Ecological Momentary Assessment Research Articles

An ecological momentary cognitive assessment study of over-attribution of threat and suicide risk factors in people with serious mental illness

IntroductionPeople with serious mental illness (SMI; schizophrenia, schizoaffective disorder, bipolar disorder) are at increased risk of suicidal ideation (SI). Over-attribution of social threat, or attributing threatening emotions to neutral faces, may contribute to social isolation through increased social avoidance and decreased social approach motivation. These factors are related to suicide, as well as perceived burdensomeness (PB) and thwarted belongingness (TB). This study examined how over-attribution of threat relates to PB, TB, and social motivations. MethodN = 273 participants with SMI were assessed for current SI and behavior, and were stratified into SI (N = 130) vs. non-SI (N = 143) groups. Participants completed smartphone surveys (via ecological momentary assessments [EMA]) 3×/day for 10 days. They also completed the Mobile Ecological Test of Emotion Recognition (METER) 1×/day. Linear mixed models and multi-level mediation tested the relationships between over-attribution of threat, METER performance, PB/TB, and social motivations. ResultsParticipants with and without SI did not significantly differ in over-attribution of threat or METER performance. In separate models, there was a relationship of over-attribution of threat with increased PB (B = 1.00, SE = 0.21, t = 4.72, p < .001), reduced social approach motivation (B = -0.74, SE = 0.22, t = −3.33, p < .001), and increased social avoidance (B = 0.90, SE = 0.24, t = 3.70, p < .001), all significant when adjusting for facial affect recognition ability. A model examining social motivations as a mediator between over-attribution of threat and PB/TB was not significant. ConclusionThese results suggest that over-attribution of threat relates to interpersonal constructs related to SI irrespective of facial affect abilities. This study may inform understanding of social cognitive processes related to suicide in SMI.

Social Media Use as a Predictor of Positive and Negative Affect: An Ecological Momentary Assessment Study of Adolescents with and without Clinical Depression.

Social media use is common in adolescents, with implications for psychosocial development and the emergence of depression. Yet, little is known about the time-linked connections between social media use and adolescents' affective experiences and how they may differ between depressed and non-depressed youth. We leveraged ecological momentary assessment in adolescents oversampled for current depression to examine (1) associations between social media use and concurrent and later positive and negative affect and (2) sex and presence of a depressive disorder as moderators of these associations. Adolescents aged 14-17 with (n = 48) and without (n = 97) clinical depression, as indicated via clinical interview, reported momentary social media use and positive and negative affect seven times per day for one week. Multilevel modeling indicated that social media use was associated with reduced positive affect both concurrently and at the next assessment. Further, among clinically depressed youth only, social media use was associated with reduced negative affect at the next assessment. Results suggest that social media use may reduce both positive and negative affect, highlighting the nuanced relation between adolescent social media use and emotional health and laying the groundwork for future research to address several open questions.

Mobile Intervention to Address Cannabis Use Disorder Among Black Adults: Protocol for a Randomized Controlled Trial.

African American or Black (hereafter referred to as Black) adults who use cannabis use it more frequently and are more likely to meet criteria for cannabis use disorder (CUD) than both White and Hispanic or Latin individuals. Black adults may be more apt to use cannabis to cope with distress, which constitutes a false safety behavior (FSB; a behavior designed to reduce psychological distress in the short term). Although FSB engagement can perpetuate the cycle of high rates of CUD among Black individuals, limited work has applied an FSB elimination treatment approach to Black adults with CUD, and no previous work has evaluated FSB reduction or elimination in the context of a culturally tailored and highly accessible treatment developed for Black individuals. This study aims to develop and pilot-test a culturally tailored adaptive intervention that integrates FSB reduction or elimination skills for cannabis reduction or cessation among Black adults with probable CUD (Culturally Tailored-Mobile Integrated Cannabis and Anxiety Reduction Treatment [CT-MICART]). Black adults with probable CUD (N=50) will complete a web-based screener, enrollment call, baseline assessment, 3 daily ecological momentary assessments (EMAs) for 6 weeks, and a follow-up self-report assessment and qualitative interview at 6 weeks after randomization. Participants will be randomized into 1 out of the 2 conditions after baseline assessment: (1) CT-MICART+EMAs for 6 weeks or (2) EMAs only for 6 weeks. The enrollment started in June 2023 and ended in November 2023. Data analysis will be completed in March 2024. No culturally tailored, evidence-based treatment currently caters to the specific needs of Black individuals with CUD. This study will lay the foundation for a new approach to CUD treatment among Black adults that is easily accessible and has the potential to overcome barriers to treatment and reduce practitioner burden in order to support Black individuals who use cannabis with probable CUD. ClinicalTrials.gov NCT05566730; https://clinicaltrials.gov/study/NCT05566730. DERR1-10.2196/52776.

Symptomatic and functional recovery after transurethral resection of bladder tumor: Data from ecological momentary symptom assessment

ObjectivesTo quantitatively describe the nature, severity, and duration of symptoms and functional impairment during recovery from transurethral resection of bladder tumors. Materials and MethodsAll patients scheduled for transurethral resection were approached for enrollment in a text-message based ecological momentary symptom assessment platform. Nine patients reported outcomes were measured 7 days before surgery and on postoperative days 1, 2, 3, 5, 7, 10, and 14 using a 5-point Likert scale. Self-reported degree of hematuria was collected using a visual scale. Clinical data was collected via retrospective chart review. ResultsA total of 159 patients were analyzed. Postoperative symptoms were overall mild, with the largest differences from baseline to postoperative day 1 seen in dysuria (median 0/5 vs. 3/5) and ability to work (median 5/5 vs. 4/5). Recovery was generally rapid, with 76% of patients reporting ≥4/5 agreement with the statement “I feel recovered from surgery” by postoperative day 2, although 15% of patients reported persistently lower levels of agreement on postoperative day 10 or 14. Patients undergoing larger resections (≥2cm) did take longer to return to baseline in multiple symptom domains, but the difference of medians vs. those undergoing smaller resections was less than 1 day across all domains. Multivariable analysis suggested that receiving perioperative intravesical chemotherapy was associated with longer time to recovery. 84% of patients reported clear yellow urine by postoperative day 3. ConclusionIn this population, hematuria and negative effects on quality of life resulting from transurethral resection of bladder tumors were generally mild and short-lived, although a small number of patients experienced longer recoveries.

For whom is mind wandering stressful: The moderating role of dispositional emotionality and personality in predicting emotional experiences in everyday life

This study tested whether dispositional emotionality and personality traits moderated the emotion a person experienced when engaging in mind wandering. Participants (n = 264) completed measures of dispositional emotionality and personality. Then on two separate days they completed a 24-hour ecological momentary assessment protocol, responding every 30 min during wake times if they were mind wandering, and how angry, sad, anxious, and happy they felt, for a total of 8,530 assessments. Using multilevel models, we found the following when mind wandering versus not: trait anger predicted more anger, depressive symptomatology more sadness, openness to experience less sadness, neuroticism more anger, and conscientiousness less happiness. Results indicate a synchrony between emotions experienced while mind wandering to one’s dispositional emotionality and personality.

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).

Daily associations between resilience factors, substance use, and affect among sexual minority youth.

Past research has highlighted that sexual minority youth (SMY) are at particular risk for heightened substance use compared to their heterosexual peers; however, few studies have investigated the associations between resilience factors and substance use among SMY. In the present preregistered study, we examined the associations among three different forms of resilience factors (i.e., general social support, lesbian, gay, bisexual, transgender, and queer (LGBTQ)-identity affirmation, LGBTQ community involvement) and alcohol, nicotine, and cannabis use, as well as on positive and negative affect. SMY (n = 82, ages 15-19, 56.1% cisgender women, 84.4% White) completed a baseline assessment then a 30-day ecological momentary assessment study. Multilevel regression models evaluated within-day and between-person associations between resilience factors and odds of substance use (alcohol, nicotine, cannabis), substance use quantity on use days (alcohol, cannabis), positive affect, and negative affect. On the day level, general social support was associated with greater positive affect, lesser negative affect, and greater drinks on drinking days. LGBTQ-identity affirmation was associated with greater positive affect, lesser negative affect, and greater odds of nicotine use. LGBTQ community involvement was associated with greater positive affect. These results highlight the nuanced ways that resilience may engender more positive affect and reduce negative affect while simultaneously promoting substance use. Future research disentangling the mechanisms connecting resilience and substance use among SMY is necessary. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Use and co-use of alcohol and cannabis following physical pain in the daily life of community adults engaged in regular substance use.

Alcohol and cannabis are often perceived as pain-relieving. However, minimal work has examined whether people use and co-use these substances following pain in daily life. Forty-six adults reporting weekly use of alcohol and/or cannabis completed a 60-day ecological momentary assessment protocol, answering at least four daily reports on their alcohol and cannabis use and pain (nassessments = 10,769 over 2,656 days). We examined whether self-reported pain so far that day (cumulative-average pain) was associated with subsequent alcohol and cannabis use and same-occasion co-use. Models also addressed whether associations differed for initiating versus continuing a use episode. Hypotheses were preregistered. A multinomial multilevel model found that cumulative-average pain was associated with a greater likelihood of same-occasion co-use in the continuation phase but not the initiation phase, compared to no use (OR = 1.48,95% CI [1.06, 2.06], p = .023) and alcohol use (OR = 1.52, CI [1.03, 2.26], p = .037). Cumulative-average pain was largely not associated with alcohol-only and cannabis-only use. After alcohol use, greater pain was associated with cannabis use (OR = 1.37, CI [1.11, 1.70], p = .004), but not the reverse. Secondary analyses found greater previous-occasion (not cumulative) pain was associated with initiation of alcohol use and number of drinks, and initiation and continuation of cannabis use, but not number of cannabis hits. Although not all hypotheses were supported, pain was associated with subsequent substance use in this sample engaged in regular substance use and not recruited for chronic pain. Cumulative pain may be particularly related to alcohol-cannabis same-occasion co-use, which may increase the risk of substance use-related problems over time. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evaluating Real-World Benefits of Hearing Aids With Deep Neural Network-Based Noise Reduction: An Ecological Momentary Assessment Study.

Noise reduction technologies in hearing aids provide benefits under controlled conditions. However, differences in their real-life effectiveness are not established. We propose that a deep neural network (DNN)-based noise reduction system trained on naturalistic sound environments will provide different real-life benefits compared to traditional systems. Real-life listening experiences collected with Ecological Momentary Assessments (EMAs) of participants who used two premium models of hearing aid are compared. One hearing aid model (HA1) used traditional noise reduction; the other hearing aid model (HA2) used DNN-based noise reduction. Participants reported listening experiences several times a day while ambient SPL, SNR, and hearing aid volume adjustments were recorded. Forty experienced hearing aid users completed a total of 3,614 EMAs and recorded 6,812 hr of sound data across two 14-day wear periods. Linear mixed-effects analysis document that participants' assessments of ambient noisiness were positively associated with SPL and negatively associated with SNR but were not otherwise affected by hearing aid model. Likewise, mean satisfaction with the two models did not differ. However, individual satisfaction ratings for HA1 were dependent on ambient SNR, which was not the case for HA2. Hearing aids with DNN-based noise reduction resulted in consistent sound satisfaction regardless of the level of background noise compared to hearing aids implementing noise reduction based on traditional statistical models. While the two hearing aid models also differed on other parameters (e.g., shape), these differences are unlikely to explain the difference in how background noise impacts sound satisfaction with the aids. https://doi.org/10.23641/asha.25114526.

Sleepless nights, sour moods: daily sleep-irritability links in a pediatric clinical sample.

Sleep, or a lack thereof, is strongly related to mood dysregulation. Although considerable research uses symptom scales to examine this relation, few studies use longitudinal, real-time methods focused on pediatric irritability. This study leveraged an ecological momentary assessment (EMA) protocol, assessing bidirectional associations between momentary irritability symptoms and daily sleep duration in a transdiagnostic pediatric sample enriched for irritability. A total of N = 125 youth (Mage = 12.58 years, SD = 2.56 years; 74% male; 68.8% White) completed digital, in vivo surveys three times a day for 7 days. For a subset of youth, their parents also completed the EMA protocol. Trait irritability was measured using youth-, parent-, and clinician-report to test its potential moderating effect on the association between sleep duration and momentary irritability. Results from multilevel modeling dynamically linked sleep to irritability. Specifically, according to youth- and parent-report, decreased sleep duration was associated with increased morning irritability (bs ≤ -.09, ps < .049). A bidirectional association between parent-reported nightly sleep duration and anger was found-increased evening anger related to decreased nightly sleep duration, and decreased sleep duration related to increased morning anger (bs ≤ -.17, ps < .019). Trait irritability moderated this association, which was stronger for more irritable youth (b = -.03, p < .027). This study adds to the literature and suggests sleep-irritability dynamics as a potential treatment target.

Emotional labor as emotion regulation investigated with ecological momentary assessment – a scoping review

BackgroundThis scoping review’s aim is to provide a comprehensive overview of ecological momentary assessment (EMA)- based research on emotional labor (EL) as emotion regulation (ER). This includes an examination of the theoretical foundation this research builds on, how the hypothesized relationships are investigated using EMA methods as well as the studies’ findings themselves. We built on the work of Grandey and Melloy (J Occup Health Psychol 22:407–22, 2004), who broadly distinguished between the two regulatory strategies of deep acting (DA) and surface acting (SA), embedded in a hierarchical model of emotional labor, as a guiding theory for structuring this review.MethodsTo be included, studies had to use EMA to measure SA or DA, with no restrictions regarding population and date of publication. The electronic databases CINAHL, PsycArticles, PsycINFO, PSYNDEX, Embase, PubMed, and Web of Science were searched. Studies were included if they met the above criteria and were written in English or German. Out of 237 publications, 12 were chosen for this review.ResultsAll studies were based on emotional labor theories, with Arlie Hochschild’s theory being the most popular, followed by Alicia Grandey's emotional labor theory and its modifications (Grandey AA. Emotion Regulation in the Workplace: A New Way to Conceptualize Emotional Labor; Grandey AA. When “the show must go on”: Surface acting and deep acting as determinants of emotional exhaustion and peer-rated service delivery. 2003). The methodological quality of the studies varied greatly. The results of the studies indicate that SA is influenced by negative events, trait SA, service innovation and certain emotions, while DA is influenced by positive events and emotional intelligence. Emotional labor benefits the organization, e.g., by improving customer conflict handling, but also causes harm by increasing employee withdrawal behavior. For the employee, emotional labor results in more harm than benefits.Conclusions The research area is still in its early stages and the findings are mostly consistent, but the small number of studies needs to be replicated to increase the reliability of the results. The lack of evidence for ertain hypotheses highlights the presence of unresolved relationships that require further exploration. We are only at the beginning of investigating emotional labor using ecological momentary assessment, and conducting more high-quality studies will significantly enhance our comprehension of emotional labor.

Cannabis advertising impacts on youth cannabis use intentions following recreational legalization in Canada: An Ecological Momentary Assessment (EMA) study

ObjectiveIn 2018, Canada’s Cannabis Act legalized adult recreational cannabis use and limited cannabis product advertising to adults. Cannabis product advertising to youth remains illegal. The extent to which adult-targeted, or illicit youth-targeted cannabis advertisements is reaching and impacting Canadian youth is unknown. We used Ecological Momentary Assessment (EMA) to describe how often and how much exposures to cannabis advertising influence Canadian youths’ real-world, real-time intentions to use cannabis. Methods120 Ontario, Canada youths ages 14–18, took photos of cannabis advertising that they encountered in their natural environments over a period of nine consecutive days. Following each exposure and twice daily device-issued random prompts, they also rated their intentions to use cannabis. ResultsMany participating youth (n = 85; 70.83 %) reported at least one cannabis advertising exposure during the study (range 1–30, M = 4.02). Exposures occurred through a range of advertising channels (e.g., internet ads, billboards). Multilevel modeling showed that youth advertising exposure increased cannabis use intentions in vivo (β = 0.06,SE = 0.03;t = 1.98;p =.04;n = 1,348). ConclusionData from this study shows that cannabis advertisements are regularly reaching Canadian youth and increasing their intentions to use cannabis. This suggests that current Canadian prohibitions on cannabis advertising to youth are ineffective and/or ineffectively enforced, and that the Canadian government needs additional or enhanced prohibitions on cannabis promotion to protect youth from harms associated with increased advertisement exposure, such as increased cannabis use.

Where does stress happen? Ecological momentary assessment of daily stressors using a mobile phone app

AbstractDespite the importance of daily stress to individuals' health and wellbeing, few studies have explored where stress happens in real time, that is, dynamic stress processes in different spaces. As such, stress interventions rarely account for the environment in which stress occurs. We used mobile phone based ecological momentary assessment (EMA) to collect daily stress data. Thirty‐three participants utilized a mobile‐phone‐based EMA app to self‐report stressors as they went about their daily lives. Geographic coordinates were automatically collected with each stress report. Data from thematic analysis of stressors by location (home, work, work from home, other) were used to determine whether certain stressors were more prevalent in certain environments. Nine daily stressors significantly differed by location. Work‐related stress was reported more often at work. Pets, household chores, sleep, and media‐related stressors were reported most at home. Physical illnesses, vehicle issues, and safety/security stressors occurred most often while participants were “working from home.” Traffic‐related stress was experienced more commonly in “other” environments. Other 18 stressors were generated regardless of location, suggesting that these stressors were persistent and without respect to location. Study findings expand the understanding of environments in which specific stressors occur, providing baseline data for potential targeted “just‐in‐time” stress interventions tailored to unique stressors in specific environments. We also provide findings related to the “work from home” phenomenon. Further work is needed to better understand the unique stressors among the large number of individuals who transitioned to working from home during and after the COVID‐19 pandemic.

Activity-related pain and sensitization predict within- and between-person pain experience in people with knee osteoarthritis: An ecological momentary assessment study

Background and objectivesKnee Osteoarthritis (OA) is a prevalent musculoskeletal condition that often results in pain and disability. Determining factors predicting variability in pain experience is critical to improving clinical outcomes. Underlying pain sensitization and its clinical manifestations, such as activity-related pain, may better predict the knee OA pain experience. This study aimed to determine whether Quantitative Sensory Testing (QST) derived sensitization measures and activity-related pain predict knee OA pain experiences collected via smartphone ecological momentary assessment (EMA). DesignIndividuals with knee OA were recruited from an urban community in New Zealand. Those eligible to participate underwent baseline QST with clinical measures of activity-related pain also being collected. The knee OA pain experience was collected via smartphone EMA three times daily for two weeks. Mixed effects location scale models were developed using a multilevel modelling approach. ResultsEighty-six participants with knee OA participated in the study. Mean age was 67.3 years, with most of the participants being female (64%) and New Zealand European (90.6%). Activity-related pain predicted worse and more variable pain intensity, pain interference, and bothersomeness outcomes within and between individuals with knee OA. Widespread cold hyperalgesia and local mechanical hyperalgesia were shown to predict higher within-person variability in pain intensity and pain interference respectively, while mechanical temporal summation predicted less within-person variability in pain intensity and interference. DiscussionThose demonstrating activity-related pain and sensitization could be at risk of experiencing worse and more variable knee OA pain in the subsequent weeks. Testing for sensitization in clinical practice could therefore identify those at greatest risk of higher and more variable knee OA pain experiences and in greatest need of treatment. Larger validation studies are required, which include individuals with more severe knee OA.

Measuring hearing aid satisfaction in everyday listening situations: Retrospective and in-situ assessments complement each other

Background: Recently, we developed a hearing-related lifestyle questionnaire (HEARLI-Q) which asks respondents to rate their hearing aid (HA) satisfaction in 23 everyday listening situations. It is unknown how HA satisfaction on the retrospective HEARLI-Q scale compares to HA satisfaction measured on the same scale implemented in Ecological Momentary Assessments (EMA). Purpose: To learn how retrospective (HEARLI-Q) and in-situ (EMA) assessments can complement each other. Research Design: An observational study. Study Sample: Twenty-one experienced HA users. Data Collection and Analysis: The participants first filled out the HEARLI-Q questionnaire, followed by a one-week EMA trial using their own hearing aids. HA satisfaction ratings were compared between the two questionnaires and the underlying drivers of discrepancies in HA satisfaction ratings were evaluated. Results: HA satisfaction scores were significantly higher in EMA for speech communication with one or several people. Hearing difficulty in these situations was rated higher in HEARLI-Q than in EMA, but occurrence of those difficult listening situations was also rated to be lower. When comparing only the situations that occur on daily or weekly basis, the two questionnaires had similar HA satisfaction ratings. Conclusions: Lower occurrence of difficult listening situations seems to be the key driver of discrepancies in HA satisfaction ratings between EMA and HEARLI-Q. The advantage of EMA is that it provides insight into an individual’s day-to-day life and is not prone to memory bias. HEARLI-Q, on the other hand, can capture situations which occur infrequently or are inconvenient to report in the moment. Administering HEARLI-Q and EMA in combination could give a more holistic view of HA satisfaction.

Feasibility of and reactivity to ecological momentary assessment (EMA) during electronic cigarette use initiation in adults who smoke daily

Background and objectivesThis pilot study tested the feasibility of tracking e-cigarette initiation over three months using a burst-of-measurement approach and examined reactivity to the ecological momentary assessment (EMA) data capture technique in this context. MethodsAdults who smoked daily and were interested in trying e-cigarette use received an e-cigarette starter kit and were randomized to complete EMA reports (n = 30) vs. not (n = 29). Participants (Mage=44.1 years [SD=12.6], 61.0 % male, 54.3 % White, 38.9 % Black/African American) smoked 13.0 cigarettes per day on average (SD=8.4) and reported mild-to-moderate nicotine dependence (MFTND=4.0 [SD=2.3]). Biochemical assessment and surveys were conducted at enrollment, e-cigarette initiation (1 week later), and 1-week, 1-month, and 3-month post e-cigarette initiation. ResultsA subset (17 %) of participants did not achieve the minimum 75 % EMA adherence at Week 1. The remaining participants showed excellent adherence with the EMA protocol, with a consistently high response rate to audibly prompted mini-surveys during screening (93 %) and follow-up weeks (93 %, 93 %, and 92 %, respectively). No consistent trend emerged in comparing the two randomized groups, either on variables relevant to the public health impact of e-cigarette initiation (i.e., cigarettes/day, exposure to smoke, exposure to nicotine, motivation to quit smoking), or in e-cigarette use (i.e., bouts/day, puffs/bout), with average Cohen's d values across timepoints ranging from d = 0.02 for exposure to smoke to d = 0.06 for cigarettes per day. ConclusionsConducting EMA with adults who smoke daily and are initiating e-cigarette use appears feasible, with some caveats. Reactivity to EMA during e-cigarette initiation appears to be small or non-significant.

The effects of childhood trauma on stress-related vulnerability factors and indicators of suicide risk: An ecological momentary assessment study

BackgroundChildhood trauma is experienced by approximately one third of young people in the United Kingdom and has been shown to confer an increased risk for mental health difficulties in adulthood. Understanding the associations between these factors before negative health outcomes manifest in adulthood is imperative to help inform the development of interventions. The aims of this study were two-fold; first, to investigate the effects of childhood trauma on daily stress-related vulnerability factors over a period of 7 days and to test whether any observed relationships were moderated by protective or risk factors. Second, to explore the indirect effects of childhood trauma on reasons for living, optimism, daily suicide ideation, defeat and entrapment through the daily stress-related vulnerability factors. Methods212 participants were recruited to an ecological momentary assessment study to complete three diaries per day for a 7-day period. Participants completed daily measures of stress, hassles, executive functioning, impulsivity, sleep quality (stress-related vulnerability factors) as well as measures of reasons for living, optimism, daily thoughts of suicide, defeat and entrapment. The Childhood Trauma Questionnaire was also completed at baseline. ResultsAnalyses found that childhood trauma was significantly associated with higher scores on the daily stress-related vulnerability factors and positively related to each of the daily indicators of suicide risk. The study also uncovered key pathways whereby trauma had indirect effects on reasons for living, optimism, daily thoughts of suicide, defeat and entrapment through executive functioning, impulsivity, sleep quality and stress. LimitationsThe measures of executive function and sleep were self-reported and future research ought to replicate the current findings using more objective methods. DiscussionThe findings from this study highlight the complexity of childhood trauma and its damaging effects on stress-related vulnerability factors and poorer mental health outcomes. Greater understanding of pathways by which trauma may impact later health outcomes is essential for development of interventions.

Examining the Reciprocal Relationship Between Social Media Use and Perceived Social Support Among Adolescents: A Smartphone Ecological Momentary Assessment Study

ABSTRACT Adolescents commonly use smartphone social media apps, which can affect their perceived social support (PSS). However, study results on social media’s effect on PSS differ, because they employ a self-reported time in social media use and concentrate only on between-person differences. They often neglect the social-anxiety level, which might be important. Our study investigated whether the within-person day-to-day changes in the time spent in two types of social media apps (communication and social networking) influence the daily PSS and vice versa, and whether social anxiety moderates these relationships. Using a mobile application that was installed on adolescents’ smartphones (N = 194), we collected the daily objective time spent in apps and the self-reported PSS for 14 days. Social anxiety was assessed with a baseline survey. The models showed that day-to-day changes in communication and social networking app use did not influence the PSS the next day and vice versa. Social anxiety did not moderate these relationships. We further elaborate on the variability related to the within-person effects.

Personalized Deep Learning for Substance Use in Hawaii: Protocol for a Passive Sensing and Ecological Momentary Assessment Study.

Artificial intelligence (AI)-powered digital therapies that detect methamphetamine cravings via consumer devices have the potential to reduce health care disparities by providing remote and accessible care solutions to communities with limited care solutions, such as Native Hawaiian, Filipino, and Pacific Islander communities. However, Native Hawaiian, Filipino, and Pacific Islander communities are understudied with respect to digital therapeutics and AI health sensing despite using technology at the same rates as other racial groups. In this study, we aimed to understand the feasibility of continuous remote digital monitoring and ecological momentary assessments in Native Hawaiian, Filipino, and Pacific Islander communities in Hawaii by curating a novel data set of longitudinal Fitbit (Fitbit Inc) biosignals with the corresponding craving and substance use labels. We also aimed to develop personalized AI models that predict methamphetamine craving events in real time using wearable sensor data. We will develop personalized AI and machine learning models for methamphetamine use and craving prediction in 40 individuals from Native Hawaiian, Filipino, and Pacific Islander communities by curating a novel data set of real-time Fitbit biosensor readings and the corresponding participant annotations (ie, raw self-reported substance use data) of their methamphetamine use and cravings. In the process of collecting this data set, we will gain insights into cultural and other human factors that can challenge the proper acquisition of precise annotations. With the resulting data set, we will use self-supervised learning AI approaches, which are a new family of machine learning methods that allows a neural network to be trained without labels by being optimized to make predictions about the data. The inputs to the proposed AI models are Fitbit biosensor readings, and the outputs are predictions of methamphetamine use or craving. This paradigm is gaining increased attention in AI for health care. To date, more than 40 individuals have expressed interest in participating in the study, and we have successfully recruited our first 5 participants with minimal logistical challenges and proper compliance. Several logistical challenges that the research team has encountered so far and the related implications are discussed. We expect to develop models that significantly outperform traditional supervised methods by finetuning according to the data of a participant. Such methods will enable AI solutions that work with the limited data available from Native Hawaiian, Filipino, and Pacific Islander populations and that are inherently unbiased owing to their personalized nature. Such models can support future AI-powered digital therapeutics for substance abuse. DERR1-10.2196/46493.

Nocturnal hypoglycemia is associated with next day cognitive performance in adults with type 1 diabetes: Pilot data from the GluCog study

Objective: Individuals with type 1 diabetes (T1D) have increased risk for cognitive dysfunction and high rates of sleep disturbance. Despite associations between glycemia and cognitive performance using cross-sectional and experimental methods few studies have evaluated this relationship in a naturalistic setting, or the impact of nocturnal versus daytime hypoglycemia. Ecological Momentary Assessment (EMA) may provide insight into the dynamic associations between cognition, affective, and physiological states. The current study couples EMA data with continuous glucose monitoring (CGM) to examine the within-person impact of nocturnal glycemia on next day cognitive performance in adults with T1D. Due to high rates of sleep disturbance and emotional distress in people with T1D, the potential impacts of sleep characteristics and negative affect were also evaluated. Methods: This pilot study utilized EMA in 18 adults with T1D to examine the impact of glycemic excursions, measured using CGM, on cognitive performance, measured via mobile cognitive assessment using the TestMyBrain platform. Multilevel modeling was used to test the within-person effects of nocturnal hypoglycemia and hyperglycemia on next day cognition. Results: Results indicated that increases in nocturnal hypoglycemia were associated with slower next day processing speed. This association was not significantly attenuated by negative affect, sleepiness, or sleep quality. Conclusions: These results, while preliminary due to small sample size, showcase the power of intensive longitudinal designs using ambulatory cognitive assessment to uncover novel determinants of cognitive fluctuation in real world settings, an approach that may be utilized in other populations. Findings suggest reducing nocturnal hypoglycemia may improve cognition in adults with T1D.