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1.  Are Expressive Suppression and Cognitive Reappraisal Associated with Stress-Related Symptoms? 
Behaviour research and therapy  2008;46(9):993-1000.
Emotion dysregulation is thought to be critical to the development of negative psychological outcomes. Gross (1998b) conceptualized the timing of regulation strategies as key to this relationship, with response-focused strategies, such as expressive suppression, as less effective and more detrimental compared to antecedent-focused ones, such as cognitive reappraisal. In the current study, we examined the relationship between reappraisal and expressive suppression and measures of psychopathology, particularly for stress-related reactions, in both undergraduate and trauma-exposed community samples of women. Generally, expressive suppression was associated with higher, and reappraisal with lower, self-reported stress-related symptoms. In particular, expressive suppression was associated with PTSD, anxiety, and depression symptoms in the trauma-exposed community sample, with rumination partially mediating this association. Finally, based on factor analysis, expressive suppression and cognitive reappraisal appear to be independent constructs. Overall, expressive suppression, much more so than cognitive reappraisal, may play an important role in the experience of stress-related symptoms. Further, given their independence, there are potentially relevant clinical implications, as interventions that shift one of these emotion regulation strategies may not lead to changes in the other.
PMCID: PMC2629793  PMID: 18687419
Emotion regulation; expressive suppression; reappraisal; trauma; stress
2.  Momentary time sampling as an estimate of percentage time: A field validation 
This study examined the percentage time estimates of momentary time sampling against the real time obtained with handheld computers in a natural setting. Twenty-two concurrent observations were conducted in elementary schools by one observer who used 15-s momentary time sampling and a second who used a handheld computer. Results for the six behaviors showed a close correspondence between the momentary time sampling percentage observation intervals and the real time percentage observation time, although 15-s momentary time sampling tended not to sample low-frequency short-duration behaviors. The results confirmed laboratory findings that short-interval momentary time sampling estimates percentage time accurately for a wide range of behavior frequencies and durations, and suggested that observers using momentary time sampling in a natural setting are able to obtain accurate data.
PMCID: PMC1286269  PMID: 16795737
time sample; methodology; naturalistic observations
3.  Time-Lagged Moment-to-Moment Interplay Between Negative Affect and Paranoia: New Insights in the Affective Pathway to Psychosis 
Schizophrenia Bulletin  2013;40(2):278-286.
Evidence suggests that affect plays a role in the development of psychosis but the underlying mechanism requires further investigation. This study examines the moment-to-moment dynamics between negative affect (NA) and paranoia prospectively in daily life. A female general population sample (n = 515) participated in an experience sampling study. Time-lagged analyses between increases in momentary NA and subsequent momentary paranoia were examined. The impact of childhood adversity, stress sensitivity (impact of momentary stress on momentary NA), and depressive symptoms on these time-lagged associations, as well as associations with follow-up self-reported psychotic symptoms (Community Assessment of Psychic Experiences and the Symptom Checklist-90-Revised) were investigated. Moments of NA increase resulted in a significant increase in paranoia over 180 subsequent minutes. Both stress sensitivity and depressive symptoms impacted on the transfer of NA to paranoia. Stress sensitivity moderated the level of increase in paranoia during the initial NA increase, while depressive symptoms increased persistence of paranoid feelings from moment to moment. Momentary paranoia responses to NA increases were associated with follow-up psychotic symptoms. Examination of microlevel momentary experience may thus yield new insights into the mechanism underlying co-occurrence of altered mood states and psychosis. Knowledge of the underlying mechanism is required in order to determine source and place where remediation should occur.
PMCID: PMC3932075  PMID: 23407984
momentary assessment methodology; stress; childhood adversity; psychotic symptoms; depressive symptoms
4.  Ruminative Self-Focus and Negative Affect 
Journal of Abnormal Psychology  2008;117(2):314-323.
The authors conducted an experience sampling study to investigate the relationship between momentary ruminative self-focus and negative affect. Ninety-three adults recorded these variables at quasi-random intervals 8 times daily for 1 week. Scores on questionnaire measures of dispositional rumination were associated with mean levels of momentary ruminative self-focus over the experience sampling week. Concurrently, momentary ruminative self-focus was positively associated with negative affect. Cross-lagged analyses revealed that whereas ruminative self-focus predicted negative affect at a subsequent occasion, negative affect also predicted ruminative self-focus at a subsequent occasion. Decomposition of the dispositional rumination measure suggested that brooding, but not reflective pondering, was associated with higher mean levels of negative affect. Though broadly consistent with Nolen-Hoeksema's (1991) response styles theory, these results suggest that a reciprocal relationship exists between ruminative self-focus and negative affect.
PMCID: PMC2672047  PMID: 18489207
depression; rumination; self-focus; experience sampling; affect
5.  Efficacy of a Web-Based, Crowdsourced Peer-To-Peer Cognitive Reappraisal Platform for Depression: Randomized Controlled Trial 
Self-guided, Web-based interventions for depression show promising results but suffer from high attrition and low user engagement. Online peer support networks can be highly engaging, but they show mixed results and lack evidence-based content.
Our aim was to introduce and evaluate a novel Web-based, peer-to-peer cognitive reappraisal platform designed to promote evidence-based techniques, with the hypotheses that (1) repeated use of the platform increases reappraisal and reduces depression and (2) that the social, crowdsourced interactions enhance engagement.
Participants aged 18-35 were recruited online and were randomly assigned to the treatment group, “Panoply” (n=84), or an active control group, online expressive writing (n=82). Both are fully automated Web-based platforms. Participants were asked to use their assigned platform for a minimum of 25 minutes per week for 3 weeks. Both platforms involved posting descriptions of stressful thoughts and situations. Participants on the Panoply platform additionally received crowdsourced reappraisal support immediately after submitting a post (median response time=9 minutes). Panoply participants could also practice reappraising stressful situations submitted by other users. Online questionnaires administered at baseline and 3 weeks assessed depression symptoms, reappraisal, and perseverative thinking. Engagement was assessed through self-report measures, session data, and activity levels.
The Panoply platform produced significant improvements from pre to post for depression (P=.001), reappraisal (P<.001), and perseverative thinking (P<.001). The expressive writing platform yielded significant pre to post improvements for depression (P=.02) and perseverative thinking (P<.001), but not reappraisal (P=.45). The two groups did not diverge significantly at post-test on measures of depression or perseverative thinking, though Panoply users had significantly higher reappraisal scores (P=.02) than expressive writing. We also found significant group by treatment interactions. Individuals with elevated depression symptoms showed greater comparative benefit from Panoply for depression (P=.02) and perseverative thinking (P=.008). Individuals with baseline reappraisal deficits showed greater comparative benefit from Panoply for depression (P=.002) and perseverative thinking (P=.002). Changes in reappraisal mediated the effects of Panoply, but not the expressive writing platform, for both outcomes of depression (ab=-1.04, SE 0.58, 95% CI -2.67 to -.12) and perseverative thinking (ab=-1.02, SE 0.61, 95% CI -2.88 to -.20). Dropout rates were similar for the two platforms; however, Panoply yielded significantly more usage activity (P<.001) and significantly greater user experience scores (P<.001).
Panoply engaged its users and was especially helpful for depressed individuals and for those who might ordinarily underutilize reappraisal techniques. Further investigation is needed to examine the long-term effects of such a platform and whether the benefits generalize to a more diverse population of users.
Trial Registration NCT02302248; (Archived by WebCite at
PMCID: PMC4395771  PMID: 25835472
Web-based intervention; crowdsourcing; randomized controlled trial; depression; cognitive behavioral therapy; mental health; social networks
6.  Memory for Fatigue in Chronic Fatigue Syndrome: Relationships to Fatigue Variability, Catastrophizing, and Negative Affect 
Fatigue in chronic fatigue syndrome (CFS) is usually assessed with retrospective measures rather than real-time momentary symptom assessments. In this study, the authors hypothesized that in participants with CFS, discrepancies between recalled and momentary fatigue would be related to catastrophizing, anxiety, and depression and to variability of momentary fatigue. They also expected that catastrophizing, anxiety, and depression would be associated with momentary fatigue. The authors asked 53 adults with CFS to carry electronic diaries for 3 weeks and record their experiences of momentary fatigue. The authors assessed participants' fatigue recall with weekly ratings and administered questionnaires for catastrophizing, depression, and anxiety. Recall discrepancy was significantly related to the variability of momentary fatigue. In addition, catastrophizing, depression, and momentary fatigue were all significantly related to recall discrepancy. Catastrophizing, depression, anxiety, and momentary negative affect were all significantly associated with momentary fatigue. The findings suggest that momentary fatigue in patients with CFS is related to modifiable psychological factors.
PMCID: PMC2567050  PMID: 18400687
affect; chronic fatigue syndrome; fatigue; measurement; pain
7.  Taking a closer look: time sampling and measurement error1 
A person manufactured his in-seat behavior for 15, 30-min sessions so that there were three blocks of five sessions where the behavior occurred 20%, 50%, and 80% of the time. Whole interval, partial interval, and momentary time-sample measures of the behavior were taken and compared to the continuous measure of the behavior i.e., per cent of time the behavior occurred. For interval time sampling, the difference between the continuous and sample measures i.e., measurement error, was: (1) extensive, (2) unidirectional, (3) a function of the time per response, and (4) inconsistent across changes in the continuous measure. A procedural analysis demonstrated that the frequency and duration of behavior are confounded in interval time sampling. Momentary time sampling was found to be superior to interval time sampling in estimating the duration a behavior occurs.
PMCID: PMC1311189  PMID: 16795556
time sampling; partial interval; whole interval; momentary; measurement error
A simulation study was conducted to provide a more thorough account of measurement error associated with interval sampling methods. A computer program simulated the application of momentary time sampling, partial-interval recording, and whole-interval recording methods on target events randomly distributed across an observation period. The simulation yielded measures of error for multiple combinations of observation period, interval duration, event duration, and cumulative event duration. The simulations were conducted up to 100 times to yield measures of error variability. Although the present simulation confirmed some previously reported characteristics of interval sampling methods, it also revealed many new findings that pertain to each method’s inherent strengths and weaknesses. The analysis and resulting error tables can help guide the selection of the most appropriate sampling method for observation-based behavioral assessments.
PMCID: PMC4580971  PMID: 24127380
interval sampling; measurement error; momentary time sampling; observation; observational data; partial-interval recording; simulation; whole-interval recording
9.  Toward Capturing Momentary Changes of Heart Rate Variability by a Dynamic Analysis Method 
PLoS ONE  2015;10(7):e0133148.
The analysis of heart rate variability (HRV) has been performed on long-term electrocardiography (ECG) recordings (12~24 hours) and short-term recordings (2~5 minutes), which may not capture momentary change of HRV. In this study, we present a new method to analyze the momentary HRV (mHRV). The ECG recordings were segmented into a series of overlapped HRV analysis windows with a window length of 5 minutes and different time increments. The performance of the proposed method in delineating the dynamics of momentary HRV measurement was evaluated with four commonly used time courses of HRV measures on both synthetic time series and real ECG recordings from human subjects and dogs. Our results showed that a smaller time increment could capture more dynamical information on transient changes. Considering a too short increment such as 10 s would cause the indented time courses of the four measures, a 1-min time increment (4-min overlapping) was suggested in the analysis of mHRV in the study. ECG recordings from human subjects and dogs were used to further assess the effectiveness of the proposed method. The pilot study demonstrated that the proposed analysis of mHRV could provide more accurate assessment of the dynamical changes in cardiac activity than the conventional measures of HRV (without time overlapping). The proposed method may provide an efficient means in delineating the dynamics of momentary HRV and it would be worthy performing more investigations.
PMCID: PMC4501678  PMID: 26172953
10.  Factors Predicting Compliance to Ecological Momentary Assessment Among Adolescent Smokers 
Nicotine & Tobacco Research  2013;16(3):351-358.
Ecological momentary assessments (EMAs) are increasingly used in smoking research to understand contextual and individual differences related to smoking and changes in smoking. To date, there has been little detailed research into the predictors of EMA compliance. However, patterns or predictors of compliance may affect key relationships under investigation and introduce sources of bias in results. The purpose of this study was to investigate predictors of compliance to random prompts among a sample of adolescents who had ever smoked.
Data for this study were drawn from a sample of 461 adolescents (9th and 10th graders at baseline) participating in a longitudinal study of smoking escalation. We examined 2 outcomes: subject-level EMA compliance (overall rate of compliance over a week-long EMA wave), and in-the-moment prompt-level compliance to the most proximal random prompt. We investigated several covariates including gender, race, smoking rate, alcohol use, psychological symptomatology, home composition, mood, social context, time in study, inter-prompt interval, and location.
At the overall subject level, higher mean negative affect, smoking rate, alcohol use, and male gender predicted lower compliance with random EMA prompts. At the prompt level, after controlling for significant subject-level predictors of compliance, increased positive affect, being outside of the home, and longer inter-prompt interval predicted lower momentary compliance.
This study identifies several factors associated with overall and momentary EMA compliance among a sample of adolescents participating in a longitudinal study of smoking. We also propose a conceptual framework for investigating the contextual and momentary predictors of compliance within EMA studies.
PMCID: PMC3920338  PMID: 24097816
11.  A Comparison of Momentary Time Sampling and Partial-Interval Recording for Evaluating Functional Relations 
In the current study, momentary time sampling (MTS) and partial-interval recording (PIR) were compared to continuous-duration recording of stereotypy and to the frequency of self-injury during a treatment analysis to determine whether the recording method affected data interpretation. Five previously conducted treatment analysis data sets were analyzed by creating separate graphic displays for each measurement method (duration or frequency, MTS, and PIR). An expert panel interview and structured criterion visual inspection were used to evaluate treatment effects across measurement methods. Results showed that treatment analysis interpretations based on both discontinuous recording methods often matched those based on frequency or duration recording; however, interpretations based on MTS were slightly more likely to match those based on duration and those based on PIR were slightly more likely to match those based on frequency.
PMCID: PMC1986695  PMID: 17970263
measurement; momentary time sampling; partial-interval recording
12.  Momentary Pain and Coping in Temporomandibular Disorder Pain: Exploring Mechanisms of Cognitive Behavioral Treatment for Chronic Pain 
Pain  2009;145(1-2):160-168.
The purpose of this study was to determine whether cognitive-behavioral treatment (CBT) operates by effecting changes in cognitions, affects, and coping behaviors in the context of painful episodes. Patients were 54 men and women with temporomandibular dysfunction-related orofacial pain (TMD) enrolled in a study of brief (6 weeks) standard conservative treatment (STD) or standard treatment plus CBT (STD+CBT). Momentary affects, pain, and coping processes were recorded on a cellphone keypad four times per day for seven days prior to treatment, and for 14 days after treatment had finished, in an experience sampling paradigm. Analyses indicated no treatment effects on general retrospective measures of pain, depression, or pain-related interference with lifestyle at posttreatment. However, mixed model analyses on momentary pain and coping recorded pre- and posttreatment indicated that STD+CBT patients reported greater decreases in pain than did STD patients, significantly greater increases in the use of active cognitive and behavioral coping, and significantly decreased catastrophization. Analyses of experience sampling data indicated that posttreatment momentary pain was negatively predicted by concurrent active coping, self-efficacy, perceived control over pain, and positive-high arousal affect. Concurrent catastrophization was strongly predictive of pain. Active behavioral coping and self-efficacy reported at the prior time point (about 3 hours previously) were also protective, while prior catastrophization and negative-high arousal mood were predictive of momentary pain. The results suggest that CB treatment for TMD pain can help patients alter their coping behaviors, and that these changes translate into improved outcomes.
PMCID: PMC2735598  PMID: 19553018
Mechanisms of treatment; cognitive-behavioral treatment; temporomandibular dysfunction; coping; catastrophizing; experience sampling
13.  Development of an ecological momentary assessment scale for appetite 
An understanding of eating behaviors is an important element of health education and treatment in clinical populations. To understand the biopsychosocial profile of eating behaviors in an ecologically valid way, ecological momentary assessment (EMA) is appropriate because its use is able to overcome the recall bias in patient-reported outcomes (PROs). As appetite is a key PRO associated with eating behaviors, this study was done to develop an EMA scale to evaluate the within-individual variation of momentary appetite and uses this scale to discuss the relationships between appetite and various psychological factors.
Twenty healthy participants (age 23.6 ± 4.2 years old) wore a watch-type computer for a week. Several times a day, including just before and after meals, they recorded their momentary psychological stress, mood states, and ten items related to appetite. In addition, they recorded everything they ate and drank into a personal digital assistant (PDA)-based food diary. Multilevel factor analysis was used to investigate the factor structure of the scale, and the reliability and validity of the scale were also explored.
Multilevel factor analyses found two factors at the within-individual level (hunger/fullness and cravings) and one factor at the between-individual level. Medians for the individually calculated Cronbach’s alphas were 0.89 for hunger/fullness, 0.71 for cravings, and 0.86 for total appetite (the sum of all items). Hunger/fullness, cravings, and total appetite all decreased significantly after meals compared with those before meals, and hunger/fullness, cravings, and total appetite before meals were positively associated with energy intake. There were significant negative associations between both hunger/fullness and total appetite and anxiety and depression as well as between cravings, and depression, anxiety and stress.
The within-individual reliability of the EMA scale to assess momentary appetite was confirmed in most subjects and it was also validated as a useful tool to understand eating behaviors in daily settings. Further refinement of the scale is necessary and further investigations need to be conducted, particularly on clinical populations.
PMCID: PMC4302437  PMID: 25614760
Appetite; Ecological momentary assessment; Food diary; Multilevel factor analysis
14.  Diurnal variation of tension-type headache intensity and exacerbation: An investigation using computerized ecological momentary assessment 
Tension-type headache is a common psychosomatic disease. However, diurnal variation of headache is yet to be clarified, perhaps due to the lack of an appropriate method to investigate it. Like other painful diseases, it would be helpful to know if there is diurnal variation in tension-type headaches, both for managing headaches and understanding their pathophysiology. The aim of this study was to determine if there is diurnal variation in the intensity and exacerbation of tension-type headache.
Patients (N = 31) with tension-type headache recorded for one week their momentary headache intensity several times a day and their acute headache exacerbations using a watch-type computer as an electronic diary (computerized ecological momentary assessment). Multilevel modeling was used to test the effects of time of day on momentary headache intensity and on the occurrence of acute exacerbations.
A significant diurnal variation in momentary headache intensity was shown (P = 0.0005), with the weakest headaches in the morning and a peak in the late afternoon. A between-individual difference in the diurnal pattern was suggested. On-demand medication use was associated with a different diurnal pattern (P = 0.025), suggesting that headache intensity decreases earlier in the evening in subjects who used on-demand medication, while headache subtype, prophylactic medication use, and sex were not associated with the difference. The occurrence of acute headache exacerbation also showed a significant diurnal variation, with a peak after noon (P = 0.0015).
Tension-type headache was shown to have a significant diurnal variation. The relation to pathophysiology and psychosocial aspects needs to be further explored.
PMCID: PMC3479012  PMID: 22943264
Tension-type headache; Ecological momentary assessment; Electronic diary; Diurnal variation
15.  Co-Variation of Depressive Mood and Locomotor Dynamics Evaluated by Ecological Momentary Assessment in Healthy Humans 
PLoS ONE  2013;8(9):e74979.
Computerized ecological momentary assessment (EMA) is widely accepted as a “gold standard” method for capturing momentary symptoms repeatedly experienced in daily life. Although many studies have addressed the within-individual temporal variations in momentary symptoms compared with simultaneously measured external criteria, their concurrent associations, specifically with continuous physiological measures, have not been rigorously examined. Therefore, in the present study, we first examined the variations in momentary symptoms by validating the associations among self-reported symptoms measured simultaneously (depressive mood, anxious mood, and fatigue) and then investigated covariant properties between the symptoms (especially, depressive mood) and local statistics of locomotor activity as the external objective criteria obtained continuously. Healthy subjects (N = 85) from three different populations (adolescents, undergraduates, and office workers) wore a watch-type computer device equipped with EMA software for recording the momentary symptoms experienced by the subjects. Locomotor activity data were also continuously obtained by using an actigraph built into the device. Multilevel modeling analysis confirmed convergent associations by showing positive correlations among momentary symptoms. The increased intermittency of locomotor activity, characterized by a combination of reduced activity with occasional bursts, appeared concurrently with the worsening of depressive mood. Further, this association remained statistically unchanged across groups regardless of group differences in age, lifestyle, and occupation. These results indicate that the temporal variations in the momentary symptoms are not random but reflect the underlying changes in psychophysiological variables in daily life. In addition, our findings on the concurrent changes in depressive mood and locomotor activity may contribute to the continuous estimation of changes in depressive mood and early detection of depressive disorders.
PMCID: PMC3773004  PMID: 24058642
16.  Methods of time sampling: A reappraisal of momentary time sampling and partial interval recording 
We compared the accuracy of momentary time sampling (MTS) and partial interval recording (PIR) in estimating both absolute behavioral levels and relative change. A computer randomly generated runs of pseudobehavior varying in duration and rate and simulated MTS and PIR of each run. Results indicated that when estimating absolute behavioral levels, duration rather than rate should be used as the dependent measure, and MTS is more accurate than PIR. In contrast, PIR is the more sensitive method for detecting relative changes in behavioral levels, although, at high rates, PIR tends to underestimate the degree of change.
PMCID: PMC1308042  PMID: 16795692
observation methods; momentary time sampling; partial interval recording; measurement error
17.  Altered Transfer of Momentary Mental States (ATOMS) as the Basic Unit of Psychosis Liability in Interaction with Environment and Emotions 
PLoS ONE  2013;8(2):e54653.
Psychotic disorders are thought to represent altered neural function. However, research has failed to map diagnostic categories to alterations in neural networks. It is proposed that the basic unit of psychotic psychopathology is the moment-to-moment expression of subtle anomalous experiences of subclinical psychosis, and particularly its tendency to persist from moment-to-moment in daily life, under the influence of familial, environmental, emotional and cognitive factors.
In a general population twin sample (n = 579) and in a study of patients with psychotic disorder (n = 57), their non-psychotic siblings (n = 59) and unrelated controls (n = 75), the experience sampling paradigm (ESM; repetitive, random sampling of momentary mental states and context) was applied. We analysed, in a within-person prospective design, (i) transfer of momentary anomalous experience at time point (t–1) to time point (t) in daily life, and (ii) moderating effects of negative affect, positive affect, daily stressors, IQ and childhood trauma. Additionally, (iii) familial associations between persistence of momentary anomalous experience and psychotic symptomatology were investigated. Higher level of schizotypy in the twins (but not higher level of psychotic symptoms in patients) predicted more persistence of momentary anomalous experience in daily life, both within subjects and across relatives. Persistence of momentary anomalous experience was highest in patients, intermediate in their siblings and lowest in controls. In both studies, persistence of momentary anomalous experience was moderated by higher levels of negative affect, daily stressors and childhood trauma (only in twins), and by lower levels of positive affect. The study of alterations in the moment-to-moment transfer of subtle anomalous experience of psychosis, resulting in their persistence, helps to explain why psychotic and emotional dysregulation tend to cluster in a single phenotype such as schizophrenia, and how familial and environmental risks increase the risk of expression of psychosis from, first, subtle momentary anomalous experience to, second, observable clinical symptoms.
PMCID: PMC3574136  PMID: 23457452
18.  Decentering as a Common Link among Mindfulness, Cognitive Reappraisal, and Social Anxiety 
The tendency to employ both cognitive reappraisal and mindfulness are associated with reduced trait social anxiety; however, it is unclear whether reappraisal and mindfulness are associated with social anxiety through the same mechanisms. It has been proposed that decentering, or the process of seeing thoughts or feelings as objective events in the mind rather than personally identifying with them, may be a key mechanism underlying both cognitive reappraisal and mindfulness.
To examine the relationships between reappraisal, mindfulness, decentering, and social anxiety.
This study utilized structural equation modeling to examine the relationships among cognitive reappraisal, mindfulness, decentering, and social anxiety in a large cross-sectional study.
Results indicate that the relationship between mindfulness and social anxiety is partially accounted for by decentering, whereas the relationship between cognitive reappraisal and social anxiety is more fully accounted for by decentering.
These results imply that decentering may be a common mechanism underlying both cognitive reappraisal and mindfulness, although mindfulness may also affect social anxiety through additional mechanisms. However, given the cross-sectional nature of these findings, results should be considered preliminary with future research being needed to further elucidate these relationships.
PMCID: PMC3756689  PMID: 23218023
19.  Ruminative self-focus, negative life events, and negative affect 
Behaviour Research and Therapy  2008;46(9):1034-1039.
Ruminative thinking is believed to exacerbate the psychological distress that follows stressful life events. An experience-sampling study was conducted in which participants recorded negative life events, ruminative self-focus, and negative affect eight times daily over one week. Occasions when participants reported a negative event were marked by higher levels of negative affect. Additionally, negative events were prospectively associated with higher levels of negative affect at the next sampling occasion, and this relationship was partially mediated by momentary ruminative self-focus. Depressive symptoms were associated with more frequent negative events, but not with increased reactivity to negative events. Trait rumination was associated with reports of more severe negative events and increased reactivity to negative events. These results suggest that the extent to which a person engages in ruminative self-focus after everyday stressors is an important determinant of the degree of distress experienced after such events. Further, dispositional measures of rumination predict mood reactivity to everyday stressors in a non-clinical sample.
PMCID: PMC2682175  PMID: 18684437
Experience-sampling; Affect; Rumination; Stressors; Depression
20.  Does sleep aggravate tension-type headache?: An investigation using computerized ecological momentary assessment and actigraphy 
Both insufficient sleep and oversleeping have been reported as precipitating and aggravating factors of tension-type headache (TTH). However, previous studies relied on recalled self-reports, and the relationship has not been confirmed prospectively and objectively in a daily life situation. Recently, ecological momentary assessment (EMA) using electronic diaries, i.e., computerized EMA, is used to record subjective symptoms with the advantages of avoiding recall bias and faked compliance in daily settings. In addition, actigraphy has become an established method to assess sleep outside laboratories. Therefore, the aim of this study was to investigate the within-individual effect of sleep on the following momentary headache intensity in TTH patients during their daily lives utilizing EMA and actigraphy.
Twenty-seven patients with TTH wore watch-type computers as electronic diaries for seven consecutive days and recorded their momentary headache intensity using a visual analog scale of 0-100 approximately every six hours, on waking up, when going to bed, and at the time of headache exacerbations. They also recorded their self-report of sleep quality, hours of sleep and number of awakenings with the computers when they woke up. Physical activity was continuously recorded by an actigraph inside the watch-type computers. Activity data were analyzed by Cole's algorithm to obtain total sleep time, sleep efficiency, sleep latency, wake time after sleep onset and number of awakenings for each night. Multilevel modeling was used to test the effect of each subjective and objective sleep-related variable on momentary headache intensity on the following day.
Objectively measured total sleep time was significantly positively associated with momentary headache intensity on the following day, while self-reported sleep quality was significantly negatively associated with momentary headache intensity on the following day.
Using computerized EMA and actigraphy, longer sleep and worse sleep quality were shown to be related to more intense headache intensity on within-individual basis and they may be precipitating or aggravating factors of TTH.
PMCID: PMC3163177  PMID: 21835045
21.  An evaluation of time-sample measures of behavior1 
Continuous and time-sample measures of the in-seat behavior of a secretary were obtained. Measurement error, i.e., the extent to which the sample measures deviated from the continuous measure, was a function of the frequency of the sample measurements and the criterion used to score an example of the behavior. If the behavior had to be exhibited throughout the observational interval (whole-interval time sampling), there was a consistent underestimate of the continuous measure. If the behavior had to be exhibited only briefly within the observational interval (partial-interval time sampling), there was a consistent overestimate of the continuous measure. And, if the behavior had to be exhibited at the end of the observational interval (momentary time sampling), overestimations and underestimations of the continuous measure occurred about equally often. As expected, the more frequently the sample measures were made the closer was the agreement between the sample and continuous measures. Two conclusions concerning measurement error in interval time sampling were made. The first was that the error will be a function of the mean time per response. The second is that this error will not be consistent across experimental conditions.
PMCID: PMC1311883  PMID: 16795509
time sampling; whole interval; partial interval; momentary; measurement error; continuous versus time-sample recording
22.  Hill-climbing by pigeons 
Pigeons were exposed to two types of concurrent operant-reinforcement schedules in order to determine what choice rules determine behavior on these schedules. In the first set of experiments, concurrent variable-interval, variable-interval schedules, key-peck responses to either of two alternative schedules produced food reinforcement after a random time interval. The frequency of food-reinforcement availability for the two schedules was varied over different ranges for different birds. In the second series of experiments, concurrent variable-ratio, variable-interval schedules, key-peck responses to one schedule produced food reinforcement after a random time interval, whereas food reinforcement occurred for an alternative schedule only after a random number of responses. Results from both experiments showed that pigeons consistently follow a behavioral strategy in which the alternative schedule chosen at any time is the one which offers the highest momentary reinforcement probability (momentary maximizing). The quality of momentary maximizing was somewhat higher and more consistent when both alternative reinforcement schedules were time-based than when one schedule was time-based and the alternative response-count based. Previous attempts to provide evidence for the existence of momentary maximizing were shown to be based upon faulty assumptions about the behavior implied by momentary maximizing and resultant inappropriate measures of behavior.
PMCID: PMC1347881  PMID: 16812310
concurrent schedules; optimal behavior; momentary maximizing; strategies; variable-interval; variable-ratio; key peck; pigeons
23.  Moment-to-Moment Transfer of Positive Emotions in Daily Life Predicts Future Course of Depression in Both General Population and Patient Samples 
PLoS ONE  2013;8(9):e75655.
Positive affect (PA) is closely linked to prevention of, and recovery from, depression. Previous studies have investigated PA reactivity to pleasant situations with respect to its protective properties in relation to mood disorder. The purpose of this study was to examine, and replicate, whether moment-to-moment transfer of PA in daily life (PA persistence) is relevant to the prediction of future course of depression.
Individuals from three different studies (one general population sample (n=540), and two patient samples (n=43 and n=50) with matching controls (n=39 and n=21, respectively)) participated in an Experience Sampling Method (ESM) study. Time-lagged multilevel analyses were used to assess the degree of transfer (or persistence) of momentary positive affective states over time, in relation to naturalistic outcome (study 1) or treatment outcome (studies 2 and 3). Depressive symptoms were measured using the Symptom Checklist (SCL-90R) in sample 1 and the Hamilton Depression Rating Scale (HDRS) in samples 2 and 3.
In study 1, participants with greater momentary PA persistence were less likely to show depressive symptoms at follow-up. In study 2, patients were more likely to respond to treatment if they displayed greater momentary PA persistence, particularly in those with recurrent depression. In study 3, patients with greater momentary PA persistence were similarly more likely to respond to treatment, especially when treated with imipramine rather than placebo.
The ability to transfer PA from one moment to the next is an important factor in the prevention of and recovery from depressive symptoms. Patients with recurrent depression and those who receive antidepressants rather than placebo may benefit most from this effect. The results suggest that treatment-induced improvement in depression is mediated by increased levels of momentary transfer of PA in daily life, acquisition of which may be contingent on duration of exposure to depressive experience.
PMCID: PMC3781091  PMID: 24086602
24.  A Method for Describing Preschoolers' Activity Preferences 
We designed a series of analyses to develop a measurement system capable of simultaneously recording the free-play patterns of 20 children in a preschool classroom. Study 1 determined the intermittency with which the location and engagement of each child could be momentarily observed before the accuracy of the measurement was compromised. Results showed that intervals up to 120 s introduced less than 10% measurement error. Study 2 determined the extent of agreement between two observers who simultaneously collected data for 20 children using 30-, 60-, 90-, and 120-s momentary time sampling (MTS) intervals. The three larger intervals resulted in high levels of interobserver agreement (above 90%), whereas the 30-s interval resulted in unacceptably low levels of agreement (less than 80%). By allowing observers to select from among the different MTS intervals via a datasheet array and then collect data with the chosen system, Study 3 determined observers' preferences for the remaining MTS intervals. Both data collectors preferred the 90-s MTS procedure. The sensitivity of the 90-s MTS procedure, which was shown to be accurate, reliable, and preferred, was then demonstrated by its use to describe activity preferences of a classroom of children in Study 4. This system identified high- and low-preference activities for individual children and revealed interesting patterns of response allocation by the group.
PMCID: PMC2078569  PMID: 18189093
choice; free play; measurement; momentary time sampling; preference assessment; preschoolers
25.  Using Ecological Momentary Assessment to Study Tobacco Behavior in Urban India: There’s an App for That 
JMIR Research Protocols  2015;4(2):e76.
Ecological momentary assessment (EMA) uses real-time data collection to assess participants’ behaviors and environments. This paper explores the strengths and limitations of using EMA to examine social and environmental exposure to tobacco in urban India among older adolescents and adults.
Objectives of this study were (1) to describe the methods used in an EMA study of tobacco use in urban India using a mobile phone app for data collection, (2) to determine the feasibility of using EMA in the chosen setting by drawing on participant completion and compliance rates with the study protocol, and (3) to provide recommendations on implementing mobile phone EMA research in India and other low- and middle-income countries.
Via mobile phones and the Internet, this study used two EMA surveys: (1) a momentary survey, sent multiple times per day at random to participants, which asked about their real-time tobacco use (smoked and smokeless) and exposure to pro- and antitobacco messaging in their location, and 2) an end-of-day survey sent at the end of each study day. Trained participants, from Hyderabad and Kolkata, India, reported on their social and environmental exposure to tobacco over 10 consecutive days. This feasibility study examined participant compliance, exploring factors related to the successful completion of surveys and the validity of EMA data.
The sample included 205 participants, the majority of whom were male (135/205, 65.9%). Almost half smoked less than daily (56/205, 27.3%) or daily (43/205, 21.0%), and 4.4% (9/205) used smokeless tobacco products. Participants completed and returned 46.87% and 73.02% of momentary and end-of-day surveys, respectively. Significant predictors of momentary survey completion included employment and completion of end-of-day surveys. End-of-day survey completion was only significantly predicted by momentary survey completion.
This first study of EMA in India offers promising results, although more research is needed on how to increase compliance. End-of-day survey completion, which has a lower research burden, may be the more appropriate approach to understanding behaviors such as tobacco use within vulnerable populations in challenging locations. Compliance may also be improved by increasing the number of study visits, compliance checks, or opportunities for retraining participants before and during data collection.
PMCID: PMC4526962  PMID: 26109369
ecological momentary assessment; tobacco control; cell phones; mobile phones; mHealth; telemedicine; smoking

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