A daily-life study of interpersonal stressors and alcohol use in individuals with borderline personality disorder and community controls

Fleming, Megan N.; Wycoff, Andrea M.; Hepp, Johanna; Griffin, Sarah A.; Helle, Ashley C.; Freeman, Lindsey K.; Trull, Timothy J.

doi:10.1016/j.drugalcdep.2021.109021

Cited by 6 publications

(3 citation statements)

References 30 publications

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“…We were unable to obtain full data from 7 studies that did not report separate results for control and BPD groups [32][33][34][35][36][37][38], which were, therefore, excluded from our study.…”

Section: Data Extractionmentioning

confidence: 99%

Study Features and Response Compliance in Ecological Momentary Assessment Research in Borderline Personality Disorder: Systematic Review and Meta-analysis

Davanzo¹,

d’Huart²,

Moessner³

et al. 2023

J Med Internet Res

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Background Borderline personality disorder (BPD) is characterized by frequent and intense moment-to-moment changes in affect, behavior, identity, and interpersonal relationships, which typically result in significant and negative deterioration of the person’s overall functioning and well-being. Measuring and characterizing the rapidly changing patterns of instability in BPD dysfunction as they occur in a person’s daily life can be challenging. Ecological momentary assessment (EMA) is a method that can capture highly dynamic processes in psychopathology research and, thus, is well suited to study intense variability patterns across areas of dysfunction in BPD. EMA studies are characterized by frequent repeated assessments that are delivered to participants in real-life, real-time settings using handheld devices capable of registering responses to short self-report questions in daily life. Compliance in EMA research is defined as the proportion of prompts answered by the participant, considering all planned prompts sent. Low compliance with prompt schedules can compromise the relative advantages of using this method. Despite the growing EMA literature on BPD in recent years, findings regarding study design features that affect compliance with EMA protocols have not been compiled, aggregated, and estimated. Objective This systematic meta-analytic review aimed to investigate the relationship between study design features and participant compliance in EMA research of BPD. Methods A systematic review was conducted on November 12, 2021, following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and MOOSE (Meta-analyses of Observational Studies in Epidemiology) guidelines to search for articles featuring EMA studies of BPD that reported compliance rates and included sufficient data to extract relevant design features. For studies with complete data, random-effect models were used to estimate the overall compliance rate and explore its association with design features. Results In total, 28 peer-reviewed EMA studies comprising 2052 participants were included in the study. Design features (sampling strategy, average prompting frequency, number of items, response window, sampling device, financial incentive, and dropout rate) showed a large variability across studies, and many studies did not report design features. The meta-analytic synthesis was restricted to 64% (18/28) of articles and revealed a pooled compliance rate of 79% across studies. We did not find any significant relationship between design features and compliance rates. Conclusions Our results show wide variability in the design and reporting of EMA studies assessing BPD. Compliance rates appear to be stable across varying setups, and it is likely that standard design features are not directly responsible for improving or diminishing compliance. We discuss possible nonspecific factors of study design that may have an impact on compliance. Given the promise of EMA research in BPD, we also discuss the importance of unifying standards for EMA reporting so that data stemming from this rich literature can be aggregated and interpreted jointly.

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Section: Data Extractionmentioning

confidence: 99%

Study Features and Response Compliance in Ecological Momentary Assessment Research in Borderline Personality Disorder: Systematic Review and Meta-analysis

Davanzo¹,

d’Huart²,

Moessner³

et al. 2023

J Med Internet Res

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“…Secondary data analyses:6 Carpenter et al, 2019;Fleming et al, 2021;Hepp et al, 2018;Napolitano et al, 2021 7 Kaurin et al, 2020bRingwald et al, 2022;Woods et al, 2020 8 Links et al, 2008Nisenbaum et al, 2010 …”

mentioning

confidence: 99%

Studying personality pathology with ecological momentary assessment: Harmonizing theory and method.

Kaurin¹,

King²,

Wright³

2023

Personality Disorders: Theory, Research, and Treatment

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Over the past 20 years, ecological momentary assessment (EMA) has become a vital part of the methods repertoire used to study personality pathology. This is because EMA facilitates modeling (dys)function consistent with clinical theory as an ensemble of contextualized dynamic within-person processes, such as when and how relevant socio-affective responses may become disrupted in daily life. Despite its popularity, there is little systematic work on the conceptual adequacy and cross-study consistency in the design choices and reporting standards of EMA studies on personality disorders. EMA protocol design choices impact the reliability and validity of conclusions, and variability in choices affect replicability and thus credibility of the conclusions drawn. We provide an overview of the core decisions researchers face in designing an EMA study organized around the "three Ds": density (frequency of surveys), depth (length of surveys), and duration (number of days in a protocol). To identify the typical and range of used study designs, including what personality disorder researchers view as important and where there are gaps in our knowledge, we reviewed relevant studies published over the years 2000 to 2021. Of 66 identified unique EMA protocols, studies scheduled $6.5 assessments per day with an average of $21 items, lasted for $13 days, and obtained a compliance of $75%. Generally, denser studies had less depth and shorter duration, whereas protocols with longer duration tended to be deeper. We offer recommendations on how valid research on personality disorders can be organized around these considerations with the goal of reliably uncovering temporal dynamics in personality (dys)functioning.

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“…The vast majority of this work has focused on links between daily stressors and negative affect, which has consistently shown that people experience more negative emotion on days stressful events occur (Bolger et al, 1989;DeLongis et al, 1988;Diehl & Hay, 2013;Howland et al, 2017;Kaurin et al, 2021;Kiang & Buchanan, 2014;Leger et al, 2016;Mroczek & Almeida, 2004) and less positive affect (Blaxton & Bergeman, 2017;Dunkley et al, 2017;Leger et al, 2016;Nezlek & Allen, 2006;van Eck et al, 1998;Zatura et al, 2005) on days stressful events occur. A few studies have shown daily stress relates to engagement in specific coping strategies (e.g., problem-solving;DeLongis & Holtzman, 2005;Dunkley et al, 2017), health-related behaviors (e.g., alcohol use; Fleming et al, 2021), or specific symptoms (e.g., binge-eating; Goldschmidt et al, 2014), but overall, there is far less ambulatory research on the non-affective components of typical, day-to-day stress responses (i.e., thoughts, behaviors) despite their prominent theoretical role in the cumulative effects of stress. A more comprehensive mapping of how people tend to respond to stress will help identify mechanisms linking stress to health outcomes.…”

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confidence: 99%

Characterizing Stress Processes by Linking Big Five Personality States, Traits, and Day-to-Day Stressors

Ringwald¹,

Nielsen²,

Mostajabi³

et al. 2022

Preprint

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The accumulation of day-to-day stressors can impact mental and physical health. How people respond to stressful events is a key mechanism responsible for the effects of stress, and individual differences in stress responses can either perpetuate or prevent negative consequences. Most research on daily stress processes has focused on affective responses to stressors, but stress responses can involve more than just affect. Additionally, most research has been on the role of neuroticism in shaping those responses, but many other individual differences are associated with stress outcomes. In this study, we more comprehensively characterized daily stress processes by expanding the nomological networks of stress responses to include Big Five personality states. We also linked those stress responses to all Big Five traits, as well as individual differences in stress exposure and stress appraisal. We studied a sample of participants (N = 1,090) who reported on stressful events, their appraisal of events in terms of severity and controllability, and their Big Five personality states daily for 7-10 days (N = 8,870 observations). Multi-level structural equation models were used to separate how characteristics of the perceived stressful situation and characteristics of the person play into daily stress processes. Results showed that (1) all Big Five personality states shift in response to perceived stress, (2) all Big Five personality traits relate to average levels of perceived stress exposure and appraisals, (3) individual differences in personality and average perceived stress exposure and perceived severity relate to the strength of personality state responses to daily stress. Our results point to new pathways by which stressors affect people in everyday life and begin to clarify processes that may explain individual differences in risk or resilience to the harmful effects of stress.

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A daily-life study of interpersonal stressors and alcohol use in individuals with borderline personality disorder and community controls

Cited by 6 publications

References 30 publications

Study Features and Response Compliance in Ecological Momentary Assessment Research in Borderline Personality Disorder: Systematic Review and Meta-analysis

Study Features and Response Compliance in Ecological Momentary Assessment Research in Borderline Personality Disorder: Systematic Review and Meta-analysis

Studying personality pathology with ecological momentary assessment: Harmonizing theory and method.

Characterizing Stress Processes by Linking Big Five Personality States, Traits, and Day-to-Day Stressors

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