Momentary Mood Research Articles

Linking physical and social environments with mental health in old age: a multisensor approach for continuous real-life ecological and emotional assessment

BackgroundUrban stress is mentioned as a plausible mechanism leading to chronic stress, which is a risk factor of depression. Yet, an accurate assessment of urban stressors in environmental epidemiology requires...

Real-Time Data Collection to Examine Relations Between Physical Activity and Affect in Adults With Mental Illness.

Adults with serious mental illness engage in limited physical activity, which contributes to significant health disparities. This study explored the use of both ecological momentary assessments (EMAs) and activity trackers in adults with serious mental illness to examine the bidirectional relationship between activity and affect with multilevel modeling. Affective states were assessed up to seven times per day using EMA across 4 days. The participants (n = 20) were equipped with a waist-worn accelerometer to measure moderate to vigorous physical activity. The participants had a mean EMA compliance rate of 88.3%, and over 90% of completed EMAs were matched with 30-min windows of accelerometer wear. The participants who reported more positive affect than others had a higher probability of engaging in moderate to vigorous physical activity. Engaging in more moderate to vigorous physical activity than one's usual was associated with more negative affect. This study begins to address the effect of momentary mood on physical activity in a population of adults that is typically difficult to reach.

The perils of murky emotions: Emotion differentiation moderates the prospective relationship between naturalistic stress exposure and adolescent depression.

Negative emotion differentiation (NED) refers to the ability to identify and label discrete negative emotions. Low NED has been previously linked to depression and other indices of low psychological well-being. However, this construct has rarely been explored during adolescence, a time of escalating depression risk, or examined in the context of naturalistic stressors. Further, the association between NED and depression has never been tested longitudinally. We propose a diathesis-stress model wherein low NED amplifies the association between stressful life events (SLEs) and depression. A sample of 233 community-recruited midadolescents (Mage 15.90 years, 54% female) completed diagnostic interviews and reported on mood and daily stressors 4 times per day for 7 days. SLEs were assessed using a semistructured interview with diagnosis-blind team coding based on the contextual threat method. Follow-up interviews were conducted 1.5 years after baseline. Low NED was correlated with depression but did not predict prospective changes in depression as a main effect. Confirming predictions and supporting a diathesis-stress model, low NED predicted (a) within-subjects associations between daily hassles and momentary depressed mood, (b) between-subjects associations between SLE severity and depression, and (c) prospective associations between SLE severity and increases in depression at follow-up. Results were specific to negative (vs. positive) emotion differentiation. Results suggest that low NED is primarily depressogenic in the context of high stress exposure. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Psychometric Properties of the Korean Version of the PsyMate Scale Using a Smartphone App: Ecological Momentary Assessment Study.

BackgroundEcological momentary assessment (EMA) is a method for capturing the changes in the variables in daily life with increased accuracy and decreased recall bias. The PsyMate scale assesses momentary moods in daily life and can be used in various settings.ObjectiveThe aim of this study was to develop a Korean version of the PsyMate (K-PsyMate) scale and evaluate its psychometric properties by using the EMA method in patients with moyamoya disease (MMD) in South Korea.MethodsPatients with MMD aged over 18 years were recruited from July 2018 to January 2019 at the inpatient and outpatient departments of a university hospital in South Korea. The K-PsyMate scale comprising 13 items was developed following a translation/back translation approach of the English version and loaded onto a mobile app. Participants were instructed to enter their moods 4 times a day for 7 consecutive days. Content validity index, factor analysis, and Pearson’s correlation were performed for validity analysis. For reliability, intraclass correlation coefficients between the first and last measurements were estimated by mean rating, absolute agreement, and a 2-way mixed-effects model. Usability was analyzed through a descriptive analysis, 2-tailed t test, and analysis of variance, and the results were confirmed by Mann-Whitney U test and the Kruskal-Wallis test, as the dependent variable was not normally distributed.ResultsIn total, 1929 assessments from 93 patients were analyzed. The mean age of the participants was 40.59 (SD 10.06) years, and 66 (71%) of the 93 participants were women. Content validity was excellent as content validity index was 0.99, and 2 factors, negative affect and positive affect, were derived by an exploratory factor analysis. The correlations between the subdomains of the K-PsyMate scale and Hospital Anxiety and Depression Scale were significant (P<.001). The agreement between the first and last measurements was poor to moderate according to the obtained intraclass correlation coefficient values. Usability was evaluated by 67 (72%) out of the 93 participants. The participants rated the accuracy of assessing their momentary moods on the app at 4.13 (SD 0.97), easiness in understanding questions, operating, and inputting answers at 4.12 (SD 0.88), and interruption by the survey alarms at 2.48 (SD 1.02) out of 5.ConclusionsThe K-PsyMate scale has good validity but poor to moderate agreement, which reflects the characteristics of the EMA data collected in real and natural living environments without control. The findings of our study show that the K-PsyMate scale uploaded in a mobile app can be a valid and reliable tool for evaluating the momentary mood of patients with MMD because using a mobile app is convenient and patients are familiar with their own smartphones, which they use in their daily lives.

Emotional states in adolescents: time of day X chronotype effects while controlling for psychopathological symptoms and sleep variables

ABSTRACT The present study primarily aimed to investigate the interactive effect of chronotype and time of day on adolescent’s emotional states. Chronotype influences behaviour throughout the day, with variables such as mood exhibiting circadian rhythmicity. We also considered the influence of potential covariates, such as sleep variables and psychopathological symptoms. A total of 190 8th-grade students (53.7% males; mean age 13.47 ±.70) completed a two-part protocol: part one probing sleep (BaSIQS), chronotype (CSM), and psychopathological symptoms (SDQ); part two targeting emotional states (FS; STAIC-S; EAPNC), while manipulating the time of day (first and last hours of the school day). The hypothesized interaction failed to reach significance, despite correlational analyses and visual inspection of mean values suggesting some interactive effects. Time of day independently impacted positive emotional states, rising from morning to afternoon, and anxiety-state, which dropped. Chronotype independently influenced momentary mood (non-significant when sleep and psychopathological symptoms were controlled for), positive affect (non-significant when controlling for psychopathological symptoms), and anxiety (non-significant when sleep quality and psychopathological symptoms were controlled for). There were consistent effects of time of day, but its interaction with chronotype did not reach significance. Some associations between chronotype and emotional states seemed to be influenced by sleep and/or psychopathological symptoms.

Mood and Stress Evaluation of Adult Patients With Moyamoya Disease in Korea: Ecological Momentary Assessment Method Using a Mobile Phone App.

BackgroundMoyamoya disease (MMD) is a known progressive obstructive cerebrovascular disorder. Monitoring and managing mood and stress are critical for patients with MMD, as they affect clinical outcomes. The ecological momentary assessment (EMA) method is a longitudinal study design by which multiple variable assessments can be performed over time to detect momentary fluctuations and changes in psychological dimensions such as mood and stress over time.ObjectiveThis study aimed to identify predicting factors associated with momentary mood and stress at both the within-person and between-person levels and to examine individual fluctuation of mood over time in the short term using an EMA method combined with a mobile phone app.MethodsParticipants aged older than 18 years were recruited from a tertiary hospital in Seoul, Korea, between July 2018 and January 2019. The PsyMate scale for negative affect (NA) and positive affect (PA) and the Trier Inventory for Chronic Stress Scale were uploaded on patient mobile phones. Using a mobile app, data were collected four times a day for 7 days. Pearson correlations and mixed modeling were used to predict relationships between repeatedly measured variables at both the between-person and within-person levels.ResultsThe mean age of the 93 participants was 40.59 (SD 10.06) years, 66 (71%) were female, and 71 (76%) were married. Participants provided 1929 responses out of a possible 2604 responses (1929/2604, 74.08%). The mean momentary NA and PA values were 2.15 (SD 1.12) and 4.70 (SD 1.31) out of 7, respectively. The momentary stress value was 2.03 (SD 0.98) out of 5. Momentary NA, PA, and stress were correlated (P<.001) and varied over time in relation to momentary variables. Common momentary variables associated with momentary mood and stress at both the within-person (level 1) and between-person (level 2) levels were identified. Momentary NA increased when being alone and being at the hospital at both levels, whereas momentary PA increased when eating or drinking, resting, being at a café, restaurant or a public place but decreased when being alone at both levels. Momentary stress increased when being at the office, at a public place, or as the time of the day went by but decreased when resting or during the weekend. Different factors affecting mood and stress at different levels were identified. Fluctuations in individual momentary mood over time at the within-person level were captured.ConclusionsThe EMA method using a mobile phone app demonstrated its ability to capture changes in mood and stress in various environmental contexts in patients with MMD. The results could provide baseline information for developing interventions to manage negative mood and stress of patients with MMD based on the identified predictors affecting mood and stress at two different levels.

The threshold effects of bus micro-environmental exposures on passengers’ momentary mood

The bus plays a crucial role in the daily travel of urban residents. Previous research on bus micro-environmental exposures and their adverse impacts on passengers’ health and comfort has attracted considerable attention. However, few studies to date have explored the correlation between bus micro-environmental exposures and passengers’ momentary mood, examined the thresholds of various micro-environmental factors, and analyzed the optimal micro-environmental exposure levels for passengers. To this end, both micro-environmental exposures and questionnaire survey data are simultaneously collected from 543 passengers in randomly selected buses operating on the 6 routes in Guangzhou, China. Multiple regression models are then applied to explore some research gaps in the existing literature. The results suggest that in-bus noise and passenger load have negative overall correlations with passengers’ momentary mood, whereas temperature and relative humidity have positive overall correlations with it. Passengers’ momentary mood is subject to the threshold effects of these four micro-environmental indicators. The thresholds of in-bus noise, temperature, and relative humidity identified in this study are 65–79 dB, 30–34 °C, and 50–65% respectively. In terms of passenger load, 8–18 is a threshold below which momentary mood gets worse, and 19–29 is the other threshold beyond which momentary mood deteriorates considerably. Further, the optimal exposure levels of these bus micro-environmental indicators are 0–65 dB, 22–28 °C, 41–50%, and 18–19 respectively. These threshold effects provide valuable implications for transportation planners and bus operators to achieve desirable and user-friendly in-bus micro-environment based on a better understanding of the changes in passengers’ momentary mood.

T94. VIRTUAL REALITY STRESS REDUCTION FOR PATIENTS WITH PSYCHIATRIC DISORDERS: CROSS-OVER RANDOMIZED CONTROLLED TRIAL

BackgroundPsychosocial stress is associated with onset and relapse of psychosis, and stress-reactivity is high in patients with psychotic disorder. Stress management is an important part of treatment, but stress-reducing interventions are challenging for people with psychotic or other psychiatric disorder. We developed a virtual reality self-management relaxation tool (VRelax; 360o nature videos with interactive elements) and investigated its immediate effects on stress level, mood states and symptoms in patients with a psychotic or other psychiatric disorder, compared to standard relaxation exercises.MethodsA randomized cross-over trial was conducted in 50 patients receiving ambulatory treatment for psychotic, anxiety, depressive or bipolar disorder. Participants were randomly assigned to start with VRelax or standard relaxation, and used both interventions for 10 days at home. They completed Visual Analogue Scales (VAS) of stress level and mood states before and after each session. Global perceived stress and psychiatric symptoms were measured before and after both intervention periods. Treatment effects were analyzed with multilevel repeated-measures regression models and two-way ANOVA.ResultsBoth VRelax and standard relaxation exercises reduced subjective stress and improved momentary mood states. Compared to standard relaxation, VRelax resulted in a significantly greater immediate improvement of anxiety (B=-4.30, 95%CI=-5.86;-2.73), sadness (B=-3.65, 95%CI =-5.39;-1.91), cheerfulness (B=3.67, 95%CI=2.15;5.18), overall positive mood (B=7.59, 95%CI=2.28;12.89), and overall negative mood (B=10.88, 95%CI=5.89;15.87). There were no significant differences between short-term effects of the two treatments on symptoms and global perceived stress.DiscussionIf the results of this trial are replicated and extended, VRelax may provide a much needed effective self-management stress intervention to enhance treatment of patients with psychotic and other psychiatric disorders.

A Bayesian Joint Model for Risk-Taking and Momentary Mood Reveals the Importance of Subjective, Non-Linear Utility Curves

Mood is one of the most common terms used in psychiatry, yet poorly defined. Here we propose a novel computational approach that links mood and reaction time to underlying cognitive processes using data from a monetary task that was conducted under closed-loop mood manipulation.

Higher well-being is related to reduced affective reactivity to positive events in daily life.

Within the study of emotions, researchers have increasingly stressed the importance of studying individual differences in emotion dynamics and emotional responding and the way these relate to more stable differences in well-being. However, there is no clear picture regarding affective reactivity to positive events and how different emotional reactions relate to differences in well-being, particularly higher levels of well-being. Theoretical work and empirical findings from different lines of research (e.g., clinical studies, aging literature, positive and personality psychology) support either of 2 predictions: Higher well-being is related to an enhanced or reduced affective reactivity to positive events in daily life. Testing these opposing predictions, we examined global well-being and affective reactivity to daily positive events in 6 studies using the experience-sampling or daily diary method (Ns = 70, 66, 95, 200, 76, and 101). Global well-being was measured with various indicators and a well-being composite score. Across the majority of studies, we found that higher global well-being was associated with reduced affective reactivity to positive events in daily life, as shown by smaller decreases in momentary negative affect. In 3 of the 6 studies, higher well-being composite scores were also associated with smaller increases in momentary positive affect. These findings seem to suggest that people with higher global well-being profit less from the joy of a positive event they experience in daily life. Instead, for people with lower well-being, positive events might be a meaningful way to brighten one's momentary mood. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Momentary mood predicts upcoming real-life sedentary behavior.

Humans in the industrialized world spend a large amount of daily time in sedentary behavior. Since sedentariness negatively impacts a variety of psychophysiological outcomes, the identification of antecedents that lead to sedentary behavior is an important public health issue. In this context, mood, a central indicator for both psychological well-being and mental health, is severely understudied. To investigate whether mood dimensions influence subsequent sedentary behavior, we assessed both constructs at baseline via questionnaires and via ambulatory assessment (AA) over 5days in 92 university employees. We continuously measured sedentary behavior using accelerometers and assessed mood repeatedly 10 times each day on smartphone diaries. We employed multiple regression analyses to analyze between-subject effects and multilevel modeling to analyze within-subject effects. Higher momentary ratings of valence (P<.05) and energetic arousal (P<.01) predicted lower amounts of subsequent sedentary behavior, whereas higher ratings of calmness (P<.01) predicted higher amounts of subsequent sedentary behavior. The context moderated the effect of energetic arousal and calmness on sedentary behavior with increased effects in the home compared to the work context. Mood significantly predicted sedentary behavior on a within-subject level but not on a between-subject level. Preliminary evidence suggests that mood regulates sedentary behavior in everyday life. Time-sensitive analyses, such as from moment to moment revealed an association between mood and sedentary behavior (within-subject), whereas analyses between different individuals revealed no associations (between-subject). These preliminary findings may inform multicomponent intervention strategies that target mood, to reduce sedentary behavior in daily life.

Rumination, mood, and maladaptive eating behaviors in overweight and healthy populations

PurposeThe literature suggests that rumination (i.e., repetitive thinking about 1 or more negative concerns that is perceived as difficult to control) is linked to impaired emotional regulation and increases negative affect. Not only individuals suffering from overweight or obesity, but also healthy individuals might use emotional eating as a coping strategy to deal with negative affect caused by rumination. The aim of the present study was to determine the link between rumination and maladaptive eating strategies in participants with normal weight and overweight/obesity using trait and ecological momentary measures.MethodIn Study 1, 88 individuals from overweight/obese (N = 33) and control group (N = 50) filled in a series of questionnaires assessing trait rumination, and eating behaviors. In Study 2 momentary affect, rumination and eating behavior of 26 participants were assessed using ecological momentary assessment (EMA) methodology.ResultsIn Study 1, the moderated mediation model revealed that emotional eating mediates the link between rumination and uncontrolled eating or snacking, but only in healthy participants and not in the participants with overweight. The results of Study 2 suggest that when both momentary rumination and sad mood are entered into the model predicting momentary daily emotional eating, only rumination remains a significant predictor of emotional eating. This relationship is not modified by the fact that the participants are from healthy controls or the overweight/obese group.DiscussionStudy 1 provided evidence on the differential role of emotional eating in participants with normal weight and with overweight. Study 2 provided initial insights into the role of momentary mood and momentary repetitive thinking in the use of emotional eating in participants’ everyday lives. The differences in group effect in trait and EMA measures indicated also the importance of considering the consciousness of using rumination and emotional eating, while studying those processes in individuals with overweight.Level of evidenceLevel III, case-control analytic study.

FACE-TO-FACE AND FACEBOOK ACROSS THE LIFESPAN: SOCIAL INTERACTIONS BUFFER STRESS ON MOOD, BUT ONLY FOR ADOLESCENTS

Social support serves as a protective factor, buffering stress in both adolescents and adults, however Socioemotional Selectivity Theory suggests developmental differences in stress reactivity and social support. It is unclear how modern forms of social contact, such as social media buffer stress, and the extent to which this differs across the lifespan. We utilized ecological momentary data to examine the moderating effects of age and two distinct types of social contacts the person had experienced in prior hours (frequency of face-to-face, or social media contacts) on the association between daily stress and momentary mood. Participants were recruited initially through Amazon.com’s Mechanical Turk (adolescents referred by a parent). A total of 119 adolescent (n = 44; Agemean= 15.73) and middle-aged/older adult participants (n = 75; Agemean= 59.67) provided momentary data three times a day, on three consecutive days, every two weeks, for up to 12 weeks. Multi-level models showed significant 3-way interactions between stress appraisal of avoiding an argument, age group, and frequency of social contact via face-to-face (β = 1.698, se = 0.542, p = .002) and social media (β = 3.341, se = 0.984, p = .001). Older adults experienced better mood than adolescents. When avoiding an argument was appraised as more stressful, both age groups displayed worse mood. Whereas high levels of recent social contact (both face-to-face and social media) seemed to exacerbate the impact of this stressor on poorer mood for older persons, high levels of recent social contact, particularly social media, had stress-buffering benefits for adolescents.

THE INFLUENCE OF EMOTIONAL IQ ON THE LAGGED RELATIONSHIPS BETWEEN MOMENTARY PAIN AND AFFECT IN OLDER ADULTS

Emotion regulation is influenced by stage of life and time perspective (Carstensen, 1992), with older adults placing greater emphasis on optimizing positive moods and repairing negative ones. Recently, there has been growing interest in emotional intelligence (EI) as a broad indicator of these mood regulation processes. Multiple cross-sectional studies have examined EI, pain and affect in older adults with chronic pain; however, little research has addressed these relationships in temporal context. The current microlongitudinal study addressed this gap by examining (1) lagged relationships between momentary pain and affect, (2) main effects of emotional intelligence (mood attention, clarity and repair) on those relations, and (3) the moderating role of EI on lagged relationships between pain and affect. Three hundred twenty-five older adults (mean age = 63.9) with knee osteoarthritis completed in-person interviews and received four phone calls daily (random within 4-hour blocks) for one week. Multilevel models examined the predictive value of affect from the previous call on current pain, and vice versa, controlling for sociodemographic variables. Across all outcomes (positive affect, negative affect, pain), a significant main effect was found for mood clarity and repair, but not attention. However, EI did not moderate lagged associations between momentary pain and affect. Average pain (across the 28 calls) significantly predicted momentary negative affect, and vice versa. Thus, while emotional intelligence is significantly related to momentary mood states, it does not appear to be related to momentary pain. Implications and ideas for future research are discussed. (R01-AG041655, P. Parmelee & D. Smith, Co-PIs)

Momentary mood response to natural outdoor environments in four European cities

Exposure to natural outdoor environments (NOE) has been shown in population-level studies to reduce anxiety and psychological distress. This study investigated how exposure to one’s everyday natural outdoor environments over one week influenced mood among residents of four European cities including Barcelona (Spain), Stoke-on-Trent (United Kingdom), Doetinchem (The Netherlands) and Kaunas (Lithuania). Participants (n = 368) wore a smartphone equipped with software applications to track location and mood (using mobile ecological momentary assessment (EMA) software), for seven consecutive days. We estimated random-effects ordered logistic regression models to examine the association between mood (positive and negative affect), and exposure to green space, represented by two binary variables indicating exposure versus no exposure to NOE using GPS tracking and satellite and aerial imagery, 10 and 30 min prior to participants’ completing the EMA. Models were adjusted for home city, day of the week, hour of the day, EMA survey type, residential NOE exposure, and sex, age, education level, mental health status and neighbourhood socioeconomic status. In addition, we tested for heterogeneity of effect by city, sex, age, residential NOE exposure and mental health status. Within 10 min of NOE exposure, compared to non-exposure, we found that overall there was a positive relationship with positive affect (OR: 1.39, 95% CI: 1.06, 1.81) of EMA surveys, and non-significant negative association with negative affect (OR: 0.80, 95% CI: 0.58, 1.10). When stratifying, associations were consistently found for Stoke-on-Trent inhabitants and men, while findings by age group were inconsistent. Weaker and less consistent associations were found for exposure 30 min prior to EMA. Our findings support increasing evidence of psychological and mental health benefits of exposure to natural outdoor environments, especially among urban populations such as those included in our study.

Stress, mood, and cortisol during daily life in women with Premenstrual Dysphoric Disorder (PMDD)

Premenstrual Dysphoric Disorder (PMDD) is characterized by significant emotional, physical and behavioral distress during the late luteal phase that remits after menses onset. Outlined as a new diagnostic category in DSM-5, the mechanisms underlying PMDD are still insufficiently known. Previous research suggests that PMDD exacerbates with stressful events, indicating a dysregulation of the hypothalamic-pituitary-adrenal axis. However, studies measuring stress-related processes in affected women in real-time and real-life are lacking. We conducted an Ambulatory Assessment (AA) study to compare subjective stress reactivity together with basal and stress-reactive cortisol activity across the menstrual cycle in women with and without PMDD. Women with current PMDD (n = 61) and age- and education matched controls (n = 61) reported momentary mood, rumination, and daily events via smartphones at semi-random time points 8 times a day over two consecutive days per cycle phase (menstrual, follicular, ovulatory, and late luteal). Twenty minutes after assessments participants collected saliva cortisol samples. Three additional morning samples determined the cortisol awakening response (CAR). Women with PMDD reported particular high daily life stress and high arousal negative affect (NAhigh) towards stressors during the late luteal phase. High momentary stress levels were linked to lower levels of high arousal positive affect (PAhigh) and to higher levels of rumination in PMDD women compared to controls irrespective of cycle phase. Across groups, more stress was linked to higher levels of low arousal NA (NAlow) and to lower levels of low arousal PA (PAlow). Moreover, PMDD was associated with a delayed CAR peak and a flattened diurnal cortisol slope. While neither group showed cortisol reactivity towards daily life stress directly, high momentary NAhigh and low momentary PA predicted high levels of cortisol across groups, whereas high momentary rumination predicted high cortisol output only in healthy women. In this AA-study we identified important stress-related psychological and endocrinological within-person variability in women with PMDD during daily life. Further research is warranted targeting identified AA-based mechanisms to study their predictive role for the clinical course of PMDD and to provide evidence-based therapeutic options for affected women.

S111. A Closed-Loop Adaptive Methodology for Tracking Mood-RPE Sensitivity

Reward prediction errors (RPEs) are dopamine-encoded signals representing the difference between expected and received rewards. RPEs are fundamental to reward learning, and research conducted by Rutledge et al. (2014) demonstrated the influence of RPEs on momentary mood. Given that aberrant RPE encoding and learning have been associated with mood disorders, we developed a closed-loop mood-machine interface (CL-MMI) task in which RPEs are individually manipulated in real-time to track mood-RPE sensitivity.

Methodological Strategies for Ecological Momentary Assessment to Evaluate Mood and Stress in Adult Patients Using Mobile Phones: Systematic Review.

BackgroundEcological momentary assessment (EMA) has utility for measuring psychological properties in daily life. EMA has also allowed researchers to collect data on diverse experiences and symptoms from various subjects.ObjectiveThe aim of this study was to review methodological strategies and useful related information for EMA using mobile phones to capture changes of mood and stress in adult patients seeking health care.MethodsWe searched PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, the Cochrane Library, PsycINFO, and Web of Science. This review included studies published in peer-reviewed journals in English between January 2008 and November 2017 that used basic- or advanced-feature mobile phones to measure momentary mood or stress in adult patients seeking health care in outpatient departments. We excluded studies of smoking and substance addictions and studies of mental disorder patients who had been diagnosed by physicians.ResultsWe reviewed 12 selected articles that used EMA via mobile phones to measure momentary mood and stress and other related variables from various patients with chronic fatigue syndrome, breast cancer, migraine, HIV, tinnitus, temporomandibular disorder, end-stage kidney disease, and traumatic brain injury. Most of the selected studies (11/12, 92%) used signal contingency and in 8 of the 12 studies (67%) alarms were sent at random or semirandom intervals to prompt the momentary measurement. Out of 12 studies, 7 (58%) used specific apps directly installed on mobile phones, 3 (25%) used mobile phones to link to Web-based survey programs, and 2 (17%) used an interactive voice-response system.ConclusionsThis study provides researchers with useful information regarding methodological details for utilizing EMA to measure mood and stress in adult patients. This review shows that EMA methods could be effective and reasonable for measuring momentary mood and stress, given that basic- and advanced-feature mobile phones are ubiquitous, familiar, and easy to approach. Therefore, researchers could adopt and utilize EMA methods using mobile phones to measure psychological health outcomes, such as mood and stress, in adult patients.

How Does Emotion Regulation Strategy Use and Psychological Wellbeing Predict Mood in Adults With and Without Autism Spectrum Disorder? A Naturalistic Assessment.

The aim of this study was to identify emotion regulation (ER) strategies that most strongly impact momentary mood in a sample of 23 adults with and 19 without autism spectrum disorder (ASD). Participants completed cognitive and behavioural assessments, online questionnaires, and experience sampling methodology questions. In the ASD group, the use of dampening and other-blame reduced mood while savouring and emotional acceptance improved mood. The use of self-blame and avoidance negatively impacted mood only in the non-ASD group, suggesting the use of these two strategies do not reduce mood in individuals with ASD. ER and mental health interventions should capture ER strategy use and aim to decrease maladaptive strategy use and increase adaptive strategy use.

14-day smartphone ambulatory assessment of depression symptoms and mood dynamics in a general population sample: comparison with the PHQ-9 depression screening

Introduction: Major depression affects over 300 million people worldwide but cases of depression are often not detected by primary care providers. Consequently, there is a high demand for low-threshold but clinically sound approaches to depression detection. Recent studies show a great willingness among users of mobile health apps to assess daily depression symptoms. In this pilot study, we present a provisional validation of the depression screening app Moodpath. The app offers a 14-day ambulatory assessment (AA) of depression symptoms based on the ICD-10 criteria as well as ecologically momentary mood ratings that allow the study of short-term mood dynamics. Materials and methods: N=113 randomly selected Moodpath users filled out the Patient Health Questionnaire (PHQ-9) after completing 14 days of AA with 3 question blocks (morning, midday and evening) per day. The psychometric properties (sensitivity, specificity, accuracy) of the ambulatory Moodpath screening were assessed on the basis of the retrospective PHQ-9 screening result. In addition, several indicators of mood dynamics (e.g. average, inertia, instability), were calculated and investigated for their individual and incremental predictive value using regression models. Results: We found a strong linear relationship between the PHQ-9 score and the AA Moodpath depression score (r = .76, p < .001). The app-based screening demonstrated a high sensitivity (.879) and acceptable specificity (.787). Different indicators of mood dynamics covered substantial amounts of PHQ-9 variance, depending on the number of days with mood data that were included in the analyses. Discussion: AA and PHQ-9 shared a large proportion of variance but may not measure exactly the same construct. This may be due to the differences in the underlying diagnostic systems or due to differences in momentary and retrospective assessments. Further validation through structured clinical interviews is indicated. The results suggest that ambulatory assessed mood indicators are a promising addition to multimodal depression screening tools. Improving app-based AA screenings requires adapted screening algorithms and corresponding methods for the analysis of dynamic processes over time.