Ecological Momentary Assessment in Behavioral Medicine
Megan L. Robbins
Search for more papers by this authorThomas Kubiak
Search for more papers by this authorMegan L. Robbins
Search for more papers by this authorThomas Kubiak
Search for more papers by this authorDavid I. Mostofsky
Search for more papers by this authorSummary
To thoroughly study how psychosocial processes influence and are influenced by health, researchers should consider using Ecological Momentary Assessment (EMA) as part of their program of research. This chapter provides a brief overview on applications of EMA in behavioral medicine. EMA is a framework for assessing momentary self-reports in situ, typically implemented as electronic diaries on a handheld computer or smartphone, with the goal to obtain ecologically valid, real-life data. Combining EMA with other methods of ambulatory assessment, such as physiology and/or behavior, raises interesting and important possibilities for the study of behavioral medicine. The chapter also discusses the advantages and disadvantages of the EMA approach, and highlights two selected applications of EMA in behavioral medicine and outlines some important recent developments: EMA as a tool in outcome research and EMA as an intervention tool.
References
- M. R. Mehl, & T. S. Conner (Eds.). (2012). Handbook of research methods for studying daily life. New York, NY: The Guilford Press.
-
A. A. Stone,
S Shiffman,
A. Atienza, &
L. Nebeling (Eds.).
(2007).
The science of real-time data capture: Self-reports in health research.
Oxford:
Oxford University Press.
10.1093/oso/9780195178715.001.0001 Google Scholar
- American Diabetes Association (2012). Standards of medical care in diabetes–2012. Diabetes Care, 35, S11–S63.
- Barker, R. G., & Wright, H. F. (1951). One boy's day: A specimen record of behavior. New York, NY: Harper & Row.
- Barta, W. E., Tennen, H., & Litt, M. D. (2012). Measurement reactivity in diary research. In M. R. Mehl & T. S. Conner (Eds.), Handbook of research methods for studying daily life (pp. 108–123). New York, NY: The Guilford Press.
- Beck, J. S. (2001). Cognitive behvaior therapy: Basics and beyond. Oxford: Oxford University Press.
- Bhattacharyya, M. R., Whitehead, D. L., Rakhit, R., & Steptoe, A. (2008). Depressed mood, positive affect, and heart rate variability in patients with suspected coronary artery disease. Psychosomatic Medicine, 70, 1020–1027.
- Bolger, N., Davis, A., & Rafaeli, E. (2003). Diary methods: Capturing life as it is lived. Annual Review of Psychology, 54, 579–616.
- Bolger, N., Zuckerman, A., & Kessler, R. C. (2000). Invisible support and adjustment to stress. Journal of Personality and Social Psychology, 79, 953–961.
-
Brunswik, E.
(1956).
Perception and the representative design of psychological experiments.
Berkeley, CA:
University of California Press.
10.1525/9780520350519 Google Scholar
- Bussmann, J. B., & Ebner-Priemer, U. W. (2012). Ambulatory assessment of movement behavior. In M. R. Mehl & T. S. Conner (Eds.), Handbook of research methods for studying daily life (pp. 235–250). New York, NY: The Guilford Press.
- Campbell, D. T., & Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychological Bulletin, 56, 81–105.
- Clarke, W., Cox, D., Gonder-Frederick, L., Julian, D., Schlundt, D., & Polonsky, W. (1995). Reduced awareness of hypoglycemia in adults with IDDM. A prospective study of hypoglycemic frequency and associated symptoms. Diabetes Care, 18, 517–522.
- Cohen, L. H., Towbes, L. C., & Flocco, R. (1988). Effects of induced mood on self-reported life events and perceived and received social support. Journal of Personality and Social Psychology, 55, 669–674.
- Conner, T., & Barrett, L. F. (2012). Trend in ambulatory self-report: Understanding the utility of momentary experiences, memories and beliefs. Psychosomatic Medicine, 74, 327–337.
- Conner, T. S., & Lehman, B. (2012). Getting started: Launching a study in daily life. In M. R. Mehl & T. S. Conner (Eds.), Handbook of research methods for studying daily life (pp. 89–107). New York, NY: The Guilford Press.
-
Conner, T. S.,
Tennen, H.,
Fleeson, W., &
Feldman
Barrett, L.
(2009).
Experience sampling methods: A modern idiographic approach to personality research.
Social and Personality Psychology Compass,
3,
1–22.
10.1111/j.1751-9004.2009.00170.x Google Scholar
- Coyne, J., C., Stefanek, M., & Palmer, S. C. (2007). Psychotherapy and survival in cancer: The conflict between hope and evidence. Psychological Bulletin, 133, 347–394.
- Cryer, P. E. (2002). Hypoglycaemia: The limiting factor in the glycaemic management of type I and type II diabetes. Diabetologia, 45, 937–948.
- Ebner-Priemer, U. W., Koudela, S., Mutz, G., & Kanning, M. (2012). Understanding real world physical activity and movement with interactive multimodal ambulatory monitoring. Frontiers in Movement Science and Sport Psychology, 3, p. 596.
- Engel, G. L. (1980). The clinical application of the biopsychosocial model. American Journal of Psychiatry, 137, 535–544.
- Fahrenberg, J. (1996). Ambulatory assessment: Issues and perspectives. In J. Fahrenberg & M. Myrtek (Eds.), Ambulatory assessment: Computer-assisted psychological and psychophysiological methods in monitoring and field studies (pp. 3–20). Seattle, WA: Hogrefe & Huber.
-
Ferguson, J. M., &
Taylor, C. B.
(1981).
Comprehensive handbook of behavioral medicine.
New York:
Spectrum.
10.1007/978-94-011-7280-6 Google Scholar
-
Favill, D., &
Rennick, C. F.
(1924).
A case of family periodic paralysis.
Archives of neurology and psychiatry,
11,
674–679.
10.1001/archneurpsyc.1924.02190360062005 Google Scholar
-
Flügel, J. C.
(1925).
A quantitative study of feeling and emotion in every day life.
British Journal of Psychology,
15,
318–355.
10.1111/j.2044-8295.1925.tb00187.x Google Scholar
- Food and Drug Administration (FDA) (2009). Guidance for the industry. Patient-reported outcome measures: Use in medical product development to support labeling claims. Retrieved October 18, 2012, from http://www.fda.gov
- Fuller, J. L., & Gordon, T. M. (1948). The radio inductograph: A device for recording physiological activity in unrestrained animals. Science, 108, 287–288.
- Goodwin, M. S., Velicer, W. F., & Intille, S. S. (2008). Telemetric monitoring in the behavior sciences. Behavior Research Methods, 40, 328–341.
-
Gottlieb, N. H.,
Vacalis, T. D.,
Palmer, D. R., &
Conlon, R. T.
(1988).
AIDS-related knowledge, attitude, behavior and intentions among Texas college students.
Health Education Research,
3,
67–73.
10.1093/her/3.1.67 Google Scholar
- Graveling, A. J., & Frier, B. M. (2010). Impaired awareness of hypoglycaemia: A review. Diabetes/Metabolism: Research and Reviews, 36, S64–74.
- Gullette, E. C., Blumenthal, J. A., Babyak, M., Jiang, W., Waugh, R. A., Frid, D. J., O'Connor, C. M., Morris, J. J., & Krantz, D. S. (1997). Effects of mental stress on myocardial ischemia during daily life. Journal of the American Medical Association, 277(19), 1521–1526.
- Gunthert, K. C., & Wenze, S. J. (2012). Daily diary methods. In M. R. Mehl & T. S. Conner (Eds.), Handbook of research methods for studying daily life (pp. 144–159). New York, NY: The Guilford Press.
- Hektner, J. M., Schmidt, J. A., & Csikszentmihalyi, M. (2007). Experience sampling method: Measuring the quality of every day life. London: Sage.
-
Helgeson, V. S., &
Cohen, S.
(1996).
Social support and adjustment to cancer: Reconciling descriptive, correlational, and intervention research.
Health Psychology,
15,
135–148.
10.1002/1099-1611(200007/08)9:4<273::AID-PON463>3.0.CO;2-F CAS PubMed Web of Science® Google Scholar
- Hermanns, N., Kulzer, B., Kubiak, T., Krichbaum, M., & Haak, T. (2007). The effect of an education programme (HyPOS) to treat hypoglycaemia problems in patients with type 1 diabetes. Diabetes/Metabolism Research and Reviews, 23, 528–538.
- Heron, K. E., & Smyth, J. M. (2010). Ecological momentary interventions: Incorporating mobile technology into psychosocial and health behavior treatments. British Journal of Health Psychology, 15, 1–39.
- Heyman, R. E. (2004). Rapid Marital Interaction Coding System (RMICS). In P. K. Kerig & D. H. Baucom (Eds.), Couple observationing coding systems (pp. 67–94). Mahwah, NJ: Erlbaum.
- Holter, N. J. (1961). New method for heart studies. Science, 134, 1214–1220.
- Holter, N. J., & Gengerelli, J. A. (1949) Remote recording of physiological data by radio. Rocky Mountain Medical Journal, 46, 749–752.
- Huffziger, S., Ebner-Priemer, U., Koudela, S., Reinhard, I., & Kuehner, C. (2012). Induced rumination in everyday life: Advancing research approaches to study rumination. Personality and Individual Differences, 53, 790–795.
-
Hunscher, H. A.,
Vincent, E. L., &
Macy, I. G.
(1930).
Psychophysiological studies. The technique of securing quantitative and coordinated psychological and physiological data on lactating women in their usual home environment.
Child development,
1,
15–28.
10.2307/1125615 Google Scholar
-
Kambouropoulou, P.
(1926).
Individual differences in the sense of humor.
American Journal of Psychology,
37,
268–278.
10.2307/1413696 Google Scholar
- F. Kanfer, & A. Goldstein (Eds.). (1975). Helping people change: A textbook of methods. New York, NY: Pergamon Press.
- Kazdin, A. E. (1974). Reactive self-monitoring: The effects of response desirability, goal setting, and feedback. Journal of Consulting and Clinical Psychology, 42, 704–716.
- Kross, E., Ayduk, O., & Mischel, W. (2005). Distinguishing rumination from reflective processing of negative emotions. Psychological Science, 16, 710–715.
- Kubiak, T., & Krog, K. (2012). Computerized sampling of experiences and behavior. In M. Mehl & T. Conner (Eds.), Handbook of research methods for studying daily life (pp. 124–143). New York, NY: The Guilford Press.
- Kubiak, T., & Stone, A. A. (2012). Ambulatory monitoring of biobehavioral processes in health and disease [Editorial to the Special Issue on Ambulatory Monitoring]. Psychosomatic Medicine, 74: 325–326.
- Lewin, K. (1951). Field theory in social sciences. New York, NY: Harper & Row.
- Linden, W. (2004). Stress management. London: Sage.
- Linton, S. J., & Melin, L. (1982). The accuracy of remembering chronic pain. Pain, 13, 281–285.
- Mehl, M. R., Robbins, M. L., & große Deters, F. G. (2012). Naturalistic observation of health-relevant social processes: The electronically activated recorder methodology in psychosomatics. Psychosomatic Medicine, 74, 410–417.
- Mehl, M. R., & Robbins, M. L. (2012). Naturalistic observation sampling: The Electronically Activated Recorder (EAR). In M. Mehl & T. Conner (Eds.), Handbook of research methods for studying daily life (pp. 124–143). New York, NY: The Guilford Press.
- Mehl, M. R., Gosling, S. D., & Pennebaker, J. W. (2006). Personality in its natural habitat: Manifestations and implicit folk theories of personality in daily life. Journal of Personality and Social Psychology, 90, 862–877.
- M. R. Mehl, & T. S. Conner (Eds.) (2012). Handbook of research methods for studying daily life. New York, NY: The Guilford Press.
- Mehl, M. R., Pennebaker, J. W., Crow, M., Dabbs, J., & Price, J. (2001). The electronically activated recorder (EAR): A device for sampling naturalistic daily activities and conversations. Behavior Research Methods, Instruments and Computers, 33, 517–523.
- Moghaddam, N. G., & Ferguson, E. (2007). Smoking, model regulation, and personality: an event-sampling exploration of potential models and moderation. Journal of Personality, 75, 451–478.
- Moskowitz, D. S., & Sadikaj, G. (2012). Event-contingent recording. In M. R. Mehl & T. S. Conner (Eds.), Handbook of research methods for studying daily life (pp. 160–175). New York, NY: The Guilford Press.
- Myrtek, M., & Foerster, F. (2001). On-line measurement of additional heart rate: Methodology and applications.. In J. Fahrenberg & M. Myrtek (Eds.), Progress in ambulatory assessment (pp. 399–414). Seattle, WA: Hogrefe & Huber.
- National Heart, Lung and Blood Institute. (2012) Guidelines for the diagnosis and management of asthma. Retrieved October 18, 2012, from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.pdf
- Nezlek, J. B. (2012). Multilevel modeling of diary-style data. In M. R. Mehl & T. S. Conner (Eds.) Handbook of research methods for studying daily life. (pp. 357–383). New York: Guilford Press.
- Nezlek, J. B., Wesselmann, E. D., Wheeler, L., & Williams, D. (2012). Ostracism in everyday life. Group Dynamics: Theory, Research, and Practice, 91, 91–104.
- Pickering, T. G., James, G. D., Boddie, C., Harsfield, G. A., Blank, S., & Laragh, J. H. (1988). How common is white coat hypertension? Journal of American Medical Association, 259, 225–228.
- Reis, H. T. (2012). Why researches should think “real world”: A conceptual rationale. In M. R. Mehl & T. S. Conner (Eds.), Handbook of research methods for studying daily life (pp. 144–159). New York, NY: Guilford Press.
- Reis, H. T., & Wheeler, L. (1991). Studying social interaction with the Rochester interaction record. In M. P. Zanna (Ed.), Advances in experimental social psychology ( Vol. 24, pp. 270–318). San Diego, CA: Academic Press.
- Reis, H. T., Nezlek, J., & Wheeler, L. (1980). Physical attractiveness in social interaction. Journal of Personality and Social Psychology, 38, 604–617.
- Robbins, M. L., Focella, E. S., Kasle, S., Weihs, K. L., López, A. M., & Mehl, M. R., (2011). Naturalistically observed swearing, emotional support and depressive symptoms in women coping with illness. Health Psychology, 30, 789–792.
- Robbins, M. L., Mehl, M. R., Holleran, S. E., & Kasle, S. (2011). Naturalistically observed sighing and depression in rheumatoid arthritis patients: A preliminary study. Health Psychology, 30, 129–133.
- Rosmalen, J. G. M., Wenting, A. M. G., de Roest, A. M., Jonge, P., & Bos, E. H. (2012). Revealing causal heterogeneity using time series analysis of ambulatory assessments: Application to the association between depression and physical activity after myocardial infarction. Psychosomatic Medicine, 74, 377–386.
- Schlotz, W. (2012). Ambulatory psychoneuroendocrinology: Assessing salivary cortisol and other hormones in daily life. In M. R. Mehl & T. S. Conner (Eds.), Handbook of research methods for studying daily life (pp. 193–209). New York, NY: The Guilford Press.
- Schwarz, N. (2012). Why researcher should think “real-time”—a cognitive rationale. In M. R. Mehl & T. S. Conner (Eds.), Handbook of research methods for studying daily life (pp. 22–42). New York, NY: The Guilford Press.
- Schwarz, N. (2007). Retrospective and concurrent self-reports: The rationale for real-time data capture. In A. A. Stone, S. S. Shiffman, A. Atienza, & L. Nebeling (Eds.), The science of real-time data capture: Self-reports in health research (pp. 11–26). New York, NY: Oxford University Press.
- Shrout, P. E., & Lane, S. P. (2012) Psychometrics. In M. R. Mehl & T. S. Conner (Eds.), Handbook of research methods for studying daily life (pp. 302–320). New York, NY: The Guilford Press.
- Siewert, K., Kubiak, T., Jonas, C., & Weber, H. (2011). Trait anger moderates the impact of anger-associated rumination on social well-being. Personality and Individual Differences, 51, 769–774.
-
Smyth, J. M., &
Stone, A. A.
(2003).
Ecological momentary assessment research in behavioral medicine.
Journal of Happiness Studies,
4,
35–52.
10.1023/A:1023657221954 Google Scholar
- Sorbi, M. J., Mak, S. B., Houtveen, J. H., van Kleiboer, A. M., & Doornen, L. J. P. (2007). Mobile Web-based monitoring and coaching: Feasibility in chronic migraine. Journal of Medical Internet Research, 9, e38.
- Stein, K. F., & Corte, C. (2003). Ecological momentary assessment of eating disordered behaviors. International Journal of Eating Disorder, 34, 349–360.
- Stone, A. A., Broderick, J. E., Schneider, S., & Schwartz, J. E. (2012). Expanding options for developing outcome measures from momentary assessment data. Psychosomatic Medicine, 74, 387–397.
- Stone, A. A., & Shiffman, S. (1994). Ecological momentary assessment (EMA) in behavioral medicine. Annals of Behavioral Medicine, 16, 199–202.
-
Stone, A.,
Shiffman, S.,
Atienza, A., &
Nebeling, L.
(2007).
The science of real-time data capture: Self-reports in health research.
New York:
Oxford University Press.
10.1093/oso/9780195178715.001.0001 Google Scholar
- The Society of Behavioral Medicine (2010). Bylaws. Retrieved on September 20, 2012. from http://www.sbm.org/about/bylaws.
- Volkers, A. C., van den Tulen, J. H. M., Broek, W. W., Bruijn, J. A., Passchier, J., & Pepplinkhuizen, L. (2003). Motor activity and autonomic cardiac functioning in major depressive disorder. Journal of Affective Disorders, 76, 23–30.
- Watkins, E. R. (2008). Constructive and unconstructive repetitive thought. Psychological Bulletin, 134, 163–206.
- Wheeler, L., & Nezlek, J. (1977). Sex differences in social participation. Journal of Personality and Social Psychology, 35, 742–754.
- Wilhelm, F. H., & Grossman, P. (2010). Emotions beyond the laboratory: Theoretical fundaments, study design, and analytic strategies for advanced ambulatory assessment. Biological Psychology, 84, 552–569.