Hehlmann Miriam I, Schwartz Brian, Lutz Teresa, Gómez Penedo Juan Martín, Rubel Julian A, Lutz Wolfgang
Department of Psychology, University of Trier, Trier, Germany.
Department of Psychology, University of Buenos Aires (Consejo Nacional de Investigaciones Científicas y Técnicas), Buenos Aires, Argentina.
Front Psychiatry. 2021 Mar 9;12:613085. doi: 10.3389/fpsyt.2021.613085. eCollection 2021.
In psychotherapy research, the measurement of treatment processes and outcome are predominantly based on self-reports. However, given new technological developments, other potential sources can be considered to improve measurements. In a feasibility study, we examined whether Ecological Momentary Assessments (EMA) using digital phenotyping (stress level) can be a valuable tool to investigate change processes during cognitive behavioral therapy (CBT). Seven outpatients undergoing psychological treatment were assessed using EMA. Continuous stress levels (heart rate variability) were assessed via fitness trackers (Garmin) every 3 min over a 2-week time period (6,720 measurements per patient). Time-varying change point autoregressive (TVCP-AR) models were employed to detect both gradual and abrupt changes in stress levels. Results for seven case examples indicate differential patterns of change processes in stress. More precisely, inertia of stress level changed gradually over time in one of the participants, whereas the other participants showed both gradual and abrupt changes. This feasibility study demonstrates that intensive longitudinal assessments enriched by digitally assessed stress levels have the potential to investigate intra- and interindividual differences in treatment change processes and their relations to treatment outcome. Further, implementation issues and implications for future research and developments using digital phenotyping are discussed.
在心理治疗研究中，治疗过程和结果的测量主要基于自我报告。然而，鉴于新的技术发展，可以考虑其他潜在来源以改进测量。在一项可行性研究中，我们检验了使用数字表型分析（压力水平）的生态瞬时评估（EMA）是否可以成为研究认知行为疗法（CBT）期间变化过程的有价值工具。使用EMA对7名接受心理治疗的门诊患者进行了评估。在为期2周的时间段内，通过健身追踪器（佳明）每3分钟评估一次连续压力水平（心率变异性）（每位患者6720次测量）。采用时变变化点自回归（TVCP-AR）模型来检测压力水平的逐渐变化和突然变化。七个案例的结果表明了压力变化过程的不同模式。更确切地说，在其中一名参与者中，压力水平的惯性随时间逐渐变化，而其他参与者则表现出逐渐变化和突然变化。这项可行性研究表明，通过数字评估的压力水平丰富的密集纵向评估有潜力研究治疗变化过程中的个体内和个体间差异及其与治疗结果的关系。此外，还讨论了使用数字表型分析的实施问题以及对未来研究和发展的影响。
