# Article - Mood disorders in everyday life: A systematic review of experience sampling and ecological momentary assessment studies 10.1016/j.cpr.2012.05.007 Aan het Rot, M.; Hogenelst, Koen; Schoevers, R.A. [[EMA]] #EMA [[Daily mood monitoring of symptoms using smartphones in bipolar disorder - A pilot study]] [[Depression]] [[Assessing mood (validation) and how mood is associated with SZ relapse]] [[aan het Rot et al_2012_Mood disorders in everyday life.pdf]] --- - In clinical practice symptoms are usually assessed retrospectively. It has been argued, however, that mood disorder patients' symptom recall is biased by their dysfunctional attitudes about themselves and their surroundings. This may lead them to selectively attend to negative aspects of their everyday lives (Beck, 1963). - In Psychology, the method used by Mokros (1993) to repeatedly assess people in real-time is best known as experience sampling (Larson & Csikszentmihalyi, 1983). - In medicine, experience sampling is probably better known as ecological momentary assessment (Stone & Shiffman, 1994). While the term was coined less than two decades ago, ecological momentary assessment has its roots in the development of clinical research diaries in the 1940s, ecological studies of behavior in the 1960s and 1970s, and ambulatory devices for continuous monitoring of cardiovascular activity in the 1980s (for a review see Shiffman, Stone, & Hufford, 2008) Related to [[20211120 All about EMA and EMI]] ## There is a difference between Experience Sampling and Ecological Momentary Assessment ^53041f - Traditionally there were some differences between experience sampling and ecological momentary assessment. ==Experience sampling was designed to measure people's internal affective states and associated activities at random time points during the day and so data recording has generally been signal-contingent. Ecological momentary assessment has focused more on actual behaviors and has been more likely to include the concurrent measurement of physiological variables such as blood pressure (Kamarck et al., 2002).Additionally, data recording has been more likely to be event-contingent, i.e. participants provide data right after the occurrence of certain events of interest, which may vary depending on the research question. == Why use EMA methods? 1. Assessing mood in real time avoid recall bias, and reveal the dynamics of mood. 2. Mood can be assessed in specific contexts and over the course of treatment so that factors that alter mood can be elucidated and treatment progress studied closely. 3. Mood can be assessed together with behavior as well as physiological variables. Topic 1: contextual factors and abnormal internal affective states in major depressive disorder - How contextual factors (quality of life perceptions, stress experiences, recent emotional events, and physical activity) influence affect, or be influenced by it. - **When MDD patients are in situation that experiences high level of Negative Affect, they have poorer perceptions of their quality of life.** - "*For example, the group of deVries has repeatedly found that on average adults with MDD report less PA and more NA than healthy controls (Barge-Schaapveld et al., 1999; Myin-Germeys et al., 2003; Peeters, Nicolson, Berkhof, Delespaul, et al., 2003). Barge-Schaapveld et al. (1999) additionally measured patients' enjoyment of their current activities, physical complaints, and perceptions of their quality of life. On average, MDD patients reported less enjoyment of everyday activities, more complaints, and a poorer quality of life, than healthy controls. More importantly, when the ESM/EMA data were analyzed in more detail (but not when a global retrospective measure was used at the end of the EMS/EMA period), it was found that patients reported their quality of life to be poor specifically in situations in which they also reported low levels of PA, high levels of NA, a lack of enjoyment of current activities, and physical complaints. Knowing which symptoms may prevent patients from reporting a good quality of life, and that it may be patients' poor perceptions of their quality of life that may lead them to report less PA and more NA, is essential because improved quality of life is considered an important outcome in the treatment of MDD (IsHak et al., 2011).*" - Higher levels of current stress is associated with lower level of positive affect. - *In this they may be different from patients with schizophrenia, who were found to be different from controls not only in how much stress increased their levels of NA but also in how much stress decreased their levels of PA (MyinGermeys et al., 2003).* Topic 2: Effects of Treatment - ESM/ EMA has been use in studies to treat treatment effects in patients. - ==EMA can be use as an integral part of treatment. Similar to our intented use, summary page of Mood trends.== - "Wichers et al. (2011) point out that ESM/EMA may also be used as an integral part of treatment, in that weekly summaries of patients' data can be discussed with them so they gain insight into the contexts in which they feel better or worse, and can adjust their behavior accordingly. This idea is in line with previous anecdotal reports of the positive effects of ESM/EMA on mood disorder patients' affective states and activities (Ben-Zeev et al., 2009; Donner, 1992; Husky et al., 2010). Using preliminary data from 21 mildly to moderately depressed individuals, Wichers et al. (2011) showed that their approach is both feasible and potentially helpful for MDD patients."