(PS2-88) Use of Ecological Methods to Establish Individualized Affective Dynamic Profiles to Inform Personalized Targets for Interventions

Data suggests that the variability and instability of multiple systems plays a central role in the manifestation of the psychiatric disorders like bipolar disorder, in which subtypes of the disorder may display different patterns of dysregulation across different domains. The aims of this paper are to: (1) examine the patterns of variability of the mood circumplex in a sample of people with a broad range of mood and anxiety disorders, and (2) develop individualized profiles across these domains to identify targets for personalized interventions. The sample included 371 adults from the National Institute of Mental Health (NIMH) Family Study of Affective Spectrum Disorders with lifetime diagnoses of bipolar I disorder (n=35), bipolar II disorder (n=44), major depressive disorder (n=133), and no mood disorder (n=159). Affective dynamics were assessed with the mood circumplex administered four times per day for two weeks using the methods of Ecological Momentary Assessment (EMA). The circumplex measured levels of sadness, energy, anxiousness, and irritability on 7-point Likert scales. We used fragmentation and variability measures to extract patterns in the circumplex to identify the stability of the domains across diagnostic groups. For example, people with BP1 disorder tended to have more variability of attention and energy, while people with BP2 disorder tended to have more fluctuations in mood and anxiety. These findings suggest that interventions for these different subgroups should be targeted to different domains: people with BP1 would benefit from interventions that address the instability of attention and energy, while those with BP2 and MDD would be more likely to respond to interventions for mood such as CBT. This work demonstrates the utility of EMA as a tool to track affective dynamics for people with various psychiatric disorders, informs the characterization of disorders like BD with implications for clinical and research settings, provides individualized profiles based on the domains most affected, and identifies points of leverage for personalized treatment.