Idiographic Analyses Research Articles

Relationship between outcomes and processes in patients with chronic low back pain plus depressive symptoms: idiographic analyses within a randomized controlled trial

Objective This study explored the extent to which within-patient changes in processes targeted in Acceptance and Commitment Therapy (ACT) and Behavioral Activation Therapy for Depression (BATD) are associated with changes within-patient in pain intensity and depressed mood and evaluated the extent that process-outcome relationships differed between patients. Methods An idiographic analysis embedded within a randomized controlled trial comparing ACT, BATD, and treatment-as-usual (TAU) was conducted to examine the strength of the relationship between outcomes and process variables in patients with chronic low back pain (CLBP) plus depressive symptoms. Based on data from ecological momentary assessment in patients (n = 82), the level of heterogeneity and the pooled effects of these relationships during the intervention period (70 days) were explored. Results Overall, a high level of heterogeneity was identified in the relationship between pain intensity or depressed mood and psychological inflexibility or behavioral activation. Individual differences in the relationships between outcomes and process variables were identified in individual people during the intervention period. These individual differences appear independent of the group (ACT, BATD, and TAU) and other definable differences (responders/non-responders, completers/non-completers, and clinical depression/non-clinical depression). Conclusions These findings suggest the potential utility of personalizing psychological interventions according to the therapeutic needs of these patients.

A network analysis of mechanisms of change during exposures over the course of intensive OCD treatment

Exposure and response prevention (ERP) is an evidence-based treatment for obsessive-compulsive disorder (OCD). Theories for how it works vary in their emphasis on active mechanisms of change. The current study aimed to clarify mechanisms of change in ERP for OCD using network analysis, comparing ERP networks at the start and end of intensive treatment (partial hospital and residential). In our sample of 182 patients, the most central node in both networks was engagement with exposure, which was consistently related to greater understanding of ERP rationale, higher willingness, and less ritualization, accounting for all other variables in the network. There were no significant differences in networks between the start and end of treatment. These results suggest that nonspecific parameters like facilitating engagement in exposures without ritualizing and providing a clear rationale to clients may be key to effective treatment. As such, it may be useful for clinicians to spend adequate time underscoring the need to eliminate rituals to fully engage in exposure tasks and explaining the rationale for ERP prior to doing exposures, regardless of theoretical orientation. Nonetheless, findings represent group-level statistics and more fine-grained idiographic analyses may reveal individual-level differences with respect to central mechanisms of change. Other limitations include demographic homogeneity of our sample.

Exploring person-specific associations of situational motivation and readiness with leisure-time physical activity effort and experience.

Identifying determinants of leisure-time physical activity (LTPA) often relies on population-level (nomothetic) averages, potentially overlooking person-specific (idiographic) associations. This study uses an idiographic perspective to explore how subjective readiness and motives for LTPA relate to volitional effort (duration, intensity) and affective experience (pleasure, displeasure). We also highlight the potential for different interpretations when data are averaged within individuals and assessed using a variable-centered approach. Participants (N = 22, 25±8 years old, 54.5% women) were asked to continue their regular PA patterns for 10 weeks. Ecological momentary assessment procedures allowed participants to provide pre-activity reports (physical, cognitive, emotional readiness and situational motive for activity) and post-activity reports (activity type, duration, perceived exertion, ratings of affective valence). Spearman rank correlation was implemented to interpret within- and between-person associations. Data visualization approaches were used to showcase person-specific differences in associations. Participants provided 519 reports of LTPA (24±11 events/person), which displayed between- and within-person variety in type, duration, intensity, and affective experience. Exemplar cases highlight discrepancies in interpretation based on level of analysis, such that the nomothetic association (rho = .42, p = .05; 95% CI -.02, .72) between motive to replenish energy and LTPA duration was observed in only one within-person analysis (41% were weak-to-large inverse effects). Alternatively, the negligible nomothetic association (rho = .02, p = .93; 95% CI -.41, .44) between physical readiness and LTPA-related affect did not reflect the 59% of within-person analyses showing moderate-to-large, positive effects. Future research aiming to identify determinants of LTPA effort and experience should integrate contemporary, idiographic analyses in early-stage research for developing person-specific strategies for LTPA promotion.

From the Individual to the Group: Using Idiographic Analyses and Two-Stage Random Effects Meta-Analysis to Obtain Population Level Inferences for within-Person Processes

In psychology, the use of portable technology and wearable devices to ease participant burden in data collection is on the rise. This creates increased interest in collecting real-time or near real-time data from individuals within their natural environments. As a result, vast amounts of observational time series data are generated. Often, motivation for collecting this data hinges on understanding within-person processes that underlie psychological phenomena. Motivated by the body of Dr. Peter Molenaar’s life work calling for analytical approaches that consider potential heterogeneity and non-ergodicity, the focus of this paper is on using idiographic analyses to generate population inferences for within-person processes. Meta-analysis techniques using one-stage and two-stage random effects meta-analysis as implemented in single-case experimental designs are presented. The case for preferring a two-stage approach for meta-analysis of single-subject observational time series data is made and demonstrated using an empirical example. This provides a novel implementation of the methodology as prior implementations focus on applications to short time series with experimental designs. Inspired by Dr. Molenaar’s work, we describe how an approach, two-stage random effects meta-analysis (2SRE-MA), aligns with recent calls to consider idiographic approaches when making population-level inferences regarding within-person processes.

Disasters in the Anthropocene: a storm in a teacup?

Dramatic alterations to the natural environment due to human activity have produced a permanent rupture in the Earth system; the relative stable epoch of the Holocene has given way to a volatile Anthropocene. Acceptance of these claims means that we now live in this altered physical reality, inviting us to rethink how we conceptualise disasters. Yet, disaster scholars have been hesitant to apply the Anthropocene label and to acknowledge the profound changes that it can bring to the study of disasters. This paper queries whether this label is a necessary adage or unnecessary baggage for disaster studies by examining the possibilities and the challenges associated with engaging with the Anthropocene. An analysis of the concepts, causes, and consequences of disasters reveals how the Anthropocene provides, as the very least, a theoretical heuristic for challenging linear temporal assumptions, the epistemological status of uncertainty, and the location of agency in disaster studies.

Exploring Temporal Changes In Exercise Behavior, Perceived Fitness, And Identity In Former High School Athletes

While exercise promotion is recommended to preserve athletes’ post-sport transition quality, specific understanding of behavioral changes after retirement is unknown and necessary for program development. PURPOSE: Document temporal changes to exercise behavior, perceived fitness, and identity in former high school athletes (FHSAs) entering college, understand their exercise experiences, and explain why observed changes occurred using mixed methods. METHODS: Over their freshman year, FHSAs completed 8 online surveys assessing bodyweight, perceived fitness (Likert scale 1-5), self-reported exercise, perceived barriers (Likert scale 1-5), and identity (Likert scale 1-7). Responses were analyzed using hierarchical mixed modeling procedures, idiographic visual analysis, and intraclass correlation coefficients (ICC). A subsample completed semi-structured interviews incorporating their survey data, which underwent thematic analysis. RESULTS: As a group, FHSAs (N=35, 7 men, 18±0 years) exhibited no statistically significant changes in any primary outcomes, but idiographic analyses revealed substantial intra-individual variation. Most variables demonstrated “poor”-“fair” consistency (ICC .271-.654); only bodyweight (ICC=.987), athlete identity (ICC=.788), and exercise identity (ICC=.898) exhibited “good”-“excellent” consistency. Interviews (n=14) yielded 5 themes: adapting to transition, from “athlete” to “athletic exerciser”, motivational determinants to exercise, within-person pre-condition, and environment. CONCLUSION: FHSAs maintained relatively high levels of exercise, identity, and ‘good’ fitness perceptions as a group. However, noted variability from participants’ time devoted to schoolwork, exercise-specific social supports, and COVID-19 restrictions suggests individual responses were not represented by average values. FHSAs’ sports backgrounds provided exercise-related competence and self-regulatory abilities, but made balancing fitness expectations and losses difficult. Future directions should explore other former athlete populations’ behavior, ways of nurturing FHSA’s exercise-related competence and self-regulation, and the cyclical relationship conceptualized from interviews between participants’ exercise and identity.

The impact of neurological disability and sensory loss on mindfulness practice

Objectives Mindfulness-based approaches are increasingly recommended in the management of medical conditions associated with sensory loss and absence, such as Spinal Cord Injury (SCI), Multiple Sclerosis (MS) and Functional Neurological Disorder (FND). Yet the implications of undertaking practices such as body scanning when living with sensory loss have not been considered. This study aimed to explore the impact of sensory loss on the practice and experience of mindfulness in qualified mindfulness teachers with SCI/FND/MS. Methods Eight mindfulness teachers (5 females, 3 males) with SCI/FND/MS, sensory loss and wheelchair use were recruited from mindfulness teacher databases. In-depth, semi-structured interviews were undertaken, lasting between 50 and 93 min. Interviews were transcribed verbatim and analysed using Interpretative Phenomenological Analysis. Idiographic analyses for descriptive, linguistic and conceptual themes were completed before cross-case analyses. Results Analyses resulted in two superordinate themes: (1) Adopting your Body; and (2) Sensation without Loss. These themes reflected the challenge of overcoming initial resistance to areas of the body with sensory disruption, building a relationship with the whole body, such that sensory awareness could be visualised and experienced without proprioception. Conclusions Mindfulness offers a unique approach to accepting and working with the body after paralysis or sensory loss. Fundamental to the use of mindfulness with such populations, is the prioritisation of inclusive sensory language and exploring sensory absence as well as sensory presence. The cognitive and emotional outcomes of body scanning may be uniquely elevated in populations with neurophysiological disorders, highlighting the benefits of mindfulness for adaptive and protective self-management. IMPLICATIONS FOR REHABILITATION Mindfulness-based practices which focus on the body and sensation are accessible to people with neurological limitations. Mindfulness techniques can be extended through the use of visualisation strategies to encourage (non-proprioceptive) awareness of paralysed limbs or areas of the body with sensory loss. The language used in mindfulness-based interventions may need adapted by practitioners so that it remains inclusive for people with sensory loss as well as sensory presence. Additional care needs to be taken when using body scans during mindfulness as they have the potential to exacerbate psychological distress in people with reduced sensory awareness.

Idiographic analyses of motivation and related processes in participants with schizophrenia following a therapeutic intervention for negative symptoms

BackgroundMotivational negative symptoms hinder quality of life and daily functioning of individuals with schizophrenia spectrum disorders. A recently developed intervention, Switch, has shown promising effects on negative symptoms and functional outcomes. Switch targets multiple cognitive, emotional and behavioural processes associated with motivation and goal directed behaviours. We aimed to investigate its effects on motivation and associated processes in a naturalistic setting, and to explore the dynamics between the processes.MethodsWe used a single case approach (n = 3), with a pre-post and follow-up assessment design, which also included ambulatory assessments (experience sampling method, ESM; and step count). We computed autoregressive lag 1 models to evaluate the effects of the intervention on daily motivation levels and related processes, descriptive pie-charts, and vector autoregressive modelling to reveal the dynamics of the processes over time.ResultsThe intervention was beneficial for each participant according to traditional evaluations of motivational negative symptoms, apathy, daily functioning and quality of life. The effects on the ESM variables revealed distinct outcomes for each individual. The dynamics between the various processes differed between participants, and fluctuated within participants (when comparing baseline, intervention phase, and follow-up).ConclusionsThis study used an innovative approach to look at the effectiveness of an intervention. The intervention seems to lead to meaningful improvements in motivational negative symptoms and functional outcomes. The mechanisms of change need to be further investigated.Trial registration numberClinicalTrials.gov, NCT04325100. Registered 27 March 27, 2020 -retrospectively registered.ReportingGuidelines from the Transparent Reporting of Evaluations with Non-randomized Designs (TREND) statement were followed.

Examining emotional pain among individuals with chronic physical pain: Nomothetic and idiographic approaches

ObjectiveEmotional pain (i.e., pain affect in response to psychological experiences such as rejection or loss) may be a component of chronic pain syndromes given high co-occurrence with depression and neurobiological overlaps in pain affect resulting from physical and emotional experiences. In the current set of studies, we examined the relationship between emotional and physical pain using both nomothetic (i.e., group-level) and idiographic (i.e., individual-level) approaches. MethodsIndividuals with chronic pain were recruited from the Washington University Pain Center. First, we assessed the relationship between emotional and physical pain at the group level. Then, three individuals from the group-level study completed ecological momentary assessment four times per day for at least four weeks. We assessed relationships between emotional and physical pain using correlations and dynamic structural equation modeling. ResultsEmotional pain severity was significantly positively correlated with physical pain at the group level. However, results from idiographic analyses suggested that one individual did not display a significant correlation between physical and emotional pain, and two individuals displayed correlations larger than expected based on the group-level data. Competing models suggested that emotional and physical pain represented distinct constructs for the individuals studied. ConclusionsThese results suggest that emotional pain may be an important component of chronic pain syndromes. However, idiographic models revealed heterogeneity that may have important implications for treatment. Further research is needed to understand whether idiographic relationships between emotional and physical pain can help identify effective treatment targets for individuals with co-occurring emotional and physical symptoms.

Dialogues in Infertility: Exploring the Potential for Psychological Adaptation.

The objective of this paper is to detail the process of psychological adaptation for a woman navigating the world after a diagnosis of age-related infertility. Infertility is a medical condition, but it occurs within a social and cultural context, thereby creating social and psychological dimensions. Discrepancies between a woman's fertility ideals and her reality may be related to both personal preferences and contributing social factors. The discussion will be based on longitudinally collected interview data. Drawing on the Dialogical Self Theory, the paper will focus on intra-psychological dynamics (dialogues) and will analyze the adaptation process in terms of I-positions. Based on idiographic analyses the conclusion is that adaptation takes place by taking subjective personal control over the uncertainty of infertility. By integrating new I-position into intra-personal phenomena, the core "I" will be united with new qualities and is seen as an authentic elaboration resulting from the formation of personal, subjective meaning in a uniquely personal developmental trajectory.

Personalized Models of Psychopathology.

The personalized approach to psychopathology conceptualizes mental disorder as a complex system of contextualized dynamic processes that is nontrivially specific to each individual, and it seeks to develop formal idiographic statistical models to represent these individual processes. Although the personalized approach draws on long-standing influences in clinical psychology, there has been an explosion of research in recent years following the development of intensive longitudinal data capture and statistical techniques that facilitate modeling of the dynamic processes of each individual's pathology. Advances are also making idiographic analyses scalable and generalizable. We review emerging research using the personalized approach in descriptive psychopathology, precision assessment, and treatment selection and tailoring, and we identify future challenges and areas in need of additional research. The personalized approach to psychopathology holds promise to resolve thorny diagnostic issues, generate novel insights, and improve the timing and efficacy of interventions.

An idiographic statistical approach to clinical hypothesis testing for routine psychotherapy: A case study

In order to develop more targeted, efficient, and effective psychotherapeutic interventions, calls have been made in the literature for greater use of idiographic hypothesis testing. Idiographic analyses can provide useful information regarding mechanisms of change within individuals over time during treatment. However, it remains unclear how clinicians might utilize idiographic statistical analyses during routine treatment to test clinical hypotheses, and in turn, guide treatment. We present an idiographic statistical framework for clinical hypothesis testing with routine treatment data that enables clinicians to examine a) whether the client's symptoms and hypothesized mechanisms change over time, b) whether trajectories of change reflect the timing of interventions, c) whether mechanisms predict subsequent symptoms, and d) whether relationships exist between multiple mechanisms, symptoms, or other treatment-related constructs over time. We demonstrate the utility of the approach for clinical hypothesis testing by applying it to routine treatment data collected from a 56 year-old male who presented with a combination of anger problems, anxiety, and depressive symptoms. We discuss how results from analyses can inform the case-formulation and guide clinical decision-making. We aim to make these methods more accessible by providing an online platform where clinicians can enter client data, test their clinical hypotheses using idiographic analyses, and utilize the results to disseminate their findings.

Moderation of alcohol craving reactivity to drinking-related contexts by individual differences in alcohol sensitivity: An ecological investigation.

Laboratory cue exposure investigations have demonstrated that, relative to drinkers who report a high sensitivity to the pharmacologic effects of alcohol, low-sensitivity (LS) drinkers show exaggerated neurocognitive and behavioral reactivity to alcohol-related stimuli. The current study extends this line of work by testing whether LS drinkers report stronger cravings for alcohol in daily life. Data were from an ecological momentary assessment study in which participants (N = 403 frequent drinkers) carried a palmtop computer for 21 days and responded to questions regarding drinking behavior, alcohol craving, mood states, and situational context. Initial analyses identified subjective states (positive and negative mood, cigarette craving) and contextual factors (bar-restaurant location, weekend, time of day, presence of friend, recent smoking) associated with elevated craving states during nondrinking moments. Effects for nearly all these craving correlates were moderated by individual differences in alcohol sensitivity, such that the associations between situational factors and current alcohol craving were larger among LS individuals (as determined by a questionnaire completed at baseline). Complementary idiographic analyses indicated that self-reported craving increased when the constellation of situational factors more closely resembled individuals' observed drinking situations. Again, this effect was moderated by alcohol sensitivity, with greater craving response increases among LS drinkers. The findings align with predictions generated from theory and laboratory cue exposure investigations and should encourage further study of craving and incentive processes in LS drinkers. (PsycINFO Database Record

Semiotic Regulation in the Construction of Maternal Bond: From Body Experience to the Semiotic Field.

The objective of this paper is to analyze how the maternal bond in first-time pregnant women emerges from bodily experiences in the pre-semiotic level and leads to the emergence of the semiotic field. The bond as a sign field is internally structured and enables the regulation of connections with other signs outside the field. As a result of the dialogue between biological and sociocultural imperatives, sociocultural meanings are turned into personal meanings and presented by women through behavior. This study is based on longitudinally-collected interview data consisting of six interviews with women from the time they were pregnant until their child turned one year old. During this period, three ruptures as turning points in the formation of the bond were identified. Based on idiographic analyses, it was concluded that body signals caused by the development of the fetus are coded by women into signs of various kinds, which define the status of mother and create the foundation for the mother-child relationship which continues throughout the lifespan.

Temporal Dynamics of Health and Well-Being: A Crowdsourcing Approach to Momentary Assessments and Automated Generation of Personalized Feedback.

Recent developments in research and mobile health enable a quantitative idiographic approach in health research. The present study investigates the potential of an electronic diary crowdsourcing study in the Netherlands for (1) large-scale automated self-assessment for individual-based health promotion and (2) enabling research at both the between-persons and within-persons level. To illustrate the latter, we examined between-persons and within-persons associations between somatic symptoms and quality of life. A website provided the general Dutch population access to a 30-day (3 times a day) diary study assessing 43 items related to health and well-being, which gave participants personalized feedback. Associations between somatic symptoms and quality of life were examined with a linear mixed model. A total of 629 participants completed 28,430 assessments, with a mean (SD) of 45 (32) assessments per participant. Most participants (n = 517 [82%]) were women and 531 (84%) had high education. Almost 40% of the participants (n = 247) completed enough assessments (t = 68) to generate personalized feedback including temporal dynamics between well-being, health behavior, and emotions. Substantial between-person variability was found in the within-person association between somatic symptoms and quality of life. We successfully built an application for automated diary assessments and personalized feedback. The application was used by a sample of mainly highly educated women, which suggests that the potential of our intensive diary assessment method for large-scale health promotion is limited. However, a rich data set was collected that allows for group-level and idiographic analyses that can shed light on etiological processes and may contribute to the development of empirical-based health promotion solutions.

Gender and stimulus control of smoking behavior.

Gender differences in smoking behavior have been proposed to account for poorer outcomes among women attempting to quit. Specifically, it has been suggested that women's smoking behavior is less motivated by nicotine-seeking and more driven by environmental cues. To date, however, few real-world studies have examined the hypothesis that women's smoking is under greater stimulus control. One hundred and ninety four daily smokers (men = 107; women = 87) completed 3 weeks of ecological momentary assessment (EMA) monitoring that provided data on real-world smoking behavior by reporting on situational contexts shown by previous research to influence smoking behavior (including social setting, cigarette availability, alcohol consumption, and mood). Analyses of particular cues found few gender differences; however, men's smoking increased to a greater extent compared with women's when they were with others who were smoking. Idiographic analyses that allow individual subjects to have different directions of linkage to situational cues also were conducted to assess how predictable subjects' smoking was from a range of contextual characteristics. Compared with women, men's smoking was significantly more closely tied to food/alcohol consumption and tended to be more closely tied to social context. No other gender differences were found. EMA analyses suggest that men and women are similarly influenced by cues, including mood. Where there were gender differences, it was men rather than women whose smoking behavior was more influenced by cues. The data contradict the hypothesis that women's smoking is more influenced by cues.

Using Virtual Human Technology to Provide Immediate Feedback About Participants′ Use of Demographic Cues and Knowledge of Their Cue Use

Demographic characteristics have been found to influence pain management decisions, but limited focus has been placed on participants' reactions to feedback about their use of sex, race, or age to make these decisions. The present study aimed to examine the effects of providing feedback about the use of demographic cues to participants making pain management decisions. Participants (N = 107) viewed 32 virtual human patients with standardized levels of pain and provided ratings for virtual humans' pain intensity and their treatment decisions. Real-time lens model idiographic analyses determined participants' decision policies based on cues used. Participants were subsequently informed about cue use and completed feedback questions. Frequency analyses were conducted on responses to these questions. Between 7.4 and 89.4% of participants indicated awareness of their use of demographic or pain expression cues. Of those individuals, 26.9 to 55.5% believed this awareness would change their future clinical decisions, and 66.6 to 75.9% endorsed that their attitudes affect their imagined clinical practice. Between 66.6 and 79.1% of participants who used cues reported willingness to complete an online tutorial about pain across demographic groups. This study was novel because it provided participants feedback about their cue use. Most participants who used cues indicated willingness to participate in an online intervention, suggesting this technology's utility for modifying biases. PerspectiveThis is the first study to make individuals aware of whether a virtual human's sex, race, or age influences their decision making. Findings suggest that a majority of the individuals who were made aware of their use of demographic cues would be willing to participate in an online intervention.

On the Contributions of a Network Approach to Personality Theory and Research

Understanding personality structure and processes is one of the most fundamental goals in personality psychology. The network approach presented by Cramer et al. represents a useful path toward this goal, and we address two facets of their approach. First, we examine the possibility that it solves the problem of breadth, which has inhibited the integration of trait theory with social cognitive theory. Second, we evaluate the value and usability of their proposed method (qgraph), doing so by conducting idiographic analyses of the symptom structure of Borderline Personality Disorder.

The Importance of Importance in the Physical Self: Support for the Theoretically Appealing but Empirically Elusive Model of James

This study tested James's theoretical assumption that the importance people attribute to different physical self-domains, in combination with perceived competence in those domains, influences higher order self-concepts. Data from four large samples (total N=1,831) from Sweden, Great Britain, Portugal, and Turkey were analyzed. A new version of an instrument, the Physical Self-Perception Profile-Revised (PSPP-R), was used to measure perceived competence and importance of physical self-domains, along with global self-esteem. Competence-importance interactions contributed significantly to higher order self-concepts in 3 of 4 PSPP subdomains. The same result was found in the structural equation modeling analyses and latent interaction analyses. Idiographic analyses showed that domains rated as intraindividually more important explained more global self-esteem variance compared with less important domains. In general, support for James's hypothesis was found across the different analyses. Differences between the methodology and results in the present study compared with previous studies are discussed.

Investigating patient characteristics on pain assessment using virtual human technology

Pain assessment and treatment is challenging and can be influenced by patient demographic characteristics. Few research studies have been able to specifically examine these influences experimentally. The present study investigated the effects of patients’ sex, race, age, and pain expression on healthcare students’ assessment of pain and pain-related sequelae using virtual human (VH) technology. A lens model design was employed, which is an analogue method for capturing how individuals use environmental information to make judgments. In this study, decision-making policies were captured at the nomothetic and idiographic level. Participants included 107 healthcare students who viewed 32 VH patients that differed in sex, race, age, and pain expression in an online study. Participants provided ratings on a 100-point scale on the VH pain intensity, pain unpleasantness, negative mood, coping, and need for medical treatment. Nomothetic analyses revealed that female, African–American, older, and high pain expression VH were rated higher than male, Caucasian, younger, and low pain expression VH, respectively, on most of the five ratings. Idiographic analyses revealed detailed findings for individuals’ decision-making policies. VH technology and the lens model design were shown to be highly effective in examining individuals’ decision-making policies. Pain assessment often varied among individuals based on patient demographic and facial expression cues. This study could serve as a model for future investigations of pain assessment and treatment in healthcare students and providers.