Testing the Impact of Variations in Administration on the Kessler Psychological Distress Scale (K10)

Self-report measures are useful in psychological research and practice, but scores may be impacted by administration methods. This study investigated whether changing the recall period (from 30 to 7 days) and response option order (from ascending to descending) alters the score distribution of the Kessler Psychological Distress Scale (K10). Participants were presented with the K10 with either different recall periods or different response option orders. There was weak evidence of lower mean K10 scores when using a 7-day recall period than when using the 30-day recall period (B = 1.96, 95% CI [0.04-3.90]) but no evidence of a change in the estimated prevalence of very high psychological distress. Presenting the response options in ascending order did not affect mean scores, but there was weak evidence of reduced prevalence of very high distress relative to the descending order (incidence rate ratio [IRR] = 0.60, 95% CI [0.36-0.98]). These findings suggest that varying the administration method may result in minor differences in population estimates of very high psychological distress when using the K10.

The Within-Subject Association of Physical Behavior and Affective Well-Being in Everyday Life: A Systematic Literature Review

BACKGROUND

The interplay of physical activity (PA) with affective well-being (AWB) is highly critical to both health behaviors and health outcomes. Current prominent theories presume AWB to be crucial for PA maintenance, and PA is evidenced to foster mental health. However, thus far, PA-AWB associations have mainly been researched in laboratory settings and with interventional designs, but the everyday life perspective had not been focused on, mostly due to technological limitations. In the course of digitization, the number of studies using device-based methods to research the within-subject association of physical activity and affective well-being (PA-AWB) under ecological valid conditions increased rapidly, but a recent comprehensive systematic review of evidence across populations, age groups, and distinct AWB components remained inconclusive.

OBJECTIVES

Therefore, we aimed to firstly review daily-life studies that assessed intensive longitudinal device-based (e.g., electronic smartphone diaries and accelerometry) and real-time PA-AWB data, secondly to develop and apply a quality assessment tool applicable to those studies, and thirdly to discuss findings and draw implications for research and practice.

METHODS

To this end, the literature was searched in three databases (Web of Science, PubMed, Scopus) up to November 2022. The systematic review followed the PRISMA guidelines and had been pre-registered (PROSPERO id: CRD42021277327). A modified quality assessment tool was developed to illustrate the risk of bias of included studies.

RESULTS

The review of findings showed that, in general, already short PA bouts in everyday life, which clearly differ from structured exercise sessions, are positively associated with AWB. In particular, feelings of energy relate to incidental (non-exercise and unstructured) activity, and PA-AWB associations depend on population characteristics. The quality assessment revealed overall moderate study quality; however, the methods applied were largely heterogeneous between investigations. Overall, the reviewed evidence on PA-AWB associations in everyday life is ambiguous; for example, no clear patterns of directions and strengths of PA-AWB relationships depending on PA and AWB components (such as intensity, emotions, affect, mood) emerged.

CONCLUSIONS

The reviewed evidence can fuel discussions on whether the World Health Organization's notion "every move counts" may be extended to everyday life AWB. Concurrently, the PA-AWB relationship findings endorse prominent theories highlighting the critical role of AWB in everyday PA engagement and maintenance. However, the review also clearly highlights the need to advance and harmonize methodological approaches for more fine-grained investigations on which specific PA/AWB characteristics, contextual factors, and biological determinants underly PA-AWB associations in everyday life. This will enable the field to tackle pressing challenges such as the issue of causality of PA-AWB associations, which will help to shape and refine existing theories to ultimately predict and improve health behavior, thereby feeding into precision medicine approaches.

Effects of Receiving Pain-Related Support on Psychological Well-Being: The Moderating Roles of Emotional Responses to Support

OBJECTIVES

We investigated whether receiving greater pain-related instrumental support is associated with poorer psychological well-being among chronic pain patients who report less positive (e.g., grateful) or more negative (e.g., angry) emotional responses to support.

METHODS

We conducted regression analyses, utilizing data from two waves of interviews with 152 knee osteoarthritis patients. Three indicators of psychological well-being were examined: depressive symptoms, positive affect, and negative affect.

RESULTS

Receiving greater support was associated with poorer psychological well-being at baseline, as well as higher depressive symptoms and negative affect at the 18-month follow-up, only among patients with low positive emotional responses to support. Furthermore, receiving greater support was related to poorer psychological well-being at baseline only among patients with high negative emotional responses to support.

DISCUSSION

Care recipients' less positive emotional responses to support may be a risk factor for poorer psychological well-being in both the short- and long-term, when receiving greater support.

Viral simulations in dreams: The effect of the COVID-19 pandemic on threatening dream content in a Finnish sample of diary dreams

Previous research indicates that the COVID-19 pandemic has affected dreaming negatively. We compared 1132 dreams collected with prospective two-week dream diary during the pandemic to 166 dreams collected before the pandemic. We hypothesized that the pandemic would increase the number of threatening events, threats related to diseases, and the severity of threats. We also hypothesized that dreams that include direct references to the pandemic will include more threatening events, more disease-related threats, and more severe threats. In contradiction with our hypotheses, results showed no differences between pandemic and pre-pandemic samples in the number of threats, threats related to diseases, or severe threats. However, dreams with direct references to the pandemic had more threats, disease-related threats, and severe threats. Our results thus do not suggest a significant overall increase in nightmarish or threatening dream content during the pandemic but show a more profound effect on a minority of dreams.

Face your fears: direct and indirect measurement of responses to looming threats

This study investigated the emotional and behavioural effects of looming threats using both recalled (self-reported valence) and real-time response measurements (facial expressions). The looming bias refers to the tendency to underestimate the time of arrival of rapidly approaching (looming) stimuli, providing additional time for defensive reactions. While previous research has shown negative emotional responses to looming threats based on self-reports after stimulus exposure, facial expressions offer valuable insights into emotional experiences and non-verbal behaviour during stimulus exposure. A face reading experiment examined responses to threats in motion, considering stimulus direction (looming versus receding motion) and threat strength (more versus less threatening stimuli). We also explored the added value of facial expression recognition compared to self-reported valence. Results indicated that looming threats elicit more negative facial expressions than receding threats, supporting previous findings on the looming bias. Further, more (vs. less) threatening stimuli evoked more negative facial expressions, but only when the threats were looming rather than receding. Interestingly, facial expressions of valence and self-reported valence showed opposing results, suggesting the importance of incorporating facial expression recognition to understand defensive responses to looming threats more comprehensively.

Receiving help at work mitigates the negative consequences of performance pressure: implications for depletion and citizenship behavior

Drawing from job-demands resources theory and conservation of resources theory, this study examines the effect of performance pressure on interpersonal citizenship behavior through exhaustion. We also explore the extent to which receiving help mitigates the exhaustion caused by performance pressure. In a critical incident design of employees from various industries (N = 268), performance pressure was positively associated with exhaustion. Subsequently, employee exhaustion decreased the tendency to perform acts of interpersonal citizenship. The relationship between performance pressure and exhaustion was weakened among employees who had received help from their colleagues. Thus, these results, supported by moderated mediation analyses, suggest that receiving help can mitigate the deleterious effects of performance pressure on interpersonal citizenship behavior through exhaustion. Implications for research and practice are discussed.

Comparing estimates of psychological distress using 7-day and 30-day recall periods: Does it make a difference?

Self-report measures are widely used in mental health research and may use different recall periods depending on the purpose of the assessment. A range of studies aiming to monitor changes in mental health over the course of the COVID-19 pandemic opted to shorten recall periods to increase sensitivity to change over time compared to standard, longer recall periods. However, many of these studies lack pre-pandemic data using the same recall period and may rely on pre-existing data using standard recall periods as a reference point for assessing the impact of the pandemic on mental health. The aim of this study was to assess whether comparing scores on the same questionnaire with a different recall period is valid. A nationally representative sample of 327 participants in Australia completed a 7-day and 30-day version of the six-item Kessler Psychological Distress Scale (K6) and a single-item measure of psychological distress (TTPN item) developed for the Taking the Pulse of the Nation survey. Linear mixed models and mixed logistic regression models were used to assess whether altering the recall period systematically changed response patterns within subjects. No substantive recall period effects were found for the K6 or the TTPN, although there was a trend towards higher K6 scores when asked about the past 30 days compared to the past 7 days (b = 1.00, 95% CI: -0.18, 2.17). This may have been driven by the "feeling nervous" item which was rated higher using the 30-day compared to the 7-day recall period. Neither the K6 nor the TTPN item were significantly affected by the recall period when reduced to a binary variable of likely severe mental illness. The results indicate that altering the recall period of psychological distress measures does not substantively alter the score distribution in the general population of Australian adults.

Posting patterns in peer online support forums and their associations with emotions and mood in bipolar disorder: Exploratory analysis

BACKGROUND

Mental health (MH) peer online forums offer robust support where internet access is common, but healthcare is not, e.g., in countries with under-resourced MH support, rural areas, and during pandemics. Despite their widespread use, little is known about who posts in such forums, and in what mood states. The discussion platform Reddit is ideally suited to study this as it hosts forums (subreddits) for MH and non-MH topics. In bipolar disorder (BD), where extreme mood states are core defining features, mood influences are particularly relevant.

OBJECTIVES

This exploratory study investigated posting patterns of Reddit users with a self-reported BD diagnosis and the associations between posting and emotions, specifically: 1) What proportion of the identified users posts in MH versus non-MH subreddits? 2) What differences exist in the emotions that they express in MH or non-MH subreddit posts? 3) How does mood differ between those users who post in MH subreddits compared to those who only post in non-MH subreddits?

METHODS

Reddit users were automatically identified via self-reported BD diagnosis statements and all their 2005-2019 posts were downloaded. First, the percentages of users who posted only in MH (non-MH) subreddits were calculated. Second, affective vocabulary use was compared in MH versus non-MH subreddits by measuring the frequency of words associated with positive emotions, anxiety, sadness, anger, and first-person singular pronouns via the LIWC text analysis tool. Third, a logistic regression distinguished users who did versus did not post in MH subreddits, using the same LIWC variables (measured from users' non-MH subreddit posts) as predictors, controlling for age, gender, active days, and mean posts/day.

RESULTS

1) Two thirds of the identified 19,685 users with a self-reported BD diagnosis posted in both MH and non-MH subreddits. 2) Users who posted in both MH and non-MH subreddits exhibited less positive emotion but more anxiety and sadness and used more first-person singular pronouns in their MH subreddit posts. 3) Feminine gender, higher positive emotion, anxiety, and sadness were significantly associated with posting in MH subreddits.

CONCLUSIONS

Many Reddit users who disclose a BD diagnosis use a single account to discuss MH and other concerns. Future work should determine whether users exhibit more anxiety and sadness in their MH subreddit posts because they more readily post in MH subreddits when experiencing lower mood or because they feel more able to express negative emotions in these spaces. MH forums may reflect the views of people who experience more extreme mood (outside of MH subreddits) compared to people who do not post in MH subreddits. These findings can be useful for MH professionals to discuss online forums with their clients. For example, they may caution them that forums may underrepresent people living well with BD.

Accurately predicting hit songs using neurophysiology and machine learning

Identifying hit songs is notoriously difficult. Traditionally, song elements have been measured from large databases to identify the lyrical aspects of hits. We took a different methodological approach, measuring neurophysiologic responses to a set of songs provided by a streaming music service that identified hits and flops. We compared several statistical approaches to examine the predictive accuracy of each technique. A linear statistical model using two neural measures identified hits with 69% accuracy. Then, we created a synthetic set data and applied ensemble machine learning to capture inherent non-linearities in neural data. This model classified hit songs with 97% accuracy. Applying machine learning to the neural response to 1st min of songs accurately classified hits 82% of the time showing that the brain rapidly identifies hit music. Our results demonstrate that applying machine learning to neural data can substantially increase classification accuracy for difficult to predict market outcomes.

Effects of a 7-Day Pornography Abstinence Period on Withdrawal-Related Symptoms in Regular Pornography Users: A Randomized Controlled Study

Little is known about whether withdrawal-like symptoms manifest when regular pornography users attempt to abstain from pornography. The present study used a randomized controlled design to examine whether (1) negative abstinence effects that may be potentially reflective of withdrawal-related symptoms manifest when a non-clinical sample of regular pornography users attempt to abstain from pornography for a 7-day period and (2) these negative abstinence effects would only manifest (or manifest more strongly) for those with higher levels of problematic pornography use (PPU). A total of 176 undergraduate students (64.2% female) who were regular pornography users (defined as having used pornography ≥ three times a week in the past 4 weeks) were randomly assigned to an abstinence group (instructed to attempt abstinence from pornography for 7 days, n = 86) or a control group (free to watch pornography as usual, n = 90). Participants completed measures of craving, positive and negative affect, and withdrawal symptoms at baseline and each night of the 7-day period. Contrary to the confirmatory hypotheses, there were no significant main effects of group (abstinence vs. control) or group × PPU interaction effects on any of the outcome measures, controlling for baseline scores. These findings indicate that no evidence of withdrawal-related symptoms was found for abstaining participants, and this was not dependent on level of PPU. However, exploratory analyses showed a significant three-way interaction (group × PPU × past 4-week frequency of pornography use [FPU]) on craving, where an abstinence effect on craving was found at high levels of PPU only once past 4-week FPU reached the threshold of daily use. While these exploratory findings should be interpreted with caution, they suggest that abstinence effects could potentially manifest when there is a combination of high PPU and high FPU-a hypothesis that warrants investigation in future prospective abstinence studies.

Systematic Review of the Effect of a One-Day Versus Seven-Day Recall Duration on Patient Reported Outcome Measures (PROMs)

BACKGROUND

There is ongoing uncertainty around the most suitable recall period for patient-reported outcome measures (PROMs).

METHOD

This systematic review integrates quantitative and qualitative literature across health, economics, and psychology to explore the effect of a one-day (or '24-h') versus seven-day (or 'one week') recall period. The following databases were searched from database inception to 30 November 2021: MEDLINE, EMBASE, PsycINFO, Web of Science, EconLit, CINAHL Complete, Cochrane Library, and Sociological Abstracts. Studies were included that compared a one-day (or '24-h') versus seven-day (or weekly) recall period condition on patient-reported scores for PROM and Health-Related Quality-of-Life (HRQoL) instrument scores in adult populations (aged 18 and above) or combined paediatric and adult populations with a majority of respondents aged over 18 years. Studies were excluded if they assessed health behaviours only, used ecological momentary assessment to derive an index of daily recall, or incorporated clinician reports of patient symptoms. We extracted results relevant to six domains with generic health relevance: physical functioning, pain, cognition, psychosocial wellbeing, sleep-related symptoms and aggregated disease-specific signs and symptoms. Quantitative studies compared weekly recall scores with the mean or maximum score over the last seven days or with the same-day recall score.

RESULTS

Overall, across the 24 quantitative studies identified, 158 unique results were identified. Symptoms tended to be reported as more severe and HRQoL lower when assessed with a weekly recall than a one-day recall. A narrative synthesis of 33 qualitative studies integrated patient perspectives on the suitability of a one-day versus seven-day recall period for assessing health state or quality of life. Participants had mixed preferences, some noted the accuracy of recall for the one-day period but others preferred the seven-day recall for conditions characterised by high symptom variability, or where PROMs concepts required integration of infrequent experiences or functioning over time.

CONCLUSION

This review identified a clear trend toward higher symptom scores and worse quality of life being reported for a seven-day compared to a one-day recall. The review also identified anomalies in this pattern for some wellbeing items and a need for further research on positively framed items. A better understanding of the impact of using different recall periods within PROMs and HRQoL instruments will help contextualise future comparisons between instruments. Questionnaires ask patients about their health over different time periods (e.g., "what were your symptoms like over the last week?" versus "what were your symptoms like today?"). Studies find that people may report their symptoms as more severe when they are asked to think about their symptoms over the last week compared to the last day. Understanding how different time periods influence patient responses will allow researchers to compare and develop new questionnaires and may help clinicians to choose the best questionnaire to understand their patient's condition. We conducted a systematic literature review on studies which had looked at the impact of using different recall periods on patient responses. We found 24 studies that compared patient scores from questionnaires asking their health "over the last day" compared to "over the last week". Overall, symptoms tended to be reported as more severe and health as poorer when they were reported over the last week compared to the last day on average. We also found 33 studies that asked patients to describe which recall period they preferred. Patients had mixed preferences with more preferring a seven-day recall where symptoms and health impacts varied a lot.

Physiological arousal guides situational appraisals and metacognitive recall for naturalistic experiences

As individuals navigate the world, they are bound to have emotionally intense experiences. These events not only influence momentary physiological and affective responses, but may also have a powerful impact on one's memory for their emotional experience. In this research, we used the naturalistic context of a haunted house to examine how physiological arousal is associated with metacognitive emotional memory (i.e., the extent to which an individual remembers having experienced a certain emotion). Participants first navigated the haunted house while heart rate and explicit situational appraisals were recorded, and then recalled specific events from the haunted house and the intensity of these affective events approximately one week later. We found that heart rate predicted both the intensity of reported scariness in the haunted house and meta-cognitive memory of affect during recall. Critically, we found evidence for malleability in metacognitive emotional memory based on how the event was initially labeled. Individuals tended to recall events that they explicitly labeled as fear-evoking as being more intense than they reported at the time of the event. We found the opposite relationship for events that they labeled as not fear-evoking. Taken together, this indicates that there are strong relationships between physiological arousal and emotional experiences in naturalistic contexts, but that affective labeling can modulate the relationship between these features when reflecting on the emotionality of that experience in memory.

The need for ecological momentary assessment in researching emotional factors in language education

Language learning is an emotional and dynamic process, which is marked by fluctuations in language learners' positive and negative emotional variables (e.g., boredom, enjoyment, anxiety). Presumably, evidence can be found for an ecological view of the patterns and variations involved in language learners' emotions under the influence of the interactive individual and contextual elements of classroom learning. The present study contends that an ecological momentary assessment (EMA), which is compatible with the complex dynamic system theory (CDST) can help to explore the dynamics of language learners' emotional variables as they develop out of the process of classroom language learning. EMA is capable of tracing the moment-by-moment changes in a certain emotional trait in language learners as they are learning a foreign or second language. This innovative approach to research compensates for the shortcomings of retrospective studies (the delay of recalls) and also single-shot research designs (for data collection). It is fit for the assessment of the emergent patterns of L2 emotional variables. The distinctive features and pedagogical implications will be further discussed here.

Factors influencing nurse spiritual care practices at the end of life: A systematic review

OBJECTIVES

The aim was to identify determinants of nurse spiritual/existential care practices toward end-of-life patients. Nurses can play a significant role in providing spiritual/existential care, but they actually provide this care less frequently than desired by patients.

METHODS

A systematic search was performed for peer-reviewed articles that reported factors that influenced nurses' spiritual/existential care practices toward adult end-of-life patients.

RESULTS

The review identified 42 studies and included the views of 4,712 nurses across a range of hospital and community settings. The most frequently reported factors/domains that influenced nurse practice were patient-related social influence, skills, social/professional role and identity, intentions and goals, and environmental context and resources.

SIGNIFICANCE OF RESULTS

A range of personal, organizational, and patient-related factors influence nurse provision of spiritual/existential care to end-of-life patients. This complete list of factors can be used to gauge a unit's conduciveness to nurse provision of spiritual/existential care and can be used as inputs to nurse competency frameworks.

Emotion regulation strategy correlates with discrete state emotion in major depression

BACKGROUND AND OBJECTIVES

Research has shown that state emotion can affect emotion regulation strategies in healthy samples. Emotion regulation plays an important role in depression. We hypothesized that for depressed individuals, experiencing anxiety or anger affects emotion regulation strategy use differently than experiencing sadness.

DESIGN AND METHODS

Individuals diagnosed with chronic or recurrent depression (N = 386) responded to vignettes of hypothetical stressors and reported their state emotions and emotion regulation strategies in a thought-listing procedure. We modeled the effect of reporting anger or anxiety compared to sadness on the use of seven emotion regulation strategies: avoidance, distraction, other-blame, problem-solving, rumination, self-blame, and social support.

RESULTS

Compared to sadness, anger was associated with a greater likelihood of using other-blame, and a lower likelihood of using avoidance, rumination, or self-blame. Compared to sadness, anxiety was associated with a greater likelihood of using self-blame. Responses with anger or anxiety did not significantly differ from sadness in coder-rated adaptiveness.

CONCLUSIONS

Differences in observed emotion regulation strategy use were correlated with the discrete emotions experienced, and not overall adaptiveness of a response. These results highlight the importance of assessing for emotion type when studying emotion regulation strategy use in depression.

Continuous Neurophysiologic Data Accurately Predict Mood and Energy in the Elderly

The elderly have an elevated risk of clinical depression because of isolation from family and friends and a reticence to report their emotional states. The present study explored whether data from a commercial neuroscience platform could predict low mood and low energy in members of a retirement community. Neurophysiologic data were collected continuously for three weeks at 1Hz and averaged into hourly and daily measures, while mood and energy were captured with self-reports. Two neurophysiologic measures averaged over a day predicted low mood and low energy with 68% and 75% accuracy. Principal components analysis showed that neurologic variables were statistically associated with mood and energy two days in advance. Applying machine learning to hourly data classified low mood and low energy with 99% and 98% accuracy. Two-day lagged hourly neurophysiologic data predicted low mood and low energy with 98% and 96% accuracy. This study demonstrates that continuous measurement of neurophysiologic variables may be an effective way to reduce the incidence of mood disorders in vulnerable people by identifying when interventions are needed.

Genetically engineered heat-resistant coral: An initial analysis of public opinion

Rising seawater temperatures are contributing to coral degradation in the Great Barrier Reef. Synthetic biology technologies offer the potential to enhance coral resilience to higher water temperatures. To explore what the public think of genetically engineered coral as a future solution, qualitative responses to an open-ended question in a survey of 1,148 of the Australian public were analysed. More respondents supported the technology (59%) than did not (11%). However, a considerable proportion indicated moderate support (29%). Participants commented about the (moral) right to interfere with nature and uncertainty regarding the consequences of implementing the technology. Participants also mentioned the need to take responsibility and act to save the reef, as well as the benefits likely to result from implementing the technology. Other themes included a desire for further testing and proof, more information, and tight regulation and controls when introducing the technology.

Stop talking about it already! Co-ruminating and social media focused on COVID-19 was associated with heightened state anxiety, depressive symptoms, and perceived changes in health anxiety during Spring 2020

BACKGROUND

Social distancing presents a significant obstacle for relationships and threatens mental health. Identifying maladaptive, voluntary coping strategies may inform how to maintain interpersonal relationships and mental health during quarantine. Co-ruminating with peers on negative events, moods and fears has adjustment trade-offs of increasing depression and anxiety risk while also enhancing friendship quality. Similarly, social media use is associated with social benefits and risk to mental health. We extend prior research by examining whether co-ruminating on COVID-19, social media use, and social media use focused on COVID-19 during social isolation was associated with heightened depression and anxiety symptoms but also lower loneliness and higher social support during initial lockdown measures in the USA.

METHODS

Adults were recruited through social media (n = 345) to complete self-report surveys on co-rumination, social media use, social distancing, social support from March-May 2020. During this cross-sectional assessment, in addition to completing surveys on current depressive symptoms and state and health anxiety, participants also provided retrospective report of their perceived health anxiety levels six months prior.

RESULTS

Co-ruminating on COVID-19 with peers and greater time on social media focused on COVID-19 predicted perceived increases in health anxiety and were also associated with higher depressive symptoms and state anxiety, even after controlling for significant demographic predictors. Further, in the context of social distancing, both interaction strategies failed to confer social benefits.

CONCLUSIONS

Results have direct implications for maintaining psychosocial health during social distancing restrictions. Adults may modify how they engage with peers by limiting COVID-19 content on social media and COVID-19 discussion.

A Review of Explicit and Implicit Assumptions When Providing Personalized Feedback Based on Self-Report EMA Data

Ecological Momentary Assessment (EMA) in which participants report on their moment-to-moment experiences in their natural environment, is a hot topic. An emerging field in clinical psychology based on either EMA, or what we term Ecological Retrospective Assessment (ERA) as it requires retrospectivity, is the field of personalized feedback. In this field, EMA/ERA-data-driven summaries are presented to participants with the goal of promoting their insight in their experiences. Underlying this procedure are some fundamental assumptions about (i) the relation between true moment-to-moment experiences and retrospective evaluations of those experiences, (ii) the translation of these experiences and evaluations to different types of data, (iii) the comparison of these different types of data, and (iv) the impact of a summary of moment-to-moment experiences on retrospective evaluations of those experiences. We argue that these assumptions deserve further exploration, in order to create a strong evidence-based foundation for the personalized feedback procedure.

Development and validation of the Maudsley Modified Patient Health Questionnaire (MM-PHQ-9)

BACKGROUND

The Patient Health Questionnaire-9 (PHQ-9) is a widely used measure of depression in primary care. It was, however, originally designed as a diagnostic screening tool, and not for measuring change in response to antidepressant treatment. Although the Quick Inventory of Depressive Symptomology (QIDS-SR-16) has been extensively validated for outcome measurement, it is poorly adopted in UK primary care, and, although free for clinicians, has licensing restrictions for healthcare organisation use.

AIMS

We aimed to develop a modified version of the PHQ-9, the Maudsley Modified PHQ-9 (MM-PHQ-9), for tracking symptom changes in primary care. We tested the measure's validity, reliability and factor structure.

METHOD

A sample of 121 participants was recruited across three studies, and comprised 78 participants with major depressive disorder and 43 controls. MM-PHQ-9 scores were compared with the QIDS-SR-16 and Clinical Global Impressions improvement scale, for concurrent validity. Internal consistency of the scale was assessed, and principal component analysis was conducted to determine the items' factor structure.

RESULTS

The MM-PHQ-9 demonstrated good concurrent validity with the QIDS-SR-16, and excellent internal consistency. Sensitivity to change over a 14-week period was d = 0.41 compared with d = 0.61 on the QIDS-SR-16. Concurrent validity between the paper and mobile app versions of the MM-PHQ-9 was r = 0.67.

CONCLUSIONS

These results indicate that the MM-PHQ-9 is a valid and reliable measure of depressive symptoms in paper and mobile app format, although further validation is required. The measure was sensitive to change, demonstrating suitability for use in routine outcome assessment.

Factor Structure of the "Top Ten" Positive Emotions of Barbara Fredrickson

In order to contribute to the consolidation in the field of Positive Psychology, we reinvestigated the factor structure of top 10 positive emotions of Barbara Fredrickson. Former research in experimental settings resulted in a three-cluster solution, which we tested with exploratory and confirmatory methodology against different factor models. Within our non-experimental data (N = 312), statistical evidence is presented, advocating for a single factor model of the 10 positive emotions. Different possible reasons for the deviating results are discussed, as well as the theoretical significance to various subfields in Positive Psychology (e.g., therapeutical interventions). Furthermore, the special role of awe within the study and its implications for further research in the field are discussed.

Short- and Long-term Effects of Support Visibility on Support Providers' Negative Affect

OBJECTIVES

Seminal research with spouses of chronic pain patients indicates that providing patients with instrumental support can be either costly or beneficial for spouses' well-being. Drawing from the invisible support literature, this study evaluated the extent to which patients' recognition of spouses' support moderated daily and long-term associations between spouses' support provision and negative affect.

METHOD

Data came from a sample of spouses (N = 145) of knee osteoarthritis (OA) patients, and the patients themselves. Participants completed a baseline interview, 22 days of daily diaries, and two follow-up interviews 6 and 18 months after baseline. Multilevel models were estimated to test study hypotheses.

RESULTS

As expected, support visibility moderated daily and long-term associations between spouses' instrumental support provision and negative affect. Spouses reported elevated levels of negative affect in response to providing patients with extra care and attention, but only when their support was not recognized (i.e., reported) by patients.

DISCUSSION

Findings from the current study pinpoint support visibility as a protective factor that may mitigate negative short- and long-term effects of spousal instrumental support provision on spouses' negative affect. Promoting patients' awareness of their spouses' support may offset negative emotional consequences of caregiving in the context of chronic health stressors.

Mapping gender transition sentiment patterns via social media data: toward decreasing transgender mental health disparities

Objective

Transgender people face substantial mental health disparities, and this population’s emotional well-being can be particularly volatile during gender transition. Understanding gender transition sentiment patterns can positively impact transgender people by enabling them to anticipate, and put support in place for, particularly difficult time periods. Yet, tracking sentiment over time throughout gender transition is challenging using traditional research methods. This study’s objective was to use social media data to understand average gender transition sentiment patterns.

Materials and Methods

Computational sentiment analysis and statistics were used to analyze 41 066 posts from 240 Tumblr transition blogs (online spaces where transgender people document gender transitions) to understand sentiment patterns over time and quantify relationships between transgender identity disclosures, sentiment, and social support.

Results

Findings suggest that sentiment increases over time on average throughout gender transition, particularly when people receive supportive responses to transgender identity disclosures. However, after disclosures to family members, people experienced temporary increased negative sentiment, followed by increased positive sentiment in the long term. After transgender identity disclosures on Facebook, an important means of mass disclosure, those with supportive networks experienced increased positive sentiment.

Conclusions

With foreknowledge of sentiment patterns likely to occur during gender transition, transgender people and their mental healthcare professionals can prepare with proper support in place throughout the gender transition process. Social media are a novel data source for understanding transgender people’s sentiment patterns, which can help reduce mental health disparities for this marginalized population during a particularly difficult time.

Effectiveness and Utility of Mobile Device Assessment of Subjective Craving during Residential Opioid Dependence Treatment

Background: Craving is a dynamic state that is both theoretically and empirically linked to relapse in addiction. Static measures cannot adequately capture the dynamic nature of craving, and research has shown that these measures are limited in their capacity to link craving to treatment outcomes. Methods: The current study reports on assessments of craving collected 4x-day across 12 days from 73 patients in residential treatment for opioid dependence. Analyses investigated whether the within-person assessments yielded expected across- and within-day variability, whether levels of craving changed across and within days, and, finally, whether individual differences in craving variability predicted post-residential treatment relapse. Results: Preliminary analyses found acceptable levels of data entry compliance and reliability. Consistent with expectations, craving varied both between (46%) and within persons, with most within-person variance (over 40%) existing within days. Other patterns that emerged indicated that, on average, craving declined across the 12-days of assessment, and was generally strongest at mid-day. Analyses also found that patients' person-level craving variability predicted post-treatment relapse, above and beyond their mean levels of craving. Conclusion: Analyses support the reliability, sensitivity, and potential utility of the 4x-day, 12-day assessment protocol for measuring craving during residential treatment.

Psychological stress and cortisol during pregnancy: An ecological momentary assessment (EMA)-Based within- and between-person analysis

BACKGROUND

Although the linkage between psychological stress and cortisol is believed to mediate the association of stress with health outcomes, several studies have been unable to demonstrate this association. We suggest this inability may be a consequence of limitations in the measurement approach and/or reliance on analytic strategies that focus on associations across, rather than within individuals. The link between psychological stress and cortisol is of particular interest in the context of pregnancy and fetal development. Using an ecological momentary assessment (EMA) design, we examined the association between psychological stress and cortisol at the between- and the within-person level.

METHODS

152 participants completed a 4-day long EMA protocol serially in early, mid and late pregnancy to provide momentary stress appraisals (average of 150 measures/subject) and saliva samples (average of 55 samples/subject) for quantification of cortisol. The association between stress and cortisol was estimated using linear mixed models.

RESULTS

After accounting for the effects of key determinants of variation in cortisol, momentary stress was significantly and positively associated with cortisol at the within-person level (B = .030, p = .031), but not at the between-person level. No association was evident for traditional retrospective measures of stress with cortisol at either the between- or the within-person level.

CONCLUSIONS

Our study highlights the value of EMA methods and linear mixed-modeling approaches in linking maternal psychological and physiological states across pregnancy. These findings may have important implications for the development of personalized risk identification and "just-in-time" intervention strategies to optimize maternal and child health.

Daily pain catastrophizing predicts less physical activity and more sedentary behavior in older adults with osteoarthritis

Musculoskeletal disorders such as knee osteoarthritis (OA) are the primary cause of chronic pain in older adults. Recommended self-management strategies for knee OA include staying physically active in the face of pain, but many patients avoid activities they are capable of doing. The overall purpose of this study was to examine the extent to which daily pain catastrophizing, a maladaptive coping strategy, could influence OA patients' physical activity and sedentary behavior. The current study used data from 143 older knee OA patients who completed electronic daily diaries for 22 days and wore an accelerometer to capture physical activity and sedentary behavior. At the beginning of each day, patients reported their pain catastrophizing regarding the day ahead. Results from multilevel models demonstrated that on mornings when patients catastrophized more than usual about their pain in the day ahead, they spent more time in sedentary behavior and engaged in fewer minutes of moderate to vigorous physical activity that day. Cross-day lagged analyses further showed that the effect of morning pain catastrophizing on subsequent sedentary behavior extended to the next day. More time spent in sedentary behavior, in turn, contributed to greater pain catastrophizing the next morning. These findings support the mechanistic role of daily pain catastrophizing in the avoidance of physical activity for older OA patients, and suggest that effective interventions for pain catastrophizing may also reduce sedentary behavior and enhance physical activity, with longer-term benefits for pain management, physical function, and overall health.

Daily and bidirectional linkages between pain catastrophizing and spouse responses

Pain catastrophizing has been shown to predict greater pain and less physical function in daily life for chronic pain sufferers, but its effects on close social partners have received much less attention. The overall purpose of this study was to examine the extent to which pain catastrophizing is an interpersonal coping strategy that is maladaptive for patients and their spouses. A total of 144 older knee osteoarthritis patients and their spouses completed baseline interviews and a 22-day diary assessment. Multilevel lagged models indicated that, on days when patients reported greater catastrophizing in the morning, their spouses experienced more negative affect throughout the day. In addition, a higher level of punishing responses from the spouse predicted greater pain catastrophizing the next morning, independent of patient pain and negative affect. Multilevel mediation models showed that patients' morning pain catastrophizing indirectly impacted spouses' negative affect and punishing responses through patients' own greater negative affect throughout the day. There was no evidence that spouses' empathic or solicitous responses either followed or preceded patients' catastrophizing. These findings suggest that cognitive-behavioral interventions that reduce pain catastrophizing should be modified for partnered patients to address dyadic interactions and the spouse's role in pain catastrophizing.

The Dynamics of Foreign Language Enjoyment: An Ecological Momentary Assessment

Following the recent shift from negative psychology to positive psychology, interest in foreign language enjoyment (FLE) has grown noticeably in second language acquisition. Given the fact that learners are “persons-in-context” and are not “ergodic ensembles,” the particular learner-context ecosystem goes through ongoing momentary changes with respect to individual differences like FLE. Ecological momentary assessment (EMA) contributes to our understanding of the dynamics of this ecosystem in terms of the interaction between individual learners and their learning environments. In this study, using a time-based sampling scheme of EMA, we explored the dynamism of different facets of FLE across different timescales including seconds, minutes, weeks, and months in a course of intermediate English as a foreign language. To do this, we applied open-ended interviews with two intermediate English language learners in a private English language institute across months, journals across weeks, enjoymeters across minutes, and the idiodynamic approach across seconds. Findings indicated that enjoyment in foreign language fluctuates in terms of a hierarchy of temporal scales, from moment-to-moment changes to the ones over months. The emerging patterns of enjoyment across different timescales in terms of the tenets of complex dynamic systems theory are discussed.

Daily Sedentary Behavior Predicts Pain and Affect in Knee Arthritis

BACKGROUND

Sedentary behavior (SB), which has been linked with numerous adverse health outcomes, is prevalent among adults with osteoarthritis (OA). The associations between SB and daily physical and psychological health outcomes for OA patients, however, have received little attention.

PURPOSE

Using accelerometer and self-report data, the current study examined how the amount of time OA patients spent in SB was associated with their pain and affect in daily life, independent of physical activity.

METHODS

Over 22 days, 143 older adults (mean age = 65 years) with knee OA wore an accelerometer to measure SB and physical activity, and also reported their pain and affect three times a day using a handheld computer. Multilevel analyses were conducted to examine the prospective within-person associations between SB and subsequent pain or affect within the same day and across days, independent of physical activity.

RESULTS

The time spent in SB daily predicted less pain but worse affect at the end of that day, above and beyond the effects of physical activity, as well as demographics and individual differences in general health and depression. Moreover, cross-day lagged analyses indicated that time spent in SB on 1 day predicted higher negative affect the next morning. Finally, the average level of SB was also associated with worse average affect at the between-person level.

CONCLUSIONS

SB may be related to less pain in the short term but detract from patients' emotional well-being. Future intervention should aim to reduce daily SB to improve OA patients' emotional well-being.

Affect Recall Bias: Being Resilient by Distorting Reality

Background

According to a growing body of literature, people are quite inaccurate in recalling past affective experiences. Nevertheless, the mechanism underlying this recall bias (i.e., the tendency to overestimate and/or underestimate positive or negative past emotional experiences) remains unclear, and its association with mental health has not been studied yet.

Methods

We adopted a smartphone-based Ecological Momentary Assessment to monitor daily affect (n = 92) and investigate the association between affect recall bias, mental health and resilience.

Results

While the tendency to overestimate negative affective experiences was observed in participants reporting mild depressive symptoms, positive affect (PA) overestimation as compared to PA underestimation was associated with better mental health (i.e. higher psychological well-being and lower depressive and anxiety symptoms) through the enhancement of resilience. Furthermore, positively biased participants (i.e. PA over estimators) benefited from greater well-being, even when compared to accurate individuals.

Conclusions

While people appear to use retrospective PA overestimation as a strategy to enhance well-being and resilience, they are not likely to underestimate past negative experiences to feel better. Accordingly, owning an optimistic vision of the past may represent an adaptive “distortion” of reality that fosters people’s mental health. The clinical implications of cultivating PA and learning strategies to regulate both negative and positive emotions are discussed.

Perceived Patient Pain and Spousal Caregivers' Negative Affect: The Moderating Role of Spouse Confidence in Patients' Pain Management

Objectives: This study examined whether older patients' greater daily pain perceived by their spouses was associated with spouses' higher daily negative affect. We further investigated whether spouses' lower confidence in patients' ability to manage pain exacerbated the daily association between perceived patient pain and spouses' negative affect. Method: We used baseline interviews and a 22-day diary of knee osteoarthritis patients and their spouses (N = 144 couples). Multilevel models were estimated to test hypotheses. Results: Daily perceived patient pain was not associated with spouses' daily negative affect. However, spouse confidence significantly moderated the association. Only spouses with lower confidence in patients' pain management experienced higher negative affect on days when they perceived that patients' level of pain was higher than usual. Discussion: Findings suggest that spousal caregivers' lack of confidence in patients' pain management may be a risk factor for spouses' affective distress in daily life.

Daily Links Between Sleep and Anger Among Spouses of Chronic Pain Patients

OBJECTIVES

This study identified daily associations between sleep, emotion, and marital functioning in the context of chronic pain. Because spouses' sleep is compromised on nights when patients experience more pain, we set out to identify implications of spouses' sleep for their own emotion (anger) upon waking and marital interaction (marital tension) throughout the rest of the day. We further considered whether spouses' critical attitudes about patients' pain-related coping exacerbated associations between their sleep, morning anger, and marital tension.

METHOD

Data came from a study of knee osteoarthritis patients (50+ years old) and spouses (N = 138 couples) who completed daily diaries across 22 days. Multilevel models were estimated to test hypotheses.

RESULTS

Spouses woke up angrier on mornings when they reported that their sleep was more unrefreshing than usual. This association was stronger among more critical spouses. Morning anger resulting from unrefreshing sleep, however, did not predict marital tension throughout the rest of the day.

DISCUSSION

Findings highlight the potential value of intervention efforts aimed at promoting spouses' sleep quality in an effort to offset negative emotional consequences that may undermine spouses' and patients' adjustment in the context of chronic pain.

Recalling Experiences: Looking at Momentary, Retrospective and Global Assessments of Relationship Satisfaction

Relationship satisfaction can be assessed in retrospection, as a global evaluation, or as a momentary state. In two experience sampling studies (N = 130, N = 510) the specificities of these assessment modalities are examined. We show that 1) compared to other summary statistics like the median, the mean of relationship satisfaction states describes retrospective and global evaluations best (but the difference to some other summary statistics was negligible); 2) retrospection introduces an overestimation of the average annoyance in the relationship reported on a momentary basis, which results in an overall negative mean-level bias for retrospective relationship satisfaction; 3) this bias is most strongly moderated by global relationship satisfaction at the time of retrospection; 4) snapshots of momentary relationship satisfaction get representative of global evaluations after approximately two weeks of sampling. The findings extend the recall bias reported in the literature for retrospection of negative affect to the domain of relationship evaluations and assist researchers in designing efficient experience sampling studies.

Why We Eat What We Eat: Assessing Dispositional and In-the-Moment Eating Motives by Using Ecological Momentary Assessment

Background

Why do we eat? Our motives for eating are diverse, ranging from hunger and liking to social norms and affect regulation. Although eating motives can vary from eating event to eating event, which implies substantial moment-to-moment differences, current ways of measuring eating motives rely on single timepoint questionnaires that assess eating motives as situation-stable dispositions (traits). However, mobile technologies including smartphones allow eating events and motives to be captured in real time and real life, thus capturing experienced eating motives in-the-moment (states).

Objective

This study aimed to examine differences between why people think they eat (trait motives) and why they eat in the moment of consumption (state motives) by comparing a dispositional (trait) and an in-the-moment (state) assessment of eating motives.

Methods

A total of 15 basic eating motives included in The Eating Motivation Survey (ie, liking, habit, need and hunger, health, convenience, pleasure, traditional eating, natural concerns, sociability, price, visual appeal, weight control, affect regulation, social norms, and social image) were assessed in 35 participants using 2 methodological approaches: (1) a single timepoint dispositional assessment and (2) a smartphone-based ecological momentary assessment (EMA) across 8 days (N=888 meals) capturing eating motives in the moment of eating. Similarities between dispositional and in-the-moment eating motive profiles were assessed according to 4 different indices of profile similarity, that is, overall fit, shape, scatter, and elevation. Moreover, a visualized person × motive data matrix was created to visualize and analyze between- and within-person differences in trait and state eating motives.

Results

Similarity analyses yielded a good overall fit between the trait and state eating motive profiles across participants, indicated by a double-entry intraclass correlation of 0.52 (P<.001). However, although trait and state motives revealed a comparable rank order (r=0.65; P<.001), trait motives overestimated 12 of 15 state motives (P<.001; d=1.97). Specifically, the participants assumed that 6 motives (need and hunger, price, habit, sociability, traditional eating, and natural concerns) are more essential for eating than they actually were in the moment (d>0.8). Furthermore, the visualized person × motive data matrix revealed substantial interindividual differences in intraindividual motive profiles.

Conclusions

For a comprehensive understanding of why we eat what we eat, dispositional assessments need to be extended by in-the-moment assessments of eating motives. Smartphone-based EMAs reveal considerable intra- and interindividual differences in eating motives, which are not captured by single timepoint dispositional assessments. Targeting these differences between why people think they eat what they eat and why they actually eat in the moment may hold great promise for tailored mobile health interventions facilitating behavior changes.

Daily Marital Tension and Symptom Severity in Older Adults With Diabetes or Osteoarthritis

Background

Greater marital quality is associated with better psychological and physical health. The quality of daily marital interactions is likely to be especially important for individuals with chronic illness, but this question has received little attention.

Purpose

Using data from two diary studies, the current study examined whether individuals with chronic illness would experience more severe symptoms on days with more marital tension due in part to greater negative affect on those days.

Methods

The samples included individuals with knee osteoarthritis (OA, N = 145) or type 2 diabetes mellitus (T2DM, N = 129) and their spouses. Participants reported on daily marital interaction quality, affect, and symptom severity (patients only) for 22 days (knee OA) or 24 days (T2DM). Separate multilevel models were run for patients and spouses, controlling for the partner's marital tension and negative affect as well as both partners' daily marital enjoyment and positive affect. We examined same-day and across-day associations.

Results

For individuals with T2DM or knee OA, more severe symptoms on days with more marital tension were due in part to their greater negative affect on those days. Individuals with knee OA who experienced more pain had more negative affect and marital tension the next day.

Conclusions

Negative marital interactions may exacerbate physical symptoms. Effects of daily marital tension likely accumulate over time and have long-term implications for health.

Biases in Affective Forecasting and Recall as a Function of Borderline Personality Disorder Features

Introduction: The ability to predict emotional experiences, “affective forecasting,” is an essential factor in individuals' decision-making processes. Research has shown that, generally, individuals are inaccurate in their affective forecasts/recollections, and that certain psychological disorders may be related to individual differences in these inaccuracies, or biases. Understanding the role of affective biases in disorders characterized by emotion dysregulation, like Borderline Personality Disorder (BPD), may provide important information regarding the sources of said dysregulation. The present study aimed to identify specific or unique patterns in affective forecasting/recall biases as a function of BPD features.

Method: Using a sample of undergraduates (n = 185), we compared predicted and recalled affective states with actual affect following a sadness-evoking film clip. We predicted that higher levels of BPD features would be associated with greater affective forecasting and recall biases.

Results: Results indicated that BPD features predicted a specific pattern of forecasting and recall biases regarding the clip. Counter to our hypotheses, as BPD features increased, forecasts/recollections of their affective states following the sadness-evoking film clip were more accurate (less biased).

Discussion: Results indicate that BPD features may be related to a specific pattern of bias with negative affective states and warrant further study. Furthermore, this study provides evidence that disorder-specific patterns of forecasting/recall bias can be studied with a laboratory-based paradigm.

Uncontrolled eating: a unifying heritable trait linked with obesity, overeating, personality and the brain

Many eating-related psychological constructs have been proposed to explain obesity and overeating. However, these constructs, including food addiction, disinhibition, hedonic hunger, emotional eating, binge eating and the like all have similar definitions, emphasizing loss of control over intake. As questionnaires measuring the constructs correlate strongly (r > 0.5) with each other, we propose that these constructs should be reconsidered to be part of a single broad phenotype: uncontrolled eating. Such an approach enables reviewing and meta-analysing evidence obtained with each individual questionnaire. Here, we describe robust associations between uncontrolled eating, body mass index (BMI), food intake, personality traits and brain systems. Reviewing cross-sectional and longitudinal data, we show that uncontrolled eating is phenotypically and genetically intertwined with BMI and food intake. We also review evidence on how three psychological constructs are linked with uncontrolled eating: lower cognitive control, higher negative affect and a curvilinear association with reward sensitivity. Uncontrolled eating mediates all three constructs' associations with BMI and food intake. Finally, we review and meta-analyse brain systems possibly subserving uncontrolled eating: namely, (i) the dopamine mesolimbic circuit associated with reward sensitivity, (ii) frontal cognitive networks sustaining dietary self-control and (iii) the hypothalamus-pituitary-adrenal axis, amygdala and hippocampus supporting stress reactivity. While there are limits to the explanatory and predictive power of the uncontrolled eating phenotype, we conclude that treating different eating-related constructs as a single concept, uncontrolled eating, enables drawing robust conclusions on the relationship between food intake and BMI, psychological variables and brain structure and function.

Study protocol for investigating physician communication behaviours that link physician implicit racial bias and patient outcomes in Black patients with type 2 diabetes using an exploratory sequential mixed methods design

INTRODUCTION

Patient-physician racial discordance is associated with Black patient reports of dissatisfaction and mistrust, which in turn are associated with poor adherence to treatment recommendations and underutilisation of healthcare. Research further has shown that patient dissatisfaction and mistrust are magnified particularly when physicians hold high levels of implicit racial bias. This suggests that physician implicit racial bias manifests in their communication behaviours during medical interactions. The overall goal of this research is to identify physician communication behaviours that link physician implicit racial bias and Black patient immediate (patient-reported satisfaction and trust) and long-term outcomes (eg, medication adherence, self-management and healthcare utilisation) as well as clinical indicators of diabetes control (eg, blood pressure, HbA1c and history of diabetes complication).

METHODS AND ANALYSIS

Using an exploratory sequential mixed methods research design, we will collect data from approximately 30 family medicine physicians and 300 Black patients with type 2 diabetes mellitus. The data sources will include one physician survey, three patient surveys, medical interaction videos, video elicitation interviews and medical chart reviews. Physician implicit racial bias will be assessed with the physician survey, and patient outcomes will be assessed with the patient surveys and medical chart reviews. In video elicitation interviews, a subset of patients (approximately 20-40) will watch their own interactions while being monitored physiologically to identify evocative physician behaviours. Information from the interview will determine which physician communication behaviours will be coded from medical interactions videos. Coding will be done independently by two trained coders. A series of statistical analyses (zero-order correlations, partial correlations, regressions) will be conducted to identify physician behaviours that are associated significantly with both physician implicit racial bias and patient outcomes.

ETHICS AND DISSEMINATION

Ethics approval was obtained from the Virginia Commonwealth University IRB. Study results will be disseminated through publications in peer-reviewed journals and presentations at conferences. A novel Medical Interaction involving Black Patients Coding System from this project will be made publicly available.

Depression history and memory bias for specific daily emotions

Reports of emotions experienced over the past week can be influenced by memory bias, which is more pronounced for people with depression. No studies, however, have examined memory bias for specific emotion clusters (e.g., sadness, anxiety, and anger) experienced on a day-to-day basis among people with depression or a history of depression. Participants (N = 1,657) from the Midlife in the United States Study were assessed for depression. Approximately 6 months later, participants reported their emotional experiences for 8 days and recalled these experiences on the final day. Differences in recalled and reported emotion were compared between participants with and without a history of depression. Participants overestimated experience only of negative emotions, particularly anger, and this negativity bias was greatest for participants with a history of depression. Feelings related to anger were prone to greater overestimation than sadness or anxiety. These findings emphasize the role of memory bias in retrospective reports of specific emotions and illustrate the presence of an amplified memory bias among people who are at a greater risk for recurrent depressive episodes.

The Retrospective Evaluation of Positive and Negative Affect

A vast amount of literature examined the relationship between retrospective affective evaluations and evaluations of affective experiences. This literature has focused on simple momentary experiences, and was based on a unidimensional concept of affect. The current article examines the relationships between evaluations of complex experiences, experiences involving both positive and negative feelings, and the retrospective evaluation of these experiences. Based on the idea that negative information is better remembered than positive information, we predict that in comparison with negative retrospective evaluations, positive evaluations have a stronger correlation with end affect and a weaker correlation with peak affect. These predictions are tested in two studies. We explore boundary conditions for these effects and demonstrate the implications of the asymmetry between positive and negative affect to various topics that are at the center of affect research: the dimensionality of affective experiences, the memory-experience gap, and the analysis of net affect.

Advances and Open Questions in the Science of Subjective Well-Being

Subjective well-being (SWB) is an extremely active area of research with about 170,000 articles and books published on the topic in the past 15 years. Methodological and theoretical advances have been notable in this period of time, with the increasing use of longitudinal and experimental designs allowing for a greater understanding of the predictors and outcomes that relate to SWB, along with the process that underlie these associations. In addition, theories about these processes have become more intricate, as findings reveal that many associations with SWB depend on people's culture and values and the context in which they live. This review provides an overview of many major areas of research, including the measurement of SWB, the demographic and personality-based predictors of SWB, and process-oriented accounts of individual differences in SWB. In addition, because a major new focus in recent years has been the development of national accounts of subjective well-being, we also review attempts to use SWB measures to guide policy decisions.