Ulrich Ebner-Priemer

Ghent University, Gand, Flanders, Belgium

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Publications (66)187.93 Total impact

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    ABSTRACT: Purpose: The cross-stressor adaptation hypothesis suggests that regular exercise leads to adaptations in the stress response systems that induce decreased physiological responses to psychological stressors. Even though an exercise intervention to buffer the detrimental effects of psychological stressors on health might be of utmost importance, empirical evidence is mixed. This may be explained by the use of cross-sectional designs and non-personally relevant stressors. Using a randomized controlled trial, we hypothesized that a 20-week aerobic exercise training does reduce physiological stress responses to psychological real-life stressors in sedentary students. Methods: Sixty-one students were randomized to either a control group or an exercise training group. The academic examination period (end of the semester) served as a real-life stressor. We used ambulatory assessment methods to assess physiological stress reactivity of the autonomic nervous system (heart rate variability: LF/HF, RMSSD), physical activity and perceived stress during 2 days of everyday life and multilevel models for data analyses. Aerobic capacity (VO2max) was assessed pre- and post-intervention via cardiopulmonary exercise testing to analyze the effectiveness of the intervention. Results: During real-life stressors, the exercise training group showed significantly reduced LF/HF (β = -0.15, t = -2.59, p = .01) and increased RMSSD (β = 0.15, t = 2.34, p = .02) compared to the control group. Conclusions: Using a randomized controlled trial and a real-life stressor, we could show that exercise appears to be a useful preventive strategy to buffer the effects of stress on the autonomic nervous system, which might result into detrimental health outcomes.
    Arbeitsphysiologie 11/2015; DOI:10.1007/s00421-015-3284-8 · 2.19 Impact Factor
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    ABSTRACT: Evidence for menstrual cycle-related mood fluctuations in the general population of women has been mixed. While most previous research has relied on retrospective self-report and did not consider possible moderators, the present study aimed to examine cycle-related mood variations in daily life and possible moderating effects of anxiety and trait rumination. We examined 59 women aged 18-44 years with natural menstrual cycles between January and October 2012. Mood components of calmness, positive valence, energetic-arousal, and irritability were assessed using smartphones by ambulatory assessment ten times per day on eight days across the cycle. The menstrual, follicular, ovulatory, and late luteal phases were each covered by two consecutive assessment days. Moderators were assessed with questionnaires. Hierarchical linear models revealed higher calmness in the luteal and menstrual than in the follicular and ovulatory phase, while menstrual cycle did not exhibit significant main effects on other mood components. Anxiety and ruminative self-reflection moderated the association between menstrual cycle and all mood variables. Specifically, highly anxious and ruminative women showed an increase in irritability, while women with lower anxiety and lower rumination were protected against mood deterioration toward the end of the cycle. Further research could examine whether reducing anxiety and rumination helps to prevent PMS-related syndromes.
    Women & Health 10/2015; DOI:10.1080/03630242.2015.1101739 · 1.05 Impact Factor
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    ABSTRACT: In ambulatory assessment, psychologists apply experience sampling methods (ESM) on mobile devices to assess self-reports from subjects. One major challenge is to support domain experts to create ESM apps themselves without prior programming knowledge. When running ESM apps, subjects are prompted to answer self-reports time-triggered at fixed points in time or randomly. The compliance of the subjects often drops due to a high frequency of prompts or a high number of questions to be answered. We propose ESMAC, an open-source ESM app configuration system that is easy to use by non-programmers and able to create context-aware apps. Leveraging context-awareness can counteract a drop in compliance by prompting event-based only in situations of relevance (reducing the frequency) and by automatically assessing information (decreasing the number of questions). The ESMAC web interface for configuring ESM apps was evaluated with two psychologists. One of their configurations was deployed and evaluated in a preliminary user study with ESM subjects. Both experiments yielding good results using SUS and UEQ benchmarks. In addition, we analyzed the share of triggers and identified that 84% of all prompts were event- and not time-based. This emphasizes the relevance of event-triggers.
    Proceedings of the 2015 EAI 5th International Conference on Wireless Mobile Communication and Healthcare (Mobihealth); 10/2015
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    Martina Kanning · Ulrich Ebner-Priemer · Wolfgang Schlicht ·
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    ABSTRACT: Background: Evidence suggests that older adults show positive affects after participating in exercise bouts. However, it is less clear, if and how physical activities in daily living enhance affective states, too. This is dissatisfying, as most of older adults' physical activities are part of their daily living. To answer these questions we used activity-triggered e-diaries to investigate the within-subject effects of physical activity on three dimensions of affective states (valence, energetic arousal, calmness) during everyday life. Methods: Older adults (N = 74) between 50 and 70 years took part in the study during three consecutive days. Physical activity in daily living was objectively assessed using accelerometers. Affects were measured 10 min after a study participant surpassed a predefined threshold for activity or inactivity. The participants were prompted by an acoustic signal to assess their momentary affective states on an e-diary. Data were analyzed with hierarchical multilevel analyses. Results: Whenever older individuals were more physically active, they felt more energized (energetic arousal) and agitated (calmness). However, they did not feel better (valence). Interestingly, body mass index (BMI) and valence were associated in a significant cross-level interaction. BMI acts as a moderating variable in the way that lower BMI scores were associated with higher levels of valence scores after being physically active. Conclusions: The innovative ambulatory assessment used here affords an interesting insight to the affective effects of daily activity of older adults. These effects are no simple and no linear ones, i.e. physical activity is not associated with positive affects per se as shown several times in experimental studies with single activity bouts. Rather there is a differentiating association seen as an enhanced feeling of energy and agitation, which is not accompanied by a better feeling. Socio-emotional selectivity theory may support the finding that older individuals are emotionally more stable during their day-to-day life, which might explain the non-significant effect on the affect dimension valence.
    International Journal of Behavioral Nutrition and Physical Activity 09/2015; 12(1):111. DOI:10.1186/s12966-015-0272-7 · 4.11 Impact Factor
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    ABSTRACT: The experience sampling method (ESM) is applied in ambulatory assessment to prompt subject self-reporting. Existing mobile apps provide time-triggered prompts but lack event-triggers. Hence, the sampling might not occur in moments that are of interest for a psychologist. To identify relevant sensor sources and contexts we conducted an online survey with ambulatory assessment experts. Most relevant for these experts are time, date and user activity, followed by location, notifications and accelerometer. A feasibility test proved that all relevant sources are accessible on Android phones. We also assessed the desired granularity of the data gathered from each sensor source. Our results are a first step towards an ESM platform to create context-aware Android apps for ambulatory assessment.
    Adjunct Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing; 09/2015
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    ABSTRACT: In ambulatory assessment, subjects are monitored in everyday life. Though, it is diffcult to unobtrusively assess information - e.g. about their context and affective state - which results in an increased burden for the subjects. This burden is caused by a complex self-report that they need to provide or by additional wearables that need to be carried. Newest technology can solve this issue by assessing a variety of information automatically. We propose to use smartwatches in combination with smartphones to assess physiological and smartphone data from which the affective state of a user can be inferred. We present the principle idea of our app and how we intend on evaluating it. A review of state of the art approaches and available Android Wear smartwatches in terms of sensors is given. We present a number of smartphone sensors and a selection of smartwatches whose combination should be evaluated regarding usefulness for mood assessment and recognition.
    Adjunct Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing; 09/2015
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    ABSTRACT: We present MoA², a context-aware smartphone app for the ambulatory assessment of mood, tiredness and stress level. In principle, it has two features: (1) mood assessment and (2) mood recognition. The mood assessment system combines benefits of state of the art approaches. The mood recognition is concluded by smartphone-based wearable sensing. In a formative study, we evaluated the usability and unobtrusiveness of our mood assessment. A median SUS score of 90 shows a high usability. Subjects reported an easy, fast and intuitive use. The mood recognition was evaluated in terms of classification accuracy. First, we analyzed which features are best for the recognition. Spatio-temporal attributes, i.e. daytime, day of week and location, correlate most with the monitored mood. Based on the identified attributes, we trained personalized classifiers using Naive Bayes and applied ten-fold-cross validation. The average recognition accuracy was 0:76 which is comparable to related work.
    Adjunct Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing; 09/2015
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    T. J. Trull · S. P. Lane · P. Koval · U. W. Ebner-Priemer ·
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    ABSTRACT: We discuss three varieties of affective dynamics (affective instability, emotional inertia, and emotional differentiation). In each case, we suggest how these affective dynamics should be operationalized and measured in daily life using time-intensive methods, like ecological momentary assessment or ambulatory assessment, and recommend time-sensitive analyses that take into account not only the variability but also the temporal dependency of reports. Studies that explore how these affective dynamics are associated with psychological disorders and symptoms are reviewed, and we emphasize that these affective processes are within a nexus of other components of emotion regulation.
    Emotion Review 07/2015; 7(4). DOI:10.1177/1754073915590617 · 2.90 Impact Factor
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    ABSTRACT: Cognitive theories of recurrent depression suggest that the relationship between mood and cognition is altered by previous depressive episodes. In individuals remitted from depression (RMD) this would be linked to a larger susceptibility for new depressive symptoms. This study explored whether the association between mood and rumination indeed is different between RMD and nondepressed controls relying on dynamic systems theory (DST). From DST we selected entropy, defined here as the level of unpredictability in the relation between mood and rumination, as the main variable of interest. Daily electronic dairy measures of mood and rumination were administered in 31 RMD patients and 32 healthy controls. The results indicate that mean levels of rumination and negative mood were elevated in RMD compared with controls. At the group level, entropy did not differ significantly and entropy was also not associated with the number of episodes. However, entropy predicted depressive symptoms in the RMD group and the brooding subtype of rumination in both groups at the 6-month follow-up. These data are specific for entropy and were not obtained using mean levels of momentary mood and rumination.
    07/2015; 3(4). DOI:10.1177/2167702615578129
  • Birte von Haaren · Sascha Haertel · Juergen Stumpp · Stefan Hey · Ulrich W. Ebner-Priemer ·
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    ABSTRACT: Objectives: To examine if a preventive 20-week aerobic exercise intervention (AET) can improve emotional stress reactivity during real-life stress. Design: Randomised controlled trial; within-subject design. Method: Sixty-one inactive students were randomly assigned to a waiting control and an AET group. To capture the situation-specific, intra-individual data in real life, electronic diaries were used. Participants reported their moods and perceived stress (PS) repeatedly over two days during their daily routines pre- and post-intervention. The pre-intervention baseline assessment was scheduled at the beginning of the semester, and the post-intervention assessment was scheduled at a real-life stressful episode, an academic examination. For the aerobic fitness assessment, both groups completed a cardiopulmonary exercise test on the treadmill before and after the intervention. Multilevel models (MLMs) were conducted to compare within- and between-subject associations. Results: Significant emotional stress reactivity was evident in both groups during all assessment periods. However, participants in the AET group showed lower emotional stress reactivity compared with their control counterparts after the 20-week training programme during the real-life stress episode (the academic examination). Conclusions: AET conferred beneficial effects on emotional stress reactivity during an academic examination, which is likely an extremely stressful real-life situation for students.AET appears to be a promising strategy against the negative health effects of accumulated emotional stress reactivity.
    Psychology of Sport and Exercise 04/2015; 20. DOI:10.1016/j.psychsport.2015.04.004 · 1.90 Impact Factor
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    ABSTRACT: Background: Abnormalities in motor activity represent a central feature in major depressive disorder. However, measurement issues are poorly understood, limiting the use of objective measurement of motor activity for diagnostics and treatment monitoring. Methods: To improve measurement issues, especially sensor placement, analytic strategies and diurnal effects, we assessed motor activity in depressed patients at the beginning (MD; n=27) and after anti-depressive treatment (MD-post; n=18) as well as in healthy controls (HC; n=16) using wrist- and chest-worn accelerometers. We performed multiple analyses regarding sensor placements, extracted features, diurnal variation, motion patterns and posture to clarify which parameters are most powerful in distinguishing patients from controls and monitoring treatment effects. Results: Whereas most feature-placement combinations revealed significant differences between groups, acceleration (wrist) distinguished MD from HC (d=1.39) best. Frequency (vertical axis chest) additionally differentiated groups in a logistic regression model (R2=0.54). Accordingly, both amplitude (d=1.16) and frequency (d=1.04) showed alterations, indicating reduced and decelerated motor activity. Differences between MD and HC in gestures (d=0.97) and walking (d=1.53) were found by data analysis from the wrist sensor. Comparison of motor activity at the beginning and after MD-treatment largely confirms our findings. Limitations: Sample size was small, but sufficient for the given effect sizes. Comparison of depressed in-patients with non-hospitalized controls might have limited motor activity differences between groups. Conclusions: Measurement of wrist-acceleration can be recommended as a basic technique to capture motor activity in depressed patients as it records whole body movement and gestures. Detailed analyses showed differences in amplitude and frequency denoting that depressed patients walked less and slower.
    PLoS ONE 04/2015; 10(4):e0124231. DOI:10.1371/journal.pone.0124231 · 3.23 Impact Factor
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    ABSTRACT: Previous research suggests disturbed emotional learning and memory in borderline personality disorder (BPD). Studies investigating the neural correlates of aversive differential delay conditioning in BPD are currently lacking. We aimed to investigate acquisition, within-session extinction, between-session extinction recall, and reacquisition. We expected increased activation in the insula, amygdala, and anterior cingulate, and decreased prefrontal activation in BPD patients. During functional magnetic resonance imaging, 27 medication-free female BPD patients and 26 female healthy controls (HC) performed a differential delay aversive conditioning paradigm. An electric shock served as unconditioned stimulus, two neutral pictures as conditioned stimuli (CS+/CS-). Dependent variables were blood-oxygen-level-dependent response, skin conductance response (SCR), and subjective ratings (valence, arousal). No significant between-group differences in brain activation were found [all p(FDR) > 0.05]. Within-group comparisons for CS+unpaired > CS- revealed increased insula activity in BPD patients but not in HC during early acquisition; during late acquisition, both groups recruited fronto-parietal areas [p(FDR) < 0.05]. During extinction, BPD patients rated both CS+ and CS- as significantly more arousing and aversive than HC and activated the amygdala in response to CS+. In contrast, HC showed increased prefrontal activity in response to CS+ > CS during extinction. During extinction recall, there was a trend for stronger SCR to CS+ > CS in BPD patients. Amygdala habituation to CS+paired (CS+ in temporal contingency with the aversive event) during acquisition was found in HC but not in patients. Our findings suggest altered temporal response patterns in terms of increased vigilance already during early acquisition and delayed extinction processes in individuals with BPD.
    European Archives of Psychiatry and Clinical Neuroscience 03/2015; DOI:10.1007/s00406-015-0593-1 · 3.53 Impact Factor
  • Annette Brose · Ulrich W Ebner-Priemer ·
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    ABSTRACT: Older adults have surprisingly high levels of well-being, which has been referred to as a paradox in the past. Improved emotion regulation has been suggested to underlie these high levels of well-being. Later life is also a period with enhanced exposure to critical life events, and this comes with risks. During such times, and towards the end of life, emotional well-being may and eventually does decline. We suggest that ambulatory assessment (AA) is ideally suited for the investigation of the above phenomena and for intervention purposes. More precisely, AA can be used to thoroughly examine within-person processes of emotion regulation, including the multiple levels on which emotions occur (physiology, experience, behavior, context, and nonverbal expressions). It thereby provides a basis for understanding competent emotion regulation, the well-being paradox, and emotionally critical periods. Such insights can be utilized to detect person-specific critical periods and for designing immediate person-specific interventions. Although this is still a vision, the benefits of such an approach seem invaluable. The major part of this paper is organized around three general principles that we suggest to further tap the potential of AA in aging research, namely (1) identify within-subject processes and their relations to important life outcomes; (2) capitalize on the full scope of AA technology via multivariate assessments, and (3) combine real-time monitoring with real-time interventions. © 2015 S. Karger AG, Basel.
    Gerontology 02/2015; 61(4). DOI:10.1159/000371707 · 3.06 Impact Factor
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    ABSTRACT: Although emotion dysregulation has consistently been conceptualized as a core problem of borderline personality disorder (BPD), a comprehensive, and empirically and ecologically validated model that captures the exact types of dysregulation remains absent. In the present article, we combine insights from basic affective science and the biosocial theory of BPD to present a theoretical model that captures the most fundamental affective dynamical processes that underlie BPD and stipulates that individuals with BPD are characterized by more negative affective homebases, higher levels of affective variability, and lower levels of attractor strength or return to baseline. Next, we empirically validate this proposal by statistically modeling data from three electronic diary studies on emotional responses to personally relevant stimuli in personally relevant environments that were collected both from patients with BPD (N = 50, 42, and 43) and from healthy subjects (N = 50, 24, and 28). The results regarding negative affective homebases and heightened affective variabilities consistently confirmed our hypotheses across all three datasets. The findings regarding attractor strengths (i.e., return to baseline) were less consistent and of smaller magnitude. The transdiagnostic nature of our approach may help to elucidate the common and distinctive mechanisms that underlie several different disorders that are characterized by affective dysregulation. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
    Journal of Abnormal Psychology 01/2015; 124(1). DOI:10.1037/abn0000021 · 4.86 Impact Factor
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    Timothy J Trull · Ulrich Ebner-Priemer ·
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    ABSTRACT: We describe the current use and future promise of an innovative methodology, ambulatory assessment (AA), that can be used to investigate psychological, emotional, behavioral, and biological processes of individuals in their daily life. The term AA encompasses a wide range of methods used to study people in their natural environment, including momentary self-report, observational, and physiological. We emphasize applications of AA that integrate two or more of these methods, discuss the smart phone as a hub or access point for AA, and discuss future applications of AA methodology to the science of psychology. We pay particular attention to the development and application of Wireless Body Area Networks (WBANs) that can be implemented with smart phones and wireless physiological monitoring devices, and we close by discussing future applications of this approach to matters relevant to psychological science.
    Current Directions in Psychological Science 12/2014; 23(6):466-470. DOI:10.1177/0963721414550706 · 3.93 Impact Factor
  • C Skirrow · U Ebner-Priemer · I Reinhard · Y Malliaris · J Kuntsi · P Asherson ·
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    ABSTRACT: Background: Emotional lability (EL), characterized by negative emotional traits and emotional instability, is frequently reported in children and adults with attention deficit hyperactivity disorder (ADHD). However, EL is primarily assessed using retrospective self-report, which is subject to reporting bias and does not consider the potential influence of positive and negative everyday experiences. Method: Ambulatory assessment was carried out in 41 men with ADHD without co-morbidity, current medication or substance abuse, and 47 healthy control participants. Reports of negative and positive emotions (irritability, frustration, anger, happiness, excitement) and the occurrence of bad and good events were completed eight times daily during a working week. Group differences in emotional intensity and instability were investigated using multilevel models, and explored in relation to bad and good events and the Affective Lability Scale - Short Form (ALS-SF), an EL questionnaire. Results: The ADHD group reported significantly more frequent bad events, heightened intensity and instability of irritability and frustration, and greater intensity of anger. The results for positive emotions were equivocal or negative. Bad events significantly contributed to the intensity and instability of negative emotions, and showed a stronger influence in the ADHD group. However, covariation for their effect did not eliminate group differences. Small-to-moderate correlations were seen between intensity and instability of negative emotions and the ALS-SF. Conclusions: Adults with ADHD report heightened intensity and instability of negative emotions in daily life. The results suggest two components of EL in ADHD: a reactive component responsive to bad events and an endogenous component, independent of negative everyday events.
    Psychological Medicine 12/2014; 44(16):3571-83. DOI:10.1017/S0033291714001032 · 5.94 Impact Factor
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    Mario Wenzel · Thomas Kubiak · Ulrich W. Ebner-Priemer ·
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    ABSTRACT: Ambulatory Assessment (AA) comprises the use of in-field methods to assess individuals’ behavior, physiology, and the experience as they unfold in naturalistic settings. We propose that AA is favorable for the investigation of gene–environment interactions and for the search for endophenotypes, being able to assess the experienced environment and to track basic regulatory processes, such as stress reactivity, affective instability, and reward experience, which are potential common factors that underlie psychiatric disorders.In this article, we (a) first describe briefly the rationale of AA and summarize the key advantages of the approach, (b) highlight within-subject regulatory processes, such as stress reactivity, affective instability, and reward experience, (c) describe studies that used AA to examine genetic influences in psychiatric disorders, and (d) briefly review longitudinal studies that have investigated phenotypes of psychiatric disorders.The reported studies yielded promising, although sometimes inconclusive evidence for genetic effects on endophenotypes of psychiatric disorders. Moreover, most studies were twin or family studies, especially in stress-sensitivity research; thus, it is unclear which specific single nucleotide polymorphisms contribute to the endophenotypes of psychiatric disorders. We do hope that within-subject regulatory processes will enable us to clarify the fundamental psychological dimensions that cut across traditional disorders and link them to their genetic underpinnings.
    Neuroscience Research 11/2014; DOI:10.1016/j.neures.2014.10.018 · 1.94 Impact Factor
  • Vera Zamoscik · Silke Huffziger · Ulrich Ebner-Priemer · Christine Kuehner · Peter Kirsch ·
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    ABSTRACT: Behavioral studies suggest a relationship between autobiographical memory, rumination, and depression. The objective of the current study was to determine whether remitted depressed patients show alterations in connectivity of the posterior cingulate cortex (PCC; a node in the default mode network) with the parahippocampal gyri (PHG; a region associated with autobiographical memory) while intensively recalling negative memories and whether this is related to daily life symptoms and to the further course of depression.Sad mood was induced with keywords of personal negative life events in participants with remitted depression (n=29) and matched healthy controls (n=29) during fMRI. Additionally, daily life assessments of mood and rumination and a six-months follow-up were conducted.Remitted depressed participants showed greater connectivity than healthy controls of the PCC with the PHG, which was even stronger in patients with more previous episodes. Furthermore, patients with increased PCC-PHG connectivity showed a sadder mood and more rumination in daily life, and a worsening of rumination and depression scores during follow-up.A relationship of negative autobiographical memory processing, rumination, sad mood, and depression on a neural level seems likely. The identified increased connectivity probably indicates a 'scar' of recurrent depression and may represent a prognostic factor for future depression.
    Social Cognitive and Affective Neuroscience 02/2014; 9(12). DOI:10.1093/scan/nsu006 · 7.37 Impact Factor
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    ABSTRACT: Affective instability is a core feature of borderline personality disorder (BPD). The use of advanced assessment methodologies and appropriate statistical analyses has led to consistent findings that indicate a heightened instability in patients with BPD compared with healthy controls. However, few studies have investigated the specificity of affective instability among patients with BPD with regard to relevant clinical control groups. In this study, 43 patients with BPD, 28 patients with posttraumatic stress disorder (PTSD), 20 patients with bulimia nervosa (BN), and 28 healthy controls carried e-diaries for 24 hours and were prompted to rate their momentary affective states approximately every 15 minutes while awake. To quantify instability, we used 3 state-of-the-art indices: multilevel models for squared successive differences (SSDs), multilevel models for probability of acute changes (PACs), and aggregated point-by-point changes (APPCs). Patients with BPD displayed heightened affective instability for emotional valence and distress compared with healthy controls, regardless of the specific instability indices. These results directly replicate earlier studies. However, affective instability did not seem to be specific to patients with BPD. With regard to SSDs, PACs, and APPCs, patients with PTSD or BN showed a similar heightened instability of affect (emotional valence and distress) to that of patients with BPD. Our results give raise to the discussion if affective instability is a transdiagnostic or a disorder-specific mechanism. Current evidence cannot answer this question, but investigating psychopathological mechanisms in everyday life across disorders is a promising approach to enhance validity and specificity of mental health diagnoses. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Journal of Abnormal Psychology 02/2014; 123(1):258-72. DOI:10.1037/a0035619 · 4.86 Impact Factor
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    Wolfgang Schlicht · Ulrich W Ebner-Priemer · Martina Kanning ·

    Frontiers in Psychology 12/2013; 4:916. DOI:10.3389/fpsyg.2013.00916 · 2.80 Impact Factor

Publication Stats

1k Citations
187.93 Total Impact Points


  • 2015
    • Ghent University
      Gand, Flanders, Belgium
  • 2009-2015
    • Karlsruhe Institute of Technology
      Carlsruhe, Baden-Württemberg, Germany
    • Universitätsklinikum Jena
      Jena, Thuringia, Germany
  • 2013
    • Universität Stuttgart
      • Institute of Sports Science
      Stuttgart, Baden-Württemberg, Germany
  • 2005-2013
    • Central Institute of Mental Health
      • Klinik für Abhängiges Verhalten und Suchtmedizin
      Mannheim, Baden-Württemberg, Germany
  • 2009-2010
    • Universität Heidelberg
      • • Clinic for Psychosomatics and Psychotherapeutic Medicine
      • • Central Institute of Mental Health
      Heidelburg, Baden-Württemberg, Germany