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Psychiatry Res. 2018 Feb 21. pii: S0165-1781(17)30094-X. doi: 10.1016/j.psychres.2018.02.032. [Epub ahead of print]

The intra-day dynamics of affect, self-esteem, tiredness, and suicidality in Major Depression.

Author information

1
UCD School of Medicine, University College Dublin, Ireland; Behavioural Science Centre, Stirling Management School, University of Stirling, United Kingdom; Institute of Health and Wellbeing, College of Veterinary, Medical and Life Sciences, University of Glasgow, Glasgow, United Kingdom. Electronic address: e.crowe.1@research.gla.ac.uk.
2
Behavioural Science Centre, Stirling Management School, University of Stirling, United Kingdom; UCD Geary Institute, University College Dublin, Ireland.
3
UCD School of Medicine, University College Dublin, Ireland; Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.
4
UCD School of Medicine, University College Dublin, Ireland.

Abstract

Despite growing interest in the temporal dynamics of Major Depressive Disorder (MDD), we know little about the intra-day fluctuations of key symptom constructs. In a study of momentary experience, the Experience Sampling Method captured the within-day dynamics of negative affect, positive affect, self-esteem, passive suicidality, and tiredness across clinical MDD (N= 31) and healthy control groups (N= 33). Ten symptom measures were taken per day over 6 days (N= 2231 observations). Daily dynamics were modeled via intra-day time-trends, variability, and instability in symptoms. MDD participants showed significantly increased variability and instability in negative affect, positive affect, self-esteem, and suicidality. Significantly different time-trends were found in positive affect (increased diurnal variation and an inverted U-shaped pattern in MDD, compared to a positive linear trend in controls) and tiredness (decreased diurnal variation in MDD). In the MDD group only, passive suicidality displayed a negative linear trend and self-esteem displayed a quadratic inverted U trend. MDD and control participants thus showed distinct dynamic profiles in all symptoms measured. As well as the overall severity of symptoms, intra-day dynamics appear to define the experience of MDD symptoms.

KEYWORDS:

Circadian rhythms; Daily symptom dynamics; Depression; Emotional instability / variability; Experience Sampling Method (ESM) / Ecological Momentary Assessment (EMA)

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