The Daily Experience of Subjective Tinnitus: Ecological Momentary Assessment Versus End-of-Day Diary

Abstract

Objective: Traditional methods of self-report assessments are susceptible to bias (i.e., memory, recall, and recency). Ecological momentary assessment (EMA) may curb these biases by repeated momentary assessment of the participant throughout the day. High costs and participant burden may, however, impede the use of EMA. End-of-day diary (EDD) provides an attractive alternative to EMA, though no direct comparison has been performed in the tinnitus field. Design: Four thousand seven-hundred thirty-two data entries were collected from nine participants undergoing cognitive behavioral treatment for tinnitus. Eleven equivalent EMA and EDD items were collected for approximately 3 months. Tinnitus experience (i.e., anger, annoyance, avoidance, distraction, fear, invasiveness, pleasantness, and sadness) and well-being (i.e., anxiety, happiness, and stress) were correlated and means compared (t-tests). Results: All variables presented adequate correlation ( r > 0.68) between the EMA and EDD counterparts. Small (<3.9%) significant daily mean differences between EMA and EDD were found for six variables (tinnitus anger, invasiveness, pleasantness, sadness, as well as anxiety and stress) with worse results reported in EDD. Conclusion: The small significant effects found may be attributed to the large number of data points. When EMA is not possible or recommended, EDD provides a viable alternative to assess tinnitus experience daily. Further research on the underlying mechanisms of tinnitus experience and recollection is warranted.

Indicated Stress Prevention Addressing Adolescents with High Stress Levels Based on Principles of Acceptance and Commitment Therapy: A Randomized Controlled Trial

“…It is rather surprising that the EMA data did not yield significant results. Other studies using EMA as a tool to collect data on stress also report differences between self-report data and EMA data [87] or between data collection in the laboratory versus at home [88].…”

“…It is rather surprising that the EMA data did not yield significant results. Other studies using EMA as a tool to collect data on stress also report differences between self-report data and EMA data [ 87 ] or between data collection in the laboratory versus at home [ 88 ]. Possible reasons for differences between EMA data and other self-report data discussed in the literature are, amongst others, a potential recall bias [ 89 ], altered self-awareness due to repeated assessments, and “retrospective reporting bias” [ 90 , p. 1102].…”

Comparative Evaluation of Ecological Momentary Assessment, Global Physical Activity Questionnaire, and Bouchard’s Physical Activity Record for Measuring Physical Activity: A Multilevel Modeling Approach (Preprint)

“…Comprising 16 questions, it is well-recognised for obtaining information on physical activity [17]. However, the retrospective approach adopted by the GPAQ exposes the system to an enhanced risk of memory bias and a lack of temporal specificity associated with the activity [18][19]. This limitation applies similarly to other measures that also rely on retrospective reports.…”

The Effects of Tinnitus in Probabilistic Learning Tasks: Protocol for an Ecological Momentary Assessment Study

“…In contrast to retrospective self-report measures where patients are required to recall and summarize their tinnitus experience in the past 1 or 2 weeks, an EMA focuses on the current moment, minimizing the potential for recall bias and increasing ecological validity. The use of EMA in tinnitus studies has increased with the development of mobile apps and the growing availability of smartphones [39][40][41]. We have developed a mobile app, AthenaCX [42], that can automatically send notifications to the participants at several time points during the day requesting that they complete a state questionnaire asking about their current tinnitus symptom levels.…”