Positive Affective Recovery in Daily Life as a Momentary Mechanism Across Subclinical and Clinical Stages of Mental Disorder: Experience Sampling Study

Leonie Ader; Anita Schick; Claudia Simons; Philippe Delespaul; Inez Myin-Germeys; Thomas Vaessen; Ulrich Reininghaus

doi:10.2196/37394

Positive Affective Recovery in Daily Life as a Momentary Mechanism Across Subclinical and Clinical Stages of Mental Disorder: Experience Sampling Study

JMIR Ment Health. 2022 Nov 23;9(11):e37394. doi: 10.2196/37394.

Authors

Leonie Ader¹, Anita Schick¹, Claudia Simons^{2

3}, Philippe Delespaul^{2

4}, Inez Myin-Germeys⁵, Thomas Vaessen^{5

6}, Ulrich Reininghaus^{1

7

8}

Affiliations

¹ Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
² Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands.
³ GGzE Institute for Mental Health Care, Eindhoven, Netherlands.
⁴ Department of Adult Psychiatry, Mondriaan Mental Health Trust, Heerlen, Netherlands.
⁵ Center for Contextual Psychiatry, Department of Neuroscience, KU Leuven, Leuven, Belgium.
⁶ Faculty of Behavioural, Management and Social Sciences, Psychology, Health & Technology, University of Twente, Enschede, Netherlands.
⁷ ESRC Centre for Society and Mental Health, King's College London, London, United Kingdom.
⁸ Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.

PMID: 36416883
PMCID: PMC9730210
DOI: 10.2196/37394

Abstract

Background: Identifying momentary risk and protective mechanisms may enhance our understanding and treatment of mental disorders. Affective stress reactivity is one mechanism that has been reported to be altered in individuals with early and later stages of mental disorder. Additionally, initial evidence suggests individuals with early and enduring psychosis may have an extended recovery period of negative affect in response to daily stressors (ie, a longer duration until affect reaches baseline levels after stress), but evidence on positive affective recovery as a putative protective mechanism remains limited.

Objective: This study aimed to investigate trajectories of positive affect in response to stress across the continuum of mental disorder in a transdiagnostic sample.

Methods: Using the Experience Sampling Method, minor activity-, event-, and overall stress and positive affect were assessed 10 times a day, with time points approximately 90 minutes apart on six consecutive days in a pooled data set including 367 individuals with a mental disorder, 217 individuals at risk for a severe mental disorder, and 227 controls. Multilevel analysis and linear contrasts were used to investigate trajectories of positive affect within and between groups.

Results: Baseline positive affect differed across groups, and we observed stress reactivity in positive affect within each group. We found evidence for positive affective recovery after reporting activity- or overall stress within each group. While controls recovered to baseline positive affect about 90 minutes after stress, patients and at-risk individuals required about 180 minutes to recover. However, between-group differences in the affective recovery period fell short of significance (all P>.05).

Conclusions: The results provide first evidence that positive affective recovery may be relevant within transdiagnostic subclinical and clinical stages of mental disorder, suggesting that it may be a potential target for mobile health interventions fostering resilience in daily life.

Keywords: depression; ecological momentary assessment; experience sampling methodology; psychosis; resilience; stress reactivity; trajectory; transdiagnostic.

©Leonie Ader, Anita Schick, Claudia Simons, Philippe Delespaul, Inez Myin-Germeys, Thomas Vaessen, Ulrich Reininghaus. Originally published in JMIR Mental Health (https://mental.jmir.org), 23.11.2022.