Clinical psychological science has seen an exciting shift toward the use of person-specific (idiographic) approaches to studying psychopathology and change in treatment at the level of the individual. One commonly used method in idiographic research is ecological momentary assessment (EMA). EMA offers a way to sample individuals intensivelyoften multiple times per dayas they go about their lives. While these methods offer benefits such as greater ecological validity and streamlined data collection, many share concerns about their feasibility across diverse clinical populations. To investigate the feasibility of using EMA to study psychological processes idiographically both in-and out of the context of therapy, the present study aggregated participants across seven studies spanning diverse clinical and community populations (N = 496), all of which utilized an idiographic EMA approach to study symptoms of psychopathology (e.g., PTSD, mood and anxiety, substance abuse). In a series of linear regression models, participant and study design characteristics were used to predict compliance with EMA surveys. Across study designs, we found that (1) participants were willing to report on symptoms and mechanisms relating to a wide range of psychopathological domains; (2) on average, participants completed 82.21% (SD = 16.34%) of all EMA surveys; and (3) compliance with EMA surveys was not significantly related to participant demographics, psychological diagnosis, personality characteristics, or most study characteristics (e.g., number of surveys per day). These findings suggest feasibility of idiographic EMA for collecting the data needed to understand psychopathology and change in treatment at the level of the individual.
Background and Objective(s): While psychotherapy treatments are largely effective, the processes and mechanisms underlying such positive changes remain somewhat unknown. Focusing on a single participant from a treatment outcome study that used a modular-based cognitive behavior therapy protocol, this article aims to answer this question by identifying changes in specific symptomatology over the course of the treatment. Using quantitative data derived from digital health methodology, we analyzed whether a given therapeutic intervention was related to downstream effects in predicted symptom domains, to assess the accuracy of our interventions. Methods: This case study employed an observational N-of-1 study design. The participant (n = 1) was a female in the age range of 25-35 years. Using digital health data from ambulatory assessment surveys completed prior to and during therapy, separate linear regression analyses were conducted to assess if hypothesized treatment targets reduced after a given module, or intervention. Results: Support was found for some of the hypothesized quantitative changes (e.g., decreases in avoidance after exposures module), yet not for others (e.g., decreases in rumination following the mindfulness module). Conclusion: We present data and results from our analyses to offer an example of a novel design that may allow for a greater understanding of the nature of symptom changes with increased granularity throughout the course of a psychological treatment from the use of digital health tools.
Background: Depression is an illness with biological, psychological, and social underpinnings, which may include the interplay of inflammation, psychological traits, stress, social relationships, and cultural background. Aims: This work examines the prospective associations between social relationship quality and depressive symptoms, and between social relationship quality and inflammatory outcomes in two distinct cultures. Methods: Data were obtained from two longitudinal, prospective cohort studies: Midlife in the United States (MIDUS), and Midlife Development in Japan (MIDJA) between 2004 and 2010. One thousand three hundred and twenty-seven community-based adults were included in analyses, 1,054 from the United States and 273 from Tokyo, Japan. Depressive symptoms (measured by the CES-D Depression Scale) and inflammation (measured by blood sample concentrations of the inflammatory biomarkers interleukin-6 and C-reactive protein) were the outcomes. Social relationship quality was the predictor. Culture, trait independence and interdependence, and psychosocial stressors were examined as moderators of the link between social relationship quality and depressive symptoms. Results: Higher social relationship quality was associated with lower depressive symptoms in the United States (β = −6.15, p < .001), but not in Japan (β = −1.25, p = .390). Social relationship quality had no association with inflammation. Psychosocial stressors moderated the link between social relationship quality and depressive symptoms in both the United States (β = −0.39, p = .001) and Tokyo (β = −0.55, p = .001), such that social relationship quality acted as a buffer against depressive symptoms as psychosocial stress increased. Conclusion: Improving the perceived quality of social relationships appears to be a stronger target for depression interventions in the United States than in Tokyo, Japan.
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