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Biomedical subjects

Arthur A Stone

Publications and source records attributed to Arthur A Stone.

At least 19 recordsLinked to original sources
PubMed2006

Would you be happier if you were richer? A focusing illusion.

The belief that high income is associated with good mood is widespread but mostly illusory. People with above-average income are relatively satisfied with their lives but are barely happier than others in moment-to-moment experience, tend to be more tense, and do not spend more time in particularly enjoyable activities. Moreover, the effect of income on life satisfaction seems to be transient. We argue that people exaggerate the contribution of income to happiness because they focus, in part, on conventional achievements when evaluating their life or the lives of others.

Affect↗
PubMed2006

Recalled pain ratings: a complex and poorly defined task.

UNLABELLED: Self-report ratings of pain intensity are ubiquitous in research and clinical practice. In addition to rating their current pain, patients are often asked to provide ratings to represent pain intensity over several days or weeks. Few data are available that provide insight into how people understand and accomplish this recall task. This study describes the results of structured interviews with 106 rheumatology patients with chronic pain about how they arrived at their ratings of pain intensity on a visual analog scale referenced to the past week. Most patients were unable to coherently articulate how they derived their ratings. Moreover, there was no consistency across patients. A variety of different strategies were identified that guided their responses. These results support the concern about the meaning and validity of retrospective recall ratings. Recall of pain, a seemingly simple task, is a deceptively more complex phenomenon. Efforts to improve the measurement of recalled pain need to be explored. Improving instructional sets, clearer specification of the dimensions of pain being targeted, avoiding use of a single item to measure pain, improved description of intended reference groups, and determining the length of time that patients are able to remember pain and limiting recall periods are reasonable methods that need to be explored. PERSPECTIVE: These results emphasize our lack of a full understanding of the meaning of the information elicited by commonly used pain recall questions. They point to the potential importance of clearly specifying what qualities of pain are sought and how the patient should summarize them over the reporting period.

Adult↗
PubMed2006

Paper and electronic diaries: Too early for conclusions on compliance rates and their effects--Comment on Green, Rafaeli, Bolger, Shrout, and Reis (2006).

This commentary discusses 4 issues relevant to interpretation of A. S. Green, E. Rafaeli, N. Bolger, P. E. Shrout, and H. T. Reis's (2006) article: (a) Self-reported compliance in medical settings has generally been substantially higher than verified compliance, suggesting that this is not a rare phenomenon; (b) none of the studies reported in Green et al. explicitly verified paper diary compliance; (c) the impact of participant motivation on diary compliance is unknown, and it may be difficult for researchers to accurately assess it in their own studies; and (d) without objective verification of diary compliance, analysis of the effects of noncompliance on data quality is difficult to interpret. The authors conclude that compliance in paper diaries and the effects of noncompliance on data quality are still unsettled issues.

Adolescent↗
PubMed2006

A population approach to the study of emotion: diurnal rhythms of a working day examined with the Day Reconstruction Method.

To date, diurnal rhythms of emotions have been studied with real-time data collection methods mostly in relatively small samples. The Day Reconstruction Method (DRM), a new survey instrument that reconstructs the emotions of a day, is examined as a method for enabling large-scale investigations of rhythms. Diurnal cycles were observed for 12 emotion adjectives in 909 women over a working day. Bimodal patterns with peaks at noon and evenings were detected for positive emotions; peaks in negative emotions were found at mid-morning and mid-afternoon. A V-shaped pattern was found for tired and an inverted U-shaped pattern for competent. Several diurnal patterns from prior studies were replicated. The DRM appears to be a useful tool for the study of emotions.

Adult↗
PubMed2005

Trait anxiety moderates the impact of performance pressure on salivary cortisol in everyday life.

Stress and negative affective states are associated with cortisol in everyday life. However, it remains unclear what types of stressors and which affective states yield these associations, and the effect of trait anxiety is unknown. This study investigates the associations of specific task-related stressors and negative affective states in everyday life with salivary cortisol, and explores the mediating and moderating role of state negative affect and trait anxiety, respectively. Salivary cortisol, subjective stress, and state negative affect were measured three times a day on 2 days in 71 participants in everyday life, using a handheld computer to collect self-reports and time stamps and an electronic device to monitor saliva sampling compliance. Stress measures comprised the experience of performance pressure and failure during daily tasks; measures of negative affect comprised worn-out, tense, unhappy, and angry. Effects were tested using multilevel fixed-occasion models. Momentary performance under pressure was related to higher momentary cortisol measures, while mean task failure was related to lower daily cortisol concentrations. The association of performance pressure with cortisol varied between subjects, and this variation was explained by trait anxiety, yielding stronger associations in participants scoring high on trait anxiety. No evidence was found for a mediating role of state negative affect. These results describe the well-documented associations of everyday stressors and affect with salivary cortisol more precisely, suggesting that performance pressure is a significant condition related to short-term changes in cortisol. Subjects scoring high on trait anxiety seem to process stress-relevant information in a way that amplifies the association of performance pressure with reactions of the hypothalamus-pituitary-adrenal axis.

Activities of Daily Living↗
PubMed2005

Variability of momentary pain predicts recall of weekly pain: a consequence of the peak (or salience) memory heuristic.

Patients' recall of their recent pain is commonly assessed by both researchers and clinicians. However, concerns have been raised about differences between recalled pain and the average of real-time recordings of pain taken over the same period, in part because of the possibility that memory processes affect how retrospective pain is reported. It was hypothesized that memory processes affect the accuracy of recall, such that those with higher versus lower variability of real-time pain will recall pain at higher levels, relative to their average momentary pain. Sixty-eight chronic pain patients with rheumatologic conditions reported their pain several times a day for 2 weeks and also recalled their weekly pain at the end of each of those 2 weeks. The hypothesis was confirmed and it was concluded that variability of real-time pain affects the recall of pain.

Chronic Disease↗
PubMed2004

A survey method for characterizing daily life experience: the day reconstruction method.

The Day Reconstruction Method (DRM) assesses how people spend their time and how they experience the various activities and settings of their lives, combining features of time-budget measurement and experience sampling. Participants systematically reconstruct their activities and experiences of the preceding day with procedures designed to reduce recall biases. The DRM's utility is shown by documenting close correspondences between the DRM reports of 909 employed women and established results from experience sampling. An analysis of the hedonic treadmill shows the DRM's potential for well-being research.

Activities of Daily Living↗
PubMed2004

Associations among pain intensity, sensory characteristics, affective qualities, and activity limitations in patients with chronic pain: a momentary, within-person perspective.

UNLABELLED: The purpose of this article is to explore the multidimensionality of the pain experience for patients with chronic pain by using a within-person, longitudinal approach. An Ecological Momentary Assessment design with a patient electronic diary was used to collect random momentary pain assessments several times a day for 2 weeks. We examined the within-person relationships between pain intensity, sensory characteristics, affective qualities, and activities limited by pain. All 3 dimensions (sensory, affective, and activities) were significantly related to pain intensity in a monotonic, but nonlinear, manner. These results expand our understanding of the pain experience by showing that changes of pain over time are associated with changes in sensory symptoms, affective distress, and activity limitations. PERSPECTIVE: Although the relationships between pain dimensions have been examined between people, the results have been interpreted as within-persons. This article confirms that pain intensity is significantly related to sensory characteristics of pain, affective qualities of pain, and activity limitations due to pain within a person.

Activities of Daily Living↗
PubMed2004

Understanding recall of weekly pain from a momentary assessment perspective: absolute agreement, between- and within-person consistency, and judged change in weekly pain.

To better understand the association between pain recalled over a previous week and the average of multiple momentary reports of pain taken during the same period, 68 patients with chronic pain completed both weekly recall and momentary reports over a 2-week period and assessed their change in pain over the 2 weeks. Pearson correlations and intraclass correlation coefficients were computed to index three different ways of comparing the measures on both a between-person and within-person basis. Between-person correspondence between weekly and momentary reports was generally moderate to high, but within-person correspondence was low. Judged change was only weakly related to changes over a week computed from weekly recall or from average momentary reports. Given the importance of within-person change for treatment studies, these results indicate a serious nonequivalence in weekly recall and averaged momentary reports of pain.

Adolescent↗
PubMed2004

The feasibility and effectiveness of an expressive writing intervention for rheumatoid arthritis via home-based videotaped instructions.

BACKGROUND: Expressive emotional writing has demonstrated efficacy for improving health status in a wide variety of healthy persons and recently in patients with chronic disease. PURPOSE: This study was a randomized, controlled effectiveness trial with 4 arms: 2 active treatment writing groups, 1 inactive writing group, and 1 attention control group. It represents the first attempt to translate the expressive writing intervention into a low-cost, community-based intervention in the form of a videotaped program. METHODS: Feasibility of the approach and patient adherence were examined in a community rheumatology practice with rheumatoid arthritis patients (N = 373). RESULTS: The videotape format was able to convey the intervention instructions accurately and produced the expected and differential ratings of stressfulness and emotional provocation across the 3 writing programs. Seventy-nine percent of eligible patients agreed to take the program home; 49% of these patients reported that they followed the protocol. Physician Disease Activity Rating and the Physical Component Summary of the SF36v2 Health Survey were assessed pre and post program. CONCLUSIONS: Intent-to-treat analyses found no effect of the treatment. Pretreatment differences among the protocol-adherent patients complicated treatment outcome interpretation. The standard writing instructions did not yield an effect; a modified set of instructions to extract meaning from the traumatic event yielded equivocal results. Contrasts between efficacy and effectiveness trials and the challenge of achieving significant outcomes in effectiveness trials are discussed.

Adaptation, Psychological↗
PubMed2003

Effectiveness of spouse involvement in cognitive behavioral therapy for binge eating disorder.

OBJECTIVE: This study examined whether involving the spouse in group cognitive behavioral therapy (CBT) for binge eating disorder (BED) enhances treatment outcome relative to standard group CBT. METHOD: Ninety-four overweight women with BED were randomly assigned to either (1) standard group CBT, (2) group CBT with spouse involvement, or (3) a wait-list control group. Eating and general psychopathology assessments were completed at baseline, after treatment, and at 6-month follow-up. RESULTS: Although both CBT groups fared significantly better than the wait-list control group on measures of binge eating, weight, eating psychopathology, and general psychopathology, CBT with spouse involvement did not result in any additional benefit over and above standard CBT. DISCUSSION: These results are in contrast to the success of spouse involvement in the treatment of several other physical and psychological disorders. Possible reasons for this disparity, and suggestions for improving spouse involvement in BED treatment, are discussed.

Adult↗
PubMed2003

Patient compliance with paper and electronic diaries.

Paper diaries are commonly used in health care and clinical research to assess patient experiences. There is concern that patients do not comply with diary protocols, possibly invalidating the benefit of diary data. Compliance with paper diaries was examined with a paper diary and with an electronic diary that incorporated compliance-enhancing features. Participants were chronic pain patients and they were assigned to use either a paper diary instrumented to track diary use or an electronic diary that time-stamped entries. Participants were instructed to make three pain entries per day at predetermined times for 21 consecutive days. Primary outcome measures were reported vs actual compliance with paper diaries and actual compliance with paper diaries (defined by comparing the written times and the electronically-recorded times of diary use). Actual compliance was recorded by the electronic diary. Participants submitted diary cards corresponding to 90% of assigned times (+/-15 min). However, electronic records indicated that actual compliance was only 11%, indicating a high level of faked compliance. On 32% of all study days the paper diary binder was not opened, yet reported compliance for these days exceeded 90%. For the electronic diary, the actual compliance rate was 94%. In summary, participants with chronic pain enrolled in a study for research were not compliant with paper diaries but were compliant with an electronic diary with enhanced compliance features. The findings call into question the use of paper diaries and suggest that electronic diaries with compliance-enhancing features are a more effective way of collecting diary information.

Adolescent↗
PubMed2003

Intensive momentary reporting of pain with an electronic diary: reactivity, compliance, and patient satisfaction.

Patient self-reports are the primary method for capturing the experience of pain, and diaries are often used to collect patient self-reports. This study was designed to determine if momentary monitoring of pain with an electronic diary affected pain levels over time, if it affected weekly recall of pain, and if daily sampling density affected compliance rates and patients' reactions to the study. Ninety-one patients with chronic pain were randomized into four groups with differing levels of momentary monitoring over 2 weeks. Little support was found for reactivity defined as temporal shifts in pain over the study or as changes in recalled weekly pain due to momentary monitoring. Compliance with the electronic diary protocol was 94% or better, and was not related to sampling density. Patients reported little difficulty with the diary procedures and were not unduly burdened by the protocol.

Adult↗
PubMed2003

Characteristics of binge eating among women in the community seeking treatment for binge eating or weight loss.

This study examined characteristics of binge eating among overweight women in the community seeking treatment for binge eating or weight loss. Five hundred and ninety-two women completed a telephone interview in which binge eating was thoroughly assessed. A large percentage of the sample (84.4%) reported features of binge eating consistent with the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV) definition of a binge. A significantly higher rate of DSM-IV BED (33.6%) was found compared to previous studies. Eleven percent of the sample denied bingeing/purging (nonbinge eating disorder, NBED) and 55.4% of the sample reported other eating problems such as bingeing or purging. Women with binge eating disorder (BED) had a higher BMI, became overweight earlier, and reported more unhealthy weight control methods than NBED women. BED women also reported more current and past depression and suicidal ideation than NBED women. BED reported more maternal overweight than NBED, but BED and NBED participants did not differ in paternal overweight or parental eating disorders. Future studies should investigate the relationship between binge eating and suicidal ideation to better understand whether depression precedes or follows binge eating.

Journal Article↗
PubMed2003

Measuring clinical pain in chronic widespread pain: selected methodological issues.

Assessing clinical pain is an important task in clinical practice and research. A large empirical literature has documented that patients' pain reports can be systematically biased by a number of methodological factors. This chapter reviews a selection of methodological issues that can affect pain ratings, including: the impact of recall bias, the use of paper and electronic diaries to assess pain experiences, ecological momentary assessment methods as a way of capturing real-time pain data in the real world, and pain scaling and data analysis considerations. Data from a recent study that implemented an electronic diary for capturing real-time pain data are presented and reviewed in the context of the methodological factors reviewed above. It is concluded that methodological factors can greatly affect our understanding of patients' pain experiences.

Area Under Curve↗
PubMed2003

Signaling does not adequately improve diary compliance.

HYPOTHESIS: Compliance with a paper diary protocol would be improved by using auditory signaling. BACKGROUND: Prior research has demonstrated that compliance with the reporting schedule in paper diary protocols is poor. METHODS: Adults with chronic pain (N = 27) were recruited from the community to participate in a 24-day experience sampling protocol of 3 pain assessments per day (10:00 a.m., 4:00 p.m., 8:00 p.m.). Diaries were instrumented to record openings and closings, thereby permitting determination of date and time when the participant could have made diary entries. Participants were signaled with a programmed wristwatch at the onset of each 30-min assessment window. Two compliance windows were defined: -/+ 15 min and -/+ 45 min of the targeted assessment time. RESULTS: Self-reported compliance based on participants' paper diaries was 85% and 91% for the 30- and 90-min windows. Verified compliance was 29% and 39% for the two windows. Signaling produced a significant increment in verified compliance when compared with an identical trial without signaling. A significant eroding of verified compliance was observed across the 3 weeks of the study. CONCLUSIONS: Self-report dating of diary entries may be misleading investigators about compliance with diary protocols. Although auditory signaling enhances compliance, the result is still unsatisfactory.

Adolescent↗
PubMed2002

Capturing momentary, self-report data: a proposal for reporting guidelines.

Self-report data are ubiquitous in behavioral and medical research. Retrospective assessment strategies are prone to recall bias and distortion. New techniques for assessing immediate experiences in respondents' natural environments (e.g., Ecological Momentary Assessment, Experience Sampling) are being used by many researchers to reduce reporting bias. This article discusses seven aspects of momentary research that are often overlooked or minimized in the presentation of momentary research reports, yet that are critical to the success of the research: (a) the rationale for the momentary sampling design, (b) the details of momentary sampling procedures, (c) the data acquisition interface, (d) rates of compliance with the sampling plan, (e) the procedures used to train and monitor participants, (f) data management procedures, and (g) the data analytic approach. Attention to these areas in both the design and reporting of momentary research studies will not only improve momentary research protocols but also allow for the successful replication of research findings by other investigators.

Guidelines as Topic↗