Assessing Posttraumatic Stress Disorder in Daily Life: A Review of Ecological Momentary Assessment

Xi Pan, MSW, MPA

McLean Hospital
Assessing Posttraumatic Stress Disorder in Daily Life: A Review of Ecological Momentary Assessment

Scientific Abstract

Background: Ecological Momentary Assessment (EMA) is a method of capturing people’s current thoughts, emotions, behaviors, and physiological states outside the laboratory in their natural environment typically via electronic wearable devices. EMA has been used extensively to capture information about mood, substance use, and psychotic symptoms. However, application of EMA to posttraumatic stress disorder (PTSD) symptoms remains understudied and best practices have yet to be synthesized. Therefore, we conducted a systematic review to examine the current state of EMA methods, feasibility and findings in PTSD. This review is dedicated to three objectives: (1) to review the application of EMA in studying PTSD symptomatology; (2) to provide an extensive overview of current study designs; (3) to discuss benefits, limitations, and gaps in our current understanding and propose suggestions for future research.

Method: A systematic review was conducted by querying the PubMed database with the terms [PTSD] OR [Posttraumatic stress disorder] AND [Ecological Momentary Assessment] OR [EMA] OR [Experience Sampling Method] OR [ESM].

Results: Fifteen peer-reviewed studies were identified and categorized into five areas by symptom assessment type: posttraumatic stress, affect, intrusions, sleep, and dissociation. EMA proved feasible for assessing the real-world expression of PTSD symptoms. On average, studies lasted approximately two weeks and participants received symptom prompts four times per day. Participant adherence rates were 82% on average though underrepresented minorities had lower adherence rates. Furthermore, the repeated evaluation of symptoms over time using EMA appears to have had a therapeutic effect in some studies.

Conclusions: EMA appears not only to be feasible for assessing PTSD symptoms in daily life with diverse populations, but may also have a therapeutic effect in and of itself. Certain types of posttraumatic stress symptoms, however, remain understudied. In particular future work should capture daily dissociative phenomenology in a real-world setting to provide a more complete picture of posttraumatic stress outside the laboratory.

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research Areas

Authors

Xi Pan, MSW, MPA, Milissa L. Kaufman, MD, PhD, Lauren A. M. Lebois, PhD

Principal Investigator

Milissa L. Kaufman, MD, PhD, Lauren A. M. Lebois, PhD

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