Affective response to binge eating as a predictor of binge eating disorder treatment outcome

This report examined baseline affective response to binge eating as a predictor of binge-eating disorder (BED) treatment outcome. Baseline affective response was defined as: (1) each individual's average net change (i.e., area under the curve [AUC]) of positive affect (PA) or negative affect (NA) before and after binge-eating episodes and (2) post-binge eating slope of PA or NA across seven-days of ecological momentary assessment (EMA). Adults with BED completed Integrative Cognitive-Affective Therapy (ICAT-BED) or cognitive behavioral therapy guided self-help (CBTgsh). Individuals with greater net increases in PA (AUC) following binge eating at baseline exhibited better treatment response in ICAT-BED at end-of-treatment and follow-up. NA affective response was only significant at end-of-treatment; individuals with less rapid post-binge improvements in NA (slope) did better in ICAT-BED, while individuals with lower net improvements in NA (AUC) did better in CBTgsh. Affective response to binge eating may be a marker of BED treatment response.

Possible Application of Ecological Momentary Assessment to Older Adults' Daily Depressive Mood: Integrative Literature Review

BACKGROUND

Ecological momentary assessment is a method of investigating individuals' real-time experiences, behaviors, and moods in their natural environment over time. Despite its general usability and clinical value for evaluating daily depressive mood, there are several methodological challenges when applying ecological momentary assessment to older adults.

OBJECTIVE

The aims of this integrative literature review were to examine possible uses of the ecological momentary assessment methodology with older adults and to suggest strategies to increase the feasibility of its application in geriatric depression research and practice.

METHODS

We searched 4 electronic databases (MEDLINE, CINAHL, PsycINFO, and EMBASE) and gray literature; we also hand searched the retrieved articles' references. We limited all database searches to articles published in peer-reviewed journals from 2009 to 2019. Search terms were "ecological momentary assessment," "smartphone assessment," "real time assessment," "electronic daily diary," "mHealth momentary assessment," "mobile-based app," and "experience sampling method," combined with the relevant terms of depression. We included any studies that enrolled older adults even as a subgroup and that reported depressive mood at least once a day for more than 2 days.

RESULTS

Of the 38 studies that met the inclusion criteria, only 1 study enrolled adults aged 65 years or older as the entire sample; the remainder of the reviewed studies used mixed samples of both younger and older adults. Most of the analyzed studies (18/38, 47%) were quantitative, exploratory (descriptive, correlational, and predictive), and cohort in design. Ecological momentary assessment was used to describe the fluctuating pattern of participants' depressive moods primarily and to examine the correlation between mood patterns and other health outcomes as a concurrent symptom. We found 3 key methodological issues: (1) heterogeneity in study design and protocol, (2) issues with definitions of dropout and adherence, and (3) variation in how depressive symptoms were measured with ecological momentary assessment. Some studies (8/38, 21%) examined the age difference of participants with respect to dropout or poor compliance rate. Detailed participant burden was reported, such as technical problems, aging-related health problems, or discomfort while using the device.

CONCLUSIONS

Ecological momentary assessment has been used for comprehensive assessment of multiple mental health indicators in relation to depressive mood. Our findings provide methodological considerations for further studies that may be implemented using ecological momentary assessment to assess daily depressive mood in older adults. Conducting more feasibility studies focusing on older adults with standardized data collection protocols and mixed-methods research is required to reflect users' experiences. Further telepsychiatric evaluation and diagnosis based on ecological momentary assessment data should involve standardized and sophisticated strategies to maximize the potential of ecological momentary assessment for older adults with depression in the community setting.

mHealth technology for ecological momentary assessment in physical activity research: a systematic review

OBJECTIVE

To systematically review the publications on ecological momentary assessment (EMA) relating to physical activity (PA) behavior in order to classify the methodologies, and to identify the main mHealth technology-based tools and procedures that have been applied during the first 10 years since the emergence of smartphones. As a result of this review, we want to ask if there is enough evidence to propose the use of the term "mEMA" (mobile-based EMA).

DESIGN

A systematic review according to PRISMA Statement (PROSPERO registration: CRD42018088136).

METHOD

Four databases (PsycINFO, CINALH, Medline and Web of Science Core Collection) were searched electronically from 2008 to February 2018.

RESULTS

A total of 76 studies from 297 potential articles on the use of EMA and PA were included in this review. It was found that 71% of studies specifically used "EMA" for assessing PA behaviors but the rest used other terminology that also adjusted to the inclusion criteria. Just over half (51.3%) of studies (39) used mHealth technology, mainly smartphones, for collecting EMA data. The majority (79.5%) of these studies (31 out of 39) were published during the last 4 years. On the other hand, 58.8% of studies that only used paper-and-pencil were published during the first 3 years of the 10-year period analyzed. An accelerometer was the main built-in sensor used for collecting PA behavior by means of mHealth (69%). Most of the studies were carried out on young-adult samples, with only three studies in older adults. Women were included in 60% of studies, and healthy people in 82%. The studies lasted between 1 and 7 days in 57.9%, and between three and seven assessments per day were carried out in 37%. The most popular topics evaluated together with PA were psychological state and social and environmental context.

CONCLUSIONS

We have classified the EMA methodologies used for assessing PA behaviors. A total of 71% of studies used the term "EMA" and 51.3% used mHealth technology. Accelerometers have been the main built-in sensor used for collecting PA. The change of trend in the use of tools for EMA in PA coincides with the technological advances of the last decade due to the emergence of smartphones and mHealth technology. There is enough evidence to use the term mEMA when mHealth technology is being used for monitoring real-time lifestyle behaviors in natural situations. We define mEMA as the use of mobile computing and communication technologies for the EMA of health and lifestyle behaviors. It is clear that the use of mHealth is increasing, but there is still a lot to be gained from taking advantage of all the capabilities of this technology in order to apply EMA to PA behavior. Thus, mEMA methodology can help in the monitoring of healthy lifestyles under both subjective and objective perspectives. The tendency for future research should be the automatic recognition of the PA of the user without interrupting their behavior. The ecological information could be completed with voice messages, image captures or brief text selections on the touch screen made in real time, all managed through smartphone apps. This methodology could be extended when EMA combined with mHealth are used to evaluate other lifestyle behaviors.

Dogs as Support and Motivation for Physical Activity

Physical activity behavior change theorists are actively shifting the field to better align with the science of motivation and decision making. With this shift has come increasing interest in the role of affective judgments, habit, and identity in long-term physical activity maintenance, as well as the importance of framing physical activity in ways that protect autonomy and support personal values. This special communication makes the case for dog walking as a physical activity modality that fits well with the field's new focus. The authors provide an overview of dog walking research performed to date and discuss unanswered research questions. Given the large percentage of U.S. households that own a dog and the mainstream animal welfare movement to rehome adoptable shelter pets, there are innumerable opportunities to leverage the human-dog bond to increase physical activity levels.Dog walking interventions may be a highly practical approach to population-level physical activity promotion.