Objectives
Self‐monitoring is recommended for individuals with bipolar disorder, with numerous technological solutions available. This study aimed to identify basic components of these solutions that increase engagement with self‐monitoring.
Methods
Participants with bipolar disorder (n = 47) monitored their symptoms with a Fitbit and a smartphone app and were randomly assigned to either review or not review recorded symptoms weekly. We tested whether individuals would better adhere to and prefer monitoring with passive monitoring with an activity tracker compared to active monitoring with a smartphone app and whether individuals would better adhere to self‐monitoring if their recorded symptoms were reviewed with an interviewer.
Results
Monitoring with a smartphone app achieved similar adherence and preference to Fitbit (P > .85). Linear mixed effects modeling found adherence decreased significantly more over the study for the Fitbit (12% more, P < .001) even though more participants reported they would use the Fitbit over a year compared to the app (72.3% vs 46.8%). Reviewing symptoms weekly did not improve adherence, but most participants reported they would prefer to review symptoms with a clinician (74.5%) and on monthly basis (57.5%) compared to alternatives. Participants endorsed sleep as the most important symptom to monitor, forgetfulness as the largest barrier to self‐monitoring, and raising self‐awareness as the best reason for self‐monitoring.
Conclusions
We recommend a combined strategy of wearable and mobile monitoring that includes reminders, targets raising self‐awareness, and tracks sleep. A clinician may want to review symptoms on a monthly basis.
Trial registration: http://ClinicalTrials.gov NCT03358238.
Meanness (i.e., callousness/unemotionality, antagonism) and disinhibition (e.g., impulsivity, antisocial behavior) are the consensus traits that undergird psychopathy. Significant debate exists regarding a proposed third dimension of boldness or fearless dominance, characterized by particularly high levels of both extraversion and emotional stability. The present study is a preregistered direct replication of the work of Gatner and colleagues (2016) regarding the importance of boldness in psychopathy. Specifically, in a large undergraduate sample (n = 1,015), which more than doubled the original study sample size, we examined whether boldness exhibited curvilinear relations to antisocial and prosocial outcomes, provided incremental predictive utility, and interacted with meanness and disinhibition. Consistent with Gatner and colleagues’ findings, incremental, interactive, or curvilinear effects of boldness did not account for more than a small amount of variance in outcomes beyond the main effects of meanness and disinhibition. We discuss both process and results in the context of promoting a culture of reproducibility as well as transparent and open practices in clinical science.
Meanness (i.e., callousness/unemotionality, antagonism) and disinhibition (e.g., impulsivity, antisocial behavior) are the consensus traits which undergird psychopathy. Significant debate exists regarding a proposed third dimension of boldness or fearless dominance, characterized by particularly high levels of both extraversion and emotional stability. The present study is a pre-registered direct replication of the work of Gatner and colleagues (2016) regarding the importance of boldness in psychopathy. Specifically, in a large undergraduate sample (n = 1,015) which more than doubled the original study sample size, we examined whether boldness exhibited curvilinear relations to antisocial and prosocial outcomes, provided incremental predictive utility, and interacted with meanness and disinhibition. Consistent with Gatner and colleagues’ findings, neither incremental, interactive, nor curvilinear effects of boldness accounted for more than a small amount of variance in outcomes beyond the main effects of meanness and disinhibition. We discuss both process and results in the context of promoting a culture of reproducibility, as well as transparent and open practices in clinical science.
The five-factor model (FFM) is a general personality model that has been frequently studied in its relation to psychopathy Widiger & Lynam, 1998) with ample evidence that Antagonism (low Agreeableness) plays a core role in the conceptualization of psychopathy. The present study examined the relations between the Self-Report Psychopathy Scale, Fourth Edition (SRP-4;Paulhus et al., 2014), one of the most commonly used self-report measures of psychopathy and the FFM. Using a preregistered analytical approach, we found that all 4 subscales and the total score of the SRP-4 are positively correlated with all facets of Antagonism and that Antagonism accounts for the overlap between SRP-4 subscales, as introducing these facets to a hierarchical regression reduced the overlap between subscales by more than 50%. Adding Conscientious to the model did not account for further reduction in overlap between the factors. Finally, a structural equation model showed the latent correlation between Antagonism and psychopathy as captured by the SRP-4 to be effectively 1.0, again highlighting the role of Antagonism in the SRP-4's conceptualization of psychopathy. The results were consistent across 2 large samples (Ns of 627 and 628). This study suggests the SRP-4 is assessing Antagonism and showcases the primary role of Antagonism in psychopathy.
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