Correlates of real-world goal-directed behavior in schizophrenia

2021 ◽  
pp. 1-9
Author(s):  
Jaisal T. Merchant ◽  
Erin K. Moran ◽  
Michael J. Strube ◽  
Deanna M. Barch
Keyword(s):  
Real World ◽  
Negative Symptoms ◽  
Functional Skills ◽  
Daily Lives ◽  
Clinical Interviews ◽  
Motivated Behavior ◽  
Targeted Treatments ◽  
Ecological Momentary ◽  
Goal Directed Behavior ◽  
Momentary Assessment

Abstract Background Deficits in goal-directed behavior (i.e. behavior conducted to achieve a specific goal or outcome) are core to schizophrenia, difficult to treat, and associated with poor functional outcomes. Factors such as negative symptoms, effort-cost decision-making, cognition, and functional skills have all been associated with goal-directed behavior in schizophrenia as indexed by clinical interviews or laboratory-based tasks. However, little work has examined whether these factors relate to the real-world pursuit of goal-directed activities in this population. Methods This study aimed to fill this gap by using Ecological Momentary Assessment (four survey prompts per day for 1 week) to test hypotheses about symptom, effort allocation, cognitive, and functional measures associated with planned and completed goal-directed behavior in the daily lives of 63 individuals with schizophrenia. Results Individuals with schizophrenia completed more goal-directed activities than they planned [t(62) = −4.01, p < 0.001]. Motivation and pleasure (i.e. experiential) negative symptoms, controlling for depressive symptoms, negatively related to planned goal-directed behavior [odds ratio (OR) 0.92, p = 0.005]. Increased effort expenditure for high probability rewards (planned: OR 1.01, p = 0.034, completed: OR 1.01, p = 0.034) along with performance on a daily functional skills task (planned: OR 1.04, p = 0.002, completed: OR 1.03, p = 0.047) negatively related to both planned and completed goal-directed activity. Conclusions Our results present correlates of real-world goal-directed behavior that largely align with impaired ability to make future estimations in schizophrenia. This insight could help identify targeted treatments for the elusive motivated behavior deficits in this population.

scholarly journals Youth Psychopathology in Daily Life: Systematically Reviewed Characteristics and Potentials of Ecological Momentary Assessment Applications

2021 ◽  
Author(s):  
Marjolein R. Thunnissen ◽  
Marije aan het Rot ◽  
Barbara J. van den Hoofdakker ◽  
Maaike H. Nauta
Keyword(s):  
Ecological Momentary Assessment ◽  
Clinical Samples ◽  
Future Research ◽  
Daily Lives ◽  
Clinical Interviews ◽  
And Behavior ◽  
Ecological Momentary ◽  
Momentary Assessment ◽  
Predict Treatment Response ◽  
Over Time

AbstractTraditionally, symptoms of youth psychopathology are assessed with questionnaires, clinical interviews, or laboratory observations. Ecological Momentary Assessment (EMA) could be a particularly valuable additional methodology, since EMA enables examining the daily lives of youths near real-time, considering fluctuations and specific contexts of symptoms. This systematic review aimed to review the characteristics of current EMA applications and to provide a synthesis of their potential in studying youth psychopathology. Following a systematic search in PsycInfo and Medline, we identified 50 studies in clinical samples. Most studies used EMA to examine fluctuations in symptoms, affect, and behavior, and the relation with contextual factors. EMA was also used to investigate interactions between parents and their children over time, and to monitor and predict treatment response. EMA appeared feasible in youth and could provide valuable insights that contribute to understanding youth psychopathology. Benefits, gaps, and suggestions for future research and clinical practice are discussed.

scholarly journals The use of ecological momentary assessment to evaluate real-world aided outcomes with children

2021 ◽  
pp. 1-11
Author(s):  
Danielle Glista ◽  
Robin O’Hagan ◽  
Maaike Van Eeckhoutte ◽  
Yuanhao Lai ◽  
Susan Scollie
Keyword(s):  
Real World ◽  
Ecological Momentary Assessment ◽  
Ecological Momentary ◽  
Momentary Assessment

scholarly journals Weaker Memory Performance Exacerbates Stress-Induced Cannabis Craving in Youths’ Daily Lives

2019 ◽  
Vol 7 (5) ◽  
pp. 1094-1108 ◽  
Author(s):  
Robert Miranda ◽  
Stephanie E. Wemm ◽  
Hayley Treloar Padovano ◽  
Ryan W. Carpenter ◽  
Noah N. Emery ◽  
...  
Keyword(s):  
Working Memory ◽  
Real World ◽  
Substance Misuse ◽  
Memory Performance ◽  
Laboratory Data ◽  
Cue Exposure ◽  
Moment Stress ◽  
Daily Lives ◽  
Ecological Momentary ◽  
Drug Cue

Theories of addiction posit that stimuli associated with drug use, including both exteroceptive (e.g., paraphernalia) and interoceptive (e.g., feeling tense or stressed), evoke craving and contribute to the pathogenesis of substance misuse. Control over drug cue response and stress is essential for moderating use. Building from laboratory data supporting associations between cue exposure, stress, and craving, this study tested whether these associations generalize to real-world settings and examined whether a well-vetted neurocognitive control capacity (i.e., working memory, or WM) moderated associations. Youths ( N = 85; 15–24 years old) completed baseline and ecological momentary assessments. Cue exposure and participants’ average stress predicted higher craving. Youths with weaker WM experienced stronger craving at higher-stress moments but not when faced with cues. Interactions were present for both previous-moment and same-moment stress. Craving among adolescents with stronger WM was not swayed by momentary stress. Findings suggest that stronger WM protects against craving at more stressful moments.

scholarly journals O1.6. AFFECTIVE DETERMINANTS OF LIFE-SPACE THROUGH GPS AND ECOLOGICAL MOMENTARY ASSESSMENT IN SCHIZOPHRENIA: WHAT GETS PEOPLE OUT OF THE HOUSE?

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S3-S3
Author(s):  
Emma Parrish ◽  
Colin Depp ◽  
Raeanne C Moore ◽  
Philip D Harvey ◽  
Jason Holden ◽  
...  
Keyword(s):  
Ecological Momentary Assessment ◽  
Negative Symptoms ◽  
Negative Emotion ◽  
Temporal Association ◽  
Life Space ◽  
Chi Square ◽  
Daily Life Activities ◽  
Ecological Momentary ◽  
Momentary Assessment ◽  
At Home

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 &lt; 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.

scholarly journals GPS mobility as a digital biomarker of negative symptoms in schizophrenia: a case control study

2019 ◽  
Vol 2 (1) ◽  
Author(s):  
Colin A. Depp ◽  
Jesse Bashem ◽  
Raeanne C. Moore ◽  
Jason L. Holden ◽  
Tanya Mikhael ◽  
...  
Keyword(s):  
Negative Symptoms ◽  
Case Control Study ◽  
Average Distance ◽  
Symptom Clusters ◽  
Proxy Measure ◽  
Highly Correlated ◽  
And Behavior ◽  
Ecological Momentary ◽  
Momentary Assessment ◽  
Control Study

Abstract Mobility is an important correlate of physical, cognitive, and mental health in chronic illness, and can be measured passively with mobile phone global positional satellite (GPS) sensors. To date, GPS data have been reported in a few studies of schizophrenia, yet it is unclear whether these data correlate with concurrent momentary reports of location, vary by people with schizophrenia and healthy comparison subjects, or associate with symptom clusters in schizophrenia. A total of 142 participants with schizophrenia (n = 86) or healthy comparison subjects (n = 56) completed 7 days of ecological momentary assessment (EMA) reports of location and behavior, and simultaneous GPS locations were tracked every five minutes. We found that GPS-derived indicators of average distance travelled overall and distance from home, as well as percent of GPS samples at home were highly correlated with EMA reports of location at the day- and week-averaged level. GPS-based mobility indicators were lower in schizophrenia with medium to large effect sizes. Less GPS mobility was related to greater negative symptom severity, particularly diminished motivation, whereas greater GPS mobility was weakly associated with more community functioning. Neurocognition, depression, and positive symptoms were not associated with mobility indicators. Therefore, passive GPS sensing could provide a low-burden proxy measure of important outcomes in schizophrenia, including negative symptoms and possibly of functioning. As such, passive GPS sensing could be used for monitoring and timely interventions for negative symptoms in young persons at high risk for schizophrenia.

scholarly journals What Do People With Schizophrenia Do All Day? Ecological Momentary Assessment of Real-World Functioning in Schizophrenia

2019 ◽  
Author(s):  
Eric Granholm ◽  
Jason L Holden ◽  
Tanya Mikhael ◽  
Peter C Link ◽  
Joel Swendsen ◽  
...  
Keyword(s):  
Social Interactions ◽  
Real World ◽  
Ecological Momentary Assessment ◽  
Reliability And Validity ◽  
Supported Housing ◽  
Self Report ◽  
New Treatments ◽  
Test Retest Reliability ◽  
Ecological Momentary ◽  
Momentary Assessment

Abstract Schizophrenia is a major cause of disability worldwide. As new treatments for functioning are tested, the need grows to demonstrate real-world functioning gains. Ecological momentary assessment (EMA) may provide a more ecologically valid measure of functioning. In this study, smartphone-based EMA was used to signal participants with schizophrenia (N = 100) and controls (N = 71) 7 times a day for 7 days to respond to brief questionnaires about social interactions and functioning behaviors. Excellent adherence was found, with both groups completing an average of 85% of surveys and only 3% of participants with schizophrenia excluded for poor adherence. Four-week test–retest reliability was high (r = .83 for total productive behaviors). Relative to controls, participants with schizophrenia reported significantly less total productive activity (d = 1.2), fewer social interactions (d = 0.3), more nonproductive behaviors (d = 1.0; watching TV, resting), and more time at home (d = 0.8). Within the schizophrenia group, participants living independently showed better functioning on EMA relative to participants in supported housing (d = 0.8) and participants engaged in vocational activities showed better functioning than individuals not engaged in vocational activities (d = 0.55). Modest correlations were found between EMA and an in-lab self-report measure of functioning activities performed in the community, but not between EMA and measures of functional capacity or potential. This study demonstrated the feasibility, sensitivity reliability, and validity of EMA methods to assess functioning in schizophrenia. EMA provides a much-needed measure of what individuals with schizophrenia are actually doing in real-world contexts. These results also suggest that there may be important disjunctions between indices of abilities and actual real-world functioning.

scholarly journals Are fluctuations in personality states more than fluctuations in affect?

2016 ◽  
Author(s):  
Robert Edmund Wilson ◽  
Renee J. Thompson ◽  
Simine Vazire
Keyword(s):  
Positive Affect ◽  
Multilevel Modeling ◽  
Big Five ◽  
Ecological Momentary Assessment ◽  
Daily Lives ◽  
State Affect ◽  
And Behaviors ◽  
Ecological Momentary ◽  
Momentary Assessment

People fluctuate in their behavior as they go about their daily lives, but little is known about the processes underlying these fluctuations. In two ecological momentary assessment studies (Ns = 124, 415), we examined the extent to which negative and positive affect accounted for the within-person variance in Big Five states. Participants were prompted six times a day over six days (Study 1) or four times a day over two weeks (Study 2) to report their recent thoughts, feelings, and behaviors. Multilevel modeling results indicated that negative and positive affect account for most, but not all, of the within-person variance in personality states. Importantly, situation variables predicted variance in some personality states even after accounting for fluctuations in affect, indicating that fluctuations in personality states may be more than fluctuations in state affect.

scholarly journals Can we use Ecological Momentary Assessment for real-world patients with schizophrenia? A study of acceptability of the passive smartphone-based app Evidence-Based Behavior (eB2). (Preprint)

10.2196/26548 ◽  
2020 ◽  
Author(s):  
Javier-David Lopez-Morinigo ◽  
María Luisa Barrigón ◽  
Alejandro Porras-Segovia ◽  
Verónica González Ruiz-Ruano ◽  
Adela Sánchez Escribano Martínez ◽  
...  
Keyword(s):  
Real World ◽  
Ecological Momentary Assessment ◽  
Evidence Based ◽  
Ecological Momentary ◽  
Momentary Assessment

scholarly journals M226. ECOLOGICAL MOMENTARY ASSESSMENT OF REAL-WORLD FUNCTIONING IN SCHIZOPHRENIA: MODERATING EFFECTS OF COGNITIVE AND FUNCTIONAL ABILITY STATUS

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S222-S222
Author(s):  
Zanjbeel Mahmood ◽  
Elizabeth Twamley ◽  
Jason Holden ◽  
Phillip D Harvey ◽  
Eric Granholm
Keyword(s):  
Home Care ◽  
Functional Capacity ◽  
Real World ◽  
Ecological Momentary Assessment ◽  
Leisure Activities ◽  
Self Care ◽  
Information Criteria ◽  
Neurocognitive Functioning ◽  
Ecological Momentary ◽  
Momentary Assessment

Abstract Background Neurocognitive and functional heterogeneity is common in schizophrenia (SZ), and functioning is notoriously difficult to measure. Ecological Momentary Assessment (EMA) may help overcome the retrospective recall and subjective biases associated with standard self-report measures; however, how EMA-measured real-world functioning indicators align with other neurocognitive and functional capacity indicators is not well established. The current study aimed to characterize individuals with schizophrenia-spectrum disorders based upon their objective global neurocognitive functioning and functional capacity, and examine differences in EMA-measured functioning. Methods The study included 100 outpatient, English-speaking adults with SZ (n=82) or schizoaffective disorder (n=18). All participants completed EMA surveys administered at stratified random intervals 7 times per day for 7 days to assess self-rated proficiency in performing activities within home-care, self-care, leisure, work/school, and treatment engagement dimensions, as well as need for assistance/prompting to complete the tasks. Moreover, participants completed an in-lab comprehensive neuropsychological assessment battery (MATRICS Consensus Cognitive Battery) and a performance-based measure of functional capacity (UCSD Performance-Based Skills Assessment-Brief [UPSA-B]). Latent profile analyses (LPA) were used to derive categorical latent variables that represent profiles of individuals who have similar global neurocognitive functioning and UPSA-B performance. The optimal number of profiles for the sample was determined by evaluating models using the Akaike information criteria (AIC; Akaike, 1974), sample size-adjusted Bayesian information criteria (sBIC; Schwarz, 1978), and the Lo–Mendell–Rubin Adjusted Likelihood Ratio Test (LMRT; Lo, Mendell, & Rubin, 2001). Independent samples t-tests were used to examine group differences between the identified latent profile groups on EMA-reported outcomes. Results LPA identified a 2-profile solution with the best fit; participants in profile 1 (n=43) demonstrated mild-to-moderate global cognitive impairment and lower UPSA-B scores (Low functioning; LF), whereas participants in profile 2 (n=57) demonstrated average cognitive functioning and higher UPSA-B performance (High functioning; HF). The groups did not significantly differ on number of EMA surveys answered (p=.12). Compared to the HF group, the LF group reported poorer proficiency in overall reported activities (p=.001), which was driven by lower reported proficiency in home-care, self-care, and leisure activities (ps&lt;.003). Compared to the HF group, the LF group also indicated requiring more assistance and/or prompting in performing productive activities (p=.02), specifically within the life domains of home-care, self-care, and in-home leisure activities (ps&lt;.03). Discussion Compared to HF participants, LF participants rated their performance in activities within various life dimensions as less proficient and reported receiving greater assistance and/or prompting to do the activities. Future research should investigate the utility of the EMA paradigm to provide psychosocial interventions that appreciate the role of cognition and functional capacity in daily functioning.

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