Perceived disturbance and predictors thereof in studies using the experience sampling method

Intensive repeated momentary diary techniques, such as the experience sampling method (ESM), place considerable burden on study participants by repeatedly prompting them to fill in a questionnaire several times throughout the day. The objective of this study was to investigate the level of disturbance reported by participants and predictors thereof using a pooled dataset of seven ESM studies including 1319 healthy participants and individuals with different mental health conditions. All studies used a design of 10 prompts per day over the course of 4 to 6 days. Participants reported no disturbance at 37% of the measurement occasions and the overall level of disturbance was relatively low. Also, clinical samples did not report significantly different levels of disturbance compared to the healthy participants. However, higher levels of disturbance were found for later study days, in the morning, and on weekends. Also, younger participants reported feeling more disturbed by the prompts. In terms of momentary states, higher levels of activity, activity stress, and tiredness were associated with higher disturbance. Also, participants experienced more disturbance when in company compared to when alone, and the level of disturbance increased when in company with less familiar people. Our findings suggest that studies using high-frequency ESM protocols can be used in mental health research, but researchers should be aware of the possible disturbance caused by their research design

Perceived disturbance and predictors thereof in studies using the experience sampling method

Intensive repeated momentary diary techniques, such as the experience sampling method (ESM), place considerable burden on study participants by repeatedly prompting them to fill in a questionnaire several times throughout the day. The objective of this study was to investigate the level of disturbance reported by participants and predictors thereof using a pooled dataset of seven ESM studies including 1319 healthy participants and individuals with different mental health conditions. All studies used a design of 10 prompts per day over the course of 4 to 6 days. Participants reported no disturbance at 37% of the measurement occasions and the overall level of disturbance was relatively low. Also, clinical samples did not report significantly different levels of disturbance compared to the healthy participants. However, higher levels of disturbance were found for later study days, in the morning, and on weekends. Also, younger participants reported feeling more disturbed by the prompts. In terms of momentary states, higher levels of activity, activity stress, and tiredness were associated with higher disturbance. Also, participants experienced more disturbance when in company compared to when alone, and the level of disturbance increased when in company with less familiar people. Our findings suggest that studies using high-frequency ESM protocols can be used in mental health research, but researchers should be aware of the possible disturbance caused by their research design

Selection of the Number of Participants in Intensive Longitudinal Studies: A User-Friendly Shiny App and Tutorial for Performing Power Analysis in Multilevel Regression Models That Account for Temporal Dependencies

In recent years, the popularity of procedures for collecting intensive longitudinal data, such as the experience-sampling method, has increased greatly. The data collected using such designs allow researchers to study the dynamics of psychological functioning and how these dynamics differ across individuals. To this end, the data are often modeled with multilevel regression models. An important question that arises when researchers design intensive longitudinal studies is how to determine the number of participants needed to test specific hypotheses regarding the parameters of these models with sufficient power. Power calculations for intensive longitudinal studies are challenging because of the hierarchical data structure in which repeated observations are nested within the individuals and because of the serial dependence that is typically present in these data. We therefore present a user-friendly application and step-by-step tutorial for performing simulation-based power analyses for a set of models that are popular in intensive longitudinal research. Because many studies use the same sampling protocol (i.e., a fixed number of at least approximately equidistant observations) within individuals, we assume that this protocol is fixed and focus on the number of participants. All included models explicitly account for the temporal dependencies in the data by assuming serially correlated errors or including autoregressive effects

Delayed affective recovery to daily-life stressors signals a risk for depression

OBJECTIVE: The aim of this study is to investigate the time to affective recovery from daily-life stressors between healthy controls (HC) and two groups with an increased risk for developing depression: individuals with subclinical symptoms of depression (SSD), and individuals remitted from a depressive episode with residual symptoms of depression (RRS). METHOD: The experience sampling method (ESM) was used to measure affective recovery to daily-life stressors. Affective recovery was defined as the moment that negative affect (NA) returned to baseline level following the first stressful event of the day. We assessed two different operationalizations of the baseline: NA at the moment before the stressful event (t-1), and mean-person NA. The effect of stress intensity, and cumulative stress were also assessed. RESULTS: Survival analyses showed significantly longer recovery times for the at risk groups in comparison to healthy individuals, albeit no significant difference was found between the two at risk groups (i.e. SSD and RRS). There was also an effect of cumulative stress, but not stress intensity on time to recovery in that cumulative stress resulted in significantly longer recovery times for all three groups. LIMITATIONS: The present study is limited by the ESM sampling design, assessments take place post-stress and therefore do not capture peak stress. Additionally, we are only able to assess patterns at the group level. Finally, there is a significant age difference between groups. CONCLUSION: Individuals at risk for depression display a delayed recovery to daily-life stressors when compared to healthy controls, which is not explained by differences in stress intensity or cumulative stress. Understanding what is driving this delay may help combat the development of depression

Delayed affective recovery to daily-life stressors signals a risk for depression

Objective: The aim of this study is to investigate the time to affective recovery from daily-life stressors between healthy controls (HC) and two groups with an increased risk for developing depression: individuals with subclinical symptoms of depression (SSD), and individuals remitted from a depressive episode with residual symptoms of depression (RRS). Method: The experience sampling method (ESM) was used to measure affective recovery to daily-life stressors. Affective recovery was defined as the moment that negative affect (NA) returned to baseline level following the first stressful event of the day. We assessed two different operationalizations of the baseline: NA at the moment before the stressful event (t−1), and mean-person NA. The effect of stress intensity, and cumulative stress were also assessed. Results: Survival analyses showed significantly longer recovery times for the at risk groups in comparison to healthy individuals, albeit no significant difference was found between the two at risk groups (i.e. SSD and RRS). There was also an effect of cumulative stress, but not stress intensity on time to recovery in that cumulative stress resulted in significantly longer recovery times for all three groups. Limitations: The present study is limited by the ESM sampling design, assessments take place post-stress and therefore do not capture peak stress. Additionally, we are only able to assess patterns at the group level. Finally, there is a significant age difference between groups. Conclusion: Individuals at risk for depression display a delayed recovery to daily-life stressors when compared to healthy controls, which is not explained by differences in stress intensity or cumulative stress. Understanding what is driving this delay may help combat the development of depression.</p

Efficacy of Acceptance and Commitment Therapy in Daily Life in Early Psychosis: Results from the Multi-Center INTERACT Randomized Controlled Trial

All rights reserved.Introduction/Objective: This study aimed to investigate efficacy of Acceptance and Commitment Therapy in Daily Life (ACT-DL), combining face-to-face therapy with an Ecological Momentary Intervention (EMI), in addition to treatment as usual (TAU) for psychotic distress, in comparison to TAU. Methods: Individuals aged 15-65 years with clinically established ultra-high risk or first episode of psychosis were randomly assigned to TAU or ACT-DL+TAU. ACT-DL+TAU consisted of 8 ACT-sessions augmented with an EMI-app. The primary outcome was psychotic distress assessed with the Comprehensive Assessment scale of At Risk Mental State (CAARMS) at post-intervention and 6- and 12-month follow-up. Secondary outcomes were functioning, symptom severity, and momentary psychotic distress. We performed multivariate mixed models according to intent-to-treat principles. Results: Between June 1, 2015 and December 31, 2018, 668 participants were referred, of whom 148 were randomized to ACT-DL+TAU (n = 71) or TAU (n = 77). One hundred and fifteen (78%) provided primary outcome data at least at one follow-up assessment. There was no evidence of greater reduction in the primary outcome measure CAARMS distress in ACT-DL+TAU compared to TAU (χ2(3) = 2.36; p = 0.50). However, out of the tested secondary outcomes, global functioning (χ2(3) = 9.05; p = 0.033), and negative symptoms (χ2(3) = 19.91; p<0.001) improved in ACT-DL+TAU compared to TAU, as did momentary psychotic distress (χ2(3) = 21.56; p < 0.001). Conclusions: INTERACT did not support a significant effect of ACT-DL over TAU on the primary outcome measure of psychotic distress as assessed with the CAARMS. Although significant improvements were found for some secondary outcome measures, further replication studies are needed to confirm the strength and specificity of these effects

Childhood trauma, suicide risk and inflammatory phenotypes of depression: insights from monocyte gene expression

Circulating monocytes contribute to inflammatory processes. We here validate abnormal expression of inflammation-related genes in monocytes of a large and well-characterised group of MDD patients, and relate the outcomes to pertinent clinical characteristics. Thirty-two genes of a previously established inflammation-related gene signature were assessed in 197 patients with MDD, and 151 controls collected during the EU-MOODINFLAME project. Monocyte gene- expression data were related to age, sex, BMI, depression severity, childhood adversity (CA) and suicide risk (SR). Three distinct gene profiles were identified within the MDD group (downregulated, mixed upregulated and strongly upregulated genes). Patients in the merged upregulated groups had a significantly higher prevalence of CA and high SR. Using hierarchical clustering of the genes, we found a cluster of mainly cytokine (production)-related genes; patients with SR had a significantly higher expression of this cluster than patients without SR (particularly for IL-6, IL1A and IL1B). Such difference did not emerge for patients with and without CA. A downregulated gene profile was found for patients not exposed to CA and without SR (particularly for glucocorticoid-signalling genes NR3C1a and HSPA1/B). No inflammatory changes were observed for healthy controls exposed to CA. Our data show that inflammatory activation in MDD is not uniform, and that immunologically discernible pheno