Hostname: page-component-76fb5796d-wq484 Total loading time: 0 Render date: 2024-04-26T08:28:24.565Z Has data issue: false hasContentIssue false
  • English
  • Français

Predictors of affect following discharge from partial hospitalization: a two-week ecological momentary assessment study

Published online by Cambridge University Press:  03 February 2020

Marie Forgeard Open the ORCID record for Marie Forgeard [Opens in a new window] ,
Courtney Beard ,
Danielle Shayani ,
Alexandra L. Silverman ,
Eli Tsukayama  and
Thröstur Björgvinsson
Marie Forgeard*
Affiliation:
McLean Hospital, 115 Mill Street, Belmont, MA, 02468, USA Harvard Medical School, Boston, MA, 02115, USA William James College, Newton, MA, 02459, USA
Courtney Beard
Affiliation:
McLean Hospital, 115 Mill Street, Belmont, MA, 02468, USA Harvard Medical School, Boston, MA, 02115, USA
Danielle Shayani
Affiliation:
McLean Hospital, 115 Mill Street, Belmont, MA, 02468, USA
Alexandra L. Silverman
Affiliation:
McLean Hospital, 115 Mill Street, Belmont, MA, 02468, USA University of Virginia, Charlottesville, VA, 22904, USA
Eli Tsukayama
Affiliation:
University of Hawaii West Oahu, Kapolei, HI, 96707, USA
Thröstur Björgvinsson
Affiliation:
McLean Hospital, 115 Mill Street, Belmont, MA, 02468, USA Harvard Medical School, Boston, MA, 02115, USA
*
Author for correspondence: Marie Forgeard, E-mail: mforgeard@mclean.harvard.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

Little is known about the everyday experiences of individuals transitioning from acute to outpatient psychiatric care, an important period of risk for mood symptom relapse. This study used ecological momentary assessment (EMA) to examine whether specific daily experiences were related to momentary affective states following discharge from a partial hospitalization program (PHP).

Methods

A sample of 114 adults (Mage = 36 years old, 52% female, 83% White) completed four brief EMA surveys every day for 2 weeks assessing intensity/type of stressful events and social contact, as well as positive/negative affect (PA/NA). Half of participants reported therapeutic skills use.

Results

Stress severity ratings prospectively predicted increased NA. NA predicted spending less time with close relationships. However, interacting with close relationships predicted increased positive affect (PA). Finally, PA predicted spending time with more people. The use of two skills (behavioral activation and interpersonal effectiveness) was concurrently, but not prospectively, associated with improved affect.

Conclusions

Examining daily experiences of individuals discharging from partial hospitalization provides important information about factors that may influence affective states during the transition from acute to outpatient care. Findings from this study can be used to help prepare patients for discharge and develop interventions for the post-acute period.

Keywords

Affectecological momentary assessmentpartial hospitalization
Type
Original Article
Information
Psychological Medicine , Volume 51 , Issue 7 , May 2021 , pp. 1157 - 1165
Check for updates
Copyright
Copyright © Cambridge University Press 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

aan het Rot, M., Hogenelst, K., & Schoevers, R. A. (2012). Mood disorders in everyday life: A systematic review of experience sampling and ecological momentary assessment studies. Clinical Psychology Review, 32, 510–523.CrossRefGoogle ScholarPubMed
Altman, S., Haeri, S., Cohen, L. J., Ten, A., Barron, E., Galynker, I. I., & Duhamel, K. N. (2006). Predictors of relapse in bipolar disorder: A review. Journal of Psychiatric Practice, 12, 269–282.CrossRefGoogle ScholarPubMed
Armey, M. F., Brick, L., Schatten, H. T., Nugent, N. R., & Miller, I. W. (2018). Ecologically assessed affect and suicidal ideation following psychiatric inpatient hospitalization. General Hospital Psychiatry. Advance Online Publication.Google ScholarPubMed
Asparouhov, T., Hamaker, E. L., & Muthén, B. (2018). Dynamic structural equation models. Structural Equation Modeling: A Multidisciplinary Journal, 25, 359–388.CrossRefGoogle Scholar
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford Press.Google Scholar
Beshai, S., Dobson, K. S., Bockting, C. L. H., & Quigley, L. (2011). Relapse and recurrence prevention in depression: Current research and future prospects. Clinical Psychology Review, 31, 1349–1360.CrossRefGoogle ScholarPubMed
Bickel, R. (2007). Multilevel analysis for applied research: It's just regression! New York: Guilford Press.Google Scholar
Björgvinsson, T., Kertz, S. J., Bigda-Peyton, J. S., Rosmarin, D. H., Aderka, I. M., & Neuhaus, E. C. (2014). Effectiveness of cognitive behavior therapy for severe mood disorders in an acute psychiatric naturalistic setting: A benchmarking study. Cognitive Behaviour Therapy, 43, 209–220.CrossRefGoogle Scholar
Boyer, C. A., McAlpine, D. D., Pottick, K. J., & Olfson, M. (2000). Identifying risk factors and key strategies in linkage to outpatient psychiatric care. American Journal of Psychiatry, 157, 1592–1598.CrossRefGoogle ScholarPubMed
Brown, L. H., Strauman, T., Barrantes-Vidal, N., Silvia, P. J., & Kwapil, T. R. (2011). An experience-sampling study of depressive symptoms and their social context. The Journal of Nervous and Mental Disease, 199, 403–409.CrossRefGoogle ScholarPubMed
Bylsma, L. M., & Rottenberg, J. (2011). Uncovering the dynamics of emotion regulation and dysfunction in daily life with ecological momentary assessment. In Nyklicek, I., Vingerhoets, A. & Zeelenberg, M. (Eds.), Emotion regulation and well-being (pp. 225–244). New York: Springer.CrossRefGoogle Scholar
Bylsma, L. M., Taylor-Clift, A., & Rottenberg, J. (2011). Emotional reactivity to daily events in major and minor depression. Journal of Abnormal Psychology, 120, 155–167.CrossRefGoogle ScholarPubMed
Cohen, S., & Wills, T. A. (1985). Stress, social support, and the buffering hypothesis. Psychological Bulletin, 98, 310–357.CrossRefGoogle ScholarPubMed
Conklin, L. R., & Strunk, D. R. (2015). A session-to-session examination of homework engagement in cognitive therapy for depression: Do patients experience immediate benefits? Behaviour Research and Therapy, 72, 56–62.CrossRefGoogle ScholarPubMed
Ebner-Priemer, U. W., & Trull, T. J. (2009). Ecological momentary assessment of mood disorders and mood dysregulation. Psychological Assessment, 21, 463–475.CrossRefGoogle ScholarPubMed
Finan, P. H., Zautra, A. J., & Wershba, R. (2011). The dynamics of emotion in adaptation to stress. In Contrada, R. & Baum, A. (Eds.), The handbook of stress science: Biology, psychology, and health (pp. 209–220). New York: Springer.Google Scholar
Forgeard, M., Beard, C., Kirakosian, N., & Björgvinsson, T. (2018). Research in partial hospital settings. In Codd, R. T. (Ed.), Practice-Based research: A guide for clinicians (pp. 212–239). New York: Routledge.CrossRefGoogle Scholar
Fuller-Tyszkiewicz, M., Karvounis, T., Pemberton, R., Hartley-Clark, L., & Richardson, B. (2017). Determinants of depressive mood states in everyday life: An experience sampling study. Motivation and Emotion, 41, 510–521.CrossRefGoogle Scholar
Geldhof, G. J., Preacher, K. J., & Zyphur, M. J. (2014). Reliability estimation in a multilevel confirmatory factor analysis framework. Psychological Methods, 19, 72–91.CrossRefGoogle Scholar
Grimm, K. J., Ram, N., & Estabrook, R. (2017). Growth modeling: Structural equation and multilevel modeling approaches. New York: Guilford.Google Scholar
Hoet, A. C., Burgin, C. J., Eddington, K. M., & Silvia, P. J. (2018). Reports of therapy skill use and their efficacy in daily life in the short-term treatment of depression. Cognitive Therapy and Research, 2, 184–192.CrossRefGoogle Scholar
Horvitz-Lennon, M., Normand, S.-L. T., Gaccione, P., & Frank, R. G. (2001). Partial versus full hospitalization for adults in psychiatric distress: A systematic review of the published literature (1957–1997). American Journal of Psychiatry, 158, 676–685.CrossRefGoogle ScholarPubMed
Hu, L. T., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6, 1–55.CrossRefGoogle Scholar
Johnson, L., Lundström, O., Åberg-Wistedt, A., & Mathé, A. (2003). Social support in bipolar disorder. Bipolar Disorders, 5, 129–137.CrossRefGoogle ScholarPubMed
Kallert, T. W., Priebe, S., McCabe, R., Kiejna, A., Rymaszewska, J., Nawka, P., … Schützwohl, M. (2007). Are day hospitals effective for acutely ill psychiatric patients? A European multicenter randomized controlled trial. The Journal of Clinical Psychiatry, 68, 278–287.CrossRefGoogle ScholarPubMed
Kazantzis, N., Brownfield, N. R., Mosely, L., Usatoff, A. S., & Flighty, A. J. (2017). Homework in cognitive behavioral therapy: A systematic review of adherence assessment in anxiety and depression (2011–2016). Psychiatric Clinics of North America, 40, 625–639.CrossRefGoogle ScholarPubMed
Kazantzis, N., Deane, F. P., & Ronan, K. R. (2004). Assessing compliance with homework assignments: Review and recommendations for clinical practice. Journal of Clinical Psychology, 60, 627–641.CrossRefGoogle ScholarPubMed
Kazantzis, N., Whittington, C., & Dattilio, F. (2010). Meta-analysis of homework effects in cognitive and behavioral therapy: A replication and extension. Clinical Psychology: Science and Practice, 17, 144–156.Google Scholar
Kessler, R. C., Kendler, K. S., Heath, A., Neale, M. C., & Eaves, L. J. (1992). Social support, depressed mood, and adjustment to stress: A genetic epidemiologic investigation. Journal of Personality and Social Psychology, 62, 257–272.CrossRefGoogle Scholar
Kline, R. B. (2005). Principles and practice of structural equation modeling. New York: Guilford.Google Scholar
Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: A new depression diagnostic and severity measure. Psychiatric Annals, 32, 509–515.CrossRefGoogle Scholar
Larivière, N., Desrosiers, J., Tousignant, M., & Boyer, R. (2010). Who benefits the most from psychiatric day hospitals? A comparison of three clinical groups. Journal of Psychiatric Practice, 16, 93–102.CrossRefGoogle ScholarPubMed
Lethbridge, R., & Allen, N. B. (2008). Mood induced cognitive and emotional reactivity, life stress, and the prediction of depressive relapse. Behaviour Research and Therapy, 10, 1142–1150.CrossRefGoogle Scholar
Linehan, M. (1993). Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.Google Scholar
Marshall, M., Crowther, R., Sledge, W. H., Rathbone, J., & Soares-Weiser, K. (2011). Day hospital versus admission for acute psychiatric disorders. The Cochrane Database of Systematic Reviews.CrossRefGoogle Scholar
Martell, C. R., Dimidjian, S., & Herman-Dunn, R. (2013). Behavioral activation for depression: A clinician's guide. New York: Guilford Press.Google Scholar
Moss, J., Li, A., Tobin, J., Weinstein, I. S., Harimoto, T., & Lanctôt, K. L. (2014). Predictors of readmission to a psychiatry inpatient unit. Comprehensive Psychiatry, 55, 426–430.CrossRefGoogle ScholarPubMed
Mroczek, D. K., & Almeida, D. M. (2004). The effect of daily stress, personality, and age on daily negative affect. Journal of Personality, 72, 355–378.CrossRefGoogle ScholarPubMed
Muthén, L. K., & Muthén, B. O. (2017). Mplus user's guide (8th ed.). Los Angeles: Muthén & Muthén.Google Scholar
Myin-Germeys, I., Klippel, A., Steinhart, H., & Reininghaus, U. (2016). Ecological momentary interventions in psychiatry. Current Opinion in Psychiatry, 29, 258–263.CrossRefGoogle ScholarPubMed
Nezlek, J. B. (2007). A multilevel framework for understanding relationships among traits, states, situations and behaviours. European Journal of Personality, 21, 789–810.CrossRefGoogle Scholar
Nezlek, J. B., & Gable, S. L. (2001). Depression as a moderator of relationships between positive daily events and day-to-day psychological adjustment. Personality and Social Psychology Bulletin, 27, 1692–1704.CrossRefGoogle Scholar
Paykel, E. S. (1994). Life events, social support and depression. Acta Psychiatrica Scandinavica, 89, 50–58.CrossRefGoogle Scholar
Peeters, F., Berkhof, J., Rottenberg, J., & Nicolson, N. A. (2010). Ambulatory emotional reactivity to negative daily life events predicts remission from major depressive disorder. Behaviour Research and Therapy, 48, 754–760.CrossRefGoogle ScholarPubMed
Pemberton, R., & Fuller Tyszkiewicz, M. D. (2016). Factors contributing to depressive mood states in everyday life: A systematic review. Journal of Affective Disorders, 200, 103–110.CrossRefGoogle ScholarPubMed
Schueller, S. M., Aguilera, A., & Mohr, D. C. (2017). Ecological momentary interventions for depression and anxiety. Depression and Anxiety, 34, 540–545.CrossRefGoogle ScholarPubMed
Sheehan, D. V., Lecrubier, Y., Sheehan, K. H., Amorim, P., Janavs, J., Weiller, E., … Dunbar, G. C. (1998). The Mini-International Neuropsychiatric Interview (MINI): The development and validation of a structured diagnostic interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.Google ScholarPubMed
Shiffman, S., Stone, A. A., & Hufford, M. R. (2008). Ecological momentary assessment. Annual Review of Clinical Psychology, 4, 1–32.CrossRefGoogle ScholarPubMed
Snippe, E., Simons, C. J., Hartmann, J. A., Menne-Lothmann, C., Kramer, I., Booij, S. H., … Wichers, M. (2016). Change in daily life behaviors and depression: Within-person and between-person associations. Health Psychology, 35, 433–441.CrossRefGoogle ScholarPubMed
Steffen, S., Kösters, M., Becker, T., & Puschner, B. (2009). Discharge planning in mental health care: A systematic review of the recent literature. Acta Psychiatrica Scandinavica, 120, 1–9.CrossRefGoogle ScholarPubMed
Suls, J., Green, P., & Hillis, S. (1998). Emotional reactivity to everyday problems, affective inertia, and neuroticism. Personality and Social Psychology Bulletin, 24, 127–136.CrossRefGoogle Scholar
van der Stouwe, E. C., Groenewold, N. A., Bos, E. H., de Jonge, P., Wichers, M., & Booij, S. H. (2019). How to assess negative affective reactivity to daily life stress in depressed and nondepressed individuals? Psychiatry Research, 279, 259–266.CrossRefGoogle ScholarPubMed
Vigod, S. N., Kurdyak, P. A., Dennis, C.-L., Leszcz, T., Taylor, V. H., Blumberger, D. M., & Seitz, D. P. (2013). Transitional interventions to reduce early psychiatric readmissions in adults: Systematic review. The British Journal of Psychiatry, 202, 187–194.CrossRefGoogle ScholarPubMed
Vranceanu, A.-M., Gallo, L. C., & Bogart, L. M. (2009). Depressive symptoms and momentary affect: The role of social interaction variables. Depression and Anxiety, 26, 464–470.CrossRefGoogle ScholarPubMed
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54, 1063–1070.CrossRefGoogle ScholarPubMed
Wichers, M., Myin-Germeys, I., Jacobs, N., Peeters, F., Kenis, G., Derom, C., … Os, J. V. (2007). Genetic risk of depression and stress-induced negative affect in daily life. The British Journal of Psychiatry, 191, 218–223.CrossRefGoogle ScholarPubMed
Zautra, A. J., Reich, J. W., Davis, M. C., Potter, P. T., & Nicolson, N. A. (2000). The role of stressful events in the relationship between positive and negative affects: Evidence from field and experimental studies. Journal of Personality, 68, 927–951.CrossRefGoogle ScholarPubMed
Supplementary material: File

Forgeard et al. supplementary material

Forgeard et al. supplementary material

Download Forgeard et al. supplementary material(File)
File 115.1 KB