Numerous studies have substantiated the efficacy of slow-paced breathing (SPB) in decreasing anxiety and increasing vagally-mediated heart rate variability (vmHRV). Given its effectiveness and simplicity, SPB is a promising candidate for a just-in-time adaptive intervention (JITAI). This study examined the efficacy of SPB, triggered by increased anxiety and perseverative cognition (PC), on reducing these symptoms and increasing vmHRV at macro, micro, and immediate levels. Eighty individuals with subclinical anxiety from the Flemish general population were randomized into experimental (EC) or passive control (CC) conditions. Anxiety symptoms were evaluated at baseline and after 15 days. Participants underwent a control period (CP; 6 days) and an intervention period (IP; 6 days), during which they reported momentary anxiety and PC via a mobile application while wearing a portable electrocardiogram. EC participants received SPB training between CP and IP and were prompted to use SPB exercises during IP when anxiety/PC increased. Analyses revealed a significant effect of SPB on reducing retrospectively reported anxiety (p < .05), but not on average daily-life anxiety and PC or vmHRV assessed throughout the IP. Micro-level analyses indicated that SPB was associated with a decrease in PC (p < .05) but not anxiety at the subsequent daily-life assessment. Anxiety and PC decreased substantially from immediately before to immediately after SPB (< 0.001). The effect of SPB on vmHRV remains inconclusive due to methodological concerns in measuring vmHRV in ambulatory settings. The results provide mixed evidence for the efficacy of SPB as a JITAI, indicating the need for replication studies to further evaluate its potential.

Key symptoms of anxiety include experiencing unpleasant emotions and hyperarousal. Growing evidence suggests that delayed affective recovery (DAR) from daily stressors plays a role in their maintenance and development on a day-to-day basis. We examined whether DAR is linked to current and future anxiety symptoms, independently of depressive symptoms. Self-reported anxiety and depressive symptoms were assessed at Wave 1 (N = 1,031) and approximately 2.5 years later at Wave 2 (N = 171) in a community sample of Flemish adolescents. Additionally, at Wave 1, the experience sampling method was used to obtain assessments of momentary affect and to infer stressful occurrences, with data collected 10 times a day, for 6 days. Using affective experience sampling method data, we constructed two variables, that is, affective valence and arousal, reflecting the (un)pleasantness and (hyper)arousal associated with emotions. The time interval for recovery was estimated using parametric survival analysis. Prospective associations were tested with multiple regression. Slower valence recovery was associated with higher concurrent anxiety symptoms. A similar association was present for the arousal recovery, however only when depressive symptoms were added to the model. We found no prospective association between the speed of valence nor arousal recovery at Wave 1 and anxiety symptoms at Wave 2. The results suggest that DAR is linked to current anxiety symptoms but does not predict their development 2.5 years later. Our findings provide insights into possible processes underlying the key features of anxiety and help identify the moments of vulnerability in the daily lives of youth.

During emotional events, people monitor the effectiveness of their emotion regulation (ER) to decide whether to keep using their current ER strategy, switch to a new strategy, or stop the regulation process. However, there is little empirical research on the monitoring phase of ER, particularly on which and how situational and individual factors influence this process. We tested situational and individual factors as predictors of real-life ER monitoring decisions. 155 young adults responded to 5 prompts per day in a 7-day experience sampling protocol. At each prompt they described an emotional event, rated the intensity of event, their current emotions and perceived success in ER, and reported their decision to simply stop using their current ER strategy or to switch to a new strategy during the event. Multilevel modeling results showed the decision to stop using the current ER strategy was predicted by perceived success in ER after both positive and negative events, and by depressive and anxiety symptoms after positive events. The decision to switch to a new strategy was more likely when there were high negative affect after a negative event, and less likely when there was perceived success after a positive event. These findings suggest that situational and individual factors affect people’s decisions about how to regulate emotion. Interventions addressing excessive regulatory stopping in response to positive events and their underlying causes may benefit individuals with depression or anxiety.

This pilot study aimed to test a comprehensive experience sampling method (ESM) protocol for investigating the relationship between stress and personality functioning (PF) in the daily lives of outpatients diagnosed with borderline personality disorder (BPD). Participants (N = 22) responded to a 32-item ESM questionnaire 10 times a day for 1 week while wearing two stress detection devices. Results showed that the protocol was feasible. There was a high level of compliance (i.e. average of 85%), and no serious adverse events. The main indices, that is, Stress and PF, demonstrated acceptable to excellent internal consistency and provisional evidence for their validity. We found that 64% of the variability in PF was due to within-subject differences. Mixed modelling showed that the momentary changes in stress (p < .001) and body position (i.e. active vs passive; p < .001) explained an estimated 46% of this within-subject variance. We found no significant within-subject effects when we used parameters of autonomic nervous system (ANS)-activity as predictors. Data loss during recording and artefact detection of electrophysiological data were substantial but not related to momentary changes in PF. The preliminary findings suggest that PF is a volatile aspect of personality pathology and that there is a strong, concurrent relationship between stress and PF in daily life. This pilot study constitutes the first demonstration of PF fluctuations within a clinical sample and initiates an examination of their association with ANS activity.

Emotion dysregulation is central to psychopathological conditions, including borderline personality disorder (BPD) and depression. However, the nature of emotion-regulation (ER) difficulties in the daily life of people with BPD or depressive features is still unclear. Therefore, in this study, we aimed to disentangle two different ER subprocesses in daily life, (a) selection of ER strategies and (b) the effectiveness of implementing strategies, in terms of their associations with subsequent emotional experience. We analyzed data from a three-wave, longitudinal, experience-sampling study of young adults with varying levels of psychopathological features (N = 202). BPD features were uniquely linked to the use but not altered effectiveness of several putatively adaptive and maladaptive ER strategies. Depressive features were uniquely associated with the use of putatively maladaptive strategies. These findings suggest that ER deficits in people with more BPD or depressive features may be primarily located in strategy selection rather than the implementation of those strategies.

Abstract Major depressive disorder (MDD) and borderline personality disorder (BPD) are characterized by disturbed patterns of emotional and interpersonal functioning, which might imply altered use of emotion regulation in interpersonal contexts. In the current study, we examined how individuals with MDD and/or BPD differ from healthy controls in (1) their overall daily life use of expressive suppression and social sharing and (2) their tendency to adjust the use of these strategies to the emotional context (i.e., preceding negative and positive affect). Thirty‐four individuals with MDD, 20 individuals with BPD, 19 individuals with comorbid MDD and BPD, and 40 healthy controls participated in a week of experience sampling during which they reported their use of expressive suppression, social sharing, and experienced negative and positive affect. The results indicated that all clinical groups reported more expressive suppression and social sharing in their daily lives than healthy controls. Group differences remained when controlling for differences in mean experienced affect, except for increased suppression for MDD and increased sharing for BPD and comorbid MDD and BPD, which seemed related to these participants' overall higher levels of negative affect. Additionally, associations between within‐person fluctuations in negative or positive affect and subsequent strategy use were equally strong for clinical and control participants, indicating that clinical groups did not differentially adjust the use of suppression and sharing to the emotional context. In conclusion, individuals with MDD and/or BPD showed increased use of suppression and sharing in daily life, which might contribute to, or follow from their emotional and interpersonal difficulties.

Background While evidence shows that people with early psychosis are flexible in using different emotion regulation (ER) strategies to manage the varying contextual demands, no studies have examined the effectiveness of such regulatory flexibility in this population. We addressed this issue by investigating whether and how ER flexibility relate to different dynamic aspects (variability, instability, inertia, and recovery) of negative affect (NA) in a combined early psychosis sample, consisting of both individuals at high clinical risk for psychosis and those diagnosed with first-episode psychosis. Methods Participants were 148 individuals from the INTERACT project, a multi-center randomized controlled trial on the efficacy of acceptance and commitment therapy in early psychosis. We utilized data from the baseline assessment, during which all participants completed six days of experience sampling assessment of momentary NA, as well as end-of-day assessments of ER strategy use. Results Multilevel models of within-person associations showed that greater ER flexibility was associated with more stable NA, and quicker recovery of NA from stressors during the day. Linear regression analyses of between-person associations showed that people who had more variable and unstable NA reported greater ER flexibility generally. No evidence was found for associations with NA inertia. Conclusions The current study identified unique within-person and between-person links between ER flexibility and dynamics of NA in early psychosis. These findings further provide evidence for ER flexibility in early psychosis, emphasizing the adaptive nature of regulatory flexibility in relation to reduced instability in NA and faster recovery from NA in everyday life.

Background: Little is known about whether and how contextual appraisals relate to emotion regulation (ER) strategy use across the ultra-high risk and first episode stages of psychosis. The present study extends previous research by investigating the extent to which different appraisal dimensions of the most negative and positive events of the day are associated with ER strategy use in individuals with ultra-high risk (UHR) and first-episode psychosis (FEP).Method: Sixty-eight UHR individuals and fifty-five FEP individuals filled out an experience sampling evening questionnaire for six consecutive days, in which their appraisal of intensity, importance and perceived control concerning the most negative or positive event of the day, and the ER strategies they deploy in response to these events were measured.Results: Multilevel mixed effect models showed that intensity appraisal was most closely associated with ER strategy use, as opposed to importance and controllability appraisals. Higher intense negative events were associated with more rumination and social sharing, while less intense negative events were associated with more reappraisal. Higher intense positive events were associated with a greater number of deployed strategies and more efforts in using savoring, expression and social sharing. The UHR and FEP individuals did not significantly differ regarding effects of above-mentioned appraisal dimensions on ER.Conclusions: These results provide evidence supporting ER flexibility in early psychosis, and event intensity emerged as the dimension most strongly associated with ER. Future research should better account for other situational factors (such as social context) that might affect ER use in psychosis.

Key symptoms of anxiety include experiencing unpleasant emotions and hyperarousal. Growing evidence suggests the role of delayed affective recovery from stress (DAR) in their maintenance and development on a day-to-day basis. We aimed to investigate whether DAR is linked to current and future anxiety symptoms, independently of depressive symptoms. Self-reported anxiety and depressive symptoms were assessed twice: at Wave 1 (N=1031) and approximately 2.5 years later at Wave 2 (N=171) in a community sample of adolescents. Additionally, at Wave 1, Experience Sampling Method (ESM) was used. Participants reported their momentary affect and stressful occurrences 10 times a day, for six days. Using ESM data and a subtraction method, we construed two variables, i.e., affective valence and arousal reflecting the (un)pleasantness and (hyper)arousal associated with emotions. The time interval for affective recovery was estimated using parametric survival analysis. Prospective associations were tested with multiple regression. Slower valence recovery was associated with higher concurrent anxiety symptoms (p&lt;.05) and this association remained present when controlling for depressive symptoms (p&lt;.05). The same association was present for the arousal recovery, however only when depressive symptoms were added to the model (p&lt;.05). We found no prospective association between the speed of valence nor arousal recovery at Wave 1 and anxiety symptoms at Wave 2. Our results suggest that DAR may be a concomitant process contributing to the maintenance of key anxiety symptoms, but not to their development. Our findings help identify the moments in the daily lives of youth, where potential interventions could be implemented.

Although the literature suggests trait-like differences in affective and cognitive vulnerabilities between individuals with and without a history of non-suicidal self-injury (NSSI), little is known about how these dispositional differences are experienced in the natural environment. The present study compares the intensity, inertia, interaction, and variability of affective (negative and positive affect) and cognitive states (rumination, self-criticism) in the everyday lives of individuals who do and do not engage in NSSI. Using experience sampling methodology (ESM), 60 emerging adults (ages=18-22 years) with and without past-year NSSI (equally distributed) completed eight questionnaires per day for 12 days (in total, 96 questionnaires per participant), resulting in 4,587 assessments (median compliance=83.3%; IQR=71.9-91.7). In a dynamic structural equation modeling framework, dynamic parameters (i.e., mean intensity, carryover effects, spillover effects, and within-person variability) were evaluated using multilevel vector autoregressive models. Emerging adults who engage in NSSI experience higher intensity and greater variability of negative affect, rumination, and self-criticism, whereas those who do not engage in NSSI experience higher intensity and lower variability of positive affect. In addition, past-year NSSI predicted stronger affective-cognitive interactions over time, with stronger spillover effects of negative and positive affect on subsequent rumination and self-criticism in individuals who engage in NSSI. Depressive symptoms and trait levels of emotion dysregulation and self-criticism partially negated these differences. Our findings provide evidence that emerging adults who self-injure experience more negative affective-cognitive states in daily life and point to the potential relevance of boosting positive emotions to buffer negative cognitions.

Contextual factors influence how people regulate their everyday emotions. While daily life is rich with situations that evoke emotion regulation, few studies have broadly investigated the role of context in regulating emotions in response to naturally occurring negative events. In this study, we use a structured diary technique—the Experience Sampling Method—to test how different types of contextual factors are associated with using reappraisal and distraction to regulate daily emotions in N = 74 young adults from the general population. The following contextual factors were assessed: time of the day, weekday, tiredness, event stressfulness, and event type. We found that higher stressfulness of negative events was associated with using more distraction within- and between-person and using more reappraisal between persons. Time of day and weekday were not associated with reappraisal or distraction use, suggesting that variation in people’s external environments due to temporal patterns does not influence reappraisal or distraction use. However, tiredness was positively associated with distraction and reappraisal use within persons. Exploratory analyses suggested that experiencing time pressure affords less distraction use, and that experiencing physical discomfort affords less reappraisal use. These findings underscore the dynamic nature of emotion regulation, and the importance of context in everyday emotion regulation.

Since the introduction of the experience sampling method (ESM), there have been concerns that the repeated assessments typically related to this method may alter the behavior, thoughts, or feelings of participants. Previous studies have offered mixed results with some studies reporting reactive changes while others failed to find such effects. Our aim was to investigate under which circumstances ESM induces reactive effects.Students (N = 151) were randomly assigned to receive a questionnaire containing 30 or 60 items 3, 6, or 9 times per day for 14 days. A random sample of 50 participants took part in qualitative interviews after the end of the data collection. We investigated changes over time in the data, while taking into account the sampling protocol and characteristics of participants, and analyzed qualitative reports of measurement reactivity.Decreases in completion time, within-person variance of ratings and subjective reports of habituation point towards the existence of a habituation period. While participants also reported increases in emotional awareness in interviews, ESM measures indicated a decrease in emotional awareness over time. Changes in behavior were rare in quantitative and qualitative reports. Positive affect was found to decrease over time in the ESM data and various changes in affect, emotion regulation, and thoughts were reported in interviews. Individual characteristics and sampling protocol had inconsistent effects on changes over time.The current results suggest that ESM induces reactivity. These reactive changes may be particularly relevant to researchers investigating within-person variability, completion times, affect, or emotional awareness.

Rumination means to perseveratively think about one's negative feelings and problems. It is a response to affective distress that is often referred to as maladaptive emotion regulation. According to the response styles theory and control theory, rumination may further prolong and exacerbate affective distress. This means that rumination can be viewed as both an antecedent and an outcome of negative affect (NA), and vice versa. However, at the level of short-term dynamics, state rumination and NA have previously mainly been examined as two separate outcomes. To model the reciprocal within-person effects and hence, to match theoretical assumptions, we combined the two interrelated time series in one model using dynamic structural equation modeling (DSEM). Both effects (NA on subsequent rumination and rumination on subsequent NA) were modeled simultaneously while acknowledging the autoregressive nature of both states (inert properties). We used data from two experience sampling studies (N-Study 1 = 200 Belgian university students; N-Study 2 = 70 German university students). Participants were paged on smartphones several times a day (Study 1: 10; Study 2: 6) for several days (Study 1: 7; Study 2: 9-12). In both studies, we found evidence for reciprocal effects of NA and rumination, and both processes showed autoregressive relationships. Aside from central findings, higher levels of rumination were also associated with higher rumination inertia, pointing toward more habitual rumination also being associated with prolonged rumination. Together, using DSEM, we found reciprocal associations between rumination and NA, while providing new insights into the dynamics between the two processes.

The spread of COVID-19 and the implementation of various containment strategies across the world have seriously disrupted people’s everyday life, and it is especially uncertain what the psychological impact of this pandemic will be for vulnerable individuals, such as psychiatric (ex-)patients. Governments fear that this virus outbreak may prelude a major mental health crisis, and psychiatrists launch critical calls to flatten an upcoming mental ill-health surge. Here, we aim to add nuance to the idea that we are heading towards a mental health pandemic and that psychiatric populations will unavoidably (re)develop psychopathology. Despite being subjected to the same challenges posed by COVID-19, we argue that people with a history of psychiatric illness will psychologically deal with this adversity in different ways. To showcase the short-term differential impact of COVID-19 on patients’ mental health, we present the day-to-day emotion and symptom trajectories of different psychiatric patients that took part in an experience sampling study before, during, and after the start of the first wave of the COVID-19 pandemic in March 2020 and associated lockdown measures in Belgium. Piecewise regression models show that not all patients’ psychological well-being is affected to a similar degree. As such, we argue that emphasizing human resilience, also among the more vulnerable in society, may be opportune in these unsettling times.

While affect is frequently measured with experience sampling methodology (ESM),the affective structure at the between- and within-person level has not been thoroughly investigated. We investigated the affective structure at the between- and within-person level, its invariance across different ESM protocols, and its reliability. Participants (N = 147) were randomly assigned to receive either a 30 or 60 item questionnaire three, six, or nine times per day, resulting in 72 to 75 participants per questionnaire length and 48 to 50 participants per sampling frequency. Momentary affect was assessed with 8 or 18 items. At both levels, a structure with two correlated factors showed the best fit compared to an orthogonal and a unidimensional model. A structure with additional freed residual correlations was invariant across protocols at the within-person level and showed high reliability. We observed indications of a more discrete affective structure within than between persons.

Persons with borderline personality disorder (BPD) experience heightened emotional instability. Different components underlie instability, and the relation between instability and well-being could be confounded by average emotionality and within-person standard deviation across emotional states, reflecting variability. Therefore, the goal was to examine which pattern of emotion dynamics parsimoniously captures the emotional trajectories of persons with BPD. Forty persons with BPD, 38 clinical controls in a major depressive episode, and 40 healthy controls rated the intensity of their emotions 10 times a day for 1 week. After correction for differences in average emotionality, persons with BPD showed heightened emotional instability compared to both control groups. When additionally correcting for emotional variability, the authors found that instability indices did not differ between groups anymore. This shows that persons with BPD differ from control groups in the magnitude of emotional deviations from the emotional baseline, and not necessarily in the degree of abruptness of these deviations.

The behaviors, thoughts, and feelings related to psychopathology are often not of a static nature, but rather change and fluctuate over time in response to changes in daily life situations. Therefore, clinical psychology research can benefit from focusing on how psychopathological features behave over time, as this can provide new perspectives and insights concerning the phenomenology and mechanisms underlying psychopathology. The collection of intensive longitudinal data, consisting of many repeated measurements from single participants, allows for the investigation of several dynamic properties of single or multiple symptoms (and their interrelations). This chapter presents an overview of some major dynamic properties that can be studied with intensive longitudinal data. First, it focuses on several univariate approaches, allowing the examination of one single feature over time. Then it discusses some methods and models to further examine the dynamic relationships between two or more symptoms. For each approach, information is provided on how to calculate simple indices on a more descriptive level, as well as how to model the dynamic features using more complex models.