Associations of Momentary Mindfulness With Affect and Cannabis Desire in a Trial of Cannabis Use Interventions With and Without Momentary Assessment

PURPOSE

Mindfulness, awareness resulting from attending to the present without judgment, has been associated with improved health. When considered as a time-varying momentary state, mindfulness is associated with other momentary states such as affect. We examined whether momentary mindfulness, specifically mindful attention and awareness (MAA), changed after counseling interventions to reduce cannabis use that included ecological momentary assessment (EMA) and explored associations with negative affect, positive affect, and cannabis desire.

METHODS

Outpatients 15-24 years using cannabis ≥3x/week were randomized to one of the three interventions, each including two motivational enhancement therapy (MET) sessions. For two interventions, MET was followed by 2 weeks of EMA (with/without messaging). Momentary MAA, negative affect, positive affect, and cannabis desire were assessed over 1 week of EMA at baseline and 3-month follow-up (N = 1,971 reports, 68 participants). We examined changes in momentary MAA from baseline to follow-up overall and by group (MET + EMA, MET-only) using generalized linear mixed effects models. We tested associations of momentary MAA with momentary affect and cannabis desire using generalized estimating equations.

RESULTS

Momentary MAA increased from baseline to follow-up after MET counseling plus EMA (β = 0.237), but did not change with MET counseling alone. Higher momentary MAA was associated with lower negative affect (β = -0.526) and cannabis desire (β = -0.521), but not with positive affect.

DISCUSSION

Among youth using cannabis frequently, momentary MAA was increased 3 months after interventions with EMA after counseling and was inversely associated with momentary negative affect and momentary cannabis desire. Mindfulness may be a useful target for momentary intervention.

Effect of brief, personalized feedback derived from momentary data on the mental health of women with risk of common mental disorders in Hong Kong: A randomized clinical trial

This study aimed to determine the efficacy of digitalized personalized feedback derived from experience sampling method (ESM) data for improving women's mental health and to explore its potential to become a prevention intervention. In this three-arm, randomized controlled trial, 124 adult women aged 18 to 64 years with mild to moderate depressive and anxiety symptoms were randomly assigned to ESM with personalized feedback (ESM-f, 40 women), ESM alone (ESM, 43 women), or no additional intervention (control, 41 women). The ESM-f and ESM groups received six weeks of ESM, but only the former received biweekly individualized feedback. The primary outcome measure was changes in mental well-being as measured by the 21-item Depression, Anxiety, and Stress Scale (DASS-21) from baseline to 8, 12, 16, 20, and 32 weeks and the comparison between the ESM-f and the control group. The ESM-f group experienced a significantly greater decline in DASS-21 total scores compared with the control group while the ESM and control groups had a comparable decline in DASS-21 total scores. ESM-derived personalized feedback can improve women's mental well-being. Additional research is needed to determine its cost-effectiveness, long-term consequences, and efficacy as a preventive intervention for common mental disorders.

Momentary versus retrospective reports of alcohol or cannabis use, sexual activity, and their co-occurrence

OBJECTIVE

Comparing people's momentary and retrospective reports of substance use and sexual activity can illuminate discrepant recall biases across these behaviors. Extant research suggests that people tend to underreport alcohol use on retrospective surveys and overreport sexual activity. We provided an updated account of these biases, extending previous work by looking at alcohol- and cannabis-involved sexual activity as well as potential gender differences in recall biases.

METHOD

Using a sample of adults (n = 110; 58.2% women), we administered surveys three times a day for 28 days to measure momentary alcohol and cannabis use, sexual activity, and substance-involved sexual activity. At the end of this momentary assessment, participants completed a retrospective survey assessing how frequently they engaged in these behaviors during the 28-day period.

RESULTS

We compared participants' momentary reports-which were scaled to account for compliance rates-and retrospective surveys. While there were no significant differences in momentary and retrospective reports of alcohol or cannabis use, participants reported higher rates of sexual activity and alcohol-involved sexual activity on the retrospective surveys than the momentary reports. Effect sizes for significant differences were medium to large (Cohen's d: 0.26-0.67).

CONCLUSIONS

Alcohol- and cannabis-involved sexual activity tend to be overreported on retrospective surveys, and preliminary findings suggest that these recall biases may vary by gender. Researchers interested in the co-occurrence of substance use and sexual activity should be aware of this potential random error and consider how to reduce recall biases based on method of data collection.

Momentary Analysis of Tinnitus: Considering the Patient

Ecological momentary assessment is a valuable research technique meant to capture real-time data and contextualize disease. While more common in neuropsychiatric research, this methodology is exceptionally fit for tinnitus. Tinnitus has been shown to be affected by many patient-level and environment-specific factors. From an individual's baseline anxiety to the level of ambient noise in their environment, the level of bother experienced by those with tinnitus can vary widely. Only assessing tinnitus within a clinical environment can distort the true impact of the disease. Ecological data can minimize bias while generating an individualistic picture of the burden being experienced by the patient. Individual data can also compliment new research methods rooted in precision medicine, providing clearer, better-suited treatments for each patient on the tinnitus spectrum.

A qualitative exploration into momentary impacts on food parenting practices among parents of pre-school aged children

Food parenting practices have been identified as a potentially significant correlate of weight status and weight-related behaviors in children. The extent to which food parenting practices fluctuate across time and context is not well known. In particular, situational factors are thought to shape the types of food parenting practices used in the moment, but the nature of those factors remain unclear. In this paper data from interviews with parents (n = 40) of preschoolers was used to: 1) describe parents' day-to-day lived experiences of food parenting within the broad theoretical domains of coercive control, structure and autonomy support; 2) identify salient momentary factors that influence use of these food parenting practices; and 3) understand how these momentary factors impact the use of different types of food parenting practices. The feeding practices described by parents align well with the three overarching themes described within the literature: coercive control, autonomy support, and structure. Parents described using a combination of practices from within each of these domains; they also indicated that their feeding practices were easily influenced by momentary factors that impacted their food parenting within and across eating occasions. For the most part, parents described momentary factors (e.g. schedule changes, parental stress, child behavior) that shifted them away from structure and autonomy support feeding practices, towards indulgent and coercive feeding practices. Researchers should be aware of the likely interplay between different types of feeding practices as well as the potential that momentary factors may shift parents from one type of practice towards another. The use of novel data collection methods, such as ecological momentary assessment, that allow for exploration of food parenting practices as dynamic, rather than static, behaviors should be explored.

It depends on when you ask: motives for using marijuana assessed before versus after a marijuana use event

BACKGROUND

Marijuana use motives are typically evaluated retrospectively using measures that summarize or generalize across episodes of use, which may compromise validity. Using Ecological Momentary Assessment data, we examined the main reason for a specific marijuana use event measured both prospectively and retrospectively. We then determined reason types, event characteristics, and user characteristics that predicted change in reason.

METHODS

Thirty-six medical outpatients age 15 to 24 years who used marijuana two times a week or more used a handheld computer to select their main reason for use from the five categories of the Marijuana Motives Measure (Simons, Correia, & Carey, 1998) just before and after each time they used marijuana over two weeks (n=263 events with before/after reason). The reasons were examined individually and according to dimensions identified in motivational models of substance use (positive/negative, internal/external).

RESULTS

The reason assessed before use changed to a different reason after use for 20% of events: 10% of events for pleasure; 21%, to cope; 35%, to be more social; 55%, to expand my mind; and 100%, to conform. In the multivariable model, external and expansion reasons each predicted change in reason for use (p<0.0001 and p=0.001, respectively). Youth were also more likely to change their reason if older (p=0.04), if male (p=0.02), and with weekend use (p=0.002).

CONCLUSION

Retrospective assessments of event-specific motives for marijuana use may be unreliable and therefore invalid for a substantial minority of events, particularly if use is for external or expansion reasons.

Real-time, contextual intervention using mobile technology to reduce marijuana use among youth: a pilot study

We evaluated the feasibility, acceptability, and potential efficacy of MOMENT, an intervention to reduce youth marijuana use that combines brief motivational enhancement therapy with mobile self-monitoring and responsive messaging. At baseline, primary care patients ages 15-24 who used marijuana frequently (at least 3 times per week) completed a recall assessment, then 1 week of mobile momentary and daily reports on use-related factors. For the intervention, youth participated in two motivational enhancement therapy sessions, during which they identified their top-3 social and emotional triggers for use and discussed healthy ways to manage them. They then completed two weeks of mobile reports. Upon reporting a top-3 trigger for use, desire to use, or recent use, they received a message supporting self-efficacy and prompting consideration of coping strategies. Generalized estimating equations examined changes in momentary-, daily-, and individual-level measures on 3-month recall and mobile assessments. Twenty-seven youth (M=19.2 years, 70% female) enrolled; there were 377-677 momentary and 50-106 daily reports per study phase. Participants reported reading the messages and finding them motivating, being comfortable with participation, and not experiencing the study as burdensome. Although proportion of momentary reports of being in a top-3 trigger context did not change (36%-43%), marijuana desire in a top-3 trigger context and marijuana use after top-3 trigger exposure decreased over the study (p<.0001 and p=.03, respectively). Daily- and individual-level measures showed similar, non-significant, improvements. The MOMENT intervention appears feasible, well-accepted, and potentially efficacious for youth who use marijuana frequently.