The temporal order of emotional, cognitive, and behavioral gains in daily life during treatment of depression.

Objective: Despite the importance for understanding mechanisms of change, little is known about the order of change in daily life emotions, cognitions, and behaviors during treatment of depression. This study examined the within-person temporal order of emotional, cognitive, and behavioral improvements using ecological momentary assessment data.

Method: Thirty-two individuals with diagnosed depression completed ecological momentary assessment questions on emotions (sad mood, happy mood), behaviors (social interaction, number of activities), and cognitive variables (worrying, negative self-thoughts) 5 times a day during a 4-month period in which they underwent psychotherapy for depression.

Monitoring emotional intensity and variability to forecast depression recurrence in real time in remitted adults.

Objective: Recurrent depressive episodes are preceded by changing mean levels of repeatedly assessed emotions (e.g., feeling restless), which can be detected in real time using statistical process control (SPC).

Individual-specific change points in circadian rest-activity rhythm and sleep in individuals tapering their antidepressant medication: an actigraphy study.

Group-level studies showed associations between depressive symptoms and circadian rhythm elements, though whether these associations replicate at the within-person level remains unclear. We investigated whether changes in circadian rhythm elements (namely, rest-activity rhythm, physical activity, and sleep) occur close to depressive symptom transitions and whether there are differences in the amount and direction of circadian rhythm changes in individuals with and without transitions. We used 4 months of actigraphy data from 34 remitted individuals tapering antidepressants (20 with and 14 without depressive symptom transitions) to assess circadian rhythm variables.

Day-to-day affect fluctuations in adults with childhood trauma history: a two-week ecological momentary assessment study.

Background: Childhood trauma (CT) may increase vulnerability to psychopathology through affective dysregulation (greater variability, autocorrelation, and instability of emotional symptoms). However, CT associations with dynamic affect fluctuations while considering differences in mean affect levels across CT status have been understudied.

Methods: 346 adults (age = 49.

Predicting recurrence of depression using cardiac complexity in individuals tapering antidepressants.

It is currently unknown whether the complexity and variability of cardiac dynamics predicts future depression and whether within-subject change herein precedes the recurrence of depression. We tested this in an innovative repeated single-subject study in individuals who had a history of depression and were tapering their antidepressants. In 50 individuals, electrocardiogram (ECG) derived Interbeat-interval (IBI) time-series data were collected for 5 min every morning and evening, for 4 months.

Recurrence of depression can be foreseen by monitoring mental states with statistical process control.

Detecting early signs of recurrence of psychopathology is key for prevention and treatment. Personalized risk assessment is especially relevant for formerly depressed patients, for whom recurrence is common. We aimed to examine whether recurrence of depression can be accurately foreseen by applying Exponentially Weighted Moving Average (EWMA) statistical process control charts to Ecological Momentary Assessment (EMA) data.

Transitions in depression: if, how, and when depressive symptoms return during and after discontinuing antidepressants.

Purpose: The aim of the current study is to provide insight into if, how, and when meaningful changes occur in individual patients who discontinue antidepressant medication. Agreement between macro-level quantitative symptom data, qualitative ratings, and micro-level Ecological Momentary Assessments is examined.

Methods: During and shortly after antidepressant discontinuation, depressive symptoms and 'feeling down' were measured in 56 participants, using the SCL-90 depression subscale weekly (macro-level) for 6 months, and 5 Ecological Momentary Assessments daily (micro-level) for 4 months (30.

Real-time monitoring of increases in restlessness to assess idiographic risk of recurrence of depressive symptoms.

Background: This confirmatory study aimed to examine whether we can foresee recurrence of depressive symptoms using personalized modeling of rises in restlessness.

Methods: Participants were formerly depressed patients ( = 41) in remission who (gradually) discontinued antidepressants. Participants completed five smartphone-based Ecological Momentary Assessments (EMA) a day, for a period of 4 months, yielding a total of 21 180 observations.

The Exponentially Weighted Moving Average Procedure for Detecting Changes in Intensive Longitudinal Data in Psychological Research in Real-Time: A Tutorial Showcasing Potential Applications.

Affect, behavior, and severity of psychopathological symptoms do not remain static throughout the life of an individual, but rather they change over time. Since the rise of the smartphone, longitudinal data can be obtained at higher frequencies than ever before, providing new opportunities for investigating these person-specific changes in real-time. Since 2019, researchers have started using the exponentially weighted moving average (EWMA) procedure, as a statistically sound method to reach this goal.

Detecting mean changes in experience sampling data in real time: A comparison of univariate and multivariate statistical process control methods.

Detecting early warning signals of developing mood disorders in continuously collected affective experience sampling (ESM) data would pave the way for timely intervention and prevention of a mood disorder from occurring or to mitigate its severity. However, there is an urgent need for online statistical methods tailored to the specifics of ESM data. Statistical process control (SPC) procedures, originally developed for monitoring industrial processes, seem promising tools.

Early warning signals and critical transitions in psychopathology: challenges and recommendations.

Empirical evidence is mounting that monitoring momentary experiences for the presence of early warning signals (EWS) may allow for personalized predictions of meaningful symptom shifts in psychopathology. Studies aiming to detect EWS require intensive longitudinal measurement designs that center on individuals undergoing change. We recommend that researchers (1) define criteria for relevant symptom shifts a priori to allow specific hypothesis testing, (2) balance the observation period length and high-frequency measurements with participant burden by testing ambitious designs with pilot studies, and (3) choose variables that are meaningful to their patient group and facilitate replication by others.

Early Warning Signals Based on Momentary Affect Dynamics can Expose Nearby Transitions in Depression: A Confirmatory Single-Subject Time-Series Study.

Background: In complex systems early warning signals such as rising autocorrelation, variance and network connectivity are hypothesized to anticipate relevant shifts in a system. For direct evidence hereof in depression, designs are needed in which early warning signals and symptom transitions are prospectively assessed within an individual. Therefore, this study aimed to detect personalized early warning signals preceding the occurrence of a major symptom transition.