Ecological momentary assessment of bulimia nervosa: Does dietary restriction predict binge eating?

The purpose of this study was to examine the relationship between caloric restriction (CR) and binge eating (BE) using ecological momentary assessment (EMA). Participants included 133 women with bulimia nervosa (BN) who completed an EMA protocol for 2 weeks. Logistic regression analyses tested whether CR increased the probability of BE episodes. The results revealed that the odds of BE increased on the day that restriction occurred as well as on the following day. In addition, both restriction and BE on one day predicted the likelihood of BE the subsequent day, but restriction for two days prior to the episode failed to add additional information for predicting BE. These findings support the cognitive behavioral therapy (CBT) model of BN, suggesting that self-reported dietary restriction is predictive of subsequent BE episodes, and that reducing dietary restriction in treatment may lead to improvements in bulimic symptoms.     

Influence of dysphoria on positive and negative cognitive reactivity to daily mood fluctuations

We used an experience sampling design to investigate the influence of dysphoria on positive and negative cognitive reactivity. Participants recorded their thoughts and mood four times per day on PDA devices for one week. We hypothesized that those higher in dysphoria would demonstrate a greater increase in negative thinking in response to negative mood, and a weaker increase in positive cognitions in response to positive mood. These hypotheses were largely supported. For those participants who reported higher initial dysphoria, there was a stronger association between negative mood and thinking and a weaker link between positive mood and thinking. Regression analyses indicated that positive and negative cognitive reactivity were independently related to dysphoria, suggesting that they represent distinct processes. Our results highlight the importance of understanding levels of both negative and positive cognitive reactivity and underscore the benefits of assessing mood and cognition with repeated measurements in "real-time," in order to better understand the antecedent effects of mood on thinking.     

Screen-based and non-screen-based sedentary behaviors are differentially associated with affective states in older adults

Excessive sedentary behavior (SB) contributes to poor affective and physical feeling states, which is particularly concerning for older adults who are the most sedentary sector of the population. Specific types of SB have been shown to differentially impact health in cross-sectional and longitudinal studies, with screen-based SB more negatively impacting aspects of mental health. This study used Ecological Momentary Assessment (EMA), a real-time, intensive longitudinal data capture methodology, to examine the differential impact of screen-based behaviors on momentary affective responses during SB in naturalistic settings. A diverse sample of older adults (pooled across 2 studies) completed an EMA protocol for 8–10 days with six randomly delivered, smartphone assessments per day. At each EMA prompt, participants reported their current activity, whether they were sitting while doing that activity, and affective states. Multilevel models assessed whether screen-based (vs. non-screen-based) behavior moderated affective response during SB.At the within-person level, older adults experienced less positive affect during SB when engaged in a screen-based behavior compared to a non-screen-based SB (B = −0.10, p < 0.01). At the between-person level, positive associations between SB and negative affect (B = 0.79, p = 0.03) were stronger if participants reported engaging in screen-based behaviors for a greater proportion of prompts. Among older adults, screen-based SB may lead to poorer affective states compared to non-screen-based SB. Interventions aiming to reduce SB in this population should consider targeting reductions in screen-based SB as means to improve affective states.     

Within-day time-varying associations between motivation and movement-related behaviors in older adults

ObjectivesEmerging evidence suggests both motivation and movement-related behaviors vary within and across days. Yet common data analytic approaches assume static or consistent relationships between motivation and behavior across time. Just as motivation and behavior change across time, so too might associations between motivation and behavior. This study will apply time-varying effect modeling to Ecological Momentary Assessment (EMA) data to examine time of day differences in how motivational constructs predict older adults’ subsequent movement-related behavior over the next 2 h.DesignOlder adults (n = 104) completed a 10-day EMA protocol.MethodParticipants answered up to 6 EMA prompts/day to assess momentary intentions and self-efficacy to stand or move as well as intentions and self-efficacy to limit sedentary time over the next 2 h. Participants wore an activPAL accelerometer continuously to measure time spent being upright (i.e., standing or moving) and time spent sitting.ResultsOn weekdays, intentions and self-efficacy were generally predictive of subsequent behavior in the expected direction over the majority of the day whereas these constructs predicted subsequent behavior in the expected directions over a smaller range of times on weekend days.ConclusionsThis study adds to emerging evidence that associations between motivational constructs and subsequent behavior change over the course of the day, but these time-varying associations may be different depending on the day of week. This work has implications for intervention design and the timing of intervention content delivery in approaches like just-in-time adaptive interventions.     

Preliminary evidence of diurnal rhythms in everyday behaviors associated with positive affect

The authors used the Electronically Activated Recorder (EAR) to track within-day variability in everyday behaviors associated with positive and negative affect across two samples. The EAR is a portable audio recorder that periodically samples snippets of ambient sounds from participants’ momentary environments. The recorded sounds are then coded for different behaviors. The study tested whether previous findings regarding diurnal patterns in self-reported mood extend to naturalistically observed behavior. Across both samples, behavior associated with positive affect (i.e., socializing, laughing, and singing) varied according to a sinusoidal 24-h rhythm centered around participants’ average waketime while behavior associated with negative affect (i.e., arguing and sighing) did not. Further, there was preliminary evidence that personality traits can moderate these rhythms (e.g., their amplitude).     

Objective and subjective bulimic episodes in the classification of bulimic-type eating disorders: Another nail in the coffin of a problematic distinction

We sought to further explore the validity of the distinction between objective bulimic episodes (OBEs) and subjective bulimic episodes (SBEs) in the study of bulimic-type eating disorders. Drawing on data obtained at the second, interview phase of a large-scale epidemiological study, we identified mutually exclusive subgroups of women with bulimic-type eating disorders who engaged in regular OBEs but not SBEs (n = 37) or regular SBEs but not OBEs (n = 52). These subgroups were compared on a wide range of outcomes, including socio-demographic characteristics, current levels of eating disorder psychopathology, general psychological distress and impairment in role functioning, current and lifetime impairment in quality of life specifically associated with an eating problem, (self)-recognition of an eating problem, health service utilization and use of psychotropic medication. The only difference between groups was that participants who reported regular OBEs were heavier than those who reported regular SBEs. The findings converge with those of previous research in suggesting that bulimic-type eating disorders characterized by regular SBEs, but not OBEs, do not differ in any clinically meaningful way from those characterized by regular OBEs, but not SBEs. Inclusion of bulimic-type eating disorders characterized by regular SBEs as a provisional category requiring further research in DSM-V appears warranted.     

Daily emotional dynamics in depressed youth: a cell phone ecological momentary assessment study

This study used a new cell phone ecological momentary assessment approach to investigate daily emotional dynamics in 47 youths with major depressive disorder (MDD) and 32 no-psychopathology controls (CON) (ages 7-17 years). Information about emotional experience in the natural environment was obtained using answer-only cell phones, while MDD youths received an 8-week course of cognitive behavioral therapy and/or psychopharmacological treatment. Compared with CON youths, MDD youths reported more intense and labile global negative affect; greater sadness, anger, and nervousness; and a lower ratio of positive to negative affect. These differences increased with pubertal maturation. MDD youths spent more time alone and less time with their families than CON youths. Although differences in emotional experiences were found across social contexts, MDD youths were more negative than CON youths in all contexts examined. As the MDD participants progressed through treatment, diagnostic group differences in the intensity and lability of negative affect decreased, but there were no changes in the ratio of positive to negative affect or in measures of social context. We discuss methodological innovations and advantages of this approach, including improved ecological validity and access to information about variability in emotions, change in emotions over time, the balance of positive and negative emotions, and the social context of emotional experience.     

Perceptions and metaperceptions of same-sex social interactions in college women with disordered eating patterns

This study compared perceptions and metaperceptions after a social interaction between a woman with disordered eating (subclinical bulimia nervosa) and a female interaction partner. Hypotheses were: women with disordered eating would have more negative metaperceptions of social interactions than women without disordered eating, and women with disordered eating would show a greater discrepancy between metaperceptions and perceptions than women without disordered eating. All participants completed questionnaires about their perceptions and metaperceptions post-interaction. Results showed women with disordered eating thought that they had made a negative impression; findings addressing the relationships among social desirability, loneliness, social support utilization, and fear of negative evaluation are also discussed.     

Eating behavior in obese BED, obese non-BED, and non-obese control participants: A naturalistic study

Laboratory studies have shown considerable differences between the eating behavior, particularly binge eating behavior, of participants with and without binge eating disorder (BED). However, these findings were not replicated in two field experiments employing ecological momentary assessment (EMA) in which obese BED and obese non-BED participants reported comparable binge eating behavior. In the current study, we examined differences in binge eating with an innovative assessment scheme employing both EMA and a standardized computer-based dietary recall program to avoid some of the limitations of past laboratory and field research. Obese BED, obese non-BED, and non-obese control participants reported significant differences in eating patterns, loss of control, overeating, and binge eating behavior. Of particular importance was the finding that BED participants engaged in more overeating and more binge eating episodes than non-BED participants. These findings suggest that the use of EMA in combination with dietary recall may be a relatively objective and useful approach to assessing binge eating behavior. The findings further suggest that individuals with BED are observably different from those without the disorder, which may have implications for eating disorder diagnoses in DSM-V.     

A systematic review of the within-person association between physical activity and affect in children's and adolescents' daily lives

BackgroundIt is important to understand the relationship between physical activity and affect because affect experienced during physical activity and momentary incidental affect may both predict physical activity behaviours. Additionally, affect experienced during physical activity may explain the mental health benefits of participation in physical activity. Utilising ambulatory assessment techniques, researchers can examine the acute within-person association between physical activity and affect in children and adolescents' daily life. The purpose of this study was to systematically review the literature to determine whether there is a within-person association between physical activity and affect in children and adolescents' daily life.MethodsMedline via EBSCOHost, SPORTdiscus, PsychINFO, and Scopus were searched up to March 2020. A narrative synthesis was used to summarize results of the included studies.ResultsTen studies, reporting on nine unique samples, met the inclusion criteria. The strongest evidence identified was for a positive within-person association between physical activity and subsequent positive affect and energy. The findings regarding the within-person association between physical activity and subsequent negative affect and moods were mixed, as were the findings regarding affect predicting subsequent physical activity.ConclusionThere was mixed support for the acute within-person association between physical activity and affect in children and adolescents. Future research should consider factors that may moderate the relationship between physical activity and affect. Additionally, experimental research should examine how manipulations of incidental affect effect physical activity participation in children and adolescents' daily life.Prospero RegistrationCRD42020141649.     

Examining the effects of perceived social support on momentary mood and symptom reports in asthma and arthritis patients

Objective: Social support has been linked to beneficial effects on health directly (main effect) and as a buffer to stress. Most research, however, has examined these relationships using global and retrospective assessments of health and stress, which may be subject to recall biases. This study used ambulatory ecological momentary assessment (EMA) methods to test the main and stress-buffering effects of social support on the daily health and well-being of asthma and rheumatoid arthritis (RA) patients.

Design: Community volunteers with asthma (n?=?97) or RA (n?=?31) responded to EMA prompts five times daily for one week.

Main outcomes: Baseline perceived social support was obtained, and then, participants reported mood, stress and symptoms using EMA. Multilevel mixed-modelling examined whether social support predicted mood and symptoms directly or via stress-reducing effects.

Results: Supporting a main effect, more perceived social support predicted decreased negative mood and stress severity. Supporting a stress-buffering effect, more perceived social support resulted in fewer reported symptoms when stress was present.

Conclusion: Results suggest perceived social support directly relates to better ambulatory status and dynamically buffers individuals against the negative effects of stressors, and highlight the importance of studying social support across different temporal and contextual levels.     

Reciprocal Prospective Effects of Momentary Cognitions and Affect in Daily Life and Mood Reactivity Toward Daily Events in Remitted Recurrent Depression

Major depressive disorder is a recurrent condition. Potential risk factors for future episodes are maladaptive cognitions, such as rumination and unfavorable reactivity toward negative daily events. Positive thoughts and positive daily events, in contrast, could act as a buffer against mood deterioration. The aim of the present study is to (a) examine differences in daily affect and cognitions in remitted depressed patients with a history of recurrent episodes (rMDD) and healthy controls, (b) analyze reciprocal prospective effects of momentary cognitions and affect, and (c) investigate effects of daily events on affect and cognitions in both groups. A sample of N = 102 participants underwent an ecological momentary assessment (EMA) phase of 5 consecutive days, where rMDD patients (n = 51) and healthy controls (n = 51) indicated their momentary rumination, positive thoughts, affect, and the occurrence of daily events 10 times per day. Via multilevel lag models, we found higher rumination to predict a decrease of positive affect (PA) in the rMDD group, but no effect of rumination on subsequent negative affect (NA) in either group. Higher positive thoughts predicted an increase in PA and a decrease in NA, similarly strong in both groups. Regarding daily events, rMDD patients reported a stronger increase in NA and rumination following negative daily events compared to controls, whereas an observed subsequent decrease of PA and positive thoughts was not moderated by group. Following positive daily events, rMDD patients showed a stronger increase in PA and positive thoughts and a stronger decrease in NA and rumination than controls. For interventions targeting relapse prevention, our results indicate the implementation of strategies fostering the responsiveness to positive events and the up-regulation of positive affect.     

Gender differences in the role of alexithymia and emotional expressivity in disordered eating

Disordered eating habits such as binge-eating, purging, and extreme diet restriction have been linked to a variety of deficits in emotion regulation. Two such aspects of emotion regulation are alexithymia and emotional expressivity, although much of the research is limited to females. This study examines associations between these aspects of emotion regulation and symptoms of bulimia nervosa (BN) in men and women. Participants were 201 female and male undergraduates who completed self-report measures of emotion regulation and BN symptoms. Consistent with prior research, results indicate that alexithymia predicted BN symptoms in females, but not in the presence of emotional expressivity, which proved to be the only unique predictor of BN symptoms. In the male sample, alexithymia predicted BN symptoms over and above emotional expressivity. These findings suggest that BN symptoms in males may partly be explained by one facet of emotion regulation, but they also highlight important gender differences in disordered eating. Future research should further examine the role of emotion regulation in eating pathology in males.     

Momentary affective response to bouts of moderate-to-vigorous physical activity predicts changes in physical activity and sedentary behavior during behavioral weight loss

BackgroundAffective responses are posited to be key predictors of the uptake and maintenance of health behaviors. However, few studies have examined how individuals’ affective response to physical activity, as well as the degree to which their affect response changes, may predict changes in physical activity and sedentary time during behavioral weight loss treatment.PurposeThe current study examined how baseline momentary affective response (i.e., stress and anxiety) to moderate-to-vigorous physical activity (MVPA) and the degree of pre--post intervention change in this response predicted change in daily sedentary, light, and MVPA time during a three-month internet-based weight loss program.MethodsWomen with overweight/obesity (final N = 37) completed 14-day ecological momentary assessment (EMA) protocols with objective measurement of physical activity (i.e., bout-related MVPA time) before and after the intervention.ResultsWomen who had more reinforcing responses to MVPA (i.e., greater reductions in anxiety and stress response following MVPA bouts) at baseline had greater increases in overall MVPA at the end of the intervention. Those who had greater anxiety reductions after MVPA bouts at baseline also evidenced less sedentary time at the end of the intervention. Changes in affective responses across the intervention were not related to changes in physical activity levels.ConclusionsFindings suggest initial levels of affective reinforcement from MVPA bouts predict future change in MVPA and sedentary time during behavioral weight loss. Future work is needed to examine the utility of more precisely targeting affective responses to physical activity to optimize intervention approaches.     

Ambulatory assessment for physical activity research: State of the science,best practices and future directions

Technological and digital progress benefits physical activity (PA) research. Here we compiled expert knowledge on how Ambulatory Assessment (AA) is utilized to advance PA research, i.e., we present results of the 2nd International CAPA Workshop 2019 “Physical Activity Assessment – State of the Science, Best Practices, Future Directions” where invited researchers with experience in PA assessment, evaluation, technology and application participated. First, we provide readers with the state of the AA science, then we give best practice recommendations on how to measure PA via AA and shed light on methodological frontiers, and we furthermore discuss future directions. AA encompasses a class of methods that allows the study of PA and its behavioral, biological and physiological correlates as they unfold in everyday life. AA includes monitoring of movement (e.g., via accelerometry), physiological function (e.g., via mobile electrocardiogram), contextual information (e.g., via geolocation-tracking), and ecological momentary assessment (EMA; e.g., electronic diaries) to capture self-reported information. The strengths of AA are data assessments near real-time, which minimize retrospective biases in real-world settings, consequentially enabling ecological valid findings. Importantly, AA enables multiple assessments across time within subjects resulting in intensive longitudinal data (ILD), which allows unraveling within-person determinants of PA in everyday life. In this paper, we show how AA methods such as triggered e-diaries and geolocation-tracking can be used to measure PA and its correlates, and furthermore how these findings may translate into real-life interventions. In sum, AA provides numerous possibilities for PA research, especially the opportunity to tackle within-subject antecedents, concomitants, and consequences of PA as they unfold in everyday life. In-depth insights on determinants of PA could help us design and deliver impactful interventions in real-world contexts, thus enabling us to solve critical health issues in the 21st century such as insufficient PA and high levels of sedentary behavior.     

Relationship between mood and blood pressure in the natural environment: an adolescent population

We examined the relation between psychological variables and blood pressure (BP) as 28 adolescents engaged in their customary activities over a 24-hr period in their natural environment. Each subject had previously participated in a laboratory study of cardiovascular reactivity. During the ambulatory monitoring period, subjects monitored mood state, perceptions of the environment, and ambulatory BP at 30-min intervals. Mood ratings and BP were averaged across the waking hours. Systolic blood pressure (SBP) reactivity to laboratory stressors was significantly correlated with average SBP in the home environment. Ambulatory SBP was positively associated with worried, hostile, depressed, and tense mood ratings as well as perceptions of the environment as hostile, demanding, and noisy. Ambulatory diastolic blood pressure was correlated with hostile, depressed, and upset mood ratings as well as with hostile and demanding perceptions of the environment. In general, average ambulatory BP appeared to be associated with negative emotions and perceptions of the environment.     

Perceived fit with an academic environment: Attitudinal and behavioral outcomes

Because person–organization fit relates to important outcomes, and because fit is a time-dependent process, there exists a need to model longitudinal data related to fit. In a multi-university sample (N = 1174), we tested hypotheses concerning person–organization fit and various behavioral and attitudinal outcomes; correlations between changes in these variables over time, and the correlates of these changes. Using autoregressive modeling and latent growth curve modeling, results indicated that academic fit leads to academic satisfaction, which in turn leads to turnover intent, and to a lesser extent GPA and class absenteeism. Changes in academic fit correlated highly with similar changes in satisfaction and GPA and with opposite changes in turnover intent. Academic satisfaction did not correlate with subsequent organizational citizenship behavior (OCB) as predicted; changes across these domains were significantly related, but were small. Consistent with our hypotheses, Realistic interests correlated negatively with changes in academic fit and satisfaction. Investigative interests were correlated positively with changes in fit and initial satisfaction levels. We conclude by discussing implications, limitations, and future research concerning the longitudinal analysis of person–organization fit.     

Drive for thinness, affect regulation and physical activity in eating disorders: a daily life study

Using Ecological Momentary Assessment, the within patient associations between drive for thinness, emotional states, momentary urge to be physically active and physical activity were studied in 32 inpatients with an eating disorder. Participants received an electronic device and had to indicate at nine random times a day during 1 week their momentary drive for thinness, positive and negative emotional states and their urge to be physically active and physical activity. Multilevel analyses indicated that patients with higher mean levels for urge to be physically active were characterized by lower body mass index (BMI) and chronically negative affect whereas patients with higher mean levels for physical activity were characterized by lower BMI and higher dispositions for drive for thinness. In addition, within patient relations between drive for thinness and urge to be physically active were moderated by BMI and chronically negative affect whereas within patient relations between drive for thinness and physical activity were moderated by BMI. Finally, also positive emotional states were significantly associated with physical activity within patients. By using a daily process design, characteristics of physical activity were revealed that have not been identified with assessment methods that have a lower time resolution.     

Everyday dynamics in generalized social and political trust

We applied the traits as density distributions of states approach to generalized expectations of trustworthiness, namely, social trust and trust in politicians. Using an experience sampling study (N = 47), we assessed state social trust and trust in politicians four times a day for 2 weeks. Within-person variability was found to be low but meaningful as it was predicted by variations in affect, interactional trust, and prior experiences. There was high stability in interindividual differences in the mean levels of state trustworthiness expectations and in the levels of within-person variability. Our study provides a comprehensive understanding of stability and variability in generalized expectations of trustworthiness and indicates broad applicability of the traits as density distributions of states approach.     

Social anxiety and the experience of positive emotion and anger in everyday life: an ecological momentary assessment approach

Abstract

A few recent studies have found evidence showing that social anxiety is associated with diminished positive affect and elevated anger. However, prior work has relied on trait self-report measures of global positive mood or anger. In this preliminary study, we examined how trait social anxiety relates to moment-to-moment positive and angry emotional states as people navigate through their natural environment in a given day. Of additional interest was whether any associations were limited to social situations or were evident more broadly in non-social situations as well. For 14 days, 38 non-clinical community adults carried electronic diaries to assess their experience of positive emotions, anger, and their current social context and activity. Participants were randomly prompted up to four times per day, leading to 1702 observations. Results showed that social anxiety was associated with less time spent feeling happy and relaxed and more time spent feeling angry throughout the day. In general, people felt happier when they were with other people compared to being alone. Interestingly, people with relatively higher levels of social anxiety reported fewer and less intense positive emotions and greater anger episodes across social and non-social situations.