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Schick A, Rauschenberg C, Ader L, Daemen M, Wieland LM, Paetzold I, Postma MR, Schulte-Strathaus JCC, Reininghaus U. Novel digital methods for gathering intensive time series data in mental health research: scoping review of a rapidly evolving field. Psychol Med 2023; 53:55-65. [PMID: 36377538 PMCID: PMC9874995 DOI: 10.1017/s0033291722003336] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 09/13/2022] [Accepted: 10/05/2022] [Indexed: 11/16/2022]
Abstract
Recent technological advances enable the collection of intensive longitudinal data. This scoping review aimed to provide an overview of methods for collecting intensive time series data in mental health research as well as basic principles, current applications, target constructs, and statistical methods for this type of data.In January 2021, the database MEDLINE was searched. Original articles were identified that (1) used active or passive data collection methods to gather intensive longitudinal data in daily life, (2) had a minimum sample size of N ⩾ 100 participants, and (3) included individuals with subclinical or clinical mental health problems.In total, 3799 original articles were identified, of which 174 met inclusion criteria. The most widely used methods were diary techniques (e.g. Experience Sampling Methodology), various types of sensors (e.g. accelerometer), and app usage data. Target constructs included affect, various symptom domains, cognitive processes, sleep, dysfunctional behaviour, physical activity, and social media use. There was strong evidence on feasibility of, and high compliance with, active and passive data collection methods in diverse clinical settings and groups. Study designs, sampling schedules, and measures varied considerably across studies, limiting the generalisability of findings.Gathering intensive longitudinal data has significant potential to advance mental health research. However, more methodological research is required to establish and meet critical quality standards in this rapidly evolving field. Advanced approaches such as digital phenotyping, ecological momentary interventions, and machine-learning methods will be required to efficiently use intensive longitudinal data and deliver personalised digital interventions and services for improving public mental health.
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Affiliation(s)
- Anita Schick
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Christian Rauschenberg
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Leonie Ader
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Maud Daemen
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Lena M. Wieland
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Isabell Paetzold
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Mary Rose Postma
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Julia C. C. Schulte-Strathaus
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
| | - Ulrich Reininghaus
- Department of Public Mental Health, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Heidelberg, Germany
- Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, London, UK
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Wonderlich JA, Crosby RD, Engel SG, Crow SJ, Peterson CB, Le Grange D, Wonderlich SA, Fischer S. Negative affect and binge eating: Assessing the unique trajectories of negative affect before and after binge-eating episodes across eating disorder diagnostic classifications. Int J Eat Disord 2022; 55:223-230. [PMID: 34877679 PMCID: PMC8861898 DOI: 10.1002/eat.23648] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/17/2021] [Accepted: 11/18/2021] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Ecological momentary assessment (EMA) studies suggest that among individuals who binge eat, emotional states and binge eating are functionally related. However, it is unclear whether the trajectory of negative affect (NA) is the same across diagnostic groups or if specific changes in affect are unique to each diagnostic category. This study examined the moderating effect of diagnosis on the trajectory of negative affect before and after binge eating. METHOD Adults with eating disorder diagnoses (anorexia nervosa [AN] = 118, bulimia nervosa [BN] = 133, binge-eating disorder [BED] = 112) completed an EMA where they reported binge eating and negative affect throughout the day. Generalized estimating equation analyses were used to model the trajectories of NA before and after binge eating. RESULTS For all individuals, the linear trajectory of NA significantly increased before (B = 0.044, p < .001) and decreased following the binge-eating episode (B = -0.054, p < .001). However, diagnosis moderated this trajectory. Specifically, individuals with BN had a greater change in linear trajectories of NA before (B = 2.305, p < .001) and after (B = -4.149, p < .001) binge eating compared to those with BED, but not those with AN. There were no differences in the trajectory of NA between individuals with BED or AN. DISCUSSION These findings suggest that binge-eating episodes in BN may be more strongly associated with NA than in BED, but similar to binge-eating episodes in AN.
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Affiliation(s)
- Joseph A. Wonderlich
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Ross D. Crosby
- Sanford Research Center for Biobehavioral Research, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Scott G. Engel
- Sanford Research Center for Biobehavioral Research, Fargo, North Dakota, USA
| | - Scott J. Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
- The Emily Program, Minneapolis, Minnesota, USA
| | - Carol B. Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, Minnesota, USA
| | - Daniel Le Grange
- Department of Psychiatry and Behavioral Science, University of California San Francisco, San Francisco, California, USA
- Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, Illinois, USA
| | - Stephen A. Wonderlich
- Sanford Research Center for Biobehavioral Research, Fargo, North Dakota, USA
- Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Sarah Fischer
- Department of Psychology, George Mason University, Fairfax, Virginia, USA
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Cascino G, Marciello F, D'Agostino G, Toricco R, Barone E, Monteleone AM. Using network analysis to explore the association between eating disorders symptoms and aggressiveness in Bulimia nervosa. Front Psychiatry 2022; 13:907620. [PMID: 36090364 PMCID: PMC9451028 DOI: 10.3389/fpsyt.2022.907620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/22/2022] [Indexed: 11/13/2022] Open
Abstract
Aggressive behaviors have been reported to be more frequent in people with eating disorders (ED), especially bulimia nervosa (BN). Network Analysis (NA) is particularly useful or examining the interactions among symptoms of comorbid conditions through the identification of "bridge symptoms," defined as those symptoms playing a key role in the connection between two syndromic clusters. The aim of the present study was to investigate the association of ED core symptoms and ED-related psychopathology with aggressiveness in a clinical sample of women with BN through NA. Two hundred and seventy-nine women with BN completed the Eating Disorder Inventory-2 and the Buss-Durkee Hostility Inventory. A NA was conducted, including ED symptoms and aggressiveness measures. The bridge function was implied to identify symptoms bridging ED symptoms and aggressiveness. The most connected nodes among communities were asceticism and impulsivity from ED-related psychopathology, drive for thinness from ED-core psychopathology and guilt and suspicion from aggressiveness domain. In particular, drive for thinness connected ED-core community to verbal hostility, while impulsivity connected ED-related symptoms to guilt and suspicion of aggressiveness community. In conclusion the present study showed that in people with BN guilt is the specific negative emotion of the hostile dimensions that may be bidirectionally associated with ED symptoms.
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Affiliation(s)
- Giammarco Cascino
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Salerno, Italy
| | - Francesca Marciello
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Salerno, Italy
| | - Giulia D'Agostino
- Section of Neurosciences, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana," University of Salerno, Salerno, Italy
| | - Rita Toricco
- Department of Psychiatry, University of Campania "Luigi Vanvitelli," Naples, Italy
| | - Eugenia Barone
- Department of Psychiatry, University of Campania "Luigi Vanvitelli," Naples, Italy
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Mousavi Asl E, Abdi L, Sadegh AM, Behrouzian F. The mediating role of self-compassion in the relationship between positive reactivity, negative reactivity, and perfectionism with disordered eating. J Educ Health Promot 2021; 10:249. [PMID: 34485546 PMCID: PMC8395989 DOI: 10.4103/jehp.jehp_1485_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 12/05/2020] [Indexed: 06/13/2023]
Abstract
BACKGROUND Individuals with disordered eating are at an increased of having one or more additional risks for comorbid disorders, such as anxiety disorder, depressive disorder, and insomnia. Therefore, the present study aimed to investigate the mediating role of self-compassion in the relationship between positive reactivity, negative reactivity, and perfectionism with disordered eating. MATERIALS AND METHODS The study method was descriptive-correlational through structural equation modeling (SEM). The present study population included all students of the University of Tehran in the city of Tehran in 2018-2019. A total of 302 students were selected by convenience sampling method and completed questionnaires on eating attitudes test-8, self-compassion scale (short form), eating disorder inventory-perfectionism scale, and Perth emotional reactivity scale. The SEM path analysis and Pearson correlation coefficient were conducted to analyze the obtained data in SPSS-23 and Lisrel-8.80. RESULTS The finding of the path analysis showed that self-compassion acts as a mediating role in the relationship of disordered eating with positive and negative emotional reactivity and perfectionism. Only the direct effect coefficient of general positive reactivity on disordered eating was not significant. CONCLUSION Based on the results of this study, self-compassion can serve as a protective factor against negative emotional reactivity and perfectionism. Therefore, self-compassion can be considered in the development of prevention and treatment programs for disordered eating.
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Affiliation(s)
- Esmaeil Mousavi Asl
- Department of Psychiatry, School of Medicine, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Leila Abdi
- Department of Psychiatry, School of Medicine, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Amirali Moghaddam Sadegh
- Department of Psychiatry, School of Medicine, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Forouzan Behrouzian
- Department of Psychiatry, School of Medicine, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Morris J, Anderson S. An update on eating disorders. BJPsych advances 2021. [DOI: 10.1192/bja.2020.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARYEating disorders are heterogeneous disorders characterised by a maladaptive drive to lose weight and, for the most part, by extreme fear of weight gain and overvaluation of thin body image. Calorie restriction, overexercise and purging behaviours put some sufferers at high risk of physical morbidity and mortality. Mental preoccupations interfere with social, professional and general quality of life. Patients’ defensive secrecy and compulsivity can make it hard to diagnose and treat such disorders despite the suffering they involve. Integrated medical and psychiatric intervention can save life and safely improve nutrition. Behavioural support – with family and carer involvement when appropriate – can counter the dysregulation that leads to vicious cycles of restriction–binge–purge, helping patients develop new skills to regulate emotion without weight losing. In the future, exciting developments in neuroimaging, neurosurgery and pharmacology may lead to ways to make the brain more responsive to therapy. Insights into risk factors may also improve preventive strategies in a climate of highly sophisticated international electronic communication.
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Mikhail ME. Affect Dysregulation in Context: Implications and Future Directions of Experience Sampling Research on Affect Regulation Models of Loss of Control Eating. Front Psychiatry 2021; 12:747854. [PMID: 34646178 PMCID: PMC8502879 DOI: 10.3389/fpsyt.2021.747854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 09/01/2021] [Indexed: 01/04/2023] Open
Abstract
Loss of control eating is a core, transdiagnostic eating disorder symptom associated with psychological distress, functional impairment, and reduced quality of life. However, the factors that contribute to persistent loss of control eating despite negative consequences are not fully understood. Understanding the mechanisms that maintain loss of control eating is crucial to advance treatments that interrupt these processes. Affect regulation models of loss of control eating hypothesize that negative emotions trigger loss of control eating, and that loss of control eating is negatively reinforced because it temporarily decreases negative affect. Several variations on this basic affect regulation model have been proposed, including theories suggesting that negative affect decreases during loss of control eating rather than afterwards (escape theory), and that loss of control eating replaces one negative emotion with another that is less aversive (trade-off theory). Experience sampling designs that measure negative affect and eating behavior multiple times per day are optimally suited to examining the nuanced predictions of these affect regulation models in people's everyday lives. This paper critically reviews experience sampling studies examining associations between negative affect and loss of control eating, and discusses the implications for different affect regulation models of loss of control eating. The review concludes by proposing an expanded affect-focused model of loss of control eating that incorporates trait-level individual differences and momentary biological and environmental variables to guide future research. Clinical implications and recommendations are discussed.
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Affiliation(s)
- Megan E Mikhail
- Department of Psychology, Michigan State University, East Lansing, MI, United States
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Schaefer LM, Engel SG, Wonderlich SA. Ecological momentary assessment in eating disorders research: recent findings and promising new directions. Curr Opin Psychiatry 2020; 33:528-33. [PMID: 32740204 DOI: 10.1097/YCO.0000000000000639] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE OF REVIEW Ecological momentary assessment (EMA) is an important tool for clarifying common precipitants and consequences of eating disorder symptoms that might be meaningfully targeted in treatments for these pernicious disorders. This article reviews recent advances in EMA work conducted within clinical eating disorder samples. RECENT FINDINGS Published studies from the past 2.5 years can broadly be categorized as involving functional analysis of eating disorder behaviors, examining hypothesized predictors of eating disorder symptoms, or applying novel approaches to EMA data. Examples of the latter category include the use of latent profile analysis with EMA data, integration of neurocognitive (e.g., ambulatory inhibitory control task) or biological indicators (e.g., fMRI, plasma leptin), and examining changes in associations between momentary variables over time through multiwave EMA data collection. SUMMARY EMA studies in eating disorders have advanced significantly in recent years, with findings demonstrating strong support for the emotion regulation function of eating disorder behaviors and momentary predictors of distinct eating disorder symptoms. The use of novel statistical and data collection approaches represent exciting areas of growth, with likely implications for intervention approaches, including those that utilize ambulatory technology to deliver treatment.
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Castellini G, Rossi E, Ricca V. The relationship between eating disorder psychopathology and sexuality: etiological factors and implications for treatment. Curr Opin Psychiatry 2020; 33:554-61. [PMID: 32858598 DOI: 10.1097/YCO.0000000000000646] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW There is a remarkable overlap between eating disorders and sexual problems, both in terms of sexual dysfunctions and risky sexual behaviors. This systematic review of the recent literature aimed at clarifying the nature of this relationship in terms of psychopathological meaning. RECENT FINDINGS Body image disturbance, and particularly body dissatisfaction and embodiment disorder, emerged as shared psychopathological dimensions between eating disorder symptoms and sexual dysfunctions. Interpersonal difficulties, a disturbed intimacy and insecure attachment style, but not a history of sexual abuse per se, resulted to play a pivotal role in the interconnection between eating disorder psychopathology and sexual dysfunctions. On the other hand, several studies confirmed the association between eating disorder symptoms and risky sexual behaviors, which has been explained in terms of several common psychopathological dimensions, including impulsivity and addiction. SUMMARY Sexuality is deeply interconnected with eating disorder psychopathology, and it should be considered a fundamental aspect in managing these disorders. An accurate assessment of sexual function might allow to characterize etiological information (e.g., sexual abuse) and maintaining factors (embodiment disorder and emotion dysregulation). Accordingly, the recovery of a good sexuality should be considered a crucial signal of recovery.
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Liebman RE, Coniglio KA, Becker KR, Tabri N, Keshishian AC, Wons O, Keel PK, Eddy KT, Thomas JJ. Behavioral inhibition moderates the association between overvaluation of shape and weight and noncompensatory purging in eating disorders. Int J Eat Disord 2020; 53:143-148. [PMID: 31758819 DOI: 10.1002/eat.23195] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/19/2019] [Accepted: 10/07/2019] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The cognitive-behavioral therapy (CBT) model of eating disorders suggests that compensatory purging behaviors (e.g., self-induced vomiting, inappropriate laxative use) are primarily driven by binge eating. However, many individuals endorse purging in the absence of binge eating (i.e., noncompensatory purging [NCP]). Research is needed to understand why some individuals purge in the absence of objective or subjective binge-eating episodes. METHOD Given the importance of overvaluation of shape/weight in the CBT model, and the existing evidence linking temperamental characteristics like behavioral inhibition (i.e., the tendency to withdraw in response to threat cues) with purging in general, we tested whether behavioral inhibition moderated the relationship between overvaluation of shape/weight and NCP in a sample of individuals in a residential eating disorder treatment center (N = 143). RESULTS Overvaluation was more strongly related to NCP in individuals with high (relative to low) levels of behavioral inhibition. Among individuals low in behavioral inhibition, overvaluation predicted engagement in NCP to a much weaker extent. DISCUSSION For those high (relative to low) in behavioral inhibition, both emotional avoidance and overvaluation may be important targets in the treatment of NCP, particularly in the absence of binge eating.
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Affiliation(s)
- Rachel E Liebman
- Department of Psychology, Ryerson University, Toronto, Ontario, Canada
| | | | - Kendra R Becker
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Nassim Tabri
- Department of Psychology, Carleton University, Ottawa, Ontario
| | - Ani C Keshishian
- Department of Psychology, University of Louisville, Louisville, KY
| | - Olivia Wons
- Department of Psychology, Drexel University, Philadelphia, PA
| | - Pamela K Keel
- Department of Psychology, Florida State University, Tallahassee, FL
| | - Kamryn T Eddy
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - Jennifer J Thomas
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
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Cardi V, Leppanen J, Leslie M, Esposito M, Treasure J. The use of a positive mood induction video-clip to target eating behaviour in people with bulimia nervosa or binge eating disorder: An experimental study. Appetite 2019; 133:400-4. [PMID: 30529607 DOI: 10.1016/j.appet.2018.12.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 11/29/2018] [Accepted: 12/05/2018] [Indexed: 12/11/2022]
Abstract
Recent theoretical models and empirical research have indicated that momentary negative affect increases the likelihood of binge eating episodes for individuals with bulimia nervosa and binge eating disorder. However, relatively little research has explored the potential for positive mood to serve a protective effect in reducing the likelihood of overeating behaviour in bulimia nervosa and binge eating disorder. The current study included 30 women with bulimia nervosa or binge eating disorder in a within-subjects crossover design. Following exposure to a video designed to induce food craving, we found that a positive mood vodcast was associated with significantly lower levels of negative mood and food consumption in a taste test meal, when compared to a neutral vodcast (p = 0.002). These findings support a role for decreasing negative mood in reducing the likelihood of binge eating behaviour in women with bulimia nervosa and binge eating disorder.
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