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Dempsey RC, Dodd AL, Gooding PA, Jones SH. The Types of Psychosocial Factors Associated with Suicidality Outcomes for People Living with Bipolar Disorder: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:525. [PMID: 38791740 PMCID: PMC11120682 DOI: 10.3390/ijerph21050525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 05/26/2024]
Abstract
Bipolar Disorder is associated with high rates of suicidal thoughts, behaviors, and outcomes, yet the lived experience of suicidality and Bipolar Disorder is not particularly well understood. Understanding the role of psychosocial aetiologies in suicidality outcomes for those living with Bipolar Disorder is key for developing appropriately targeted interventions focusing on factors that are amenable to change. In line with PRISMA guidance, we conducted a scoping review to identify the types of psychosocial factors studied in relation to the experience of suicidality for people living with Bipolar Disorder diagnoses. Systematic literature searches identified a sample of 166 articles from which key study data were extracted and charted. A narrative synthesis of the reviewed literature is presented ordered by the factors investigated across studies, a frequency count of the types of psychological/social aetiologies studied, and a brief overview of the key findings for each aetiology. Most of the identified literature took the form of quantitative cross-sectional studies, with only one qualitative study and 18 quantitative prospective studies. The most studied aetiologies were trauma (specifically early adverse experiences and childhood traumas) and stressful life events, impulsivity (primarily subjective self-reported trait impulsivity), social support and functioning, and personality/temperament factors. Only six studies in the final sample reported basing their research questions and/or hypotheses on an explicit theoretical model of suicide. The literature was primarily focused on using self-report measurements of key aetiologies and on factors which lead to worsened suicidality rather than focusing on potentially protective or buffering factors. Future research needs to better justify the aetiologies investigated in relation to suicidality outcomes for people living with Bipolar Disorder, including a firmer basis in theory and hypothesis testing, more prospective designs, and the use of alternative assessments of psychosocial aetiologies in addition to self-report questionnaires.
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Affiliation(s)
- Robert C. Dempsey
- Department of Psychology, Faculty of Health and Education, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Alyson L. Dodd
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Patricia A. Gooding
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Steven H. Jones
- Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK
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Hernandez R, Schneider S, Pinkham AE, Depp CA, Ackerman R, Pyatak EA, Badal VD, Moore RC, Harvey PD, Funsch K, Stone AA. Comparisons of Self-Report With Objective Measurements Suggest Faster Responding but Little Change in Response Quality Over Time in Ecological Momentary Assessment Studies. Assessment 2024:10731911241245793. [PMID: 38634454 DOI: 10.1177/10731911241245793] [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: 04/19/2024]
Abstract
Response times (RTs) to ecological momentary assessment (EMA) items often decrease after repeated EMA administration, but whether this is accompanied by lower response quality requires investigation. We examined the relationship between EMA item RTs and EMA response quality. In one data set, declining response quality was operationalized as decreasing correspondence over time between subjective and objective measures of blood glucose taken at the same time. In a second EMA study data set, declining response quality was operationalized as decreasing correspondence between subjective ratings of memory test performance and objective memory test scores. We assumed that measurement error in the objective measures did not increase across time, meaning that decreasing correspondence across days within a person could be attributed to lower response quality. RTs to EMA items decreased across study days, while no decrements in the mean response quality were observed. Decreasing EMA item RTs across study days did not appear problematic overall.
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Affiliation(s)
| | | | | | - Colin A Depp
- University of California San Diego, USA
- Veterans Affairs San Diego Healthcare System, CA, USA
| | | | | | | | | | - Philip D Harvey
- University of Miami, FL, USA
- Bruce W. Carter Veterans Affairs Medical Center, Miami, FL, USA
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Turri F, Jones A, Constanty L, Ranjbar S, Drexl K, Miano G, Lepage C, Plessen KJ, Urben S. Self-regulatory control processes in youths: A temporal network analysis approach. JCPP ADVANCES 2024; 4:e12200. [PMID: 38486949 PMCID: PMC10933645 DOI: 10.1002/jcv2.12200] [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: 02/03/2023] [Accepted: 09/11/2023] [Indexed: 03/17/2024] Open
Abstract
Objective This study aimed to better understand the temporal interrelationships among self-control, response inhibition, and anger (i.e., momentary state and rumination) on both the within- and between-person levels in male adolescents. Method We applied temporal network analyses among 62 male adolescents with a wide range of behavioral difficulties. Self-control, momentary anger, and anger rumination were mapped by self-report measures, whereas we measured response inhibition through an ambulatory Go/No-go task (two measures a day-morning and afternoon-over a 9-day period). Results Temporal network analysis, at the within-person level, revealed that morning measures of response inhibition, anger rumination, and self-control were related to the corresponding measure in the afternoon. More efficient response inhibition in the morning was associated with higher self-control in the afternoon. Higher anger rumination in the morning led to higher momentary anger in the afternoon. In a concurrent within-person network, higher momentary anger was reciprocally associated with lower self-control. At the between-person level, higher momentary anger was correlated to higher anger rumination, lower response inhibition, and lower self-control. Discussion This study provides insight into the dynamic interactions among self-control, response inhibition, and anger (momentary state and rumination) in male adolescents, advancing the understanding of self-regulatory control functioning.
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Affiliation(s)
- Fiorella Turri
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
| | - Andrew Jones
- School of PsychologyLiverpool John Moores UniversityLiverpoolUK
| | - Lauriane Constanty
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
| | - Setareh Ranjbar
- Center of Psychiatric Epidemiology and PsychopathologyDepartment of PsychiatryLausanne University HospitalUniversity of LausannePrillySwitzerland
| | - Konstantin Drexl
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
| | - Giorgia Miano
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
| | - Caroline Lepage
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
| | - Kerstin Jessica Plessen
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
- Faculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland
| | - Sébastien Urben
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
- Faculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland
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Urben S, Constanty L, Lepage C, Rosselet Amoussou J, Durussel J, Turri F, Wouters E, Mürner-Lavanchy I, Plessen KJ. The added value of a micro-level ecological approach when mapping self-regulatory control processes and externalizing symptoms during adolescence: a systematic review. Eur Child Adolesc Psychiatry 2023; 32:2387-2397. [PMID: 35294631 PMCID: PMC10682160 DOI: 10.1007/s00787-022-01972-1] [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: 11/01/2021] [Accepted: 03/03/2022] [Indexed: 11/03/2022]
Abstract
Deficits in self-regulatory control (SRC) represent a core characteristic of externalizing (EXT) symptoms (e.g., rule-breaking behavior or aggressive behaviors) in adolescents. This review aims to specify the added value of ecologically valid assessments at a micro-level when examining the associations between SRC and EXT symptoms in adolescents. This systematic review was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020. The search strategy addressed the added value of (1) naturalistic assessment for the understanding of the relationship between (2) SRC and (3) EXT symptoms in (4) adolescents. We conducted comprehensive searches in bibliographic databases. An additional search was conducted in Google Scholar and supplementary studies were identified through backward and forward citation tracking. Twenty-four studies (n = 4071 adolescents) met the inclusion criteria. The methods used to assess naturalistic aspects included the experience sampling method (ecological momentary- or ambulatory assessment) and the time-course approach (i.e., real-time assessment of SRC processes referring to situations approximating real-life experience where SRC are to be engaged such as in frustrating situations). Micro-level ecological assessments, when mapping the intra-individual relationships between SRC processes and EXT symptoms over time in adolescents within their natural context (i.e., real world) of expression in real time, added a finer-grained observation alongside with a higher ecological validity. Micro-level approaches may enhance the understanding of the complex interplay between SRC and EXT symptoms in adolescence, especially in interventional studies, allowing for the acquisition of endpoints with a higher relevance for everyday functioning.
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Affiliation(s)
- Sébastien Urben
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
| | - Lauriane Constanty
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Caroline Lepage
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Joëlle Rosselet Amoussou
- Psychiatry Library, Education and Research Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Julie Durussel
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Fiorella Turri
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Emilie Wouters
- Unit of Child and Adolescent Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Ines Mürner-Lavanchy
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kerstin Jessica Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
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Baumgartner JN, Haupt MR, Case LK. Chronic pain patients low in social connectedness report higher pain and need deeper pressure for pain relief. Emotion 2023; 23:2156-2168. [PMID: 36996174 PMCID: PMC10544689 DOI: 10.1037/emo0001228] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
The experience of rejection and disconnection reliably amplifies pain. Yet, little is known about the impact of enduring feelings of closeness, or social connectedness, on experiences of chronic pain. The current secondary analysis tested the hypothesis that greater social connectedness would predict lower chronic pain ratings, mediated by lower depression and anxiety. In addition, based on the social-affective effects of deeper pressure, and our previous finding that deeper pressure from a weighted blanket reduced chronic pain ratings, we examined whether deeper pressure from a weighted blanket would induce greater pain relief in socially disconnected chronic pain patients. We assessed social connectedness, anxiety, and depression at baseline and pain levels before and after a remote, 7-day randomized-controlled trial of a heavy or light (control) weighted blanket in a predominately White (86%) and female (80%) sample of 95 chronic pain patients. Results revealed that lower social connectedness was associated with higher chronic pain ratings, which was mediated by anxiety, but not depression. Pressure level (light vs. deep) moderated associations between social connectedness and pain reductions, such that deeper pressure was necessary for pain relief in the most socially disconnected participants. Our findings suggest a close relationship between social connectedness and chronic pain through a mechanistic pathway of anxiety. Furthermore, our findings demonstrate that sensory-affective interventions such as a weighted blanket may be a beneficial tool for chronic pain sufferers who are prone to social disconnection, potentially by activating embodied representations of safety and social support. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Jennifer N. Baumgartner
- NIH Office of Disease Prevention, Office of the Director, DPCPSI, 6705 Rockledge Drive, Room 733, MSC 7990, Bethesda, MD 20892
- UC San Diego Health, Department of Anesthesiology, 9500 Gilman Drive MC 0719, La Jolla, CA 92093, 858-246-4968
| | - Michael R. Haupt
- University of California San Diego, Department of Cognitive Science, 9500 Gilman Dr, La Jolla, CA, 92093
| | - Laura K. Case
- UC San Diego Health, Department of Anesthesiology, 9500 Gilman Drive MC 0719, La Jolla, CA 92093, 858-246-4968
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Rogerson O, Prudenzi A, O'Connor DB. Exploring the relationship between suicide vulnerability, impulsivity and executive functioning during COVID-19: A longitudinal analysis. PSYCHIATRY RESEARCH COMMUNICATIONS 2022; 2:100088. [PMCID: PMC9694475 DOI: 10.1016/j.psycom.2022.100088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/18/2022] [Accepted: 11/22/2022] [Indexed: 11/27/2022]
Abstract
Public health emergencies increase the presence and severity of multiple suicide risk factors and thus may increase suicide vulnerability. Understanding how suicide risk factors interact throughout the course of a global pandemic can inform how to help the most vulnerable groups in society. The aims of the research were to explore the associations between, and changes in, suicide vulnerability, COVID-related stress, worry, rumination, executive functioning and impulsivity across the first 6 weeks of UK lockdown (1st April – May 17, 2020). 418 adults in the UK completed an online survey at three time points during the first lockdown (Time 1 (April 1–5th), Time 2 (April 15–19th April), Time 3 (May 13–17th). Impulsivity and executive functioning remained stable across the first six weeks of UK lockdown. COVID-related stress, worry, and rumination decreased throughout the 6 weeks. Suicide vulnerability was associated with greater impulsivity and poorer executive functioning. Sub-group analysis revealed individuals vulnerable to suicide reported worse COVID-related stress, poorer executive function and greater impulsivity than individuals who reported no suicide vulnerability. Individuals vulnerable to suicide appear to have experienced poorer executive functioning, greater impulsivity and COVID-related stress in the initial phase of the COVID-19 pandemic.
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7
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Titone MK, Depp C, Klaus F, Carrasco J, Young JW, Eyler LT. The interplay of daily affect and impulsivity measured by mobile surveys in bipolar disorder. Int J Bipolar Disord 2022; 10:25. [DOI: 10.1186/s40345-022-00270-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/16/2022] [Indexed: 11/05/2022] Open
Abstract
Abstract
Background
Impulsivity is a prominent feature of bipolar disorder associated with various negative sequelae; moreover, it may be a precursor to shifts in affect or mood, but little is known about its association with affect on a day-to-day timescale. Ecological momentary assessments (a method that captures moment-to-moment ratings of psychological states by repeatedly sampling the same individual) of impulsivity and affect using mobile surveys allow for more nuanced examination of mechanisms of mood and behavior dysregulation. However, few existing studies have validated an ecological momentary assessment of impulsivity in bipolar disorder and examined its time-lagged associations with positive and negative affect. 70 participants with bipolar disorder and 102 healthy comparisons participated in an intensive longitudinal study: they underwent 14 days of ecological momentary assessment data collection annually for 1–4 years. Multiple measures of impulsivity and affect were collected using self-report, behavioral, and ecological momentary assessment modalities; these measures were compared, and levels of impulsivity were compared between bipolar disorder and healthy comparison groups. Time-lagged analyses using daily means explored the next-day predictive relationship of impulsivity on positive/negative affect, and vice versa.
Results
The ecological momentary measure of impulsivity was moderately correlated with the self-report but not behavioral impulsivity measure. Bipolar disorder participants evinced higher self-report, behavioral, and daily impulsivity than healthy comparison participants. Time-lagged analyses revealed a bi-directional association between high impulsivity and high next-day negative (but not positive) affect. Post hoc analyses showed that impulsivity specifically predicted next-day anger and anxiety.
Conclusions
Our multimodal assessment of impulsivity allowed for an examination of the day-to-day course of impulsivity and affect, crucial steps toward understanding the mechanisms of mood symptom and episode onset in bipolar disorder.
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Moore RC, Parrish EM, Van Patten R, Paolillo E, Filip TF, Bomyea J, Lomas D, Twamley EW, Eyler LT, Depp CA. Initial Psychometric Properties of 7 NeuroUX Remote Ecological Momentary Cognitive Tests Among People With Bipolar Disorder: Validation Study. J Med Internet Res 2022; 24:e36665. [PMID: 35904876 PMCID: PMC9377465 DOI: 10.2196/36665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/25/2022] [Accepted: 05/29/2022] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND As smartphone technology has become nearly ubiquitous, there is a growing body of literature suggesting that ecological momentary cognitive testing (EMCT) offers advantages over traditional pen-and-paper psychological assessment. We introduce a newly developed platform for the self-administration of cognitive tests in ecologically valid ways. OBJECTIVE The aim of this study is to develop a Health Insurance Portability and Accountability Act-compliant EMCT smartphone-based platform for the frequent and repeated testing of cognitive abilities in everyday life. This study examines the psychometric properties of 7 mobile cognitive tests covering domains of processing speed, visual working memory, recognition memory, and response inhibition within our platform among persons with and without bipolar disorder (BD). Ultimately, if shown to have adequate psychometric properties, EMCTs may be useful in research on BD and other neurological and psychiatric illnesses. METHODS A total of 45 persons with BD and 21 demographically comparable healthy volunteer participants (aged 18-65 years) completed smartphone-based EMCTs 3 times daily for 14 days. Each EMCT session lasted approximately 1.5 minutes. Only 2 to 3 tests were administered in any given session, no test was administered more than once per day, and alternate test versions were administered in each session. RESULTS The mean adherence to the EMCT protocol was 69.7% (SD 20.5%), resulting in 3965 valid and complete tests across the full sample. Participants were significantly more likely to miss tests on later versus earlier study days. Adherence did not differ by diagnostic status, suggesting that BD does not interfere with EMCT participation. In most tests, age and education were related to EMCT performance in expected directions. The average performances on most EMCTs were moderately to strongly correlated with the National Institutes of Health Toolbox Cognition Battery. Practice effects were observed in 5 tests, with significant differences in practice effects by BD status in 3 tests. CONCLUSIONS Although additional reliability and validity data are needed, this study provides initial psychometric support for EMCTs in the assessment of cognitive performance in real-world contexts in BD.
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Affiliation(s)
- Raeanne C Moore
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
| | - Emma M Parrish
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
| | - Ryan Van Patten
- Psychiatry and Human Behavior, Brown University, Providence, RI, United States
- Providence VA Medical Center, Providence, RI, United States
| | - Emily Paolillo
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States
| | - Tess F Filip
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
| | - Jessica Bomyea
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
- VA San Diego Healthcare System, San Diego, CA, United States
| | - Derek Lomas
- Industrial Design Engineering, Delft University of Technology, Delft, Netherlands
| | - Elizabeth W Twamley
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
- VA San Diego Healthcare System, San Diego, CA, United States
| | - Lisa T Eyler
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
- VA San Diego Healthcare System, San Diego, CA, United States
| | - Colin A Depp
- Department of Psychiatry, University of California San Diego, San Diego, CA, United States
- VA San Diego Healthcare System, San Diego, CA, United States
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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.
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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
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Luise L, Nina H, Nina W, Thomas F, Dajana R, Heide G, Lena S. Daily impulsivity: Associations with suicidal ideation in unipolar depressive psychiatric inpatients. Psychiatry Res 2022; 308:114357. [PMID: 34974411 DOI: 10.1016/j.psychres.2021.114357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 12/18/2021] [Accepted: 12/20/2021] [Indexed: 11/18/2022]
Abstract
Recent studies suggest that impulsivity fluctuates over time. It is unclear if state-impulsivity serves as a risk factor of suicidal ideation (SI) at a state level. A sample of 74 psychiatric inpatients with depression (M = 37.6 years, 72% female) and SI completed baseline measurements and an ecological momentary assessment over a 6-day period. Despite considerable within-person variance, state impulsivity was not significantly associated with clinical characteristics (depression, baseline SI, past suicide attempts). Daily variability of passive SI showed a significant prospective association with state impulsivity. Limiting factors are the small sample size and the short observation period.
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Affiliation(s)
- Lucht Luise
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany.
| | - Hallensleben Nina
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Willhardt Nina
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Forkmann Thomas
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Rath Dajana
- Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Glaesmer Heide
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany; Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
| | - Spangenberg Lena
- Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany; Department of Clinical Psychology, University of Duisburg-Essen, Essen, Germany
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11
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Plessen KJ, Constanty L, Ranjbar S, Turri F, Miano G, Lepage C, Urben S. The role of self-regulatory control processes in understanding aggressive ideations and behaviors: An experience sampling method study. Front Psychiatry 2022; 13:1058814. [PMID: 36741583 PMCID: PMC9893502 DOI: 10.3389/fpsyt.2022.1058814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION In this study, we aimed to examine the association between aggressive ideations and aggressive behaviors in everyday life, as well as the role of processes related to self-regulatory control (i.e., self-control, ego depletion, and emotional states), using experience sampling methods (ESM). METHODS A total of 62 male adolescents performed a baseline measure of aggression, violent ideations (trait level), and ESM assessments, including four measures per day during nine consecutive days. RESULTS At a state level, aggressive ideations were associated with higher negative emotions during the previous day as well as with lower self-control and stronger anger rumination at the moment. Aggressive behaviors were related to higher anger rumination at the moment and to the manifestation of higher intensity of aggressive ideations derived in the previous measure. Higher self-control was related to a lower probability of aggressive behavior. DISCUSSION This study highlights the temporal link between aggressive ideations and behaviors in everyday life as well as the role of self-control in understanding aggressivity in the lap of time. Furthermore, we observed that expressions of anger (i.e., reactivity, as well as rumination) were central in the understanding of aggressive ideations and behaviors in the everyday life (i.e., at within-person variability at the state level).
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Affiliation(s)
- Kerstin Jessica Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Lauriane Constanty
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Setareh Ranjbar
- Center of Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Fiorella Turri
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Giorgia Miano
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Caroline Lepage
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Sébastien Urben
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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12
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Jameel L, Valmaggia L, Barnes G, Cella M. mHealth technology to assess, monitor and treat daily functioning difficulties in people with severe mental illness: A systematic review. J Psychiatr Res 2021; 145:35-49. [PMID: 34856524 DOI: 10.1016/j.jpsychires.2021.11.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/18/2021] [Accepted: 11/20/2021] [Indexed: 11/21/2022]
Abstract
Severe mental illness (SMI) is associated with poor daily functioning; however available interventions currently under-deliver on their recovery prospect. Mobile digital health (mHealth) interventions are increasingly being developed and evaluated, and have the potential to support recovery. This review evaluates the use of mHealth technology to assess, monitor and reduce functioning difficulties in people with SMI. Studies were systematically searched on multiple databases. Study quality was assessed and double-rated independently. Findings were organised using a narrative synthesis and results were summarised according to the mHealth device purpose, i.e., assessment and monitoring or intervention. Thirty-eight studies comprised of 2262 participants met the inclusion criteria. Smartphones were the most popular mHealth device; personal digital assistants, wearables and tablets were also used. mHealth was widely found to be acceptable and feasible, with preliminary findings suggesting it can support functional recovery by augmenting an intervention, simplifying the assessment, increasing monitoring frequency and/or providing more detailed information. Considerations for overcoming barriers to implementation, recommendations for future research to establish effectiveness, personalisation and specification of mHealth devices and methodologies are discussed. The value of mHealth for remote delivery of recovery based interventions is also considered.
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Affiliation(s)
- Leila Jameel
- South London and the Maudsley NHS Trust, UK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.
| | - Lucia Valmaggia
- South London and the Maudsley NHS Trust, UK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; Katholieke Leuven Universitet, Belgium
| | - Georgina Barnes
- South London and the Maudsley NHS Trust, UK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Matteo Cella
- South London and the Maudsley NHS Trust, UK; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
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13
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Baumgartner JN, Quintana D, Leija L, Schuster NM, Bruno KA, Castellanos JP, Case LK. Widespread Pressure Delivered by a Weighted Blanket Reduces Chronic Pain: A Randomized Controlled Trial. THE JOURNAL OF PAIN 2021; 23:156-174. [PMID: 34425251 DOI: 10.1016/j.jpain.2021.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 07/08/2021] [Accepted: 07/22/2021] [Indexed: 11/30/2022]
Abstract
Pleasant sensation is an underexplored avenue for modulation of chronic pain. Deeper pressure is perceived as pleasant and calming, and can improve sleep. Although pressure can reduce acute pain, its effect on chronic pain is poorly characterized. The current remote, double-blind, randomized controlled trial tested the hypothesis that wearing a heavy weighted blanket - providing widespread pressure to the body - relative to a light weighted blanket would reduce ratings of chronic pain, mediated by improvements in anxiety and sleep. Ninety-four adults with chronic pain were randomized to wear a 15-lb. (heavy) or 5-lb. (light) weighted blanket during a brief trial and overnight for one week. Measures of anxiety and chronic pain were collected pre- and post-intervention, and ratings of pain intensity, anxiety, and sleep were collected daily. After controlling for expectations and trait anxiety, the heavy weighted blanket produced significantly greater reductions in broad perceptions of chronic pain than the light weighted blanket (Cohen's f = .19, CI [-1.97, -.91]). This effect was stronger in individuals with high trait anxiety (P = .02). However, weighted blankets did not alter pain intensity ratings. Pain reductions were not mediated by anxiety or sleep. Given that the heavy weighted blanket was associated with greater modulation of affective versus sensory aspects of chronic pain, we propose that the observed reductions are due to interoceptive and social/affective effects of deeper pressure. Overall, we demonstrate that widespread pressure from a weighted blanket can reduce the severity of chronic pain, offering an accessible, home-based tool for chronic pain. The study purpose, targeted condition, study design, and primary and secondary outcomes were pre-registered in ClinicalTrials.gov (NCT04447885: "Weighted Blankets and Chronic Pain"). Perspective: This randomized-controlled trial showed that a 15-lb weighted blanket produced significantly greater reductions in broad perceptions of chronic pain relative to a 5-lb weighted blanket, particularly in highly anxious individuals. These findings are relevant to patients and providers seeking home-based, nondrug therapies for chronic pain relief.
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Affiliation(s)
- Jennifer N Baumgartner
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Desiree Quintana
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Linda Leija
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Nathaniel M Schuster
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Kelly A Bruno
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Joel P Castellanos
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California
| | - Laura K Case
- Department of Anesthesiology, University of California San Diego Health, La Jolla, California.
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14
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Veilleux JC, Skinner KD, Baker DE, Chamberlain KD. Perceived willpower self-efficacy fluctuates dynamically with affect and distress intolerance. JOURNAL OF RESEARCH IN PERSONALITY 2021. [DOI: 10.1016/j.jrp.2020.104058] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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15
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Lenze EJ, Nicol GE, Barbour DL, Kannampallil T, Wong AWK, Piccirillo J, Drysdale AT, Sylvester CM, Haddad R, Miller JP, Low CA, Lenze SN, Freedland KE, Rodebaugh TL. Precision clinical trials: a framework for getting to precision medicine for neurobehavioural disorders. J Psychiatry Neurosci 2021; 46:E97-E110. [PMID: 33206039 PMCID: PMC7955843 DOI: 10.1503/jpn.200042] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The goal of precision medicine (individually tailored treatments) is not being achieved for neurobehavioural conditions such as psychiatric disorders. Traditional randomized clinical trial methods are insufficient for advancing precision medicine because of the dynamic complexity of these conditions. We present a pragmatic solution: the precision clinical trial framework, encompassing methods for individually tailored treatments. This framework includes the following: (1) treatment-targeted enrichment, which involves measuring patients' response after a brief bout of an intervention, and then randomizing patients to a full course of treatment, using the acute response to predict long-term outcomes; (2) adaptive treatments, which involve adjusting treatment parameters during the trial to individually optimize the treatment; and (3) precise measurement, which involves measuring predictor and outcome variables with high accuracy and reliability using techniques such as ecological momentary assessment. This review summarizes precision clinical trials and provides a research agenda, including new biomarkers such as precision neuroimaging, transcranial magnetic stimulation-electroencephalogram digital phenotyping and advances in statistical and machine-learning models. Validation of these approaches - and then widespread incorporation of the precision clinical trial framework - could help achieve the vision of precision medicine for neurobehavioural conditions.
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Affiliation(s)
- Eric J Lenze
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
| | - Ginger E Nicol
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
| | - Dennis L Barbour
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
| | - Thomas Kannampallil
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
| | - Alex W K Wong
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
| | - Jay Piccirillo
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
| | - Andrew T Drysdale
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
| | - Chad M Sylvester
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
| | - Rita Haddad
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
| | - J Philip Miller
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
| | - Carissa A Low
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
| | - Shannon N Lenze
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
| | - Kenneth E Freedland
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
| | - Thomas L Rodebaugh
- From the Washington University School of Medicine, St. Louis, Missouri (Lenze, Nicol, Kannampallil Wong, Piccirillo, Drysdale, Sylvester, Haddad, Miller, Lenze, Freedland); the Washington University McKelvey School of Engineering, St. Louis, MO (Barbour); the University of Pittsburgh, Pittsburgh, PA (Low); and the Washington University School of Arts & Sciences, St. Louis, MO (Rodebaugh)
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16
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Wang Q, Wang Y, Zuo J, Zhou Y, Yang WFZ, Liao Y, Tang J, Wang X, Yang Q, Wu Q, Wu HE, Goodman CB, Liu T, Zhang X. Factors of Negative Affect in Elderly Patients With Substance Use Disorders During COVID-19 Pandemic. Front Psychiatry 2021; 12:697472. [PMID: 34354617 PMCID: PMC8329338 DOI: 10.3389/fpsyt.2021.697472] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Accepted: 06/14/2021] [Indexed: 12/14/2022] Open
Abstract
Background: The outbreak of the novel coronavirus disease 2019 (COVID-19) has become the greatest public health emergency and has attracted global attention. During the COVID-19 pandemic, the negative affect (NA) of elderly patients with substance use disorders (SUDs) has also become a more serious public concern. The current study aims to clarify the NA and its influencing factors in elderly patients with SUDs during the pandemic. Methods: Two psychiatrists conducted semi-structured interviews with 77 SUD patients aged above 50 years to collect their demographical information and certain drug use characteristics. Barratt Impulse Scale and the Positive and Negative Affect Scale were used to obtain information about patients' self-reported impulsivity and NA. Results: Univariate linear regression analysis showed that NA was positively correlated with the frequency of drug use, type of SUDs, cravings during COVID-19, and impulsivity. Multiple linear regression analysis showed that being female, higher frequency of drug use, stronger cravings, and greater impulsiveness jointly accounted for the variation of NA in elderly patients with SUDs. Conclusions: This study confirmed that, during the COVID-19 pandemic, gender, frequency of drug use, cravings, and impulsivity were associated with NA in elderly patients with SUDs. This study provided a theoretical basis for clinicians to reduce the patients' NA.
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Affiliation(s)
- Qianjin Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, the Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Yingying Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, the Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Jinsong Zuo
- School of Life Science and Chemistry, Hunan University of Technology, Zhuzhou, China
| | - Yanan Zhou
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, the Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Winson Fu Zun Yang
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX, United States
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xin Wang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, the Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Qian Yang
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, the Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Qiuxia Wu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, the Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Hanjing Emily Wu
- Department of Psychiatry and Behavioral Sciences, the University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Colin B Goodman
- Department of Psychiatry and Behavioral Sciences, the University of Texas Health Science Center at Houston, Houston, TX, United States
| | - Tieqiao Liu
- National Clinical Research Center for Mental Disorders, and Department of Psychiatry, the Second Xiangya Hospital of Central South University, Changsha, China.,Hunan Key Laboratory of Psychiatry and Mental Health, Changsha, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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17
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Gee BL, Han J, Benassi H, Batterham PJ. Suicidal thoughts, suicidal behaviours and self-harm in daily life: A systematic review of ecological momentary assessment studies. Digit Health 2020; 6:2055207620963958. [PMID: 33224516 PMCID: PMC7649887 DOI: 10.1177/2055207620963958] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 09/11/2020] [Indexed: 12/13/2022] Open
Abstract
Background Ecological Momentary Assessments (EMA) offer an approach to understand the daily risk factors of suicide and self-harm of individuals through the use of self-monitoring techniques using mobile technologies. Objectives This systematic review aimed to examine the results of studies on suicidality risk factors and self-harm that used Ecological Momentary Assessments. Methods Pubmed and PsycINFO databases were searched up to April 2020. Bibliographies of eligible studies were hand-searched, and 744 abstracts were screened and double-coded for inclusion. Results The 49 studies using EMA included in the review found associations between daily affect, rumination and interpersonal interactions and daily non-suicidal self-injury (NSSI). Studies also found associations between daily negative affect and positive affect, social support, sleep, and emotions and a person's history of suicide and self-harm. Associations between daily suicide thoughts and self-harm, and psychopathology factors measured at baseline were also observed. Conclusions Research using EMA has the potential to offer clinicians the ability to understand the daily predictors, or risk factors, of suicide and self-harm. However, there are no clear reporting standards for EMA studies on risk factors for suicide. Further research should utilise longitudinal study designs, harmonise datasets and use machine learning techniques to identify patterns of proximal risk factors for suicide behaviours.
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Affiliation(s)
- Brendan Loo Gee
- Centre for Mental Health Research, Australian National University, Acton, Australia.,Australasian Institute of Digital Health, Level 1, 85 Buckhurst Street, South Melbourne, Australia
| | - Jin Han
- Black Dog Institute, University of New South Wales, New South Wales, Australia
| | - Helen Benassi
- Centre for Mental Health Research, Australian National University, Acton, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Australian National University, Acton, Australia
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18
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Ryan KA, Babu P, Easter R, Saunders E, Lee AJ, Klasnja P, Verchinina L, Micol V, Doil B, McInnis MG, Kilbourne AM. A Smartphone App to Monitor Mood Symptoms in Bipolar Disorder: Development and Usability Study. JMIR Ment Health 2020; 7:e19476. [PMID: 32960185 PMCID: PMC7539167 DOI: 10.2196/19476] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 06/23/2020] [Accepted: 07/18/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is considerable scientific interest in finding new and innovative ways to capture rapid fluctuations in functioning within individuals with bipolar disorder (BD), a severe, recurrent mental disorder associated with frequent shifts in symptoms and functioning. The use of smartphones can provide valid and real-world tools for use in measurement-based care and could be used to inform more personalized treatment options for this group, which can improve standard of care. OBJECTIVE We examined the feasibility and usability of a smartphone to capture daily fluctuations in mood within BD and to relate daily self-rated mood to smartphone use behaviors indicative of psychomotor activity or symptoms of the illness. METHODS Participants were 26 individuals with BD and 12 healthy control individuals who were recruited from the Prechter Longitudinal Study of BD. All were given a smartphone with a custom-built app and prompted twice a day to complete questions of mood for 28 days. The app automatically and unobtrusively collected phone usage data. A poststudy satisfaction survey was also completed. RESULTS Our sample showed a very high adherence rate to the daily momentary assessments (91% of the 58 prompts completed). Multivariate mixed effect models showed that an increase in rapid thoughts over time was associated with a decrease in outgoing text messages (β=-.02; P=.04), and an increase in impulsivity self-ratings was related to a decrease in total call duration (β=-.29; P=.02). Participants generally reported positive experiences using the smartphone and completing daily prompts. CONCLUSIONS Use of mobile technology shows promise as a way to collect important clinical information that can be used to inform treatment decision making and monitor outcomes in a manner that is not overly burdensome to the patient or providers, highlighting its potential use in measurement-based care.
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Affiliation(s)
- Kelly Ann Ryan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Pallavi Babu
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Rebecca Easter
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Erika Saunders
- Department of Psychiatry, Pennsylvania State University, Hershey, PA, United States
| | - Andy Jinseok Lee
- School of Information, University of Michigan, Ann Arbor, MI, United States
| | - Predrag Klasnja
- School of Information, University of Michigan, Ann Arbor, MI, United States
| | - Lilia Verchinina
- Brehm Center for Diabetes Research, University of Michigan, Ann Arbor, MI, United States
| | - Valerie Micol
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Brent Doil
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, United States
| | - Amy M Kilbourne
- Department of Learning Health Sciences, University of Michigan, Ann Arbor, MI, United States.,US Department of Veterans Affairs Health Services Research & Development, VA Depart of Veterans Affairs, Ann Arbor, MI, United States
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19
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Kim H, Kim S, Kong SS, Jeong YR, Kim H, Kim N. Possible Application of Ecological Momentary Assessment to Older Adults' Daily Depressive Mood: Integrative Literature Review. JMIR Ment Health 2020; 7:e13247. [PMID: 32484442 PMCID: PMC7298638 DOI: 10.2196/13247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Revised: 01/31/2020] [Accepted: 03/31/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Ecological momentary assessment is a method of investigating individuals' real-time experiences, behaviors, and moods in their natural environment over time. Despite its general usability and clinical value for evaluating daily depressive mood, there are several methodological challenges when applying ecological momentary assessment to older adults. OBJECTIVE The aims of this integrative literature review were to examine possible uses of the ecological momentary assessment methodology with older adults and to suggest strategies to increase the feasibility of its application in geriatric depression research and practice. METHODS We searched 4 electronic databases (MEDLINE, CINAHL, PsycINFO, and EMBASE) and gray literature; we also hand searched the retrieved articles' references. We limited all database searches to articles published in peer-reviewed journals from 2009 to 2019. Search terms were "ecological momentary assessment," "smartphone assessment," "real time assessment," "electronic daily diary," "mHealth momentary assessment," "mobile-based app," and "experience sampling method," combined with the relevant terms of depression. We included any studies that enrolled older adults even as a subgroup and that reported depressive mood at least once a day for more than 2 days. RESULTS Of the 38 studies that met the inclusion criteria, only 1 study enrolled adults aged 65 years or older as the entire sample; the remainder of the reviewed studies used mixed samples of both younger and older adults. Most of the analyzed studies (18/38, 47%) were quantitative, exploratory (descriptive, correlational, and predictive), and cohort in design. Ecological momentary assessment was used to describe the fluctuating pattern of participants' depressive moods primarily and to examine the correlation between mood patterns and other health outcomes as a concurrent symptom. We found 3 key methodological issues: (1) heterogeneity in study design and protocol, (2) issues with definitions of dropout and adherence, and (3) variation in how depressive symptoms were measured with ecological momentary assessment. Some studies (8/38, 21%) examined the age difference of participants with respect to dropout or poor compliance rate. Detailed participant burden was reported, such as technical problems, aging-related health problems, or discomfort while using the device. CONCLUSIONS Ecological momentary assessment has been used for comprehensive assessment of multiple mental health indicators in relation to depressive mood. Our findings provide methodological considerations for further studies that may be implemented using ecological momentary assessment to assess daily depressive mood in older adults. Conducting more feasibility studies focusing on older adults with standardized data collection protocols and mixed-methods research is required to reflect users' experiences. Further telepsychiatric evaluation and diagnosis based on ecological momentary assessment data should involve standardized and sophisticated strategies to maximize the potential of ecological momentary assessment for older adults with depression in the community setting.
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Affiliation(s)
- Heejung Kim
- College of Nursing, Yonsei University, Seoul, Republic of Korea.,Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Sunah Kim
- College of Nursing, Yonsei University, Seoul, Republic of Korea.,Mo-Im Kim Nursing Research Institute, Yonsei University, Seoul, Republic of Korea
| | - Seong Sook Kong
- School of Nursing, College of Medicine, Soonchunhyang University, Cheonan, Republic of Korea
| | | | - Hyein Kim
- Severance Hospital, Seoul, Republic of Korea
| | - Namhee Kim
- College of Nursing, Yonsei University, Seoul, Republic of Korea
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20
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Swann AC, Lijffijt M, O'Brien B, Mathew SJ. Impulsivity and Suicidal Behavior. Curr Top Behav Neurosci 2020; 47:179-195. [PMID: 32472429 DOI: 10.1007/7854_2020_144] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Suicide is the leading cause of injury mortality in the United States and the second-leading cause of death in people aged 10-34 years. While many long-term risk factors are known, the short-term prediction of suicidal behavior remains elusive. Many characteristics of suicidal behavior cut across diagnoses, but suicide is increased in recurrent psychiatric disorders, addictive disorders, and trauma-related disorders. Suicide results from the interaction of short-term and long-term behavioral regulation. The shorter the time-course of the mechanism, the closer it is to actual suicidal behavior, and the harder it is to prevent. We will discuss the manner in which impulsivity, a major determinant of short-term suicide risk, interacts with longer-term risk factors, especially sensitization to addictive or traumatic stimuli. Impulsivity predisposes to sensitization; in turn, impulsivity is a prominent component of sensitized behavior. Impulsivity can be described as a general pattern of behavior ("trait" impulsivity), as responses that are not conformed to their context (action-impulsivity), or as inability to delay reward or to take future consequences into account (choice-impulsivity). Each of these contributes to suicidal behavior. The neural mechanisms of impulsivity and sensitization are analogous, and sensitization can produce rapidly fluctuating patterns of impulsive behavior, arousal, and anhedonia. In order to recognize and prevent suicidal behavior, it is necessary to identify factors associated with susceptibility to bouts of impulsive behavior in people at elevated long-term risk.
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Affiliation(s)
- Alan C Swann
- Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA. .,Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
| | - Marijn Lijffijt
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.,Research Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
| | - Brittany O'Brien
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Sanjay J Mathew
- Mental Health Care Line, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA.,Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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21
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Mofsen AM, Rodebaugh TL, Nicol GE, Depp CA, Miller JP, Lenze EJ. When All Else Fails, Listen to the Patient: A Viewpoint on the Use of Ecological Momentary Assessment in Clinical Trials. JMIR Ment Health 2019; 6:e11845. [PMID: 31066701 PMCID: PMC6524455 DOI: 10.2196/11845] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 02/05/2019] [Accepted: 04/03/2019] [Indexed: 01/09/2023] Open
Abstract
A major problem in mental health clinical trials, such as depression, is low assay sensitivity in primary outcome measures. This has contributed to clinical trial failures, resulting in the exodus of the pharmaceutical industry from the Central Nervous System space. This reduced assay sensitivity in psychiatry outcome measures stems from inappropriately broad measures, recall bias, and poor interrater reliability. Limitations in the ability of traditional measures to differentiate between the trait versus state-like nature of individual depressive symptoms also contributes to measurement error in clinical trials. In this viewpoint, we argue that ecological momentary assessment (EMA)-frequent, real time, in-the-moment assessments of outcomes, delivered via smartphone-can both overcome these psychometric challenges and reduce clinical trial failures by increasing assay sensitivity and minimizing recall and rater bias. Used in this manner, EMA has the potential to further our understanding of treatment response by allowing for the assessment of dynamic interactions between treatment and distinct symptom response.
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Affiliation(s)
- Aaron M Mofsen
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, MO, United States
| | - Thomas L Rodebaugh
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, MO, United States
| | - Ginger E Nicol
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, MO, United States
| | - Colin A Depp
- Department of Psychiatry, University of California - San Diego, San Diego, CA, United States
| | - J Philip Miller
- Division of Biostatistics, School of Medicine, Washington University in St Louis, St Louis, MO, United States
| | - Eric J Lenze
- Department of Psychiatry, School of Medicine, Washington University in St Louis, St Louis, MO, United States
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22
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Visser KF, Esfahlani FZ, Sayama H, Strauss GP. An ecological momentary assessment evaluation of emotion regulation abnormalities in schizophrenia. Psychol Med 2018; 48:2337-2345. [PMID: 29361997 DOI: 10.1017/s0033291717003865] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Prior studies using self-report questionnaires and laboratory-based methods suggest that schizophrenia is characterized by abnormalities in emotion regulation (i.e. using strategies to increase or decrease the frequency, duration, or intensity of negative emotion). However, it is unclear whether these abnormalities reflect poor emotion regulation effort or adequate effort, but limited effectiveness. It is also unclear whether dysfunction results primarily from one of the three stages of the emotion regulation process: identification, selection, or implementation. METHOD The current study used ecological momentary assessment (EMA) to address these questions in the context of everyday activities. Participants included 28 outpatients diagnosed with schizophrenia (SZ) and 28 demographically matched healthy controls (CN) who completed 6 days of EMA reports of in-the-moment emotional experience, emotion regulation strategy use, and context. RESULTS Results indicated that SZ demonstrated adequate emotion regulation effort, but poor effectiveness. Abnormalities were observed at each of the three stages of the emotion regulation process. At the identification stage, SZ initiated emotion regulation efforts at a lower threshold of negative emotion intensity. At the selection stage, SZ selected more strategies than CN and strategies attempted were less contextually appropriate. At the implementation stage, moderate to high levels of effort were ineffective at decreasing negative emotion. CONCLUSIONS Findings suggest that although SZ attempt to control their emotions using various strategies, often applying more effort than CN, these efforts are unsuccessful; emotion regulation abnormalities may result from difficulties at the identification, selection, and implementation stages.
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Affiliation(s)
| | | | - Hiroki Sayama
- Department of Systems Science and Industrial Engineering,Binghamton University,NY,USA
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23
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Sulis W. Assessing the continuum between temperament and affective illness: psychiatric and mathematical perspectives. Philos Trans R Soc Lond B Biol Sci 2018; 373:20170168. [PMID: 29483352 PMCID: PMC5832692 DOI: 10.1098/rstb.2017.0168] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/27/2017] [Indexed: 12/21/2022] Open
Abstract
Temperament of healthy people and mental illnesses, particularly affective disorders, have been conjectured to lie along a continuum of neurobehavioural regulation. Understanding the nature of this continuum may better inform the construction of taxonomies for both categories of behaviour. Both temperament and mental illness refer to patterns of behaviour that manifest over long time scales (weeks to years) and they appear to share many underlying neuroregulatory systems. This continuum is discussed from the perspectives of nonlinear dynamical systems theory, neurobiology and psychiatry as applied to understanding such multiscale time-series behaviour. Particular emphasis is given to issues of generativity, fungibility, metastability, non-stationarity and contextuality. Implications of these dynamical properties for the development of taxonomies will be discussed. Problems with the over-reliance of psychologists on statistical and mathematical methods in deriving their taxonomies (particularly those based on factor analysis) will be discussed from a dynamical perspective. An alternative approach to temperament based upon functionality, and its discriminative capabilities in mental illness, is presented.This article is part of the theme issue 'Diverse perspectives on diversity: multi-disciplinary approaches to taxonomies of individual differences'.
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Affiliation(s)
- William Sulis
- Collective Intelligence Laboratory, Department of Psychiatry and Behavioral Science, McMaster University, 92 Bowman Street, Hamilton, Ontario, Canada
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24
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Moore RC, Swendsen J, Depp CA. Applications for self-administered mobile cognitive assessments in clinical research: A systematic review. Int J Methods Psychiatr Res 2017; 26:e1562. [PMID: 28370881 PMCID: PMC5623609 DOI: 10.1002/mpr.1562] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/28/2016] [Accepted: 02/17/2017] [Indexed: 11/09/2022] Open
Abstract
Frequent, brief and repeated self-administered mobile assessments of cognitive function, conducted in everyday life settings, are a promising complementary tool to traditional assessment approaches. Mobile cognitive assessments promote patient-centered care and might enhance capacity to inform individual-level outcomes over time (i.e. detecting subtle declines in cognitive function), as well as in assessing cognition and its correlates in the naturalistic environment. The goal of this systematic review was to assess the feasibility and psychometric properties of mobile cognitive assessments. Through a comprehensive search, we identified 12 articles using self-administered, mobile phone-based cognitive assessments. Studies sampled participants between 1 and 6 times per day for 1-14 days. Samples ranged in age from 14 to 83 years old and were generally healthy populations without cognitive impairment. Working memory was the most frequently-assessed cognitive domain (n = 7), followed by attention/reaction time (n = 4). Seven studies reported adherence, with mean adherence rates of 79.2%. In addition to positive evidence of feasibility, there was general support for high levels of between- and within-person reliability and construct validity. While research has only begun to explore the utility of mobile cognitive assessments, studies to-date indicate they may be a promising complementary tool to traditional assessment methods with potential to improve clinical care and research.
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Affiliation(s)
- Raeanne C Moore
- Department of Psychiatry, University of California, San Diego, California, USA.,VA San Diego Healthcare System, San Diego, California, USA
| | - Joel Swendsen
- National Center for Scientific Research, University of Bordeaux, EPHE, Bordeaux, France
| | - Colin A Depp
- Department of Psychiatry, University of California, San Diego, California, USA.,VA San Diego Healthcare System, San Diego, California, USA
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25
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Sperry SH, Lynam DR, Kwapil TR. The convergence and divergence of impulsivity facets in daily life. J Pers 2017; 86:841-852. [PMID: 29125631 DOI: 10.1111/jopy.12359] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Impulsivity appears to be best conceptualized as a multidimensional construct. For example, the UPPS-P model posits that there are five underlying facets of impulsivity. The present study examined the expression of the UPPS-P facets in daily life using experience sampling methodology. A specific goal of the study was to examine positive urgency, a facet added to the original UPPS model, and its convergence and divergence from the negative urgency facet. METHOD A large nonclinical sample of young adults (n = 294) completed the UPPS-P scale and was signaled to complete questionnaires assessing daily affect, cognitions, sense of self, and impulsive behaviors eight times a day for 7 days. RESULTS Results indicated that the UPPS-P facets are associated with disruptions in affect, cognitions, and behavior in daily life. Furthermore, all of the UPPS-P facets were associated with impulsivity in daily life. Contrary to expectation, positive urgency was associated with negative affect rather than positive affect and had a profile indistinguishable from negative urgency. CONCLUSIONS These results generally support a four-factor model of multidimensional impulsivity with a general overall urgency factor instead of separate positive and negative urgency facets.
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Affiliation(s)
- Sarah H Sperry
- University of North Carolina at Greensboro.,University of Illinois at Urbana-Champaign
| | | | - Thomas R Kwapil
- University of North Carolina at Greensboro.,University of Illinois at Urbana-Champaign
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26
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Batra S, Baker RA, Wang T, Forma F, DiBiasi F, Peters-Strickland T. Digital health technology for use in patients with serious mental illness: a systematic review of the literature. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2017; 10:237-251. [PMID: 29042823 PMCID: PMC5633292 DOI: 10.2147/mder.s144158] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND As the capabilities and reach of technology have expanded, there is an accompanying proliferation of digital technologies developed for use in the care of patients with mental illness. The objective of this review was to systematically search published literature to identify currently available health technologies and their intended uses for patients with serious mental illness. MATERIALS AND METHODS The Medline, Embase, and BIOSIS Previews electronic databases were searched to identify peer-reviewed English language articles that reported the use of digital, mobile, and other advanced technology in patients with schizophrenia/schizoaffective disorder, bipolar disorder, and major depressive disorder. Eligible studies were systematically reviewed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS Eighteen studies that met the inclusion criteria were identified. Digital health technologies (DHTs) assessed in the selected studies included mobile applications (apps), digital medicine, digital personal health records, and an electronic pill container. Smartphone apps accounted for the largest share of DHTs. The intended uses of DHTs could be broadly classified as monitoring to gain a better understanding of illness, clinical assessment, and intervention. Overall, studies indicated high usability/feasibility and efficacy/effectiveness, with several reporting validity against established clinical scales. Users were generally engaged with the DHT, and mobile assessments were deemed helpful in monitoring disease symptoms. CONCLUSION Rapidly proliferating digital technologies seem to be feasible for short-term use in patients with serious mental illness; nevertheless, long-term effectiveness data from naturalistic studies will help demonstrate their usefulness and facilitate their adoption and integration into the mental health-care system.
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Affiliation(s)
- Sonal Batra
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, Piscataway
| | - Ross A Baker
- Global Medical Affairs, Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, NJ
| | - Tao Wang
- Medical Affairs, Otsuka Pharmaceutical Development and Commercialization Inc., Rockville, MD
| | | | - Faith DiBiasi
- Medical Affairs, Otsuka Pharmaceutical Development and Commercialization Inc., Rockville, MD
| | - Timothy Peters-Strickland
- Global Clinical Development, Otsuka Pharmaceutical Development and Commercialization Inc., Princeton, NJ, USA
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27
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Patock-Peckham JA, Canning JR, Leeman RF. Shame is bad and guilt is good: An examination of the impaired control over drinking pathway to alcohol use and related problems. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017; 121:62-66. [PMID: 29311753 DOI: 10.1016/j.paid.2017.09.023] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Tension Reduction Theory (Kushner et al., 1994) suggests alcohol is used as a means to alleviate negative affect (NA) such as shame and guilt. Shame is an internalized response in which blame is placed on the self, while guilt is not internalized and the blame is placed on the situation (Dearing et al., 2005). This study aims to investigate relationships of shame and guilt to alcohol use and problems through the mechanisms of multiple facets of impulsivity (i.e. UPPS) and impaired control over drinking (IC), which reflect behavioral control processes. The sample consisted of 419 college students (53% female). We examined direct and indirect relationships of shame and guilt on alcohol use and related problems through facets of impulsivity and IC. Shame and guilt were found to diverge (Woien et al., 2003). We found that those higher on shame-proneness used more alcohol and experienced more alcohol-related problems through increased negative urgency and IC. Conversely, guilt-prone individuals used less alcohol and experienced fewer alcohol-related problems through less negative urgency and IC. Our findings suggest that guilt is an adaptive form of negative affect, particularly when it comes to alcohol-related outcomes.
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