Emotional determinants of life-space through GPS and ecological momentary assessment in schizophrenia: What gets people out of the house?

Abstract Background Previous research employing global positioning satellite (GPS) data and ecological momentary assessment (EMA) has shown that greater aggregated time at home and less distance traveled (diminished life-space) were associated with poorer community functioning and with more severe negative symptoms in people with schizophrenia. Emotional experiences (e.g., pleasure or anxious avoidance) may reduce time spent outside of the home. We evaluated the associations between concurrent and time-lagged positive and negative affective experiences in relation to time at home and distance travelled in the community (life-space) among people with schizophrenia compared to healthy comparators (HCs). Methods Sixty HCs (mean age = 51.2, SD = 10.9) and 91 people with schizophrenia (mean age=52, SD=9), matched on demographic characteristics, completed in-lab assessments of symptoms, cognition, and functioning. They were then given a smartphone and completed EMA assessments 7 times daily for 7 days at stratified random intervals. EMA surveys included questions about daily life activities and affect. GPS coordinates were collected every 5 minutes, 24 hours a day, over the 7-day study period. Results Participants with schizophrenia spent more time at home than HCs (t = -4.95, p < 0.001). Sadness and ratings of relaxation were not associated with distance traveled away or time spent at home. For HCs, happiness was associated with more distance traveled away as measured by GPS (B=6.85, SE= 3.04, Wald Chi-Square = 5.067, p=0.024). However, for people with schizophrenia, only greater nervousness ratings were associated with more distance from home (B=3.41, SE=1.30, Wald Chi-Square=6.88, p=0.009). Moreover, for people with schizophrenia, greater nervousness ratings were associated with more time spent at home (B=2.07, SE= 0.98, Wald Chi-Square=4.43, p=0.035), and greater nervousness also predicted that a person with schizophrenia would be at home at the next survey in lead analyses, (F(1, 3029)=7.533, p=0.006). Taken together, these results suggest both greater nervousness associated with greater distance away from home and anxious avoidance of leaving the home. Discussion For individuals with schizophrenia, greater overall anxiety was associated with reduced time spent out of the home, and when patients did leave the home, greater distance travelled was associated with greater nervousness. In contrast, HC participants experienced greater positive emotion with larger life-space. These data suggest a significant momentary temporal association of anxiety and behavior in schizophrenia, such that greater nervousness predicted an individual would be more likely to stay at home. These findings suggest avoidance of negative emotion may also contribute to diminished motivated behavior, which may even act as an emotion regulation strategy. Life-space, which can be measured readily over time by mobile devices, may be a novel target for rehabilitative interventions for anxious avoidance in schizophrenia.

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Emotionsregulation bei Depression

Psychologische Rundschau ◽

10.1026/0033-3042/a000172 ◽

2013 ◽

Vol 64 (4) ◽

pp. 235-243 ◽

Cited By ~ 14

Author(s):

Sven Barnow ◽

Maren Aldinger ◽

Ines Ulrich ◽

Malte Stopsack

Keyword(s):

Ecological Momentary Assessment ◽

Ecological Momentary ◽

Momentary Assessment

Die Anzahl der Studien, die sich mit dem Zusammenhang zwischen Emotionsregulation (ER) und depressiven Störungen befassen, steigt. In diesem Review werden Studien zusammengefasst und metaanalytisch ausgewertet, die den Zusammenhang zwischen ER und Depression mittels Fragebögen bzw. Ecological Momentary Assessment (EMA) erfassen. Dabei zeigt sich ein ER-Profil welches durch die vermehrte Nutzung von Rumination, Suppression und Vermeidung bei gleichzeitig seltenerem Einsatz von Neubewertung und Problemlösen gekennzeichnet ist. Mit mittleren bis großen Effekten, ist der Zusammenhang zwischen Depression und maladaptiven Strategien besser belegt als bei den adaptiven Formen, wo die Effekte eher moderat ausfielen. EMA-Messungen bestätigen dieses Profil. Da EMA-Studien neben der Häufigkeit des Strategieeinsatzes auch die Erfassung anderer ER-Parameter wie Effektivität und Flexibilität ermöglichen, sollten solche Designs in der ER-Forschung zukünftig vermehrt Einsatz finden.

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Using Personal Cell Phones for Ecological Momentary Assessment

European Psychologist ◽

10.1027/1016-9040/a000127 ◽

2013 ◽

Vol 18 (1) ◽

pp. 3-11 ◽

Cited By ~ 42

Author(s):

Emmanuel Kuntsche ◽

Florian Labhart

Keyword(s):

Data Collection ◽

Ecological Momentary Assessment ◽

Communication Systems ◽

Cell Phones ◽

Personal Digital Assistants ◽

Natural Environments ◽

Mobility Patterns ◽

Standard Data ◽

Ecological Momentary ◽

Momentary Assessment

Ecological Momentary Assessment (EMA) is a way of collecting data in people’s natural environments in real time and has become very popular in social and health sciences. The emergence of personal digital assistants has led to more complex and sophisticated EMA protocols but has also highlighted some important drawbacks. Modern cell phones combine the functionalities of advanced communication systems with those of a handheld computer and offer various additional features to capture and record sound, pictures, locations, and movements. Moreover, most people own a cell phone, are familiar with the different functions, and always carry it with them. This paper describes ways in which cell phones have been used for data collection purposes in the field of social sciences. This includes automated data capture techniques, for example, geolocation for the study of mobility patterns and the use of external sensors for remote health-monitoring research. The paper also describes cell phones as efficient and user-friendly tools for prompt manual data collection, that is, by asking participants to produce or to provide data. This can either be done by means of dedicated applications or by simply using the web browser. We conclude that cell phones offer a variety of advantages and have a great deal of potential for innovative research designs, suggesting they will be among the standard data collection devices for EMA in the coming years.

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