Completed Ecological Momentary Assessment Research Articles

Interpersonal Tensions and Pain Among Older Adults: The Mediating Role of Negative Mood.

To examine whether (a) negative social encounters and physical pain are linked throughout the day, (b) negative mood mediates these associations, and (c) these associations vary by closeness with social partners. Adults aged 65+ (n = 313) completed ecological momentary assessments and reported their negative social encounters, physical pain, and mood every 3 hr throughout the day for 5-6 days. Multilevel models revealed that negative social encounters were associated with greater pain at each 3-hr interval and that this association was mediated by negative mood during the same interval. Negative encounters with less close partners were associated with pain, but negative encounters with close partners were not. Regulating older adults' negative emotions may be crucial to improving their daily pain. Further, interventions focusing on negative encounters with less close partners in daily life may help mitigate older adults' experiences of pain throughout the day.

MATTERS OF THE HEART: DAILY SOCIAL INTERACTIONS AND CARDIOVASCULAR REACTIVITY IN MIDDLE AND OLD AGE

Social ties are essential for survival but the mechanisms accounting for this link are unclear. This study examined links between daily interpersonal experiences and cardiovascular reactivity. A total of 34 participants (aged 40 to 80) completed ecological momentary assessment surveys every three hours for 4 days and wore a device that assessed heart rate (HR) and heart rate variability (HRV). Multilevel models revealed that a greater number of social interactions and negative social interactions predicted increased HR. Links between social interactions and cardiovascular reactivity varied by gender and race. A greater number of interactions and negative interactions predicted increased HRV among men and not women. A greater number of social interactions predicted increased HR among Black individuals and White women but not White men. Thus, social interactions appear to get under the skin via the cardiovascular system but in unique ways that vary by gender and race.

Depressive Symptoms Amplify Emotional Reactivity to Daily Perceptions of Peer Rejection in Adolescence

During adolescence, interpersonal stressors such as peer rejection pose challenges to emotion regulation. Yet, very little is known about how these transactional processes unfold in adolescents' daily lives. This study investigated adolescents' (a) emotional reactivity to daily perceptions of peer rejection, which concerns concurrent changes in negative and positive emotions, and (b) emotional recovery from daily perceptions of peer rejection, which concerns subsequent changes in negative and positive emotions. Because depressive symptoms can compromise effectiveness of emotion regulation, it was investigated as a moderator for emotional reactivity and recovery to daily perceptions of peer rejection. The sample consisted of 303 adolescents (59% girls; Mage = 14.20, SD = 0.54; range 13-16 years) who reported depressive symptoms at baseline and completed ecological momentary assessments of emotions and perceived peer rejection at nine random time-points per day for six consecutive days. Results from multi-level modeling analyses showed that perceived peer rejection was related to emotional reactivity (i.e., higher levels of negative emotions and lower levels of positive emotions). This effect was stronger for those with higher depressive symptoms. For emotional recovery, perceived peer rejection had lasting effects on adolescents' negative emotions, but was not related to positive emotions. Depressive symptoms did not moderate effects of perceived peer rejection on emotional recovery. This study provides a more nuanced understanding of how depressive symptoms amplify the emotional impact of perceived peer rejection in adolescents' day-to-day lives.

Bidirectional Associations of Momentary Affect with Physical Activity and Sedentary Behaviors in Working Adults.

Affective experiences and movement-based behaviors form a system that has been shown to influence exercise adherence and mental health outcomes. Little is known about the naturalistic dynamics of the reciprocal associations in this system. We examined the time intervals at which momentary affect precedes and follows movement-based behaviors in everyday life. A community sample of working adults (n = 111) completed ecological momentary assessments (EMA) asking about current affect states (sad, happy, tired, and interested) six times a day for three consecutive days. Ratings were used to generate scores for momentary affective arousal and valence. Participants also wore an activity monitor. Total activity counts and sedentary duration in the shorter to longer time intervals (5-120 min) before or after EMA were used as indicators of movement-based behaviors. Multilevel modeling showed that current affective arousal predicted higher subsequent activity counts in the longer time intervals (120 min) and less subsequent sedentary behavior in the shorter to longer time intervals (5, 60, and 120 min). For the reversed sequence, neither movement-based behavior predicted subsequent momentary arousal or valence. Affective valence was unrelated to movement-based behaviors in either temporal direction. Some naturally occurring affective experiences (i.e., arousal) might precede, rather than follow, movement-based behaviors. Understanding affective arousal may contribute to improved management of subsequent movement-based behaviors in everyday life.

Cognitive performance of breast cancer survivors in daily life: Role of fatigue and depressed mood.

Cancer and its treatment are associated with long-term cognitive deficits. However, most studies of cancer patients have used traditional, office-based cognitive evaluations instead of assessing patients in their daily lives. Recent research in cognitive aging suggests that variability in performance may be a sensitive indicator of cognitive decline. Using ecological momentary assessment (EMA), we examined cognitive variability among breast cancer survivors and evaluated whether ratings of fatigue and depressed mood were associated with cognition. Participants were 47 women (M age = 53.3 years) who completed treatment for early stage breast cancer 6 to 36 months previously. Smartphones were preloaded with cognitive tests measuring processing speed, executive functioning, and memory, as well as rating scales for fatigue and depressed mood. Participants were prompted five times per day over a 14-day period to complete EMA cognitive tasks and fatigue and depressed mood ratings. Cognitive variability was observed across all three EMA cognitive tasks. Processing speed responses were slower at times that women rated themselves as more fatigued than their average (P < .001). Ratings of depressed mood were not associated with cognition. This study is the first to report cognitive variability in the daily lives of women treated for breast cancer. Performance was worse on a measure of processing speed at times when a woman rated her fatigue as greater than her own average. The ability to identify moments when cognition is most vulnerable may allow for personalized interventions to be applied at times when they are most needed.

(117) Characterizing Fibrofog in Daily Life: Ambulatory Cognitive Functioning in Adults with Fibromyalgia and Matched Controls

Most people with fibromyalgia (FM) report “fibrofog”, or cognitive dysfunction. To better characterize fibrofog in daily life, we conducted an ambulatory study of subjective and objective cognitive function in real-world settings in persons with FM and sex-, age-, and education-matched healthy controls (HC) to test whether: 1) people with FM demonstrate poorer cognitive function on ambulatory measures; 2) people with FM demonstrate a different diurnal pattern of cognitive function; and 3) subjective cognitive function corresponds more highly with objective cognitive measures in HC compared to FM. Participants (N=102; nFM=50; nHC=52) completed ecological momentary assessments of perceived cognitive function (perceived clarity and speed) on a numerical rating scale of 0-100 and cognitive tests of processing speed (Symbol Search) and working memory (Dot Matrix) via a smartphone app at 5 quasi-random times/day for 8 days. The FM group scored significantly lower than HC on measures of self-reported cognitive functioning, as well as on objective measures of processing speed and working memory. Results from multilevel models showed that both groups demonstrated similar diurnal patterns for objective measures of working memory, which was stable across the day, and objective processing speed, which was slowest at wake- and bed-times and fastest midday. For both groups, perceived cognitive dysfunction was highest upon waking and improved across the day; however, the HC group showed a significantly steeper rate of improvement. Perceived cognitive dysfunction corresponded only with processing speed, not working memory, and there were no group differences in these associations. Findings for ambulatory subjective and objective cognitive function in FM are generally consistent with findings from lab-based studies; the FM group demonstrated relatively worse cognitive functioning, but diurnal patterns and associations between objective/subjective functioning were similar to HC.

(119) The Role of Environmental Distractions in the Experience of Fibrofog in Real-World Settings

Cognitive problems in fibromyalgia (FM), or “fibrofog,” are highly prevalent but not well-characterized. Research shows that deficits in cognitive performance in FM only emerge in the context of a stimulating testing environment, suggesting a potentially important role for distraction in the experience of both subjective (perceived) and objective (performed) fibrofog. Unexplored to date is the role of real-world distractions in fibrofog in everyday life. To address limitations in our understanding of fibrofog in daily life, we conducted a study of ambulatory subjective and objective cognitive function in a sample of adults with FM and age-, sex-, and education-matched healthy controls (HC) to test the hypotheses that: 1) people with FM report environmental distractions at a higher rate than HCs; and 2) relative to HCs, people with FM show steeper declines in subjective and objective cognitive functioning in the context of real-world distraction. Fifty adults with FM and 52 controls (N=102) completed ecological momentary assessments of perceived cognitive dysfunction on a numerical rating scale of 0-100 and cognitive tests of processing speed (Symbol Search) and working memory (Dot Matrix) via a smartphone app, 5X/day for 8 consecutive days. After each cognitive testing session, participants were asked whether they were distracted by anything in the environment during testing. Consistent with expectations, the FM group reported distractions during ambulatory tests at a higher rate (41.1% of tests) compared to the HCs (30.0% of tests; χ2=45.20, p

Exploring the Use of Smartphone Geofencing to Study Characteristics of Alcohol Drinking Locations in High-Risk Gay and Bisexual Men.

Geofencing offers new opportunities to study how specific environments affect alcohol use and related behavior. In this study, we examined the feasibility of using geofencing to examine social/environmental factors related to alcohol use and sexual perceptions in a sample of gay and bisexual men (GBM) who engage in heavy drinking and high-risk sex. HIV-negative GBM (N=76) completed ecological momentary assessments for 30days via a smartphone application and were prompted to complete surveys when inside general geofences set around popular bars and clubs. A subset (N=45) were also asked to complete surveys when inside personal geofences, which participants set themselves by identifying locations where they typically drank heavily. Approximately 49% of participants received a survey prompted by a general geofence. Among those who identified at least 1 personal drinking location, 62.2% received a personal geofence-prompted survey. Of the 175 total location-based surveys, 40.2% occurred when participants were not at the location that was intended to be captured. Participants reported being most able to openly express themselves at gay bars/clubs and private residences, but these locations were also more "sexualized" than general bars/clubs. Participants did not drink more heavily at gay bars/clubs, but did when in locations with more intoxicated patrons or guests. Geofencing has the potential to improve the validity of studies exploring environmental influences on drinking. However, the high number of "false-positive" prompts we observed suggests that geofences should be used carefully until improvements in precision are more widely available.

Smartphones for Real-time Assessment of Adherence Behavior and Symptom Exacerbation for High-Risk Youth with Asthma: Pilot Study

BackgroundYouth with asthma who have poor medication adherence, have limited access to care, and are frequently seen in the acute care setting are often termed “high risk.”ObjectiveThis study aimed to design and test the feasibility of using smartphone technology to assess contextual factors that may impact changes in daily medication adherence and to identify new symptom episodes among high-risk youth with asthma in their home environment.MethodsYouth aged 8-17 years with high-risk asthma from 2 children’s hospitals were eligible for the 2-month study. An app was downloaded on participants’ phones at enrollment. Daily text message (short message service) reminders were sent to complete ecological momentary assessment of asthma symptoms and other contextual factors such as emotional state using the app. Bluetooth inhaler devices were used to record timestamps of inhaler use with the ability to review and manually enter data. The acceptability was assessed with surveys, key informant interviews (KII), and frequency of days with asthma data. KII data were used in an iterative design approach to identify challenges, strengths, and suggestions for maximizing use. Generalized linear mixed modeling was used to preliminarily explore contextual factors associated with changes in daily adherence.ResultsWe enrolled 14 children aged 8-16 years (13/14, 93% were African Americans). Over the 2-month study period, participants reported coughing (42/110, 38%), wheezing (8/111, 7%), chest tightness (9/109, 8%), boredom (57/109, 52%), and 10 new asthma symptom episodes. The controller medication adherence was 30%, which increased significantly on days with asthma symptoms or boredom. Data were received on 89% (606/681) of study days. Surveys and KIIs suggest acceptability among youth and their caregivers. Challenges reported during the study included lost or damaged phones and available memory.ConclusionsYouth and their caregivers reported the acceptability of using smartphones for real-time asthma monitoring. Overall, the controller medication adherence was low but increased significantly on days with reported asthma symptoms or boredom, suggesting that daily contextual factors may be associated with a change in the adherence behavior.

Intra-individual study of mindfulness: ecological momentary perspective in post-surgical lung cancer patients.

The period of recovery following a lung-cancer surgery presents unique challenges and psychological demands. The study utilized ecological momentary assessments (EMA) to repeatedly sample mindfulness states in a sample of mindfulness-untrained individuals following hospital discharge. Intra- and inter- individual variability was assessed to examine cancer patients' natural capacity to exhibit mindfulness states during two weeks of recovery. Fifty nine stage I lung cancer patients (61% women, mean age = 66.1, SD = 7.9) completed EMA twice a day for two weeks. Mean level of mindfulness in the sample was low and equaled .49 (SD = .51) on the 5 point scale, with older participants being less likely to endorse mindful states. Net variability in mindfulness, defined as the person-based standard deviation in momentary scores, equaled .42 (SD = .26), ranging for 0 to 1.3 and indicating very modest variability for most participants. Results of the multi-level variance partitioning model revealed 41.4% of variance in mindfulness scores at the inter-individual, 2.4% on the temporal (i.e., .2% weekly and 2.2% daily), and 56.2% on the momentary levels. Findings indicate that, for cancer patients recovering from surgery, the innate ability to exhibit mindfulness is limited. From the methodological standpoint, consideration of intra-individual variability has implications for conceptualization and design of EMA studies.

Reprint of Using ecological momentary assessments to predict relapse after adult substance use treatment

BackgroundA key component of relapse prevention is to self-monitor the internal (feelings or cravings) and external (people, places, activities) factors associated with relapse. Smartphones can deliver ecological momentary assessments (EMA) to help individuals self-monitor. The purpose of this exploratory study was to develop a model for predicting an individual's risk of future substance use after each EMA and validate it using a multi-level model controlling for repeated measures on persons. MethodsData are from 21,897 observations from 43 adults following their initial episode of substance use treatment in Chicago from 2015 to 2016. Participants were provided smartphones for six months and asked to complete two to three minute EMAs at five random times per day (81% completion). In any given EMA, 2.7% reported substance use and 8% reported any use in the next five completed EMA. Chi-square Automatic Interaction Detector (CHAID) was used to classify EMAs into six levels of risk and then validated with a hierarchical linear model (HLM). ResultsThe major predictors of substance use in the next five completed EMAs were substance use pattern over the current and prior five EMAs (no recent/current use, either recent or current use [but not both], continued use [both recent and current]), negative affect (feelings), and craving (rating). Negative affect was important for EMAs with no current or recent use reported; craving was important for EMAs with either recent or current use; and neither mattered for EMAs with continued use. The CHAID gradated EMA risk from 0.7% to 36.6% of the next five completed EMAs with substance use reported. It also gradated risk of “any” use in the next five completed EMAs from 3% to 82%. ConclusionsThis study demonstrated the potential of using smartphone-based EMAs to monitor and provide feedback for relapse prevention in future studies.

Are individuals with loss-of-control eating more prone to dietary lapse in behavioural weight loss treatment? An ecological momentary assessment study.

Individuals with overweight/obesity and loss-of-control eating (LOC) may experience poorer outcomes from behavioural weight loss due to reactivity to internal (e.g., affective and physical) states that impact treatment adherence (e.g., dietary lapses). This study examined (a) whether the presence of LOC increased risk for dietary lapses and (b) the moderating role of LOC on the relation between internal states and dietary lapses. Individuals (n=189) with overweight and obesity completed ecological momentary assessment early in behavioural weight loss. LOC was positively associated with dietary lapse. LOC did not moderate the relation between momentary changes in internal states and dietary lapses. However, the effect of average levels of internal states on lapses was attenuated for those with LOC. Results suggest that those with LOC are at higher risk of dietary lapse, whereas elevated average levels of internal states may contribute to early inadherence for those without LOC.

Using ecological momentary assessments to predict relapse after adult substance use treatment

BackgroundA key component of relapse prevention is to self-monitor the internal (feelings or cravings) and external (people, places, activities) factors associated with relapse. Smartphones can deliver ecological momentary assessments (EMA) to help individuals self-monitor. The purpose of this exploratory study was to develop a model for predicting an individual's risk of future substance use after each EMA and validate it using a multi-level model controlling for repeated measures on persons. MethodsData are from 21,897 observations from 43 adults following their initial episode of substance use treatment in Chicago from 2015 to 2016. Participants were provided smartphones for six months and asked to complete two to three minute EMAs at five random times per day (81% completion). In any given EMA, 2.7% reported substance use and 8% reported any use in the next five completed EMA. Chi-square Automatic Interaction Detector (CHAID) was used to classify EMAs into six levels of risk and then validated with a hierarchical linear model (HLM). ResultsThe major predictors of substance use in the next five completed EMAs were substance use pattern over the current and prior five EMAs (no recent/current use, either recent or current use [but not both], continued use [both recent and current]), negative affect (feelings), and craving (rating). Negative affect was important for EMAs with no current or recent use reported; craving was important for EMAs with either recent or current use; and neither mattered for EMAs with continued use. The CHAID gradated EMA risk from 0.7% to 36.6% of the next five completed EMAs with substance use reported. It also gradated risk of “any” use in the next five completed EMAs from 3% to 82%. ConclusionsThis study demonstrated the potential of using smartphone-based EMAs to monitor and provide feedback for relapse prevention in future studies.

Ecological momentary assessment of self-attitudes in response to dietary lapses.

To examine whether self-attitudes and self-efficacy after dietary lapses relate to lapse frequency or predict risk for lapsing again on the same day. Adults with overweight/obesity (n = 91) completed ecological momentary assessment for 14 days at the start of a lifestyle modification program. At each survey, participants reported whether they had experienced a dietary lapse, and, if so, reported their self-attitudes (i.e., self-criticism, self-forgiveness, self-regard) and self-efficacy. The relationships between participants' typical (i.e., average level for each participant across lapses) self-attitudes/self-efficacy after lapsing and lapse frequency were examined using correlations. Generalized estimating equations examined whether participants' typical (average across lapses; between-person effect) self-attitudes/self-efficacy or momentary (i.e., level of each variable at a particular lapse relative to one's typical level; within-person effect) self-attitudes/self-efficacy predicted same-day lapse occurrence. Lower typical self-efficacy and more negative typical self-regard related to greater lapse frequency. Additionally, lower momentary self-criticism predicted greater likelihood of same-day lapse occurrence. There also was a quadratic relationship between typical self-regard and risk of same-day lapse occurrence, such that individuals with either more negative or more positive typical self-regard were more likely to lapse on the same day. Findings provide preliminary support for the relevance of self-attitudes and self-efficacy to lapses during early lifestyle modification. While greater typical self-efficacy and more positive typical self-regard are associated with fewer lapses, lower momentary self-criticism and very positive or negative typical self-regard may confer risk for same-day lapses. (PsycINFO Database Record

Rationale, design and pilot feasibility results of a smartphone-assisted, mindfulness-based intervention for smokers with mood disorders: Project mSMART MIND

BackgroundAlthough individuals with psychiatric disorders are disproportionately affected by cigarette smoking, few outpatient mental health treatment facilities offer smoking cessation services. In this paper, we describe the development of a smartphone-assisted mindfulness smoking cessation intervention with contingency management (SMI-CM), as well as the design and methods of an ongoing pilot randomized controlled trial (RCT) targeting smokers receiving outpatient psychiatric treatment. We also report the results of an open-label pilot feasibility study. MethodsIn phase 1, we developed and pilot-tested SMI-CM, which includes a smartphone intervention app that prompts participants to practice mindfulness, complete ecological momentary assessment (EMA) reports 5 times per day, and submit carbon monoxide (CO) videos twice per day. Participants earned incentives if submitted videos showed CO≤6ppm. In phase 2, smokers receiving outpatient treatment for mood disorders are randomized to receive SMI-CM or enhanced standard treatment plus non-contingent CM (EST). ResultsThe results from the pilot feasibility study (N=8) showed that participants practiced mindfulness an average of 3.4times/day (≥3min), completed 72.3% of prompted EMA reports, and submitted 68.0% of requested CO videos. Participants reported that the program was helpful overall (M=4.85/5) and that daily mindfulness practice was helpful for both managing mood and quitting smoking (Ms=4.50/5). ConclusionsThe results from the feasibility study indicated high levels of acceptability and satisfaction with SMI-CM. The ongoing RCT will allow evaluation of the efficacy and mechanisms of action underlying SMI-CM for improving cessation rates among smokers with mood disorders.

Craving and acute effects of alcohol in youths' daily lives: Associations with alcohol use disorder severity.

Identifying factors associated with the progression from recreational to pathological drinking in youth holds high clinical and theoretical importance. The present study tested cross-sectional associations of alcohol use disorder (AUD) severity with putative mechanisms of AUD progression among youth ages 15-24 years, namely acute subjective effects of alcohol and craving. Male (n = 44) and female (n = 42) youth completed ecological momentary assessments when not drinking, just before drinking, and while drinking in the natural environment via handheld wireless devices. Youth were recruited from the community and were frequent and heavy drinkers, the majority (93%) with at least 1 AUD symptom (M = 3.4, SD = 2.4). Findings from youths' daily lives suggested that how youth feel while they drink depends, in part, on their severity of AUD pathology. In support of hypotheses, youths with more progressed drinking pathology (i.e., those with more symptoms of AUD) reported greater reductions in craving and tension while drinking, relative to nondrinking times. In partial support of hypotheses, males with greater AUD symptomatology reported marginally attenuated increases in stimulatory states while drinking; however, contrary to hypotheses, females with greater AUD symptomatology reported enhanced increases in stimulation while drinking. This research leveraged ecological momentary assessment methods to study subjective responses to alcohol and craving in youths' daily lives and to cross-sectionally test putative associations with AUD etiology. This work adds to literature supporting subjective responses to alcohol in the pathogenesis of alcoholism, specifically by highlighting their importance during the period in life when alcohol problems typically first emerge. (PsycINFO Database Record

Momentary Associations Between Reported Craving and Valuing Health in Daily Smokers.

Research suggests that a blunted response to nondrug rewards, especially under conditions associated with strong cigarette cravings, is associated with reduced abstinence motivation in daily smokers. One limitation of previous studies is that they have largely focused on monetary rewards as broad representative of nondrug rewards. It remains unclear whether craving dampens responses to more abstract nondrug rewards, such as personal values. Personal values often have a positive valence and are frequently assumed to remain stable across time and situations. However, there may be time-varying and contextual influences on smokers' appraisal of values in daily life. Characterizing fluctuations in value importance in relation to relapse precipitants (eg, craving) may inform interventions that leverage personal values as motivation for cessation. Daily smokers (n = 18) completed ecological momentary assessment surveys measuring the importance of specific personal values and smoking-related variables during 8 days of monetarily reinforced cigarette abstinence. We hypothesized that value ratings would demonstrate adequate within-person heterogeneity for multilevel modeling and that within-person fluctuations in craving would be negatively related to valuing personal health. All values demonstrated adequate within-person variability for multilevel modeling. Within-person craving was negatively related to health valuation (p = .012) and a cross-level interaction (p > .0001) suggested this effect is stronger for individuals who report greater overall craving. Greater craving is associated with decreased importance of personal health in the moment, particularly for those with high average levels of craving. Timely interventions that bolster importance of health during moments of elevated craving can potentially improve cessation outcomes. This study builds on research highlighting the positive influence of personal values in motivating behavior change. Values are an often used, but poorly studied, construct that has considerable utility in smoking cessation. Valuing personal health is frequently reported as a primary motivator for a quit attempt. Inasmuch as personal health is a distal nondrug reward used to motivate smoking abstinence, naturalistic evaluation of health importance, and motivators for continued smoking (ie, craving) could inform the timing and content of smoking treatment. This study is among the first to evaluate momentary assessment of personal values and craving within daily life.

Ecological Momentary Assessment of Dietary Lapses Across Behavioral Weight Loss Treatment: Characteristics, Predictors, and Relationships with Weight Change.

Adherence to dietary prescriptions is critical for successful weight loss and weight loss maintenance. However, research on specific instances of inadherence (lapses) is limited, and findings regarding the frequency, nature, and causes of lapses are mixed. Additionally, no studies have examined lapses over the course of a weight loss program. In the context of a reduced calorie diet prescribed as part of a behavioral treatment, we aimed to characterize lapse occurrence, examine lapse frequency across treatment, examine predictors of lapses, and assess the relationship between lapses and weight loss. Adults (n=189) enrolled in a 12-month behavioral weight loss program completed ecological momentary assessment (EMA) at baseline, mid-treatment, and end of treatment. At each EMA survey, participants indicated whether a lapse had occurred, and responded to questions assessing situational, environmental, and affective states. Lapse frequency showed a curvilinear relationship over time, such that frequency first decreased and then increased. Lapse frequency at baseline was negatively associated with early and overall weight loss. Lapses most often occurred at home, in the evenings, on the weekends, and entailed eating a forbidden food. Greater overall levels of assessed affective and environmental triggers predicted lapses, and greater momentary hunger and deprivation, and the presence of palatable food, also prospectively predicted lapses. In addition to characterizing lapse frequency, the current study identified prospective predictors of lapses across treatment. These findings support the importance of lapses to weight control and provide insight for potential targets of intervention to prevent lapse occurrence.

Ecological Momentary Assessment (EMA) Goes to Jail

Abstract. Ecological Momentary Assessment (EMA) involves the repeated collection of data in everyday life. This method has helped uncover underlying mechanisms in several mental disorders. EMA studies are still scarce in adolescent patients and particularly incarcerated juvenile offenders (IJO), possibly due to their frequent rule-breaking and high impulsivity. This study evaluated the feasibility and reliability of EMA in IJO. One hundred three antisocial adolescents (mean age 14.8, 78% boys, including 52 IJO and 51 institutionalized antisocial adolescents, IAA) answered four times a day during 8 days questions about their antisocial behavior, negative affect, impulsivity, and fear of punishment, on a handheld computer. Staff members also regularly reported on each participant’s antisocial behavior. This first application of EMA in IJO overall supported its feasibility, with an excellent participation rate (95%) and a good compliance in completers (84%). About one-third of IJO participants dropped out, with no evidence of sampling bias across a wide range of indicators, while 96% of IAA completed EMA. No reactivity or lack of objectivity was observed. One- to two-thirds of the variance was within-person and reliability was acceptable to good. EMA can thus be reliably used in IJO to study the dynamics of daily antisocial behavior as it naturally unfolds in its context.

MovingU: A prospective cohort study to understand behavioural and environmental contexts influencing physical activity during the transition into emerging adulthood.

BackgroundChildren and youth are often considered the most active segment of the population, however, research indicates that physical activity (PA) tends to peak during the adolescent years, declining thereafter with age. In particular, the acute transition out of high school is a period for which individuals appear to be at high-risk for becoming less active. Relatively few studies have investigated the factors influencing the changes in PA during this transition period. Therefore the purpose of the MovingU study is to gain a comprehensive understanding of the behavioural patterns and the socio-ecological factors related to the changes in PA during the transition out of high school.Methods/DesignMovingU is comprised of two phases. Phase I is a prospective cohort design and aims to follow 120 students in their last year of high school through to their first year out of high school. Students will be asked to complete questionnaires measuring various psychosocial and socio-environmental variables (e.g., self-efficacy and distress) four times throughout this transition period. Students will also be given a wrist-worn accelerometer to wear for 7-days at each of the four assessments. Phase II is a cross-sectional study involving 100 first-year university students. Students will be asked to complete the same questionnaire from phase I, wear a wrist-worn accelerometer for 5-days, and complete ecological momentary assessments (EMA) using their smartphones at randomly selected times throughout the day for 5-days. EMA items will capture information regarding contextual and momentary correlates of PA.DiscussionThe MovingU study represents the first to evaluate the social and environmental influences of PA behaviour changes, including the use of intensive real-time data capture strategies during the transition out of high school. This information will be critical in the development of interventions aimed to prevent or attenuate such drastic declines in PA during emerging adulthood period.