Clinical assessment of affective instability: Comparing EMA indices, questionnaire reports, and retrospective recall.

Abstract

Traditional self-report measures of psychopathology may be influenced by a variety of recall biases. Ecological momentary assessment (EMA) reduces these biases by assessing individuals' experiences as they occur in their natural environments. This study examines the discrepancy between trait questionnaire, retrospective report, and EMA measures of affective instability in psychiatric outpatients either with a borderline personality diagnosis (BPD; n=58) or with a current major depressive episode or dysthymia (MDD/DYS; n=42). We examined the agreement of three trait measures of affective instability (Personality Assessment Inventory-Borderline Features scaleAffective Instability scale, Affect Intensity Measure, and the Affect Lability Scales) and one retrospective mood recall task with EMA indices of mood and mood instability. Results indicate only modest to moderate agreement between momentary and questionnaire assessments of trait affective instability; agreement between recalled mood changes and EMA indices was poor. Implications for clinical research and practice and possible applications of EMA methodology are discussed. KeywordsBorderline Personality Disorder; affective instability; Ecological Momentary Assessment; retrospective report Clinical researchers and practitioners primarily rely on retrospective self-reports of experiences such as emotions, symptoms, traits, and behaviors when evaluating an individual's functioning. Traditional questionnaire assessments have a variety of strengths, including ease of administration and cost-effectiveness. In addition, the clinical or diagnostic interview is a major tool used by clinical psychologists for evaluation and treatment planning. Both questionnaires and interviews, however, require the respondent to retrospect and integrate information from memory in order to rate items or answer questions. Unfortunately, retrospective reports are influenced by a variety of recall biases, which may introduce error and limit the usefulness of findings based on these reports .Alternate methodologies, such as Ecological Momentary Assessment (EMA; Stone & Shiffman, 1994), offer ways to circumvent (or at least minimize) many sources of recall bias and thereby provide the opportunity to assess the discrepancies between reports of recalled Correspondence concerning this article should be addressed to Timothy J. Trull, Department of Psychological Sciences, 210 McAlester Hall, University of Missouri-Columbia, Columbia, MO 65211. Electronic mail may be sent to trullt@missouri.edu. Publisher's Disclaimer: The following manuscript is the final accepted manuscript. It has not been subjected to the final copyediting, fact-checking, and proofreading required for formal publication. It is not the definitive, publisher-authenticated version. The American Psychological Association and its Council of Editors disclaim any responsibility or liabilities for errors or omissions of this manuscript version, any version derived from this manuscript by NIH, or other third parties. The publis...

Ecological Momentary Assessment in Borderline Personality Disorder: A Review of Recent Findings and Methodological Challenges

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