Ecological Momentary Assessment Period Research Articles

Investigating home-based opioid use among youth with sickle cell disease using ecological momentary assessment.

Opioids are a common and essential treatment for acute sickle cell disease (SCD) pain. However, opioids carry well-known adverse side effects, including potential development of hyperalgesia and nociplastic pain. We characterized opioid use in youth with SCD using ecological momentary assessment (EMA) data, and investigated the relationships between home-based opioid use, pain, and a range of biopsychosocial factors. Eighty-eight youth with SCD (aged 8-17years) completed EMAs assessing home-based opioid use, pain, and related factors. Analyses consisted of descriptive and multilevel logistic regression to predict daily home opioid use. Youth averaged 3.64weeks of EMAs. Approximately 35% of the sample (n=31) took an opioid during the EMA period, and used them on only 24% of reported pain days. Youth who took opioids reported a higher percentage of pain days (t=-2.67, p<.05) and mean pain severity scores (t=-2.30, p<.05) than youth who did not take opioids. Multilevel logistic regression analyses indicated that high daily pain severity (odds ratio [OR]=1.02, p<.01), older age (OR=1.324, p<.01), and low positive affect (OR=0.91, p<.01) were each related to an increased likelihood of opioid use. Youth with SCD take opioids appropriately in response to their pain, based on daily self-report. Beyond daily pain severity, age, and daily variation in positive affect were related to home-based opioid use. This suggests that behavioral interventions that enhance positive affect may promote reduced opioid use among youth with SCD.

Retraction of "Event-level risk for negative alcohol consequences in emerging adults: The role of affect, motivation, and context" by Waddell et al. (2024).

Reports the retraction of "Event-level risk for negative alcohol consequences in emerging adults: The role of affect, motivation, and context" by Jack T. Waddell, Scott E. King, Sarah A. Okey and William R. Corbin (Psychology of Addictive Behaviors, 2024[Feb], Vol 38[1], 8-18). This article is being retracted at the request of the publisher, and the editor and all authors of the original article consented. This article was published in error, as it is a first stage Registered Report that has received in-principle acceptance. Given the workflow of a Registered Report, the first journal publication appears after data collection and results have been reported in the second stage Registered Report submission (see workflow at https://www.cos.io/initiatives/registered-reports). This stage one article is being removed from the literature to avoid confusion and will instead be preregistered as a Registered Report Protocol Preregistration (https://osf.io/7euzd/). (The following abstract of the original article appeared in record 2022-80654-001.) Objective: Decades of research has found support for the motivational model of alcohol use, such that positive/negative affect are indirectly associated with drinking behavior through drinking motives. However, research on event-level drinking motives is in its nascent stage, and studies have yet to consider how drinking context plays a role in the motivational pathway to both event- and person-level drinking behavior. Therefore, the present study seeks to test whether drinking context mediates the effect of affect and motivation on drinking outcomes at both the event- and person-level. Method: Data for this Stage 1 Registered Report will come from a recently completed ecological momentary assessment (EMA) study in emerging adults. The study collected data on 131 emerging adults, of whom 107 reported event-level social and solitary drinking during the EMA period. Multilevel structural equation modeling will be used to test whether predrinking affect is associated with predrinking motives, and whether drinking context (social vs. solitary drinking) mediates the effect of drinking motives on drinking outcomes. Models will parse within-/between-person variance, allowing the present study to test whether drinking context serves as a mechanism of risk in the motivational model at the event-level, or solely at the between-person level. Findings will inform personalized interventions and motivational models of drinking behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Event-level risk for negative alcohol consequences in emerging adults: The role of affect, motivation, and context.

Decades of research has found support for the motivational model of alcohol use, such that positive/negative affect are indirectly associated with drinking behavior through drinking motives. However, research on event-level drinking motives is in its nascent stage, and studies have yet to consider how drinking context plays a role in the motivational pathway to both event- and person-level drinking behavior. Therefore, the present study seeks to test whether drinking context mediates the effect of affect and motivation on drinking outcomes at both the event- and person-level. Data for this Stage 1 Registered Report will come from a recently completed ecological momentary assessment (EMA) study in emerging adults. The study collected data on 131 emerging adults, of whom 107 reported event-level social and solitary drinking during the EMA period. Multilevel structural equation modeling will be used to test whether predrinking affect is associated with predrinking motives, and whether drinking context (social vs. solitary drinking) mediates the effect of drinking motives on drinking outcomes. Models will parse within-/between-person variance, allowing the present study to test whether drinking context serves as a mechanism of risk in the motivational model at the event-level, or solely at the between-person level. Findings will inform personalized interventions and motivational models of drinking behavior. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Tension and disordered eating behaviors in the daily lives of adolescents and young adults from the general population: Associations and moderating role of trait emotion regulation.

Experiences of tension and difficulties in emotion regulation have been linked to eating pathology in clinical samples and are targeted in respective treatment approaches. The present study aimed to investigate the impact of tension on engagement in disordered eating behaviors (DEBs) and potential moderating effects of trait emotion regulation in young people from the general population. A subsample of 971 adolescents and young adults from an epidemiological cohort study reported on levels of tension and four different DEBs (skipping eating, restrained eating, eating large amounts of food, loss-of-control-eating) via ecological momentary assessment (EMA), as well as on trait emotion regulation via questionnaire. In multilevel models, momentary tension did not predict levels of subsequent DEBs. However, higher average levels of tension across the EMA period predicted higher levels of all DEBs. No interactions with emotion regulation emerged. Individuals experiencing overall higher levels of tension appear to be more prone to engaging in DEBs.

The role of habit in maintaining binge/purge behaviors: An ecological momentary assessment study.

Individuals with eating disorders transdiagnostically engage in binge eating (BE) and/or purging, despite life-threatening consequences. Little is known about factors that contribute to the persistence of these behaviors. This study explored whether habitual control over binge/purge (B/P) spectrum behaviors contributes to symptom persistence and whether negative reinforcement via reductions in negative affect is less influential in maintaining B/P behaviors that are under habitual control and are persistent. Women with BE and/or purging (N = 81) completed self-report measures assessing habit strength of BE and purging. Then, they completed a 14-day ecological momentary assessment (EMA) protocol during which they completed measures of negative affect, BE, and purging multiple times per day. Habitual control over purging was associated with a greater frequency of purging during the EMA period. However, habitual control over BE was not associated with the severity of loss of control eating or the frequency of BE episodes. Habitual control did not moderate temporal relations between negative affect and B/P behaviors during the EMA period. However, exploratory analyses revealed that individuals with a longer duration of BE and greater habitual control over BE showed a less pronounced reduction in negative affect following BE. Overall, these findings suggest that purging may be maintained by habitual stimulus-response learning. In addition, they support the possibility that reduction in negative affect may play a less prominent role in maintaining BE that is habitual and persistent. This study investigated whether habit contributes to the persistence of symptoms in women with binge/purge spectrum behaviors and whether negative reinforcement via reductions in negative affect is less influential in maintaining binge/purge behaviors that are under habitual control. The findings suggest that purging may be maintained through habit. This supports the potential utility of habit reversal interventions to decrease habitual purging.

Social jetlag and trajectories of mood symptoms and reward responsiveness in individuals at low-risk, high-risk, and with bipolar spectrum disorders: An ecological momentary assessment study

A specific type of sleep disruption, social jetlag, involves an incongruence of sleep time between weekends and weekdays. This study investigated relationships between social jetlag and mood symptom lability and trajectories of daily reward responsiveness and mood symptoms. Participants (N = 130) from three groups (moderate reward sensitivity, high reward sensitivity, and high reward sensitivity with a diagnosed bipolar spectrum disorder [BSD]) were recruited from an ongoing longitudinal study based on their self-reported reward sensitivity and a diagnostic interview. For this study, they completed 20 days of ecological momentary assessment (EMA) of reward responsiveness and mood symptoms and a daily sleep diary. Social jetlag was significantly associated with differences in trajectories of depressive symptoms between groups. Specifically, greater social jetlag was associated with a greater increase in depressive symptoms over the 20 days for participants in the high reward sensitivity and BSD groups compared to the moderate reward sensitivity group. Social jetlag also was significantly associated with depressive symptom lability during the EMA period, but this finding was reduced to a trend toward significance when controlling for self-reported sleep duration. The study adds to the literature with methodological strengths including the EMA design and assessment of symptom and reward responsiveness trajectories.

Circadian, Reward, and Emotion Systems in Teens prospective longitudinal study: protocol overview of an integrative reward-circadian rhythm model of first onset of bipolar spectrum disorder in adolescence

BackgroundBipolar spectrum disorders (BSDs) are associated with a heightened sensitivity to rewards and elevated reward-related brain function in cortico-striatal circuitry. A separate literature documents social and circadian rhythm disruption in BSDs. Recently, integrated reward-circadian models of BSDs have been proposed. These models draw on work indicating that the two systems influence each other and interact to affect mood functioning. When dysregulated, reward and circadian system signaling may combine to form a positive feedback loop, whereby dysregulation in one system exacerbates dysregulation in the other. Project CREST (Circadian, Reward, and Emotion Systems in Teens) provides a first systematic test of reward-circadian dysregulation as a synergistic and dynamic vulnerability for first onset of BSD and increases in bipolar symptoms during adolescence.MethodsThis NIMH-funded R01 study is a 3-year prospective, longitudinal investigation of approximately 320 community adolescents from the broader Philadelphia area, United States of America. Eligible participants must be 13–16 years old, fluent in English, and without a prior BSD or hypomanic episode. They are being selected along the entire dimension of self-reported reward responsiveness, with oversampling at the high tail of the dimension in order to increase the likelihood of BSD onsets. At Times 1–6, every 6 months, participants will complete assessments of reward-relevant and social rhythm disruption life events and self-report and diagnostic assessments of bipolar symptoms and episodes. Yearly, at Times 1, 3, and 5, participants also will complete self-report measures of circadian chronotype (morningness-eveningness) and social rhythm regularity, a salivary dim light melatonin onset (DLMO) procedure to assess circadian phase, self-report, behavioral, and neural (fMRI) assessments of monetary and social reward responsiveness, and a 7-day ecological momentary assessment (EMA) period. During each EMA period, participants will complete continuous measures of sleep/wake and activity (actigraphy), a daily sleep diary, and three within-day (morning, afternoon, evening) measures of life events coded for reward-relevance and social rhythm disruption, monetary and social reward responsiveness, positive and negative affect, and hypo/manic and depressive symptoms. The fMRI scan will occur on the day before and the DLMO procedure will occur on the first evening of the 7-day EMA period.DiscussionThis study is an innovative integration of research on multi-organ systems involved in reward and circadian signaling in understanding first onset of BSD in adolescence. It has the potential to facilitate novel pharmacological, neural, and behavioral interventions to treat, and ideally prevent, bipolar conditions.

Agreement between momentary and retrospective reports of cannabis use and alcohol use: Comparison of ecological momentary assessment and timeline followback indices.

This study compares three methods of cannabis and of alcohol use assessment in a sample of regular cannabis users: (a) ecological momentary assessment (EMA) repeated momentary surveys aggregated to the daily level, (b) EMA morning reports (MR) where participants reported on their total use from the previous day, and (c) retrospective timeline followback (TLFB) interviews covering the same period of time as the EMA portion of the study. We assessed the overall correspondence between these methods in terms of cannabis and alcohol use occasions and also investigated predictors of agreement between methods. Forty-nine individuals aged 18-50 (Mage = 24.49, 49% female, 84% White) who reported regular cannabis use completed a 14-day EMA study. At the end of the EMA period, participants returned to the laboratory to complete a TLFB (administered via computer) corresponding to the same dates of the EMA period. Daily aggregated EMA and TLFB reports showed a low to modest agreement for both alcohol and cannabis use. Overall, agreement between EMA and MR was better than agreement between EMA and TLFB, likely because less retrospection is required when only reporting on behavior from the previous day. Quantity and frequency of use differentially predicted agreement across reporting methods when assessing alcohol compared to cannabis. When reporting cannabis use, but not alcohol use, individuals who used more demonstrated higher agreement between EMA and TLFB. Results suggest that retrospective reporting methods assessing alcohol and cannabis should not be considered a direct "substitute" for momentary or daily assessments. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Greater Ecologically Assessed Positive Experiences Predict Heightened Sex Hormone Concentrations Across Two Weeks in Older Adults.

Sex hormones are important components of healthy aging, with beneficial effects on physical and mental health. Positive experiences such as elevated mood, lowered stress, and higher well-being also contribute to health outcomes and, in younger adults, may be associated with elevated sex hormone levels. However, little is known about the association between positive experiences and sex hormones in older adults. In this study, older men and women (N = 224, 70+ years of age) provided blood samples before and after a 2-week period of ecological momentary assessment (EMA) of positive and negative experiences (assessed based on self-reporting items related to affect, stress, and well-being). Concentrations of a panel of steroid sex hormones and glucocorticoids were determined in blood. Higher levels of positive experiences reported in daily life across 2 weeks were associated with increases in free (biologically active) levels of testosterone (B = 0.353 [0.106, 0.601], t(221.3) = 2.801, p = .006), estradiol (B = 0.373 [0.097, 0.649], t(225.1) = 2.645, p = .009), and estrone (B = 0.468 [0.208, 0.727], t(224.3) = 3.535, p < .001) between the start and the end of the 2-week EMA period. These findings suggest that sex hormones may be a pathway linking positive experiences to health in older adults.

The relations between real-time use of emotion regulation strategies and anxiety and depression symptoms.

How individuals differentially implement specific emotion regulation (ER) strategies is a critical indicator of the progression of depressive and anxiety disorders. Symptoms of anxiety and depression may be associated with differences in ER, but little evidence to date had examined whether anxiety and depression were associated with individual differences in the real-time use of ER strategies. This study used ecological momentary assessment (EMA) in two samples (n = 276) of undergraduate students from a single university who were assessed for 8-10 days. Baseline surveys captured participant self-reported anxiety symptoms and depressive symptoms using the PROMIS-Anxiety scale and the PROMIS-Depression scale, respectively. We measured ER through EMA-adapted prompts from the Cognitive Emotion Regulation Questionnaire (CERQ), which participants received on their internet-enabled cell phones. In pre-registered analyses, we tested the associations between anxiety symptoms with the use of discrete ER strategies in EMA using generalized estimating equations with a log-link function to account for nesting of EMA observations within participants, and further tested whether the findings generalized to depression (not pre-registered). Symptoms of anxiety and depression were associated with greater odds of using both maladaptive and adaptive ER strategy use during the EMA period, and with lower odds of reporting no strategy use. Moreover, associations were generally stronger for maladaptive than adaptive ER strategies. Anxiety and depressive symptoms are related to increased regulatory efforts overall, and results suggest that individuals with anxiety and depressive symptoms may be especially prone to use maladaptive ER strategies. Tracking ER strategies in a natural environment can further inform our understanding of how anxious and depressed individuals attempt to regulate emotions.

Estradiol, stress reactivity, and daily affective experiences in trauma-exposed women.

Women experience higher risk for PTSD following trauma compared with men. Fluctuations in ovarian hormones might contribute to this greater vulnerability, given that estradiol is associated with affect and stress reactivity. Our objective was to test the relations between menstrual cycle-related changes in estradiol, affect, stress reactivity, and trauma-related symptoms. We assessed trauma-related symptoms in ethnically diverse naturally cycling women with a history of trauma during a clinical interview. Participants also completed a 10-day ecological momentary assessment (EMA) that included lower- and higher-estradiol phases. We tested associations between estradiol and PTSD symptoms and stress reactivity to a trauma reminder using Spearman correlation and Wilcoxon rank-sum tests. We tested the effect of menstrual cycle day on daily affect using multilevel modeling. Estradiol was negatively associated with symptom severity (rs = -.36), and participants in low- versus high-estradiol cycle phases at interview had higher sympathetic (r = .35) and lower hypothalamic-pituitary-adrenal axis (r = .41) reactivity. Across the EMA period, participants showed a decrease in daily PTSD symptoms (b = -.39), negative (b = -.11) and positive (b = -.24) affect, and variability in daily valence (b = -.07) and arousal (b = -.08), from the low- to high-estradiol phase. Consistent with prior evidence of more aversive affective experiences in low-estradiol states, lower estradiol was associated with higher trauma-related symptoms. In addition, trauma-exposed women showed a discordant pattern of stress reactivity to a trauma reminder, higher daily symptoms, and greater affective lability in a low-estradiol phase. Given that our sample consisted of high-functioning trauma-exposed women, these results should be replicated in women with PTSD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Occasions of Alcohol and Cannabis Use and Associated Risk for Sexual Assault Among College Women With Higher Sexual Risk Alcohol Expectancies

College women report high rates of sexual assault. Research focused on women's risk factors for sexual assault remains necessary to assist women in reducing their risk. Previous work has shown alcohol use and cannabis use to be associated with sexual assault. The current study examined whether individual difference variables moderated women's risk for sexual assault during occasions of alcohol use and cannabis use using ecological momentary assessment (EMA). Participants were 18- to 24-year-old first-year undergraduate women (N = 101) who were unmarried and interested in dating men, consumed three or more alcoholic drinks on one occasion in the month before baseline, and engaged in sexual intercourse at least once. Baseline individual difference variables included sex-related alcohol expectancies, alcohol problems, decision skills, and sexual attitudes. EMA reports, collected three times per day over 42 days, included items regarding alcohol and cannabis use and sexual assault experiences. Among women who experienced sexual assault during the EMA period (n = 40), those with higher sexual risk expectancies had a higher probability of sexual assault during occasions when they were using alcohol or cannabis. Several modifiable risk factors for sexual assault and individual differences factors may exacerbate risk. Ecological momentary interventions may be useful to reduce sexual assault risk for women with high sexual risk expectancies who use alcohol or cannabis.

Occasions of Alcohol and Cannabis Use and Associated Risk for Sexual Assault among College Women with Higher Sexual Risk Alcohol Expectancies.

College women report high rates of sexual assault (SA). Research focused on women's risk factors for SA remains necessary to assist women in reducing their risk. Previous work has shown alcohol and cannabis use to be associated with SA. The current study examined whether individual difference variables moderated women's risk for SA during occasions of alcohol and cannabis use using ecological momentary assessment (EMA). Participants were 18-24-year-old first-year undergraduate women (N=101), who were unmarried and interested in dating men, consumed three or more alcoholic drinks on one occasion in the month before baseline, and engaged in sexual intercourse at least once. Baseline individual difference variables included sex-related alcohol expectancies, alcohol problems, decision skills, and sexual attitudes. EMA reports, collected three times per day over 42 days, included items regarding alcohol and cannabis use and SA experiences. Among women who experienced SA during the EMA period (n=40), those with higher sexual risk expectancies had a higher probability of SA during occasions when they were using alcohol or cannabis. Several modifiable risk factors for SA and individual differences factors may exacerbate risk. Ecological momentary interventions may be useful to reduce SA risk for women with high sexual risk expectancies who use alcohol or cannabis.

Testing if attitudes mediate the association between advertising exposure and adolescent tobacco use

IntroductionA growing body of evidence indicates that exposure to tobacco advertising among adolescents increases the likelihood of subsequent tobacco use. It is important to understand the process by which this occurs, in order to appropriately target factors for intervention. The objective of this study was to test whether attitudes towards tobacco advertising mediates the impact of advertising exposure on tobacco use. MethodsFrom an ongoing prospective cohort study of male adolescents (aged 11–16 at baseline), we recruited a subset of tobacco users and non-users to participate in an additional ecological momentary assessment (EMA) project (N = 164). Adolescents completed smartphone-based surveys 2–3 times/day over a 10-day period with items assessing their exposures and attitudes towards tobacco-related advertising. If participants reported exposure to tobacco advertising, they were asked about their attitudes toward it (how much they enjoyed it, liked it, and found it appealing). ResultsAdolescents who reported a greater amount of advertising exposure during the EMA period were more likely to report past-30-day tobacco use at their next cohort follow-up (6–12 months later). Moreover, the impact of advertising exposure on subsequent use was mediated by attitudes toward the tobacco advertisements, as reported during the EMA. This effect remained after controlling for baseline tobacco use. ConclusionsBy pairing EMA with long-term follow-up, we identified attitudes as a mediator between adolescent advertising exposure and subsequent tobacco use. Interventions to lessen adolescents’ positive attitudes toward tobacco advertisements may help disrupt this impact.

Multi-modal assessment of reward functioning in adolescent anhedonia.

Anhedonia is a core symptom of depression that predicts worse treatment outcomes. Dysfunction in neural reward circuits is thought to contribute to anhedonia. However, whether laboratory-based assessments of anhedonia and reward-related neural function translate to adolescents' subjective affective experiences in real-world contexts remains unclear. We recruited a sample of adolescents (n = 82; ages 12-18; mean = 15.83) who varied in anhedonia and measured the relationships among clinician-rated and self-reported anhedonia, behaviorally assessed reward learning ability, neural response to monetary reward and loss (as assessed with functional magnetic resonance imaging), and repeated ecological momentary assessment (EMA) of positive affect (PA) and negative affect (NA) in daily life. Anhedonia was associated with lower mean PA and higher mean NA across the 5-day EMA period. Anhedonia was not related to impaired behavioral reward learning, but low PA was associated with reduced nucleus accumbens response during reward anticipation and reduced medial prefrontal cortex (mPFC) response during reward outcome. Greater mean NA was associated with increased mPFC response to loss outcome. Traditional laboratory-based measures of anhedonia were associated with lower subjective PA and higher subjective NA in youths' daily lives. Lower subjective PA and higher subjective NA were associated with decreased reward-related striatal functioning. Higher NA was also related to increased mPFC activity to loss. Collectively, these findings demonstrate that laboratory-based measures of anhedonia translate to real-world contexts and that subjective ratings of PA and NA may be associated with neural response to reward and loss.

Using an ecological momentary assessment protocol to understand problem anger in veterans

Background and objectivesProblem anger is highly destructive, and is one of the most commonly reported issues in military and veteran populations. The goal of this study was to use ecological momentary assessment (EMA) to explore and characterize moment-to-moment experiences of problem anger in a sample of Australian veterans. MethodsSixty veterans with problem anger (measured on the Dimensions of Anger Reactions Scale) completed measures of anger and anger rumination, before and after a 10-day EMA period which assessed the frequency, intensity, and expression of momentary anger experiences. ResultsFindings showed that 75% of respondents indicated some level of anger during EMA monitoring. In 25% of cases, anger was reported as severe. Moreover, anger was expressed verbally in 43% of cases, and expressed physically in 27% of cases. While anger fluctuated frequently during the day, more severe anger was more likely to be reported in the late afternoon/early evening. Problem anger symptoms decreased significantly over time, from pre-EMA to post EMA (p < .001). LimitationsThe generalizability of findings is limited to a predominantly male sample, with low levels of risk of harm or violence. The study was also limited in the selection of outcome variables assessed and the lack of a control group; other momentary factors could influence experience of problem anger and provide further explanation of study results. ConclusionsEMA is a valuable assessment tool for individuals with problem anger, and the potential for EMA as an intervention needs to be explored further.

Sex and age moderate the trajectory of guilt among children and adolescents with and without recent suicidal ideation

ABSTRACT We aimed to examine whether the trajectories of ecologically derived guilt differ among a transdiagnostic sample of youth with and without recent suicidal ideation and whether sex and age moderated this association. We assessed guilt 3 times a day over a 2-week period via ecological momentary assessment (EMA) technology in 102 children recruited from the community, outpatient, and inpatient settings. The average age of children was 10.95 y.o. (SD = 2.26, range 8–16) and the majority were male (54.9%) and White (76.5%). We found that the real-world guilt during a two-week EMA period was higher among youth with greater suicidal ideation severity in the past six months. Moreover, there was a significant moderating effect of sex and age on this association, such that the association between suicidal ideation severity and guilt was particularly strong among females compared to males and youth who were 10 years old or older. The findings were maintained when we adjusted for the relevant demographic and clinical characteristics, including age, minority status, parental income, EMA response rate, and current internalising symptoms. These preliminary findings highlight the clinical relevance of assessing and targeting feelings of guilt in the day-to-day lives of youth, particularly for females and older youth.

Multiply marginalized: Linking minority stress due to sexual orientation, gender, and weight to dysregulated eating among sexual minority women of higher body weight.

This study assessed whether baseline levels of distal and proximal minority stressors related to sexual orientation, gender, and weight were associated with prospective risk for dysregulated eating in daily life among sexual minority women with overweight/obesity. Fifty-five sexual minority women ages 18-60 (M = 25 ± 9) with BMI > 25kg/m2 (M = 32 ± 5) completed baseline assessments of distal and proximal minority stressors due to sexual orientation, gender, and weight. Participants then completed an Ecological Momentary Assessment (EMA) protocol. For five days, participants responded to five random prompts assessing engagement in dysregulated eating (i.e., overeating, binge eating). The cumulative number of EMA-measured overeating and binge eating episodes was summed per participant. Several minority stressors related to sexual orientation, gender, and weight were associated with prospective risk for dysregulated eating behaviors during EMA. Women with higher (vs. lower) baseline levels of internalized homophobia reported more cumulative episodes of binge eating during the EMA period. Women reporting greater (vs. less) baseline sexual orientation concealment reported more episodes of overeating during the EMA period. Women with greater (vs. less) baseline weight bias experiences and internalization reported more overeating and binge eating episodes during the EMA period. Findings from this pilot study identify internalized homophobia, sexual orientation concealment, and experienced and internalized weight bias as potential risk factors for dysregulated eating behaviors among sexual minority women of higher body weight.

Predicting college student prescription stimulant misuse: An analysis from ecological momentary assessment.

Prescription stimulant misuse (PSM) is common in young adult college students, at over 10% in the past year, and it is associated with other substance use and risk behaviors. Research focused on the real-time drivers of PSM is absent, impeding prevention and intervention. This research aimed to fill that gap by examining the relationships between affect, global stress, or academic stress and PSM via ecological momentary assessment (EMA); we also investigated baseline predictors of PSM frequency during the 21-day EMA period. Forty-one full-time college students (mean age: 20.5, 66% female) who endorsed current PSM (≥ 6 past-year episodes) participated. Participants were asked to complete EMA questions in response to 3 daily investigator-initiated prompts and after every PSM episode. Assessments were selected based on affect regulation (e.g., positive affect [PA], negative affect [NA]) and drug instrumentalization (e.g., academic stress and/or demands) theories of substance use. Mixed-effects linear models examined EMA data, and negative binomial regression analyses examined baseline predictors of PSM episode frequency. PA was higher on PSM days and increased post-PSM, whereas NA was unrelated to PSM. Although global and academic stress were largely unrelated to PSM, when the motive endorsed for PSM was "to study," pre-PSM ratings of academic demand and stress were significantly higher. Finally, a history of recreational motives (e.g., to get high) or higher levels of attention-deficit/hyperactivity disorder symptoms predicted a greater number of PSM episodes over the EMA period. The results offered mixed support for both affect regulation and instrumentalization as applied to PSM. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Daily Ecological Momentary Assessments of happy and sad moods in people with schizophrenia and bipolar disorders: What do participants who are never sad think about their activities and abilities?

ObjectivesPeople with schizophrenia have challenges in their self-assessments of everyday functioning and those who report no sadness also tend to overestimate their everyday functional abilities. While previous studies were cross-sectional, this study related longitudinal assessments of sadness to self-reports of abilities in domains of everyday functioning and cognitive abilities. Methods71 people with bipolar illness (BPI) were compared to 102 people with schizophrenia (SCZ). Participants were sampled 3 times per day for 30 days with a smartphone-based Ecological Momentary Assessment (EMA) survey. Each survey asked where they were, with whom they were, what they were doing, and if they were sad. Performance based assessments of executive functioning, social competence, and everyday activities were collected after the EMA period, at which time the participants and observers were asked to provide ratings of three different domains of everyday functioning and neurocognitive ability. Results18% of participants with SCZ reported that they were never sad on any one of the 90 EMA surveys. Reports of never being sad were associated with overestimated functioning compared to observers and SCZ participants who reported that they were never sad were more commonly home and alone than both SCZ participants who reported occasional sadness and participants with BPI. These participants reported being significantly happier than all people in the study. ImplicationsReporting that you were never sad was associated with overestimation of everyday functioning and cognitive abilities. Although participants who were never sad did not perform more poorly on objective measures than those were occasionally sad, their self-assessed functioning was significantly elevated. These data suggest that negative symptoms constructs such as reduced emotional experience need to consider reduced ability to subjectively evaluate emotional experience as a feature of negative symptoms.