A procedure for evaluating sensitivity to within-person change: can mood measures in diary studies detect change reliably?

The recent growth in diary and experience sampling research has increased research attention on how people change over time in natural settings. Often however, the measures in these studies were originally developed for studying between-person differences, and their sensitivity to within-person changes is usually unknown. Using a Generalizability Theory framework, the authors illustrate a procedure for developing reliable measures of change using a version of the Profile of Mood States (POMS; McNair, Lorr, & Droppleman, 1992) shortened for diary studies. Analyzing two data sets, one composed of 35 daily reports from 68 persons experiencing a stressful examination and another composed of daily reports from 164 persons over a typical 28-day period, we demonstrate that three-item measures of anxious mood, depressed mood, anger, fatigue, and vigor have appropriate reliability to detect within-person change processes.     

Mood profiles of Masters track and field athletes

In several studies attributing positive health benefits to running, the benefits include reduced depression, fatigue, anger, and increased vigor. Until now, little research has focused on Masters track and field athletes. The present study reports on 587 men and women Masters who participated in a mailed survey measuring mood states using the Profile of Mood States. In comparison to other groups of athletes, these Masters tend to be less depressed, less angry, and less fatigued. Attribution to lifestyle and maturity with their sport is discussed.     

Witnessing interparental psychological aggression in childhood: implications for daily conflict in adult intimate relationships

We examined the consequences of witnessing interparental psychological aggression in childhood for daily conflict processes in adult intimate relationships. Both partners in 73 heterosexual couples provided daily diary reports of relationship conflict over a 28-day period. Partners' reports of witnessing mother-to-father and father-to-mother psychological aggression were used to predict exposure to daily relationship conflicts and reactivity to those conflicts (as reflected in end-of-day anger). Results showed no evidence of exposure effects: Witnessing interparental psychological aggression was unrelated to the number of conflict days reported by either partner. Reactivity effects emerged for males only, with father's aggression predicting increased reactivity and mother's aggression predicting the opposite. However, we found evidence of direct or unmediated effects of interparental conflict on daily anger for both males and females. Mirroring the reactivity pattern, the same-sex parent's psychological aggression predicted greater daily anger, whereas the opposite-sex parent's aggression predicted less daily anger. These effects emerged independently of Big Five measures of personality; moreover, Big Five measures did not predict outcomes independently of interparental aggression.     

Receiving and providing support in couples dealing with multiple sclerosis: A diary study using an equity perspective

This study examined the effects of daily support exchanges in couples facing multiple sclerosis (MS). Two issues were examined: the imbalance between received and provided support, and the extent to which reciprocal exchanges of received and provided support are associated with end‐of‐day well‐being (positive and negative mood and self‐esteem). Guided by equity theory, we expected that one‐sided support provision or receipt would be harmful for well‐being for both patients and partners. We argued that these negative outcomes could be offset by reciprocating support, that is, when both partners receive and provide support. Sixty‐one patients and their partners filled out questionnaires on demographics and disease‐related characteristics and subsequently completed computerized daily diaries for 14 days. At the end of each day, both partners completed diaries on end‐of‐day mood, self‐esteem, received and provided emotional and instrumental support, and several control variables (daily hassles and MS‐related symptoms for patients). Reciprocity in instrumental support transactions was associated with higher levels of self‐esteem among both patients and partners. However, the other results all showed independent effects of support received and provided. Patients’ well‐being was related to providing emotional support and instrumental support, whereas partners’ well‐being was related to receiving emotional support from patients.     

Attachment and anger in an anxiety-provoking situation.

In this study, women were told they would engage in an anxiety-provoking activity. Women then waited with their dating partner for the activity to begin. During this 5-min "stress" period, each couple's interaction was videotaped unobtrusively. Each couple was then told that the woman would not have to do the stressful activity, and each couple was unobtrusively videotaped again during a 5-min "recovery" period. The behavior of both partners was then coded during both periods. The major results revealed that more-avoidant men displayed greater anger during the stress period, especially if their partners were more anxious or distressed or sought more support from them. More-avoidant women also displayed greater anger, particularly if they were highly anxious or distressed and received little support or encountered anger from their partners. During the recovery period, highly ambivalent women behaved more negatively toward their partners if they had been more anxious in the stress period or had sought more support from their partners. These results are discussed in terms of attachment theory.     

Changes in Problematic Anger,Shame, and Disgust in Anxious and Depressed Adults Undergoing Treatment for Emotion Dysregulation

Emotion dysregulation, the pervasive difficulty managing negative emotions, is a core problem across mood and anxiety disorders. Anger, shame, and disgust are particularly problematic emotions, impacting both disorder severity and treatment outcome. We previously found that a 16-week dialectical behavior therapy skills training group (DBT-ST) was superior to an activities-based support group (ASG) in decreasing emotion dysregulation in 44 adults with high emotion dysregulation who met diagnostic criteria for an anxiety or depressive disorder. We presently examine these participants’ changes in anger, shame, disgust, and distress using self-reports collected over 6 months during and after treatment. Hierarchical linear modeling analyses show that DBT-ST was superior to ASG in decreasing anger suppression (d = 0.93) and distress (d = 1.04). Both conditions significantly reduced shame, disgust propensity, and disgust sensitivity, but neither was superior for these outcomes. The treatments did not significantly reduce anger expression. Mediation analyses suggest that condition indirectly influenced 4-month anger suppression, shame, and distress through its effect on 2-month emotion dysregulation. These findings suggest that DBT-ST is efficacious for certain problematic emotions and distress in depressed and anxious adults and that common factors may account for some, but not all, of its benefits.     

Temporal patterns of anxious and depressed mood in generalized anxiety disorder: a daily diary study

Research suggests that anxiety disorders tend to temporally precede depressive disorders, a finding potentially relevant to understanding comorbidity. The current study used diary methods to determine whether daily anxious mood also temporally precedes daily depressed mood. 55 participants with generalized anxiety disorder (GAD) and history of depressive symptoms completed a 21-day daily diary tracking anxious and depressed mood. Daily anxious and depressed moods were concurrently associated. Daily anxious mood predicted later depressed mood at a variety of time lags, with significance peaking at a two-day lag. Depressed mood generally did not predict later anxious mood. Results suggest that the temporal antecedence of anxiety over depression extends to daily symptoms in GAD. Implications for the refinement of comorbidity models, including causal theories, are discussed.     

Daily supportive equity in close relationships

Receiving support in committed relationships has frequently been associated with negative psychological outcomes in the recipient, such as increased distress. The authors hypothesized that these negative effects could be offset by support recipients' reciprocation of support, that is, by creating a sense of supportive equity. To investigate this hypothesis, the authors obtained daily reports of mood and of received and given emotional support from both partners in 85 couples throughout a 4-week period. Reciprocity in support transactions was associated with higher levels of positive mood and lower levels of negative mood. In line with previous research, receiving support without reciprocation was associated with increases in negative mood. Giving support, regardless of receipt, was associated with a decrease in negative mood.     

Therapist Interventions Associated with Productive Emotional Processing in the Context of Attachment-Based Family Therapy for Depressed and Suicidal Adolescents

Productive emotional processing is considered a key change mechanism in attachment-based family therapy (ABFT). This study examined the impact of attachment-based family therapy therapist interventions aimed to promote productive emotional processing of primary adaptive emotions in a sample of 30 depressed and suicidal adolescents who had participated in a larger randomized clinical trial. Results of sequential analyses revealed that relational reframes and therapists’ focus on primary adaptive emotions were associated with the subsequent initiation of adolescents’ productive emotional processing of primary adaptive emotions. In contrast, interpretations, reassurances, and therapists’ focus on adolescents’ rejecting anger toward their parents were all followed by the discontinuation of adolescents’ emotional processing that had already begun. Finally, therapists’ general encouragement of affect and focus on adolescents’ unmet attachment/identity needs were associated with both the initiation of adolescents’ productive emotional processing, and with the discontinuation of such processing once it had already begun. Theoretical and clinical implications are discussed.     

Social support for women with chronic pelvic pain: what is helpful from whom?

Eight women with Chronic Pelvic Pain (CPP) were asked, by means of semi-structured interview, what had been helpful and unhelpful in terms of social support from their partners, families, friends, acquaintances, doctors, nurses and other women with CPP. Firstly, thematic analysis employing a pre-defined social support category system revealed that particular forms of tangible support were preferred from specific support providers but emotional and informational support was appreciated from the whole support network. Secondly, interpretative phenomenological analysis revealed three major additional themes: ‘Pain and Suffering’ described the trauma suffered by these patients and the anger and anxiety surrounding their experience; ‘Ideal Social Support’ revealed a picture of desired support consisting of enduring emotional and practical support which did not undermine individual autonomy; ‘Shortfalls in Social Support’ had subsidiary themes entitled ‘Lack of empathy’ and ‘Lack of engagement’. These themes were described and discussed in relation to each other, extant research and their clinical implications.     

The Affective Consequences of Minority Stress Among Bisexual,Pansexual, and Queer (Bi+) Adults: A Daily Diary Study

Bisexual, pansexual, and queer (bi+) individuals are at increased risk for depression and anxiety. These disparities are hypothesized to be due to the unique, minority-specific stressors that they experience. Prior research supports that bi+ stressors are associated with depression and anxiety, but nearly all studies have been cross-sectional, limiting our understanding of how experiencing bi+ stress influences individuals’ levels of depression and anxiety as they occur in their day-to-day lives. To address this gap, we examined the daily associations between bi+ stressors (discrimination, internalized stigma, rejection sensitivity, and identity concealment) and depressed/anxious mood in a 28-day diary study. Participants were 208 bi+ individuals who completed daily measures of bi+ stressors and depressed/anxious mood. We tested unlagged (same-day) and lagged (next-day) associations, and we also tested whether internalized stigma, rejection sensitivity, and identity concealment functioned as mechanisms underlying the daily associations between discrimination and depressed/anxious mood. Participants reported higher depressed/anxious mood on days when they reported higher discrimination, internalized stigma, rejection sensitivity, and identity concealment. There were significant unlagged indirect effects of discrimination on depressed and anxious mood via internalized stigma and rejection sensitivity, and there was also a significant unlagged indirect effect of discrimination on anxiety via identity concealment. However, none of the lagged associations were significant. Results suggest that bi+ stress is related to same-day, but not next-day, depressed/anxious mood. The nonsignificant lagged associations could reflect that bi+ individuals are using adaptive coping skills in response to bi+ stress, or that other experiences throughout the day have stronger influences on next-day mood.     

Emotionally Focused Couple Therapy with Couples Facing Terminal Illness

Research on effective therapeutic interventions for couples dealing with terminal illness is scant. Changes in daily routine, added responsibilities, role changes, and the grief process are all contributors to the enormous stress and emotional strain felt by these couples. Couples where one partner is terminally ill may experience anger, depression, guilt, and anxiety. The authors propose that emotionally focused couple therapy (EFT), originally developed by Greenberg and Johnson (Emotionally focused therapy for couples, Guilford Press, New York, NY, 1988) may be effective in addressing this distress and in facilitating the grieving and support process in couples dealing with terminal illness. EFT is a systemic, experiential form of therapy that builds upon Bowlby’s (Attachment and loss: Volume I: Attachment, Basic Books, New York, NY, 1969) attachment theory. By exploring the emotional experience of both partners it may be possible to re-structure the couple’s emotional partnership and support the grief process for both partners.     

Anger style, psychopathology, and regional brain activity

Depression and anxiety often involve high levels of trait anger and disturbances in anger expression. Reported anger experience and outward anger expression have recently been associated with left-biased asymmetry of frontal cortical activity, assumed to reflect approach motivation. However, different styles of anger expression could presumably involve different brain mechanisms and/or interact with psychopathology to produce various patterns of brain asymmetry. The present study explored these issues by comparing resting regional electroencephalographic activity in participants high in trait anger who differed in anger expression style (high anger-in, high anger-out, both) and participants low in trait anger, with depression and anxiety systematically assessed. Trait anger, not anger-in or anger-out, predicted left-biased asymmetry at medial frontal EEG sites. The anger-in group reported higher levels of anxious apprehension than did the anger-out group. Furthermore, anxious apprehension moderated the relationship between trait anger, anger-in, and asymmetry in favor of the left hemisphere. Results suggest that motivational direction is not always the driving force behind the relationship of anger and left frontal asymmetry. Findings also support a distinction between anxious apprehension and anxious arousal.     

Differentiating cognitive content between depressed and anxious outpatients

Quantitative research suggests that depressed and anxious patients can be differentiated based on their cognitive content. This study used qualitative research methods to separate the specific components of open-ended depressive and anxious thought content in 79 psychiatric outpatients. Patients with major depressive disorder (MDD; n = 36), generalized anxiety disorder (GAD; n = 10), and other psychiatric disorders (PC; n = 33) were instructed to (a) describe their most bothersome problem; (b) imagine the worst possible negative outcome followed by the best possible positive outcome; and (c) describe associated thoughts and emotions for each scenario. The content of patients' responses were coded to examine (a) the types and severity of problems; (b) the presence or absence of hopelessness, catastrophizing, hopefulness, and unrealistic positive expectations; and (c) the presence or absence of particular emotions associated with imagined worst and best outcomes. More GAD patients than MDD and PC patients indicated anticipated anxious emotions associated with imagined worst outcomes, and fewer MDD patients than GAD and PC patients indicated anticipated happiness associated with imagined best outcomes. No group differences emerged for the other variables considered. These findings suggest that depressed and anxious patients differ in their cognitive expectancies about future life events in terms of their own anticipated emotional reactions.     

Prenatal paternal depression

Prenatal depressive symptoms, anxiety, anger and daily hassles were investigated in 156 depressed and non-depressed pregnant women and their depressed and non-depressed partners (fathers-to-be). Depressed versus non-depressed fathers had higher depression, anxiety and daily hassles scores. Although the pregnant women in general had lower anxiety, anger and daily hassles scores than the men, the scores on the measures for depressed fathers and depressed mothers did not differ. Paternal depression appeared to have less effect than maternal depression on their partners’ scores. However, the similarity between the scores of depressed mothers and depressed fathers highlights the importance of screening for depression in fathers-to-be as well as mothers-to-be during pregnancy.     

Fatigue,emotional functioning,and executive dysfunction in pediatric multiple sclerosis

Objective: Fatigue, depression, anxiety, and executive dysfunction are associated with multiple sclerosis (MS) in adults. Existing research suggests similar problems in pediatric MS, but relationships between these variables have not been investigated. This study investigates the associations between executive functioning and fatigue, emotional functioning, age of onset, and disease duration in pediatric MS.

Methods: Twenty-six MS or Clinically Isolated Syndrome (CIS) patients, ages 7 to 18, were evaluated through a multidisciplinary demyelinating diseases clinic. Participants completed neuropsychological screening including Verbal Fluency, Digit Span, and Trail-Making Test. Parents completed rating forms of behavioral, emotional, and executive functioning. Patients and parents completed questionnaires related to the patient’s quality of life and fatigue. Pearson’s correlation coefficients were calculated to investigate relationships between fatigue, emotional functioning, and executive functioning, as well as to examine correlations between parent and child reports of fatigue.

Results: Rates of parent-reported anxiety, depression, fatigue, and executive dysfunction varied widely. Means were below average on the Trail-Making Test and average on Verbal Fluency and Digit Span, though scores varied widely. Various fatigue and emotional functioning indices—but not age of onset or disease duration—significantly correlated with various performance-based measures of executive functioning.

Conclusion: Results indicate pediatric MS is associated with some degree of fatigue, emotional difficulties, and executive dysfunction, the latter of which is associated with the two former. Notably, age of onset and disease duration did not significantly correlate with executive functioning. Results advance understanding of psychological and clinical variables related to neurocognitive outcomes in pediatric MS.     

The influence of breast cancer survivors' Perceived partner social support and need satisfaction on depressive symptoms: A longitudinal analysis

The present study examines the ways in which breast cancer survivors’ perceptions of emotional and instrumental social support from an intimate partner and need satisfaction in their partner role influence depression during and after breast cancer treatment. Our sample was comprised of 163 women who were an average of 57 years old, mostly White/Caucasian, and diagnosed primarily with early-stage breast cancer. Longitudinal data were analysed using both multilevel and structural equation modelling. Results reveal that (a) greater perceived partner emotional support is associated with lowered levels of depression at each wave, (b) partner-role need satisfaction mediates the relationship between perceived partner emotional support and depression at each wave, (c) perceived partner emotional support predicts subsequent changes in depression by way of need satisfaction and (d) depression prospectively predicts lowered perceptions of partner emotional and instrumental support. The findings confirm that basic need satisfaction, within intimate relationships, is an important predictor of lowered depression among breast cancer survivors.     

The experience and effects of emotional support: What the study of cultural and gender differences can tell us about close relationships,emotion, and interpersonal communication

Theorists claim that emotional support is one of the most significant provisions of close relationships, and studies suggest that the receipt of sensitive emotional support is associated with diverse indices of well–being. Research highlighting the beneficial outcomes of emotional support raises several important questions: Does emotional support play a similar role in the personal relationships of both men and women and those representing different ethnicities and nationalities? Is what counts as effective, sensitive, emotional support the same for everyone? And when seeking to provide emotional support, do members of distinct social groups pursue similar or different goals? This article reviews and synthesizes empirical research assessing gender, ethnic, and cultural differences in emotional support in the effort to ascertain the extent and import of these differences. Particular attention is given to demographic differences in (a) the value placed on the emotional support skills of relationship partners, (b) the intentions or goals viewed as especially relevant in emotional support situations, and (c) the evaluation of distinct approaches to providing emotional support. Theoretical, methodological, and practical implications of the findings are explored.     

Implications of Family Cohesion and Conflict for Adolescent Mood and Well-Being: Examining Within- and Between-Family Processes on a Daily Timescale

Family-level conflict and cohesion are well-established predictors of adolescent mental health. However, traditional approaches focusing on between-family differences in cohesion and conflict may overlook daily intrafamily variability that might provide important new information. We used data from a 21-day daily diary protocol in a sample of 151 caregivers (95.3% female) and their adolescent child (61.5% female) in two-caregiver families to test whether daily changes in family functioning are associated with daily changes in adolescent well-being and whether adolescent well-being depends on average levels of family functioning. We examined family cohesion and conflict in relation to adolescent angry, depressed, and anxious mood, as well as happiness, life satisfaction, and meaning and purpose in life in multilevel models. Both cohesion and conflict exhibited meaningful daily variation. Adolescent-reported cohesion and conflict had unique within-family associations with all six adolescent outcomes. Models using parent reports of family functioning yielded fewer associations than models with adolescent reports; however, several findings remained. Cross-level interactions indicated that within-family variations in cohesion were only associated with adolescent depression in families with lower average levels of cohesion across days. In sum, this study provides compelling evidence that families exhibit meaningful variability from day to day and that daily variation has important implications for adolescent well-being.     

Perceptions of conflict and support in romantic relationships: the role of attachment anxiety

Guided by attachment theory, a 2-part study was conducted to test how perceptions of relationship-based conflict and support are associated with relationship satisfaction/closeness and future quality. Dating partners completed diaries for 14 days (Part 1) and then were videotaped while discussing a major problem that occurred during the diary study (Part 2). Part 1 reveals that more anxiously attached individuals perceived more conflict with their dating partners and reported a tendency for conflicts to escalate in severity. Perceptions of daily relationship-based conflicts negatively impacted the perceived satisfaction/closeness and relationship futures of highly anxious individuals, whereas perceptions of greater daily support had positive effects. Part 2 reveals that highly anxious individuals appeared more distressed and escalated the severity of conflicts (rated by observers) and reported feeling more distressed. The authors discuss the unique features of attachment anxiety and how changing perceptions of relationship satisfaction/closeness and stability could erode commitment over time.