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Ecological momentary assessment versus standard assessment instruments for measuring mindfulness, depressed mood, and anxiety among older adults
Open accessAbstract
As mobile data capture tools for patient-reported outcomes proliferate in clinical research, a key dimension of measure performance is sensitivity to change. This study compared performance of patient-reported measures of mindfulness, depression, and anxiety symptoms using traditional paper-and-pencil forms versus real-time, ambulatory measurement of symptoms via ecological momentary assessment (EMA). Sixty-seven emotionally distressed older adults completed paper-and-pencil measures of mindfulness, depression, and anxiety along with two weeks of identical items reported during ambulatory monitoring via EMA before and after participation in a randomized trial of Mindfulness-Based Stress Reduction (MBSR) or a health education intervention. We calculated effect sizes for these measures across both measurement approaches and estimated the Number-Needed-to-Treat (NNT) in both measurement conditions. Study outcomes greatly differed depending on which measurement method was used. When EMA was used to measure clinical symptoms, older adults who participated in the MBSR intervention had significantly higher mindfulness and significantly lower depression and anxiety than participants in the health education intervention at post-treatment. However, these significant changes in symptoms were not found when outcomes were measured with paper-and-pencil measures. The NNT for mindfulness and depression measures administered through EMA were approximately 25-50% lower than NNTs derived from paper-and-pencil administration. Sensitivity to change in anxiety was similar across administration modes. In conclusion, EMA measures of depression and mindfulness substantially outperformed paper-and-pencil measures with the same items. The additional resources associated with EMA in clinical trials would seem to be offset by its greater sensitivity to detect change in key outcome variables.
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“(a) greater sensitivity to clinical changes (Moore et al., 2016)”
From Online ACT intervention for fibromyalgia: An exploratory study of feasibility and preliminary effectiveness with smartphone-delivered experiential sampling assessment (2022) · cites this paper as Moore et al., 2016
Experimental — accuracy not yet measuredIn the citing paper
“This approach has many advantages87 over “one-time, in-clinic” measures, including the generation of more stable estimates of neurobehavioural symptoms for outcomes research;88 the assessment of dynamic changes among theoretically linked constructs;89 the reduction of recall bias for patients with neurobehavioural disorders;90,91 and the ability to model causal intra-individual relationships.92”
From Precision clinical trials: a framework for getting to precision medicine for neurobehavioural disorders (2021) · cites this paper as [88]
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Metadata
- Authors
- Moore, R. C., Depp, C. A., Wetherell, J. L., & Lenze, E. J.
- Affiliations
- University of California San Diego (US)
- Washington University in St. Louis (US)
- Corresponding author
- Moore, Raeanne C.
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2016-04
- Volume
- 75
- Pages
- 116-123
- ISSN
- 0022-3956 (ISSN-L)
- PMC
- PMC4769895
- OpenAlex
- W2263248765
- Cited by
- 274
- References
- 34
- Citations by year
- 2026: 29 · 2025: 26 · 2024: 38 · 2023: 26 · 2022: 31 · 2021: 30 · 2020: 31 · 2019: 20 · 2018: 18 · 2017: 17 · 2016: 7
- FWCI
- 29.34
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute on Aging (AG049369, R01AG049369)
- National Institute of Mental Health (K23MH107260, L30 MH104725, R01MH100417, MH100417)
- National Center for Complementary and Integrative Health (R34AT007070, R34AT007064)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- ecological momentary assessment, mindfulness, depression, anxiety, older adults, mindfulness-based stress reduction, patient-reported outcomes, ambulatory monitoring, number needed to treat, sensitivity to change, health education intervention, emotional distress
- MeSH terms
- Ecological Momentary Assessment, Aged, Anxiety Disorders, Depression, Female, Humans, Male, Statistics as Topic, Outcome Assessment, Health Care, Executive Function, Mindfulness
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