Ecological Momentary Assessment of State-Dependent Decision-Making and Metacognition Across a Psychopathology Continuum

Registry record from ClinicalTrials.gov (NCT07801079). This is a study registration, not published results. Lead sponsor: National Institute of Mental Health (NIMH). Recruitment status: NOT_YET_RECRUITING. Study type: OBSERVATIONAL. Enrollment: 420 participants (ESTIMATED). Conditions: Depression, Anxiety, Addiction, Emotion, Craving, Stress. Primary outcome measures: To establish the relationship between psychiatric symptom severity and the reactivity of decision-making to changes in internal state. , Throughout the study, transdiagnostic measures of trait- and state-level symptom severity and clinical diagnosis determined by Structured Clinical Interview for DSM Disorders (SCID).; To identify how individual differences in metacognition might moderate the influence of internal states on decision-making. , In 12 weeks of EMA, measure of metacognition derived from questionnaires and confidence ratings in decision-making tasks.; To estimate the temporal profile of internal state; the lag between changes in internal state and measurable changes in decision-making and to assess whether different aspects of decision-makings are sensitive to acute versus sustained changes i... , In 12 weeks of EMA, self-report of internal states in different time scale and following significant life event.; To assess the influence of naturally occurring fluctuations in internal states on value-based decision-making. , In 12 weeks of EMA, self-report of internal states and significant life events as well as behaviors in established and novel cognitive-behavioral decision-making tasks.. Brief summary: Background: Making decisions during daily life is a complicated behavior. Even simple choices can be affected by a range of emotions, stresses, and moods. Mental health issues such as depression and anxiety can lead people to make decisions that have negative effects on their lives. Learning how changes in feeling affect a person's decisions may help researchers find ways to help them make more positive choices. Objective: To learn how changes in a person's feelings and emotions affect their decisions. Eligibility: People aged 18 to 55 years who are healthy or who have some level of depressive, anxiety, substance-related, or addictive disorders. Design: All study activities can be done remotely; participants may use a smartphone app, a website, or telehealth. Participants will have a baseline visit. They will complete tasks that require decisions; these tasks are like games they play on their phone. They will also answer questions about their habits, how they feel, their sleep quality, and any problem behaviors. They may wear a smartwatch during the study; it will record data such as their movements and heart rate. For 12 weeks, a study app will prompt participants to respond. They will be asked to answer questions about how they are feeling, any problematic behaviors, or big life events; they will be asked to complete tasks that require making decisions. They may record a video or audio clip describing their day and how they feel. For 3 of the 12 weeks, participants will get prompts up to 6 times per day. For 9 weeks, they will get up to 3 prompts per day. They will have an end-of-study visit to discuss their experiences.