of mortality.

The daily impact of pain from metastatic breast cancer on spousal relationships: a dyadic electronic diary study

Women with metastatic breast cancer (MBC) experience high levels of emotional distress and pain. Although individuals often rely on their intimate partners to provide physical and emotional support when they are in pain, the daily impact of pain on the spousal relationship in the context of advanced cancer is unclear. To understand how relationships are affected by pain, 57 MBC patients and their partners completed electronic diary assessments 6 times a day for 14 days. Patients and partners rated the patient's pain, their own mood (circumplex adjectives), the provision/receipt of social support, and the degree to which cancer interfered with their relationship. Multilevel mediation models with the couple as the unit of analysis were estimated. Partners and patients reported greater relationship interference when patients experienced more pain and less aroused (i.e., more tired, less peppy, less active) mood. Greater tired mood during the day accounted for 17% and 82% of the association between patients' morning pain and their evening ratings of emotional and physical support from their partners, respectively. Partners did not directly respond to patients' pain by providing emotional or physical support; however, they were more likely to provide support when patients experienced more tired and less active mood as a consequence of their pain. Results suggest that one way that pain may wear on couples' relationships is through its adverse effects on patients' daily mood. They also suggest that partners may base their provision of support on their perception of the adverse effects of pain on patients' aroused mood.