Assessment in clinical psychology typically relies on global retrospective self-reports collected at research or clinic visits, which are limited by recall bias and are not well suited to address how behavior changes over time and across contexts. Ecological momentary assessment (EMA) involves repeated sampling of subjects’ current behaviors and experiences in real time, in subjects’ natural environments. EMA aims to minimize recall bias, maximize ecological validity, and allow study of microprocesses that influence behavior in real-world contexts. EMA studies assess particular events in subjects’ lives or assess subjects at periodic intervals, often by random time sampling, using technologies ranging from written diaries and telephones to electronic diaries and physiological sensors. We discuss the rationale for EMA, EMA designs, methodological and practical issues, and comparisons of EMA and recall data. EMA holds unique promise to advance the science and practice of clinical psychology by shedding ligh...

Ecological Momentary Assessment

In diary studies, people provide frequent reports on the events and experiences of their daily lives. These reports capture the particulars of experience in a way that is not possible using traditional designs. We review the types of research questions that diary methods are best equipped to answer, the main designs that can be used, current technology for obtaining diary reports, and appropriate data analysis strategies. Major recent developments include the use of electronic forms of data collection and multilevel models in data analysis. We identify several areas of research opportunities: 1. in technology, combining electronic diary reports with collateral measures such as ambulatory heart rate; 2. in measurement, switching from measures based on between-person differences to those based on within-person changes; and 3. in research questions, using diaries to (a) explain why people differ in variability rather than mean level, (b) study change processes during major events and transitions, and (c) study interpersonal processes using dyadic and group diary methods.

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Diary Methods: Capturing Life as it is Lived

This review focuses on the pathway leading from the marital relationship to physical health. Evidence from 64 articles published in the past decade, particularly marital interaction studies, suggests that marital functioning is consequential for health; negative dimensions of marital functioning have indirect influences on health outcomes through depression and health habits, and direct influences on cardiovascular, endocrine, immune, neurosensory, and other physiological mechanisms. Moreover, individual difference variables such as trait hostility augment the impact of marital processes on biological systems. Emerging themes in the past decade include the importance of differentiating positive and negative dimensions of marital functioning, the explanatory power of behavioral data, and gender differences in the pathways from the marital relationship to physiological functioning. Contemporary models of gender that emphasize self-processes, traits, and roles furnish alternative perspectives on the differential costs and benefits of marriage for men's and women's health.

Marriage and health: his and hers.

1.0 BACKGROUND ACTIGRAPHY HAS BEEN USED TO STUDY SLEEP/WAKE PATTERNS FOR OVER 20 YEARS. The advantage of actigraphy over traditional polysomnography (PSG) is that actigraphy can conveniently record continuously for 24-hours a day for days, weeks or even longer. In 1995, Sadeh et al.,1 under the auspices of the American Sleep Disorders Association (now called the American Academy of Sleep Medicine, AASM), reviewed the current knowledge about the role of actigraphy in the evaluation of sleep disorders. They concluded that actigraphy does provide useful information and that it may be a “cost-effective method for assessing specific sleep disorders...[but that] methodological issues have not been systematically addressed in clinical research and practice.” Based on that task force’s report, the AASM Standards of Practice Committee concluded that actigraphy was not indicated for routine diagnosis or for assessment of severity or management of sleep disorders, but might be a useful adjunct for diagnosing insomnia, circadian rhythm disorders or excessive sleepiness.2 Since that time, actigraph technology has improved, and many more studies have been conducted. Several review papers have concluded that wrist actigraphy can usefully approximate sleep versus wake state during 24 hours and have noted that actigraphy has been used for monitoring insomnia, circadian sleep/wake disturbances, and periodic limb movement disorder.3,4 This paper begins where the 1995 paper left off. Under the auspices of the AASM, a new task force was established to review the current state of the art of this technology.

The Role of Actigraphy in the Study of Sleep and Circadian Rhythms AMERICAN ACADEMY OF SLEEP MEDICINE REVIEW PAPER

Here I argue that addicted people become unable to make drug-use choices on the basis of long-term outcome, and I propose a neural framework that explains this myopia for future consequences. I suggest that addiction is the product of an imbalance between two separate, but interacting, neural systems that control decision making: an impulsive, amygdala system for signaling pain or pleasure of immediate prospects, and a reflective, prefrontal cortex system for signaling pain or pleasure of future prospects. After an individual learns social rules, the reflective system controls the impulsive system via several mechanisms. However, this control is not absolute; hyperactivity within the impulsive system can override the reflective system. I propose that drugs can trigger bottom-up, involuntary signals originating from the amygdala that modulate, bias or even hijack the goal-driven cognitive resources that are needed for the normal operation of the reflective system and for exercising the willpower to resist drugs.

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Decision making, impulse control and loss of willpower to resist drugs: a neurocognitive perspective

Elevated levels of inflammatory biomarkers are associated with the pathophysiology of cardiovascular diseases and are predictors of cardiovascular events. The objective of this study was to determine the unique contributions of metabolic factors as predictors of inflammation (C-reactive protein (CRP) and interleukin-6 (IL-6)), adhesion (soluble intercellular adhesion molecule-1 (sICAM-1)), and coagulation (D-dimer) in healthy younger-aged adults. Participants were 83 women and 92 men (mean age 30.04 years, s.d. +/- 4.8, range 22-39) of normal weight to moderate obese weight (mean BMI 24.4 kg/m(2), s.d. +/- 3.35, range 17-32). The primary data analytical approaches included Pearson correlation and multiple linear regression. Circulating levels of CRP, IL-6, sICAM-1, and D-dimer were determined in plasma. Higher levels of CRP were independently associated with higher BMI, a greater waist-to-hip ratio, female gender, and higher triglycerides (P < 0.001). Higher IL-6 levels were independently associated with a greater waist-to-hip ratio (P < 0.01). Higher levels of sICAM-1 were independently associated with higher BMI, higher triglycerides, and lower insulin resistance (P < 0.001). Higher D-dimer levels were independently associated with higher BMI and being female (P < 0.001). Having a higher BMI was most consistently associated with elevated biomarkers of inflammation, adhesion, and coagulation in this sample of healthy younger-aged adults, although female gender, insulin resistance, and lipid levels were also related to the biomarkers. The findings provide insight into the adverse cardiovascular risk associated with elevated body weight in younger adults.

Metabolic predictors of inflammation, adhesion, and coagulability in healthy younger-aged adults.

Objectives: Thisstudyexaminedwomen’smoodresponsiveness on work and off days during different phases of the menstrual cycle. Methods: Self-reports of negative, positive, and energy dimensions of mood were obtained throughout the day on two work and two off daysduringthe lutealandfollicularphasesofthemenstrualcycle in 203 women nurses. Individual differences in daytime and nighttime epinephrine, norepinephrine, and cortisol were assessed. Results: High daytime norepinephrine, epinephrine, and cortisol levelswereassociatedwithhigherratingsofstressandtired,andwith lower ratings of happy. The phase of the menstrual cycle and the day factor (workday, off day) were also associated with mood differences, and the direction of the effects depended on hormone levels and hormone sampling period. Conclusion: The experience of moods is affected by the arousal-related interaction of hormone levels with the phase of the menstrual cycle and occupational stress. D 2005 Elsevier Inc. All rights reserved.

Moods in everyday situations: effects of menstrual cycle, work, and stress hormones B

Single versus triplicate measurements: a commentary on Fagan et al.

Seit langer Zeit sprechen verschiedenste Befunde dafur, das Gefuhle, Lebenssituationen, Stres und andere Verhaltens- und Umgebungsfaktoren eine bedeutende Rolle bei der Entwicklung, Unterhaltung, Behandlung und Vorbeugung der Hypertonie spielen konnen. Die Beweise sind direkter als auch indirekter Art: gelegentliche Berichte von Arzten, Bestimmung der psychologischen Charakteristika von hypertonen Patienten, epidemiologische und soziologische Studien und eine Fulle an psychophysiologischer Literatur, die die verschiedenen Einflusse des Verhaltens auf Blutdruckveranderungen und andere Reaktionen des kardiovaskularen Systems aufzeigen. Fur allgemeine Ubersichtsartikel siehe Cohen und Obrist [21], Eyer [36], Gutmann und Benson [58], Harris und Forsyth [66], Heine [67], A. P. Shapiro et al. [133, 134]. Bemerkenswert sind auch Ergebnisse, die zeigen, das in vielen der schwarzen Bevolkerungsgruppen der Blutdruck typischerweise mit dem Alter ansteigt, wahrend er es bei einigen anderen nicht tut [10].

Verhaltensmuster und ihre Beziehung zur Hypertonie

Heart rate and blood pressure were studied with the beat-to-beat tracking cuff system in two groups (n=20 per group) of healthy, unmedicated males, one between 60 and 75 years of age and the second between 18 and 29 years of age. The study confirms the previously reported blunted heart rate response to standing and the fact that, when blood pressure is recorded by conventional means, the response exhibited during orthostasis does not differ in healthy groups of young and elderly subjects. With the tracking cuff system, however, the elderly exhibited a smaller immediate systolic and diastolic drop in response to the change to upright posture and less variability in beat-to-beat blood pressure changes. The results have implications for cardiovascular studies, where age and posture can influence both blood pressure and heart rate.

Iris B. Goldstein

Papers

Metabolic predictors of inflammation, adhesion, and coagulability in healthy younger-aged adults.

Moods in everyday situations: effects of menstrual cycle, work, and stress hormones B

Single versus triplicate measurements: a commentary on Fagan et al.

Verhaltensmuster und ihre Beziehung zur Hypertonie

The beat-to-beat blood pressure response to postural change in young and elderly healthy adult males.