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Forrer F, Rubo M, Meyer AH, Munsch S. Binge-eating adolescent treatment (BEAT) - findings from a pilot study on effects and acceptance of a blended treatment program for youth with loss of control eating. BMC Psychol 2023; 11:415. [PMID: 38012794 PMCID: PMC10683190 DOI: 10.1186/s40359-023-01429-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 11/06/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Loss of Control Eating (LOC) is the most prevalent form of eating disorder pathology in youth, but research on evidence-based treatment in this group remains scarce. We assessed for the first time the effects and acceptance of a blended treatment program for youth between 14 and 24 years with LOC (Binge-eating Adolescent Treatment, BEAT). METHODS Twenty-four youths (mean age 19.1 years) participated in an active treatment of nine-weeks including three face-to-face workshops and six weekly email-guided self-help sessions, followed by four email guided follow-up sessions, one, three, six and 12 months after the active treatment. All patients completed a two-weeks waiting-time period before treatment begin (within-subject waitlist control design). RESULTS The number of weekly LOC episodes substantially decreased during both the waiting-time (effect size d = 0.45) and the active treatment (d = 1.01) period and remained stable during the subsequent 12-months follow-up (d = 0.20). The proportion of patients with full-threshold binge-eating disorder (BED) diagnoses decreased and transformed into LOC during the study course, while the abstainer rate of LOC increased. Values for depressive symptoms (d = 1.5), eating disorder pathology (d = 1.29) and appearance-based rejection sensitivity (d = 0.68) all improved on average from pretreatment to posttreatment and remained stable or further improved during follow-up (d between 0.11 and 0.85). Body weight in contrast remained constant within the same period. Treatment satisfaction among completers was high, but so was the dropout rate of 45.8% at the end of the 12-months follow-up. CONCLUSIONS This first blended treatment study BEAT might be well suited to decrease core symptoms of LOC, depressive symptoms and appearance-based rejection sensitivity. More research is needed to establish readily accessible interventions targeted more profoundly at age-salient maintaining factors such as appearance-based rejection sensitivity, while at the same time keeping dropout rates at a low level. TRIAL REGISTRATION The trial was registered at the German Clinical Trials Register (ID: DRKS00014580; registration date: 21/06/2018).
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Affiliation(s)
- Felicitas Forrer
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Rue P.-A.-de-Faucigny 2, Fribourg, 1700, Switzerland.
| | - Marius Rubo
- Department of Psychology, Cognitive Psychology, Perception and Research Methods, University of Bern, Fabrikstrasse 8, 3012, Bern, Switzerland
| | - Andrea H Meyer
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Rue P.-A.-de-Faucigny 2, Fribourg, 1700, Switzerland
- Department of Psychology, Division of Clinical Psychology and Epidemiology, University of Basel, Missionsstrasse 62A, Basel, 4055, Switzerland
| | - Simone Munsch
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Rue P.-A.-de-Faucigny 2, Fribourg, 1700, Switzerland
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2
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Examining reactivity to intensive longitudinal ecological momentary assessment: 12-month prospective study. Eat Weight Disord 2023; 28:26. [PMID: 36849665 PMCID: PMC9971140 DOI: 10.1007/s40519-023-01556-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/16/2023] [Indexed: 03/01/2023] Open
Abstract
PURPOSE To examine the association between intensive, longitudinal ecological momentary assessment (EMA) and self-reported eating behaviors. METHODS Secondary analysis of the EMPOWER study-a 12-month observational study that examined the microprocesses of relapse following intentional weight loss using smartphone-administered EMA-was conducted. Participants were asked to complete four types of EMA surveys using a mobile app. For this analysis, only the number of completed random EMA surveys was used. Using linear mixed-effects modeling, we analyzed whether the number of completed random EMA surveys was associated with changes in self-reported dietary restraint, dietary disinhibition, and susceptibility to hunger measured using the Three-Factor Eating Questionnaire (TFEQ). RESULTS During the 12-month study, 132 participants completed a mean of 1062 random EMA surveys (range: 673-1362). The median time it took for participants to complete random EMA surveys was 20 s and 90% of random EMA surveys were completed within 46 s. The number of completed random EMA surveys was not significantly associated with the TFEQ scores. CONCLUSIONS Intensive longitudinal EMA did not influence self-reported eating behaviors. The findings suggest that EMA can be used to frequently assess real-world eating behaviors with minimal concern about assessment reactivity. Nonetheless, care must be taken when designing EMA surveys-particularly when using self-reported outcome measures. LEVEL OF EVIDENCE Level III, prospective observational study.
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Pruessner L, Hartmann S, Rubel JA, Lalk C, Barnow S, Timm C. Integrating a web-based intervention into routine care of binge-eating disorder: Study protocol for a randomized controlled trial. Internet Interv 2022; 28:100514. [PMID: 35281702 PMCID: PMC8907668 DOI: 10.1016/j.invent.2022.100514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 02/17/2022] [Accepted: 02/18/2022] [Indexed: 12/05/2022] Open
Abstract
Background Although binge eating disorder (BED) is the most common eating pathology and carries a high mental and physical burden, access to specialized treatment is limited due to patient-related barriers and insufficient healthcare resources. Integrating web-based self-help programs into clinical care for BED may address this treatment gap by making evidence-based eating disorder interventions more accessible. Methods A two-armed randomized controlled trial will be conducted to evaluate the effectiveness of a web-based self-help intervention for BED in routine care settings. Patients aged 18-65 years fulfilling the diagnostic criteria for BED (N = 152) will be randomly allocated to (1) an intervention group receiving a 12-week web-based self-help program or (2) a waitlist control group with delayed access to the intervention. The primary outcome will be the number of binge eating episodes. Secondary outcomes include global eating pathology, functional impairments, work capacity, well-being, comorbid psychopathology, self-esteem, and emotion regulation abilities. Measurements will be conducted at baseline (study entrance), 6 weeks after baseline (mid-treatment), and 12 weeks after baseline (post-treatment). To capture outcomes and treatment mechanisms in real-time, traditional self-reports will be combined with weekly symptom monitoring and ecological momentary assessment. Discussion Evaluating the effectiveness of web-based interventions is essential to overcome the treatment gap for patients with BED. When adequately integrated into standard care, these programs have the potential to alleviate the high burden of BED for individuals, their families, and society. Trial registration https://clinicaltrials.gov/ct2/show/NCT04876183, Identifier: NCT04876183 (registered on May 6th, 2021).
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Affiliation(s)
- Luise Pruessner
- Department of Psychology, Heidelberg University, Hauptstr. 47-51, 69117 Heidelberg, Germany
| | - Steffen Hartmann
- Department of Psychology, Heidelberg University, Hauptstr. 47-51, 69117 Heidelberg, Germany
| | - Julian A. Rubel
- Psychotherapy Research Unit, University of Giessen, Otto-Behaghel-Straße 10, 35394 Giessen, Germany
| | - Christopher Lalk
- Psychotherapy Research Unit, University of Giessen, Otto-Behaghel-Straße 10, 35394 Giessen, Germany
| | - Sven Barnow
- Department of Psychology, Heidelberg University, Hauptstr. 47-51, 69117 Heidelberg, Germany
| | - Christina Timm
- Department of Psychology, Heidelberg University, Hauptstr. 47-51, 69117 Heidelberg, Germany
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4
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Hartmann S, Pruessner L, Rubel JA, Lalk C, Barnow S, Timm C. Applying a web-based self-help intervention for bulimia nervosa in routine care: Study protocol for a randomized controlled trial. Internet Interv 2022; 28:100512. [PMID: 35251938 PMCID: PMC8894237 DOI: 10.1016/j.invent.2022.100512] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 02/11/2022] [Accepted: 02/15/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Individuals with bulimia nervosa (BN) experience persistent episodes of binge eating and inappropriate compensatory behavior associated with impaired physical and mental health. Despite the existence of effective treatments, many individuals with BN remain untreated, leading to a high burden and an increased risk of chronicity. Web-based interventions may help facilitate access to evidence-based treatments for BN by reducing barriers to the health care system. METHODS The present study will investigate the effectiveness of a web-based self-help intervention for BN in a two-armed randomized controlled trial. Individuals diagnosed with BN (N = 152) will be randomly assigned to either (1) an intervention group receiving a 12-week web-based intervention or (2) a waitlist control group with delayed access to the intervention. Further assessments will be scheduled 6 (mid-treatment) and 12 (post-treatment) weeks after baseline. Changes in the number of binge eating episodes and compensatory behaviors will be examined as primary outcomes. Secondary outcomes include global eating pathology, functional impairments, well-being, comorbid psychopathology, self-esteem, and emotion regulation abilities. DISCUSSION Adding web-based interventions into routine care is a promising approach to overcome the existing treatment gap for patients with BN. Therefore, the current study will test the effectiveness of a web-based intervention for BN under standard clinical care settings. TRIAL REGISTRATION ClinicalTrials.gov, Identifier: NCT04876196 (registered on May 6th, 2021).
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Affiliation(s)
- Steffen Hartmann
- Department of Psychology, Heidelberg University, Hauptstr. 47-51, 69117 Heidelberg, Germany
| | - Luise Pruessner
- Department of Psychology, Heidelberg University, Hauptstr. 47-51, 69117 Heidelberg, Germany
| | - Julian A. Rubel
- Psychotherapy Research Unit, University of Giessen, Otto-Behaghel-Straße 10, 35394 Giessen, Germany
| | - Christopher Lalk
- Psychotherapy Research Unit, University of Giessen, Otto-Behaghel-Straße 10, 35394 Giessen, Germany
| | - Sven Barnow
- Department of Psychology, Heidelberg University, Hauptstr. 47-51, 69117 Heidelberg, Germany
| | - Christina Timm
- Department of Psychology, Heidelberg University, Hauptstr. 47-51, 69117 Heidelberg, Germany
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5
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Semborski S, Henwood B, Redline B, Dzubur E, Mason T, Intille S. Feasibility and Acceptability of Ecological Momentary Assessment With Young Adults Who Are Currently or Were Formerly Homeless: Mixed Methods Study. JMIR Form Res 2022; 6:e33387. [PMID: 35333187 PMCID: PMC8994151 DOI: 10.2196/33387] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 12/08/2021] [Accepted: 12/29/2021] [Indexed: 12/02/2022] Open
Abstract
Background Ecological momentary assessment (EMA) has been used with young people experiencing homelessness to gather information on contexts associated with homelessness and risk behavior in real time and has proven feasible in this population. However, the extent to which EMA may affect the attitudes or behaviors of young adults who are currently or were formerly homeless and are residing in supportive housing has not been well investigated. Objective This study aims to describe the feedback regarding EMA study participation from young adults who are currently or were formerly homeless and examine the reactivity to EMA participation and compliance. Methods This mixed methods study used cross-sectional data collected before and after EMA, intensive longitudinal data from a 7-day EMA prompting period, and focus groups of young adults who are currently or were formerly homeless in Los Angeles, California, between 2017 and 2019. Results Qualitative data confirmed the quantitative findings. Differences in the experience of EMA between young adults who are currently or were formerly homeless were found to be related to stress or anxiety, interference with daily life, difficulty charging, behavior change, and honesty in responses. Anxiety and depression symptomatology decreased from before to after EMA; however, compliance was not significantly associated with this decrease. Conclusions The results point to special considerations when administering EMA to young adults who are currently or were formerly homeless. EMA appears to be slightly more burdensome for young adults who are currently homeless than for those residing in supportive housing, which are nuances to consider in the study design. The lack of a relationship between study compliance and symptomatology suggests low levels of reactivity.
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Affiliation(s)
- Sara Semborski
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Benjamin Henwood
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Brian Redline
- School of Medicine, Oregon Health and Science University, Portland, OR, United States
| | - Eldin Dzubur
- Suzanne Dworak-Peck School of Social Work, University of Southern California, Los Angeles, CA, United States
| | - Tyler Mason
- Department of Population and Public Health Science, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Stephen Intille
- Khoury College of Computer Sciences, Northeastern University, Boston, MA, United States.,Bouvé College of Health Sciences, Northeastern University, Boston, MA, United States
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6
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Reesor-Oyer L, Parker H, Burkart S, Smith MT, Dugger R, von Klinggraeff L, Weaver RG, Beets MW, Armstrong B. Measuring Micro Temporal Processes Underlying Preschoolers Screen Use and Behavioral Health: Protocol for the Tots & Tech Study (Preprint). JMIR Res Protoc 2022; 11:e36240. [PMID: 36169993 PMCID: PMC9557980 DOI: 10.2196/36240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 08/10/2022] [Accepted: 08/29/2022] [Indexed: 12/19/2022] Open
Abstract
Background Excessive screen time is associated with poor health and behavioral outcomes in children. However, research on screen time use has been hindered by methodological limitations, including retrospective reports of usual screen time and lack of momentary etiologic processes occurring within each day. Objective This study is designed to assess the feasibility and utility of a comprehensive multibehavior protocol to measure the digital media use and screen time context among a racially and economically diverse sample of preschoolers and their families. This paper describes the recruitment, data collection, and analytical protocols for the Tots and Tech study. Methods The Tots and Tech study is a longitudinal, observational study of 100 dyads: caregivers and their preschool-age children (aged 3-5 years). Both caregivers and children will wear an Axivity AX3 accelerometer (Axivity Ltd) for 30 days to assess their physical activity, sedentary behavior, and sleep. Caregivers will complete ecological momentary assessments (EMAs) for 1 week to measure child behavioral problems, caregiver stress, and child screen time. Results The Tots and Tech study was funded in March 2020. This study maintains rolling recruitment, with each dyad on their own assessment schedule, depending on the time of enrollment. Enrollment was scheduled to take place between September 2020 and May 2022. We aim to enroll 100 caregiver-child dyads. The Tots and Tech outcome paper is expected to be published in 2022. Conclusions The Tots and Tech study attempts to overcome previous methodological limitations by using objective measures of screen time, physical activity, sedentary behavior, and sleep behaviors with contextual factors measured by EMA. The results will be used to evaluate the feasibility and utility of a comprehensive multibehavior protocol using objective measures of mobile screen time and accelerometry in conjunction with EMA among caregiver-child dyads. Future observational and intervention studies will be able to use this study protocol to better measure screen time and its context. International Registered Report Identifier (IRRID) DERR1-10.2196/36240
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Affiliation(s)
- Layton Reesor-Oyer
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Hannah Parker
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Sarah Burkart
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Michal T Smith
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Roddrick Dugger
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Lauren von Klinggraeff
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - R Glenn Weaver
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Michael W Beets
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
| | - Bridget Armstrong
- Department of Exercise Science, University of South Carolina, Columbia, SC, United States
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7
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Wyssen A, Meyer AH, Messerli-Bürgy N, Forrer F, Vanhulst P, Lalanne D, Munsch S. BED-online: Acceptance and efficacy of an internet-based treatment for binge-eating disorder: A randomized clinical trial including waitlist conditions. EUROPEAN EATING DISORDERS REVIEW 2021; 29:937-954. [PMID: 34418221 PMCID: PMC9292199 DOI: 10.1002/erv.2856] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/04/2021] [Accepted: 07/31/2021] [Indexed: 01/21/2023]
Abstract
Objective Internet‐based guided self‐help (GSH) programs increase accessibility and utilization of evidence‐based treatments in binge‐eating disorder (BED). We evaluated acceptance and short as well as long‐term efficacy of our 8‐session internet‐based GSH program in a randomized clinical trial with an immediate treatment group, and two waitlist control groups, which differed with respect to whether patients received positive expectation induction during waiting or not. Method Sixty‐three patients (87% female, mean age 37.2 years) followed the eight‐session guided cognitive‐behavioural internet‐based program and three booster sessions in a randomized clinical trial design including an immediate treatment and two waitlist control conditions. Outcomes were treatment acceptance, number of weekly binge‐eating episodes, eating disorder pathology, depressiveness, and level of psychosocial functioning. Results Treatment satisfaction was high, even though 27% of all patients dropped out during the active treatment and 9.5% during the follow‐up period of 6 months. The treatment, in contrast to the waiting conditions, led to a significant reduction of weekly binge‐eating episodes from 3.4 to 1.7 with no apparent rebound effect during follow‐up. All other outcomes improved as well during active treatment. Email‐based positive expectation induction during waiting period prior to the treatment did not have an additional beneficial effect on the temporal course and thus treatment success, of binge episodes in this study. Conclusion This short internet‐based program was clearly accepted and highly effective regarding core features of BED. Dropout rates were higher in the active and lower in the follow‐up period. Positive expectations did not have an impact on treatment effects. The present internet‐based guided self‐help program adds to the existing research regarding online treatment of binge‐eating disorder and is currently one of the two existing validated programs available in German language. It is based on an established cognitive‐behavioural treatment approach, shows high acceptance by patients and high efficacy after eight guided online sessions, thereby representing the shortest duration of currently evaluated treatments During the internet‐based therapy, the number of weekly binge‐eating episodes, depressive symptoms, eating disorder pathology as well as impairments in psychosocial functioning all significantly decreased. These positive effects were maintained during follow‐up (6 months). Abstainer rate (no binge‐eating during last month) continued to increase during follow‐up with booster sessions An email‐based pre‐treatment positive expectation induction did not alter the temporal course and thus treatment success, of binge episodes
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Affiliation(s)
- Andrea Wyssen
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Andrea H Meyer
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland.,Institute of Psychology, Clinical Psychology and Epidemiology, University of Basel, Basel, Switzerland
| | - Nadine Messerli-Bürgy
- Department of Psychology, Clinical Child Psychology & Biological Psychology, University of Fribourg, Fribourg, Switzerland
| | - Felicitas Forrer
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland
| | - Pierre Vanhulst
- Department of Informatics, Human-IST Institute, University of Fribourg, Fribourg, Switzerland
| | - Denis Lalanne
- Department of Informatics, Human-IST Institute, University of Fribourg, Fribourg, Switzerland
| | - Simone Munsch
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland
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Shui X, Zhang M, Li Z, Hu X, Wang F, Zhang D. A dataset of daily ambulatory psychological and physiological recording for emotion research. Sci Data 2021; 8:161. [PMID: 34183677 PMCID: PMC8239004 DOI: 10.1038/s41597-021-00945-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 04/28/2021] [Indexed: 02/06/2023] Open
Abstract
To better understand the psychological and physiological basis of human emotion, increasing interest has been drawn towards ambulatory recordings of emotion-related data beyond the laboratories. By employing smartphones-based ambulatory assessment and wrist-worn physiological recording devices, the Daily Ambulatory Psychological and Physiological recording for Emotion Research (DAPPER) dataset provides momentary self-reports and physiological data of people's emotional experiences in their daily life. The dataset consists of ambulatory psychological recordings from 142 participants and physiological recordings from 88 of them over five days. Both the experience sampling method (ESM) and the day reconstruction method (DRM) were employed to have a comprehensive description of the participants' daily emotional experiences. Heart rate, galvanic skin response, and three-axis acceleration were recorded during the day time. By including multiple types of physiological and self-report data at a scale of five days with 100+ participants, the present dataset is expected to promote emotion researches in real-life, daily settings.
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Affiliation(s)
- Xinyu Shui
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing, China
| | - Mi Zhang
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing, China
| | - Zhuoran Li
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing, China
| | - Xin Hu
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing, China
| | - Fei Wang
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing, China
- Tsinghua Laboratory of Brain and Intelligence, Tsinghua University, Beijing, China
| | - Dan Zhang
- Department of Psychology, School of Social Sciences, Tsinghua University, Beijing, China.
- Tsinghua Laboratory of Brain and Intelligence, Tsinghua University, Beijing, China.
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Williams MT, Lewthwaite H, Fraysse F, Gajewska A, Ignatavicius J, Ferrar K. Compliance With Mobile Ecological Momentary Assessment of Self-Reported Health-Related Behaviors and Psychological Constructs in Adults: Systematic Review and Meta-analysis. J Med Internet Res 2021; 23:e17023. [PMID: 33656451 PMCID: PMC7970161 DOI: 10.2196/17023] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 03/01/2020] [Accepted: 10/31/2020] [Indexed: 01/08/2023] Open
Abstract
Background Mobile ecological momentary assessment (mEMA) permits real-time capture of self-reported participant behaviors and perceptual experiences. Reporting of mEMA protocols and compliance has been identified as problematic within systematic reviews of children, youth, and specific clinical populations of adults. Objective This study aimed to describe the use of mEMA for self-reported behaviors and psychological constructs, mEMA protocol and compliance reporting, and associations between key components of mEMA protocols and compliance in studies of nonclinical and clinical samples of adults. Methods In total, 9 electronic databases were searched (2006-2016) for observational studies reporting compliance to mEMA for health-related data from adults (>18 years) in nonclinical and clinical settings. Screening and data extraction were undertaken by independent reviewers, with discrepancies resolved by consensus. Narrative synthesis described participants, mEMA target, protocol, and compliance. Random effects meta-analysis explored factors associated with cohort compliance (monitoring duration, daily prompt frequency or schedule, device type, training, incentives, and burden score). Random effects analysis of variance (P≤.05) assessed differences between nonclinical and clinical data sets. Results Of the 168 eligible studies, 97/105 (57.7%) reported compliance in unique data sets (nonclinical=64/105 [61%], clinical=41/105 [39%]). The most common self-reported mEMA target was affect (primary target: 31/105, 29.5% data sets; secondary target: 50/105, 47.6% data sets). The median duration of the mEMA protocol was 7 days (nonclinical=7, clinical=12). Most protocols used a single time-based (random or interval) prompt type (69/105, 65.7%); median prompt frequency was 5 per day. The median number of items per prompt was similar for nonclinical (8) and clinical data sets (10). More than half of the data sets reported mEMA training (84/105, 80%) and provision of participant incentives (66/105, 62.9%). Less than half of the data sets reported number of prompts delivered (22/105, 21%), answered (43/105, 41%), criterion for valid mEMA data (37/105, 35.2%), or response latency (38/105, 36.2%). Meta-analysis (nonclinical=41, clinical=27) estimated an overall compliance of 81.9% (95% CI 79.1-84.4), with no significant difference between nonclinical and clinical data sets or estimates before or after data exclusions. Compliance was associated with prompts per day and items per prompt for nonclinical data sets. Although widespread heterogeneity existed across analysis (I2>90%), no compelling relationship was identified between key features of mEMA protocols representing burden and mEMA compliance. Conclusions In this 10-year sample of studies using the mEMA of self-reported health-related behaviors and psychological constructs in adult nonclinical and clinical populations, mEMA was applied across contexts and health conditions and to collect a range of health-related data. There was inconsistent reporting of compliance and key features within protocols, which limited the ability to confidently identify components of mEMA schedules likely to have a specific impact on compliance.
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Affiliation(s)
- Marie T Williams
- Innovation, Implementation And Clinical Translation in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Hayley Lewthwaite
- Innovation, Implementation And Clinical Translation in Health, Allied Health and Human Performance, University of South Australia, Adelaide, Australia.,Department of Kinesiology and Physical Education, Faculty of Education, McGill University, Montreal, QC, Canada
| | - François Fraysse
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Alexandra Gajewska
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Jordan Ignatavicius
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
| | - Katia Ferrar
- Alliance for Research in Exercise, Nutrition and Activity, Allied Health and Human Performance, University of South Australia, Adelaide, Australia
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10
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Do B, Wang SD, Naya CH, Dunton GF, Mason TB. Momentary and personal characteristics predicting maternal fruit and vegetable preparation for children using ecological momentary assessment. Eat Behav 2021; 41:101492. [PMID: 33677396 PMCID: PMC8131213 DOI: 10.1016/j.eatbeh.2021.101492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 12/02/2020] [Accepted: 02/13/2021] [Indexed: 11/20/2022]
Abstract
A large body of literature on child-focused research regarding healthy eating within the family context has focused on behavioral management strategies, such as reinforcement, or parental modeling through personal intake or encouragement. However, food preparation behaviors among mothers have been understudied. Also unknown is how maternal food preparation behaviors vary across population subgroups and contexts. The study objective was to elucidate momentary characteristics (i.e., time of day, weekday, and family meals) and personal characteristics (i.e., ethnicity, working status, household characteristics, body mass index, income, and child's age) associated with maternal fruit and vegetable (F/V) preparation through ecological momentary assessment (EMA). 186 mothers (Mage = 40.81) of children (Mage = 9.61, 49.5% female) completed six semi-annual waves, each lasting seven days. Mothers completed up to eight EMA surveys a day, which assessed family meals and F/V preparation, and reported personal characteristics through paper questionnaires. Multilevel generalized estimating equations examined the likelihood of F/V preparation. Momentary, within-day characteristics (i.e., occurrence of family meals, weekdays, afternoons) were associated with greater likelihood of mothers' fresh F/V preparation (ps < 0.05). Additionally, personal characteristics such as non-Hispanic ethnicity, not working full-time, having a child aged six months to five years in the household, and lower child BMI-z were associated with greater fresh F/V preparation among mothers (ps < 0.05). Findings may inform family-based obesity and nutrition intervention programs by understanding which families and in what contexts mothers are more likely to prepare F/Vs.
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Affiliation(s)
- Bridgette Do
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Shirlene D Wang
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Christine H Naya
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F Dunton
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA; Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Tyler B Mason
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
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11
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Wyssen A, Leins J, Reichenberger J, Blechert J, Munsch S, Steins-Loeber S. Body-related cognitive distortions (thought-shape fusion body) associated with thin-ideal exposure in female students-An ecological momentary assessment study. Clin Psychol Psychother 2020; 27:220-227. [PMID: 31868277 DOI: 10.1002/cpp.2421] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 11/28/2019] [Accepted: 12/19/2019] [Indexed: 11/07/2022]
Abstract
Etiological models of eating disorders (EDs) describe body dissatisfaction (BD)as one of the major influences fostering dysfunctional body-related behaviour and disordered eating behaviour. BD is influenced by repeated exposure to thin ideals that evoke high self-ideal discrepancy and result in body-related cognitive distortions such as thought-shape fusion body (TSF-B). The aim of this study was to investigate the covariation of daily media exposure and the experience of TSF-B in a naturalistic setting. It was further analysed whether TSF-B is associated with self-ideal discrepancy, dysfunctional body-related behaviour, and disordered eating behaviour. Moreover, person-related predictors of TSF-B were explored. Altogether, 51healthy female students (mean age 21.06years, SD = 1.76) participated in an ecological momentary assessment study with four daily surveys during 10consecutive days. Exposure with thin ideals in contrast to exposure to unspecific media contents went along with the experience of TSF-B. TSF-B was associated with higher self-ideal discrepancy and dysfunctional body-related behaviour as well as more pronounced disordered eating behaviour, suggesting that TSF-B is a common phenomenon in young healthy females' everyday life. A main effect of trait measures (e.g., pre-existing BD) on TSF-B was observable but has no moderating effect. Thus, a specific vulnerability has not been detected.
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Affiliation(s)
- Andrea Wyssen
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland
| | - Judith Leins
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich University of Bamberg, Bamberg, Germany
| | - Julia Reichenberger
- Department of Psychology, Centre for Cognitive Neuroscience, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Jens Blechert
- Department of Psychology, Centre for Cognitive Neuroscience, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Simone Munsch
- Department of Psychology, Clinical Psychology and Psychotherapy, University of Fribourg, Fribourg, Switzerland
| | - Sabine Steins-Loeber
- Department of Clinical Psychology and Psychotherapy, Otto-Friedrich University of Bamberg, Bamberg, Germany
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12
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Rupp C, Falke C, Gühne D, Doebler P, Andor F, Buhlmann U. A study on treatment sensitivity of ecological momentary assessment in obsessive-compulsive disorder. Clin Psychol Psychother 2019; 26:695-706. [PMID: 31365952 DOI: 10.1002/cpp.2392] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 06/21/2019] [Accepted: 07/24/2019] [Indexed: 11/11/2022]
Abstract
As part of a larger clinical trial, this ecological momentary assessment (EMA) study pursued the main goal of demonstrating that the EMA method is sensitive to treatment effects of detached mindfulness and cognitive restructuring for obsessive-compulsive disorder (OCD). A second goal was to provide a descriptive analysis of OCD symptoms and influencing factors in participants' everyday lives. Thirty-nine participants were included in the final analyses. EMA sampling involved a smartphone and comprised 4 days with 10 random prompts per day both before (Pre-Treatment EMA) and after the completion of a 2-week clinical intervention of either detached mindfulness or cognitive restructuring (Post-Treatment EMA) that participants had been randomly allocated to. The EMA questionnaire included items on the frequency of obsessions, subjective burden due to obsessions, perceived current stress, emotions, and on the frequency of compulsions and other dysfunctional behaviors. Descriptive Pre-Treatment EMA results highlight the importance of compulsions and emotional states of tension/discomfort in OCD. Pre-Post comparisons showed a significant reduction of avoidance behavior, obsessions, and burden due to obsessions, with a nonsignificant trend also indicating a reduction of compulsions. There was no pre to post effect concerning emotions. This study adds to the existing research on OCD symptoms and offers further evidence in confirmation of established theoretical models of OCD. Also, our results can be taken as evidence for treatment sensitivity of the EMA method in OCD. Further research is needed to replicate, broaden, and generalize our results.
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Affiliation(s)
- Christian Rupp
- Institute of Psychology, Westfälische Wilhelms-University Münster, Münster, Germany.,Christoph-Dornier-Stiftung, Münster, Germany
| | - Charlotte Falke
- Institute of Psychology, Westfälische Wilhelms-University Münster, Münster, Germany.,Christoph-Dornier-Stiftung, Münster, Germany
| | - Daniela Gühne
- Department of Statistics, TU Dortmund University, Dortmund, Germany
| | - Philipp Doebler
- Department of Statistics, TU Dortmund University, Dortmund, Germany
| | | | - Ulrike Buhlmann
- Institute of Psychology, Westfälische Wilhelms-University Münster, Münster, Germany
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13
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Kim J, Marcusson-Clavertz D, Togo F, Park H. A Practical Guide to Analyzing Time-Varying Associations between Physical Activity and Affect Using Multilevel Modeling. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2018; 2018:8652034. [PMID: 30105083 PMCID: PMC6076963 DOI: 10.1155/2018/8652034] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 05/15/2018] [Accepted: 05/24/2018] [Indexed: 11/29/2022]
Abstract
There is growing interest in within-person associations of objectively measured physical and physiological variables with psychological states in daily life. Here we provide a practical guide with SAS code of multilevel modeling for analyzing physical activity data obtained by accelerometer and self-report data from intensive and repeated measures using ecological momentary assessments (EMA). We review previous applications of EMA in research and clinical settings and the analytical tools that are useful for EMA research. We exemplify the analyses of EMA data with cases on physical activity data and affect and discuss the future challenges in the field.
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Affiliation(s)
- Jinhyuk Kim
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
| | - David Marcusson-Clavertz
- Department of Biobehavioral Health, The Pennsylvania State University, University Park, PA, USA
- Department of Psychology, Lund University, Lund, Sweden
| | - Fumiharu Togo
- Educational Physiology Laboratory, Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Hyuntae Park
- Department of Health Care and Science, College of Health Science, Dong-A University, Busan, Republic of Korea
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14
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Verhagen SJW, Simons CJP, van Zelst C, Delespaul PAEG. Constructing a Reward-Related Quality of Life Statistic in Daily Life-a Proof of Concept Study Using Positive Affect. Front Psychol 2017; 8:1917. [PMID: 29163294 PMCID: PMC5673660 DOI: 10.3389/fpsyg.2017.01917] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/16/2017] [Indexed: 12/25/2022] Open
Abstract
Background: Mental healthcare needs person-tailored interventions. Experience Sampling Method (ESM) can provide daily life monitoring of personal experiences. This study aims to operationalize and test a measure of momentary reward-related Quality of Life (rQoL). Intuitively, quality of life improves by spending more time on rewarding experiences. ESM clinical interventions can use this information to coach patients to find a realistic, optimal balance of positive experiences (maximize reward) in daily life. rQoL combines the frequency of engaging in a relevant context (a 'behavior setting') with concurrent (positive) affect. High rQoL occurs when the most frequent behavior settings are combined with positive affect or infrequent behavior settings co-occur with low positive affect. Methods: Resampling procedures (Monte Carlo experiments) were applied to assess the reliability of rQoL using various behavior setting definitions under different sampling circumstances, for real or virtual subjects with low-, average- and high contextual variability. Furthermore, resampling was used to assess whether rQoL is a distinct concept from positive affect. Virtual ESM beep datasets were extracted from 1,058 valid ESM observations for virtual and real subjects. Results: Behavior settings defined by Who-What contextual information were most informative. Simulations of at least 100 ESM observations are needed for reliable assessment. Virtual ESM beep datasets of a real subject can be defined by Who-What-Where behavior setting combinations. Large sample sizes are necessary for reliable rQoL assessments, except for subjects with low contextual variability. rQoL is distinct from positive affect. Conclusion: rQoL is a feasible concept. Monte Carlo experiments should be used to assess the reliable implementation of an ESM statistic. Future research in ESM should asses the behavior of summary statistics under different sampling situations. This exploration is especially relevant in clinical implementation, where often only small datasets are available.
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Affiliation(s)
- Simone J W Verhagen
- Department of Psychiatry and Neuropsychology, Faculty of Health Medicine and Lifesciences, Maastricht University, Maastricht, Netherlands
| | - Claudia J P Simons
- Department of Psychiatry and Neuropsychology, Faculty of Health Medicine and Lifesciences, Maastricht University, Maastricht, Netherlands.,GGzE Institute of Mental Health Care Eindhoven and De Kempen, Eindhoven, Netherlands
| | - Catherine van Zelst
- Department of Psychiatry and Neuropsychology, Faculty of Health Medicine and Lifesciences, Maastricht University, Maastricht, Netherlands
| | - Philippe A E G Delespaul
- Department of Psychiatry and Neuropsychology, Faculty of Health Medicine and Lifesciences, Maastricht University, Maastricht, Netherlands.,Department of Adult Psychiatry, Mondriaan Mental Health Trust, Heerlen, Netherlands
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15
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Nicholls W, Devonport TJ, Blake M. The association between emotions and eating behaviour in an obese population with binge eating disorder. Obes Rev 2016; 17:30-42. [PMID: 26644173 DOI: 10.1111/obr.12329] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2015] [Revised: 08/30/2015] [Accepted: 08/30/2015] [Indexed: 01/23/2023]
Abstract
There is utility in understanding the antecedents of binge eating (BE), with a view to explaining poorer weight loss treatment responses in this subgroup. A systematic review was completed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines with the aim of exploring associations between emotions and eating behaviour in a population affected by obesity and binge eating disorder (BED). A comprehensive literature search of four electronic databases (2004-2014) yielded 15 studies for inclusion. Included studies performed poorly on data quality analysis with respect to controlling for confounding variables, and sample size. Included papers largely focused on negative emotions as antecedents of BE; depression was consistently associated with a BED-obese classification and BE. Negative mood, sadness, tension and instability of emotions were found to be antecedents of BE in an adult BED-obese sample. However, findings were mixed regarding the role of stress, anger and positive emotions within the BED-obese population. Recommendations are presented for the identification of BED, and ecologically valid experimental designs that further understanding of the complex and varied emotions that associate with BE. The implications of these and other limitations for both researchers and practitioners are discussed. The paper concludes with recommendations for future research alongside suggestions for practitioners. © 2015 World Obesity.
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Affiliation(s)
- W Nicholls
- Institute of Psychology, University of Wolverhampton, Wolverhampton, UK
| | - T J Devonport
- Institute of Sport, University of Wolverhampton, Wolverhampton, UK
| | - M Blake
- Institute of Sport, University of Wolverhampton, Wolverhampton, UK
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16
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Dziak JJ, Li R, Tan X, Shiffman S, Shiyko MP. Modeling intensive longitudinal data with mixtures of nonparametric trajectories and time-varying effects. Psychol Methods 2015; 20:444-69. [PMID: 26390169 PMCID: PMC4679529 DOI: 10.1037/met0000048] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Behavioral scientists increasingly collect intensive longitudinal data (ILD), in which phenomena are measured at high frequency and in real time. In many such studies, it is of interest to describe the pattern of change over time in important variables as well as the changing nature of the relationship between variables. Individuals' trajectories on variables of interest may be far from linear, and the predictive relationship between variables of interest and related covariates may also change over time in a nonlinear way. Time-varying effect models (TVEMs; see Tan, Shiyko, Li, Li, & Dierker, 2012) address these needs by allowing regression coefficients to be smooth, nonlinear functions of time rather than constants. However, it is possible that not only observed covariates but also unknown, latent variables may be related to the outcome. That is, regression coefficients may change over time and also vary for different kinds of individuals. Therefore, we describe a finite mixture version of TVEM for situations in which the population is heterogeneous and in which a single trajectory would conceal important, interindividual differences. This extended approach, MixTVEM, combines finite mixture modeling with non- or semiparametric regression modeling, to describe a complex pattern of change over time for distinct latent classes of individuals. The usefulness of the method is demonstrated in an empirical example from a smoking cessation study. We provide a versatile SAS macro and R function for fitting MixTVEMs.
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Affiliation(s)
- John J Dziak
- The Methodology Center, The Pennsylvania State University
| | - Runze Li
- Department of Statistics, The Pennsylvania State University
| | - Xianming Tan
- Research Institute of the McGill University Health Centre, McGill University
| | | | - Mariya P Shiyko
- Department of Counseling and Applied Educational Psychology, Northeastern University
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17
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Dunton GF, Liao Y, Dzubur E, Leventhal AM, Huh J, Gruenewald T, Margolin G, Koprowski C, Tate E, Intille S. Investigating within-day and longitudinal effects of maternal stress on children's physical activity, dietary intake, and body composition: Protocol for the MATCH study. Contemp Clin Trials 2015; 43:142-54. [PMID: 25987483 PMCID: PMC4861058 DOI: 10.1016/j.cct.2015.05.007] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 05/11/2015] [Accepted: 05/13/2015] [Indexed: 10/23/2022]
Abstract
Parental stress is an understudied factor that may compromise parenting practices related to children's dietary intake, physical activity, and obesity. However, studies examining these associations have been subject to methodological limitations, including cross-sectional designs, retrospective measures, a lack of stress biomarkers, and the tendency to overlook momentary etiologic processes occurring within each day. This paper describes the recruitment, data collection, and data analytic protocols for the MATCH (Mothers And Their Children's Health) study, a longitudinal investigation using novel real-time data capture strategies to examine within-day associations of maternal stress with children's physical activity and dietary intake, and how these effects contribute to children's obesity risk. In the MATCH study, 200 mothers and their 8 to 12 year-old children are participating in 6 semi-annual assessment waves across 3 years. At each wave, measures for mother-child dyads include: (a) real-time Ecological Momentary Assessment (EMA) of self-reported daily psychosocial stressors (e.g., work at a job, family demands), feeling stressed, perceived stress, parenting practices, dietary intake, and physical activity with time and location stamps; (b) diurnal salivary cortisol patterns, accelerometer-monitored physical activity, and 24-hour dietary recalls; (c) retrospective questionnaires of sociodemographic, cultural, family, and neighborhood covariates; and (d) height, weight, and waist circumference. Putative within-day and longitudinal effects of maternal stress on children's dietary intake, physical activity, and body composition will be tested through multilevel modeling and latent growth curve models, respectively. The results will inform interventions that help mothers reduce the negative effects of stress on weight-related parenting practices and children's obesity risk.
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Affiliation(s)
- Genevieve F Dunton
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA.
| | - Yue Liao
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Eldin Dzubur
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Adam M Leventhal
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Jimi Huh
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Tara Gruenewald
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Gayla Margolin
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Carol Koprowski
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Eleanor Tate
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
| | - Stephen Intille
- Department of Preventive Medicine, University of Southern California, 2001 N. Soto Street, 3rd floor, Rm 302E, MC 9239, Los Angeles, CA 90033-9045, USA
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18
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Reaction Times to Appearance-Related or Non-appearance-Related Word Choice Among Women With and Without Eating Psychopathology. COGNITIVE THERAPY AND RESEARCH 2014. [DOI: 10.1007/s10608-014-9653-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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19
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Shiyko MP, Burkhalter J, Li R, Park BJ. Modeling nonlinear time-dependent treatment effects: an application of the generalized time-varying effect model (TVEM). J Consult Clin Psychol 2014; 82:760-72. [PMID: 24364799 PMCID: PMC4067470 DOI: 10.1037/a0035267] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The goal of this article is to introduce to social and behavioral scientists the generalized time-varying effect model (TVEM), a semiparametric approach for investigating time-varying effects of a treatment. The method is best suited for data collected intensively over time (e.g., experience sampling or ecological momentary assessments) and addresses questions pertaining to effects of treatment changing dynamically with time. Thus, of interest is the description of timing, magnitude, and (nonlinear) patterns of the effect. METHOD Our presentation focuses on practical aspects of the model. A step-by-step demonstration is presented in the context of an empirical study designed to evaluate effects of surgical treatment on quality of life among early stage lung cancer patients during posthospitalization recovery (N = 59; 61% female, M age = 66.1 years). Frequency and level of distress associated with physical symptoms were assessed twice daily over a 2-week period, providing a total of 1,544 momentary assessments. RESULTS Traditional analyses (analysis of covariance [ANCOVA], repeated-measures ANCOVA, and multilevel modeling) yielded findings of no group differences. In contrast, generalized TVEM identified a pattern of the effect that varied in time and magnitude. Group differences manifested after Day 4. CONCLUSIONS Generalized TVEM is a flexible statistical approach that offers insight into the complexity of treatment effects and allows modeling of nonnormal outcomes. The practical demonstration, shared syntax, and availability of a free set of macros aim to encourage researchers to apply TVEM to complex data and stimulate important scientific discoveries.
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Affiliation(s)
- Mariya P. Shiyko
- Department of Counseling & Applied Educational Psychology Bouvé College of Health Sciences, Northeastern University 404 INV, 360 Huntington Ave Boston, MA 02115 617-373-7527
| | - Jack Burkhalter
- Department of Psychiatry & Behavioral Sciences Memorial Sloan-Kettering Cancer Institute
| | - Runze Li
- Department of Statistics and The Methodology Center Pennsylvania State University
| | - Bernard J. Park
- Chief of Thoracic Surgery Hackensack University Medical Center
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20
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Fischer S, Meyer AH, Dremmel D, Schlup B, Munsch S. Short-term Cognitive-Behavioral Therapy for Binge Eating Disorder: Long-term efficacy and predictors of long-term treatment success. Behav Res Ther 2014; 58:36-42. [DOI: 10.1016/j.brat.2014.04.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2014] [Revised: 04/25/2014] [Accepted: 04/28/2014] [Indexed: 10/25/2022]
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21
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Holmes M, Fuller-Tyszkiewicz M, Skouteris H, Broadbent J. Tests of an extension of the dual pathway model of bulimic symptoms to the state-based level. Eat Behav 2014; 15:280-5. [PMID: 24854819 DOI: 10.1016/j.eatbeh.2014.03.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Revised: 01/16/2014] [Accepted: 03/11/2014] [Indexed: 11/16/2022]
Abstract
The dual pathway model proposes that trait body dissatisfaction leads to bulimic symptoms via two distinct pathways: dieting and trait negative affect. As many of these modelled variables have state-based equivalents, the present study evaluated the generalisability of this model to predict associations between state body dissatisfaction and instances of disordered eating. 124 women aged 18 to 40 years completed an online survey (accessed via a mobile phone device with web access) over a 7-day period. The mobile phone device prompted participants at random intervals seven times daily to self-report their state body dissatisfaction, current mood experiences, dieting attempts, and disordered eating practices. Multi-level mediation modelling revealed that both negative mood states and dieting significantly mediated the state body dissatisfaction-disordered eating relationships, although the strength of these associations depended on the aspect of disordered eating measured and individual differences in trait body dissatisfaction, internalization of appearance standards, tendency towards dieting, and BMI. Collectively, these results not only support adapting the dual pathway model to the state-level, but also suggest that several of the model implied pathways may be more relevant for individuals with more pathological eating- and body-related concerns and behaviours.
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Affiliation(s)
| | | | - Helen Skouteris
- School of Psychology, Deakin University, Victoria, Australia
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22
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Dunton GF, Dzubur E, Kawabata K, Yanez B, Bo B, Intille S. Development of a smartphone application to measure physical activity using sensor-assisted self-report. Front Public Health 2014; 2:12. [PMID: 24616888 PMCID: PMC3937780 DOI: 10.3389/fpubh.2014.00012] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 01/27/2014] [Indexed: 11/13/2022] Open
Abstract
Introduction: Despite the known advantages of objective physical activity monitors (e.g., accelerometers), these devices have high rates of non-wear, which leads to missing data. Objective activity monitors are also unable to capture valuable contextual information about behavior. Adolescents recruited into physical activity surveillance and intervention studies will increasingly have smartphones, which are miniature computers with built-in motion sensors. Methods: This paper describes the design and development of a smartphone application (“app”) called Mobile Teen that combines objective and self-report assessment strategies through (1) sensor-informed context-sensitive ecological momentary assessment (CS-EMA) and (2) sensor-assisted end-of-day recall. Results: The Mobile Teen app uses the mobile phone’s built-in motion sensor to automatically detect likely bouts of phone non-wear, sedentary behavior, and physical activity. The app then uses transitions between these inferred states to trigger CS-EMA self-report surveys measuring the type, purpose, and context of activity in real-time. The end of the day recall component of the Mobile Teen app allows users to interactively review and label their own physical activity data each evening using visual cues from automatically detected major activity transitions from the phone’s built-in motion sensors. Major activity transitions are identified by the app, which cues the user to label that “chunk,” or period, of time using activity categories. Conclusion: Sensor-driven CS-EMA and end-of-day recall smartphone apps can be used to augment physical activity data collected by objective activity monitors, filling in gaps during non-wear bouts and providing additional real-time data on environmental, social, and emotional correlates of behavior. Smartphone apps such as these have potential for affordable deployment in large-scale epidemiological and intervention studies.
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Affiliation(s)
- Genevieve Fridlund Dunton
- Department of Preventive Medicine, University of Southern California , Los Angeles, CA , USA ; Department of Psychology, University of Southern California , Los Angeles, CA , USA
| | - Eldin Dzubur
- Department of Preventive Medicine, University of Southern California , Los Angeles, CA , USA
| | - Keito Kawabata
- Department of Preventive Medicine, University of Southern California , Los Angeles, CA , USA
| | - Brenda Yanez
- Department of Preventive Medicine, University of Southern California , Los Angeles, CA , USA
| | - Bin Bo
- College of Computer and Information Science, Northeastern University , Boston, MA , USA
| | - Stephen Intille
- College of Computer and Information Science, Northeastern University , Boston, MA , USA ; Bouvé College of Health Sciences, Northeastern University , Boston, MA , USA
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23
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Fuller-Tyszkiewicz M, Skouteris H, Richardson B, Blore J, Holmes M, Mills J. Does the burden of the experience sampling method undermine data quality in state body image research? Body Image 2013; 10:607-13. [PMID: 23856302 DOI: 10.1016/j.bodyim.2013.06.003] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2013] [Revised: 06/11/2013] [Accepted: 06/11/2013] [Indexed: 11/17/2022]
Abstract
Despite growing popularity of experience sampling methodology (ESM) for evaluations of state-based components of body image, there have been concerns that the frequent repeated measurement might encourage problematic responding resulting in low data quantity and/or quality. Using a sample of 105 women (mean age=24.84), this study used multilevel modelling to investigate whether (a) there were changes in compliance or response variability across a 7-day period, and (b) whether such changes are explained by participant characteristics. Present findings suggest that demands of ESM protocol undermine quantity more so than quality of obtained data. Decline in procedural compliance across the testing period correlated with BMI and body shame, whereas reduced variability in state-based assessments did not adversely impact the strength of association between state body satisfaction ratings and other variables in the dataset. The authors make several recommendations for ensuring the quality of ESM-based data in future studies.
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24
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Is intensive measurement of body image reactive? A two-study evaluation using Ecological Momentary Assessment suggests not. Body Image 2013; 10:35-44. [PMID: 22999225 PMCID: PMC3532563 DOI: 10.1016/j.bodyim.2012.08.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 08/14/2012] [Accepted: 08/14/2012] [Indexed: 11/21/2022]
Abstract
Intensive assessment methods (e.g., Ecological Momentary Assessment [EMA]) are increasingly used to capture body image experiences in daily life. One concern with EMA is multiple assessments may increase reactivity to internal or external cues, potentially biasing measurement. Reactivity to EMA was evaluated in two studies (Study 1: N=63 female undergraduates, Study 2: N=131 women with high body dissatisfaction/disordered eating). Participants completed five daily surveys on handheld computers for 1-2 weeks and body image-related questionnaires at the start and end of each study. Results showed no systematic changes in pre- and post-EMA measures or momentary EMA reports, suggesting women were not reactive to the EMA protocols. Completing 1-2 weeks of EMA does not appear to affect body dissatisfaction, mood, or attitudes in non-clinical or at-risk samples of women. These studies provide evidence that EMA methods can be used to assess real-world body image experiences without undue concern about measurement reactivity.
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25
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Munsch S, Meyer AH, Biedert E. Efficacy and predictors of long-term treatment success for Cognitive-Behavioral Treatment and Behavioral Weight-Loss-Treatment in overweight individuals with binge eating disorder. Behav Res Ther 2012; 50:775-85. [DOI: 10.1016/j.brat.2012.08.009] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2012] [Revised: 08/28/2012] [Accepted: 08/29/2012] [Indexed: 10/27/2022]
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Munsch S, Meyer AH, Quartier V, Wilhelm FH. Binge eating in binge eating disorder: a breakdown of emotion regulatory process? Psychiatry Res 2012; 195:118-24. [PMID: 21849214 DOI: 10.1016/j.psychres.2011.07.016] [Citation(s) in RCA: 71] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2010] [Revised: 06/09/2011] [Accepted: 07/07/2011] [Indexed: 11/27/2022]
Abstract
Current explanatory models for binge eating in binge eating disorder (BED) mostly rely on models for bulimia nervosa (BN), although research indicates different antecedents for binge eating in BED. This study investigates antecedents and maintaining factors in terms of positive mood, negative mood and tension in a sample of 22 women with BED using ecological momentary assessment over a 1-week. Values for negative mood were higher and those for positive mood lower during binge days compared with non-binge days. During binge days, negative mood and tension both strongly and significantly increased and positive mood strongly and significantly decreased at the first binge episode, followed by a slight though significant, and longer lasting decrease (negative mood, tension) or increase (positive mood) during a 4-h observation period following binge eating. Binge eating in BED seems to be triggered by an immediate breakdown of emotion regulation. There are no indications of an accumulation of negative mood triggering binge eating followed by immediate reinforcing mechanisms in terms of substantial and stable improvement of mood as observed in BN. These differences implicate a further specification of etiological models and could serve as a basis for developing new treatment approaches for BED.
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Affiliation(s)
- Simone Munsch
- University of Fribourg, Department of Psychology, Fribourg, Switzerland.
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Wilhelm FH, Grossman P. Emotions beyond the laboratory: theoretical fundaments, study design, and analytic strategies for advanced ambulatory assessment. Biol Psychol 2010; 84:552-69. [PMID: 20132861 DOI: 10.1016/j.biopsycho.2010.01.017] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2009] [Revised: 01/19/2010] [Accepted: 01/26/2010] [Indexed: 12/30/2022]
Abstract
Questionnaire and interview assessment can provide reliable data on attitudes and self-perceptions on emotion, and experimental laboratory assessment can examine functional relations between stimuli and reactions under controlled conditions. On the other hand, ambulatory assessment is less constrained and provides naturalistic data on emotion in daily life, with the potential to (1) assure external validity of laboratory findings, (2) provide normative data on prevalence, quality and intensity of real-life emotion and associated processes, (3) characterize previously unidentified emotional phenomena, and (4) model real-life stimuli for representative laboratory research design. Technological innovations now allow for detailed ambulatory study of emotion across domains of subjective experience, overt behavior and physiology. However, methodological challenges abound that may compromise attempts to characterize biobehavioral aspects of emotion in the real world. For example, emotional effects can be masked by social engagement, mental and physical workloads, as well as by food intake and circadian and quasi-random variation in metabolic activity. The complexity of data streams and multitude of factors that influence them require a high degree of context specification for meaningful data interpretation. We consider possible solutions to typical and often overlooked issues related to ambulatory emotion research, including aspects of study design decisions, recording devices and channels, electronic diary implementation, and data analysis.
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Affiliation(s)
- Frank H Wilhelm
- University of Basel, Institute for Psychology, Department of Clinical Psychology and Psychotherapy, Missionsstrasse 60/62, CH-4055 Basel, Switzerland.
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