Introduction: Over the last decades, our understanding of the cognitive, motivational, and neural processes involved in addictive behavior has increased enormously. A plethora of laboratory-based and cross-sectional studies has linked cognitive-behavioral measures to between-subject differences in drinking behavior. However, such laboratory-based studies inevitably suffer from small sample sizes and the inability to link temporal fluctuations in task measures to fluctuations in real-life substance use. To overcome these problems, several existing behavioral tasks have been transferred to smartphones to allow studying cognition in the field. Method: In this narrative review, we first summarize studies that used existing behavioral tasks in the laboratory and self-reports of substance use with ecological momentary assessment (EMA) in the field. Next, we review studies on psychometric properties of smartphone-based behavioral tasks. Finally, we review studies that used both smartphone-based tasks and self-reports with EMA in the field. Results: Overall, studies were scarce and heterogenous both in tasks and in study outcomes. Nevertheless, existing findings are promising and point toward several methodological recommendations: concerning psychometrics, studies show that – although more systematic studies are necessary – task validity and reliability can be improved, for example, by analyzing several measurement sessions at once rather than analyzing sessions separately. Studies that use tasks in the field, moreover, show that power can be improved by choosing sampling schemes that combine time-based with event-based sampling, rather than relying on time-based sampling alone. Increasing sampling frequency can further increase power. However, as this also increases the burden to participants, more research is necessary to determine the ideal sampling frequency for each task. Conclusion: Although more research is necessary to systematically study both the psychometrics of smartphone-based tasks and the frequency at which task measures fluctuate, existing studies are promising and reveal important methodological recommendations useful for researchers interested in implementing behavioral tasks in EMA studies.

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Studies suggest that sleep disturbance may be an important etiological factor in the development of comorbid anxiety and depressive disorders, whereby anxiety leads to sleep difficulties, which in turn increase the vulnerability for depression. The primary aim of this study was to determine whether the sequential comorbidity patterns observed at the disorder level (i.e., where anxiety disorders most often precede insomnia, and insomnia most often precedes depression) were also present in daily fluctuations of symptoms. The secondary aim was to explore possible moderators of any observed temporal associations. Participants were 15 patients with generalized anxiety disorder (GAD; mean age = 28.9 years, SD = 9.8) and 15 good sleeper controls (mean age = 27.1 years, SD = 8.3) who were comparable in female:male ratio (73% female vs. 67% female). For 14 days, participants wore an actigraph to objectively assess sleep quality (sleep onset latency, total sleep time, wake after sleep onset, sleep efficiency) and completed daily symptom ratings multiple times each day using their smartphones to assess symptoms of anxiety, depressed mood, and subjective sleep quality. Study aims were assessed using multilevel modeling, with daily symptoms nested within individuals. Many of the analyses were lagged such that the time-varying predictor variable preceded the time-varying outcome variable temporally. Consistent with hypotheses, results demonstrated that anxious mood was predictive of later subjective and objective sleep disturbance in individuals with GAD, and this effect was strongest among individuals with higher levels of neuroticism, negative affect, and dysfunctional beliefs about sleep. Anxious mood was not associated with later subsequent sleep disturbance in healthy controls. In the GAD group, subjective and objective sleep disturbance predicted later depressed mood; this effect was moderated by temperament and dysfunctional beliefs about sleep. For the control group, the effect of subjective sleep disturbance on later depressed mood was moderated by neuroticism and the effect of objective sleep disturbance was moderated by dysfunctional beliefs about sleep, suggesting that sleep disturbance may increase vulnerability for depressed mood even in healthy individuals. These results suggest that explicitly targeting sleep disturbance during the treatment of GAD may attenuate the experience of depressive symptoms.

Non-suicidal self-injury (NSSI), the deliberate and direct damage of one’s body tissue without suicidal intent, is a pervasive public health concern often leading to clinically significant long-term consequences (e.g., permanent scarring, hospitalization) that is theorized to be facilitated by negative affect and emotion dysregulation. The Emotional Cascade Model proposes that NSSI partially functions to disrupt the reciprocal and rapid amplification of negative affect driven by rumination. However, limited research has focused on state rumination and the distinct contribution of maladaptive and adaptive rumination subtypes, as well as the role of positive affect within this framework. Thus, the purpose of the current study was to replicate and explore the independent influences of overall and momentary (1) positive and negative affect and (2) rumination on NSSI acts and urges, as well as (3) the extent to which rumination moderates the relationship between affect and NSSI. To do so, rumination, affect, and NSSI urges and acts were assessed 4 times daily via ecological momentary assessment for 21-days among thirty undergraduate participants with past month NSSI. Our results partially replicated existing literature, such that overall negative affect was associated with greater overall NSSI urge strength and momentary negative affect and rumination predicted stronger NSSI urges at the next alert, with increased momentary rumination strengthening the relationship between momentary negative affect and NSSI urge. Exploratory investigations of overall and momentary positive affect showed some negative associations with NSSI urges and behaviors, with no moderating effect of rumination. Data did not support the independent examination of maladaptive and adaptive rumination subtypes. Taken together, this study highlighted the importance of exploring state rumination (in addition to trait) and affect in understanding NSSI thoughts and behaviors, and calls for future studies to further investigate distinct properties of rumination to understand its impact on specific emotions that maintain NSSI engagement. / Psychology

La Dépression Post-AVC (DPAVC) constitue une des complications psychiatriques les plus fréquentes dans les suites d’un Accident Vasculaire Cérébral (AVC) avec des conséquences majeures en termes de récupération fonctionnelle et de qualité de vie. Il est nécessaire de disposer de critères permettant une identification précoce des patients à risque afin de leur proposer des aides adaptées. L’objectif de ce travail de thèse est d’étudier certains facteurs de risque et de protection de la DPAVC avec une approche en vie quotidienne chez des patients présentant un AVC peu invalidant. Dans une première partie, nous présentons l’étude du rôle exercé par le soutien social et la routinisation sur la sévérité des symptômes dépressifs trois mois après l’AVC par la méthode « Ecological Momentary Assessment ». Dans une seconde partie, nous explorons le rôle de la voix comme marqueur précoce de la DPAVC. Nous avons mis en évidence que la perception du soutien social initial influence l’intensité des symptômes dépressifs et les activités trois mois après. D’autre part, nous avons observé une dynamique temporelle unidirectionnelle entre l’augmentation des routines et la survenue de symptômes dépressifs plus intenses. Enfin, les analyses vocales nous ont permis d’identifier des marqueurs de DPAVC avec des modifications longitudinales de la fréquence fondamentale ainsi que des marqueurs précoces (shimmer et ruptures de voisement). Au-delà des facteurs cliniques traditionnellement reconnus, ce travail a mis en évidence de façon écologique de nouveaux marqueurs de risque de DPAVC dont la détection pourrait permettre d’élaborer de nouvelles stratégies de prévention et de prise en charge / Post-stroke depression (PSD) is one of the most common psychiatric complications following stroke with detrimental consequences in terms of functional recovery and quality of life. Its identification and treatment at the earliest stages of care remains a clinical challenge. The aim of this thesis is to study risk and protective factors for PSD based on data collected in the contexts of daily life. In the first section, we present a study of the role played by social support and routinization on the severity of depressive symptoms three months after stroke by Ecological Momentary Assessment (EMA). In the second section, we examine the voice as an early marker of PSD. We observed that patient perceptions of better support quality, and not quantity, immediately following mild stroke, are associated with better behavioral and emotional outcomes three months later. In addition, we observed a unidirectional pattern of association between mood and routines, whereby the occurrence of routines was associated with a higher level of depressive symptomatology over subsequent hours. Finally, voice analysis allowed us to identify PSD markers with longitudinal changes in fundamental voice frequency and discriminant analysis demonstrated that initial voice breaks coupled with shimmer are strongly predictive of subsequent PSD. Beyond commonly-recognized clinical risk factors such as stroke severity, these ecological investigations identified new markers for PSD whose detection could lead to new strategies for prevention and care

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