1
|
Stadel M, Stulp G, Langener AM, Elmer T, van Duijn MAJ, Bringmann LF. Feedback About a Person's Social Context - Personal Networks and Daily Social Interactions. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2024; 51:476-489. [PMID: 37615808 PMCID: PMC11196300 DOI: 10.1007/s10488-023-01293-8] [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] [Accepted: 08/02/2023] [Indexed: 08/25/2023]
Abstract
The social context of a person, meaning their social relationships and daily social interactions, is an important factor for understanding their mental health. However, personalised feedback approaches to psychotherapy do not consider this factor sufficiently yet. Therefore, we developed an interactive feedback prototype focusing specifically on a person's social relationships as captured with personal social networks (PSN) and daily social interactions as captured with experience sampling methodology (ESM). We describe the development of the prototype as well as two evaluation studies: Semi-structured interviews with students (N = 23) and a focus group discussion with five psychotherapy patients. Participants from both studies considered the prototype useful. The students considered participation in our study, which included social context assessment via PSN and ESM as well as a feedback session, insightful. However, it remains unclear how much insight the feedback procedure generated for the students beyond the insights they already gained from the assessments. The focus group patients indicated that in a clinical context, (social context) feedback may be especially useful to generate insight for the clinician and facilitate collaboration between patient and clinician. Furthermore, it became clear that the current feedback prototype requires explanations by a researcher or trained clinician and cannot function as a stand-alone intervention. As such, we discuss our feedback prototype as a starting point for future research and clinical implementation.
Collapse
Affiliation(s)
- Marie Stadel
- Department of Sociology, University of Groningen, Groningen, The Netherlands.
- Department of Psychometrics and Statistics, University of Groningen, Groningen, The Netherlands.
| | - Gert Stulp
- Department of Sociology, University of Groningen, Groningen, The Netherlands
- Inter-University Center for Social Science Theory and Methodology, University of Groningen, Groningen, the Netherlands
| | - Anna M Langener
- Department of Sociology, University of Groningen, Groningen, The Netherlands
- Department of Psychometrics and Statistics, University of Groningen, Groningen, The Netherlands
- Groningen Institute for Evolutionary Life Sciences, University of Groningen, Groningen, The Netherlands
| | - Timon Elmer
- Department of Psychology, University of Zurich, Zurich, Switzerland
| | - Marijtje A J van Duijn
- Department of Sociology, University of Groningen, Groningen, The Netherlands
- Inter-University Center for Social Science Theory and Methodology, University of Groningen, Groningen, the Netherlands
| | - Laura F Bringmann
- Department of Psychometrics and Statistics, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
2
|
Reininghaus U, Schwannauer M, Barne I, Beames JR, Bonnier RA, Brenner M, Breznoščáková D, Dančík D, De Allegri M, Di Folco S, Durstewitz D, Gugel J, Hajdúk M, Heretik A, Izáková Ľ, Katreniakova Z, Kiekens G, Koppe G, Kurilla A, Marelli L, Nagyova I, Nguyen H, Pečeňák J, Schulte-Strathaus JCC, Sotomayor-Enriquez K, Uyttebroek L, Weermeijer J, Wolters M, Wensing M, Boehnke JR, Myin-Germeys I, Schick A. Strategies, processes, outcomes, and costs of implementing experience sampling-based monitoring in routine mental health care in four European countries: study protocol for the IMMERSE effectiveness-implementation study. BMC Psychiatry 2024; 24:465. [PMID: 38915006 PMCID: PMC11194943 DOI: 10.1186/s12888-024-05839-4] [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: 04/19/2024] [Accepted: 05/13/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Recent years have seen a growing interest in the use of digital tools for delivering person-centred mental health care. Experience Sampling Methodology (ESM), a structured diary technique for capturing moment-to-moment variation in experience and behaviour in service users' daily life, reflects a particularly promising avenue for implementing a person-centred approach. While there is evidence on the effectiveness of ESM-based monitoring, uptake in routine mental health care remains limited. The overarching aim of this hybrid effectiveness-implementation study is to investigate, in detail, reach, effectiveness, adoption, implementation, and maintenance as well as contextual factors, processes, and costs of implementing ESM-based monitoring, reporting, and feedback into routine mental health care in four European countries (i.e., Belgium, Germany, Scotland, Slovakia). METHODS In this hybrid effectiveness-implementation study, a parallel-group, assessor-blind, multi-centre cluster randomized controlled trial (cRCT) will be conducted, combined with a process and economic evaluation. In the cRCT, 24 clinical units (as the cluster and unit of randomization) at eight sites in four European countries will be randomly allocated using an unbalanced 2:1 ratio to one of two conditions: (a) the experimental condition, in which participants receive a Digital Mobile Mental Health intervention (DMMH) and other implementation strategies in addition to treatment as usual (TAU) or (b) the control condition, in which service users are provided with TAU. Outcome data in service users and clinicians will be collected at four time points: at baseline (t0), 2-month post-baseline (t1), 6-month post-baseline (t2), and 12-month post-baseline (t3). The primary outcome will be patient-reported service engagement assessed with the service attachment questionnaire at 2-month post-baseline. The process and economic evaluation will provide in-depth insights into in-vivo context-mechanism-outcome configurations and economic costs of the DMMH and other implementation strategies in routine care, respectively. DISCUSSION If this trial provides evidence on reach, effectiveness, adoption, implementation and maintenance of implementing ESM-based monitoring, reporting, and feedback, it will form the basis for establishing its public health impact and has significant potential to bridge the research-to-practice gap and contribute to swifter ecological translation of digital innovations to real-world delivery in routine mental health care. TRIAL REGISTRATION ISRCTN15109760 (ISRCTN registry, date: 03/08/2022).
Collapse
Affiliation(s)
- Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
- Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
- German Center for Mental Health (DZPG), partner site Mannheim-Heidelberg-Ulm, Mannheim, Germany.
| | | | - Islay Barne
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Joanne R Beames
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Rafaël A Bonnier
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Manuel Brenner
- Hector Institute for AI in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dagmar Breznoščáková
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Daniel Dančík
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
- Department of Psychiatry, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Manuela De Allegri
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Simona Di Folco
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Daniel Durstewitz
- Hector Institute for AI in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Theoretical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jessica Gugel
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Michal Hajdúk
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
- Department of Psychiatry, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Anton Heretik
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
| | - Ľubomíra Izáková
- Department of Psychiatry, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Zuzana Katreniakova
- Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | - Glenn Kiekens
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- Faculty of Psychology and Educational Sciences, Clinical Psychology, KU Leuven, Leuven, Belgium
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Georgia Koppe
- Hector Institute for AI in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Theoretical Neuroscience, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Adam Kurilla
- Department of Psychology, Faculty of Arts, Comenius University, Bratislava, Slovakia
| | - Luca Marelli
- Centre for Sociological Research, KU Leuven, Leuven, Belgium
- Department of Medical Biotechnology and Translational Medicine, University of Milan, Milan, Italy
| | - Iveta Nagyova
- Department of Social and Behavioural Medicine, Faculty of Medicine, PJ Safarik University, Kosice, Slovakia
| | - Hoa Nguyen
- Heidelberg Institute of Global Health, University Hospital and Faculty of Medicine, Heidelberg University, Heidelberg, Germany
| | - Ján Pečeňák
- Department of Psychiatry, Faculty of Medicine, Comenius University, Bratislava, Slovakia
| | - Julia C C Schulte-Strathaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Lotte Uyttebroek
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Jeroen Weermeijer
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Maria Wolters
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- School of Informatics, University of Edinburgh, Edinburgh, UK
- OFFIS Institute for Information Technology, Oldenburg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, Heidelberg University Hospital, Heidelberg, Germany
| | - Jan R Boehnke
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- School of Health Sciences, University of Dundee, Dundee, UK
| | - Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Anita Schick
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| |
Collapse
|
3
|
Kumar D, Corner S, Kim R, Meuret A. A randomized controlled trial of brief behavioral activation plus savoring for positive affect dysregulation in university students. Behav Res Ther 2024; 177:104525. [PMID: 38653177 DOI: 10.1016/j.brat.2024.104525] [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: 10/24/2023] [Revised: 03/19/2024] [Accepted: 03/22/2024] [Indexed: 04/25/2024]
Abstract
Rising rates of depression on university campuses accentuate the need for specific intervention. Interventions targeting disturbances in positive affect, in particular, remain sparse, yet such deficits interfere substantially with functioning and further exacerbate or maintain negative symptoms. The current study aimed to evaluate the impact of a virtual, two-session Behavioral Activation augmented with Savoring (BA + S) intervention compared to an Emotional Awareness (EA) control group in increasing positive affect. Sixty university students with low positive affect were randomized to BA + S or EA and completed 21 days of experience-sampling of positive affect. Weekly measures of positive and negative valence symptoms were assessed at baseline, sessions one and two, and at one-week follow-up. Through a prori analyses utilizing multilevel and multivariate multilevel models, our results demonstrate that daily positive affect measured via experience-sampling significantly improved in BA + S, whereas positive affect did not change for those receiving EA, though the interaction of condition and time was not significant. Furthermore, interactions in weekly variables were significant. Increases in positive valence symptoms (affect, anhedonia, etc.) were only reported for students receiving BA + S but not EA. Negative valence symptoms (affect, depression, general distress) improved in both conditions but with superior improvements in BA + S compared to EA. BA + S shows promise for a scalable and accessible intervention to university students with clinical levels of positive and negative affect. ClinicalTrials ID: NCT05234476.
Collapse
Affiliation(s)
- Divya Kumar
- Department of Psychology, Southern Methodist University, PO Box 750442, Dallas, TX, USA; McLean Hospital/Harvard Medical School, 115 Mill Street, Belmont, MA, 02478, USA.
| | - Sarah Corner
- Department of Psychology, Southern Methodist University, PO Box 750442, Dallas, TX, USA
| | - Richard Kim
- Department of Psychology, Southern Methodist University, PO Box 750442, Dallas, TX, USA
| | - Alicia Meuret
- Department of Psychology, Southern Methodist University, PO Box 750442, Dallas, TX, USA.
| |
Collapse
|
4
|
Lazeron-Savu E, Lenaert B, Dijkstra J, Ponds R, van Heugten C. Feasibility of a novel blended-care intervention for fatigue after acquired brain injury: a pilot study of the Tied by Tiredness intervention. Brain Inj 2024; 38:448-458. [PMID: 38324645 DOI: 10.1080/02699052.2024.2311346] [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: 04/30/2023] [Accepted: 01/24/2024] [Indexed: 02/09/2024]
Abstract
PURPOSE Evidence-based treatments for fatigue after brain injury are scarce and often not personalized. An approach to foster personalization is Experience Sampling Methodology (ESM), consisting of repeated daily measurements of fatigue and related factors in daily life. We investigated the feasibility and usability of a novel six-week ESM-based intervention for fatigue after brain injury. MATERIALS AND METHODS Ten individuals with acquired brain injury (six men; four women) aged between 36-70 years (M = 53.3, SD = 12.9) used a mHealth application for three days each week during six-weeks; seven completed the intervention. Momentary fatigue, activities, mood, worrying, and social context were assessed with ESM and participants received weekly personalized feedback by a therapist.. RESULTS 56% of ESM-questionnaires (568/1008) were completed, providing detailed insights into individual fatigue patterns. No statistically significant decrease in response rate was found over the course of treatment. Qualitative feedback from participants revealed increased insight into factors underlying fatigue, and no problems with treatment duration or difficulties using the app. Five participants showed a decline in fatigue level during treatment. CONCLUSIONS This pilot study provides initial support for the feasibility and usability of this novel blended-care intervention, aimed at alleviating fatigue through personalized feedback and treatment strategies.
Collapse
Affiliation(s)
- Ela Lazeron-Savu
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Medical Psychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Bert Lenaert
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Department of Lifespan Psychology, Faculty of Psychology, Open University, Heerlen, The Netherlands
| | - Jeanette Dijkstra
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Medical Psychology, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Rudolf Ponds
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Limburg Brain Injury Center, Maasticht University, Maastricht, The Netherlands
- Department of Medical Psychology, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Caroline van Heugten
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, The Netherlands
- Limburg Brain Injury Center, Maasticht University, Maastricht, The Netherlands
| |
Collapse
|
5
|
Wong CSM, Chan WC, Lo KWY, Chen EYH, Lam LCW. Environmental stress and emotional reactivity: an exploratory experience sampling method study. Front Psychiatry 2024; 15:1375735. [PMID: 38774437 PMCID: PMC11106578 DOI: 10.3389/fpsyt.2024.1375735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 04/04/2024] [Indexed: 05/24/2024] Open
Abstract
Background Previous studies have shown a relationship between environments and mental health. However, limited studies have investigated the impact of environment stress (ES) on emotional reactivity. Our study aimed to fill this gap by examining how daily ES affects momentary emotional reactivity using experience sampling method (ESM). Methods Participants were randomly recruited from a prospective cohort study in Hong Kong to participate in a 7-day ESM study. The participants received eight electronic signals daily assessing their ES, positive affect (PA) and negative affect (NA). Participants were categorized into depressed group or control group based on Revised Clinical Interview Schedule. Psychometric properties of the ESM assessment were evaluated. Multilevel linear regression analyzes were conducted to examine the association of ES with PA, NA and the group status of the participants (cases versus controls). Results A total of 15 participants with depression and 15 healthy controls were recruited, and 1307 momentary assessments were completed with a compliance rate of 77.8%. The depressed group demonstrated a significant increase in NA in response to ES, while the control group showed a decrease in PA. In addition, the depressed group reported a lower perception of control and interaction with their environment compared to the control group. Conclusion Using ESM, a valid, reliable, and easy-to-use self-reporting tool, our findings provided valuable insights on the potential mechanisms underlying emotional responses to stressful environments.
Collapse
Affiliation(s)
- Corine Sau Man Wong
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Wai Chi Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kristen Wing Yan Lo
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Eric Yu Hai Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Linda Chiu Wa Lam
- Department of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| |
Collapse
|
6
|
van Dalen M, Snijders A, Dietvorst E, Bracké K, Nijhof SL, Keijsers L, Hillegers MHJ, Legerstee JS. Applications of the experience sampling method (ESM) in paediatric healthcare: a systematic review. Pediatr Res 2024; 95:887-900. [PMID: 38062256 PMCID: PMC10920184 DOI: 10.1038/s41390-023-02918-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/19/2023] [Accepted: 11/03/2023] [Indexed: 03/09/2024]
Abstract
BACKGROUND With the Experience Sampling Method (ESM) participants are asked to provide self-reports of their symptoms, feelings, thoughts and behaviours in daily life. This preregistered systematic review assessed how ESM is being used to monitor emotional well-being, somatic health, fatigue and pain in children and adolescents with a chronic somatic illness. METHODS Databases were searched from inception. Studies were selected if they included children or adolescents aged 0-25 years with a chronic somatic illness and used ESM focussing on mental health or psychosocial wellbeing, biopsychosocial factors and/or somatic health. Two reviewers extracted data of the final 47 papers, describing 48 studies. RESULTS Most studies evaluated what factors influence medical or psychological symptoms and how symptoms influence each other. Another common purpose was to study the feasibility of ESM or ESM as part of an app or intervention. Study methods were heterogeneous and most studies lack adequate reporting of ESM applications and results. CONCLUSIONS While ESM holds great potential for providing results and feedback to patients and caregivers, little use is being made of this option. Future studies should consider what they report in their studies, conduct a priori power analyses and how ESM can be embedded in clinical practice. IMPACT While ESM has many clinical applications, it is currently mostly used for research purposes. Current studies using ESM are heterogeneous and lack consistent, high-quality reporting. There is great potential in ESM for providing patients and parents with personalised feedback.
Collapse
Affiliation(s)
- Marije van Dalen
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands.
| | - Anne Snijders
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Evelien Dietvorst
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Katrien Bracké
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus MC, Rotterdam, The Netherlands
| | - Sanne L Nijhof
- Department of Paediatrics, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Loes Keijsers
- Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Jeroen S Legerstee
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, The Netherlands
| |
Collapse
|
7
|
De la Barrera U, Arrigoni F, Monserrat C, Montoya-Castilla I, Gil-Gómez JA. Using ecological momentary assessment and machine learning techniques to predict depressive symptoms in emerging adults. Psychiatry Res 2024; 332:115710. [PMID: 38194800 DOI: 10.1016/j.psychres.2023.115710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 12/28/2023] [Accepted: 12/30/2023] [Indexed: 01/11/2024]
Abstract
The objective of this study was to predict the level of depressive symptoms in emerging adults by analyzing sociodemographic variables, affect, and emotion regulation strategies. Participants were 33 emerging adults (M = 24.43; SD = 2.80; 56.3 % women). They were asked to assess their current emotional state (positive or negative affect), recent events that may relate to that state, and emotion regulation strategies through ecological momentary assessment. Participants were prompted randomly by an app 6 times per day between 10 am and 10 pm for a seven-day period. They answered 1233 of the 2058 surveys (beeps), collectively. The analysis of observations, using Machine Learning (ML) techniques, showed that the Random Forest algorithm yields significantly better predictions than other models. The algorithm used 13 out of the 36 variables adopted in the study. Furthermore, the study revealed that age, emotion of worried and a specific emotion regulation strategy related to social exchange were the most accurate predictors of severe depressive symptoms. By carefully selecting predictors and utilizing appropriate sorting techniques, these findings may provide valuable supplementary information to traditional diagnostic methods and psychological assessments.
Collapse
Affiliation(s)
- Usue De la Barrera
- Departamento de Psicología Evolutiva y de la Educación, Facultad de Psicología y Logopedia, Universitat de València, Spain
| | - Flavia Arrigoni
- Departamento de Psicología, Facultad de Ciencias de la Educación, Universidad de Cádiz, Spain
| | - Carlos Monserrat
- Valencian Research Institute for Artificial Intelligence, Universitat Politècnica de València, Spain
| | - Inmaculada Montoya-Castilla
- Departamento de Personalidad, Evaluación y Tratamientos Psicológicos, Facultad de Psicología y Logopedia, Universitat de València, Spain
| | - José-Antonio Gil-Gómez
- Instituto Universitario de Automática e Informática Industrial, Universitat Politècnica de València, Camino de Vera s/n, 46022, Valencia, Spain.
| |
Collapse
|
8
|
Hoogerwerf E, Greeven A, Goekoop R, Spinhoven P. Personalized exposure and experience sampling method feedback versus exposure as usual for obsessive-compulsive disorder: a study protocol for a randomized controlled trial. Trials 2024; 25:43. [PMID: 38217045 PMCID: PMC10785525 DOI: 10.1186/s13063-023-07780-5] [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: 03/20/2023] [Accepted: 11/06/2023] [Indexed: 01/14/2024] Open
Abstract
BACKGROUND Patients with obsessive-compulsive disorder (OCD) suffer from repetitive fearful intrusions which they try to neutralize by performing compulsions. OCD is considered to be the most resistant anxiety disorder with a remission rate of only 53% after a year of an evidence-based treatment. Therefore, it remains an obligation to develop and investigate more effective treatment interventions. This study aims to compare personalized exposure with response prevention (ERP) using experience sampling methodology-based feedback to ERP as usual in patients with OCD. Personalized exposure will be provided screen-to-screen in an ecologically valid (real time and real place) context by means of a smartphone application. This app will also be used to collect both objective and subjective data by means of experience sampling methodology (ESM). This ESM data will be used to identify triggers and protective factors for symptom severity, provide personalized feedback and optimize the effect of ERP. The primary goal of this RCT is to compare the effectiveness of personalized ERP to ERP as usual in the traditional context of a therapist's room in patients with OCD in OCD symptom severity, as well as differences in quality of life, depressive symptoms and anxiety states. Since both self-efficacy and experiential avoidance are known to influence symptom severity in OCS, a secondary goal is to examine if a possible treatment effect is mediated by self-efficacy or experiential avoidance. METHODS This study involves a randomized controlled trial with 20 weekly sessions by 2 groups (ERP as usual versus personalized ERP), repeated measurements at baseline (T0), 5 weeks of treatment (T1), 10 weeks of treatment (T2), 15 weeks of treatment (T3), posttest at 20 weeks (T4), 6 weeks follow-up (T5), 3 months follow-up (T6), 6 months follow-up (T7) and a year follow-up (T8). A hundred and sixty patients with an OCD diagnosis according to DSM-5 criteria will participate. Half of the group will receive exposure with response prevention as usual, the other half will receive personalized exposure with response prevention with a smartphone application and personalized feedback sessions based on experience sampling data. Multilevel mixed modelling analysis will be used to investigate differences in treatment effect, as well as differences in quality of life, depressive symptoms and anxiety states. We will use the macro of Preacher and Hayes and apply bootstrapping methods to assess the possible mediating effect of changes in self-efficacy and experiential avoidance on subsequent treatment effects. DISCUSSION This randomized controlled trial is the first to assess the influence of delivering ERP through video-calling and the use of an ESM intervention on the symptom severity of OCD. Since the global pandemic COVID-19, the use of video-calling to deliver psychological treatments has become more common, increasing the relevance of this study. TRIAL REGISTRATION ICTRP Trial NL8254. Registered on 2019-12-24.
Collapse
Affiliation(s)
- Elena Hoogerwerf
- Parnassia Groep Academie, Dadelplein 1, 2552DS, The Hague, The Netherlands.
- Institute of Psychology, Section of Clinical Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands.
| | - Anja Greeven
- Parnassia Groep Academie, Dadelplein 1, 2552DS, The Hague, The Netherlands
| | - Rutger Goekoop
- Parnassia Groep Academie, Dadelplein 1, 2552DS, The Hague, The Netherlands
| | - Philip Spinhoven
- Institute of Psychology, Section of Clinical Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
- Department of Psychiatry, Leiden University Medical Center, Albinusdreef 2, 2333 ZA, Leiden, Leiden, the Netherlands
| |
Collapse
|
9
|
Dietvorst E, Hillegers MHJ, Legerstee JS, Vries LPD, Vreeker A, Keijsers L. Real-time personalized feedback in mHealth for adolescents. Digit Health 2024; 10:20552076241247937. [PMID: 38766361 PMCID: PMC11100393 DOI: 10.1177/20552076241247937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 03/28/2024] [Indexed: 05/22/2024] Open
Abstract
Mobile Health (mHealth) interventions have the potential to improve early identification, prevention, and treatment of mental health problems. Grow It! is a multiplayer smartphone app designed for youth aged 12-25, allowing them to monitor their emotions and engage in daily challenges based on Cognitive Behavioral Therapy (CBT) principles. Recently, a personalized mood profile was added to improve the app. We investigated whether real-time personalized feedback on mood enhances app engagement, user experience, and the effects on affective and cognitive well-being. Sample A (N = 1269, age = 18.60 SD = 3.39, 80.6% girls, 95.4% Dutch) played the original app without feedback on their mood, and an independent Sample B (N = 386, age = 16.04 SD = 3.21, 67.6% girls, 82.9% Dutch) received the renewed version with personalized real-time feedback on their mood. Participants who received personal feedback did not have higher app engagement (t(1750,400) = 1.39, P = .206, d = 0.07; t(692,905) = 0.36, P = .971, d = 0.0) nor higher user experience (t(177,596) = 0.21, P = .831, d = 0.02; (t(794) = 1.28, P = .202, d = 0.12; χ2 (659,141) = 2.83, P = .091). Players of the renewed version (Sample B) experienced significant improvements in affective (t(175) = 3.01, P = .003, d = 0.23) and cognitive well-being (t(175) = 3.48, P = <.001, d = 0.26) over the course of three weeks. The renewed version Grow It! has the potential to enhance youths' affective and cognitive well-being. However, adding real-time insights did not seem to affect app engagement nor user experience.
Collapse
Affiliation(s)
- Evelien Dietvorst
- Department of Child and Adolescents Psychiatry/Psychology Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Manon HJ Hillegers
- Department of Child and Adolescents Psychiatry/Psychology Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Jeroen S Legerstee
- Department of Child and Adolescents Psychiatry/Psychology Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Lianne P De Vries
- Department of Child and Adolescents Psychiatry/Psychology Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Annabel Vreeker
- Department of Child and Adolescents Psychiatry/Psychology Erasmus MC Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands
- Erasmus School of Social and Behavioural Sciences Department of Psychology, Education & Child Studies Erasmus University, Rotterdam, The Netherlands
| | - Loes Keijsers
- Erasmus School of Social and Behavioural Sciences Department of Psychology, Education & Child Studies Erasmus University, Rotterdam, The Netherlands
| |
Collapse
|
10
|
Weermeijer JDM, Wampers M, de Thurah L, Bonnier R, Piot M, Kuppens P, Myin-Germeys I, Kiekens G. Usability of the Experience Sampling Method in Specialized Mental Health Care: Pilot Evaluation Study. JMIR Form Res 2023; 7:e48821. [PMID: 37988137 DOI: 10.2196/48821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Mental health problems occur in interactions in daily life. Yet, it is challenging to bring contextual information into the therapy room. The experience sampling method (ESM) may facilitate this by assessing clients' thoughts, feelings, symptoms, and behaviors as they are experienced in everyday life. However, the ESM is still primarily used in research settings, with little uptake in clinical practice. One aspect that may facilitate clinical implementation concerns the use of ESM protocols, which involves providing practitioners with ready-to-use ESM questionnaires, sampling schemes, visualizations, and training. OBJECTIVE This pilot study's objective was to evaluate the usability of an ESM protocol for using the ESM in a specialized mental health care setting. METHODS We created the ESM protocol using the m-Path software platform and tested its usability in clinical practice. The ESM protocol consists of a dashboard for practitioners (ie, including the setup of the template and data visualizations) and an app for clients (ie, for completing the ESM questionnaires). A total of 8 practitioners and 17 clients used the ESM in practice between December 1, 2020, and July 31, 2021. Usability was assessed using questionnaires, ESM compliance rates, and semistructured interviews. RESULTS The usability was overall rated reasonable to good by practitioners (mean scores of usability items ranging from 5.33, SD 0.91, to 6.06, SD 0.73, on a scale ranging from 1 to 7). However, practitioners expressed difficulty in personalizing the template and reported insufficient guidelines on how to use the ESM in clinical practice. On average, clients completed 55% (SD 25%) of the ESM questionnaires. They rated the usability as reasonable to good, but their scores were slightly lower and more variable than those of the practitioners (mean scores of usability items ranging from 4.18, SD 1.70, to 5.94, SD 1.50 on a scale ranging from 1 to 7). Clients also voiced several concerns over the piloted ESM template, with some indicating no interest in the continued use of the ESM. CONCLUSIONS The findings suggest that using an ESM protocol may facilitate the implementation of the ESM as a mobile health assessment tool in psychiatry. However, additional adaptions should be made before further implementation. Adaptions include providing training on personalizing questionnaires, adding additional sampling scheme formats as well as an open-text field, and creating a dynamic data visualization interface. Future studies should also identify factors determining the suitability of the ESM for specific treatment goals among different client populations.
Collapse
Affiliation(s)
| | - Martien Wampers
- Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Lena de Thurah
- Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Rafaël Bonnier
- Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Maarten Piot
- Quantitative Psychology and Individual Differences, KU Leuven, Leuven, Belgium
| | - Peter Kuppens
- Quantitative Psychology and Individual Differences, KU Leuven, Leuven, Belgium
| | | | - Glenn Kiekens
- Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
- Quantitative Psychology and Individual Differences, KU Leuven, Leuven, Belgium
- Research Unit of Clinical Psychology, KU Leuven, Leuven, Belgium
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
| |
Collapse
|
11
|
Aleva A, van den Berg T, Laceulle OM, van Aken MAG, Chanen AM, Betts JK, Hessels CJ. A smartphone-based intervention for young people who self-harm ('PRIMARY'): study protocol for a multicenter randomized controlled trial. BMC Psychiatry 2023; 23:840. [PMID: 37964199 PMCID: PMC10647141 DOI: 10.1186/s12888-023-05301-x] [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: 10/02/2023] [Accepted: 10/23/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND Self-harm in young people is a public health concern connected with severe mental health problems, such as personality pathology. Currently, there are no specific evidence-based interventions available for young people who self-harm. Therefore, we developed PRe-Intervention Monitoring of Affect and Relationships in Youth (PRIMARY), a smartphone-based intervention, co-designed by clinicians and young people with lived experience of mental ill-health. PRIMARY combines the Experience Sampling Method (ESM) with weekly report sessions. The study aims to examine the effectiveness of PRIMARY with regard to reducing self-harm, and improving emotion regulation and quality of relationships. METHODS This study is a multicenter, parallel groups, randomized controlled trial (RCT) comparing the PRIMARY intervention to a waiting list control group. PRIMARY comprises 28 consecutive days of questionnaires five times each day (i.e., ESM) and four weekly report sessions. Participants will comprise 180 young people referred for treatment to the participating Dutch mental healthcare institutions and (1) are aged 12 to 25 years, and (2) engaged in ≥ 1 act of self-harm in the past year. Participants are randomly allocated to a study group after screening in a 1:1 ratio by an independent researcher using computer-generated randomization sequences with stratified block randomization by age (12 to 15 years / 16 to 25 years). Staff will conduct assessments with all participants at baseline (Wave 1), after 28 days (Wave 2), and in a subsample after 10 weeks of subsequent specialized treatment (Wave 3). The primary outcomes are self-harm, emotion regulation, and quality of relationships. Secondary outcomes include patient and clinician satisfaction. Exploratory analyses of ESM data will examine the relationship between emotions, social relationships, and self-harm. DISCUSSION The results of this trial will clarify whether an innovative smartphone-based intervention is effective for reducing self harm and improving emotion regulation and the quality of social relationships. It has the potential to fill a treatment gap of interventions specifically targeting self-harm. If proven effective, it would provide an accessible, easy-to-implement, low-cost intervention for young people. Furthermore, the ESM-data will allow detailed analyses into the processes underlying self-harm, which will contribute to theoretical knowledge regarding the behavior. TRIAL REGISTRATION ISRCTN42088538 ( https://doi.org/10.1186/ISRCTN42088538 ), retrospectively registered on the 26th of October 2022.
Collapse
Affiliation(s)
- Anouk Aleva
- HYPE Centre of Expertise on Early Intervention for Borderline Personality Disorder, GGz Centraal, Amersfoort, The Netherlands.
- Department of Developmental Psychology, Utrecht University, Utrecht, The Netherlands.
| | - Tessa van den Berg
- HYPE Centre of Expertise on Early Intervention for Borderline Personality Disorder, GGz Centraal, Amersfoort, The Netherlands
- Department of Developmental Psychology, Utrecht University, Utrecht, The Netherlands
| | - Odilia M Laceulle
- HYPE Centre of Expertise on Early Intervention for Borderline Personality Disorder, GGz Centraal, Amersfoort, The Netherlands
- Department of Developmental Psychology, Utrecht University, Utrecht, The Netherlands
| | - Marcel A G van Aken
- Department of Developmental Psychology, Utrecht University, Utrecht, The Netherlands
| | - Andrew M Chanen
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Jennifer K Betts
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Christel J Hessels
- HYPE Centre of Expertise on Early Intervention for Borderline Personality Disorder, GGz Centraal, Amersfoort, The Netherlands
| |
Collapse
|
12
|
Bogaert L, Van der Gucht K, Kuppens P, Kock M, Schreuder MJ, Kuyken W, Raes F. The effect of universal school-based mindfulness on anhedonia and emotional distress and its underlying mechanisms: A cluster randomised controlled trial via experience sampling in secondary schools. Behav Res Ther 2023; 169:104405. [PMID: 37797436 PMCID: PMC10938062 DOI: 10.1016/j.brat.2023.104405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 09/04/2023] [Accepted: 09/11/2023] [Indexed: 10/07/2023]
Abstract
This cluster randomised controlled trial examined the effectiveness of universal school-based mindfulness training (MT; vs. passive control) to lower anhedonia and emotional distress among mid-adolescents (15-18 years). It further examined three potential mechanisms: dampening of positive emotions, non-acceptance/suppression of negative emotions, and perceived social pressure not to experience/express negative emotions. Adolescents (ncontrol = 136, nintervention = 95) participated in three assessment points (before, after and two/three months after the in-class MT), consisting of Experience Sampling (ES) assessments and self-report questionnaires (SRQs) to corroborate the ES assessments. Analyses were based on general linear modelling and multilevel modelling. Overall, no evidence was found for a significant beneficial and long-lasting impact of the MT on adolescents' mental health. Importantly, some barriers inherently linked to universal MT approaches (low engagement in and mixed attitudes towards the MT) may have tempered the effectiveness of the MT in the current trial. Further research should prioritise overcoming these barriers to optimise programme implementation. Additionally, given the potential complex interplay of moderators at micro- (home practice), meso- (school climate), and macro-level (broader context), research should simultaneously focus on alternative ways of delivering MT at schools to strengthen adolescents' mental health.
Collapse
Affiliation(s)
- Liesbeth Bogaert
- Research Unit Behaviour, Health and Psychopathology, KU Leuven, Belgium; Leuven Mindfulness Centre, KU Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium.
| | - Katleen Van der Gucht
- Leuven Mindfulness Centre, KU Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium; Research Unit Methods, Individual and Cultural Differences, Affect and Social Behavior, KU Leuven, Belgium; Social and Behavioral Sciences, Tilburg University, the Netherlands
| | - Peter Kuppens
- Leuven Mindfulness Centre, KU Leuven, Belgium; Research Unit Methods, Individual and Cultural Differences, Affect and Social Behavior, KU Leuven, Belgium
| | - Merle Kock
- Research Unit Behaviour, Health and Psychopathology, KU Leuven, Belgium; Leuven Mindfulness Centre, KU Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium
| | - Marieke J Schreuder
- Research Unit Methods, Individual and Cultural Differences, Affect and Social Behavior, KU Leuven, Belgium
| | - Willem Kuyken
- Department of Psychiatry, Medical Sciences Division, University of Oxford, United Kingdom; University of Oxford Mindfulness Research Centre, University of Oxford, United Kingdom
| | - Filip Raes
- Research Unit Behaviour, Health and Psychopathology, KU Leuven, Belgium; Leuven Mindfulness Centre, KU Leuven, Belgium; KU Leuven Child and Youth Institute, KU Leuven, Belgium.
| |
Collapse
|
13
|
Bartels SL, van Zelst C, Melo Moura B, Daniëls NE, Simons CJ, Marcelis M, Bos FM, Servaas MN. Feedback based on experience sampling data: Examples of current approaches and considerations for future research. Heliyon 2023; 9:e20084. [PMID: 37809510 PMCID: PMC10559801 DOI: 10.1016/j.heliyon.2023.e20084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 09/11/2023] [Accepted: 09/11/2023] [Indexed: 10/10/2023] Open
Abstract
Methodologies such as the Experience Sampling Method (ESM) or Ecological Momentary Assessment allow the gathering of fine-graded, dynamic, personal data within a patient's daily life. Currently, it is studied whether feedback based on experience sampling data (ESM-based feedback) can be used as a clinical tool to inform shared decision-making in clinical practice. Although the potential of feedback is recognized, little is known on how to generate, use, and implement it. This article (i) presents n = 15 ongoing ESM projects within the Belgian-Dutch network for ESM research wherein ESM-based feedback is provided to various patient populations, and (ii) summarizes qualitative data on experiences with ESM-based feedback of researchers (n = 8) with extensive expertise with ESM (average of 10 years) involved in these ongoing studies. The following aspects appear to be of relevance when providing ESM-based feedback: training for healthcare professionals and researchers, the use of online interfaces and graphical visualizations to present data, and interacting with patients in a face-to-face setting when discussing the contextual relevance and potential implications. Prospectively, research may build on these aspects and create coherent consensus-based guidelines for the use of ESM-based feedback.
Collapse
Affiliation(s)
- Sara Laureen Bartels
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Catherine van Zelst
- Department of Psychosis Research and Innovation, Parnassia Psychiatric Institute, The Hague, the Netherlands
- GGzE Institute for Mental Health Care Eindhoven, Eindhoven, the Netherlands
| | - Bernardo Melo Moura
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Institute of Pharmacology and Neurosciences, Faculty of Medicine, University of Lisbon, Lisbon, Portugal
- Universidade Católica Portuguesa, Faculdade de Medicina, Portugal
| | - Naomi E.M. Daniëls
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Family Medicine, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - Claudia J.P. Simons
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- GGzE Institute for Mental Health Care Eindhoven, Eindhoven, the Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
- GGzE Institute for Mental Health Care Eindhoven, Eindhoven, the Netherlands
| | - Fionneke M. Bos
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
- Department of Psychiatry, Rob Giel Research Center, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Michelle N. Servaas
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| |
Collapse
|
14
|
von Klipstein L, Servaas MN, Schoevers RA, van der Veen DC, Riese H. Integrating personalized experience sampling in psychotherapy: A case illustration of the Therap-i module. Heliyon 2023; 9:e14507. [PMID: 36967959 PMCID: PMC10036928 DOI: 10.1016/j.heliyon.2023.e14507] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Revised: 03/03/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023] Open
Abstract
Background The experience sampling methodology (ESM) is increasingly being suggested as a clinical tool in mental health care, as it offers ecologically valid, microlevel information on psychopathological processes. Patients and clinicians have recommended that applications of ESM should be personalized and integrated into the existing clinical process, but there is still much uncertainty about how implementation may look like. Objective To provide an example of personalized ESM assessment and feedback being integrated into psychotherapy for depression, specifically looking at the collaborative use of ESM in case conceptualization. Methods George, a 27-year-old man diagnosed with depression, and his therapist participated in the Therap-i randomized controlled trial, which investigates the efficacy of a personalized ESM module added to psychotherapy. Together, they created a personalized ESM questionnaire, aiming to capture their hypotheses and questions regarding George's case conceptualization. George then filled out his ESM questionnaire five times per day, for 8 weeks. During this period, ESM data were discussed and interpreted by George, his therapist, and a researcher, in three feedback sessions. In these sessions, data were visualized in a flexible feedback interface that allowed for collaborative exploration of George's data. Both patient and therapist evaluated the module through questionnaires and George also participated in a semi-structured evaluation interview. Results George's ESM questionnaire included personalized items on the topics of self-esteem and open versus withdrawn behavior. He completed 241 (89.3%) assessments. Discussions during the feedback sessions focused on two core themes: First, George's low energy level, which was further explored with regard to his sleep, medication, and activity patterns. Second, his low sense of self-esteem, which led to an in-depth exploration of his thinking patterns and social interactions. The ESM module was seen as useful and insightful by both George and therapist. Conclusions This case shows how ESM and ESM-based feedback can stimulate the collaborative exploration of the patient's complaints, and how it can provide useful insights for treatment. We discuss how our personalized ESM module relates to current clinical principles and practices, and make suggestions for further implementation.
Collapse
|
15
|
Liu R, Duan W. Assessing perceptions of resilience: The understanding from network analysis. Front Public Health 2023; 11:1017871. [PMID: 36741960 PMCID: PMC9895415 DOI: 10.3389/fpubh.2023.1017871] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/03/2023] [Indexed: 01/22/2023] Open
Abstract
Introduction Previous studies have yet to reach a consensus on the construct of resilience perception, and how to enhance the effect of resilience intervention remains an urgent issue. In this consideration, this study examines the fundamental construct of resilience. It provides insight into the critical prevention goal for resilience intervention by utilizing the latest methods of psychological network analysis. Methods The sample is the graduate students enrolled in September 2021. Participants completed (1) the Connor-Davidson Resilience Scale, (2) the University of Washington Resilience Scale-8 Item, (3) the Brief Resilience Scale, and (4) the Resilience Scale for Adults, each representing different orientations of resilience. Results The network analysis grants greater clarity to the resilience perception as a dynamic system that interacts between an individual's tendency to intrinsic capacity and response to external resources. This study has shown that a positive perception of external social resources is the most important for individuals' resilience cognition; the effect of resilience intervention can be achieved more quickly by changing the individual's sense of hope. Discussion Based on the results, a psychometric instrument that integrates different orientations of resilience concepts and is based on time-varying needs to be developed.
Collapse
Affiliation(s)
- Rong Liu
- Student Counseling and Mental Health Center, East China University of Science and Technology, Shanghai, China
| | - Wenjie Duan
- Social and Public Administration School, East China University of Science and Technology, Shanghai, China
| |
Collapse
|
16
|
Schick A, Rauschenberg C, Ader L, Daemen M, Wieland LM, Paetzold I, Postma MR, Schulte-Strathaus JCC, Reininghaus U. Novel digital methods for gathering intensive time series data in mental health research: scoping review of a rapidly evolving field. Psychol Med 2023; 53:55-65. [PMID: 36377538 PMCID: PMC9874995 DOI: 10.1017/s0033291722003336] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 09/13/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022]
Abstract
Recent technological advances enable the collection of intensive longitudinal data. This scoping review aimed to provide an overview of methods for collecting intensive time series data in mental health research as well as basic principles, current applications, target constructs, and statistical methods for this type of data.In January 2021, the database MEDLINE was searched. Original articles were identified that (1) used active or passive data collection methods to gather intensive longitudinal data in daily life, (2) had a minimum sample size of N ⩾ 100 participants, and (3) included individuals with subclinical or clinical mental health problems.In total, 3799 original articles were identified, of which 174 met inclusion criteria. The most widely used methods were diary techniques (e.g. Experience Sampling Methodology), various types of sensors (e.g. accelerometer), and app usage data. Target constructs included affect, various symptom domains, cognitive processes, sleep, dysfunctional behaviour, physical activity, and social media use. There was strong evidence on feasibility of, and high compliance with, active and passive data collection methods in diverse clinical settings and groups. Study designs, sampling schedules, and measures varied considerably across studies, limiting the generalisability of findings.Gathering intensive longitudinal data has significant potential to advance mental health research. However, more methodological research is required to establish and meet critical quality standards in this rapidly evolving field. Advanced approaches such as digital phenotyping, ecological momentary interventions, and machine-learning methods will be required to efficiently use intensive longitudinal data and deliver personalised digital interventions and services for improving public mental health.
Collapse
Affiliation(s)
- Anita Schick
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Christian Rauschenberg
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Leonie Ader
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Maud Daemen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Lena M. Wieland
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Isabell Paetzold
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Mary Rose Postma
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Julia C. C. Schulte-Strathaus
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Ulrich Reininghaus
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
- Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
| |
Collapse
|
17
|
Wong SM, Chen EY, Wong CS, Suen YN, Chan DL, Tsang SH, Wong TY, Cheung C, Chan KT, Lui SS, Wong MT, Chan SK, Lee EH, Myin-Germeys I, Hui CL. Impact of smartphone overuse on 1-year severe depressive symptoms and momentary negative affect: Longitudinal and experience sampling findings from a representative epidemiological youth sample in Hong Kong. Psychiatry Res 2022; 318:114939. [PMID: 36343577 DOI: 10.1016/j.psychres.2022.114939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 10/21/2022] [Accepted: 10/30/2022] [Indexed: 11/06/2022]
Abstract
Smartphone overuse can have detrimental impacts on youth mental health. How it may be longitudinally associated with depressive symptoms and functioning, and with daily momentary affect, remains to be investigated. A total of 3,033 young people were consecutively recruited from a large-scale epidemiological youth mental health study in Hong Kong. A subsample (n = 936) was followed-up after 1 year, with experience sampling data collected from 177 participants. Separate multivariable logistic regression models were applied to examine the prospective associations between smartphone overuse and depressive symptoms, with multilevel models fitted to examine its associations with momentary affect. The prevalence of smartphone overuse in the Hong Kong youth population was 29.3%. Smartphone overuse was significantly associated with more depressive symptoms and functional impairments both cross-sectionally and longitudinally. The associations between smartphone overuse and 1-year depressive symptoms were significant, even when accounting for baseline symptoms, social media use, and other risk and protective factors. Baseline depressive symptoms, in contrast, were not associated with 1-year smartphone overuse after adjusting for baseline smartphone overuse. Smartphone overuse was also significantly associated with higher levels of momentary negative affect, even when accounting for depressive symptoms. Strategies to mitigate the impact of smartphone overuse can have important long-term implications.
Collapse
Affiliation(s)
- Stephanie My Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Eric Yh Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong.
| | - Corine Sm Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Y N Suen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Dorothy Lk Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Samantha Hs Tsang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - T Y Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Charlton Cheung
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - K T Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Simon Sy Lui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Michael Th Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Sherry Kw Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Edwin Hm Lee
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Inez Myin-Germeys
- Department for Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Christy Lm Hui
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| |
Collapse
|
18
|
Paetzold I, Schick A, Rauschenberg C, Hirjak D, Banaschewski T, Meyer-Lindenberg A, Butz S, Floesser C, Schueltke L, Boehnke JR, Boecking B, Reininghaus U. A Hybrid Ecological Momentary Compassion–Focused Intervention for Enhancing Resilience in Help-Seeking Young People: Prospective Study of Baseline Characteristics in the EMIcompass Trial. JMIR Form Res 2022; 6:e39511. [PMID: 36331526 PMCID: PMC9675017 DOI: 10.2196/39511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/19/2022] [Accepted: 08/09/2022] [Indexed: 11/06/2022] Open
Abstract
Background Young people are a target population for mental health–related early intervention and prevention. Although evidence for early intervention is promising, availability of and access to youth mental health services remain limited. Therefore, the development of an evidence-based hybrid intervention is urgently needed. Objective This study aimed to present a manual for a hybrid intervention, combining an ecological momentary intervention and face-to-face sessions aimed for enhancing resilience in help-seeking young people based on compassion-focused interventions, and explore whether participants’ baseline characteristics are associated with putative mechanisms and outcomes of the EMIcompass intervention. Specifically, we aimed to explore initial signals as to whether participants’ sociodemographic, clinical, and functional characteristics at baseline are associated with putative mechanisms (ie, change in self-compassion, change in emotion regulation, working alliance, training frequency); and whether participants’ sociodemographic, clinical, and functional characteristics, self-compassion, and emotion regulation at baseline are associated with clinical outcomes (ie, psychological distress and general psychopathology at postintervention and 4-week follow-ups) in the experimental condition and obtain first parameter estimates. Methods We recruited young people aged 14 to 25 years, with psychological distress, Clinical High At-Risk Mental State, or first episodes of severe mental disorder for an exploratory randomized controlled trial with assessments at baseline and postintervention and 4-week follow-ups. A structured manual was developed and optimized based on a pilot study’s manual, a scoping review of existing literature and manuals, exchange with experts, the team’s clinical experience of working with compassion-focused interventions, and the principles of ecological momentary interventions. This analysis focuses on the experimental condition receiving the EMIcompass intervention. Results A total of 46 young individuals were randomized to the experimental condition. There was evidence for initial signals of effects of age (B=0.11, 95% CI 0.00-0.22), general psychopathology (B=0.08, 95% CI −0.01 to 0.16), and clinical stage (B=1.50, 95% CI 0.06-2.93) on change in momentary self-compassion and change in emotion regulation from baseline to postintervention assessments. There was no evidence for associations of other baseline characteristics (eg, gender, minority status, and level of functioning) and putative mechanisms (eg, overall self-compassion, working alliance, and training frequency). In addition, except for an initial signal for an association of momentary self-compassion at baseline and psychological distress (B=−2.83, 95% CI −5.66 to 0.00), we found no evidence that baseline characteristics related to clinical outcomes. Conclusions The findings indicated the reach of participants by the intervention largely independent of sociodemographic, clinical, and functional baseline characteristics. The findings need to be confirmed in a definitive trial. Trial Registration German Clinical Trials Register NDRKS00017265; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017265 International Registered Report Identifier (IRRID) RR2-10.2196/27462
Collapse
Affiliation(s)
- Isabell Paetzold
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Anita Schick
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christian Rauschenberg
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Dusan Hirjak
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sebastian Butz
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Chiara Floesser
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Leonie Schueltke
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Benjamin Boecking
- Tinnitus Center, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- ESRC Centre for Society and Mental Health and Social Epidemiology Research Group, King's College London, London, United Kingdom
- Health Service and Population Research Department, Centre for Epidemiology and Public Health, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| |
Collapse
|
19
|
Suen YN, Yau JY, Wong PS, Li YK, Hui CLM, Chan SKW, Lee EHM, Chang WC, Chen EYH. Effect of brief, personalized feedback derived from momentary data on the mental health of women with risk of common mental disorders in Hong Kong: A randomized clinical trial. Psychiatry Res 2022; 317:114880. [PMID: 37732870 DOI: 10.1016/j.psychres.2022.114880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/24/2022] [Accepted: 10/01/2022] [Indexed: 10/31/2022]
Abstract
This study aimed to determine the efficacy of digitalized personalized feedback derived from experience sampling method (ESM) data for improving women's mental health and to explore its potential to become a prevention intervention. In this three-arm, randomized controlled trial, 124 adult women aged 18 to 64 years with mild to moderate depressive and anxiety symptoms were randomly assigned to ESM with personalized feedback (ESM-f, 40 women), ESM alone (ESM, 43 women), or no additional intervention (control, 41 women). The ESM-f and ESM groups received six weeks of ESM, but only the former received biweekly individualized feedback. The primary outcome measure was changes in mental well-being as measured by the 21-item Depression, Anxiety, and Stress Scale (DASS-21) from baseline to 8, 12, 16, 20, and 32 weeks and the comparison between the ESM-f and the control group. The ESM-f group experienced a significantly greater decline in DASS-21 total scores compared with the control group while the ESM and control groups had a comparable decline in DASS-21 total scores. ESM-derived personalized feedback can improve women's mental well-being. Additional research is needed to determine its cost-effectiveness, long-term consequences, and efficacy as a preventive intervention for common mental disorders.
Collapse
Affiliation(s)
- Yi Nam Suen
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Jezreel Yeung Yau
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Pui Sze Wong
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Yee Kwan Li
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | | | - Sherry Kit Wa Chan
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, China
| | - Edwin Ho Ming Lee
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Wing Chung Chang
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, China
| | - Eric Yu Hai Chen
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong SAR, China.
| |
Collapse
|
20
|
Lenferink LIM, van Eersel JHW, Franzen M. Is it acceptable and feasible to measure prolonged grief disorder symptoms in daily life using experience sampling methodology? Compr Psychiatry 2022; 119:152351. [PMID: 36341747 DOI: 10.1016/j.comppsych.2022.152351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 10/07/2022] [Accepted: 10/16/2022] [Indexed: 01/31/2023] Open
Abstract
INTRODUCTION Current grief research is dominated by cross-sectional studies assessing prolonged grief disorder (PGD) symptoms retrospectively. Examining grief in daily life, using Experience Sampling Methodology (ESM), may advance the field. Because of the lack of ESM-research on PGD, we evaluated the acceptability and feasibility of assessing PGD symptoms in daily life of bereaved people. MATERIALS AND METHODS ESM-items assessing PGD symptoms were developed using cognitive interviewing with five ESM/grief experts. Eighty bereaved adults completed these ESM-items five times a day for two weeks. Before and after this ESM-phase, interviews were administered assessing PGD retrospectively (using the Traumatic Grief Inventory-Clinical Administered). t-tests were performed comparing symptom severity of aggregated moment-to-moment recall (using ESM-items) with retrospective recall (based on interviews) of PGD symptoms. Acceptability of participating in ESM-research (assessed with the Reactions to Research Participation Questionnaire) was examined using descriptive statistics. Feasibility was evaluated by reporting compliance and retention rates. RESULTS Minor changes were made to the ESM-items based on expert interviews. Average levels of aggregated moment-to-moment recall of the symptoms "yearning" (d = -1.04), "preoccupation with the deceased" (d = -0.91), "marked sense of disbelief" (d = -0.43), and "intense loneliness" (d = -0.28) were lower compared with retrospective recalling these symptoms. On average, bereaved people were neutral about personal benefits gained through participation in this EMS-study. They indicated that participation did not raise emotional reactions. Compliance and retention rates were 60% and 65%, respectively. DISCUSSION Our findings indicate that whereas compliance and retention is challenging, using ESM to study PGD symptoms in daily life might be useful. Nevertheless, more research is needed.
Collapse
Affiliation(s)
- L I M Lenferink
- Department of Psychology, Health & Technology, Faculty of Behavioural Management and Social Sciences, University of Twente, P.O. Box 217, 7500 AE Enschede, the Netherlands; Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, the Netherlands; Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands.
| | - J H W van Eersel
- Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, P.O. Box 80140, 3508 TC Utrecht, the Netherlands
| | - M Franzen
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Grote Kruisstraat 2/1, 9712 TS Groningen, the Netherlands; Department of Psychology, Education & Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, 3062 PA Rotterdam, the Netherlands
| |
Collapse
|
21
|
Piot M, Mestdagh M, Riese H, Weermeijer J, Brouwer JM, Kuppens P, Dejonckheere E, Bos FM. Practitioner and researcher perspectives on the utility of ecological momentary assessment in mental health care: A survey study. Internet Interv 2022; 30:100575. [PMID: 36193339 PMCID: PMC9526140 DOI: 10.1016/j.invent.2022.100575] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 07/05/2022] [Accepted: 09/23/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Ecological momentary assessment (EMA) is a scientific self-monitoring method to capture individuals' daily life experiences. Early on, EMA has been suggested to have the potential to improve mental health care. However, it remains unclear if and how EMA should be implemented. This requires an in-depth investigation of how practitioners and researchers view the implementation of EMA. OBJECTIVE Explore the perspectives of mental health practitioners and EMA researchers on the utility of EMA for mental health care. METHODS Practitioners (n = 89; psychiatrists, psychologists, psychiatric nurses) and EMA researchers (n = 62) completed a survey about EMA in clinical practice. This survey addressed EMA goals for practitioner and patient, requirements regarding clinical use of EMA, and (dis)advantages of EMA compared to treatment-as-usual. t-Tests were used to determine agreement with each statement and whether practitioners' and researchers' views differed significantly. Linear regression was used to explore predictors of goals and preferences (e.g., EMA experience). RESULTS Practitioners and researchers considered EMA to be a useful clinical tool for diverse stages of care. They indicated EMA to be most useful for gaining insight into the context specificity of symptoms (55.0 %), whereas receiving alerts when symptoms increase was rated the least useful (11.3 %, alerts is in 95 % of bootstrap iterations between rank 8 and 10). Compared to treatment-as-usual, EMA was considered easier to use (M = 4.87, t = 5.30, p < .001) and interpret (M = 4.52, t = 3.61, p < .001), but also more burdensome for the patient (M = 4.48, t = 3.17, p < .001). Although participants preferred personalization of the EMA diary, they also suggested that EMA should cost practitioners and patients limited time. The preference for creating personalized EMA was related to the level of experience with EMA. Finally, they highlighted the need for practitioner training and patient full-time access to the EMA feedback. CONCLUSIONS This survey study demonstrated that practitioners and researchers expect EMA to have added value for mental health care. Concrete recommendations for implementation of EMA are formulated. This may inform the development of specific clinical applications and user-friendly EMA software.
Collapse
Affiliation(s)
- Maarten Piot
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Corresponding author at: Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Leuven 3000, Belgium.
| | - Merijn Mestdagh
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Harriëtte Riese
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Jeroen Weermeijer
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Jannie M.A. Brouwer
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| | - Peter Kuppens
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Egon Dejonckheere
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Department Medical and Clinical Psychology, Tilburg School of Social and Behavioral Sciences, Tilburg, Belgium
| | - Fionneke M. Bos
- University of Groningen, University Medical Center Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), Groningen, the Netherlands
| |
Collapse
|
22
|
Bos FM, von Klipstein L, Emerencia AC, Veermans E, Verhage T, Snippe E, Doornbos B, Hadders-Prins G, Wichers M, Riese H. A Web-Based Application for Personalized Ecological Momentary Assessment in Psychiatric Care: User-Centered Development of the PETRA Application. JMIR Ment Health 2022; 9:e36430. [PMID: 35943762 PMCID: PMC9399881 DOI: 10.2196/36430] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 04/11/2022] [Accepted: 05/06/2022] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Smartphone self-monitoring of mood, symptoms, and contextual factors through ecological momentary assessment (EMA) provides insights into the daily lives of people undergoing psychiatric treatment. Therefore, EMA has the potential to improve their care. To integrate EMA into treatment, a clinical tool that helps clients and clinicians create personalized EMA diaries and interpret the gathered data is needed. OBJECTIVE This study aimed to develop a web-based application for personalized EMA in specialized psychiatric care in close collaboration with all stakeholders (ie, clients, clinicians, researchers, and software developers). METHODS The participants were 52 clients with mood, anxiety, and psychotic disorders and 45 clinicians (psychiatrists, psychologists, and psychiatric nurses). We engaged them in interviews, focus groups, and usability sessions to determine the requirements for an EMA web application and repeatedly obtained feedback on iteratively improved high-fidelity EMA web application prototypes. We used human-centered design principles to determine important requirements for the web application and designed high-fidelity prototypes that were continuously re-evaluated and adapted. RESULTS The iterative development process resulted in Personalized Treatment by Real-time Assessment (PETRA), which is a scientifically grounded web application for the integration of personalized EMA in Dutch clinical care. PETRA includes a decision aid to support clients and clinicians with constructing personalized EMA diaries, an EMA diary item repository, an SMS text message-based diary delivery system, and a feedback module for visualizing the gathered EMA data. PETRA is integrated into electronic health record systems to ensure ease of use and sustainable integration in clinical care and adheres to privacy regulations. CONCLUSIONS PETRA was built to fulfill the needs of clients and clinicians for a user-friendly and personalized EMA tool embedded in routine psychiatric care. PETRA is unique in this codevelopment process, its extensive but user-friendly personalization options, its integration into electronic health record systems, its transdiagnostic focus, and its strong scientific foundation in the design of EMA diaries and feedback. The clinical effectiveness of integrating personalized diaries via PETRA into care requires further research. As such, PETRA paves the way for a systematic investigation of the utility of personalized EMA for routine mental health care.
Collapse
Affiliation(s)
- Fionneke M Bos
- Rob Giel Research Center, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Lino von Klipstein
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Ando C Emerencia
- Research Support, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Erwin Veermans
- Rob Giel Research Center, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Tom Verhage
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Evelien Snippe
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | | | - Grietje Hadders-Prins
- Rob Giel Research Center, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Marieke Wichers
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Harriëtte Riese
- Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| |
Collapse
|
23
|
Rosen M, Betz LT, Montag C, Kannen C, Kambeitz J. Transdiagnostic Psychopathology in a Help-Seeking Population of an Early Recognition Center for Mental Disorders: Protocol for an Experience Sampling Study. JMIR Res Protoc 2022; 11:e35206. [PMID: 35916702 PMCID: PMC9379784 DOI: 10.2196/35206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 05/11/2022] [Accepted: 05/12/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Prevention in psychiatry provides a promising way to address the burden of mental illness. However, established approaches focus on specific diagnoses and do not address the heterogeneity and manifold potential outcomes of help-seeking populations that present at early recognition services. Conceptualizing the psychopathology manifested in help-seeking populations from a network perspective of interacting symptoms allows transdiagnostic investigations beyond binary disease categories. Furthermore, modern technologies such as smartphones facilitate the application of the Experience Sampling Method (ESM). OBJECTIVE This study is a combination of ESM with network analyses to provide valid insights beyond the established assessment instruments in a help-seeking population. METHODS We will examine 75 individuals (aged 18-40 years) of the help-seeking population of the Cologne early recognition center. For a maximally naturalistic sample, only minimal exclusion criteria will be applied. We will collect data for 14 days using a mobile app to assess 10 transdiagnostic symptoms (ie, depressive, anxious, and psychotic symptoms) as well as distress level 5 times a day. With these data, we will generate average group-level symptom networks and personalized symptom networks using a 2-step multilevel vector autoregressive model. Additionally, we will explore associations between symptom networks and sociodemographic, risk, and resilience factors, as well as psychosocial functioning. RESULTS The protocol was designed in February 2020 and approved by the Ethics Committee of the University Hospital Cologne in October 2020. The protocol was reviewed and funded by the Köln Fortune program in September 2020. Data collection began in November 2020 and was completed in November 2021. Of the 258 participants who were screened, 93 (36%) fulfilled the inclusion criteria and were willing to participate in the study. Of these 93 participants, 86 (92%) completed the study. The first results are expected to be published in 2022. CONCLUSIONS This study will provide insights about the feasibility and utility of the ESM in a help-seeking population of an early recognition center. Providing the first explorative phenotyping of transdiagnostic psychopathology in this population, our study will contribute to the innovation of early recognition in psychiatry. The results will help pave the way for prevention and targeted early intervention in a broader patient group, and thus, enable greater intended effects in alleviating the burden of psychiatric disorders. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/35206.
Collapse
Affiliation(s)
- Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Linda T Betz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| | - Christian Montag
- Institute of Psychology and Education, Ulm University, Ulm, Germany
| | | | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital of Cologne, University of Cologne, Cologne, Germany
| |
Collapse
|
24
|
Zuidersma M, Müller F, Snippe E, Zuidema SU, Oude Voshaar RC. Feasibility, usability and clinical value of intensive longitudinal diary assessments in older persons with cognitive impairment and depressive symptoms. Aging Ment Health 2022:1-10. [PMID: 35876158 DOI: 10.1080/13607863.2022.2102143] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVES To evaluate the feasibility, usability and clinical value of daily diary assessments combined with actigraphy in older persons with cognitive impairment. METHODS For 63 days, patients ≥60 years with cognitive impairments filled out a daily diary (including standardized questionnaires and cognitive test battery), and wore an actiwatch (sleep). After the study, participants and clinicians received personal feedback about patterns and daily triggers of depressive symptoms, sleep and cognitive performance. We assessed feasibility (participation rate, compliance and subjective burden), usability (variability and floor- or ceiling effects) and clinical value for patients and their clinicians (questionnaires). RESULTS Of 96 eligible patients, 13 agreed to participate (13.5%). One patient dropped out after 2 days, another after 37 days, and another did not complete the cognitive test battery. Compliance rate was high (6.7-10% missing values). Subjective burden was relatively low. Time-series data showed sufficient variability and no floor- or ceiling effects, except for one relevant ceiling effect on the One Back task. The personal feedback report was considered insightful by 4 out of 11 participants and 5 out of 7 clinicians. CONCLUSION Daily assessments are suitable for a minority of cognitively impaired older persons, but is helpful to increase insight into their symptoms.
Collapse
Affiliation(s)
- Marij Zuidersma
- Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Fabiola Müller
- Department of Health Psychology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Evelien Snippe
- Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sytse U Zuidema
- Department of General Practice and Elderly Care Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Richard C Oude Voshaar
- Interdisciplinary Center Psychopathology and Emotion regulation, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
25
|
Digital tools for the assessment of pharmacological treatment for depressive disorder: State of the art. Eur Neuropsychopharmacol 2022; 60:100-116. [PMID: 35671641 DOI: 10.1016/j.euroneuro.2022.05.007] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 12/23/2022]
Abstract
Depression is an invalidating disorder, marked by phenotypic heterogeneity. Clinical assessments for treatment adjustments and data-collection for pharmacological research often rely on subjective representations of functioning. Better phenotyping through digital applications may add unseen information and facilitate disentangling the clinical characteristics and impact of depression and its pharmacological treatment in everyday life. Researchers, physicians, and patients benefit from well-understood digital phenotyping approaches to assess the treatment efficacy and side-effects. This review discusses the current possibilities and pitfalls of wearables and technology for the assessment of the pharmacological treatment of depression. Their applications in the whole spectrum of treatment for depression, including diagnosis, treatment of an episode, and monitoring of relapse risk and prevention are discussed. Multiple aspects are to be considered, including concerns that come with collecting sensitive data and health recordings. Also, privacy and trust are addressed. Available applications range from questionnaire-like apps to objective assessment of behavioural patterns and promises in handling suicidality. Nonetheless, interpretation and integration of this high-resolution information with other phenotyping levels, remains challenging. This review provides a state-of-the-art description of wearables and technology in digital phenotyping for monitoring pharmacological treatment in depression, focusing on the challenges and opportunities of its application in clinical trials and research.
Collapse
|
26
|
Zarate D, Stavropoulos V, Ball M, de Sena Collier G, Jacobson NC. Exploring the digital footprint of depression: a PRISMA systematic literature review of the empirical evidence. BMC Psychiatry 2022; 22:421. [PMID: 35733121 PMCID: PMC9214685 DOI: 10.1186/s12888-022-04013-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 05/17/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND This PRISMA systematic literature review examined the use of digital data collection methods (including ecological momentary assessment [EMA], experience sampling method [ESM], digital biomarkers, passive sensing, mobile sensing, ambulatory assessment, and time-series analysis), emphasizing on digital phenotyping (DP) to study depression. DP is defined as the use of digital data to profile health information objectively. AIMS Four distinct yet interrelated goals underpin this study: (a) to identify empirical research examining the use of DP to study depression; (b) to describe the different methods and technology employed; (c) to integrate the evidence regarding the efficacy of digital data in the examination, diagnosis, and monitoring of depression and (d) to clarify DP definitions and digital mental health records terminology. RESULTS Overall, 118 studies were assessed as eligible. Considering the terms employed, "EMA", "ESM", and "DP" were the most predominant. A variety of DP data sources were reported, including voice, language, keyboard typing kinematics, mobile phone calls and texts, geocoded activity, actigraphy sensor-related recordings (i.e., steps, sleep, circadian rhythm), and self-reported apps' information. Reviewed studies employed subjectively and objectively recorded digital data in combination with interviews and psychometric scales. CONCLUSIONS Findings suggest links between a person's digital records and depression. Future research recommendations include (a) deriving consensus regarding the DP definition and (b) expanding the literature to consider a person's broader contextual and developmental circumstances in relation to their digital data/records.
Collapse
Affiliation(s)
- Daniel Zarate
- Institute for Health and Sport, Victoria University, Melbourne, Australia.
| | - Vasileios Stavropoulos
- grid.1019.90000 0001 0396 9544Institute for Health and Sport, Victoria University, Melbourne, Australia ,grid.5216.00000 0001 2155 0800Department of Psychology, University of Athens, Athens, Greece
| | - Michelle Ball
- grid.1019.90000 0001 0396 9544Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Gabriel de Sena Collier
- grid.1019.90000 0001 0396 9544Institute for Health and Sport, Victoria University, Melbourne, Australia
| | - Nicholas C. Jacobson
- grid.254880.30000 0001 2179 2404Center for Technology and Behavioral Health, Geisel School of Medicine, Dartmouth College, Hanover, USA ,grid.254880.30000 0001 2179 2404Department of Biomedical Data Science, Geisel School of Medicine, Dartmouth College, Hanover, USA ,grid.254880.30000 0001 2179 2404Department of Psychiatry, Geisel School of Medicine, Dartmouth College, Hanover, USA ,grid.254880.30000 0001 2179 2404Quantitative Biomedical Sciences Program, Dartmouth College, Hanover, USA
| |
Collapse
|
27
|
Fletcher K, Lindblom K, Seabrook E, Foley F, Murray G. Pilot Testing in the Wild: Feasibility, Acceptability, Usage Patterns, and Efficacy of an Integrated Web and Smartphone Platform for Bipolar II Disorder. JMIR Form Res 2022; 6:e32740. [PMID: 35639462 PMCID: PMC9198820 DOI: 10.2196/32740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 11/24/2022] Open
Abstract
Background Bipolar II disorder (BD-II) is associated with significant burden, disability, and mortality; however, there continues to be a dearth of evidence-based psychological interventions for this condition. Technology-mediated interventions incorporating self-management have untapped potential to help meet this need as an adjunct to usual clinical care. Objective The objective of this pilot study is to assess the feasibility, acceptability, and clinical utility of a novel intervention for BD-II (Tailored Recovery-oriented Intervention for Bipolar II Experiences; TRIBE), in which mindfulness-based psychological content is delivered via an integrated web and smartphone platform. The focus of the study is evaluation of the dynamic use patterns emerging from ecological momentary assessment and intervention to assist the real-world application of mindfulness skills learned from web-delivered modules. Methods An open trial design using pretest and posttest assessments with nested qualitative evaluation was used. Individuals (aged 18-65 years) with a diagnosis of BD-II were recruited worldwide and invited to use a prototype of the TRIBE intervention over a 3-week period. Data were collected via web-based questionnaires and phone interviews at baseline and 3-week follow-up. Results A total of 25 participants completed baseline and follow-up assessments. Adherence rates (daily app use) were 65.6% across the 3-week study, with up to 88% (22/25) of participants using the app synergistically alongside the web-based program. Despite technical challenges with the prototype intervention (from user, hardware, and software standpoints), acceptability was adequate, and most participants rated the intervention positively in terms of concept (companion app with website: 19/25, 76%), content (19/25, 76%), and credibility and utility in supporting their management of bipolar disorder (17/25, 68%). Evaluation using behavioral archetypes identified important use pathways and a provisional model to inform platform refinement. As hypothesized, depression scores significantly decreased after the intervention (Montgomery-Asberg Depression Rating Scale baseline mean 8.60, SD 6.86, vs follow-up mean 6.16, SD 5.11; t24=2.63; P=.01; Cohen d=0.53, 95% CI 0.52-4.36). Conclusions Our findings suggest that TRIBE is feasible and represents an appropriate and acceptable self-management program for patients with BD-II. Preliminary efficacy results are promising and support full development of TRIBE informed by the present behavioral archetype analysis. Modifications suggested by the pilot study include increasing the duration of the intervention and increasing technical support.
Collapse
Affiliation(s)
- Kathryn Fletcher
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Katrina Lindblom
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Elizabeth Seabrook
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Fiona Foley
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| | - Greg Murray
- Centre for Mental Health, Swinburne University of Technology, Melbourne, Australia
| |
Collapse
|
28
|
Cannabis use as a predictor and outcome of positive and negative affect in college students: An ecological momentary assessment study. Addict Behav 2022; 128:107221. [PMID: 35077928 DOI: 10.1016/j.addbeh.2021.107221] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/19/2021] [Accepted: 12/20/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Reinforcement models identify negative affect (NA) and positive affect (PA) to be important momentary determinants and outcomes of cannabis use. Sensitization and allostatic models further suggest that these mood-cannabis associations are stronger among individuals with more cannabis-related problems. Despite this theoretical background and the fact that cannabis is commonly used for its mood-enhancing effects among college students, surprisingly, little is known about the momentary associations between mood and cannabis use in this population. AIMS To examine the associations between (a) momentary within-person variations in NA (worried, stressed, nervous) and PA (happy, enthusiastic, proud, excited) and intention to use cannabis within the next hour, (b) the within-person variations in time elapsed since last cannabis use, amount used and momentary NA and PA, and (c) to test whether cannabis-related problems moderate the stated associations. METHOD Eighty, more-than-weekly, cannabis using students at the University of Amsterdam reported on cannabis use, NA and PA three times daily for 14 consecutive days. Mixed-effects models were performed to analyze the dataset. RESULTS Within-persons, relatively high PA and low NA were associated with a higher likelihood of intending to use cannabis. Within-persons, more recent and greater amounts of cannabis use were associated with relatively high PA. More recent cannabis use was associated with relatively low NA. Cannabis-related problems did not moderate the associations. CONCLUSIONS While recent cannabis use related to higher PA and lower NA, high PA but low NA preceded use, supporting positive reinforcement rather than negative reinforcement in this college sample of regular cannabis users.
Collapse
|
29
|
Beymer PN, Robinson KA. Motivating by Measuring Motivation? Examining Reactivity in a Diary Study on Student Motivation. CONTEMPORARY EDUCATIONAL PSYCHOLOGY 2022. [DOI: 10.1016/j.cedpsych.2022.102072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
30
|
Lazeron-Savu E, Lenaert B, Ponds R, van Heugten C. The association of personality traits with poststroke fatigue in daily life: An exploratory experience sampling method and cross-sectional study. Neuropsychol Rehabil 2022:1-16. [PMID: 35383536 DOI: 10.1080/09602011.2022.2059524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Fatigue is a frequently occurring and persistent symptom after stroke. Many biological, psychosocial, and behavioural factors are associated with poststroke fatigue, but research into associations with personality traits is relatively sparse. In this study, we explored whether personality traits were related to poststroke fatigue measured with conventional fatigue questionnaires as well as experience sampling methodology (ESM). Twenty-four individuals with stroke completed 10 daily questionnaires about momentary (here-and-now) fatigue for six consecutive days using the mHealth ESM application PsyMateTM. Further, they completed questionnaires assessing personality (NEO-FFI and LOR-T) and fatigue (FSS). Results showed that higher extraversion (ß = -.44, SE = .12, p = .001; 95% CI = -.67-.19) and optimism (ß = -.18, SE = .06, p = .007; 95% CI = -.30-.05) were associated with lower momentary fatigue. No association was found between neuroticism and momentary fatigue, but higher neuroticism (r = 0.531, p = .008, 95% CI = .160-.759; r = .574, p = .003, 95% CI = .245-.767) was associated with higher scores on the retrospective FSS scales. We conclude that personality traits differentially influence poststroke fatigue, but this also depends on the way fatigue is measured (with retrospective or with momentary measures). When functional gains are not in line with expected progress during the rehabilitation treatment of fatigue, it may be appropriate to take into account how person characteristics are related to momentary fatigue.
Collapse
Affiliation(s)
- Ela Lazeron-Savu
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Department of Medical Psychology, Maastricht University Medical Center, Maastricht, Netherlands
| | - Bert Lenaert
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Limburg Brain Injury Center, Maastricht, Netherlands.,Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands.,Faculty of Psychology, Op Univeristy, Heerlen, The Netherlands
| | - Rudolf Ponds
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Limburg Brain Injury Center, Maastricht, Netherlands.,Department of Medical Psychology, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Caroline van Heugten
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.,Limburg Brain Injury Center, Maastricht, Netherlands.,Department of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| |
Collapse
|
31
|
Piccirillo ML, Rodebaugh TL. Personalized networks of social anxiety disorder and depression and implications for treatment. J Affect Disord 2022; 298:262-276. [PMID: 34699851 PMCID: PMC8690310 DOI: 10.1016/j.jad.2021.10.034] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 10/01/2021] [Accepted: 10/20/2021] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Social anxiety disorder (SAD) and major depressive disorder (MDD) often co-occur; however, there is limited research evaluating how cognitive-affective and behavioral factors maintain SAD and MDD for specific individuals. Evidence suggests that individuals exhibit symptom-level heterogeneity, necessitating a person-specific approach to assessment and intervention. We compared group and person-specific models of SAD-MDD comorbidity and hypothesized that individuals would demonstrate person-specific patterns of comorbidity factors that differed from the group. METHODS Cisgender women (N = 35) with SAD and a current or past major depressive episode were recruited. Ages ranged from 18 to 37 years old and a majority of women were White (n = 18; 51.43%). Brief ecological momentary assessment surveys related to SAD-MDD comorbidity were administered five times a day for a month (T = 4,357). RESULTS Multilevel and person-specific network analyses were used to examine between-, within-, and person-specific patterns. Intra-daily depressed mood demonstrated the strongest connections to other variables and exhibited additional, unexpected temporal effects. All models demonstrated person-specific patterns relevant to SAD-MDD comorbidity. LIMITATIONS These results are descriptive in nature from women with a similar psychiatric profile. Future research integrating intensive EMA and personalized modeling within the context of experimental design is needed to determine the extent to which individuals truly differ from the group. CONCLUSIONS Patterns of SAD-MDD comorbidity varied substantially across women, underscoring the potential for results from person-specific (idiographic) networks to inform the development and implementation of personalized directives for clinical assessment and intervention.
Collapse
Affiliation(s)
- Marilyn L Piccirillo
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA.
| | - Thomas L Rodebaugh
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO 63130, USA
| |
Collapse
|
32
|
Bartels SL, van Knippenberg RJM, Viechtbauer W, Simons CJP, Ponds RW, Myin-Germeys I, Verhey FRJ, de Vugt ME. Intervention mechanisms of an experience sampling intervention for spousal carers of people with dementia: a secondary analysis using momentary data. Aging Ment Health 2022; 26:294-304. [PMID: 33291998 DOI: 10.1080/13607863.2020.1857692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objectives: A psychosocial intervention for spousal carers of people with dementia promoted emotional well-being through self-monitoring and personalized feedback, as demonstrated in a previous randomized controlled trial. The mechanism behind the intervention effects is thought to lie in increased awareness of, and thus, engagement in behaviours that elicit positive emotions (PA). This secondary analysis tests the assumption by investigating momentary data on activities, affect, and stress and explores the relevance of personalized feedback compared to self-monitoring only.Methods: The intervention was based on the experience sampling method (ESM), meaning that carers self-monitored own affect and behaviours 10 times/day over 6 weeks. The experimental group received personalized feedback on behaviours that elicit PA, while the pseudo-experimental group performed self-monitoring only. A control group was also included. ESM-data of 72 carers was analysed using multilevel mixed-effects models.Results: The experimental group reported significant increases in passive relaxation activities over the 6 weeks (B = 0.28, SE = 0.12, Z = 2.43, p < .05). Passive relaxation in this group was negatively associated with negative affect (r = -0.50, p = .01) and positively associated with activity-related stress (r = 0.52, p = .007) from baseline to post-intervention. Other activities in this or the other groups did not change significantly.Conclusion: Carer's daily behaviours were only affected when self-monitoring was combined with personalized feedback. Changing one's daily behaviour while caring for a person with dementia is challenging and aligned with mixed emotions. Acknowledging simultaneously positive and negative emotions, and feelings of stress is suggested to embrace the complexity of carer's life and provide sustainable support.
Collapse
Affiliation(s)
- Sara Laureen Bartels
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Rosalia J M van Knippenberg
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Claudia J P Simons
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands.,GGzE, Institute of Mental Health Care Eindhoven, Eindhoven, The Netherlands
| | - Rudolf W Ponds
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Inez Myin-Germeys
- Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Frans R J Verhey
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| | - Marjolein E de Vugt
- Alzheimer Center Limburg, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, the Netherlands
| |
Collapse
|
33
|
van Genugten CR, Schuurmans J, Hoogendoorn AW, Araya R, Andersson G, Baños RM, Berger T, Botella C, Cerga Pashoja A, Cieslak R, Ebert DD, García-Palacios A, Hazo JB, Herrero R, Holtzmann J, Kemmeren L, Kleiboer A, Krieger T, Rogala A, Titzler I, Topooco N, Smit JH, Riper H. A Data-Driven Clustering Method for Discovering Profiles in the Dynamics of Major Depressive Disorder Using a Smartphone-Based Ecological Momentary Assessment of Mood. Front Psychiatry 2022; 13:755809. [PMID: 35370856 PMCID: PMC8968132 DOI: 10.3389/fpsyt.2022.755809] [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: 08/10/2021] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although major depressive disorder (MDD) is characterized by a pervasive negative mood, research indicates that the mood of depressed patients is rarely entirely stagnant. It is often dynamic, distinguished by highs and lows, and it is highly responsive to external and internal regulatory processes. Mood dynamics can be defined as a combination of mood variability (the magnitude of the mood changes) and emotional inertia (the speed of mood shifts). The purpose of this study is to explore various distinctive profiles in real-time monitored mood dynamics among MDD patients in routine mental healthcare. METHODS Ecological momentary assessment (EMA) data were collected as part of the cross-European E-COMPARED trial, in which approximately half of the patients were randomly assigned to receive the blended Cognitive Behavioral Therapy (bCBT). In this study a subsample of the bCBT group was included (n = 287). As part of bCBT, patients were prompted to rate their current mood (on a 1-10 scale) using a smartphone-based EMA application. During the first week of treatment, the patients were prompted to rate their mood on three separate occasions during the day. Latent profile analyses were subsequently applied to identify distinct profiles based on average mood, mood variability, and emotional inertia across the monitoring period. RESULTS Overall, four profiles were identified, which we labeled as: (1) "very negative and least variable mood" (n = 14) (2) "negative and moderate variable mood" (n = 204), (3) "positive and moderate variable mood" (n = 41), and (4) "negative and highest variable mood" (n = 28). The degree of emotional inertia was virtually identical across the profiles. CONCLUSIONS The real-time monitoring conducted in the present study provides some preliminary indications of different patterns of both average mood and mood variability among MDD patients in treatment in mental health settings. Such varying patterns were not found for emotional inertia.
Collapse
Affiliation(s)
- Claire R van Genugten
- Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands.,Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands
| | - Josien Schuurmans
- Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | - Adriaan W Hoogendoorn
- Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | - Ricardo Araya
- Institute of Psychiatry Psychology and Neurosciences, King's College London, London, United Kingdom
| | - Gerhard Andersson
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Rosa M Baños
- Polibienestar Research Institute, University of Valencia, Valencia, Spain.,CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain.,Department of Personality, Evaluation and Psychological Treatment, Faculty of Psychology, University of Valencia, Valencia, Spain
| | - Thomas Berger
- Department of Clinical Psychology, University of Bern, Bern, Switzerland
| | - Cristina Botella
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain.,Department of Basic and Clinical Psychology and Psychobiology, Faculty of Health Sciences, Jaume I University, Castellon de la Plana, Spain
| | - Arlinda Cerga Pashoja
- Department of Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Roman Cieslak
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland.,Lyda Hill Institute for Human Resilience, Colorado Springs, CO, United States
| | - David D Ebert
- Department for Sport and Health Sciences, Technical University (TU) Munich, Munich, Germany
| | - Azucena García-Palacios
- CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain.,Department of Basic and Clinical Psychology and Psychobiology, Faculty of Health Sciences, Jaume I University, Castellon de la Plana, Spain
| | - Jean-Baptiste Hazo
- Eceve, Unit 1123, Inserm, University of Paris, Health Economics Research Unit, Assistance Publique-Hôpitaux de Paris, Paris, France.,Unité de Recherche en Economie de la Santé, Assistance Publique, Hôpitaux de Paris, Paris, France
| | - Rocío Herrero
- Polibienestar Research Institute, University of Valencia, Valencia, Spain.,CIBERObn Physiopathology of Obesity and Nutrition, Instituto de Salud Carlos III, Madrid, Spain
| | - Jérôme Holtzmann
- Mood Disorders and Emotional Pathologies Unit, Centre Expert Depression Résistante Fondation Fondamental, Pôle de Psychiatrie, Neurologie et Rééducation Neurologique, University Hospital Grenoble Alpes, Grenoble, France
| | - Lise Kemmeren
- Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | - Annet Kleiboer
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands
| | - Tobias Krieger
- Department of Clinical Psychology, University of Bern, Bern, Switzerland
| | - Anna Rogala
- Faculty of Psychology, SWPS University of Social Sciences and Humanities, Warsaw, Poland
| | - Ingrid Titzler
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen, Germany
| | - Naira Topooco
- Department of Behavioural Sciences and Learning, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.,Center for m2Health, Palo Alto, CA, United States
| | - Johannes H Smit
- Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands
| | - Heleen Riper
- Department of Psychiatry, Amsterdam Public Health Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, Netherlands.,Department of Clinical, Neuro and Developmental Psychology, Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands.,Institute of Telepsychiatry, University of Southern Denmark, Odense, Denmark.,University of Turku, Faculty of Medicine, Turku, Finland
| |
Collapse
|
34
|
Youth Psychopathology in Daily Life: Systematically Reviewed Characteristics and Potentials of Ecological Momentary Assessment Applications. Child Psychiatry Hum Dev 2022; 53:1129-1147. [PMID: 34075490 PMCID: PMC9560926 DOI: 10.1007/s10578-021-01177-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/21/2021] [Indexed: 11/25/2022]
Abstract
Traditionally, symptoms of youth psychopathology are assessed with questionnaires, clinical interviews, or laboratory observations. Ecological Momentary Assessment (EMA) could be a particularly valuable additional methodology, since EMA enables examining the daily lives of youths near real-time, considering fluctuations and specific contexts of symptoms. This systematic review aimed to review the characteristics of current EMA applications and to provide a synthesis of their potential in studying youth psychopathology. Following a systematic search in PsycInfo and Medline, we identified 50 studies in clinical samples. Most studies used EMA to examine fluctuations in symptoms, affect, and behavior, and the relation with contextual factors. EMA was also used to investigate interactions between parents and their children over time, and to monitor and predict treatment response. EMA appeared feasible in youth and could provide valuable insights that contribute to understanding youth psychopathology. Benefits, gaps, and suggestions for future research and clinical practice are discussed.
Collapse
|
35
|
Temporal dynamics of depression, cognitive performance and sleep in older persons with depressive symptoms and cognitive impairments: a series of eight single-subject studies. Int Psychogeriatr 2022; 34:47-59. [PMID: 33715659 DOI: 10.1017/s1041610221000065] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVES To investigate the presence, nature and direction of the daily temporal association between depressive symptoms, cognitive performance and sleep in older individuals. DESIGN, SETTING, PARTICIPANTS Single-subject study design in eight older adults with cognitive impairments and depressive symptoms. MEASUREMENTS For 63 consecutive days, depressive symptoms, working memory performance and night-time sleep duration were daily assessed with an electronic diary and actigraphy. The temporal associations of depressive symptoms, working memory and total sleep time were evaluated for each participant separately with time-series analysis (vector autoregressive modeling). RESULTS For seven out of eight participants we found a temporal association between depressive symptoms and/or sleep and/or working memory performance. More depressive symptoms were preceded by longer sleep duration in one person (r = 0.39; p < .001), by longer or shorter sleep duration than usual in one other person (B = 0.49; p < .001), by worse working memory in one person (B = -0.45; p = .007), and by better working memory performance in one other person (B = 0.35; p = .009). Worse working memory performance was preceded by longer sleep duration (r = -.35; p = .005) in one person, by shorter or longer sleep duration in three other persons (B = -0.76; p = .005, B = -0.61; p < .001; B = -0.34; p = .002), and by more depressive symptoms in one person (B = -0.25; p = .009). CONCLUSION The presence, nature and direction of the temporal associations between depressive symptoms, cognitive performance and sleep differed between individuals. Knowledge of personal temporal associations may be valuable for the development of personalized intervention strategies in order to maintain their health, quality of life, functional outcomes and independence.
Collapse
|
36
|
Williams AJ, Arcelus J, Townsend E, Michail M. Feasibility and acceptability of experience sampling among LGBTQ+ young people with self-harmful thoughts and behaviours. Front Psychiatry 2022; 13:916164. [PMID: 36061288 PMCID: PMC9428709 DOI: 10.3389/fpsyt.2022.916164] [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: 04/08/2022] [Accepted: 07/20/2022] [Indexed: 11/13/2022] Open
Abstract
This study was the first to determine whether it was feasible and acceptable to use experience sampling methods (ESM) among LGBTQ+ young people, who had current experiences of self-harm. Sixteen LGBTQ+ young people (16-25 years old) took part in the experience sampling study. This included a baseline assessment, a 7-day ESM assessment (participants were sampled six times a day using a phone app), and the option of an interview at the end of the 7-day ESM assessment. Feasibility data was descriptively analysed, with pilot ESM data presented. Qualitative data was thematically analysed to determine the acceptability (barriers and facilitators) of taking part in this study. Study feasibility was assessed by enrolment rate (55.2%), participant retention across assessment period (100%), ESM app feasibility (87.5%), and good adherence to total number of ESM surveys (67.6%). Individual study adherence ranged between 43 and 95.2%. Study acceptability was assessed by participant interviews. Thematic analysis indicated four superordinate themes; (i) Self-reflection and awareness; (ii) Practicalities of ESM surveys; (iii) Daily timeframes; and (iv) Suggestions for future studies. Pilot ESM data demonstrates that there was fluctuation of depressive and anxiety symptoms within- and between- participants over the course of the study, however, greater sample power is needed for full analysis. This study demonstrated that ESM designs are feasible and acceptable among LGBTQ+ young people with current experiences of self-harm. Pilot data indicated that specific experiences and moods are likely to be important to self-harm. These potentially have a temporal influence on self-harm behaviour or ideation, and therefore should be examined in a fully powered sample.
Collapse
Affiliation(s)
- A J Williams
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom.,Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, United Kingdom.,Informatics, Faculty of Natural, Mathematical and Engineering Sciences, King's College London, London, United Kingdom
| | - Jon Arcelus
- Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom.,Bellvitge Biomedical Research Institute (IDIBELL), University of Barcelona, Barcelona, Spain
| | - Ellen Townsend
- Self-Harm Research Group, School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Maria Michail
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, United Kingdom
| |
Collapse
|
37
|
Leertouwer IJ, Cramer AOJ, Vermunt JK, Schuurman NK. A Review of Explicit and Implicit Assumptions When Providing Personalized Feedback Based on Self-Report EMA Data. Front Psychol 2021; 12:764526. [PMID: 34955984 PMCID: PMC8693716 DOI: 10.3389/fpsyg.2021.764526] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 10/15/2021] [Indexed: 11/30/2022] Open
Abstract
Ecological Momentary Assessment (EMA) in which participants report on their moment-to-moment experiences in their natural environment, is a hot topic. An emerging field in clinical psychology based on either EMA, or what we term Ecological Retrospective Assessment (ERA) as it requires retrospectivity, is the field of personalized feedback. In this field, EMA/ERA-data-driven summaries are presented to participants with the goal of promoting their insight in their experiences. Underlying this procedure are some fundamental assumptions about (i) the relation between true moment-to-moment experiences and retrospective evaluations of those experiences, (ii) the translation of these experiences and evaluations to different types of data, (iii) the comparison of these different types of data, and (iv) the impact of a summary of moment-to-moment experiences on retrospective evaluations of those experiences. We argue that these assumptions deserve further exploration, in order to create a strong evidence-based foundation for the personalized feedback procedure.
Collapse
Affiliation(s)
- IJsbrand Leertouwer
- Department of Methodology and Statistics, Tilburg University, Tilburg, Netherlands
| | - Angélique O J Cramer
- Department of Methodology and Statistics, Tilburg University, Tilburg, Netherlands
| | - Jeroen K Vermunt
- Department of Methodology and Statistics, Tilburg University, Tilburg, Netherlands
| | - Noémi K Schuurman
- Department of Methodology and Statistics, Utrecht University, Utrecht, Netherlands
| |
Collapse
|
38
|
Sznitman SR, Shochat T, van Rijswijk L, Greene T, Cousijn J. Cannabis and Alcohol Use and Their Associations with Sleep: A Daily Diary Investigation of Single-Use and Co-Use in College Students. Cannabis Cannabinoid Res 2021. [PMID: 34935467 DOI: 10.1089/can.2021.0106] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Sleep continuity problems are widespread among college students and may be influenced by single-use and co-use of alcohol and cannabis. We examined the within-person associations of alcohol and cannabis use with subsequent sleep experiences in the everyday life of college students. Materials and Methods: A sample of 80 college students reported prior-night alcohol and cannabis use and sleep experiences for 14 consecutive days. Mixed-effects models examined the within-person relationships between alcohol and cannabis use (single- and co-use) and subsequent (1) sleep-onset latency, (2) total sleep time, (3) number of awakenings, and (4) early awakenings that night. Results: Compared to no-use evenings, alcohol and cannabis, used separately or together (co-use), were associated with shorter sleep-onset latency and longer total sleep time. Students reported more nightly awakenings after alcohol-only use compared to no-use and after co-use, and they reported fewer early awakenings after no-use and co-use. Conclusions: In line with previous experimental findings, we found that alcohol and cannabis use in the everyday life of college students were associated with sleep-inducing effects, and that alcohol use was associated with disturbed sleep continuity. The results suggest that cannabis may curb alcohol's detrimental effect on the number of awakenings and may reduce the incidence of early awakenings. Yet, due to lack of control for potentially important confounders (e.g., quantity of cannabis/alcohol consumed, withdrawal) the current results may be best seen as preliminary and further research is needed before causal inferences can be reached.
Collapse
Affiliation(s)
| | - Tamar Shochat
- The Cheryl Spencer Department of Nursing, University of Haifa, Haifa, Israel
| | - Lukas van Rijswijk
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Talya Greene
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Janna Cousijn
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Neuroscience of Addiction (NofA) Lab, Department of Psychology, Education and Child Studies, Erasmus University Rotterdam, Rotterdam, The Netherlands
| |
Collapse
|
39
|
Mouchabac S, Maatoug R, Conejero I, Adrien V, Bonnot O, Millet B, Ferreri F, Bourla A. In Search of Digital Dopamine: How Apps Can Motivate Depressed Patients, a Review and Conceptual Analysis. Brain Sci 2021; 11:1454. [PMID: 34827453 PMCID: PMC8615613 DOI: 10.3390/brainsci11111454] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/26/2021] [Accepted: 10/28/2021] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Depression is highly prevalent and causes considerable suffering and disease burden despite the existence of wide-ranging treatment options. Momentary assessment is a promising tool in the management of psychiatric disorders, and particularly depression. It allows for a real-time evaluation of symptoms and an earlier detection of relapse or treatment efficacy. Treating the motivational and hedonic aspects of depression is a key target reported in the literature, but it is time-consuming in terms of human resources. Digital Applications offer a major opportunity to indirectly regulate impaired motivational circuits through dopaminergic pathways. OBJECTIVE The main objective of this review was twofold: (1) propose a conceptual and critical review of the literature regarding the theoretical and technical principles of digital applications focused on motivation in depression, activating dopamine, and (2) suggest recommendations on the relevance of using these tools and their potential place in the treatment of depression. MATERIAL AND METHODS A search for words related to "dopamine", "depression", "smartphone apps", "digital phenotype" has been conducted on PubMed. RESULTS Ecological momentary interventions (EMIs) differ from traditional treatments by providing relevant, useful intervention strategies in the context of people's daily lives. EMIs triggered by ecological momentary assessment (EMA) are called "Smart-EMI". Smart-EMIs can mimic the "dopamine reward system" if the intervention is tailored for motivation or hedonic enhancement, and it has been shown that a simple reward (such as a digital badge) can increase motivation. DISCUSSION The various studies presented support the potential interest of digital health in effectively motivating depressed patients to adopt therapeutic activation behaviors. Finding effective ways to integrate EMIs with human-provided therapeutic support may ultimately yield the most efficient and effective intervention method. This approach could be a helpful tool to increase adherence and motivation. CONCLUSION Smartphone apps can motivate depressed patients by enhancing dopamine, offering the opportunity to enhance motivation and behavioral changes, although longer term studies are still needed.
Collapse
Affiliation(s)
- Stephane Mouchabac
- Department of Psychiatry, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, 75012 Paris, France
- iCRIN (Infrastructure for Clinical Research in Neurosciences), Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, 75013 Paris, France
| | - Redwan Maatoug
- iCRIN (Infrastructure for Clinical Research in Neurosciences), Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, 75013 Paris, France
- Sorbonne Université, AP-HP, Service de Psychiatrie Adulte de la Pitié-Salpêtrière, Institut du Cerveau, ICM, 75013 Paris, France
| | - Ismael Conejero
- Department of Psychiatry, CHU Nîmes, University of Montpellier, 30090 Nîmes, France
- Inserm, Unit 1061 "Neuropsychiatry: Epidemiological and Clinical Research", 34000 Montpellier, France
| | - Vladimir Adrien
- Department of Psychiatry, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, 75012 Paris, France
- iCRIN (Infrastructure for Clinical Research in Neurosciences), Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, 75013 Paris, France
| | - Olivier Bonnot
- CHU de Nantes, Department of Child and Adolescent Psychiatry, 44093 Nantes, France
- Pays de la Loire Psychology Laboratory, EA 4638, 44000 Nantes, France
| | - Bruno Millet
- iCRIN (Infrastructure for Clinical Research in Neurosciences), Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, 75013 Paris, France
- Sorbonne Université, AP-HP, Service de Psychiatrie Adulte de la Pitié-Salpêtrière, Institut du Cerveau, ICM, 75013 Paris, France
| | - Florian Ferreri
- Department of Psychiatry, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, 75012 Paris, France
- iCRIN (Infrastructure for Clinical Research in Neurosciences), Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, 75013 Paris, France
| | - Alexis Bourla
- Department of Psychiatry, Hôpital Saint-Antoine, AP-HP, Sorbonne Université, 75012 Paris, France
- iCRIN (Infrastructure for Clinical Research in Neurosciences), Brain Institute (ICM), Sorbonne Université, INSERM, CNRS, 75013 Paris, France
- Jeanne d'Arc Hospital, INICEA Korian, 94160 Saint-Mandé, France
| |
Collapse
|
40
|
Mestdagh M, Dejonckheere E. Ambulatory assessment in psychopathology research: Current achievements and future ambitions. Curr Opin Psychol 2021; 41:1-8. [DOI: 10.1016/j.copsyc.2021.01.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 12/18/2020] [Accepted: 01/04/2021] [Indexed: 11/30/2022]
|
41
|
Schellekens MPJ, Bootsma TI, van Woezik RAM, van der Lee ML. Personalizing Psychological Care for Chronic Cancer-Related Fatigue: A Case Study on Symptom Dynamics. J Pers Oriented Res 2021; 7:1-13. [PMID: 34548915 PMCID: PMC8411882 DOI: 10.17505/jpor.2021.23447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Approximately 25% of cancer patients suffer from chronic cancer-related fatigue (CCRF), which is a complex, multifactorial condition. While there are evidence-based interventions, it remains unclear what treatment works best for the individual patient. Psychological network models can offer a schematic representation of interrelations among fatigue and protective and perpetuating factors for the individual patient. We explored whether feedback based on these individual fatigue networks can help personalize psychological care for CCRF. A 34-year old woman with CCRF was referred to our mental healthcare institute for psycho-oncology. During the waitlist period, she filled out an experience sampling app for 101 days, including five daily assessments of fatigue, pain, mood, activity and fatigue coping. The interplay between items was visualized in network graphs at the moment-level and day-level, which were discussed with the patient. For example, acceptance of fatigue in the past three hours was associated with less hopelessness and less fatigue in the following moment. At the day-level, acceptance was also being associated with less fatigue, less hopelessness, a better mood, and more motivation to do things. The patient recognized these patterns and explained how unexpected waves of fatigue can make her feel hopeless. This started a dialogue on how cultivating acceptance could potentially help her handle the fatigue. The patient would discuss this with her therapist. Feedback based on individual fatigue networks can provide direct insight into how one copes with CCRF and subsequently offer directions for treatment. Further research is needed in order to implement this in clinical practice.
Collapse
Affiliation(s)
- Melanie P J Schellekens
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Professor Bronkhorstlaan 20, 3723MB Bilthoven, the Netherlands.,Tilburg University School of Social and Behavioral Sciences, Department of Medical and Clinical Psychology, Warandelaan 2, Postbus 90153, 5000 LE Tilburg, The Netherlands
| | - Tom I Bootsma
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Professor Bronkhorstlaan 20, 3723MB Bilthoven, the Netherlands.,Tilburg University School of Humanities and Digital Sciences, Department of Culture Studies, Warandelaan 2, Postbus 90153, 5000 LE Tilburg, The Netherlands
| | - Rosalie A M van Woezik
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Professor Bronkhorstlaan 20, 3723MB Bilthoven, the Netherlands
| | - Marije L van der Lee
- Helen Dowling Institute, Centre for Psycho-Oncology, Scientific Research Department, Professor Bronkhorstlaan 20, 3723MB Bilthoven, the Netherlands.,Tilburg University School of Social and Behavioral Sciences, Department of Medical and Clinical Psychology, Warandelaan 2, Postbus 90153, 5000 LE Tilburg, The Netherlands
| |
Collapse
|
42
|
Klaassen T, Smeets FGM, Vork L, Tack J, Talley NJ, Simrén M, Aziz Q, Ford AC, Kruimel JW, Conchillo JM, Leue C, Masclee AAM, Keszthelyi D. Psychometric evaluation of an experience sampling method-based patient-reported outcome measure in functional dyspepsia. Neurogastroenterol Motil 2021; 33:e14136. [PMID: 33934444 PMCID: PMC8519073 DOI: 10.1111/nmo.14136] [Citation(s) in RCA: 3] [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: 12/15/2020] [Revised: 02/16/2021] [Accepted: 03/09/2021] [Indexed: 12/14/2022]
Abstract
BACKGROUND Due to important biases, conventional end-of-day and end-of-week assessment methods of gastrointestinal symptoms in functional dyspepsia (FD) are considered suboptimal. Real-time symptom assessment based on the experience sampling method (ESM) could be a more accurate measurement method. This study aimed to evaluate validity and reliability of an ESM-based patient-reported outcome measure (PROM) for symptom assessment in FD. METHODS Thirty-five patients with FD (25 female, mean age 44.7 years) completed the ESM-based PROM (a maximum of 10 random moments per day) and an end-of-day symptom diary for 7 consecutive days. On day 7, end-of-week questionnaires were completed including the Nepean Dyspepsia Index (NDI) and Patient Assessment of Gastrointestinal Symptom Severity Index (PAGI-SYM). KEY RESULTS Experience sampling method and corresponding end-of-day scores for gastrointestinal symptoms were significantly associated (ICCs range 0.770-0.917). However, end-of-day scores were significantly higher (Δ0.329-1.031) than mean ESM scores (p < 0.05). Comparing ESM with NDI and PAGI-SYM scores, correlations were weaker (Pearson's r range 0.467-0.846). Cronbach's α coefficient was good for upper gastrointestinal symptoms (α = 0.842). First half-week and second half-week scores showed very good consistency (ICCs range 0.913-0.975). CONCLUSION AND INFERENCES Good validity and reliability of a novel ESM-based PROM for assessing gastrointestinal symptoms in FD patients was demonstrated. Moreover, this novel PROM allows to evaluate individual symptom patterns and can evaluate interactions between symptoms and environmental/contextual factors. ESM has the potential to increase patients' disease insight, provide tools for self-management, and improve shared decision making. Hence, this novel tool may aid in the transition toward personalized health care for FD patients.
Collapse
Affiliation(s)
- Tim Klaassen
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
| | - Fabienne G. M. Smeets
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
| | - Lisa Vork
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
| | - Jan Tack
- Department of Clinical and Experimental MedicineTranslational Research Centre for Gastrointestinal Disorders (TARGID)University of LeuvenLeuvenBelgium
| | - Nicholas J. Talley
- Faculty of Health and MedicineUniversity of NewcastleCallaghanNSWAustralia
| | - Magnus Simrén
- Department of Molecular and Clinical MedicineInstitute of MedicineSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Qasim Aziz
- Centre for Neuroscience and TraumaWingate Institute of NeurogastroenterologyBlizard Institute, Barts and the London School of Medicine & DentistryQueen Mary University of LondonLondonUK
| | - Alexander C. Ford
- Leeds Gastroenterology InstituteLeeds Teaching Hospitals NHS TrustLeedsUK,Leeds Institute of Medical Research at St. James'sUniversity of LeedsLeedsUK,Leeds Institute of Biomedical and Clinical SciencesUniversity of LeedsLeedsUK
| | - Joanna W. Kruimel
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
| | - José M. Conchillo
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
| | - Carsten Leue
- Department of Psychiatry and PsychologyMaastricht University Medical CentreMaastrichtThe Netherlands
| | - Adrian A. M. Masclee
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
| | - Daniel Keszthelyi
- Division of Gastroenterology‐HepatologyDepartment of Internal MedicineSchool of Nutrition and Translational Research in Metabolism (NUTRIM)Maastricht University Medical Centre+MaastrichtThe Netherlands
| |
Collapse
|
43
|
Beames JR, Kikas K, Werner-Seidler A. Prevention and early intervention of depression in young people: an integrated narrative review of affective awareness and Ecological Momentary Assessment. BMC Psychol 2021; 9:113. [PMID: 34392830 PMCID: PMC8365890 DOI: 10.1186/s40359-021-00614-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 06/21/2021] [Indexed: 01/03/2023] Open
Abstract
Depression has a devastating impact on young people around the world. This impact is pervasive and long-long lasting, still causing havoc as young people transition into adulthood. Prevention and timely early intervention efforts are necessary to lessen the disease burden of depression in young people. There is some evidence for the effectiveness of existing prevention and early intervention programs when delivered early. However, there is no consensus on what the active ingredients of these programs are. Identifying these ingredients is important because focusing on those that have maximal benefit will help to minimise the costs and resourcing of (already intensive) therapeutic approaches. We explored whether, and in what circumstances, affective awareness (i.e., knowing how one feels) is a candidate for protecting against and decreasing vulnerability to depression in young people. We specifically looked at how Ecological Momentary Assessment methods (EMA) were used to measure and/or increase affective awareness. We integrated three streams of data, including narrative review findings, perspectives from young people and psychologists, and publicly available information online (e.g., discussion forums). Across data sources, we found converging evidence that affective awareness is important in the prevention and early intervention of depression although there were considerable gaps in knowledge. More work needs to be done with young people and their health care teams to build affective awareness in the right way, at the right time, with individual differences in mind. The identification of how EMA can be best incorporated into young people's lives to facilitate these outcomes is also needed.
Collapse
Affiliation(s)
- Joanne R Beames
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia.
| | - Katarina Kikas
- Black Dog Institute, University of New South Wales, Sydney, NSW, Australia
| | | |
Collapse
|
44
|
Everitt N, Broadbent J, Richardson B, Smyth JM, Heron K, Teague S, Fuller-Tyszkiewicz M. Exploring the features of an app-based just-in-time intervention for depression. J Affect Disord 2021; 291:279-287. [PMID: 34058610 DOI: 10.1016/j.jad.2021.05.021] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Revised: 05/09/2021] [Accepted: 05/14/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Technological advancements make it possible to deliver depression interventions via smartphone applications ("Apps"), including those that deliver content "just-in-time" (e.g., in response to acute negative mood states). This study examined whether an app-based just-in-time intervention (ImproveYourMood+) decreased depressive symptoms, and whether the following features were related to symptom improvement: micro-intervention content, mood monitoring, and just-in-time prompts to use content. METHODS Participants (n = 235) from the general population who self-identified as wanting to improve their negative mood were randomised to a waitlist control group (n = 55) or one of three intervention groups: MoodTracker (monitoring-only, n = 58), ImproveYourMood (monitoring and content; n = 62), or ImproveYourMood+ (monitoring, content, and prompts; n = 60). The active intervention phase was 3 weeks. Depressive and anxiety symptoms, and negative automatic thoughts were assessed at baseline, immediately post-intervention, and one month following post-intervention. RESULTS Linear mixed modelling revealed greater declines over time in depressive and anxiety symptoms and negative automatic thoughts for the ImproveYourMood group (standardized mean differences [SMDs] ranged from .32 to .40) and improves for the ImproveYourMood+ group for negative automatic thoughts (SMDs ≥ .37) compared to the waitlist control group. No between-group differences were observed between the MoodTracker and control groups (SMDs = .04-.23). User experience appeared to be superior in more comprehensive/multi-modal versions. LIMITATIONS The study employed a naturalistic design, whereby participants self-selected to utilise the program, did not complete eligibility assessments, and did not receive compensation. The study therefore attained considerable drop-out rate (~50% by the follow-up timepoints), potentially reflecting the usage patterns of real-world mental health apps. CONCLUSIONS The findings suggest that micro-interventions can be an effective way to reduce depressive symptoms both in the moment and 1-2 months later. Integration of micro-interventions with full treatment programs is a viable next step in micro-intervention research.
Collapse
Affiliation(s)
| | | | | | - Joshua M Smyth
- Departments of Biobehavioral Health and of Medicine, The Pennsylvania State University, United States
| | - Kristin Heron
- Department of Psychology, Old Dominion University & Virginia Consortium Program in Clinical Psychology, United States
| | | | | |
Collapse
|
45
|
Discovering different profiles in the dynamics of depression based on real-time monitoring of mood: a first exploration. Internet Interv 2021; 26:100437. [PMID: 34458105 PMCID: PMC8377528 DOI: 10.1016/j.invent.2021.100437] [Citation(s) in RCA: 3] [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: 09/30/2020] [Revised: 07/19/2021] [Accepted: 07/23/2021] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Although depression is typically characterized by a persistent depressed mood, mood dynamics do seem to vary across a depressed population. Heterogeneity of mood variability (magnitude of changes) and emotional inertia (speed at which mood shifts) is seen in clinical practice. However, studies investigating the heterogeneity of these mood dynamics are still scarce. The aim of the present study is to explore different distinctive profiles in real-time monitored mood dynamics among depressed persons. METHODS After completing baseline measures, mildly-to-moderately depressed persons (n = 37) were prompted to rate their current mood (1-10 scale) on their smartphones, 3 times a day for 7 consecutive days. Latent profile analyses were applied to identify profiles based on average mood, variability of mood and emotional inertia as reported by the participants. RESULTS Two profiles were identified in this sample. The overwhelming majority of the sample belonged to profile 1 (n = 31). Persons in profile 1 were characterized by a mood just above the cutoff for positive mood (M = 6.27), with smaller mood shifts (lower variability [SD = 1.05]) than those in profile 2 (n = 6), who displayed an overall negative mood (M = 4.72) and larger mood shifts (higher variability [SD = 1.95]) but at similar speed (emotional inertia) (AC = 0.19, AC = 0.26, respectively). CONCLUSIONS The present study provides preliminary indications for patterns of average mood and mood variability, but not emotional inertia, among mildly-to-moderately depressed persons.
Collapse
Key Words
- AC, autocorrelation
- AIC, Akaike information criterion
- BIC, Bayesian information criterion
- BLRT, bootstrapped likelihood ratio test
- CES-D, Center for Epidemiological Studies Depression Scale
- Cluster analysis
- DSM-5, Diagnostic manual of mental disorders, 5th edition
- Depression
- EMA, ecological momentary assessment
- Ecological momentary assessment
- Heterogeneity
- IQR, interquartile range
- LMRA-LRT, Lo-Mendell-Rubin adjusted likelihood ratio test
- LPA, latent profile analysis
- M, mean
- Mdn, median
- Mood dynamics
- Mood instability
- PHQ-9, Patient Health Questionnaire
- SD, Standard deviation
- VAS, Visual analogue scale
Collapse
|
46
|
Folkersma W, Veerman V, Ornée DA, Oldehinkel AJ, Alma MA, Bastiaansen JA. Patients' experience of an ecological momentary intervention involving self-monitoring and personalized feedback for depression. Internet Interv 2021; 26:100436. [PMID: 34430220 PMCID: PMC8371226 DOI: 10.1016/j.invent.2021.100436] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/07/2021] [Accepted: 07/16/2021] [Indexed: 12/12/2022] Open
Abstract
Experts in clinical mental health research count on personalized approaches based on self-monitoring and self-management to improve treatment efficacy in psychiatry. Among other things, researchers expect that Ecological Momentary Interventions (EMI) based on self-monitoring and personalized feedback will reduce depressive symptoms. Clinical trial findings have, however, been conflicting. A recent trial (ZELF-i) investigated whether depression treatment might be enhanced by an add-on EMI with self-monitoring items and feedback focused on positive affect and activities (Do-module) or on negative affect and thinking patterns (Think-module). There was no statistical evidence that this EMI impacted clinical or functional outcomes beyond the effects of regular care, regardless of module content. In apparent contrast, 86% of the participants who completed the intervention indicated they would recommend it to others. In the present study, we used in-depth interviews (n = 20) to better understand the EMI's personal and clinical benefits and downsides. A thematic analysis of the interviews generated six areas of impact with various subthemes. In line with the trial results, few participants reported behavioral changes or symptom improvement over time; the self-assessments mainly amplified momentary mood, in either direction. The most often mentioned benefits were an increase in self-awareness, insight, and self-management (e.g., a stronger sense of control over complaints). Consistently, these domains received the highest ratings in our evaluation questionnaire (n = 89). Furthermore, the EMI instilled a routine into the days of individuals without regular jobs or other activities. Participants reported few downsides. The experiences were rather similar between the two modules. This study suggests that EMI might contribute to health by helping individuals deal with their symptoms, rather than reducing them. Measures on self-awareness, insight, and self-management should be more emphatically involved in future EMI research.
Collapse
Affiliation(s)
| | - Vera Veerman
- Synaeda Psycho Medisch Centrum, Leeuwarden, the Netherlands
| | - Daan A. Ornée
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands,Department of Education and Research, Friesland Mental Health Care Services, Leeuwarden, the Netherlands
| | - Albertine J. Oldehinkel
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Manna A. Alma
- Applied Health Sciences, Department of Health Sciences, University of Groningen, University Medical Center Groningen, the Netherlands
| | - Jojanneke A. Bastiaansen
- Interdisciplinary Center Psychopathology and Emotion regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands,Department of Education and Research, Friesland Mental Health Care Services, Leeuwarden, the Netherlands,Corresponding author at: Interdisciplinary Center Psychopathology and Emotion Regulation, Department of Psychiatry, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB Groningen, the Netherlands.
| |
Collapse
|
47
|
Kunkels YK, van Roon AM, Wichers M, Riese H. Cross-instrument feasibility, validity, and reproducibility of wireless heart rate monitors: Novel opportunities for extended daily life monitoring. Psychophysiology 2021; 58:e13898. [PMID: 34286857 PMCID: PMC10138748 DOI: 10.1111/psyp.13898] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 03/19/2021] [Accepted: 05/10/2021] [Indexed: 11/28/2022]
Abstract
Wired ambulatory monitoring of the electrocardiogram (ECG) is an established method used by researchers and clinicians. Recently, a new generation of wireless, compact, and relatively inexpensive heart rate monitors have become available. However, before these monitors can be used in scientific research and clinical practice, their feasibility, validity, and reproducibility characteristics have to be investigated. Therefore, we tested how two wireless heart rate monitors (i.e., the Ithlete photoplethysmography (PPG) finger sensor and the Cortrium C3 ECG monitor perform against an established wired reference method (the VU-AMS ambulatory ECG monitor). Monitors were tested on cross-instrument and test-retest reproducibility in a controlled laboratory setting, while feasibility was evaluated in protocolled ambulatory settings at home. We found that the Cortrium and the Ithlete monitors showed acceptable agreement with the VU-AMS reference in laboratory setting. In ambulatory settings, assessments were feasible with both wireless devices although more valid data were obtained with the Cortrium than with the Ithlete. We conclude that both monitors have their merits under controlled laboratory settings where motion artefacts are minimized and stationarity of the ECG signal is optimized by design. These findings are promising for long-term ambulatory ECG measurements, although more research is needed to test whether the wireless devices' feasibility, validity, and reproducibility characteristics also hold in unprotocolled daily life settings with natural variations in posture and activities.
Collapse
Affiliation(s)
- Yoram K Kunkels
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Arie M van Roon
- Department of Vascular Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marieke Wichers
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Harriëtte Riese
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
48
|
Reichert M, Gan G, Renz M, Braun U, Brüßler S, Timm I, Ma R, Berhe O, Benedyk A, Moldavski A, Schweiger JI, Hennig O, Zidda F, Heim C, Banaschewski T, Tost H, Ebner-Priemer UW, Meyer-Lindenberg A. Ambulatory assessment for precision psychiatry: Foundations, current developments and future avenues. Exp Neurol 2021; 345:113807. [PMID: 34228998 DOI: 10.1016/j.expneurol.2021.113807] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 06/18/2021] [Accepted: 07/02/2021] [Indexed: 11/30/2022]
Abstract
Precision psychiatry stands to benefit from the latest digital technologies for assessment and analyses to tailor treatment towards individuals. Insights into dynamic psychological processes as they unfold in humans' everyday life can critically add value in understanding symptomatology and environmental stressors to provide individualized treatment where and when needed. Towards this goal, ambulatory assessment encompasses methodological approaches to investigate behavioral, physiological, and biological processes in humans' everyday life. It combines repeated assessments of symptomatology over time, e.g., via Ecological Momentary Assessment (e.g., smartphone-diaries), with monitoring of physical behavior, environmental characteristics (such as geolocations, social interactions) and physiological function via sensors, e.g., mobile accelerometers, global-positioning-systems, and electrocardiography. In this review, we expand on promises of ambulatory assessment in the investigation of mental states (e.g., real-life, dynamical and contextual perspective), on chances for precision psychiatry such as the prediction of courses of psychiatric disorders, detection of tipping points and critical windows of relapse, and treatment effects as exemplified by ongoing projects, and on future avenues of how ambulatory interventions can benefit personalized care for psychiatric patients (e.g., through real-time feedback in everyday life). Ambulatory assessment is a key contributor to precision psychiatry, opening up promising avenues in research, diagnoses, prevention and treatment.
Collapse
Affiliation(s)
- Markus Reichert
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany; mental mHealth Lab, Department of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Baden-Wuerttemberg, Germany; Department of eHealth and Sports Analytics, Faculty of Sports Science, Ruhr-University Bochum (RUB), 44801 Bochum, North Rhine-Westphalia, Germany.
| | - Gabriela Gan
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Malika Renz
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Urs Braun
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Sarah Brüßler
- mental mHealth Lab, Department of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Irina Timm
- mental mHealth Lab, Department of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Ren Ma
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Oksana Berhe
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Anastasia Benedyk
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Alexander Moldavski
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Janina I Schweiger
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Oliver Hennig
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Francesca Zidda
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Christine Heim
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health (BIH), Institute of Medical Psychology, Berlin, Germany
| | - Tobias Banaschewski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Heike Tost
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany
| | - Ulrich W Ebner-Priemer
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany; mental mHealth Lab, Department of Sports and Sports Science, Karlsruhe Institute of Technology (KIT), 76131 Karlsruhe, Baden-Wuerttemberg, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg, Medical Faculty Mannheim, 68159 Mannheim, Baden-Wuerttemberg, Germany.
| |
Collapse
|
49
|
van Barneveld E, Manders J, van Osch FHM, van Poll M, Visser L, van Hanegem N, Lim AC, Bongers MY, Leue C. Depression, Anxiety, and Correlating Factors in Endometriosis: A Systematic Review and Meta-Analysis. J Womens Health (Larchmt) 2021; 31:219-230. [PMID: 34077695 DOI: 10.1089/jwh.2021.0021] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Background: Endometriosis stage is not directly related to the burden of symptoms, and recurrence of symptoms occurs frequently. It is suggested that symptoms are associated with psychological distress, as in depression and anxiety disorders. Our aim was to explore the strength of the associations between endometriosis and depression or anxiety and to review correlating factors. Materials and Methods: A literature search was carried out using the electronic databases Embase, PubMed, Web-of-science, and PsycINFO. Search terms related to depression, anxiety, and endometriosis were combined resulting in 1,837 records. Articles were included when describing an association between patients with endometriosis and symptoms of depression or anxiety assessed by validated tools, structured psychiatric interviews, or a documented diagnosis. With 47 articles a systematic qualitative review was performed. Seventeen studies were eligible for meta-analysis. Results: Endometriosis patients experienced significantly more symptoms of depression (standardized mean difference [SMD] of 0.71 (95% confidence interval [CI] 0.36-1.06)) and anxiety (SMD 0.60 (95% CI 0.35-0.84)) compared with healthy controls, but no differences were found comparing endometriosis patients with other chronic pelvic pain patients (SMD -0.01 [95% CI -0.17 to 0.15] for depression and SMD -0.02 [95% CI -0.22 to 0.18] for anxiety). Besides the effect of pain, other correlating factors included age, quality of life, quality of sleep, fatigue, sexual function, gastrointestinal symptoms, comorbidity, self-esteem, emotional self-efficacy, coping style, social adjustment, pain imagery, and pain sensitization. Conclusion: This systematic review supports the assumption that symptoms of depression and anxiety occur frequently in endometriosis patients and are related to chronic pain. Correlating factors should further be investigated.
Collapse
Affiliation(s)
- Esther van Barneveld
- Department of Gynaecology and Obstetrics, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jessica Manders
- Department of Gynaecology and Obstetrics, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Frits H M van Osch
- Department of Clinical Epidemiology, VieCuri Medical Centre, Venlo, The Netherlands
- Department of Complex Genetics, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht, The Netherlands
| | - Mikal van Poll
- Department of Gynaecology and Obstetrics, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Linda Visser
- Department of Psychiatry and Psychology, Zuyderland Hospital, Heerlen, The Netherlands
| | - Nehalennia van Hanegem
- Department of Gynaecology and Obstetrics, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Reproductive Medicine and Gynaecology, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Arianne C Lim
- Department of Gynaecology and Obstetrics, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Marlies Y Bongers
- Department of Gynaecology and Obstetrics, GROW School of Oncology and Developmental Biology, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Carsten Leue
- Department of Psychiatry and Psychology, MeHNS School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| |
Collapse
|
50
|
Borah TJ, Murray AL, Eisner M, Jugl I. Developing and Validating an Experience Sampling Measure of Aggression: The Aggression-ES Scale. JOURNAL OF INTERPERSONAL VIOLENCE 2021; 36:NP6166-NP6182. [PMID: 30474466 DOI: 10.1177/0886260518812068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Experience sampling methodologies are likely to play an important role in advancing our understanding of momentary influences on aggression, including short-term antecedent psychological states and situations. In this study, we evaluate whether a newly developed experiencing sampling measure of aggression, the Aggression Experience Sampler (Aggression-ES), provides a valid and reliable measure of aggression in experience sampling contexts. Participants were a convenience sample of 23 young adults recruited from the local University community. Data were collected using an experience sampling smartphone application over 8 days. They were analyzed using multilevel structural equation modeling. Our results support the within- and between-person reliability and the criterion validity of the Aggression-ES. The Aggression-ES represents a good choice of measure for use in experience sampling studies of aggression. Further work in other samples will help to provide further validity evidence for the measure.
Collapse
Affiliation(s)
| | | | | | - Irina Jugl
- University of Erlangen-Nuremberg, Germany
| |
Collapse
|