Positive Affective Recovery in Daily Life as a Momentary Mechanism Across Subclinical and Clinical Stages of Mental Disorder: Experience Sampling Study

Abstract

Background Identifying momentary risk and protective mechanisms may enhance our understanding and treatment of mental disorders. Affective stress reactivity is one mechanism that has been reported to be altered in individuals with early and later stages of mental disorder. Additionally, initial evidence suggests individuals with early and enduring psychosis may have an extended recovery period of negative affect in response to daily stressors (ie, a longer duration until affect reaches baseline levels after stress), but evidence on positive affective recovery as a putative protective mechanism remains limited. Objective This study aimed to investigate trajectories of positive affect in response to stress across the continuum of mental disorder in a transdiagnostic sample. Methods Using the Experience Sampling Method, minor activity-, event-, and overall stress and positive affect were assessed 10 times a day, with time points approximately 90 minutes apart on six consecutive days in a pooled data set including 367 individuals with a mental disorder, 217 individuals at risk for a severe mental disorder, and 227 controls. Multilevel analysis and linear contrasts were used to investigate trajectories of positive affect within and between groups. Results Baseline positive affect differed across groups, and we observed stress reactivity in positive affect within each group. We found evidence for positive affective recovery after reporting activity- or overall stress within each group. While controls recovered to baseline positive affect about 90 minutes after stress, patients and at-risk individuals required about 180 minutes to recover. However, between-group differences in the affective recovery period fell short of significance (all P>.05). Conclusions The results provide first evidence that positive affective recovery may be relevant within transdiagnostic subclinical and clinical stages of mental disorder, suggesting that it may be a potential target for mobile health interventions fostering resilience in daily life.

The Role of Childhood Trauma in Affective Stress Recovery in Early Psychosis: An Experience Sampling Study

“…While our previous findings also pointed toward longer positive affective recovery in patients with a mental disorder and individuals at risk for mental disorder, 10 we found no group differences in positive affective recovery across transdiagnostic stages 10 or in stages of psychosis in the present study. Levels of positive affect were, on average, lower in patients, which may impact how affective recovery as a momentary mechanism operates on individuals to exert its detrimental and/or protective effects.…”

“… 28 , 31 We have recently started to examine whether this conceptualization can be transferred to the realm of daily life by investigating trajectories of positive affect in response to daily stressors, ie, positive affective recovery. 10 In a transdiagnostic sample, we found indications that individuals with a psychotic or depressive disorder and individuals at risk for those disorders may take longer to recover from a daily stressor than controls. Another study suggests that individuals in early stages of psychosis require more time than controls and than individuals with a chronic course of psychosis to recover to baseline values of negative affect.…”

“…Momentary psychological mechanisms in daily life can enhance our understanding and inform treatment of mental disorders. 1–3 Especially in psychosis, the response to daily stressors, 4–8 but also the recovery from a stressor, 9 , 10 may vary across clinical stages.…”

Cognitive Biases and Socio-Occupational Functioning Mediate the Relationship between Executive Functions and the Severity of Psychopathology among Young Adults with Psychotic-like Experiences: 1-Year Follow-Up Study

“…According to the meta-analysis of Muddle et al [ 113 ], stressful daily events and patients’ emotional responses to them have a significant impact on the symptoms of those with chronic psychosis, at early stage of disease as well as with subclinical PLEs. Therefore, further analyses could explore variables such as resilience [ 114 ]; coping strategies [ 115 ]; or emotional regulation, like a positive affect in response to stress [ 116 , 117 ], as they may play significant roles in managing and improving the symptoms in different “at-risk” mental states.…”

Transdiagnostic Ecological Momentary Intervention for Improving Self-Esteem in Youth Exposed to Childhood Adversity

“…Secondary outcomes included positive and negative self-esteem, 48 positive and negative schematic self-beliefs, 49 emotional well-being, 50 psychological distress, 51 , 52 general psychopathology, 52 , 53 clinical symptoms, 54 , 55 functioning, 56 , 57 and quality of life. 52 , 58 Momentary self-esteem, 24 , 25 resilience, 59 , 60 , 61 and positive/negative affect 62 , 63 , 64 were measured with the EMA. 64 , 65 , 66 Serious adverse events (SAEs) were monitored throughout the entire study period.…”