Ecological momentary assessment (EMA) of mental health outcomes in veterans and servicemembers: A scoping review

Gromatsky, Molly; Sullivan, Sarah R.; Spears, Angela Page; Mitchell, Emily L.; Walsh, Samantha; Kimbrel, Nathan A.; Goodman, Marianne

doi:10.1016/j.psychres.2020.113359

Cited by 23 publications

(19 citation statements)

References 65 publications

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“…Another limitation is related to the relatively low number of EMA observations completed by the group, due to the multiple reasons mentioned above. This number is low compared to other studies (43,111) and may limit the generalizability of the results. Finally, the mood reporting scale in our study did not allow for separate analysis of negative vs. positive mood -which seems important based on previous literature.…”

Section: Study Limitationsmentioning

confidence: 66%

“…Using Ecological Momentary Assessment (EMA), in which data are collected in the natural environment and repeatedly across multiple time points, one can effectively assess the dynamics of mental health-related symptoms in everyday life (41,42). Indeed, large variability in daily mood reporting (i.e., less mental health stability) was found as a significant predictor of mental health status (40,41,(43)(44)(45). In addition, female adolescents show greater variability in EMA of mood compared with male adolescents (46,47).…”

Section: Introductionmentioning

confidence: 99%

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Ecological Momentary Mood, Resilience, and Mental Health Status as Predictors of Quality of Life Among Young Adults Under Stress: A Structural Equation Modeling Analysis

et al. 2021

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Multiple internal factors, such as psychological resilience and mental health status, have been shown to contribute to overall quality of life (QoL). However, very few studies to date have examined how these factors contribute to QoL of youth and young adults in a stressful situation. Here, we studied the contribution of these factors, as well as of ecological momentary mood assessment, to QoL of young army recruits during their Basic Training Combat (BCT). To this end, we collected data from 156 male and female soldiers in a mixed-gender unit in the Israel Defense Forces (IDF). Using a mobile app installed on participants' phones, participants provided self-reports regarding their mental health status and psychological resilience at baseline, and QoL 2 weeks later. Momentary mood reporting was further collected during the 2-week interval period using a daily self-report mood scale (IMS-12). Structural equation modeling (SEM) was used to examine the interrelationships among the study variables based on a hypothesized model. We found that a model with all factors (gender, resilience, mental health status and momentary mood) provided a good fit for the data based on its fit indices [χ2(38) = 47.506, p = 0.139, CFI = 0.979, NFI = 0.910, RMSEA = 0.040, TLI = 0.964]. However, the only direct contributors to QoL were gender and momentary mood, accounting together for 61.5% of the variance of QoL. Psychological resilience and mental health status contributed to QoL only indirectly, through their associations with momentary mood. Collectively, these results highlight the importance of ecological momentary assessment of mental-health related factors such as mood to the prediction of QoL in young adults under stress. These findings may have broader implications for monitoring and improvement of well-being in young healthy populations as well as in clinical ones.

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Section: Study Limitationsmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 99%

Ecological Momentary Mood, Resilience, and Mental Health Status as Predictors of Quality of Life Among Young Adults Under Stress: A Structural Equation Modeling Analysis

et al. 2021

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“…Furthermore, while group studies are undeniably useful for assessing treatments, their methods inherently lack the nuance required for understanding individual differences in conditions and responses to treatments. The EMA approach has been useful in fields investigating conditions of high heterogeneity of symptoms and treatment responses such as psychology and psychiatry ( 76 ). One of the reasons that successful tinnitus treatments have remained elusive and of variable benefit is because of the highly heterogeneous nature of the condition in terms of etiology, experience, reaction, and response to treatment ( 4 ).…”

Section: Resultsmentioning

confidence: 99%

A State-of-Art Review of Digital Technologies for the Next Generation of Tinnitus Therapeutics

Searchfield

Sanders

Doborjeh

et al. 2021

Front. Digit. Health

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Background: Digital processing has enabled the development of several generations of technology for tinnitus therapy. The first digital generation was comprised of digital Hearing Aids (HAs) and personal digital music players implementing already established sound-based therapies, as well as text based information on the internet. In the second generation Smart-phone applications (apps) alone or in conjunction with HAs resulted in more therapy options for users to select from. The 3rd generation of digital tinnitus technologies began with the emergence of many novel, largely neurophysiologically-inspired, treatment theories that drove development of processing; enabled through HAs, apps, the internet and stand-alone devices. We are now of the cusp of a 4th generation that will incorporate physiological sensors, multiple transducers and AI to personalize therapies.Aim: To review technologies that will enable the next generations of digital therapies for tinnitus.Methods: A “state-of-the-art” review was undertaken to answer the question: what digital technology could be applied to tinnitus therapy in the next 10 years? Google Scholar and PubMed were searched for the 10-year period 2011–2021. The search strategy used the following key words: “tinnitus” and [“HA,” “personalized therapy,” “AI” (and “methods” or “applications”), “Virtual reality,” “Games,” “Sensors” and “Transducers”], and “Hearables.” Snowballing was used to expand the search from the identified papers. The results of the review were cataloged and organized into themes.Results: This paper identified digital technologies and research on the development of smart therapies for tinnitus. AI methods that could have tinnitus applications are identified and discussed. The potential of personalized treatments and the benefits of being able to gather data in ecologically valid settings are outlined.Conclusions: There is a huge scope for the application of digital technology to tinnitus therapy, but the uncertain mechanisms underpinning tinnitus present a challenge and many posited therapeutic approaches may not be successful. Personalized AI modeling based on biometric measures obtained through various sensor types, and assessments of individual psychology and lifestyles should result in the development of smart therapy platforms for tinnitus.

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“…For this study, the method focuses on symptoms, experiences with caregiving and adaptive behaviors, and aims to map the fluctuations of daily function within both caregivers and care recipients. This method is considered suitable for understanding daily changes in mood, stress, and medical symptomology [ 38 , 45 , 95 ]. EMA is a useful tool in research for collecting data which are often unobtainable by other methods and providing ecologic validity based on a reduction of recall bias and therefore assessment error.…”

Section: Discussionmentioning

confidence: 99%

Military Injuries—Understanding Posttraumatic Epilepsy, Health, and Quality-of-Life Effects of Caregiving: Protocol for a Longitudinal Mixed Methods Observational Study

Bouldin¹,

Delgado²,

Peacock³

et al. 2022

JMIR Res Protoc

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Background Veterans with posttraumatic epilepsy (PTE), particularly those with comorbidities associated with epilepsy or traumatic brain injury (TBI), have poorer health status and higher symptom burden than their peers without PTE. One area that has been particularly poorly studied is that of the role of caregivers in the health of veterans with PTE and the impact caring for someone with PTE has on the caregivers themselves. Objective In this study, we aim to address the following: describe and compare the health and quality of life of veterans and caregivers of veterans with and without PTE; evaluate the change in available supports and unmet needs for services among caregivers of post-9/11 veterans with PTE over a 2-year period and to compare support and unmet needs with those without PTE; and identify veteran and caregiver characteristics associated with the 2-year health trajectories of caregivers and veterans with PTE compared with veterans without PTE. Methods We conducted a prospective cohort study of the health and quality of life among 4 groups of veterans and their caregivers: veterans with PTE, nontraumatic epilepsy, TBI only, and neither epilepsy nor TBI. We will recruit participants from previous related studies and collect information about both the veterans and their primary informal caregivers on health, quality of life, unmet needs for care, PTE and TBI symptoms and treatment, relationship, and caregiver experience. Data sources will include existing data supplemented with primary data, such as survey data collected at baseline, intermittent brief reporting using ecological momentary assessment, and qualitative interviews. We will make both cross-sectional and longitudinal comparisons, using veteran-caregiver dyads, along with qualitative findings to better understand risk and promotive factors for quality of life and health among veterans and caregivers, as well as the bidirectional impact of caregivers and care recipients on one another. Results This study was approved by the institutional review boards of the University of Utah and Salt Lake City Veterans Affairs and is under review by the Human Research Protection Office of the United States Army Medical Research and Development Command. The Service Member, Veteran, and Caregiver Community Stakeholders Group has been formed and the study questionnaire will be finalized once the panel reviews it. We anticipate the start of recruitment and primary data collection by January 2022. Conclusions New national initiatives aim to incorporate the caregiver into the veteran’s treatment plan; however, we know little about the impact of caregiving—both positive and negative—on the caregivers themselves and on the veterans for whom they provide care. We will identify specific needs in this understudied population, which will inform clinicians, patients, families, and policy makers about the specific impact and needs to equip caregivers in caring for veterans at home. International Registered Report Identifier (IRRID) PRR1-10.2196/30975

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Ecological momentary assessment (EMA) of mental health outcomes in veterans and servicemembers: A scoping review

Cited by 23 publications

References 65 publications

Ecological Momentary Mood, Resilience, and Mental Health Status as Predictors of Quality of Life Among Young Adults Under Stress: A Structural Equation Modeling Analysis

Ecological Momentary Mood, Resilience, and Mental Health Status as Predictors of Quality of Life Among Young Adults Under Stress: A Structural Equation Modeling Analysis

A State-of-Art Review of Digital Technologies for the Next Generation of Tinnitus Therapeutics

Military Injuries—Understanding Posttraumatic Epilepsy, Health, and Quality-of-Life Effects of Caregiving: Protocol for a Longitudinal Mixed Methods Observational Study

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