CoChat
Sign Up
Cited by 70Mental Health Research TopicsAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health via Writing

Effect of self-monitoring through experience sampling on emotion differentiation in depression

Open access
Widdershoven, Raf L.A., Wichers, Marieke, Kuppens, Peter, Hartmann, Jessica A., Menne-Lothmann, Claudia, Simons, Claudia J.P., Bastiaansen, Jojanneke A.·2019·Journal of Affective Disorders
DOI 10.1016/j.jad.2018.10.092
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND Major depressive disorder has been linked to an inability to differentiate between negative emotions. The current study investigates whether emotion differentiation improves when individuals with major depressive disorder are required to report on specific emotions multiple times a day through the experience sampling method (ESM) - a structured self-report diary technique. METHODS Seventy-nine patients diagnosed with major depressive disorder participated in this study, of whom 55 used ESM for 6 weeks (3 days a week, 10 times a day). Changes from baseline to post assessment in positive and negative emotion differentiation were compared between the participants who did and those who did not use ESM. RESULTS Engaging in ESM related to an improvement in both positive and negative emotion differentiation, but only the latter reached statistical significance. The relationship between the number of ESM measurements (dose) and emotion differentiation change (response) was not significant. LIMITATIONS The sample size for the dose-response analysis was relatively small (N = 55). It is unknown whether emotion differentiation improvements generalize beyond the emotions (N = 12) we probed in this study. Other factors could also have contributed to the change (e.g., meetings with the researchers). CONCLUSIONS The present study suggests that patients with depression using ESM for 3 days a week for 6 weeks can improve their negative emotion differentiation. Future studies should assess after what period of ESM changes in emotion differentiation become apparent, and whether these changes are persistent and relate to actual improvement in depressive symptoms.

AI snapshot

Written from the paper’s full text.

TL;DR

In patients with major depressive disorder, six weeks of experience sampling method (ESM) self-monitoring was associated with improved negative emotion differentiation compared with a control group, while positive emotion differentiation improvement was not statistically significant. The number of completed ESM questionnaires was not significantly related to change in emotion differentiation.

Key findings

  • Negative emotion differentiation improved significantly in the ESM group from baseline (M = 0.17, SD = 0.37) to post-assessment (M = 0.37, SD = 0.43), t(54) = -3.17, p = .003, d = 0.43; the control group did not improve significantly, t(23) = -0.41, p = .683, d = 0.08. In hierarchical regression, adding group status explained an additional 6.7% of variance in post-assessment negative emotion differentiation, F(1, 76) = 6.14, p = .015.
  • Positive emotion differentiation showed a nonsignificant improvement in the ESM group, t(54) = -1.52, p = .136, d = 0.20; adding group status explained 3.6% more variance but was not a significant improvement, F(1, 76) = 3.40, p = .069.
  • No significant dose-response relationship was found: number of filled-in questionnaires did not significantly predict negative emotion differentiation change, ∆R² = .04, F(1, 52) = 2.54, p = .117, or positive emotion differentiation change, ∆R² = .00, F(1, 52) = .06, p = .801. ESM participants responded to an average of 149.76 beeps (SD = 21.33), ranging from 87 to 224.

Methods

  • Seventy-nine patients with DSM-IV-TR major depressive disorder were included; 55 were in the combined ESM group (ESM plus ESM-with-feedback) and 24 were in the control group. All completed a 5-day baseline and post-assessment ESM period; the ESM group completed 10 questionnaires per day on 3 consecutive days per week for 6 weeks, while the control group did not participate in ESM during the intervention period.
  • Emotion differentiation was calculated from intraclass correlations (ICCs) with consistency of agreement among negative adjectives (down, irritated, lonely, restless, agitated, suspicious, guilty, anxious) and positive adjectives (cheerful, satisfied, enthusiastic, relaxed), rated on a 7-point Likert scale. ICCs were Fisher’s Z-transformed and subtracted from 1 so higher values indicated better differentiation.
  • Hierarchical multiple regressions in Stata 14 tested post-assessment emotion differentiation with baseline emotion differentiation as a covariate and group status as a predictor; separate regressions within the ESM group tested number of filled-in questionnaires as a dose predictor.

Limitations

  • The paper states that the dose-response analysis sample was relatively small (N = 55); it is unknown whether improvements generalize beyond the 12 emotions probed; other factors such as meetings with researchers could have contributed; and the design cannot determine which part of the ESM intervention caused the change.
  • The paper also states that the sample size may not have been large enough to detect some effects, particularly dose-response relationships; generalization beyond the eight negative adjectives is uncertain; and clinical relevance or persistence could not be tested because the most substantial depressive symptom improvements occurred after post-assessment.
  • Evident from the text: the ESM-with-feedback and ESM groups were combined for main analyses, although a post-hoc test found no significant difference between them; the dose-response range was restricted because all ESM participants completed at least 87 measurements, with a median of 151.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.jad.2018.10.092

Cites

32 of 32 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

0 of 10 cited sources checked · 0 supported · 0 flagged

  • Findingnone given

    When used for an extended period of time, the use of ESM to study emotion differentiation can have an effect on emotion differentiation.

    “The results of this study also indicate that when used for an extended period of time, the use of ESM to study emotion differentiation can have an effect on emotion differentiation.”
    Quote in the paperSubstantial claim
  • Findingown data

    The control group did not significantly improve in positive emotion differentiation from pre- to post-test.

    “The control group did not significantly improve from pre to post-test, t (23) = 0.60, p = .558,d = 0.12, 95% CI [-0.08, 0.15].”
    Quote in the paperSubstantial claim
  • Findingown data

    The number of completed ESM questionnaires during the 6-week period was not significantly associated with change in negative or positive emotion differentiation at post-assessment.

    “The relationship between the number of ESM measurements (dose) and emotion differentiation change (response) was not significant.”
    • Also stated in: § A C C E P T E D M A N U S C R I P T · plain
      “Adding the number of filled in questionnaires as a second predictor did not significantly increase the explained variance, ∆R 2 = .04,F (1, 52) = 2.54, p = .117.”
    Quote in the paperNot a substantial claim
  • Findingown data

    Changes in emotional intensity or depression were not related to negative or positive emotion differentiation in this study.

    “However, in our study changes in emotional intensity or depression were not related to negative or positive emotion differentiation.”
    Quote in the paperSubstantial claim
  • Findingown data

    No statistical evidence was found for a dose-response relationship between the actual number of filled in ESM measurements and negative emotion differentiation.

    “Although the present study found that patients with depression who filled in ESM measurements for 6 weeks showed a small improvement in (negative) emotion differentiation, no statistical evidence was found for a dose-response relationship with the actual number of filled in ESM measurements.”
    Quote in the paperSubstantial claim
  • May combine two claims. 5
  • Classified as probably not a substantial claim. 20

  • May combine two claims.

    Findingown data

    Patients with depression filling in ESM 3 days a week for 6 weeks improved in positive emotion differentiation when compared to the control group, but this effect was small and not significant.

    “In the present study, patients with depression filling in ESM 3 days a week for 6 weeks improved in positive emotion differentiation when compared to the control group, but this effect was small and not significant.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    On average, participants in the ESM group responded to 149.76 beeps (SD = 21.33), ranging from 87 to 224.

    “On average, participants in the ESM group responded to 149.76 beeps (SD = 21.33)ranging from 87 to 224.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductnone given

    Specific emotions and emotion differentiation were neither the focus of the weekly meetings in the ESM group nor the ESM-with-feedback group.

    “However, specific emotions and emotion differentiation were neither the focus of the weekly meetings in the ESM group nor the ESMwith-feedback group.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    The assumptions of hierarchical multiple regression (normality, linearity, homoscedasticity, no multicollinearity) were not violated.

    “For all analyses, the assumptions of a hierarchical multiple regression (i.e.normality, linearity, homoscedasticity and no multicollinearity) were not violated.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Premisecitation

    The most substantial improvements in depressive symptoms in the sample occurred after post assessment, when there were no more ESM measurements to determine whether improvements in emotion differentiation were sustained.

    “In the present study, this could not be tested as the most substantial improvements in depressive symptoms in the sample occurred after post assessment (Kramer et al., 2014), when there were no more ESM measurements to be able to determine whether improvements in emotion differentiation were sustained.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kramer et al., 2014 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Randomizing the time-sampling procedure and using non-intrusive devices can achieve a reduction in reactivity.

    “This can be achieved by randomizing the time-sampling procedure and using non-intrusive devices (Delespaul, 1995).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Delespaul, 1995

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The weekly meetings with the researcher could have enhanced participants' attention to their emotional states.

    “These meetings could have enhanced participants' attention to their emotional states.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    It is not certain that improvement in negative emotion differentiation can be generalized beyond the eight adjectives used in this study.

    “One of them being that even though it can be reasoned that the participants in this study trained negative emotion differentiation as a skill, it is not certain that improvement in negative emotion differentiation can be generalized beyond the eight adjectives used in this study.”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The affect items measured in this study are the ones often used in ESM research.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisecitation

    Reactivity can be reduced by decreasing an individual's continuous self-awareness.

    “Reactivity can be reduced by decreasing an individual's continuous self-awareness.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    The intervention was directed at reducing emotional intensity.

    “Another thing that should be considered is that the intervention was directed at reducing emotional intensity, and that may have influenced results.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    Negative intraclass correlation coefficients were set to zero in line with previous research.

    “In line with previous research, negative intraclass correlation coefficients were set to zero (e.g.Boden et al., 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Boden et al., 2013 source

      Not checked in the free run.

  • Classified as probably not a substantial claim.

    Premisecitation

    Better negative emotion differentiation can be linked to more adaptive emotion regulation.

    “Furthermore, it has been suggested that better negative emotion differentiation can be linked to more adaptive emotion regulation (Barrett et al., 2001)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Barrett et al., 2001 source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    It is unknown whether emotion differentiation improvements generalize beyond the 12 emotions probed in this study.

    “It is unknown whether emotion differentiation improvements generalize beyond the emotions (N=12) we probed in this study.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Premisereasoning

    Being asked to rate different emotions for an extended period multiple times a day can help people differentiate between emotions, because it directs them to think about the intensity of separate emotions rather than negative or positive affect in general.

    “It can be reasoned, though, that being asked to rate different emotions for an extended period multiple times a day can help to differentiate between emotions, because people are directed to think about the intensity of separate emotions rather than negative or positive affect in general.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Measurement reactivity in ESM is an important phenomenon that demands attention.

    “It is recognized that measurement reactivity in ESM is an important phenomenon that demands attention (Myin-Germeys et al., 2018)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Myin-Germeys et al., 2018

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    Randomization was stratified based on current psychotherapy and duration of pharmacological treatment.

    “Randomization was stratified based on current psychotherapy (yes or no) and duration of pharmacological treatment (shorter or longer than 8 weeks prior to study entry).”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationreasoning

    This effect of ESM on emotion differentiation could have implications for all studies using ESM as a measurement tool.

    “This could have implications for all studies using ESM as a measurement tool.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductown data

    There were no significant baseline differences between groups in mean levels of affect items and positive and negative emotion differentiation ICCs.

    “There were no significant group differences in terms of mean levels of the affect items and positive and negative emotion differentiation ICCs.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductnone given

    Apart from filling in ESM questionnaires for 6 weeks, another difference between the ESM group and the control group were the weekly meetings with the researcher.

    “One of the things that should be considered is that apart from filling in ESM questionnaires for 6 weeks another difference between the ESM group and the control group were the weekly meetings with the researcher.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductown data

    The sample size for the dose-response analysis was relatively small (N=55).

    “The sample size for the dose-response analysis was relatively small (N=55).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    The results of the present research give more insight into measurement reactivity.

    “and the results of the present research give more insight into measurement reactivity.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The smaller effect on positive emotion differentiation could be due to less room for improvement in positive differentiation in depression.

    “Based on the findings by Demiralp and colleagues (2012) that positive emotion differentiation did not differ between individuals suffering from depression and healthy controls, this could be due to less room for improvement in positive differentiation in depression.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Demiralp and colleagues (2012)

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Interpretationreasoning

    When using ESM to modify behaviors, reactivity might be of use.

    “Conversely, when using ESM to modify behaviors, for example to train emotion differentiation, reactivity might be of use, and the ESM procedure should be adapted accordingly.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    It cannot be discarded that focusing on positive emotions multiple times a day might have an effect on emotion differentiation.

    “All things considered, it cannot be discarded that focusing on positive emotions multiple times a day might have an effect on emotion differentiation.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationreasoning

    The present study might have enabled participants to train negative emotion differentiation more because there were more negative (n = 8) than positive (n = 4) affect items in the ESM measurements.

    “Alternatively, given that there were more negative (n = 8) than positive (n = 4) affect items in the ESM measurements, the present study might have enabled participants to train negative emotion differentiation more.”
    Quote in the paperNot a substantial claim
25 of 25

  • The paper relies on this without support.

    Many emotion differentiation studies used ESM only for a couple of days and did not examine changes in emotion differentiation over time.

    “Many emotion differentiation studies used this procedure only for a couple of days without looking at changes in emotion differentiation over time.”

  • The authors state this as an assumption.

    The presence of general feedback in the ESM-with-feedback condition would not additionally influence emotion differentiation.

    “Therefore, it was not expected that the presence of feedback would influence emotion differentiation, and the ESMwith-feedback and ESM groups, who both engaged in ESM for 6 weeks, were combined into one ESM group for the main analyses.”
    “To verify this assumption, a post-hoc hierarchical multiple regression was conducted with negative emotion differentiation at post-test as dependent variable,”

  • The paper relies on this without support.

    The affect items measured in this study are the ones often used in ESM research.

    “It should be noted, however, that the affect items that were measured are the ones often used in ESM research.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • In clinical practice, self-management and self-insight may be enhanced by obtaining insights into one's emotion dynamics.

    “In clinical practice, self-management and self-insight may be enhanced by obtaining insights into one's emotion dynamics [22,26,27].”

    From A Smartphone Serious Game for Adolescents (Grow It! App): Development, Feasibility, and Acceptance Study (2022) · cites this paper as [27]

    The Discussion (page not supplied) suggests that self-monitoring may improve negative emotion differentiation in patients with depression, potentially helping them choose emotion-regulation strategies. This supports the proposed self-management benefit, but the paper does not establish that obtaining insights into emotion dynamics enhances self-insight. (LLM, conf=0.80)

    Experimental — accuracy not yet measured

  • Self-management may be enhanced by obtaining insights into everyday functioning dynamics based on ESM data.

    “Moreover, self-management may be enhanced by obtaining insights into everyday functioning dynamics, based on ESM data [22,26,27].”

    From A Smartphone Serious Game for Adolescents (Grow It! App): Development, Feasibility, and Acceptance Study (2022) · cites this paper as [27]

    The Discussion reports that ESM self-monitoring improved negative emotion differentiation in patients with depression and suggests this might help them choose emotion-regulation strategies. The methods also describe ESM-derived feedback about daily activities and events. The paper does not establish that insights from those data enhanced self-management; it says further research is needed to determine whether the observed change improves outcomes. Page numbers were not available in our copy. (LLM, conf=0.82)

    Experimental — accuracy not yet measured

  • After 6 weeks of self-monitoring, there was a significant improvement in negative emotions' differentiation and a close-to-significance improvement in positive emotions' differentiation, regardless of EMA-derived feedbacks.

    “Widdershoven and colleagues observed a significant improvement in negative emotions’ differentiation and a close-to-significance improvement in positive emotions’ differentiation after 6-weeks of self-monitoring, regardless of EMA-derived feedbacks”

    From Current state and future directions of technology-based ecological momentary assessment and intervention for major depressive disorder: a systematic review (2019) · cites this paper as [68]

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • Not confirmedF(53, 1) = 4.86reported p = .032 · recomputed p = .348

    “F (53, 1) = 4.86, p = .032”

  • ConsistentF(1, 77) = 8.47reported p = .005 · recomputed p = .005

    “F (1, 77) = 8.47, p = .005”

  • ConsistentF(1, 76) = 6.14reported p = .015 · recomputed p = .015

    “F (1, 76) = 6.14, p = .015”

  • Consistentt(54) = -3.17reported p = .003 · recomputed p = .003

    “t (54) = -3.17,p = .003”

  • ConsistentF(1, 52) = 0reported p = .963 · recomputed p = 1.000

    “F (1, 52) = 0.00, p = .963”

  • ConsistentF(1, 77) = 14.98reported p < .001 · recomputed p < .001

    “F (1, 77) = 14.98, p < .001”

  • Consistentt(54) = -1.52reported p = .136 · recomputed p = .134

    “t (54) = -1.52,p = .136”

  • Consistentt(23) = 0.6reported p = .558 · recomputed p = .554

    “t (23) = 0.60, p = .558”

  • ConsistentF(1, 52) = 0.27reported p = .603 · recomputed p = .606

    “F (1, 52) = 0.27, p = .603”

  • ConsistentF(1, 53) = 5.03reported p = .029 · recomputed p = .029

    “F (1, 53) = 5.03, p = .029”

  • ConsistentF(1, 52) = 2.54reported p = .117 · recomputed p = .117

    “F (1, 52) = 2.54, p = .117”

  • ConsistentF(1, 52) = 0.06reported p = .801 · recomputed p = .807

    “F (1, 52) = .06,p = .801”

  • Consistentt(23) = -0.41reported p = .683 · recomputed p = .686

    “t (23) = -0.41,p = .683”

13 of 13

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Seven-point scale has eight stated values

    Minor

    A scale numbered from 0 through 7 has eight integer response values, not seven.

  • Six, not eight, negative items were used during the intervention

    Minor

    The discussion attributes the opportunity to train negative emotion differentiation to eight negative items, but the methods say two of the eight were excluded from the six-week ESM period.

2 of 2

Cites

Flagged first, then by citations

1 of the 33 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Widdershoven, R. L. A., Wichers, M., Kuppens, P., Hartmann, J. A., Menne-Lothmann, C., Simons, C. J. P., & Bastiaansen, J. A.
Affiliations
  • Maastricht University (NL)
  • University Medical Center Groningen (NL)
  • KU Leuven (BE)
  • The University of Melbourne (AU)
  • Maastricht University Medical Centre (NL)
Corresponding author
Bastiaansen, Jojanneke A.
ORCID
Venue
Journal of Affective Disorders
Publisher
Elsevier BV
Published
2019-02
Volume
244
Pages
71-77
ISSN
0165-0327 (ISSN-L)
DOI
10.1016/j.jad.2018.10.092
OpenAlex
W2895204532
Semantic Scholar
059200bd6568c183c6ded8e083148fd366d409f2
Cited by
70
References
33
Citations by year
2026: 7 · 2025: 8 · 2024: 12 · 2023: 7 · 2022: 11 · 2021: 11 · 2020: 12 · 2019: 2
FWCI
8.19
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of Affective Disorders (publishedVersion)
  • PubMed (publishedVersion)
  • Research Publications (Maastricht University) (publishedVersion)
  • Lirias (submittedVersion, other-oa)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion, cc-by-nc-nd)
  • Research Publications (Maastricht University) (submittedVersion)
Funders
  • Dutch Health Research Council (171001002, 91501003)
  • European Community's Seventh Framework Program (HEALTH-F2-2009-241909)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Social Sciences › Psychology › Social Psychology › Mental Health via Writing
Keywords
major depressive disorder, emotion differentiation, ecological momentary assessment, self-monitoring, negative emotions, positive emotions, emotion regulation, dose-response relationship
MeSH terms
Ecological Momentary Assessment, Adolescent, Adult, Aged, Depressive Disorder, Major, Major Depressive Disorder, Emotions, Female, Humans, Male, Middle Aged, Young Adult, Self Report

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-10.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-10.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review