Forecasting turbulence: Evidence of affective projection biases in momentary predictive fluctuations using dynamic structural equation modelling.

Negative reinforcement models suggest that negative affect should predict event-level substance use, however, supporting daily-life evidence is lacking. One reason may be an emphasis in ecological momentary assessment (EMA) research on use behavior, which is subject to contextual and societal constraints that other substance outcomes, such as craving, may not be subject to. Therefore, the present study tested momentary, within-person reciprocal relations among negative affect and craving for alcohol and cannabis in daily life. Adults (N = 48) completed 60 days of EMA, consisting of four daily reports spanning 7 a.m.-11 p.m. assessing current negative affect and alcohol/cannabis craving. Preregistered analyses used dynamic structural equation modeling to test whether (a) within-person increases in negative affect co-occurred with within-person increases in alcohol and cannabis craving, and (b) within-person increases in negative affect predicted later within-person increases in craving (and vice versa), and (c) relations differed by substance use frequency. Within-person increases in negative affect were contemporaneously associated with within-person increases in alcohol and cannabis craving. However, increases in negative affect did not prospectively predict increases in craving, and within-person increases in craving did not prospectively predict within-person increases in negative affect. Within-person relations were not moderated by substance use frequency. Negative affect and craving were associated in community adults. However, results advance a growing body of EMA work suggesting that the association of daily-life negative affect and substance use is, at best, not straightforward. Careful attention is needed to better translate existing negative reinforcement theory to the realities of daily life. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: Physical symptoms (SXS) are commonly reported among adults with T2D and have a significant impact on functioning and self-management. Although there is evidence that symptom reporting is closely linked to the experience of negative affect (NA) , the directionality of this relationship remains unclear. This study used EMA to evaluate bidirectional temporal associations between SXS and NA in adults with sub-optimally controlled T2D. Methods: Adults with T2D (N = 61; Age = 55 (10) yrs; Women = 64.5%; Black = 61%; Latino = 36%; A1C = 8.5 (2.3) completed smartphone EMA of SXS and NA 3 x daily over a 14-day period. Linear mixed effect models were used to assess associations of total number of SXS reported (0-13) and subsequent levels of NA (0-5) , and vice-versa. Results: There were significant within- and between-person bidirectional associations between SXS and NA. Within-persons, a 1-point increase in SXS from one’s personal mean was associated with a 0.03-point increase in subsequent NA (95%CI: 0.01-0.04, p = .008) and a 1-point increase in NA from one’s personal mean was associated with a 0.39-point increase in subsequent SXS (95%CI: 0.27-0.50, p < .0001) . Between-persons, a 1-point increase in SXS personal mean was associated with a 0.18-point increase in subsequent NA (95%CI: 0.12-0.26, p < .0001) and a 1-point increase in one’s NA personal mean was associated with a 1.8-point increase in SXS (95%CI: 1.15-2.46, p < .0001) . Conclusion: Results showed bidirectional relations between SXS and NA, observed both within- and between-persons over the course of a day, among predominantly ethnic minority adults with T2D. If these patterns reflect causal associations, they suggest that interventions that reduce negative affect would also reduce the experience of physical symptoms, and vice versa. Given prior evidence linking these factors to self-management, functioning, and health outcomes in T2D, such interventions could have substantial impact. Disclosure S.R.Fishman: None. J.S.Gonzalez: Consultant; Virta Health Corp. C.J.Hoogendoorn: None. C.Wang: None. S.A.Mulvaney: None. V.H.Jonas: None. H.Mendez-rodriguez: None. R.Fang: None. C.A.Solon: None. J.P.Crandall: Research Support; Abbott Diabetes. Funding NIH P30 DK111022

Associations between affect, craving, and smoking in Korean smokers: An ecological momentary assessment study

Introduction Adolescents with later circadian timing evidence an increased risk for depression. Depressed individuals report higher negative affect (NA), especially in the morning, which may reflect altered circadian timing in NA. Untangling the circadian influences on mood is challenging due to inconsistent operationalizations of circadian timing. This study aims to analyze the associations between three metrics of circadian timing (circadian preference, chronotype, and circadian phase) and daily levels of NA among adolescents. Methods This study analyzed 8 days of ecological momentary assessment (EMA) data among 119 adolescents (54.6% female; mean age 17.3 years). Participants completed sleep diaries with a visual analog scale (VAS) measuring NA (0-100; calm-tense) each morning, and the Positive and Negative Affect Scale–Short Form (PANAS-SF) approximately every 3 waking hours. NA scores were averaged across mornings, evenings, and overall. Circadian preference was assessed by the Composite Scale of Morningness (CSM), chronotype by the Munich Chronotype Questionnaire (MCTQ), and circadian phase by salivary dim light melatonin onset (DLMO; 4pg/ml threshold). We conducted multiple regression analyses to examine circadian preference, chronotype, and circadian phase predicting morning (PANAS, VAS), evening, and overall NA (PANAS), controlling for age, sex, and socioeconomic status. Results Correlations between circadian metrics were low (rDLMO-MCTQ=.20; rDLMO-CSM=.39; rCSM-MCTQ=.27). Greater evening preference predicted higher morning NA (PANAS: p=.026, β=-.21; VAS: p< 0.001, β=-.33) and evening NA (p=.032, β=-.20), but not overall NA (p=.106, β=-.15). These associations were not significant after isolating the Sleep Timing and Activity factor of the CSM. Later chronotype predicted higher NA on the morning VAS (VAS: p=.048, β=.18), but not on the PANAS (p=.756, β=-.03); chronotype did not predict evening NA (p=.259, β=-.11) or overall NA (p=.412, β=-.08). Circadian phase did not predict morning NA (PANAS: p=.841, β=-.02; VAS: p=.552, β=.05), evening NA (p=.625, β=.05), or overall NA (p=.391, β=.03). Conclusion These results highlight the importance of specificity when operationalizing circadian timing and NA, and add to the mixed literature concerning the role of circadian phase in negative mood modulation. Adolescents with later chronotype may be particularly vulnerable to negative mood in the morning. Important next steps involve modeling diurnal patterns of NA and positive affect. Support (if any) R01-AA025626 (Hasler)

Brain translocator protein 18k Da (TSPO) binding, a putative marker of neuroinflammatory processes (eg, gliosis), is associated with stress and elevated in depressed and suicidal populations. However, it is unclear whether neuroinflammation moderates the impact of daily life stress on suicidal ideation and negative affect, thereby increasing risk for suicidal behavior. To examine the association of TSPO binding in participants with depression with real-world daily experiences of acute stress-related suicidal ideation and negative affect, as well as history of suicidal behavior and clinician-rated suicidal ideation. Data for this cross-sectional study were collected from June 2019 through July 2023. Procedures were conducted at a hospital-based research center in New York, New York. Participants were recruited via clinical referrals, the Columbia University research subject web portal, and from responses to internet advertisements. Of 148 participants who signed informed consent for study protocols, 53 adults aged 18 to 60 years who met DSM-5 diagnostic criteria for current major depressive disorder completed procedures with approved data and were enrolled. Participants were free of schizophrenia spectrum disorders, active physical illness, cognitive impairment, and substance intoxication or withdrawal at the time of scan. All participants underwent positron emission tomography imaging of TSPO binding with 11C-ER176 and concurrent arterial blood sampling. A weighted average of 11C-ER176 total distribution volume (VT) was computed across 11 a priori brain regions and made up the primary outcome measure. Clinician-rated suicidal ideation was measured via the Beck Scale for Suicidal Ideation (BSS). A subset of participants (n = 21) completed 7 days of ecological momentary assessment (EMA), reporting daily on suicidal ideation, negative affect, and stressors. In the overall sample of 53 participants (mean [SD] age, 29.5 [9.8] years; 37 [69.8%] female and 16 [30.2%] male), 11C-ER176 VT was associated at trend levels with clinician-rated suicidal ideation severity (β, 0.19; 95% CI, -0.03 to 0.39; P = .09) and did not differ by suicide attempt history (n = 15; β, 0.18; 95% CI, -0.04 to 0.37; P = .11). Exploratory analyses indicated that presence of suicidal ideation (on BSS or EMA) was associated with higher 11C-ER176 VT (β, 0.21; 95% CI, 0.01 to 0.98; P = .045). In 21 participants who completed EMA, 11C-ER176 VT was associated with greater suicidal ideation and negative affect during EMA periods with stressors compared with nonstress periods (β, 0.12; SE, 0.06; 95% CI, 0.01 to 0.23; P = .03 and β, 0.19; SE, 0.06; 95% CI, 0.08 to 0.30; P < .001, respectively). TSPO binding in individuals with depression may be a marker of vulnerability to acute stress-related increases in suicidal ideation and negative affect. Continued study is needed to determine the causal direction of TSPO binding and stress-related suicidal ideation or negative affect and whether targeting neuroinflammation may improve resilience to life stress in patients with depression.

Evidence on the harms and benefits of social media use is mixed, in part because the effects of social media on well-being depend on a variety of individual difference moderators. Here, we explored potential neural moderators of the link between time spent on social media and subsequent negative affect. We specifically focused on the strength of correlation among brain regions within the frontoparietal system, previously associated with the top-down cognitive control of attention and emotion. Participants (N = 54) underwent a resting state functional magnetic resonance imaging scan. Participants then completed 28 days of ecological momentary assessment and answered questions about social media use and negative affect, twice a day. Participants who spent more than their typical amount of time on social media since the previous time point reported feeling more negative at the present moment. This within-person temporal association between social media use and negative affect was mainly driven by individuals with lower resting state functional connectivity within the frontoparietal system. By contrast, time spent on social media did not predict subsequent affect for individuals with higher frontoparietal functional connectivity. Our results highlight the moderating role of individual functional neural connectivity in the relationship between social media and affect.

Models of affect, like the tripartite model, suggest that positive affect (PA) and negative affect (NA) are independent between subjects and negatively correlated within. Correlations may differ in bipolar disorder (BD) and schizophrenia. Using ecological momentary assessment (EMA) and clinical ratings, this secondary analysis evaluated the tripartite model by examining PA and NA. Two hundred eighty-one participants with BD or a psychotic disorder completed 30 days of EMA of PA and NA, and clinical raters assessed depression. PA and NA were more related between subjects and less related within subjects among participants with schizophrenia. In BD, lower momentary PA was positively associated with clinical ratings of depression, although greater momentary NA was not significantly associated with clinical ratings. In schizophrenia, the inverse was found. These results suggest that the tripartite model was not confirmed in people with schizophrenia or BD. However, PA and NA manifested associations in BD that were more congruent with population studies than in schizophrenia. These findings may have implications for clinical interventions targeting depression, PA, and NA in these populations.

Objective: Binge eating, characterized by eating a large amount of food accompanied by a sense of loss of control over eating, is a public health crisis. The affect regulation model of binge eating posits that elevated negative affect increases momentary risk for binge eating, as engaging in binge eating alleviates negative affect and reinforces the behavior. However, the field's existing capacity to identify moments of elevated negative affect, and thus risk for binge eating, has exclusively relied on ecological momentary assessment (EMA), which involves the completion of surveys in real time on one's smartphone to report behavioral, cognitive, and emotional symptoms. EMA surveys are often delivered only 5-6 times per day, involve self-report of affect intensity only, and are unable to assess affect-related physiological arousal. Wearable, psychophysiological sensors that measure markers of affect arousal (e.g., heart rate, heart rate variability, and electrodermal activity) may augment EMA surveys to improve our capacity to accurately detect risk for binge eating in real time. However, it is unknown whether data from these sensors can adequately distinguish between positive and negative affect states, as physiological arousal may occur during both negative and positive affect states. The aims of this study were: 1) test the hypothesis that sensor features can distinguish positive and negative affect states in individuals with binge eating with &gt; 60% accuracy, 2) test the hypothesis that a machine learning algorithm using sensor data and EMA-reported negative affect data to predict binge eating episodes can predict binge eating with greater accuracy than an algorithm using EMA-reported negative affect alone, 3) evaluate the feasibility and acceptability of using sensors among adults with binge eating. The study also involved an exploratory aim to evaluate user design preferences for a sensor-powered ecological momentary intervention system for adults with binge eating. Method: The study recruited 30 individuals with clinically significant binge eating who wore Fitbit Sense 2 smartwatches to passively measure heart rate and electrodermal activity and reported affect and binge eating on EMA surveys for four weeks. The participants and 6 community eating disorder clinicians completed self-report surveys and qualitative interviews on the feasibility, acceptability, and user design preferences for a future sensor-integrated momentary intervention. Results: The best performing model using sensor data to distinguish positive and negative affect demonstrated accuracy of 0.63, sensitivity of 0.20, and specificity of 0.93; the model's accuracy exceeded 0.60 indicating adequate accuracy. The best performing model using EMA data alone for predicting binge eating had accuracy of 0.65, sensitivity of 0.53, and specificity of 0.69. The optimal model combining EMA data and sensors data for the predicting binge eating demonstrated accuracy of 0.58, sensitivity of 0.90, and specificity of 0.48. Mixed methods data from both participants with binge eating and eating disorder clinicians substantiated the feasibility and acceptability of smartwatches and a future sensor-integrated digital intervention for binge eating. Participants with binge eating and community eating disorder clinicians preferred the just-in-time adaptive intervention format. Conclusions: Findings from the present study indicate that data from psychophysiological sensors included in commercial smartwatches can distinguish between instances of positive and negative affect among individuals with binge eating and that these data augment EMA data for accurate prediction of binge eating episodes. Individuals with binge eating and eating disorder clinicians are enthusiastic about the potential for a digital intervention to augment outpatient therapy and data collected in this study set the stage for the future user-centered design of such an intervention.

Objective:Despite associations between hypoglycemia and cognitive performance using cross-sectional and experimental methods (e.g., Insulin clamp studies), few studies have evaluated this relationship in a naturalistic setting. This pilot study utilizes an EMA study design in adults with T1D to examine the impact of hypoglycemia and hyperglycemia, measured using CGM, on cognitive performance, measured via ambulatory assessment.Participants and Methods:Twenty adults with T1D (mean age 38.9 years, range 26-67; 55% female; 55% bachelor’s degree or higher; mean HbA1c = 8.3%, range 5.4% - 12.5%), were recruited from the Joslin Diabetes Center at SUNY Upstate Medical University. A blinded Dexcom G6 CGM was worn during everyday activities while completing 3-6 daily EMAs using personal smartphones. EMAs were delivered between 9 am and 9 pm, for 15 days. EMAs included 3 brief cognitive tests developed by testmybrain.org and validated for brief mobile administration (Gradual Onset CPT d-prime, Digit Symbol Matching median reaction time, Multiple Object Tracking percent accuracy) and self-reported momentary negative affect. Day-level average scores were calculated for the cognitive and negative affect measures. Hypoglycemia and hyperglycemia were defined as the percentage of time spent with a sensor glucose value &lt;70 mg/dL or &gt; 180 mg/dL, respectively. Daytime (8 am to 9 pm) and nighttime (9 pm to 8 am) glycemic excursions were calculated separately. Multilevel models estimated the between- and within-person association between the night prior to, or the same day, time spent in hypoglycemia or hyperglycemia and cognitive performance (each cognitive test was modeled separately). To evaluate the effect of between-person differences, person-level variables were calculated as the mean across the study and grand-mean centered. To evaluate the effect of within-person fluctuations, day-level variables were calculated as deviations from these person-level means.Results:Within-person fluctuations in nighttime hypoglycemia were associated with daytime processing speed. Specifically, participants who spent a higher percentage of time in hypoglycemia than their average percentage the night prior to assessment performed slower than their average performance on the processing speed test (Digit Symbol Matching median reaction time, b = 94.16, p = 0.042), while same day variation in hypoglycemia was not associated with variation in Digit Symbol Matching performance. This association remained significant (b = 97.46, p = 0.037) after controlling for within-person and between-person effects of negative affect. There were no significant within-person associations between time spent in hyperglycemia and Digit Symbol Matching, nor day/night hypoglycemia or hyperglycemia and Gradual Onset CPT or Multiple Object Tracking.Conclusions:Our findings from this EMA study suggest that when individuals with T1D experience more time in hypoglycemia at night (compared to their average), they have slower processing speed the following day, while same day hypoglycemia and hyperglycemia does not similarly impact processing speed performance. These results showcase the power of intensive longitudinal designs using ambulatory cognitive assessment to uncover novel determinants of cognitive variation in real world settings that have direct clinical applications for optimizing cognitive performance. Future research with larger samples is needed to replicate these findings.

Ecological momentary assessment (EMA) can be used to examine the dynamics of suicidal ideation in daily life. While the general acceptability and feasibility of EMA in suicide research has been established, further examination of potential iatrogenic effects (i.e., negative reactivity) and identifying those more likely to react negatively is needed. Participants (N = 82) with current suicidal ideation completed 21 days of EMA (4×/day) and filled in M = 78% (Med = 84%) of the EMA. No positive or negative affect reactivity was observed in EMA ratings over the study period. Retrospectively, most participants rated their experience as positive (69%); 22% indicated mood worsening, and 18% suicidal ideation reactivity. Those with more borderline personality traits, posttraumatic stress disorder (PTSD), and higher depressive, anxiety, and suicidal ideation symptoms, were more likely to report iatrogenic effects. In conclusion, while high compliance rates and lack of affect reactivity during EMA indicate that EMA is well tolerated in suicide research, a minority of participants may report subjective mood effects in retrospect.

Background and AimsThis study examined how gender minority stressors and resilience experienced by transgender and gender diverse (TGD) youth relate to daily and momentary occurrences of alcohol use risk processes (e.g., alcohol craving, drinking motives, and distress), alcohol use, and alcohol‐related harms. The feasibility of ecological momentary assessment (EMA) was evaluated.MethodsForty TGD youth (mean 22.42 years [SD = 3.03]; range 18–29) completed a baseline interview followed by 21 days of EMA. Daily morning surveys assessed stressors and resilience, alcohol risk processes, use and harms experienced “yesterday” and twice‐daily random surveys assessed most of these experiences in the “past 30 min” or “right now.”ResultsUsing multilevel models, at the daily (within‐person) level, gender minority stressors were significantly related to increased alcohol use (incidence rate ratio (IRR) = 1.16, 95% confidence interval [CI]: 1.03–1.32), drinking to cope (B = 0.16, 95% CI: 0.06–0.26), psychological distress (B = 0.19, 95% CI: 0.03–0.35) and alcohol craving (B = 0.05, 95% CI: 0.01–0.10), but not alcohol harms or negative affect. At the momentary (within‐person) level, gender minority stress was associated with increased drinking to cope (B = 0.76, 95% CI: 0.51–1.01), alcohol craving (B = 0.43, 95% CI: 0.31–0.55), and negative affect (B = 2.17, 95% CI: 1.31–3.02). Daily resilience was also associated with increased alcohol use (IRR = 1.32, 95% CI: 1.15–1.52), but not craving or negative affect. Momentary resilience was associated with reduced drinking to cope (B = ‐0.56, 95% CI: −0.88, −0.23) and negative affect (B = ‐0.52, 95% CI: −0.81, −0.23), but not craving. Adherence rates and participants' ratings about study acceptability were favorable.ConclusionsGender minority stressors are a risk factor for same‐day alcohol use. Resilience factors may be associated with increased alcohol use through other mechanisms (e.g., drinking for social or conformity reasons). Interventions to reduce TGD youth's alcohol use should address gender minority stressors and support TGD youth to cope with these stressors.

Cannabis use is prevalent and increasing among adults in the United States. Individuals who use cannabis commonly endorse using cannabis to enhance positive affect (PA) or cope with negative affect (NA). Importantly, enhancement motives are associated with greater frequency of use, and coping motives are associated with cannabis-related problems. We used ecological momentary assessment to test whether daily-life reports of enhancement- and coping-motivated use are associated with improved affective states. Participants (N = 48, Mage = 24.15, 81.3% White, 50.0% female, 45.8% male, 4.2% nonbinary) who reported using cannabis 3+ times per week completed 14 days of ecological momentary assessment, which included random and self-initiated cannabis use surveys. Participants reported PA and NA at every survey and cannabis use motives any time they reported using cannabis. Multilevel models adjusted for last-prompt PA/NA, person-level motives, alcohol use, social context, weekend, time of day, age, and gender. Higher momentary enhancement motives predicted increased PA from the last survey (b = 0.28, SE = 0.07, p < .001), and higher momentary coping motives predicted increased NA from the last survey (b = 0.07, SE = 0.02, p = .003). Findings highlight positive reinforcement purposes of cannabis use and suggest that endorsement of coping motives for cannabis use may be accompanied by exacerbated NA rather than improved NA. Future work should examine the generalizability of these findings in samples with greater representation of diverse ethnic and cultural backgrounds and among individuals who are in or seeking treatment for cannabis-related problems. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Loneliness is linked to a wide range of negative outcomes, including worse emotional well-being. Although prior research has demonstrated the relationship between loneliness and typical levels of negative and positive emotions, the degree to which loneliness is associated with emotional instability, a potential indicator of unhealthy patterns of emotional experiences, is unknown. We evaluated whether individual differences in loneliness were related to instability across days in positive emotions (PE) and negative emotions (NE) in daily life. A diverse community sample of 252 adults (age 25–65) completed a baseline assessment of loneliness followed by 14 days of ecological momentary assessments, during which participants reported PE and NE five times each day. Loneliness was significantly associated with greater instability in both PE and NE, after adjusting for demographic characteristics, objective social isolation, and person-mean emotion levels. Notably, the association with PE instability remained significant even after controlling for depressive symptoms, whereas the association with NE instability was attenuated and no longer significant. These findings suggest that loneliness is characterised not only by differences in average emotional states but also by greater emotional variability, particularly in PE, which may be a key feature linking loneliness to broader health and well-being outcomes.

Drinking commonly occurs in social settings and may bolster social reinforcement. Laboratory studies suggest that subjective effects and mood are mechanisms through which the social context influences alcohol consumption. Ecological momentary assessment (EMA) may be useful for extending these findings to the natural environment. This pre-registered secondary analysis of EMA data investigated the influence of the social environment on: (1) stimulating and sedating subjective effects of alcohol, (2) contentedness and negative affect, and (3) next-day evaluations of the drinking occasion. Nontreatment seeking adults reporting past-month heavy drinking (N = 131; Mage = 28.09; 42% female) completed 7 days of EMA (in the morning, at random, and following drinking prompts), which included questions on their social context (drinking in the presence of known others or alone), contemporaneous stimulating and sedating effects, contentedness and negative affect, alcohol consumption, and next-day evaluations of a prior day's drinking event (how satisfying/pleasant was drinking). We used multi-level models in SAS 9.4 M7 software to examine relations among the variables. Contemporaneous subjective effects (stimulating or sedating), negative affect, and contentedness did not significantly depend on the social context. For next-day evaluations of pleasure/satisfaction from drinking, context effects were dependent on consumption totals. As the total number of standard drinks consumed increased, recollections of pleasure/satisfaction were higher when drinking had occurred with others, relative to alone. At lower consumption totals, next-day evaluations did not appear to depend on social context. When reported contemporaneously, subjective effects and affect do not appear dependent upon the presence of known others. However, heavier drinking events, relative to lighter drinking events, are appraised more favorably the following day when occurring within social contexts.

MP19-05 DAILY ECOLOGICAL MOMENTARY ASSESSMENTS OF PAIN AND ABILITY TO WORK AFTER URETEROSCOPY AND STENTING