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Strakeljahn F, Lincoln T, Krkovic K, Schlier B. Predicting the onset of psychotic experiences in daily life with the use of ambulatory sensor data - A proof-of-concept study. Schizophr Res 2024; 267:349-355. [PMID: 38615563 DOI: 10.1016/j.schres.2024.03.049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 03/25/2024] [Accepted: 03/31/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Predictive models of psychotic symptoms could improve ecological momentary interventions by dynamically providing help when it is needed. Wearable sensors measuring autonomic arousal constitute a feasible base for predictive models since they passively collect physiological data linked to the onset of psychotic experiences. To explore this potential, we investigated whether changes in autonomic arousal predict the onset of hallucination spectrum experiences (HSE) and paranoia in individuals with an increased likelihood of experiencing psychotic symptoms. METHOD For 24 h of ambulatory assessment, 62 participants wore electrodermal activity and heart rate sensors and were provided with an Android smartphone to answer questions about their HSE-, and paranoia-levels every 20 min. We calculated random forests to detect the onset of HSEs and paranoia. The generalizability of our models was tested using leave-one-assessment-out and leave-one-person-out cross-validation. RESULTS Leave-one-assessment-out models that relied on physiological data and participant ID yielded balanced accuracy scores of 80 % for HSE and 66 % for paranoia. Adding baseline information about lifetime experiences of psychotic symptoms increased balanced accuracy to 82 % (HSE) and 70 % (paranoia). Leave-one-person-out models yielded lower balanced accuracy scores (51 % to 58 %). DISCUSSION Using passively collectible variables to predict the onset of psychotic experiences is possible and prediction models improve with additional information about lifetime experiences of psychotic symptoms. Generalizing to new individuals showed poor performance, so including personal data from a recipient may be necessary for symptom prediction. Completely individualized prediction models built solely with the data of the person to be predicted might increase accuracy further.
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Affiliation(s)
- Felix Strakeljahn
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, University of Hamburg, 20146 Hamburg, Germany.
| | - Tania Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, University of Hamburg, 20146 Hamburg, Germany
| | - Katarina Krkovic
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, University of Hamburg, 20146 Hamburg, Germany
| | - Björn Schlier
- Clinical Child and Adolescent Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, University of Wuppertal, 42119 Wuppertal, Germany
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Bogudzińska B, Jaworski A, Zajdel A, Skrzypek K, Misiak B. The experience sampling methodology in psychosis risk states: A systematic review. J Psychiatr Res 2024; 175:34-41. [PMID: 38704979 DOI: 10.1016/j.jpsychires.2024.04.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/03/2024] [Accepted: 04/25/2024] [Indexed: 05/07/2024]
Abstract
The experience sampling method (ESM) is a structured diary technique, which is used to assess thoughts, mood and appraise subjective experiences in daily life. It has been recognized as a useful tool for understanding the characteristics, dynamics, and underlying mechanisms of prodromal symptoms of psychosis. The present systematic review aimed to provide a qualitative synthesis of findings provided by the ESM studies conducted in people with psychosis risk states. A systematic review of the MEDLINE, ERIC, Academic Search Ultimate, and Health Source: Nursing/Academic Edition databases, utilizing search terms related to the ESM and the risk of psychosis was conducted. Out of 1069 publication records identified, 77 studies met the inclusion criteria for the review. Data were synthesized around the following topics: 1) assessment of symptoms dynamics and social functioning; 2) assessment of the mechanisms contributing to the emergence of psychotic experiences and 3) assessment of stress sensitivity. The studies have shown that negative emotions are associated with subsequent development of paranoia. The tendency to draw hasty conclusions, aberrant salience, self-esteem, and emotion regulation were the most frequently reported mechanisms associated with the emergence of psychotic experiences. Studies using the ESM also provided evidence for the role of stress sensitivity, in the development of psychotic symptoms. The ESM has widely been applied to studies investigating psychosis risk states, using a variety of protocols. Findings from this systematic review might inform future studies and indicate potential targets for interventions.
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Affiliation(s)
- Bogna Bogudzińska
- Departament of Psychiatry, Wroclaw Medical University, Wroclaw, Poland.
| | | | | | | | - Błażej Misiak
- Departament of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
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Chau AKC, So SHW, Barkus E. The role of loneliness and negative schemas in the moment-to-moment dynamics between social anxiety and paranoia. Sci Rep 2023; 13:20775. [PMID: 38008774 PMCID: PMC10679161 DOI: 10.1038/s41598-023-47912-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 11/20/2023] [Indexed: 11/28/2023] Open
Abstract
Social anxiety and paranoia often co-occur and exacerbate each other. While loneliness and negative schemas contribute to the development of social anxiety and paranoia separately, their role in the development of the two symptoms co-occurring is rarely considered longitudinally. This study examined the moment-to-moment relationship between social anxiety and paranoia, as well as the effects of loneliness and negative schemas on both experiences individually and coincidingly. A total of 134 non-clinical young adults completed experience sampling assessments of momentary social anxiety, paranoia, and loneliness ten times per day for six consecutive days. Participants' negative-self and -other schemas were assessed with the Brief Core Schema Scale. Dynamic structural equation modelling revealed a bidirectional relationship between social anxiety and paranoia across moments. Loneliness preceded increases in both symptoms in the next moment. Higher negative-self schema was associated with a stronger link from paranoia to social anxiety; whereas higher negative-other schema was associated with a stronger link from social anxiety to paranoia. Our findings support the reciprocal relationship between social anxiety and paranoia. While loneliness contributes to the development of social anxiety and paranoia, negative self and other schemas appear to modify the relationships between the two symptoms.
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Affiliation(s)
- Anson Kai Chun Chau
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, New Territories, 3/F Wong Foo Yuan Building, Hong Kong, People's Republic of China
- Institute of Health Equity, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, People's Republic of China
| | - Suzanne Ho-Wai So
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, New Territories, 3/F Wong Foo Yuan Building, Hong Kong, People's Republic of China.
| | - Emma Barkus
- Department of Psychology, Northumbria University, Newcastle Upon Tyne, UK
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Li X, Lafit G, van Aubel E, Vaessen T, Hiekkaranta AP, Houben M, Beijer-Klippel A, de Haan L, Schirmbeck F, Reininghaus U, Myin-Germeys I. Emotion regulation in daily life in early psychosis: The role of contextual appraisals. Schizophr Res 2023; 261:130-138. [PMID: 37722209 DOI: 10.1016/j.schres.2023.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 05/19/2023] [Accepted: 09/11/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND Little is known about whether and how contextual appraisals relate to emotion regulation (ER) strategy use across the ultra-high risk and first episode stages of psychosis. The present study extends previous research by investigating the extent to which different appraisal dimensions of the most negative and positive events of the day are associated with ER strategy use in individuals with ultra-high risk (UHR) and first-episode psychosis (FEP). METHOD Sixty-eight UHR individuals and fifty-five FEP individuals filled out an experience sampling evening questionnaire for six consecutive days, in which their appraisal of intensity, importance and perceived control concerning the most negative or positive event of the day, and the ER strategies they deploy in response to these events were measured. RESULTS Multilevel mixed effect models showed that intensity appraisal was most closely associated with ER strategy use, as opposed to importance and controllability appraisals. Higher intense negative events were associated with more rumination and social sharing, while less intense negative events were associated with more reappraisal. Higher intense positive events were associated with a greater number of deployed strategies and more efforts in using savoring, expression and social sharing. The UHR and FEP individuals did not significantly differ regarding effects of above-mentioned appraisal dimensions on ER. CONCLUSIONS These results provide evidence supporting ER flexibility in early psychosis, and event intensity emerged as the dimension most strongly associated with ER. Future research should better account for other situational factors (such as social context) that might affect ER use in psychosis.
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Affiliation(s)
- Xu Li
- Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven 3000, Belgium; School of Psychology, Central China Normal University, Wuhan 430079, China
| | - Ginette Lafit
- Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven 3000, Belgium; Faculty of Psychology and Educational Sciences, Research Group of Quantitative Psychology and Individual Differences, KU Leuven, Leuven 3000, Belgium
| | - Evelyne van Aubel
- Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven 3000, Belgium
| | - Thomas Vaessen
- Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven 3000, Belgium; Center for eHealth and Well-being Research, Department of Psychology, Health, and Technology, University of Twente, Twente 7500 AE, the Netherlands
| | - Anu P Hiekkaranta
- Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven 3000, Belgium
| | - Marlies Houben
- Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven 3000, Belgium; Department of Medical and Clinical Psychology, Tilburg University, 5037 AB Tilburg, the Netherlands
| | - Annelie Beijer-Klippel
- Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven 3000, Belgium; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht 6229 GT, the Netherlands; Faculty of Psychology, Department of Lifespan Psychology, Open University, Heerlen 6419 AT, the Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, the Netherlands
| | - Frederike Schirmbeck
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam 1105 AZ, the Netherlands
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim 68167, Germany; ESRC Centre for Society and Mental Health and Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London WC2R 2LS, UK
| | - Inez Myin-Germeys
- Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven 3000, Belgium.
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Frondozo CE, Mendoza NB, Dizon JIWT, Buenconsejo JU. The Cognitive Emotion Regulation Questionnaire-Short Specific to the COVID-19 Pandemic. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2022. [DOI: 10.1080/07481756.2022.2102506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Cherry E. Frondozo
- Department of Curriculum and Instruction, Faculty of Education and Human Development, The Education University of Hong Kong, New Territories, Hong Kong SAR, China
| | - Norman B. Mendoza
- Department of Curriculum and Instruction, Faculty of Education and Human Development, The Education University of Hong Kong, New Territories, Hong Kong SAR, China
| | - John Ian Wilzon T. Dizon
- Bau Institute of Medical and Health Sciences Education, The University of Hong Kong, Hong Kong, China
- Department of Psychology, College of Arts and Sciences, Angeles University Foundation, Angeles City, Pampanga, Philippines
| | - Jet U. Buenconsejo
- Department of Special Education and Counselling, Faculty of Education and Human Development, The Education University of Hong Kong, New Territories, Hong Kong SAR, China
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The Influence of Emotion Regulation on the Association Between Depression and Heart Rate Variability in Cardiac Patients. Psychosom Med 2022; 84:702-710. [PMID: 35412515 DOI: 10.1097/psy.0000000000001077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Poor vagally mediated heart rate variability (vmHRV) is a mechanism linking depression to coronary heart disease (CHD). Reduced vmHRV is also considered an index of emotion dysregulation-the frequent use of maladaptive emotion regulation strategies, one of the most important being expressive suppression-which is a key component of depression. Therefore, this study aimed to investigate the moderating role of expressive suppression in the relation between depression and vmHRV in patients with CHD. METHODS The sample included 235 patients with CHD (mean [standard deviation] age = 61.6 [9.8] years; 12% women) admitted to cardiac rehabilitation after a cardiac intervention. The Beck Depression Inventory-II was administered to assess depressive symptoms. Emotion regulation strategies based on either expressive suppression or cognitive reappraisal were assessed through the Emotion Regulation Questionnaire. Resting electrocardiographic recordings were collected for 5 minutes to compute HRV indices. RESULTS Expressive suppression moderated the relation between depressive symptoms and vmHRV ( b = -0.03, p = .012). Patients with lower expressive suppression scores showed no association between depressive symptoms and vmHRV ( b = -0.00, p = .94), whereas those with higher expressive suppression scores showed a significant negative association between depressive symptoms and vmHRV ( b = -0.05, p = .015). CONCLUSIONS The use of expressive suppression is likely to potentiate the relation between depressive symptoms and poor vmHRV, which could increase the cardiac risk in these patients. Targeting emotion regulation skills in cardiac rehabilitation programs may be useful for reducing the impact of depression in cardiac patients.
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Bahlinger K, Lincoln TM, Clamor A. Are Acute Increases and Variability in Emotion Regulation Strategies Related to Negative Affect and Paranoid Thoughts in Daily Life? COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-021-10253-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Background
Negative affect reliably predicts paranoid thoughts. Previous studies point to the importance of emotion regulation for paranoid thoughts but have not yet focused on effects of acute increases and variability in strategy use.
Methods
We conducted an experience-sampling study for one week in a subclinical sample. Acute increases in the intensity of strategy use from one measurement point until the next, between-strategy variability (i.e., standard deviation between all strategies at one measurement point), and within-strategy variability (i.e., standard deviation of each strategy over one day) were analyzed for effects on negative affect and paranoid thoughts.
Results
Multi-level-models indicated that acute increases in acceptance and reappraisal are associated with less negative affect. Acute increases in acceptance, but not in reappraisal, were related to less paranoid thoughts. In contrast, acute increases in rumination and suppression were associated with more negative affect and paranoid thoughts. Between- and within-strategy variability were no significant predictors.
Conclusions
Acute increases in the intensity of but not variability in emotion regulation strategies are related to negative affect and paranoid thoughts in daily life. Future studies are needed to examine whether improving emotion regulation leads to sustainable reductions in symptoms.
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