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Browsing by Subject "Ecological momentary assessment"
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Item Mobile devices for the remote acquisition of physiological and behavioral biomarkers in psychiatric clinical research(Elsevier, 2017-02) Adams, Zachary; McClure, Erin A.; Gray, Kevin M.; Danielson, Carla Kmett; Treiber, Frank A.; Ruggiero, Kenneth J.; Psychiatry, School of MedicinePsychiatric disorders are linked to a variety of biological, psychological, and contextual causes and consequences. Laboratory studies have elucidated the importance of several key physiological and behavioral biomarkers in the study of psychiatric disorders, but much less is known about the role of these biomarkers in naturalistic settings. These gaps are largely driven by methodological barriers to assessing biomarker data rapidly, reliably, and frequently outside the clinic or laboratory. Mobile health (mHealth) tools offer new opportunities to study relevant biomarkers in concert with other types of data (e.g., self-reports, global positioning system data). This review provides an overview on the state of this emerging field and describes examples from the literature where mHealth tools have been used to measure a wide array of biomarkers in the context of psychiatric functioning (e.g., psychological stress, anxiety, autism, substance use). We also outline advantages and special considerations for incorporating mHealth tools for remote biomarker measurement into studies of psychiatric illness and treatment and identify several specific opportunities for expanding this promising methodology. Integrating mHealth tools into this area may dramatically improve psychiatric science and facilitate highly personalized clinical care of psychiatric disorders.Item Novel statistical models for ecological momentary assessment studies of sexually transmitted infections(2016-07-18) He, Fei; Harezlak, Jaroslaw; Liu, Ziyue; Monahan, Patrick; Hensel, Devon J.The research ideas included in this dissertation are motivated by a large sexually trans mitted infections (STIs) study (IU Phone study), which is also an ecological momentary assessment (EMA) study implemented by Indiana University from 2008 to 2013. EMA, as a group of methods used to collect subjects’ up-to-date behaviors and status, can increase the accuracy of this information by allowing a participant to self-administer a survey or diary entry, in their own environment, as close to the occurrence of the behavior as possible. IU Phone study’s high reporting level shows one of the benefits gain from introducing EMA in STIs study. As a prospective study lasting for 84 days, participants in IU Phone study undergo STI testing and complete EMA forms with project-furnished cellular telephones according to the predetermined schedules. At pre-selected eight-hour intervals, participants respond to a series of questions to identify sexual and non-sexual interactions with specific partners including partner name, relationship satisfaction and sexual satisfaction with this partner, time of each coital event and condom use for each event. etc. STIs lab results of all the participants are collected weekly as well. We are interested in several variables related to the risk of infection and sexual or non-sexual behaviors, especially the relationship among the longitudinal processes of those variables. New statistical models and applications are established to deal with the data with complex dependence and sampling data structures. The methodologies covers various of statistical aspect like generalized mixed models, mul tivariate models and autoregressive and cross-lagged model in longitudinal data analysis, misclassification adjustment in imperfect diagnostic tests, and variable-domain functional regression in functional data analysis. The contribution of our work is we bridge the meth ods from different areas with EMA data in the IU Phone study and also build up a novel understanding of the association among all the variables of interest from different perspec tives based on the characteristic of the data. Besides all the statistical analyses included in this dissertation, variety of data visualization techniques also provide informative support in presenting the complex EMA data structure.Item Personalizing Interventions Using Real-World Interactions: Improving Symptoms and Social Functioning in Schizophrenia with Tailored Metacognitive Therapy(American Psychological Association, 2022) Minor, Kyle S.; Marggraf, Matthew P.; Davis, Beshaun J.; Mickens, Jessica L.; Abel, Danielle B.; Robbins, Megan L.; Buck, Kelly D.; Wiehe, Sarah E.; Lysaker, Paul H.; Psychology, School of ScienceObjective: When clients' lives are not reflected in therapy, they struggle to apply the skills learned in treatment to everyday situations. In this pilot study, we determined if using clients' real-world interactions in therapy could effectively target metacognitive capacity-yielding improved symptoms and social functioning-by tailoring treatment to focus on issues faced by clients in daily life. Method: Using a randomized controlled trial design, schizophrenia subjects with metacognitive deficits completed 24 sessions of: (a) Standard Metacognitive Reflection and Insight Therapy (MERIT); or (b) Tailored MERIT. Real-world interactions were captured via the Electronically Activated Recorder (EAR), a smartphone application that passively records audio in daily life. All subjects wore the EAR; however, real-world interactions were only used to personalize sessions in Tailored MERIT. Results: Feasibility and acceptability were shown; those in Tailored MERIT wore the EAR 84% of their waking hours and reported minimal burden. When compared to Standard MERIT, Tailored MERIT participants showed large pre-post reductions in negative metacognitive beliefs and disorganized symptoms. Small, but nonsignificant, improvements in social functioning were also observed. Conclusions: Compared to an evidence-based benchmark, we observed that real-world interactions can be used to tailor metacognitive therapy and improve outcomes in schizophrenia. Tailored MERIT has the potential to impact practice by personalizing treatment to account for individual variations in environment and lifestyle-aligning with the Precision Medicine Initiative-in a way that is not possible with current therapy. This is particularly salient in schizophrenia, where limited insight and cognitive deficits often make subjective reporting unreliable.Item Quality versus Quantity: Determining Real-world Social Functioning Deficits in Schizophrenia(Elsevier, 2021) Abel, Danielle B.; Salyers, Michelle P.; Wu, Wei; Monette, Mahogany A.; Minor, Kyle S.; Psychology, School of ScienceSocial dysfunction is a hallmark of schizophrenia that is associated with emotional disturbances. Researchers have employed ecological momentary assessment (EMA) to measure social and emotional functioning in people with schizophrenia. Yet, few studies have evaluated quality of real-world social interactions, and it is unclear how interactions impact emotional experiences in this population. Using novel EMA that passively collects audio data, we examined daily social behavior and emotion in schizophrenia (n=38) and control (n=36) groups. Contrary to hypotheses, both groups interacted with others at the same rate and exhibited similar levels of positive emotion. However, as expected, the schizophrenia group exhibited significantly less high-quality interactions and reported more negative emotion than controls. Social versus non-social context did not influence experienced emotion in either group. This is the first real-world study to passively assess quality of social interactions in schizophrenia. Although those with schizophrenia did not differ in their number of interactions, they were less likely to engage in substantive, personal conversations. Because high-quality interactions are linked with better social outcomes, this finding has important potential treatment implications. Future research should investigate quality of interactions across different types of social activities to gain a more nuanced understanding of social dysfunction in schizophrenia.Item Social Functioning in Schizophrenia: Comparing Laboratory-based Assessment with Real-world Measures(Elsevier, 2021) Abel, Danielle B.; Minor, Kyle S.; Psychology, School of ScienceResearchers have measured social functioning in schizophrenia using many different strategies. Recent technological advances have made it possible to passively measure behaviors in real-world social situations-allowing for more objective, ecologically valid assessments. Yet, research testing the convergent validity among real-world and laboratory-based social functioning assessment is sparse. The purpose of this study was to test the convergent validity among four social functioning measures: two interview-based rating scales, a self-reported ecological momentary assessment (EMA), and a passive, ambulatory ecological assessment. Data was collected from 36 people with schizophrenia and 33 control participants. Across the entire sample, relationships between interview-based ratings and real-world measures of social functioning only demonstrated small correlations (r's = 0.17-0.19), whereas real-world measures exhibited moderate correlations with one another (r = 0.36). Within groups, real-world measures showed moderate, significant relationships in the control group (r = 0.44) but not in the schizophrenia group (r = 0.27). For those with schizophrenia, the interview-based measures of social functioning were moderately associated with ambulatory ecological assessment (r's = 0.38 and 0.47), but only small associations were observed with self-reported EMA (r's = 0.15 and 0.17). Results suggest social functioning assessments are not highly convergent and likely target different aspects of social functioning. Laboratory-based measures offer global impressions of social functioning whereas real-world measures represent a more nuanced approach. Moreover, ambulatory ecological assessment may most accurately gauge frequency of daily social interactions for those with schizophrenia as it circumvents common pitfalls of self-report and offers a less-biased, in-depth evaluation of social behavior.Item Social functioning in schizotypy: How affect influences social behavior in daily life(Wiley, 2020-12) Minor, Kyle S.; Hardin, Kathryn L.; Beaudette, Danielle M.; Waters, Lesley C.; White, Anna L.; Gonzenbach, Virgilio; Robbins, Megan L.; Psychology, School of ScienceObjective: Social deficits are already exhibited by people at risk for schizophrenia-spectrum disorders. Technological advances have made passive detection of social deficits possible at granular levels. Method: In this real-world study, we tested if schizotypy status (high/low) predicted two types of social behavior: (1) being around other people; and (2) actively socializing with others. We also examined if schizotypy influences relationships between social behavior and affect using subjective and objective instruments. Results: Our findings revealed that socializing with others was significantly decreased in the high schizotypy group. Positive affect increased in social situations and predicted later social behavior in those low, but not high, in schizotypy. Conclusion: Decreased social behavior in schizotypy may be explained, in part, by these individuals being less incentivized than their peers to pursue social situations. Future studies should test this explanation in larger samples exhibiting elevated positive, negative, and disorganized schizotypy traits.Item The feasibility of using ecological momentary assessment to understand urinary and fecal incontinence experiences in adults with spina bifida: A 30-day study(Public Library of Science, 2023-11-30) Hensel, Devon J.; Young, Audrey I.; Szymanski, Konrad M.; Pediatrics, School of MedicineIn this paper, we evaluate the feasibility of using ecological momentary assessment (EMA) to understand urinary (UI) and fecal (FI) incontinence in adults with spina bifida (SB). As part of a larger 30-day prospective study to understand the incontinence in adults with SB (N = 89), participants completed end-of-day EMA diaries assessing the frequency and context of UI and FI. We used these data to assess the method feasibility across six dimensions: (a) compliance, or data entry which is consistent with study protocol and substantially complete; (b) reactivity, or behavior change attributed to study participation; (c) participant acceptability, or convenience and ease of method beneficial to compliance; (d) data capture, or the volume of incontinence behaviors collected; (e) the accuracy of incontinence reports; and f) participant-provided feedback for future studies. Participants were highly compliant with diary entry protocol and schedule: submitting 95.7% (2576/2700) of the expected total daily entries. The average completion time was two minutes. Neither the total number of submissions nor the completion time varied by demographic characteristics or health history. A sufficient volume of incontinence and affective outcomes were captured, with small downtrends in reporting of UI and affect over time. Exit survey recall was highly correlated with diary reports. Participants found the methodology to be acceptable, reported their experiences honestly, enjoyed and felt comfortable participating in the study and would engage in similar study in the future. Accurate information about the daily context of UI and FI is a key factor in the success of intervention or education programs relying on this information. Our findings demonstrate that EMA is a feasible way to describe UI and FI in adults with SB.