Using Biosensor Devices and Ecological Momentary Assessment to Measure Emotion Regulation Processes: Pilot Observational Study With Dialectical Behavior Therapy

Abstract

Novel technologies, such as ecological momentary assessment (EMA) and wearable biosensor wristwatches, are increasingly being utilized 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. In this study, we explored the feasibility and acceptability of incorporating these technologies into Dialectical Behavior Therapy (DBT) and conducted a pilot evaluation of whether these technologies can be used to assess emotion regulation processes and associated problems over the course of treatment. Twenty adults with borderline personality disorder were enrolled in a six-month course of DBT. For one 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 negative affect, among other items. 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 hours/day (SD = 6.47 hours) and for 92.6% of all days. Importantly, no associations were found between emotional state and SCL, whether examining a composite of all high-arousal negative emotions or individual emotional states. Results indicated moderate overall compliance with EMA and wearing the watch, however there was no concurrence between EMA and wristwatch data on emotions. These results raise concerns about the reliability and validity of these technologies in emotion regulation mechanism research.