Graduate School of Applied and Professional Psychology, Rutgers University, 152 Frelinghuysen Road, Piscataway, NJ, 08854, United States, 1 8484453914.
Evidence-Based Practice Institute, Seattle, WA, United States.
JMIR Ment Health. 2024 Oct 9;11:e60035. doi: 10.2196/60035.
Novel technologies, such as ecological momentary assessment (EMA) and wearable biosensor wristwatches, are increasingly being used to assess outcomes and mechanisms of change in psychological treatments. However, there is still a dearth of information on the feasibility and acceptability of these technologies and whether they can be reliably used to measure variables of interest.
Our objectives were to assess the feasibility and acceptability of incorporating these technologies into dialectical behavior therapy and conduct a pilot evaluation of whether these technologies can be used to assess emotion regulation processes and associated problems over the course of treatment.
A total of 20 adults with borderline personality disorder were enrolled in a 6-month course of dialectical behavior therapy. For 1 week out of every treatment month, participants were asked to complete EMA 6 times a day and to wear a biosensor watch. Each EMA assessment included measures of several negative affect and suicidal thinking, among other items. We used multilevel correlations to assess the contemporaneous association between electrodermal activity and 11 negative emotional states reported via EMA. A multilevel regression was conducted in which changes in composite ratings of suicidal thinking were regressed onto changes in negative affect.
On average, participants completed 54.39% (SD 33.1%) of all EMA (range 4.7%-92.4%). They also wore the device for an average of 9.52 (SD 6.47) hours per day and for 92.6% of all days. Importantly, no associations were found between emotional state and electrodermal activity, whether examining a composite of all high-arousal negative emotions or individual emotional states (within-person r ranged from -0.026 to -0.109). Smaller changes in negative affect composite scores were associated with greater suicidal thinking ratings at the subsequent timepoint, beyond the effect of suicidal thinking at the initial timepoint.
Results indicated moderate overall compliance with EMA and wearing the watch; however, there was no concurrence between EMA and wristwatch data on emotions. This pilot study raises questions about the reliability and validity of these technologies incorporated into treatment studies to evaluate emotion regulation mechanisms.
生态瞬时评估（EMA）和可穿戴生物传感器腕带等新技术越来越多地被用于评估心理治疗的结果和变化机制。然而，关于这些技术的可行性和可接受性，以及它们是否可以可靠地用于测量感兴趣的变量，仍然缺乏信息。
我们的目标是评估将这些技术纳入辩证行为疗法的可行性和可接受性，并进行一项试点评估，以确定这些技术是否可以用于评估治疗过程中的情绪调节过程和相关问题。
共有 20 名患有边缘型人格障碍的成年人参加了为期 6 个月的辩证行为疗法课程。在每个治疗月的一周内，要求参与者每天完成 6 次 EMA，并佩戴生物传感器手表。每次 EMA 评估都包括多项负性情绪和自杀思维等项目的测量。我们使用多层相关来评估通过 EMA 报告的皮肤电活动与 11 种负性情绪状态之间的同期关联。进行了多层回归分析，将自杀思维综合评分的变化回归到负性情绪的变化上。
平均而言，参与者完成了所有 EMA 的 54.39%（SD 33.1%）（范围 4.7%-92.4%）。他们还每天佩戴设备 9.52（SD 6.47）小时，每天佩戴设备的时间占 92.6%。重要的是，无论是检查所有高唤醒负性情绪的综合情况还是个别情绪状态（个体内 r 范围从-0.026 到-0.109），都没有发现情绪状态与皮肤电活动之间存在关联。负性情绪综合评分的较小变化与随后时间点的自杀思维评分更大相关，超出了初始时间点自杀思维的影响。
结果表明，对 EMA 和佩戴手表的总体依从性中等；然而，EMA 和手表数据在情绪方面没有一致性。这项初步研究对将这些技术纳入治疗研究以评估情绪调节机制的可靠性和有效性提出了质疑。
