Ecological Momentary Assessment Measures Research Articles

Reclaiming Pleasure: Does Satisfying Consensual Sexual Activity Predict Next-Day Positive Affect Among Women with a History of Sexual Assault?

ABSTRACT Substantial research documents the psychosocial benefits of sexual activity, including heightened positive affect and lowered negative affect following sexual encounters. However, it is important to examine whether affective benefits of consensual sexual activity are present among individuals who have also experienced non-consensual sexual activity (i.e. sexual assault), given that sexual assault may have harmful consequences for sexual functioning and pleasure during consensual encounters. This study tested consensual sexual activity and satisfaction as predictors of next-day positive and negative affect among 82 women sexual assault survivors. Participants completed ecological momentary assessment measures for three weeks, including measures of past-day dyadic (i.e. partnered) sexual activity and satisfaction in the morning and current affect in the afternoon. As hypothesized, dyadic sexual activity and greater than usual sexual satisfaction predicted increased next-day positive affect after controlling for past-day positive affect. In contrast, and partially supporting hypotheses, sexual satisfaction, but not activity alone, predicted lowered next-day negative affect after controlling for past-day negative affect. At the between person level, greater sexual satisfaction (but not overall frequency of dyadic sexual activity) was associated with greater positive and lower negative affect on average after controlling for several covariates. Findings indicate that satisfying dyadic sexual encounters lead to relatively long-lasting positive affect changes in women who have experienced sexual assault.

Bidirectional temporal associations between sleep and affect and cognitive symptoms among community-dwelling stroke survivors: An ecological momentary assessment study.

Sleep plays a critical role in daily functioning and stroke recovery but receives little attention in stroke rehabilitation. Sleep disturbances are linked to affective and cognitive impairments, but temporal associations between sleep and affect and cognitive symptomsare less clear. Understanding these temporal associations may inform new directions in intervention and prevention to support continued stroke recovery. To examine the bidirectional temporal associations between sleep and affect and cognitive symptoms among community-dwelling stroke survivors. A secondary analysis of a longitudinal observational study involving 7 days of ecological momentary assessment (EMA), during which participants completed eight EMA surveys and a sleep diary per day. Multilevel modeling was used to analyze data. Community. Community-dwelling stroke survivors (N = 40). Not applicable. EMA measures of depressed affect, cheerful affect, and cognitive symptoms. Sleep quality and duration as measured using a sleep diary. Between-person sleep quality was negatively associated with next-day depressed affect (B = -.16; p = .028) and positively associated with next-day cheerful affect (B = .63; p < .001). Inversely, between-person depressed affect was negatively associated with next night sleep quality (B = -.77; p = .015), and vice versa for cheerful affect (between-person: B = .45; p < .001; within-person: B = .09; p = .008). Long sleep (>9 hours) was positively associated with next-day cognitive symptoms (B = .13; p = .002), whereas cognitive symptoms were associated with a higher odds of long sleep the following night (odds ratio [OR] = 0.25; p = .047). This study identified the bidirectional associations of sleep with affect and cognitive symptoms in the context of the everyday life of stroke survivors. The findings suggest that interventions addressing sleep quality and duration may impact affect and cognitive symptoms, and vice versa.

Unraveling the interplay between daily life fatigue and physical activity after subarachnoid hemorrhage: an ecological momentary assessment and accelerometry study

BackgroundFatigue is one of the most commonly reported symptoms after subarachnoid hemorrhage (SAH) and is indirectly associated with physical activity (PA). Associations between fatigue and PA are primarily examined based on conventional measures (i.e. a single fatigue score or average PA levels), thereby assuming that fatigue and PA do not fluctuate over time. However, levels of fatigue and PA may not be stable and may interrelate dynamically in daily life. Insight in direct relationships between fatigue and PA in daily life, could add to the development of personalized rehabilitation strategies. Therefore we aimed to examine bidirectional relationships between momentary fatigue and PA in people with SAH.MethodsPeople (n = 38) with SAH who suffer from chronic fatigue were included in an observational study using Ecological Momentary Assessment (EMA) and accelerometry. Momentary fatigue was assessed on a scale from 1 to 7 (no to extreme fatigue), assessed with 10–11 prompts per day for 7 consecutive days using EMA with a mobile phone. PA was continuously measured during this 7-day period with a thigh-worn Activ8 accelerometer and expressed as total minutes of standing, walking, running and cycling in a period of 45 min before and after a momentary fatigue prompt. Multilevel mixed model analyses including random effects were conducted.ResultsMean age was 53.2 years (SD = 13.4), 58% female, and mean time post SAH onset was 9.5 months (SD = 2.1). Multilevel analyses with only time effects to predict fatigue and PA revealed that fatigue significantly (p < 0.001) increased over the day and PA significantly (p < 0.001) decreased. In addition, more PA was significantly associated with higher subsequent fatigue (β = 0.004, p < 0.05) and higher fatigue was significantly associated with less subsequent PA (β=-0.736, p < 0.05). Moreover, these associations significantly differed between participants (p < 0.001).ConclusionsBy combining EMA measures of fatigue with accelerometer-based PA we found that fatigue and PA are bidirectionally associated. In addition, these associations differ among participants. Given these different bidirectional associations, rehabilitation aimed at reducing fatigue should comprise personalized strategies to improve both fatigue and PA simultaneously, for example by combining exercise therapy with cognitive behavioral and/or energy management therapy.

A Series of Personalized Virtual Light Therapy Interventions for Fatigue: Feasibility Randomized Crossover Trial for N-of-1 Treatment.

Fatigue is one of the most common symptoms treated in primary care and can lead to deficits in mental health and functioning. Light therapy can be an effective treatment for symptoms of fatigue; however, the feasibility, scalability, and individual-level heterogeneity of light therapy for fatigue are unknown. This study aimed to evaluate the feasibility, acceptability, and effectiveness of a series of personalized (N-of-1) interventions for the virtual delivery of bright light (BL) therapy and dim light (DL) therapy versus usual care (UC) treatment for fatigue in 60 participants. Participants completed satisfaction surveys comprising the System Usability Scale (SUS) and items assessing satisfaction with the components of the personalized trial. Symptoms of fatigue were measured using the Patient-Reported Outcomes Measurement Information System (PROMIS) daily, PROMIS weekly, and ecological momentary assessment (EMA) questionnaires delivered 3 times daily. Comparisons of fatigue between the BL, DL, and UC treatment periods were conducted using generalized linear mixed model analyses between participants and generalized least squares analyses within individual participants. Participants rated the usability of the personalized trial as acceptable (average SUS score=78.9, SD 15.6), and 92% (49/53) of those who completed satisfaction surveys stated that they would recommend the trial to others. The levels of fatigue symptoms measured using the PROMIS daily fatigue measure were lower or improved in the BL (B=-1.63, 95% CI -2.63 to -0.63) and DL (B=-1.44, 95% CI -2.50 to -0.38) periods relative to UC. The treatment effects of BL and DL on the PROMIS daily measure varied among participants. Similar findings were demonstrated for the PROMIS weekly and EMA measures of fatigue symptoms. The participant scores on the SUS and satisfaction surveys suggest that personalized N-of-1 trials of light therapy for fatigue symptoms are both feasible and acceptable. Both interventions produced significant (P<.05) reductions in participant-reported PROMIS and EMA fatigue symptoms relative to UC. However, the heterogeneity of these treatment effects across participants indicated that the effect of light therapy was not uniform. This heterogeneity along with high ratings of usability and satisfaction support the use of personalized N-of-1 research designs in evaluating the effect of light therapy on fatigue for each patient. Furthermore, the results of this trial provide additional support for the use of a series of personalized N-of-1 research trials. ClinicalTrials.gov NCT04707846; https://clinicaltrials.gov/ct2/show/NCT04707846.

Predicting quantity of cannabis smoked in daily life: An exploratory study using machine learning

BackgroundCannabis use is prevalent in the United States and is associated with a host of negative consequences. Importantly, a robust indicator of negative consequences is the amount of cannabis consumed. MethodsData were obtained from fifty-two adult, regular cannabis flower users (3+ times per week) recruited from the community; participants completed multiple ecological momentary assessment (EMA) surveys each day for 14 days. In this exploratory study, we used various machine learning algorithms to build models to predict the amount of cannabis smoked since participants’ last report including forty-three EMA measures of mood, impulsivity, pain, alcohol use, cigarette use, craving, cannabis potency, cannabis use motivation, subjective effects of cannabis, social context, and location in daily life. ResultsOur best-fitting model (Gradient Boosted Trees; 71.15% accuracy, 72.46% precision) found that affects, subjective effects of cannabis, and cannabis use motives were among the best predictors of cannabis use amount in daily life. The social context of being with others, and particularly with a partner or friend, was moderately weighted in the final prediction model, but contextual items reflecting location were not strongly weighted in the final prediction model, the one exception being not at work. ConclusionsMachine learning approaches can help identify additional environmental and psychological phenomena that may be clinically-relevant to cannabis use.

Testing reward processing models of obesity using in-the-moment assessments of subjective enjoyment of food and non-food activities

ObjectiveAlthough altered reward processing is proposed to play a key role in obesity maintenance, the role of food enjoyment and enjoyment of non-food naturally rewarding activities (“non-food enjoyment”) in obesity maintenance remains unknown. This study examined how food and non-food enjoyment were associated with baseline body mass index (BMI) and weight loss (WL) following year-long behavioral WL treatment. MethodsAt baseline, participants (MAge = 51.81; 73.8 % White, N = 279) with overweight/obesity completed a 7-day ecological momentary assessment (EMA) protocol inquiring about pleasure/enjoyment derived from eating and non-food activities over the past few hours. Participants also completed retrospective self-report measures of food/non-food enjoyment. With linear regressions, associations between EMA food/non-food enjoyment and BMI and post-treatment WL were examined. Race was included as a covariate. ResultsEMA and retrospective food/non-food enjoyment measures had modest concordance, providing preliminary psychometric support for the EMA measures. Partially consistent with hypotheses, greater EMA food enjoyment was associated with lower BMI (B = −1.03, p = .01) and with greater WL, though the latter association was not statistically significant (B = 1.15, p = .07). Exploratory analyses suggested that race was associated with food enjoyment (non-White participants had greater food enjoyment than White participants, d = 0.81, p = .005), and that race may have affected associations between food enjoyment and weight outcomes. Associations between non-food enjoyment and weight outcomes were small and nonsignificant (ps > .93). ConclusionsResults suggest enjoyment from food, but not from non-food domains, is associated with weight outcomes.

Daily Functional Activities in Context After Stroke: A Large-Scale Ecological Momentary Assessment (EMA) Study

<h3>Research Objectives</h3> To describe where, with whom, and how time was spent daily, to characterize these daily activity patterns as a function of employment, mobility device use, and cognitive functioning, and to validate EMA methods of daily activities and symptoms in people with stroke. <h3>Design</h3> Longitudinal observational study using EMA to assess real-time daily functional activities in natural contexts. <h3>Setting</h3> Home and community. <h3>Participants</h3> 212 participants with mild-to-moderate chronic stroke (55% males, 90% ischemic stroke; median age = 60 years). <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Participants responded to a smartphone app five times daily for two weeks. The app queried activities, environmental contexts, and concurrent post-stroke symptoms. Participants also completed standardized assessments of daily activities and symptoms during lab visits. <h3>Results</h3> Participants spent the most time at home. They participated most in passive, unproductive activities (27%) but least in physical activities (4%). Unemployed individuals reported fewer vocational activities but more activities of daily living (ADL) and passive activities than employed counterparts. Mobility device users and those with cognitive problems spent less time on vocational activities and more on ADL than non-users and those without cognitive problems. Our data showed small-to-moderate correlations of EMA with in-lab measures of daily functioning (r=-0.30 to 0.35, p-value < 0.05) and large correlations between EMA and in-lab measures of symptoms (r= -0.64 to 0.79, p-value < 0.0001). <h3>Conclusions</h3> EMA can provide context-dependent information of daily functional activities in people after stroke. Clinicians may consider using EMA to examine post-stroke functional recovery and monitor patients for home- and community-based programs. <h3>Author(s) Disclosures</h3> None disclosed.

Reduced Real-life Affective Well-being and Amygdala Habituation in Unmedicated Community Individuals at Risk for Depression and Anxiety

Early identification of risk for depression and anxiety disorders is important for prevention, but real-life affective well-being and its biological underpinnings in the population remain understudied. Here, we combined methods from epidemiology, psychology, ecological momentary assessment, and functional magnetic resonance imaging to study real-life and neural affective functions in individuals with subclinical anxiety and depression from a population-based cohort of young adults. We examined psychological measures, real-life affective valence, functional magnetic resonance imaging amygdala habituation to negative affective stimuli, and the relevance of neural readouts for daily-life affective function in 132 non-help-seeking community individuals. We compared psychological and ecological momentary assessment measures of 61 unmedicated individuals at clinical risk for depression and anxiety (operationalized as subthreshold depression and anxiety symptoms or a former mood or anxiety disorder) with those of 48 nonrisk individuals and 23 persons with a mood or anxiety disorder. We studied risk-associated functional magnetic resonance imaging signals in subsamples with balanced sociodemographic and image quality parameters (26 nonrisk, 26 at-risk persons). Compared with nonrisk persons, at-risk individuals showed significantly decreased real-life affective valence (p= .038), reduced amygdala habituation (familywise error-corrected p= .024, region of interest corrected), and an intermediate psychological risk profile. Amygdala habituation predicted real-life affective valence in control subjects but not in participants at risk (familywise error-corrected p= .005, region of interest corrected). Our data suggest real-life and neural markers for affective alterations in unmedicated community individuals at risk for depression and anxiety and highlight the significance of amygdala habituation measures for the momentary affective experience in real-world environments.

The feasibility and acceptability of using smartphones to assess suicide risk among Spanish-speaking adult outpatients.

Hispanic/Latino adults, particularly Spanish speakers, are underserved in mental healthcare, and little is known about the day-to-day variation in their suicide risk. Smartphones have the potential to overcome geographical and linguistic barriers to mental health assessment and intervention. The purpose of the current study was to examine (a) the feasibility/acceptability of smartphone-based ecological momentary assessment (EMA) to assess suicide ideation and suicide risk factors among high-risk Spanish-speaking adults and (b) the degree of within-person variation of suicide ideation and suicide risk in this population. Sixteen primary Spanish-speaking psychiatry outpatients completed EMA measures of suicide ideation and suicide risk factors four times a day for 14 days. A majority of participants consented to active and passive remote assessments and reported the acceptability of study procedures. Adherence to EMA was high and not associated with symptom severity. EMA instances completed were not associated with symptom severity at follow-up. Average point-to-point variability in suicide ideation and risk factors were moderate to high, respectively. EMA captured more dramatic changes than standard baseline and follow-up assessments. Results provide preliminary support for the feasibility and acceptability of using smartphones to assess suicide risk in a real-time and real-world setting among high-risk Spanish-speaking adults.

Neural indices of performance monitoring are associated with daily emotional functioning in youth with anxiety disorders: An ERP and EMA study

Excessive monitoring of one's performance is a characteristic of anxiety disorders that has been linked to alterations in implicit emotion regulation (ER), including elevations in neural measures of performance monitoring (i.e., error- and correct-related negativity; ERN and CRN). Elevations in ERN and CRN amplitudes have been reported consistently in anxiety disorders, suggesting that an overactive performance monitoring system is linked to ER difficulties in anxiety. Yet, the relevance of these lab-based neural measures for day-to-day emotional functioning remains poorly understood. This study examined the degree to which ERN and CRN amplitudes are associated with measures of daily ER difficulties in youth with anxiety disorders. Youth (N = 100, Mage = 11.14, SDage = 1.46) completed a computerized flanker task assessing the ERN and CRN. They then completed a 5-day ecological momentary assessment (EMA) protocol assessing their daily ER (i.e., intensity of momentary and peak negative affect, intensity of worry, reliance on maladaptive ER strategies). Results showed that more negative mean CRN amplitudes were associated with higher levels of negative emotional reactivity and more intense worries. There were no significant associations between ERN amplitude and EMA measures. Furthermore, elevations in CRN were linked to more frequent use of maladaptive ER strategies (i.e., rumination, physiological reactivity, avoidance). Together, results indicate that among youth with anxiety, individual differences in CRN, but not ERN, amplitudes are related to daily ER difficulties. Findings highlight the clinical utility of a lab-based neural measure of ER, suggesting that the CRN, rather than the ERN, reflects individual ER differences in the context of daily life among youth with pediatric anxiety disorders. As such, the CRN might serve as an important dimensional index of a treatment target that can be tracked with a validated, multi-method measure.

Temporal relationships of ecological momentary mood and actigraphy-based sleep measures in bipolar disorder

Sleep disturbances are a key feature of bipolar disorder (BD), and poor sleep has been linked to mood symptoms. Recent use of ecological momentary assessment (EMA) has allowed for nuanced exploration of the sleep-mood link; though, the scale and directionality of this relationship is still unclear. Using EMA, actigraphy, and self-reported sleep measures, this study examines the concurrent and predictive relationships between sleep and mood. Participants with BD (n = 56) wore actigraphy devices for up to 14 days and completed validated scales and daily EMA surveys about mood and sleep quality. Linear mixed models were used to examine overall and time-lagged relationships between sleep and mood variables. EMA mood ratings were correlated with validated rating scales for depression, mania, anxiety, and impulsivity. Poor self-reported sleep quality was associated with worse overall ratings of sadness and anger. Worse self-reported sleep quality was associated with greater sadness the following day. Higher daytime impulsivity was associated with worse sleep quality the following night. Exploratory analyses found relationships between worse and more variable mood (sadness, anger, and impulsivity) with worse and more variable sleep that evening (efficiency, WASO, and sleep onset time). The sample size was modest, fairly homogenous, and included mainly euthymic persons with BD. EMA-based assessments of mood and sleep are correlated with validated scale scores and provide novel insight into intra-individual variability. Further work on the complex two-way interactions between sleep and mood is needed to better understand how to improve outcomes in BD.

Ecological Momentary Assessment of Real-World Functional Behaviors in Individuals With Stroke: A Longitudinal Observational Study

ObjectiveTo validate and characterize real-world functional behaviors in individuals after stroke. DesignLongitudinal observational study using ecological momentary assessment (EMA) as a real-time assessment of functional behaviors in natural contexts. Wilcoxon rank-sum tests, Fisher exact tests, and Spearman correlations were used to analyze data. SettingCommunity. ParticipantsIndividuals with mild to moderate stroke (N=212). InterventionsNot applicable. Main Outcome MeasuresIndividuals were assessed 5 times daily for 14 days with EMA surveys to determine what, with whom, and where individuals were doing activities and appraise mental, somatic, and cognitive symptoms. Individuals also completed standardized assessments during laboratory visits, including Lawton Instrumental Activities of Daily Living Scale, Activity Card Sort, Patient-Reported Outcome Measurement Information System, and Quality of Life in Neurological Disorders. ResultsMost individuals (median age, 60 years; 55% male) were ischemic stroke (90%) and had mild stroke severity (median National Institutes of Health Stroke Scale, 2). A total of 14,140 EMA surveys were analyzed. Individuals were home 78% of the time; primarily participated in passive, unproductive activities (27%), especially watching television and resting; and participated least in physical activities (4%). EMA was sensitive to indicators of poststroke disability; unemployed individuals reported fewer vocational activities but more activities of daily living (ADL) and passive activities than employed counterparts. Users of mobility devices and individuals with cognitive problems spent significantly less time on vocational activities and more on ADL than nonusers and those without cognitive problems. Our data supported the validity of EMA methods in stroke, with small to moderate correlations of EMA with in-laboratory measures of daily functioning (r=−0.30 to 0.35, P<.05) and very large correlations between EMA and in-laboratory measures of symptoms, especially those measuring same constructs (r=−0.64 to 0.79, P<.0001). ConclusionsOur findings reveal that EMA tracked poststroke functioning precisely. EMA may be beneficial in examining poststroke functional recovery, in monitoring patients for home-based interventions, and for longitudinal research.

Chronic Fatigue After Subarachnoid Hemorrhage Is Not Stable: Evidence From An Ecological Momentary Assessment Study

<h3>Research Objectives</h3> To study daily variability in fatigue after subarachnoid hemorrhage (SAH) using the ecological momentary assessment (EMA) method. <h3>Design</h3> Observational study with repeated-measures of fatigue during 7 consecutive days using EMA. <h3>Setting</h3> General community. <h3>Participants</h3> Patients (n=42) with SAH who suffer from chronic fatigue, recruited by their treating physician. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Momentary fatigue on a 1 to 7 scale, assessed 10-12 times per day for 7 consecutive days using the EMA method and average fatigue on a 1 to 7 scale assessed with the Fatigue Severity Scale (FSS). <h3>Results</h3> Mean age of the group was 53.9 years (SD=13.0), 43% male, and mean time post SAH onset was 9.3 months (SD=3.2). All patients completed in total 2872 momentary fatigue questions. Mean momentary fatigue over all days was 3.22 (SD=1.47) and mean FSS score was 5.02 (SD=1.18). Total variance in fatigue (2.21) was explained for 52.3% by between-person variance and for 47.7% by within-person variance. Multilevel analyses revealed that fatigue varied significantly (p<0.001) within the day. Moreover, diurnal patterns of fatigue differed between and within individuals. <h3>Conclusions</h3> Fatigue is often assessed retrospectively with a questionnaire (e.g. FSS), in which daily variability in fatigue is not reflected. This study shows that fatigue after SAH is not stable: momentary fatigue varies over the day and is lower than retrospectively assessed fatigue. In addition, individuals show different momentary fatigue patterns between days. These results imply that fatigue is an ambiguous construct; retrospectively assessed fatigue might not capture all the aspects of fatigue as experienced by patients after SAH. Therefore it should be considered to also take into account EMA measures in the assessment of fatigue, this might provide valuable input to optimize personalized interventions to treat fatigue after SAH. <h3>Author(s) Disclosures</h3> The authors have no conflicts of interest to disclose.

A multi-study approach to refining ecological momentary assessment measures for use among midlife women with elevated risk for cardiovascular disease.

Ample evidence indicates that everyday perceptions of the social environment can affect health behaviors; these include social comparisons (i.e., self-evaluations compared to others) and positive versus negative social interactions. However, relations between social perceptions and healthy behaviors have received little attention among specific medical populations for whom an improved understanding of behavioral determinants could inform updates to tailored interventions. Research methods that capture and differentiate between stable, person-level differences and dynamic, within-person variability in these relations would be particularly useful, both for identifying their nature in daily life and informing improvements to tailored interventions. We conducted a series of three formative research studies to adapt and test the measures and instructions for an ecological momentary assessment (EMA) protocol with midlife women who had elevated risk for cardiovascular disease (CVD; e.g., current diagnosis of hypertension, type 2 diabetes). Study 1 involved a pilot test of initial EMA items, sent to participants' smartphones 5 times per day for 7 days (N=13; MAge =47, MBMI =33.7 kg/m2), as well as brief exit interviews to identify points of confusion and suggestions for improvement. Study 2 used 1-hour, individual qualitative interviews with a new sample to elicit women's perceptions of revised items and identify additional opportunities for refinement (N=10, MAge =52, MBMI =29.8 kg/m2). In Study 3, a new sample of participants completed 7 days of EMA with revised items and instructions (5 times per day; N=13, MAge =50, MBMI =33.4 kg/m2). Item performance in Study 3, including the frequencies of reporting social comparisons and interactions, was compared to that in Study 1 using multilevel modeling; these tests showed meaningful improvement in reporting patterns between Studies 1 and 3 (e.g., changes of d=0.33-0.75 where appropriate). Together, findings from this series of studies demonstrate the utility of a multi-study approach to refining EMA methods for use with midlife women who have elevated CVD risk, which may generalize to other populations of interest.

A-111 Ecological Momentary Assessment of Mood after Moderate to Severe Traumatic Brain Injury

Abstract Objective In persons with moderate–severe traumatic brain injury (msTBI), we compared traditional measures of mood with dynamic measures of affect derived from ecological momentary assessment (EMA), for the purpose of validating the EMA indices and exploring their unique contributions to emotional assessment. Method 23 community-dwelling participants with chronic msTBI were enrolled in a treatment trial for anxiety and/ or depression. At baseline, participants completed the Brief Symptom Inventory-18 Depression and Anxiety subscales (BSI-D, BSI-A) and the Environmental Reward Observation Scale (EROS), a measure of everyday pleasure and reward. EMA data, including the Positive and Negative Affect Scale (PANAS), were collected via smartphone 5 times daily for 7–14 days prior to treatment (M = 8.65; SD = 1.87). Spearman correlations tested associations between baseline BSI-D, BSI-A, and EROS scores with both overall means and temporal variability measures for positive and negative affect (PA, NA). Results Mean PA was significantly correlated with BSI-D (rho −0.60, p &amp;lt; 0.05) and EROS (rho 0.72, p &amp;lt; 0.01). Mean NA and affect variability measures were uncorrelated with baseline scores. NA mean and variability were intercorrelated (rho 0.87, p &amp;lt; 0.001), but this was not the case for PA. Conclusion EMA measures of averaged positive affect showed robust relationships with retrospective measures of depression and environmental reward, providing support for the validity of EMA measures of PA, and for use of the EROS in msTBI. While negative findings must be interpreted with caution, the lack of association of affective variability with retrospective measures suggest a unique role for EMA in examining temporal dynamics of affect.

Does Assessment Alter Responses? An Examination of Measurement Reactivity in an Ecological Momentary Assessment of Body Comparisons

Introduction: Body comparisons have been implicated in body dissatisfaction and eating disorder development. Ecological momentary assessment (EMA) has been used to capture body comparisons in everyday life; however, the potential for measurement reactivity this approach has on EMA responses has yet to be examined. The present study systematically evaluated measurement reactivity in EMA of body comparisons. Methods: Undergraduate women (N = 75) completed four surveys daily for 11 days; Days 1–4 did not include comparison assessments and Days 5–11 did. Changes were examined in related EMA measures between these time periods and individual difference measures pre- and post-EMA. Results: A within-person MANOVA showed no significant change in the individual difference measures. Multilevel analyses revealed that participants reported fewer comparisons as day of study increased. When they completed EMA with versus without comparison items, they reported fewer occasions of loss of control while eating and less pleasant social company at time of assessment. Discussion: Findings suggest limited concern for reactivity in this approach, though researchers examining body comparisons, loss of control eating, and perceptions of social company should be cautious when interpreting their findings and consider examining reactivity directly. Future research on body comparisons should also consider using run-in periods to improve data quality.

Ecological Momentary Assessment of the Relationship between Positive Outcome Expectancies and Gambling Behaviour.

Relapse prevention models suggest that positive outcome expectancies can constitute situational determinants of relapse episodes that interact with other factors to determine the likelihood of relapse. The primary aims were to examine reciprocal relationships between situational positive gambling outcome expectancies and gambling behaviour and moderators of these relationships. An online survey and a 28 day Ecological Momentary Assessment (EMA) were administered to 109 past-month gamblers (84% with gambling problems). EMA measures included outcome expectancies (enjoyment/arousal, self-enhancement, money), self-efficacy, craving, negative emotional state, interpersonal conflict, social pressure, positive emotional state, financial pressures, and gambling behaviour (episodes, expenditure). Pre-EMA measures included problem gambling severity, motives, psychological distress, coping strategies, and outcome expectancies. No reciprocal relationships between EMA outcome expectancies and gambling behaviour (episodes, expenditure) were identified. Moderations predicting gambling episodes revealed: (1) cravings and problem gambling exacerbated effects of enjoyment/arousal expectancies; (2) positive emotional state and positive reframing coping exacerbated effects of self-enhancement expectancies; and (3) instrumental social support buffered effects of money expectancies. Positive outcome expectancies therefore constitute situational determinants of gambling behaviour, but only when they interact with other factors. All pre-EMA expectancies predicted problem gambling severity (OR = 1.61–3.25). Real-time interventions addressing gambling outcome expectancies tailored to vulnerable gamblers are required.

Moderating Role of Thin-ideal Internalization in the Relationship between Negative Affect and Eating: An Ecological Momentary Assessment Study

Eating has been regarded as a regulatory behavior in coping with negative affect. However, individual differences in the relationship between negative affect and eating behavior remain relatively unexplored. This study aims to investigate this association while examining the role of potential moderators, namely thin-ideal internalization and impulse control difficulties using ecological momentary assessment (EMA) methodology. Female participants (N=72) aged 18 to 29 years completed a 7-day EMA protocol and questionnaires. Daily EMA measures included negative affect (NA) and caloric intake. Hierarchical linear modeling was applied to analyze the data. NA did not significantly predict caloric intake at the within-person level. However, the non-significant association between NA and caloric intake was negatively moderated by thin-ideal internalization on the between-person level. The moderating role of impulse control difficulties was not significant. These findings extend prior research on risk factors of emotional undereating and they highlight the importance of further research. The limitations of this study and suggestions for future research have been discussed.

Horizontal Collectivism Moderates the Relationship Between in-the-Moment Social Connections and Well-Being Among Latino/a College Students

Sleep problems and poorer well-being may be particularly salient for Latino/a college students as they tend to experience sociocultural adjustments during this transitory time. Social connections, a correlate of health, change moment-to-moment for college students and may be experienced differently for people who more strongly endorse horizontal collectivist cultural values. We used ecological momentary assessment (EMA) to examine how in-the-moment social connections influence in-the-moment health, and how horizontal collectivism moderates the moment-to-moment associations. Self-identified Latino/a college students (n = 221) completed a demographic information and cultural values questionnaire and then responded to EMA measures on their social connections, affective and subjective well-being, and sleep for 14 consecutive days. Better in-the-moment social connections associated with better health. Horizontal collectivism moderated some, but not all associations between social connections and health. Social connections are multidimensional and differently predict in-the-moment health among Latino/a college students who more strongly endorse horizontal collectivistic values. We discuss implications for identifying vulnerable well-being moments among this understudied population.

Predicting Non-Suicidal Self-Injury in Young Adults with and without Borderline Personality Disorder: a Multilevel Approach Combining Ecological Momentary Assessment and Self-Report Measures.

Non-suicidal self-injury (NSSI) is an increasingly prevalent phenomenon associated with many detrimental outcomes, ranging from poor academic performance to suicide attempts. Research on self-harming behaviors has identified emotion dysregulation, negative affect, and borderline pathology as strong risk factors of NSSI, whereas the potential protective effects of metacognitive skills such as decentering have not yet been explored. The current study combined ecological momentary assessment (EMA) and self-report measures to explore potential risk and protective factors of NSSI in a clinical group of Borderline Personality Disorder (BPD) patients with NSSI (N = 22), a subclinical group of college students with NSSI (N = 19), and a non-clinical healthy control group (N = 23). Participants completed self-report measures of borderline pathology, emotion dysregulation, decentering ability, and negative emotional symptoms, and they used the Sinjur App (EMA instrument) at least three times a day for 15days to capture negative affect and NSSI in daily life. A multilevel mixed-effect regression analysis with both self-report and EMA measures was conducted to identify predictors of NSSI. The multilevel analysis showed that only momentary frustration directly predicted NSSI. Momentary guilt and anger only predicted NSSI when interacting with more stable traits of borderline pathology and negative emotional symptoms. Most importantly, greater decentering capacity protected against self-injury and attenuated the association between momentary sadness and NSSI. Findings contribute novel knowledge about NSSI, documenting the protective effects of decentering and highlighting the benefit of interventions that target metacognitive emotion regulation skills.