Understanding Daily Fluctuations in Self-Regulation
Condition: Impulsive Behavior; Self-Regulation
MeSH terms: Impulsive Behavior
Study type: Observational

Summary: 
      Understanding Daily Fluctuations in Self-Regulation, also known as the Digital Marshmallow
      Test (DMT), is a collaboration by Northwell Health, Cornell Tech, and Sage Bionetworks.
      Funded by the Robert Wood Johnson Foundation, this is a pioneering study to advance the
      science in identifying and helping individuals who act on short-term temptations, despite
      long-term consequences. Using Apple's ResearchKit(™) and Android's ResearchStack
      applications, the Digital Marshmallow Test will leverage the powerful capabilities of the
      smartphone to examine impulsivity using a range of game-like tasks and sensor capabilities
      within the mobile phone. Across studies, more impulsive individuals are significantly more
      likely to suffer from obesity, Type II Diabetes, substance abuse, gambling problems, suicidal
      behaviors, and increased criminality among many other problems. Early self-report studies
      reveal a relationship between the inability to delay gratification and different patterns of
      mobile phone use. This will be the first study to develop non-invasive mobile methods to
      identify and help those at greatest risk for impulsive responding before serious problems
      occur.
    

Detailed description: 
      Poor self-regulation and impulsivity are underlying symptoms of numerous mental health
      problems such as obesity, substance abuse, Attention Deficit Hyperactivity Disorder (ADHD),
      gambling, binge eating, bipolar disorder, borderline personality disorder, and suicidal
      behaviors. This makes it one of the most important personal and public health intervention
      targets. The classic Marshmallow Test done by Mischel and colleagues determined that the
      inability to delay gratification in childhood was predictive of lower Scholastic Aptitude
      Test (SAT) scores and higher BMI in adulthood. However, assessments of impulsivity and poor
      self-regulation are rarely included in routine medical care because of time and financial
      constraints.

      The mobile phone has changed our ability to assess and intervene with individuals remotely,
      providing an avenue for ambulatory diagnostic testing and just-in-time adaptive interventions
      that can be accessed by billions of people. Newer methods of assessment using the mobile
      phone, including Apple's ResearchKit, provide the opportunity for powerful assessments of
      impulsivity beyond simple self-report. To date, there have been no measures of impulsivity
      integrated into ResearchKit or any mobile application, aside from the beta version that the
      investigators recently built, nor has the research community explored the possibilities of
      passive impulsivity assessment using mobile analytics embedded in all phones. There is
      preliminary evidence that mobile analytics, such as latency to respond to a text, can predict
      personality traits associated with impulsivity such as extroversion and neuroticism, and
      self-report studies reveal that there is a direct relationship between the inability to delay
      gratification and different patterns of mobile phone use. These studies highlight potential
      power of mobile phenotyping as a ubiquitous measure of health determinants in billions of
      people by using passive data that doesn't require user participation. However, foundational
      research is needed to validate assessments, build adaptive tools, and include individual
      differences self-regulation capacity as well as interventions to improve regulation in the
      discussion.

      The investigators propose to test a new diagnostic self-regulation mobile assessment tool
      app. The application built in Apple's ResearchKit(™) and Android's ResearchStack(™) includes
      a self-report assessment, three continuous performance tasks, and passive data collection
      developed for in-person use.

      The goal is that by differentiating between high and low impulsive people using mobile
      assessment tools, the investigators identify those at greatest risk for self-regulation
      problems. Individuals higher in impulsivity have less self-control when faced with short-term
      temptations regardless of their knowledge of the consequences of these choices. This would be
      the first step in developing a completely remote measurement tool for this purpose.

      The primary goal of this exploratory project is to develop and validate a mobile application
      to test impulsivity remotely, and test how self-report indicators of impulsivity via mobile
      assessment correlate with objective impulsivity tests on the mobile phone.

      Because this is an exploratory study, the investigators are looking at how often participants
      use the mobile app in the real-world and how the tasks perform over time once they leave the
      laboratory. In addition, the investigators will test the validity of the measures over time.
    

Intervention name(s): Assessment only
Intervention type(s): Behavioral
Intervention description(s): Mobile ecological assessment only.
Observational model: Cohort
Time perspective: Prospective
Sampling method: Probability Sample
Study population: 
        Participant must be fluent and able to read in English at the eight grade level, be between
        the ages of 18 and 75, be willing to provide informed consent, and own a mobile smartphone
        (iOS or Android) and are willing to receive and respond to text messages.