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Zhu X, Yang Y, Xiao Z, Pooley A, Ozdemir E, Speyer LG, Leung M, Thurston C, Kwok J, Li X, Eisner M, Ribeaud D, Murray AL. Daily life affective dynamics as transdiagnostic predictors of mental health symptoms: An ecological momentary assessment study. J Affect Disord 2024; 351:808-817. [PMID: 38320660 DOI: 10.1016/j.jad.2024.01.269] [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: 07/28/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Affective dynamics have been identified as a correlate of a broad span of mental health issues, making them key candidate transdiagnostic factors. However, there remains a lack of knowledge about which aspects of affective dynamics - especially as they manifest in the course of daily life - relate to a general risk for mental health issues versus specific symptoms. METHODS We leverage an ecological momentary assessment (EMA) study design with four measures per day over a two-week period to explore how negative affect levels, inertia, lability, and reactivity to provocation and stress in the course of daily life relate to mental health symptoms in young adults (n = 256) in the domains of anxiety, depression, psychosis-like symptoms, behaviour problems, suicidality, and substance use. RESULTS Dynamic structural equation modelling (DSEM) suggested that negative affect levels in daily life were associated with depression, anxiety, indirect and proactive aggression, psychosis, anxiety, and self-injury; negative affective lability was associated with depression, physical aggression, reactive aggression, suicidal ideation, and ADHD symptoms; negative affective inertia was associated with depression, anxiety, physical aggression, and cannabis use; and emotional reactivity to provocation was related to physical aggression. LIMITATIONS The cross-sectional design, the limited span of mental health issues included, and the convenience nature and small size of the sample are limitations. CONCLUSIONS Findings suggest that a subset of mental health symptoms have shared negative affective dynamics patterns. Longitudinal research is needed to rigorously examine the directionality of the effects underlying the association between affective dynamics and mental health issues.
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Affiliation(s)
- Xinxin Zhu
- Department of Psychology, University of Edinburgh, UK
| | - Yi Yang
- Department of Psychology, University of Edinburgh, UK
| | - Zhuoni Xiao
- Department of Psychology, University of Edinburgh, UK
| | - Abby Pooley
- Department of Psychology, University of Edinburgh, UK
| | - Ercan Ozdemir
- School of Health in Social Science, University of Edinburgh, UK
| | - Lydia Gabriela Speyer
- Department of Psychology, University of Edinburgh, UK; Department of Psychology, Lancaster University, UK
| | | | | | - Janell Kwok
- Department of Psychology, University of Edinburgh, UK
| | - Xuefei Li
- Department of Psychology, University of Edinburgh, UK
| | - Manuel Eisner
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland; Institute of Criminology, University of Cambridge, UK
| | - Denis Ribeaud
- Jacobs Center for Productive Youth Development, University of Zurich, Switzerland
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van den Brink B, Jongkind M, Wijzenbroek W, Duif M, Braam AW, Delespaul P, Schaap-Jonker H. The Experience Sampling Method: A New Way of Assessing Variability of the Emotional Dimensions of Religiosity and Spirituality in a Dutch Psychiatric Population. JOURNAL OF RELIGION AND HEALTH 2023; 62:3687-3701. [PMID: 37418048 DOI: 10.1007/s10943-023-01857-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/14/2023] [Indexed: 07/08/2023]
Abstract
Religiosity and spirituality (R/S) are often regarded as being relatively stable over time. The present exploratory experience sampling method (ESM) study aims to assess the variability of three R/S parameters concerning affective representations of God and spiritual experiences in a psychiatric population. Depressed in- and outpatients self-identifying as being spiritual or religious participated, from two Dutch mental health care institutions. The twenty-eight participants rated momentary affective R/S-variables up to 10 times per day over a 6-day period when prompted by a mobile application. All three examined R/S parameters varied significantly within the day. ESM examination of R/S showed good compliance and little reactivity. This indicates that ESM offers a feasible, usable, and valid way to explore R/S in a psychiatric population.
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Affiliation(s)
- Bart van den Brink
- Center for Research and Innovation in Christian Mental Health Care (Kicg), Zuiderinslag 4C, 3871 MR, Hoevelaken, The Netherlands.
- Psychiatric Acute Care Unit, Eleos, Christian Institution for Mental Health Care, Bosch en Duin, The Netherlands.
- Department of Emergency Psychiatry, GGz Centraal, Amersfoort, The Netherlands.
| | - Matthias Jongkind
- Independent Clinical Psychologist, Utrecht, The Netherlands
- Department of Clinical Psychology, University Utrecht, Utrecht, The Netherlands
| | - Willemijn Wijzenbroek
- Center for Research and Innovation in Christian Mental Health Care (Kicg), Zuiderinslag 4C, 3871 MR, Hoevelaken, The Netherlands
| | - Mira Duif
- Open University, Heerlen, The Netherlands
| | - Arjan W Braam
- Department of Humanist Chaplaincy Studies for a Plural Society, University of Humanistic Studies, Utrecht, The Netherlands
- Department of Emergency Psychiatry and Residency Training, Altrecht Mental Health Care, Utrecht, The Netherlands
| | | | - Hanneke Schaap-Jonker
- Center for Research and Innovation in Christian Mental Health Care (Kicg), Zuiderinslag 4C, 3871 MR, Hoevelaken, The Netherlands
- Department of Religion and Theology, Vrije Universiteit, Amsterdam, The Netherlands
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Quang Dao P, Dat PT, Khoa NN. Anxiety as a mediator in the relationship between the socioeconomic impact of COVID-19 and quality of life: a cross-sectional study in Vietnam. PSYCHOL HEALTH MED 2023; 28:2526-2536. [PMID: 36878882 DOI: 10.1080/13548506.2023.2188231] [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: 10/08/2022] [Accepted: 02/28/2023] [Indexed: 03/08/2023]
Abstract
Previous studies have investigated the effects of the pandemic on quality of life; both economical and psychosocial effects were explored. Some studies also mentioned mediating factors as mechanisms in this relationship; however, the mediating role of anxiety has not been examined. The present study examined the mediating effects of anxiety on the relationship between socioeconomic impact of COVID-19 and quality of life. An online survey of 280 Vietnamese residents was conducted in the context of the pandemic outbreak. Anxiety was found to be a completely mediating variable in the association between the socioeconomic impact of the pandemic and quality of life during the lockdown period. This finding contributes to a better understanding of how the pandemic affects people's quality of life and serves as the foundation for lessening the negative effects of the epidemic on people's lives.
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Affiliation(s)
- Pham Quang Dao
- Faculty of Psychology, Ural Federal University, Yekaterinburg, Sverdlovsk Oblast, Russia
| | - Pham Tien Dat
- Faculty of Psychology, Ho Chi Minh City University of Education, Ho Chi Minh, Vietnam
| | - Nguyen Ngoc Khoa
- Faculty of Psychology, Ho Chi Minh City University of Education, Ho Chi Minh, Vietnam
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Baik SY, Newman MG. The transdiagnostic use of worry and rumination to avoid negative emotional contrasts following negative events: A momentary assessment study. J Anxiety Disord 2023; 95:102679. [PMID: 36863193 PMCID: PMC10191629 DOI: 10.1016/j.janxdis.2023.102679] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/21/2022] [Accepted: 02/03/2023] [Indexed: 02/09/2023]
Abstract
The contrast avoidance model (CAM) suggests that individuals with generalized anxiety disorder (GAD) are sensitive to a sharp increase in negative and/or decrease in positive affect. They thus worry to increase negative emotion to avoid negative emotional contrasts (NECs). However, no prior naturalistic study has examined reactivity to negative events, or ongoing sensitivity to NECs, or the application of CAM to rumination. We used ecological momentary assessment to examine effects of worry and rumination on negative and positive emotion before and after negative events and intentional use of repetitive thinking to avoid NECs. Individuals with major depressive disorder (MDD) and/or GAD (N = 36) or without psychopathology (N = 27) received 8 prompts/day for 8 days and rated items on negative events, emotions, and repetitive thoughts. Regardless of group, higher worry/rumination before negative events was associated with less increased anxiety and sadness, and less decreased happiness from before to after the events. Participants with MDD/GAD (vs. controls) reported higher ratings on focusing on the negative to avoid NECs and greater vulnerability to NECs when feeling positive. Results support the transdiagnostic ecological validity for CAM extending to rumination and intentional engagement in repetitive thinking to avoid NECs among individuals with MDD/GAD.
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Affiliation(s)
- Seung Yeon Baik
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802, United States.
| | - Michelle G Newman
- Department of Psychology, The Pennsylvania State University, University Park, PA 16802, United States
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Llera SJ, Newman MG. Incremental validity of the contrast avoidance model: A comparison with intolerance of uncertainty and negative problem orientation. J Anxiety Disord 2023; 95:102699. [PMID: 36958137 PMCID: PMC10166139 DOI: 10.1016/j.janxdis.2023.102699] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Revised: 02/23/2023] [Accepted: 03/15/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND This study examined the incremental validity of the Contrast Avoidance Model (CAM) in predicting generalized anxiety disorder (GAD) symptoms when compared against well-established constructs in the GAD literature: intolerance of uncertainty (IU) and negative problem orientation (NPO). METHOD In this study, 185 students (108 of whom endorsed clinical levels of GAD symptoms) completed questionnaires to assess for all constructs. GAD symptoms were regressed on measures of contrast avoidance (CA; Contrast Avoidance-General Emotion and Contrast Avoidance-Worry Questionnaires; Llera & Newman, 2017) tendencies in addition to measures of IU and NPO in separate analyses. Commonality analyses explored the unique versus overlapping contributions of each factor in explaining GAD symptoms. RESULTS In all models, CA was a significant predictor after controlling for demographic variables (age, gender, race, and ethnicity) and both IU and NPO. This was also true when excluding CA items referencing worry. All variables contributed unique explanatory power in the prediction of GAD. CONCLUSION Results provide evidence of the incremental validity of the CAM as a model of GAD.
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Affiliation(s)
- Sandra J Llera
- Towson University, Department of Psychology, 8000 York Rd., Towson, MD 21252, USA.
| | - Michelle G Newman
- Penn State University, Department of Psychology, 371 Moore Building, University Park, PA 16802, USA
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Feng G, Xu X, Lei J. Tracking perceived stress, anxiety, and depression in daily life: a double-downward spiral process. Front Psychol 2023; 14:1114332. [PMID: 37143594 PMCID: PMC10151810 DOI: 10.3389/fpsyg.2023.1114332] [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: 12/02/2022] [Accepted: 03/31/2023] [Indexed: 05/06/2023] Open
Abstract
Introduction Previous studies using retrospective questionnaires have suggested a complex relationship between perceived stress and related negative emotions and emphasized their importance in mental health. However, how daily perceived stress, anxiety, and depression interact dynamically in a natural context remains largely unexplored. Methods This study conducted a longitudinal survey that applied experience sampling methodology to data from 141 Chinese college students (58% women, mean age = 20.1 ± 1.63 years). Results The hierarchical linear models confirmed that daily perceived stress and negative emotions (i.e., perceived depression and anxiety) could reciprocally reinforce one another with the characteristic dynamics of a cognitive-emotional downward spiral. Additionally, anxiety and depression could further circularly aggravate each other imminently. These two intertwined downward-spiral processes constitute a double-downward-spiral model. Discussion The findings contribute to a better understanding of the interactive mechanisms underlying perceived stress and its related negative emotions in everyday life and highlight the significance of early emotion regulation and stress relief in healthy people.
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Affiliation(s)
- Guo Feng
- Psychological Research and Counseling Center, Southwest Jiaotong University, Chengdu, Sichuan, China
- Institute of Applied Psychology, Southwest Jiaotong University, Chengdu, Sichuan, China
- *Correspondence: Guo Feng,
| | - Xiaxia Xu
- Psychological Research and Counseling Center, Southwest Jiaotong University, Chengdu, Sichuan, China
| | - Jiawei Lei
- Psychological Research and Counseling Center, Southwest Jiaotong University, Chengdu, Sichuan, China
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Morriss J, Goh K, Hirsch CR, Dodd HF. Intolerance of uncertainty heightens negative emotional states and dampens positive emotional states. Front Psychiatry 2023; 14:1147970. [PMID: 37032949 PMCID: PMC10073686 DOI: 10.3389/fpsyt.2023.1147970] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 03/06/2023] [Indexed: 04/11/2023] Open
Abstract
Individuals high in self-reported Intolerance of Uncertainty (IU) tend to view uncertainty as unbearable and stressful. Notably, IU is transdiagnostic, and high levels of IU are observed across many different emotional disorders (e.g., anxiety, depression). Research has primarily focused on how IU evokes and modulates emotional states such as fear and anxiety. However, recent research suggests that IU may have relevance for a broader range of emotional states. Here, an online survey was conducted to examine whether IU evokes and modulates a range of negative (e.g., fear/anxiety, sadness/upset, anger/frustration, disgust) and positive (e.g., happiness/joy, excitement/enthusiasm, surprise/interest) emotional states. Findings within a community sample (n = 231) revealed that individuals with higher levels of IU report: (1) that uncertainty in general and uncertainty under ambiguity are more likely to evoke negative emotional states and less likely to evoke positive emotional states, (2) that uncertainty under risk is less likely to evoke positive emotional states, and (3) that uncertainty heightens existing negative emotional states and dampens existing positive emotional states. Importantly, these IU-related findings remained when controlling for current experiences of general distress, anxious arousal, and anhedonic depression. Taken together, these findings suggest that IU is involved in evoking and modulating a wide array of emotional phenomena, which likely has relevance for transdiagnostic models and treatment plans for emotional disorders.
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Affiliation(s)
- Jayne Morriss
- Faculty of Environmental and Life Sciences, School of Psychology, University of Southampton, Southampton, United Kingdom
- *Correspondence: Jayne Morriss,
| | - Kimberly Goh
- School of Psychology and Clinical Language Sciences, University of Reading, Reading, United Kingdom
| | - Colette R. Hirsch
- King’s College London, Institute of Psychology, Psychiatry and Neuroscience, London, United Kingdom
- South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Helen F. Dodd
- College of Medicine and Health, University of Exeter, Exeter, United Kingdom
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Newman MG, Schwob JT, Rackoff GN, Doren NV, Shin KE, Kim H. The naturalistic reinforcement of worry from positive and negative emotional contrasts: Results from a momentary assessment study within social interactions. J Anxiety Disord 2022; 92:102634. [PMID: 36182690 PMCID: PMC10187062 DOI: 10.1016/j.janxdis.2022.102634] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND The Contrast Avoidance Model (Newman & Llera, 2011) proposes that worry is reinforced by avoiding a negative contrast and increasing the likelihood of a positive contrast. OBJECTIVE To determine if reinforcement of worry occurs naturalistically via contrasts in both negative and positive emotion. METHOD Using event-contingent momentary assessment we assessed social interactions, pre-interaction state worry and pre-post interaction positive and negative emotion. Participants with generalized anxiety disorder (GAD; N = 83) completed an online questionnaire after social interactions lasting at least 1 min for 8 days. Three-level multilevel models were conducted. RESULTS Higher worry was concurrently associated with increased negative emotion and decreased positive emotion. Regardless of pre-interaction worry level, negative emotion decreased, and positive emotion increased from before to after interactions, suggesting that most interactions were benign or positive. At lower levels of pre-interaction worry, participants experienced increased negative emotion and decreased positive emotion from before to after interactions. At higher levels of pre-interaction worry, participants experienced decreased negative emotion and increased positive emotion from before to after interactions. CONCLUSION Among persons with GAD, worrying before social interactions may be both negatively and positively reinforced; furthermore, not worrying before social interactions may be both negatively and positively punished.
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The Impact of Emotion Regulation on the Relationship Between Momentary Negative Affect and End-of-Day Worry and Rumination. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10339-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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10
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Xiong Z, Weng X, Wei Y. SandplayAR: Evaluation of diagnosis game for people with generalized anxiety disorder. ARTS IN PSYCHOTHERAPY 2022. [DOI: 10.1016/j.aip.2022.101934] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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Gu XX, Jin Y, Fu T, Zhang XM, Li T, Yang Y, Li R, Zhou W, Guo JX, Zhao R, Li JJ, Dong C, Gu ZF. Relevant Characteristics Analysis Using Natural Language Processing and Machine Learning Based on Phenotypes and T-Cell Subsets in Systemic Lupus Erythematosus Patients With Anxiety. Front Psychiatry 2021; 12:793505. [PMID: 34955935 PMCID: PMC8703039 DOI: 10.3389/fpsyt.2021.793505] [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: 10/12/2021] [Accepted: 11/09/2021] [Indexed: 11/13/2022] Open
Abstract
Anxiety is frequently observed in patients with systemic lupus erythematosus (SLE) and the immune system could act as a trigger for anxiety. To recognize abnormal T-cell and B-cell subsets for SLE patients with anxiety, in this study, patient disease phenotypes data from electronic lupus symptom records were extracted by using natural language processing. The Hospital Anxiety and Depression Scale (HADS) was used to distinguish patients, and 107 patients were selected to meet research requirements. Then, peripheral blood was collected from two patient groups for multicolor flow cytometry experiments. The characteristics of 75 T-cell and 15 B-cell subsets were investigated between SLE patients with- (n = 23) and without-anxiety (n = 84) groups by four machine learning methods. The findings showed 13 T-cell subsets were significantly different between the two groups. Furthermore, BMI, fatigue, depression, unstable emotions, CD27+CD28+ Th/Treg, CD27-CD28- Th/Treg, CD45RA-CD27- Th, and CD45RA+HLADR+ Th cells may be important characteristics between SLE patients with- and without-anxiety groups. The findings not only point out the difference of T-cell subsets in SLE patients with or without anxiety, but also imply that T cells might play the important role in patients with anxiety disorder.
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Affiliation(s)
- Xi-Xi Gu
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China.,Joint Research Center, Affiliated Hospital of Nantong University, Nantong, China.,Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Yi Jin
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China.,Joint Research Center, Affiliated Hospital of Nantong University, Nantong, China.,Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Ting Fu
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Xiao-Ming Zhang
- Joint Research Center, Affiliated Hospital of Nantong University, Nantong, China.,Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Teng Li
- Joint Research Center, Affiliated Hospital of Nantong University, Nantong, China.,Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Ying Yang
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China
| | - Rong Li
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China.,Joint Research Center, Affiliated Hospital of Nantong University, Nantong, China.,Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Wei Zhou
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China.,Joint Research Center, Affiliated Hospital of Nantong University, Nantong, China.,Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Jia-Xin Guo
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China.,Joint Research Center, Affiliated Hospital of Nantong University, Nantong, China.,Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Rui Zhao
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, Nantong, China
| | - Jing-Jing Li
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China
| | - Chen Dong
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China.,Joint Research Center, Affiliated Hospital of Nantong University, Nantong, China.,Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
| | - Zhi-Feng Gu
- Department of Rheumatology, Affiliated Hospital of Nantong University, Nantong University, Nantong, China.,Joint Research Center, Affiliated Hospital of Nantong University, Nantong, China.,Institut Pasteur of Shanghai, Chinese Academy of Sciences, Shanghai, China
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