Emotional change in its "natural habitat": Measuring everyday emotion regulation with passive and active ambulatory assessment methods

Ecological Momentary Assessment in psychotherapy research: A systematic review

Ecological Momentary Assessment (EMA) stands as a valuable method to capture real-time data on individuals' daily experiences and behaviors. In recent years, the utilization of EMA as a measurement method has substantially increased with the majority of studies emphasizing its clinical utility. However, a comprehensive overview of its use in psychotherapy research is lacking. This study addresses that gap by systematically reviewing EMA's application in psychotherapy research. In total, 168 studies met the inclusion criteria and were classified according to clinical utilization. Six areas of clinical EMA application were identified: prediction of therapy outcome (n = 8), prediction of psychopathology (n = 40), prediction of biopsychosocial states (n = 44), evaluation of therapy outcome (n = 21), acquisition of further clinical insights into specific disorders (n = 68) and adaptation of treatment processes (n = 18). Despite studies consistently highlighting EMA's potential in tailoring psychotherapeutic treatments, its limited use in this area warrants further research. Drawing from our findings, we discuss future research directions for the direct application of EMA in psychotherapeutic settings.

A randomized controlled trial of a compassion-centered spiritual health intervention to improve hospital inpatient outcomes

BACKGROUND

Inpatient medical settings lack evidence-based spiritually integrated interventions to address patient care needs within a pluralistic religious landscape. To address this gap, CCSH™ (Compassion-Centered Spiritual Health) was developed to leverage the skillsets of healthcare chaplains to improve patient outcomes through spiritual consultation. Here, we report the results of a randomized, wait-list controlled, pre-registered (NCT03529812) study that evaluated the impact of CCSH on patient-reported depression and explored putative mediators of CCSH's effects.

METHOD

Chaplain residents were randomized to be trained in CCSH as part of their clinical pastoral education (CPE) residency in the fall (n =  8) or spring semester (n =  8). After fall training, all residents provided spiritual consultations with hospitalized patients (n =  119; n =  54 seen by CCSH-trained chaplains). Those not yet trained to deliver CCSH provided a traditional consult. Patients' pre-consult distress was measured using the National Comprehensive Cancer Network Distress Thermometer, and post-consult depression was measured using the Hospital Anxiety and Depression Scale (HADS). Consults were audio-recorded and transcribed verbatim, and we conducted linguistic analyses using LIWC 2015 software to quantify chaplain linguistic behavior.

RESULTS

Patients seen by CCSH-trained chaplains had lower post-consult depression scores (M =  4.10, SD =  5.04) than patients who were seen by wait-listed chaplains (M =  6.12, SD =  5.08), after adjusting for pre-consult distress (p = .048). There was also a significant relationship between post-consult depression and chaplain LIWC clout scores (r =  -0.24, p = .017), a linguistic measure thought to reflect the expressive confidence and other-oriented focus of the speaker. An exploratory mediation model revealed an indirect effect of CCSH on patient depression through chaplain clout language b =  -0.11 (90% CI, -.257, -.003).

IMPLICATIONS

These data suggest that CCSH decreases patient depression among inpatients, in part due to CCSH-trained chaplains' use of more inclusive, confident, and other-oriented language. We connect these findings with current understandings of effective clinical linguistic behavior and reflect on what this work may mean for integrated spiritual health care.

Diversity, equity, and inclusivity in observational ambulatory assessment: Recommendations from two decades of Electronically Activated Recorder (EAR) research

Ambient audio sampling methods such as the Electronically Activated Recorder (EAR) have become increasingly prominent in clinical and social sciences research. These methods record snippets of naturalistically assessed audio from participants' daily lives, enabling novel observational research about the daily social interactions, identities, environments, behaviors, and speech of populations of interest. In practice, these scientific opportunities are equaled by methodological challenges: researchers' own cultural backgrounds and identities can easily and unknowingly permeate the collection, coding, analysis, and interpretation of social data from daily life. Ambient audio sampling poses unique and significant challenges to cultural humility, diversity, equity, and inclusivity (DEI) in scientific research that require systematized attention. Motivated by this observation, an international consortium of 21 researchers who have used ambient audio sampling methodologies created a workgroup with the aim of improving upon existing published guidelines. We pooled formally and informally documented challenges pertaining to DEI in ambient audio sampling from our collective experience on 40+ studies (most of which used the EAR app) in clinical and healthy populations ranging from children to older adults. This article presents our resultant recommendations and argues for the incorporation of community-engaged research methods in observational ambulatory assessment designs looking forward. We provide concrete recommendations across each stage typical of an ambient audio sampling study (recruiting and enrolling participants, developing coding systems, training coders, handling multi-linguistic participants, data analysis and interpretation, and dissemination of results) as well as guiding questions that can be used to adapt these recommendations to project-specific constraints and needs.

If it Ain't Broke, Don't Fix it: Positive Versus Negative Emotion Regulation in Daily Life and Depressive Symptoms

BACKGROUND

Despite the importance of positive emotions for affective psychopathology, prior research primarily focused on negative emotion regulation. To address this gap, this ecological momentary assessment study compared a broad set of emotion regulation strategies in the context of positive versus negative emotions regarding their effectiveness and associations with depressive symptoms.

METHODS

We analyzed data from 1066 participants who were notified five times daily for seven consecutive days to complete a smartphone survey assessing their predominant emotions, strategies to regulate them, and subsequent emotional outcomes.

RESULTS

Findings show that the effectiveness of most regulation strategies depended on whether the emotional context was positive or negative. While acceptance and savoring predicted improved emotional outcomes across emotional contexts, reappraisal and problem-solving were associated with deteriorated emotional outcomes and increased depressive symptoms when regulating positive but not negative emotions.

LIMITATIONS

Future studies should replicate our findings in demographically and culturally diverse clinical samples to improve generalizability.

CONCLUSION

These results emphasize that strategies effective for regulating negative emotions may be less helpful in the context of positive emotions. Thus, context-specific interventions may be a promising approach to improve the treatment of affective disorders.