Summary

Background: The temporal properties of symptom fluctuations and the understanding of the dynamic contexts that give rise to these fluctuations are poorly understood. As a result, much remains to be learned about the factors that influence symptomatology and well-being as well as patients’ general inability to precisely reflect and report about their experiences. This research study will use ecological momentary assessment/ event sampling methodology (EMA/ESM), an assessment method that captures data close to the time of occurrence in participants’ own environment, as a means of capturing data that inform about maintaining factors of symptoms and well-being. The relative neglect of these issues to date and the failure to fully explore rich variability of dynamic expression of patient symptomatology has led to obfuscation about the factors that maintain psychopathology and incomplete theories of psychopathology.

Method: In this study we will obtain EMA/ESM data to test current theory about factors that exacerbate and ameliorate psychopathological symptoms and mental states such as well-being. In order to examine the gap between people’s experiences and memory of these experiences, participants will retrospectively recall aspects of the data they recorded via EMA/ESM. Participants will include patients with mental disorders and healthy controls (n=117). The patient groups will consist of people diagnosed with social phobia (n = 48) and major depressive disorder (MDD) (n=117), both of which are prevalent and associated with high levels of disability, suffering, and lost opportunity. Factors to be examined include affect, daily events, social interactions, health behaviors, experiential avoidance, and psychological flexibility. Importantly, the inclusion of an anxiety disorder, a mood disorder, and healthy controls allows for critical testing of the generalizability and specificity of our findings.

Expected Outcomes: In gathering rich multi-level data, we will be able to critically examine various aspects about the psychopathology of MDD and social phobia. First, the EMA/ESM data will provide information on the factors that exacerbate symptomatology and promote well-being. This information will be further used to help determine factors that promote stability/ instability of daily symptom fluctuations. Second, these data will be used to determine the degree of accuracy in recalling EMA/ESM assessed symptomatology/ well-being and explore which heuristics (e.g., recency and saliency bias) and characteristics are associated with the memory-experience gap. Participants’ retrospectively recalled data will be examined to determine whether participant characteristics (e.g., severity and type of symptomatology, degree of emotional suppression, symptom stability, etc.) potentiate the inaccuracies. By examining these factors across a mood disorder, an anxiety disorder, and a control group with neither disorder, the implication of our findings will have transdiagnostic relevance.  As such, the proposed project has the potential to be of high scientific and societal value by helping to better understand and assess two prevalent and debilitating mental disorders.