The presentation of major depressive disorder (MDD) can vary widely due to its heterogeneity, including inter- and intraindividual symptom variability, making MDD difficult to diagnose with standard measures in clinical settings. Prior work has demonstrated that passively collected actigraphy can be used to detect MDD at a disorder level; however, given the heterogeneous nature of MDD, comprising multiple distinct symptoms, it is important to measure the degree to which various MDD symptoms may be captured by such passive data. The current study investigated whether individual depressive symptoms could be detected from passively collected actigraphy data in a (a) clinical subpopulation (i.e., moderate depressive symptoms or greater) and (b) general population. Using data from the National Health and Nutrition Examination Survey, a large nationally representative sample (N = 8,378), we employed a convolutional neural network to determine which depressive symptoms in each population could be detected by wrist-worn, minute-level actigraphy data. Findings indicated a small-moderate correspondence between the predictions and observed outcomes for mood, psychomotor, and suicide items (area under the receiver operating characteristic curve [AUCs] = 0.58-0.61); a moderate-large correspondence for anhedonia (AUC = 0.64); and a large correspondence for fatigue (AUC = 0.74) in the clinical subpopulation (n = 766); and a small-moderate correspondence for sleep, appetite, psychomotor, and suicide items (AUCs = 0.56-0.60) in the general population (n = 8,378). Thus, individual depressive symptoms can be detected in individuals who likely meet the criteria for MDD, suggesting that wrist-worn actigraphy may be suitable for passively assessing these symptoms, providing important clinical implications for the diagnosis and treatment of MDD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
Psychological functioning is shaped by how people navigate their environment. Accordingly, psychopathology is often caused and maintained by patterns of responding to the environment that do not meet situational demands. In particular, psychopathology is often expressed in an inflexible or intense manner of coping with stressful situations. Prior research on psychopathology and daily life stress is limited by an overreliance on negative affect reactivity, which neglects the myriad responses that can create problems in a person's life. In this study, we assessed a broad range of daily manifestations of psychopathology to examine daily psychopathology-stress associations. We conceptualized individual differences in functioning as psychopathology traits and daily fluctuations in the interrelated thoughts, behaviors, and emotions as psychopathology states, with traits and states corresponding to the same domains of functioning (i.e., antagonism, detachment, disinhibition, negative affectivity, anankastia, psychoticism). Data have been taken from two samples enriched for psychopathology (N = 112, N = 294 participants) who completed daily assessments of stressors and psychopathological states (n = 9,201, n = 4,292 days). We used multilevel structural equation models to examine average, within-person associations between stressors and psychopathological states and correlations between psychopathological traits and stress responses. Results showed that (a) most people experience increases in psychopathological states when stressed and (b) psychopathological traits relate to more consistent and stronger increases in psychopathological states. Our study suggests that psychopathology reflects how people cope with stressful situations, and what distinguishes people with high-trait psychopathology from those who experience typical upticks in psychopathology when stressed is the consistency and extremity of their responses. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
This viewpoint article discusses the utility of high-dosage experiments (HDEs) in everyday life to test theories in clinical science. HDEs involve experimental manipulations and assessments that occur over much longer periods of time than traditional experiments-generally days or even weeks. By nature, they also occur outside the lab, in the everyday environments of participants. Additionally, as with other experiments, the purpose of the study is concealed from participants. Experimental design is one of the most distinguishable characteristics of psychology that separates it from other behavioral sciences. Studies that rely on experiments are essential for theory testing and establishing the potential causal role of mechanisms that underlie psychopathology. Yet despite the value of experimental research, experimental studies are not currently given special prominence in clinical psychological science. For example, in the Journal of Psychopathology and Clinical Science, of all the empirical studies in the most recent year (2023), only three of 77 incorporated an experimental manipulation. Experimental research appears to be less popular in clinical psychology than in other fields, such as social psychology. What might account for this discrepancy? First, clinical samples are more difficult to recruit. This is important because experimental manipulations may produce small effects that require large samples for detection. Additionally, mechanisms hypothesized to underlie psychopathology are often chronic and intransigent. For example, cognitive factors (e.g., perfectionistic beliefs) could require an especially strong manipulation to modify in isolation. Researchers have argued that psychology has been experiencing a crisis in theory development. Eronen and Bringmann (2021) stated that one major reason for this crisis is the difficulty in establishing causal relationships between psychological constructs. The replication crisis has garnered even more attention (Open Science Collaboration, 2015). HDEs would help address these two crises and provide stronger and more replicable tests of theory. This could allow us to more precisely identify important mechanisms underlying psychopathology, potentially enhancing treatment efficacy, and enabling us to move the field forward. (PsycInfo Database Record (c) 2024 APA, all rights reserved).