Ecological Momentary Assessment Research Articles

Leveraging Ecological Momentary Assessment Data to Characterize Individual Mobility: Exploratory Pilot Study in Rural Uganda.

The geographical environments within which individuals conduct their daily activities may influence health behaviors, yet little is known about individual-level geographic mobility and specific, linked behaviors in rural low- and middle-income settings. Nested in a 3-month ecological momentary assessment intervention pilot trial, this study aims to leverage mobile health app user GPS data to examine activity space through individual spatial mobility and locations of reported health behaviors in relation to their homes. Pilot trial participants were recruited from the Rakai Community Cohort Study-an ongoing population-based cohort study in rural south-central Uganda. Participants used a smartphone app that logged their GPS coordinates every 1-2 hours for approximately 90 days. They also reported specific health behaviors (alcohol use, cigarette smoking, and having condomless sex with a non-long-term partner) via the app that were both location and time stamped. In this substudy, we characterized participant mobility using 3 measures: average distance (kilometers) traveled per week, number of unique locations visited (deduplicated points within 25 m of one another), and the percentage of GPS points recorded away from home. The latter measure was calculated using home buffer regions of 100 m, 400 m, and 800 m. We also evaluated the number of unique locations visited for each specific health behavior, and whether those locations were within or outside the home buffer regions. Sociodemographic information, mobility measures, and locations of health behaviors were summarized across the sample using descriptive statistics. Of the 46 participants with complete GPS data, 24 (52%) participants were men, 30 (65%) participants were younger than 35 years, and 33 (72%) participants were in the top 2 socioeconomic status quartiles. On median, participants traveled 303 (IQR 152-585) km per week. Over the study period, participants on median recorded 1292 (IQR 963-2137) GPS points-76% (IQR 58%-86%) of which were outside their 400-m home buffer regions. Of the participants reporting drinking alcohol, cigarette smoking, and engaging in condomless sex, respectively, 19 (83%), 8 (89%), and 12 (86%) reported that behavior at least once outside their 400-m home neighborhood and across a median of 3.0 (IQR 1.5-5.5), 3.0 (IQR 1.0-3.0), and 3.5 (IQR 1.0-7.0) unique locations, respectively. Among residents in rural Uganda, an ecological momentary assessment app successfully captured high mobility and health-related behaviors across multiple locations. Our findings suggest that future mobile health interventions in similar settings can benefit from integrating spatial data collection using the GPS technology in mobile phones. Leveraging such individual-level GPS data can inform place-based strategies within these interventions for promoting healthy behavior change.

Daily-Level Associations between Situational Familiarity with Location and People and Use of Alcohol-related Protective Behavioral Strategy Among Adolescents and Young Adults.

Despite protective behavioral strategies (PBS) being an important part of alcohol prevention programs, utilization of PBS is sub-optimal, and research is needed to determine factors associated with use and non-use of PBS. The present study examined daily-level associations between situational familiarity (i.e., familiarity with locations and people) and the use of alcohol-related PBS among adolescents and young adults. Participants (analysis N = 564, 55.1% females, 45.2% White, Non-Hispanic, ages 15 to 25, mean = 21.07 years [SD = 2.79]) were part of a longitudinal ecological momentary assessment burst study on cognitions and alcohol use. Mixed effects Poisson models were used to analyze data for engagement in PBS (i.e., serious harm reduction, stopping/limiting, and manner of drinking PBS). Within-person results indicated when participants had elevated (i.e., higher than their own average) familiarity with their location, they were less likely to use serious harm reduction PBS (Rate ratio [RR] = 0.94, p < 0.001) and stopping/limiting PBS (RR = 0.95, p < 0.001). Results showed that on drinking days with elevated familiarity with people, individuals were more likely to use serious harm reduction PBS (RR = 1.03, p = 0.01). There were no significant daily-level associations between familiarity with people or location and manner of drinking PBS. The study suggests PBS use, particularly for serious harm reduction and stopping/limiting strategies, varies among adolescents and young adults based on familiarity with location and people. Alcohol prevention interventions, including just-in-time interventions, should consider how to promote PBS use particularly in familiar locations and with less familiar people.

Effectiveness of the HEAR-Aware App for Adults Not Ready for Hearing Aids, but Open to Self-Management Support: Results of a Randomized Controlled Trial.

Recently, the HEAR-aware app was developed to support adults who are eligible for hearing aids (HAs) but not yet ready to use them. The app serves as a self-management tool, offering assistance for a range of target behaviors (TBs), such as communication strategies and emotional coping. Using ecological momentary assessment and intervention, the app prompts users to complete brief surveys regarding challenging listening situations they encounter in their daily lives (ecological momentary assessment). In response, users receive educational content in the form of "snippets" (videos, texts, web links) on the TBs, some of which are customized based on the reported acoustic environmental characteristics (ecological momentary intervention). The primary objective of this study was to assess the effectiveness of the HEAR-aware app in enhancing readiness to take action on various TBs and evaluate its impact on secondary outcomes. The secondary objective was to examine the app's usability, usefulness, and user satisfaction. A randomized controlled trial design with two arms was used. Participants with hearing loss aged 50 years and over were recruited via an HA retailer and randomly assigned to the intervention group (n = 42, mean age = 65 years [SD = 9.1]) or the control group (n = 45, mean age = 68 years [SD 8.7]). The intervention group used the app during 4 weeks. The control group received no intervention. All participants completed online questionnaires at baseline (T0), after 4 weeks (T1), and again 4 weeks later (T2). Participants' readiness to take action on five TBs was measured with The Line Composite. A list of secondary outcomes was used. Intention-to-treat analyses were performed using Linear Mixed effect Models including group (intervention/control), time (T0/T1/T2), and Group × Time Interactions. In addition, a per protocol analysis was carried out to explore whether effects depended on app usage. For the secondary aim the System Usability Scale (SUS), the Intrinsic Motivation Inventory, item 4 of the International Outcome Inventory-Alternative Intervention (IOI-AI), and a recommendation item were used (intervention group only at T1). For objective 1, there was no significant group difference for The Line Composite over the course of T0, T1, and T2. However, a significant (p = 0.033) Group × Time Interaction was found for The Line Emotional coping, with higher increase in readiness to take action on emotional coping in the intervention group than in the control group. The intention-to-treat analyses revealed no other significant group differences, but the per protocol analyses showed that participants in the intervention group were significantly more ready to take up Assistive Listening Devices (The Line Assistive Listening Devices) and less ready to take up HAs (Staging Algorithm HAs) than the control group (p = 0.049). Results for objective 2 showed that on average, participants rated the app as moderately useful (mean Intrinsic Motivation Inventory score 5 out of 7) and its usability as "marginal" (mean SUS score 68 out of 100) with about half of the participants rating the app as "good" (SUS score >70) and a minority rating is as "unacceptable" (SUS score ≤50). This study underscores the potential of self-management support tools like the HEAR-aware app in the rehabilitation of adults with hearing loss who are not yet ready for HAs. The range in usability scores suggest that it may not be a suitable intervention for everyone.

Network Analysis of Ecological Momentary Assessment Exploring the Role of Online and Offline Social Comparisons in the Mood and Wellbeing of Undergraduate Students

Whilst research suggests online social comparisons may be detrimental to wellbeing, little is known about the underlying temporal dynamics. Here we used Ecological Momentary Assessment to sample 100 undergraduate students’ experiences five times per day for 21 consecutive days, in conjunction with network analysis, to map dynamic interactions between (upward) online and offline social comparisons and multiple indicators of wellbeing. Contemporaneous, temporal, and between-subjects networks were estimated. Whilst online comparisons predicted lower self-esteem in the contemporaneous network, online comparisons predicted subsequent increases in positive, and decreases in negative, affect. In contrast, associations between offline social comparisons and poorer wellbeing were seen in all networks, and for multiple indices of wellbeing. Consistent with a two-step model of social comparisons, the findings suggest the effects of online comparisons may operate differently at different times-scales, and further, that offline comparisons may be more strongly related to poor wellbeing, with a potential causal association.

Loneliness in daily life: A comparison between youths with autism spectrum disorders and 22q11.2 deletion syndrome (22q11DS).

Loneliness is a negative emotional experience that can stem from a gap between desires and the reality of social relationships. It is also a predictor of mental health. Loneliness is therefore important to investigate in neurodevelopmental populations known for having difficulties in the social sphere. This co-registered study involved 48 youths with autism spectrum disorders (ASD), 54 youths with 22q11.2 deletion syndrome (22q11DS) and 65 typically developing youths (TD) aged 12-30. State loneliness was assessed with an ecological momentary assessment. Paper-pencil questionnaires assessing attitude toward aloneness, trait loneliness, and mental health, were completed by the youths and their caregivers. A comparable level of state loneliness between clinical groups and TD were found, with greater loneliness when alone than in a social context. Clinical groups showed a greater intra-individual variability. Both individuals with ASD and 22q11DS revealed a greater affinity toward being alone than TD, but only individuals with ASD reported greater trait loneliness. However, no significant association was found between attitude toward aloneness, trait and state loneliness. Emotional reactivity to loneliness was different between the clinical groups. Self-reported mental health only was associated with loneliness in the clinical groups. These results provide new insights into the understanding of loneliness in these clinical populations and have an impact on clinical care by highlighting the need to remain vigilant when encountering youths who report feeling lonely, and that these youths need to be supported in developing their social network, which appears to be a protective factor against loneliness.

A naturalistic examination of feeling fat: Characteristics, predictors, and the relationship with eating disorder behaviors.

Although literature implicates feeling fat in the maintenance of binge-spectrum eating disorders (EDs; e.g., bulimia nervosa, binge-ED), research in this area is small, nascent, and relies on retrospective self-report. The current study sought to understand the temporal pattern of feeling fat and its role as a precipitant and consequence of ED behaviors. Totally 106 treatment-seeking adults with binge-spectrum EDs completed 7-14-day ecological momentary assessments. They rated feeling fat, negative affect states, and reported on ED behaviors six times per day. Multilevel models evaluated whether feeling fat mediates prospective links between negative affect states and ED behaviors, assessed if negative affect states mediate the prospective association of feeling fat on ED behaviors, and examined the bidirectional prospective association between feeling fat and ED behaviors. Feeling fat was highest in the early morning (6-8:59 a.m.). Individuals with binge-ED-spectrum EDs demonstrated greater variability in feeling fat than those with bulimia nervosa-spectrum EDs who had stable and high levels of feeling fat. Guilt, sadness, anxiety, and the overall NA at Time 2 mediated the prospective associations between at Time 1 feeling fat and Time 3 dietary restraint, actual dietary restriction, and compensatory exercise. There was a bidirectional prospective association between feeling fat and binge eating. Feeling fat serves as a proximal predictor and mediator of the prospective association between guilt and binge eating. Feeling fat and binge eating mutually reinforce each other. Little is understood regarding the experience of feeling fat in natural environments among individuals with binge-spectrum eating disorders. We found that the risk for having the experience of feeling fat is high in the morning and evening. Feeling fat triggers guilt, anxiety, and sadness which in turn, increases engagement in dietary restraint/restriction and compensatory exercise. Feeling fat also triggers binge eating, and binge eating leads to feelings of fatness.

Longitudinal multisite study of the chronobiological control of chronic pain: the CircaHealth CircaPain study protocol

IntroductionOne in five Canadians lives with chronic pain. Evidence shows that some individuals experience pain that fluctuates in intensity following a circadian (24-hour) rhythm. Endogenous molecular rhythms regulate the function...

Evidence for mood instability in patients with bipolar disorder: Applying multilevel hidden Markov modeling to intensive longitudinal ecological momentary assessment data.

Bipolar disorder (BD) is a chronic psychiatric condition characterized by large episodic changes in mood and energy. Recently, BD has been proposed to be conceptualized as chronic cyclical mood instability, as opposed to the traditional view of alternating discrete episodes with stable periods in-between. Recognizing this mood instability may improve care and call for high-frequency measures coupled with advanced statistical models. To uncover empirically derived mood states, a multilevel hidden Markov model (HMM) was applied to 4-month ecological momentary assessment data in 20 patients with BD, yielding ∼9,820 assessments in total. Ecological momentary assessment data comprised self-report questionnaires (5 × daily) measuring manic and depressive constructs. Manic and depressive symptoms were also assessed weekly using the Altman Self-Rating Mania Scale and the Quick Inventory for Depressive Symptomatology Self-Report. Alignment between HMM-uncovered momentary mood states and weekly questionnaires was assessed with a multilevel linear model. HMM uncovered four mood states: neutral, elevated, mixed, and lowered, which aligned with weekly symptom scores. On average, patients remained < 25 hr in one state. In almost half of the patients, mood instability was observed. Switching between mood states, three patterns were identified: patients switching predominantly between (a) neutral and lowered states, (b) neutral and elevated states, and (c) mixed, elevated, and lowered states. In all, elevated and lowered mood states were interspersed by mixed states. The results indicate that chronic mood instability is a key feature of BD, even in "relatively" euthymic periods. This should be considered in theoretical and clinical conceptualizations of the disorder. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Daily diary engagement among caregivers of patients undergoing hematopoietic stem cell transplant.

e23064 Background: Caregivers of allogeneic hematopoietic stem cell transplant (allo-HSCT) recipients bear significant responsibilities involving commitment to be available 24/7 up to at least 100 days post-transplant to provide emotional and physical support to their patients. Caregiving for such an extended duration is associated with reduced quality of life, compromised psychological well-being, and dysregulated metabolic and immunological functioning. Ecological momentary assessment (EMA) may allow a better understanding of the dynamic day-to-day experiences of this unique population. However, no prior research on EMA exists in this population. This study reports on the feasibility of delivering EMAs in the form of a daily diary (DD) and how completion of the DD relates to the patient’s course of treatment and caregiver’s demographics among the caregivers of allo-HSCT caregivers. Results are part of an ongoing 3-arm randomized controlled trial (71% enrolled to date) of those individuals randomized to the usual care condition. Methods: Caregivers (n = 46) received DD prompts for 6 weeks during their patient’s active treatment phase: before transplant (week 1), transplant through discharge (weeks 2 and 3), after discharge (weeks 3 through 6). The DD included six affect items from the Positive and Negative Affect Schedule (stressed, overwhelmed, frustrated, drained, guilty, and hopeful), three state mindfulness items (attention, non-judgement, and decentering), and one item related to caregiver’s self-efficacy in patient care. Results: Among 46 caregivers (mean age = 55.8 [SD = 15.7], 74% female, 32% retired), the overall completion rate (CR = total number of prompts completed/total number of prompts received) was 65.5%, with 72% of participants completing &gt; 50% and 22% of participants completing &gt; 85% of the prompts. For the duration before transplant, the overall CR was 63.2%, with 66.7% of participants completing &gt; 50%, and 33.3% completing &gt; 85% of the prompts. For the duration between transplant through discharge, the overall CR was 65.57%, with 76% of participants completing &gt; 50%, and 26% completing &gt; 85% of the prompts. Similarly, for the duration after discharge, the overall CR was 65.14%, with 66.7% completing &gt; 50%, and 28.9% completing &gt; 85% of the prompts. DD completion was not related to the caregiver’s age, sex, or employment status ( ps &gt; 0.1). Conclusions: The completion rate for the DD was very similar across the patient’s course of treatment, suggesting EMA completion is not excessively burdensome for caregivers potentially experiencing dynamic distress. Furthermore, EMA completion was not associated with age, sex, or employment status, indicating that all caregivers, regardless of demographics, were amenable to completing EMAs. Our findings suggest that delivering EMAs is feasible in this population. Clinical trial information: NCT05078229 .

Spillover from parent stress to family meals among diverse families: An ecological momentary assessment study.

Family meals are beneficial for youth healthy development. However, parents' experiences of daily stressors may hinder their capacity to facilitate family meals, serve healthful foods, and have implications for the family meal atmosphere. Using data from ecological momentary assessment, we examined whether family meals are less likely to occur, meals are less healthful, and meal atmosphere is less positive on days when parents experience higher-than-usual stress and whether coparenting support buffers these associations. We also explored the role of family stressors in these links. Participants were 497 parents (Mage = 35.86 years; 91% female) of 5- to 9-year-old children who identified as Asian (15%), Black (17%), Hispanic (10%), Native American (10%), Native Hawaiian (< 1%), White (38%), multiracial (8%), or other (< 1%). Results from multilevel models indicated that daily deviations in parents' stress levels were not correlated with family meal occurrence, healthfulness, or positive atmosphere. However, on days when the source of parents' stress was family related (e.g., family demands), odds of a positive meal atmosphere were significantly lower (OR = 0.92, 95% CI [0.88, 0.96]), adjusting for other sources of stress. Coparenting relationship quality was positively associated with family meal occurrence (OR = 1.34, 95% CI [1.01, 1.79]) and healthfulness (γ = 0.20, p < .001), however, it did not moderate links between stress and family meal occurrence, healthfulness, or atmosphere. Findings suggest that day-to-day fluctuations in parents' stress levels may not disrupt whether a family meal occurs, the healthfulness of foods served, or the atmosphere of family meals. However, family stressors and coparenting relationship quality merit investigation as potential intervention targets. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Collaboration matters: A randomized controlled trial of patient-clinician collaboration in suicide risk assessment and intervention

BackgroundClinician collaboration can help high-risk individuals to manage their suicidal crises. However, limited research has directly examined how higher patient-clinician collaboration during assessment and intervention can effectively reduce suicidal ideation. This novel randomized clinical trial compared a high vs. low level of patient-clinician collaboration by pairing commonly used assessment (Structured Interview vs. Narrative Assessment) and intervention approaches (Safety Planning Intervention vs. Crisis Response Planning). We hypothesized that the interventions involving higher (than lower) patient-clinician collaboration during assessment (Narrative Assessment) or intervention (Crisis Response Planning) would lead to larger reductions in suicidal ideation. MethodsEighty-two participants with a history of suicide ideation and/or attempts were randomly assigned to one of the four interventions varying in patient-clinician collaboration. After attrition, sixty-six participants completed the study. Suicidal ideation via ecological momentary assessment was measured 14 days before and 14 days after treatment. ResultsAlthough the severity of suicidal ideation decreased in all groups, the two groups that included highly collaborative assessment had larger pre-post reductions in suicidal ideation (Narrative Assessment+Safety Plan; dwithin = 0.26, and Narrative Assessment+Crisis Response Plan; dwithin = 0.19) than the groups that included a checklist-based assessment (Structured Interview). LimitationsLonger follow-up periods with a larger sample would have provided an understanding of the durability of intervention effects. ConclusionResults suggest that the inclusion of higher patient-clinician collaboration techniques during suicide risk assessment can effectively reduce suicidal thoughts. Thus, clinician-led collaborative risk assessment approaches can enhance the effects of safety planning-type interventions among patients with elevated risk for suicide versus checklist-based assessment approaches.

A test of competing mediators linking trouble sleeping to cannabis use in adolescents and emerging adults.

This study examined day-level associations between trouble sleeping and three cannabis-use indices (likelihood/quantity of use and impaired control). We evaluated behavioral and cognitive mediators of the association between trouble sleeping and cannabis outcomes. Youth (N = 86, ages 15-24, 48.8% female, 58.8% White, 18.6% Latine) who regularly used cannabis were recruited for an intervention study. This preregistered secondary data analysis leveraged data from a 1-week ecological momentary assessment (EMA) study completed prior to intervention. Trouble sleeping, cannabis use, and impaired control over use were assessed each morning; negative affect, risk-taking propensity, and cannabis craving were assessed multiple times and aggregated to create a daily average. Multilevel structural equation modeling evaluated hypothesized temporally sequenced associations and putative mechanisms at the day (i.e., within) and person (i.e., between) level. In bivariate analyses at the person level, there were large-effect associations between trouble sleeping and craving and negative affect, and between craving and cannabis-use likelihood and quantity (rs from .34 to .48). In multilevel analyses at the day level, participants were less likely to use cannabis the next day after reporting more trouble sleeping (β = -.65, p < .001). Trouble sleeping was not directly associated with subsequent cannabis-use quantity or impaired control, or indirectly via negative affect, risk-taking propensity, or craving. Trouble sleeping had differential relations with cannabis-use indices at the day and person levels. To promote youth health and reduce cannabis use, future research may consider the unique, person- and situation-driven mechanistic processes at play. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Flexibility or instability? Emotion goal dynamics and mental health.

Emotion goals (i.e., what people want or do not want to feel) have important implications for emotional and mental health because they can shape whether, when, and how people regulate their emotions. Although research has shown that emotion goals vary across individuals and situations, we know relatively little about the dynamic changes in emotion goals in daily life and their potential implications. Given the dynamic features of emotions and emotion regulation, emotion goals may also fluctuate across time and their fluctuations may be critically linked to mental health. This research assessed the everyday dynamics of emotion goals, in particular, variability and inertia, and their associations with mental health. In two studies (N = 56 in Study 1 and N = 173 in Study 2), we included different indices of mental health and used Ecological Momentary Assessments to measure both pleasant and unpleasant emotion goals and experiences at a momentary level in daily life. We found that variability in unpleasant, but not pleasant, emotion goals was linked to better mental health outcomes, even after controlling for the mean levels of emotion goals, and the variability and mean levels of the corresponding emotional experiences. Emotion goal inertia was unrelated to mental health. These findings suggest that emotion goal variability is an important novel factor that may contribute to or reflect mental health. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Empathy is associated with interpersonal emotion regulation goals in everyday life.

Responding to the emotions of the people around us is a phenomenon traversing human lives; however, research has only recently started exploring the predictors of interpersonal emotion regulation (IER). In two ecological momentary assessment studies conducted in 2021 and 2022, we tested whether facets of empathy (i.e., mentalizing, experience sharing, empathic concern, and personal distress) are associated with other-focused IER goals and their attainment in everyday life (Ns = 125 and 204). Study 1 examined associations between mentalizing, experience sharing, and global hedonic and counter-hedonic IER goals (i.e., making others feel better or worse) in a relatively young and predominantly female student sample in Germany. Study 2 expanded these findings to empathic concern, personal distress, and specific types of hedonic and counter-hedonic IER goals (i.e., increasing, decreasing, and/or maintaining others' positive and/or negative emotions) in a more diverse U.S. community sample. Participants primarily endorsed hedonic IER goals, which were associated with higher mentalizing and experience sharing in both studies and higher empathic concern and lower personal distress in Study 2. Counter-hedonic IER goals were positively associated with experience sharing and personal distress in Study 2. Conversely, empathic concern and mentalizing were negatively related to counter-hedonic IER goals. We also found differential associations for state and trait empathy with IER goals. All empathy facets except personal distress were positively associated with goal attainment in Study 2. These findings address a major gap in our knowledge about everyday IER and offer a novel perspective on empathy in social emotion regulation processes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Daily Time-Use Patterns and Quality of Life in Parents: Protocol for a Pilot Quasi-Experimental, Nonrandomized Controlled Trial Using Ecological Momentary Assessment.

The gender gap in time use and its impact on health and well-being are still prevalent. Women work longer hours than men when considering both paid and unpaid (eg, childcare and chores) work, and this gender disparity is particularly visible among parents. Less is known about factors that could potentially mediate or moderate this relationship (eg, work-family conflict and gender role beliefs). Ecological momentary assessment (EMA) allows for the documentation of changes in momentary internal states, such as time use, stress, or mood. It has shown particular validity to measure shorter-term activities (eg, unpaid work) and is thus useful to address gender differences. The feasibility of the daily EMA surveys in a parent sample will be examined. The associations between time use, well-being, and stress will be examined, along with potential moderating and mediating factors such as gender, gender role beliefs, and work-family conflict. Finally, the act of monitoring one's own time use, well-being, and stress will be examined in relation to, for example, the quality of life. We conducted a quasi-experimental, nonrandomized controlled trial with 3 data collection methods, namely, online questionnaires, EMA surveys, and qualitative interviews. The intervention group (n=64) will participate in the online questionnaires and EMA surveys, and a subsample of the intervention group (n=6-17) will also be invited to participate in qualitative interviews. Over a period of 1 week, participants in the intervention group will answer daily EMA surveys (4 times per day). In contrast, the control group (n=17) will only participate in the online questionnaires at baseline and after 1 week. The following constructs were surveyed: sociodemographic background (eg, age, gender, and household composition; baseline questionnaire); mediators and moderators (eg, gender role beliefs and work-family conflict; baseline and follow-up questionnaires); well-being, quality of life, and trait mindfulness (baseline and follow-up questionnaires); momentary activity and well-being, as well as state mindfulness (EMA); and feasibility (baseline and follow-up questionnaires as well as interviews). We anticipate that participants will regard the daily EMA as feasible. Particular daily time-use patterns (eg, high paid and unpaid workload) are expected to be related to lower well-being, higher stress, and health-related quality of life. These associations are expected to be moderated and mediated by factors such as gender, gender role beliefs, work-family conflict, and social support. Participants in the intervention group are expected to show higher values of mindfulness, well-being, health-related quality of life, and lower stress. Patient recruitment started in November 2023 and ended in mid April 2024. Data analysis commenced in mid April 2024. This study aims to provide valuable insights into the feasibility of using EMAs and the potential benefits of activity tracking in various aspects of daily life. Open Science Framework 8qj3d; https://osf.io/8qj3d. PRR1-10.2196/54728.

Characterizing the momentary association between loneliness, depression, and social interactions: Insights from an ecological momentary assessment study

Evidence suggests that loneliness causes people to feel more depressed. It is unknown, however, why this association occurs and whether momentary versus chronic experiences of loneliness are implicated. Theoretical accounts suggest that momentary feelings of loneliness produce two competing motivations: social reaffiliation and social withdrawal. Social affiliation is protective against depression; social withdrawal, in contrast, is a risk factor. Thus, engaging in frequent and high-quality interactions following experiences of loneliness may protect against subsequent depression. We tested this hypothesis using a random-interval experience sampling design (5x/day/day, 14 days; Nobs = 6568) with a racially/ethnically diverse sample of adults with elevated depression symptoms (N = 102). Momentary loneliness was associated with depressed mood at the same time point and ∼2.5h and ∼5h later. Frequency and quality of social interaction did not moderate these associations. Findings suggest that momentary feelings of loneliness may be an important target for clinical intervention.

Be present now, sleep well later: Mindfulness promotes sleep health via emotion regulation.

Despite the popularity of mindfulness in research and interventions, information is missing about how and why mindfulness may benefit employee sleep health. Drawing from emotion regulation theory, we evaluate affective rumination, negative affect, and positive affect as potential mechanisms. We also explore differential effects of trait and state attentional mindfulness on both subjective (e.g., quality and sufficiency) and actigraphy-measured aspects (e.g., duration and wake after sleep onset) of sleep health. Ecological momentary assessment and sleep actigraphy data were collected across two independent samples of health care workers (N1 = 60, N2 = 84). Ecological momentary assessment was also used to collect daily information on state mindfulness, affect, and rumination. Our results support rumination and, to a less consistent extent, negative affect as mediators of the association between mindfulness and sleep health but not positive affect. Trait and state mindfulness demonstrate comparable benefits for employee sleep health, but these benefits largely emerge for subjective sleep dimensions than actigraphy-measured. These findings support emotion regulation as a sound theoretical framework for sleep and mindfulness research and may support more informed workplace mindfulness interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Supplemental Material for Evidence for Mood Instability in Patients With Bipolar Disorder: Applying Multilevel Hidden Markov Modeling to Intensive Longitudinal Ecological Momentary Assessment Data

Supplemental Material for Evidence for Mood Instability in Patients With Bipolar Disorder: Applying Multilevel Hidden Markov Modeling to Intensive Longitudinal Ecological Momentary Assessment Data

Real-world adolescent smartphone use is associated with improvements in mood: An ecological momentary assessment study.

Rates of adolescent mood disorders and adolescent smartphone use have risen in parallel, leading some to suggest that smartphone use might have detrimental effects on adolescents' moods. Alternatively, it is possible that adolescents turn to smartphone use when experiencing negative mood. The purpose of this study was to explore the relationship between adolescent smartphone use and mood using a longitudinal methodology that measured both in real-time. This study used an Ecological Momentary Assessment (EMA) procedure completed by 253 12-17-year old participants from across the United States. Participants received short surveys delivered to their smartphones at random points throughout the day. Measures included real-time, in-situ assessments of smartphone use, current mood, and mood before smartphone use. Based on tests of a multilevel regression model, adolescent moods were positively associated with smartphone use (β = 0.261, F(1,259.49) = 19.120, p < 0.001), and that mood was positively associated with the length of phone use sessions (length of phone use β = 0.100, F(1, 112.88) = 5.616, p = 0.020). Participants also reported significant changes in mood during phone use, such that moods before phone use were significantly lower than moods during phone use (MChange = 0.539, t(2491) = 23.174, p < 0.001). Change in mood (mood before minus mood during phone use) was positively associated with the length of smartphone use sessions (β = 0.097, F(1,122.20) = 4.178, p = 0.043), such that participants who had a higher change in mood were more likely to report a longer length of smartphone use. Findings suggest that adolescent smartphone use is positively associated with mood. This finding may suggest that adolescents use smartphones for mood modification, which aligns with an understanding of smartphone use as potentially addictive behavior.

The Di-Eu-Stress State Scale (DESS Scale)

Abstract: This paper describes the development and empirical validation of an instrument for measuring state distress and eustress, the Di-Eu-Stress State (DESS) Scale. In three studies, factorial validity (Study 1), construct validity (Study 2), predictability, and predictive validity (Study 3) were tested. We used data from 1,250 participants including 819 undergraduates and 431 employees from seven distinct cross-sectional and one ecological momentary assessment (EMA) sample. Study 1: Following exploratory factor analysis, two cross-sectional and one multilevel confirmatory factor analyses supported the resultant two-factor structure of distress and eustress across different contexts and measurement methods as well as against established holistic stress measures. Study 2: Construct validity of the DESS Scale was evaluated with convergent and discriminant measures as well as against established holistic stress measures. Study 3: Multilevel regression models showed the assumed results of demands and resources as antecedents of distress and eustress, respectively, as well as of the prediction of job and study satisfaction by distress and eustress. We discuss the key findings and limitations of each study as well as the practical implications of the DESS Scale in both the field of stress research and the vocational world. Suggestions for further validation of the DESS Scale are proposed.