Joshua M. Smyth's research while affiliated with William Penn University and other places

Publications (338)

Chapter
Ecological Momentary Assessment (EMA) is the state-of-the-art methodology to capture an individual’s experiences (e.g., feelings, thoughts, behaviors) in daily life in an ecologically valid way. In this chapter, we outline the prominent role of EMA within a broader mobile sensing framework connecting domains of data acquisition from a range of sens...
Article
Students from lower socioeconomic status (SES) backgrounds can experience stigma in undergraduate educational settings but little research on this topic has been conducted at the PhD level. Lower‐SES PhD students may feel lower levels of social integration as they experience incidents of interpersonal disconnection from others inside and outside of...
Chapter
Expressive writing is a blanket term encompassing many specific approaches to writing therapeutically, typically consisting of one or several brief writing sessions that encourage the expression of one's deepest thoughts and feelings about a personally important or stressful experience. Participants who write in this way often show meaningful impro...
Article
Tremendous interest exists in the use of brief digital “micro-interventions” for online and mobile intervention. Most digital micro-interventions, however, lack a strong theoretical or empirical basis and have not demonstrated efficacy and acceptability. We developed a suite of brief digital stress management micro-interventions based on theory and...
Article
Background Artificial intelligence has provided new opportunities for human interactions with technology for the practice of medicine. Among the recent artificial intelligence innovations, personal voice assistants have been broadly adopted. This highlights their potential for health care–related applications such as behavioral counseling to promot...
Preprint
Although the use of nondrug rewards (e.g., money) to facilitate smoking cessation is widespread, recent research has found that such rewards may be least effective when people who smoke cigarettes are tempted to do so. Specifically, among people who smoke, the neural response to nondrug rewards appears blunted when access to cigarettes is anticipat...
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Stress and sleep are related, but the nature and time course of this relation is not well understood. We explored the within-person associations of three components of emotional responses to everyday stressors, indexed by negative affect, reactivity (initial response to a stressor), recovery (persistence of the post-stressor response), and pile-up...
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Repeated assessments in everyday life enables collecting ecologically valid data on dynamic, within-persons processes. These methods have widespread utility and application and have been extensively used for the study of stressors and stress responses. Enhanced conceptual sophistication of characterizing intraindividual stress responses in everyday...
Article
Introduction: There is reason to believe that introversion may relate to different patterns of negative and positive experiences in everyday life ("hassles" and "uplifts"), but there is little evidence for this based on reports made in daily life as events occur. We thus extend the literature by using data from ecological momentary assessments to...
Article
Objective To examine the association between COVID-19 impact and clinical outcomes of an integrated collaborative care intervention for adults with obesity and comorbid depression. Methods Latent class analysis identified clusters of self-reported COVID-19 impact. Cluster characteristics were examined using Fishers’ least significant difference me...
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Background Low- and middle-income countries (LMICs) are experiencing major increases in diabetes and cardiovascular conditions linked to overweight and obesity. Lifestyle interventions such as the United States National Diabetes Prevention Program (DPP) developed in high-income countries require adaptation and cultural tailoring for LMICs. The obje...
Article
Background Integrated treatments for comorbid depression (often with anxiety) and obesity are lacking; mechanisms are poorly investigated. Methods In a mechanistic pilot trial, adults with BMI ≥30 and Patient Health Questionnaire-9 scores ≥10 were randomized to usual care (n=35) or an integrated behavioral intervention (n=71). Outcomes were change...
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Response bias characterized by decreases in self-reported subjective states when measured repeatedly over short time-frames is a potential concern in social science. Recent work suggests that this initial elevation bias (IEB) is pronounced among young adult students' self-reports of affect when using ambulatory methods, but it is unclear if such bi...
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Conceptualizing physical pain and negative affect as potentially interactive, we hypothesized that higher levels of peripheral inflammatory markers would be observed consistently only among individuals with both higher negative affect and pain symptomatology. Participants were generally healthy midlife adults from the Bronx, NY (N = 212, Mage = 46....
Article
Background: Wearable transdermal alcohol concentration (TAC) sensors allow passive monitoring of alcohol concentration in natural settings and measurement of multiple features from drinking episodes, including peak intoxication level, speed of intoxication (absorption rate) and elimination, and duration. These passively collected features extend c...
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Background The aim of this paper is to describe the utility of various recruitment modalities utilized in the Working to Increase Stability through Exercise (WISE) study. WISE is a pragmatic randomized trial that is testing the impact of a 3-year, multicomponent (strength, balance, aerobic) physical activity program led by trained volunteers or del...
Article
An array of negative psychological states – including depressive symptoms, perceived stress, rumination, and negative affect – have been linked to immune function and inflammatory responses. Herein we show evidence of gender-dependent associations between ex vivo lipopolysaccharide (LPS)-stimulated cytokine responses and such psychological states,...
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Perceiving and interpreting eye gaze cues is foundational for social cognition and social interactions because it involves the ability to use eye gaze direction to predict the actions and intentions of others. Autism is a disability that impacts social interactions. A diagnostic symptom of autism is difficulty understanding eye gaze cues as social...
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Women in midlife (ages 40–60) show decreases in physical activity (PA) that exacerbate risk for cardiovascular disease. Social comparisons (i.e., self-evaluations relative to others) are known to influence PA in other groups, but their association in this population is unknown. The present study used ecological momentary assessment to examine this...
Article
Background: Depression hinders obesity treatment; elucidating mechanisms may enable treatment enhancements. Objectives: The aim was to investigate whether changes in neural targets in the negative affect circuit following psychotherapy mediate subsequent changes in weight and behaviors. Methods: Adults (n = 108) with obesity and depression wer...
Article
Whether exclusion hurts or inclusion feels good is debated within social psychology, and research designs often compare people who are excluded from those who are included. Here, we examined how participants differ when they are excluded or included relative to when they are not engaging in social interactions. Participants completed an ecological...
Article
Evidence is mixed with regard to whether positively valanced affect (PA) is associated with engagement in health behaviors. Both affective arousal (activated/ deactivated) and level of analysis (between and within-person) may influence such associations. Adults (N = 121; 25-65 years) completed ambulatory assessments of affect and daily reports of s...
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Data from 213 adults were analyzed to test the stress accumulation and stress sensitization models as they relate to daily mood, health behaviors and social interactions. Adults reported on childhood adversity, past year adversity, and daily experiences on 14 evenings. Results largely supported the stress accumulation and not stress sensitization m...
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Objective: Intensive ambulatory assessment, such as ecological momentary assessment (EMA), is increasingly used to capture naturalistic patient-reported outcomes. EMA design features (eg, study duration, prompt frequency) vary widely between studies, but it is not known if such design decisions influence potential subjects' willingness to particip...
Article
Background Research pairing ecological momentary assessment (EMA) methodology and ambulatory cortisol during daily life is still rare, as is careful testing of the within-person associations between stress, affect, and cortisol. Using a circumplex approach, we considered both valence and arousal components of affect. Purpose To examine the within-...
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The purpose of this study was to investigate the feasibility, acceptability, and short-term adherence to an adult outdoor group sport play program designed to maximize enjoyment that was modified to incorporate COVID-19 risk mitigation strategies. We enrolled 17 healthy, but sedentary, central Pennsylvania adults (mean age = 31.6 ± 7.3) without obe...
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Background: Ecological momentary assessment (EMA) has the potential to minimize recall bias by having people report on their experiences in the moment (momentary model) or over short periods (coverage model). This potential hinges on the assumption that participants provide their ratings based on the reporting time frame instructions prescribed in...
Preprint
Artificial intelligence (AI)-based voice technology offers considerable promise in healthcare; however, its application for behavioral therapy in a real-world or research setting has yet to be determined. We describe the design and evaluation of LumenTM, a fully functional voice-only virtual coach that delivers evidence-based, problem-solving treat...
Article
Background Technological advancements make it possible to deliver depression interventions via smartphone applications (“Apps”), including those that deliver content “just-in-time” (e.g., in response to acute negative mood states). This study examined whether an app-based just-in-time intervention (ImproveYourMood+) decreased depressive symptoms, a...
Article
Research on the predictive value of neuroimaging measures as prognostic markers for mood and related disorders with cognitive and behavioral treatment is lacking.
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Background Depression exerts a staggering toll that is worsened with co-occurring chronic conditions such as obesity. It is imperative to develop more effective interventions for depression and to identify objective and biological plausible neural mechanisms to understand intervention outcomes. The current study uses functional neuroimaging to dete...
Article
Ostracism is associated with poor outcomes, but it is unclear if online versus in-person ostracism elicits divergent psychological and physiological responses. Participants (N = 54) were randomly assigned to online or in-person ostracism, and provided pre- and post-ostracism measures of affect, self-esteem, self-feelings, and salivary cortisol. No...
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Anticipatory stress can prospectively and negatively influence diverse outcomes, including cognitive performance and emotional well-being. It has been suggested that perseverative cognitions (e.g., worry, rumination) during the anticipation period constitute a key mechanism driving these effects. The present study investigated the temporal dynamics...
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This review characterizes the effect of technology-supported interventions on prenatal gestational weight gain (GWG), physical activity, and healthy eating behaviors and describes intervention characteristics that may influence intervention effectiveness. A systematic search was conducted using PubMed, Web of Science, and CINHAL and identified pren...
Article
Background Sex influences health and related behaviors due to biological and psychosocial/socioeconomic factors. Assessing sex-specific responses to integrated treatment for comorbid obesity and depression could inform intervention targeting. Purpose To test (a) whether sex moderates the effects of integrated collaborative care on weight and depre...
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Full-text available
Background Ecological momentary assessment (EMA) has the potential to minimize recall bias by having people report on their experiences in the moment (momentary model) or over short periods (coverage model). This potential hinges on the assumption that participants provide their ratings based on the reporting time frame instructions prescribed in t...
Preprint
BACKGROUND Ecological Momentary Assessment (EMA) has the potential to minimize recall bias by having people report on their experiences in the moment (momentary model) or over short periods of time (coverage model). This potential hinges on the assumption that participants provide ratings based on the reporting timeframe instructions prescribed in...
Article
Full-text available
Despite the myriad benefits associated with regular physical activity (PA), few American adults accrue sufficient weekly PA. Though “lack of time” is often cited as a correlate of physical inactivity, a growing body of evidence suggests that, perhaps more importantly, people allocate their limited leisure-time to activities they find more enjoyable...
Article
Objective The present nonrandomized controlled trial aimed to evaluate feasibility, acceptability, and preliminary efficacy of a tailored text message intervention for increasing adolescent physical activity, as compared with passive monitoring. Methods Forty adolescents (13–18 years old) received either a tailored text messaging intervention (Net...
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Incorporating technological supplements into existing group mindfulness-based interventions (MBIs), particularly for use with adolescents, is an important next step in the implementation of MBIs. Yet there is little available content. Herein we present the development and content of a technological supplement for MBIs, which incorporates multiple t...
Article
Background There are emerging data indicating that sleep disturbance may be linked with an increase in opioid use. The majority of sickle cell disease (SCD) patients experience sleep disturbances, which can elevate pain severity and pain catastrophizing, both of which are important predictors of opioid consumption. Purpose We conducted a prelimina...
Article
Expressive writing (EW) is a structured writing technique that encourages the expression or disclosure of one's deepest thoughts and feelings about stressful or traumatic events. EW has been shown to improve health, both psychological and physical functioning, although benefits are not universal. In this chapter we review EW research, focusing on e...
Article
Background : Examining variability in the presenting symptoms of depression may be particularly important in characterizing depression in patients with comorbid conditions such as obesity. Identifying the underlying constructs of depression in such patients may produce phenotypic information to aid diagnosis and treatment decisions. Objective : To...
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Background Midlife women are at an elevated risk for cardiovascular disease (CVD) and associated mortality. Those who have additional risk conditions such as obesity or hypertension report specific barriers to engaging in cardioprotective behaviors such as physical activity (PA). Considerable effort has been devoted to understanding PA determinants...
Article
Objective The Strength and Vulnerability Integration (SAVI) theory posits boundary conditions, such as chronic stress, which place constraints on positive emotional aging. We examine SAVI’s prediction that higher levels of chronic stress will attenuate favorable age gradients for multiple indices of well-being. Method We used cross-sectional data...
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Mindfulness interventions have been shown to improve several subcomponents of attention; however, the psychological mechanisms driving these improvements are unknown. Mindfulness interventions train individuals to monitor present moment experiences while adopting an attitude of acceptance toward these experiences. We conducted a theoretically drive...
Article
Churches are well positioned to promote better mental health outcomes in underserved populations, including rural adults. Mind–body (MB) practices improve psychological well-being yet are not widely adopted among faith-based groups due to conflicting religious or practice beliefs. Thus, “Harmony & Health” (HH) was developed as a culturally adapted...
Preprint
BACKGROUND With the growing interest in mobile health (mHealth), behavioral medicine researchers are increasingly conducting intervention studies that use mobile technology (eg, to support healthy behavior change). Such studies’ scientific premises are often sound, yet there is a dearth of implementational data on which to base mHealth research met...
Article
Background With the growing interest in mobile health (mHealth), behavioral medicine researchers are increasingly conducting intervention studies that use mobile technology (eg, to support healthy behavior change). Such studies’ scientific premises are often sound, yet there is a dearth of implementational data on which to base mHealth research met...
Preprint
Full-text available
Background: Behavioral interventions for obesity have modest and variable effectiveness. Emotion dysregulation may hinder effective weight loss interventions, especially among those with comorbid depression. Whether neural mechanisms related to emotion dysregulation mediate the effect of behavioral intervention on improving health behaviors in obes...
Article
Despite evidence for effective integrated behavior therapy for treating comorbid obesity and depression, treatment response is highly variable and the underlying neurobiological mechanisms remain unknown. This hampers efforts to identify mechanistic targets in order to optimize treatment precision and potency. Funded within the NIH Science of Behav...
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Recent work using naturalistic, repeated, ambulatory assessment approaches have uncovered a range of within-person mood- and body image-related dynamics (such as fluctuation of mood and body dissatisfaction) that can prospectively predict eating disorder behaviors (e.g., a binge episode following an increase in negative mood). The prognostic signif...
Article
Weight stigma and discrimination have been linked to negative health outcomes. Most research on this topic is retrospective, which may not accurately capture day-to-day experiences. The current used ecological momentary assessment to examine weight stigma and discrimination in everyday life. Participants answered ecological momentary assessments ab...
Article
Purpose Social support (SS) has been shown to moderate the relationship between psychological distress and physical activity (PA) in adults, including those with no history of cancer and cancer survivors (CS). The purpose of this study was to explore the relationship between stress and leisure‐time PA and test if SS is a moderator of this relations...
Article
Objectives: This study explored associations between narcissistic grandiosity (including its component traits) and reported risky health behaviors in college students. Participants: College men and women (N = 122) participated between December 2015 and January 2016. Methods: Participants completed self-report measures of grandiosity, alcohol consum...
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Voice-based personal assistants using artificial intelligence (AI) have been widely adopted and used in home-based settings. Their success has created considerable interest for its use in healthcare applications; one area of prolific growth in AI is that of voice-based virtual counselors for mental health and well-being. However, in spite of its pr...
Article
Objective: Higher affect variability (the extent to which individuals vary in their affect over time) has been associated with poorer health indicators, but associations with inflammation are less well understood. The purpose of the present study was to examine whether affect variability was associated with inflammation in ways consistent with the...
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Background Mobile technology has increased the reach of health behavior interventions but raised new challenges in assessing the fidelity of treatment receipt. Fidelity can be compromised if participant fatigue or burden reduces engagement, leading to missed or delayed treatments for just-in-time interventions. Objective This study aimed to invest...
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Introduction The RAINBOW randomized clinical trial validated the efficacy of an integrated collaborative care intervention for obesity and depression in primary care, although the effect was modest. To inform intervention optimization, this study investigated within-treatment variability in participant engagement and progress. Methods Data were col...
Preprint
BACKGROUND Midlife women are at an elevated risk for cardiovascular disease (CVD) and associated mortality. Those who have additional risk conditions such as obesity or hypertension report specific barriers to engaging in cardioprotective behaviors such as physical activity (PA). Considerable effort has been devoted to understanding PA determinants...
Article
Full-text available
The RAINBOW trial demonstrated that an integrated collaborative care intervention was effective for improving weight and depression. This study examined mediation of the treatment effect by a priori specified lifestyle behaviors and cognitive functioning. Participants were randomized to a 12-month integrated intervention (n = 204) or usual care (n...
Poster
Introduction: Neural mechanisms underlying behavior therapy in obesity are poorly understood, particularly in patients with comorbid depression. Putative targets include neural circuits for conscious and nonconscious emotion regulation. Hypothesis: Changes in a priori neural circuits for emotion regulation from baseline (0) to 2 mo (mediators, M)...
Article
Introduction: Obesity and depression often co-occur, especially in women. Efficacious treatments exist for both conditions, but treatment outcomes vary. Assessing sex-specific responses to integrated therapy of these conditions could inform opportunities for tailoring. Hypothesis: Sex will significantly moderate the effects of an integrated collabo...
Poster
Full-text available
BACKGROUND o The trait extraversion is associated with positive affect and social characteristics (gregariousness, assertiveness) o These characteristics manifest in daily life as affective states, behaviors, cognitions, and desires that interact with environmental characteristics 1-3 o Lower extraversion (colloquially "introversion") is associated...
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With wearable, relatively unobtrusive health monitors and smartphone sensors, it is increasingly easy to collect continuously streaming physiological data in a passive mode without placing much burden on participants. At the same time, smartphones provide the ability to survey participants to provide “ground-truth” reporting on psychological states...
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Background: Adolescents diagnosed with persistent asthma commonly take less than 50% of their prescribed inhaled corticosteroids (ICS), placing them at risk for asthma-related morbidity. Adolescents' difficulties with adherence occur in the context of normative developmental changes (eg, increased responsibility for disease management) and rely up...
Preprint
BACKGROUND Adolescents diagnosed with persistent asthma commonly take less than 50% of their prescribed inhaled corticosteroids (ICS), placing them at-risk for asthma-related morbidity. Adolescents’ difficulties with adherence occur in the context of normative developmental changes (e.g., increased responsibility for disease management) and rely up...