Ecological momentary assessment in borderline personality disorder: a review of recent findings and methodological challenges
Abstract
The use of Ecological Momentary Assessment (EMA) has led to increased insight into borderline personality disorder (BPD) symptoms, especially regarding affective instability. EMA is characterized by a series of repeated assessments of current affective, behavioral, and contextual experiences or physiological processes while participants engage in normal daily activities. EMA has several advantages. It enables researchers to avoid biased recollection, to investigate within-person processes, and to enhance real-life generalizability. This review is dedicated to four main objectives: (1) to discuss the characteristics of EMA in studying BPD symptomatology; (2) to provide an extensive overview of EMA findings in BPD structured into findings regarding DSM-IV criteria and findings regarding emotional dysregulation as stated in the biosocial theory of Linehan; (3) to discuss challenges of EMA and to give recommendations for the proper use of it; and (4) to highlight prospects and promising applications that should be addressed.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
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?
Recent reviews indicate that EMA is an acceptable and feasible data collection method in psychiatric samples.
“These reviews indicate that EMA is an acceptable and feasible data collection method in psychiatric samples as well”
From Don't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research (2022) · cites this paper as [14]
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Development and validation of brief measures of positive and negative affect: The PANAS scales.
Watson, D., Clark, L. A., & Tellegen, A. (1988) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.54.6.1063 · Cited by 32,433 · see citing works
Society and the Adolescent Self-Image
Rosenberg, M. (1965) · doi:10.1515/9781400876136 · Cited by 30,126 · see citing works
(1993) · Cited by 7,136 · see citing works
Diary Methods: Capturing Life as it is Lived
Bolger, N., Davis, A., & Rafaeli, E. (2003) · Annual Review of Psychology · doi:10.1146/annurev.psych.54.101601.145030 · Cited by 3,843 · see citing works
The PANAS-X: Manual for the Positive and Negative Affect Schedule - Expanded Form
Watson, D., & Clark, L. A. (1994) · doi:10.17077/48vt-m4t2 · Cited by 3,697 · see citing works
Review of personality and social psychology
Davies, M. (1983) · Personality and Individual Differences · doi:10.1016/0191-8869(83)90072-7 · Cited by 3,393 · see citing works
Handbook of research methods for studying daily life
Mehl, M. R., Conner, T. S., & Csíkszentmihályi, M. (2012) · Choice Reviews Online · doi:10.5860/choice.50-1159 · Cited by 2,121 · see citing works
Ecological Momentary Assessment (Ema) in Behavioral Medicine
Stone, A. A., & Shiffman, S. (1994) · Annals of Behavioral Medicine · doi:10.1093/abm/16.3.199 · Cited by 1,931 · see citing works
Experience Sampling Method: Measuring the Quality of Everyday Life
Hektner, J. M., Schmidt, J. A., & Csíkszentmihályi, M. (2006) · Cited by 1,255 · see citing works
The Experience Sampling Method
Larson, R. W., & Csíkszentmihályi, M. (2014) · Springer eBooks · doi:10.1007/978-94-017-9088-8_2 · Cited by 1,047 · see citing works
Jahng, S., Wood, P. K., & Trull, T. J. (2008) · Psychological Methods · doi:10.1037/a0014173 · Cited by 593 · see citing works
Ecological momentary assessment of mood disorders and mood dysregulation
Ebner-Priemer, U. W., & Trull, T. J. (2009) · Psychological Assessment · doi:10.1037/a0017075 · Cited by 530 · see citing works
Self-citationTrull, T. J., Solhan, M. B., Tragesser, S. L., Jahng, S., Wood, P. K., Piasecki, T. M., & Watson, D. (2008) · Journal of Abnormal Psychology · doi:10.1037/a0012532 · Cited by 503 · see citing works
Wilhelm, P., & Schoebi, D. (2007) · European Journal of Psychological Assessment · doi:10.1027/1015-5759.23.4.258 · Cited by 477 · see citing works
Solhan, M. B., Trull, T. J., Jahng, S., & Wood, P. K. (2009) · Psychological Assessment · doi:10.1037/a0016869 · Cited by 362 · see citing works
Ambulatory Assessment - Monitoring Behavior in Daily Life Settings
Fahrenberg, J., Myrtek, M., Pawlik, K., & Perrez, M. (2007) · European Journal of Psychological Assessment · doi:10.1027/1015-5759.23.4.206 · Cited by 317 · see citing works
Wilhelm, F. H., & Grossman, P. (2010) · Biological Psychology · doi:10.1016/j.biopsycho.2010.01.017 · Cited by 311 · see citing works
Butler, A. C., Hokanson, J. E., & Flynn, H. A. (1994) · Journal of Personality and Social Psychology · doi:10.1037//0022-3514.66.1.166 · Cited by 290 · see citing works
The Science of Real-Time Data Capture: Self-Reports in Health Research
Atienza, A. A. (2007) · Cited by 289 · see citing works
Ebner‐Priemer, U., Eid, M., Kleindienst, N., Stabenow, S., & Trull, T. J. (2009) · Journal of Abnormal Psychology · doi:10.1037/a0014868 · Cited by 284 · see citing works
Self-citationRussell, J. J., Moskowitz, D. S., Zuroff, D. C., Sookman, D., & Paris, J. (2007) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.116.3.578 · Cited by 272 · see citing works
Stiglmayr, C., Grathwol, T., Linehan, M. M., Ihorst, G., Fahrenberg, J., & Bohus, M. (2005) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2004.00466.x · Cited by 271 · see citing works
Self-citationState affective instability in borderline personality disorder assessed by ambulatory monitoring
Ebner‐Priemer, U., Kuo, J. R., Kleindienst, N., Welch, S. S., Reisch, T., Reinhard, I., Lieb, K., Linehan, M. M., & Bohus, M. (2007) · Psychological Medicine · doi:10.1017/s0033291706009706 · Cited by 255 · see citing works
Self-citationBorderline personality disorder and emotional responding: a review of the research literature
Rosenthal, M. Z., Gratz, K. L., Kosson, D. S., Cheavens, J. S., Lejuez, C. W., & Lynch, T. R. (2008) · Clinical Psychology Review · doi:10.1016/j.cpr.2007.04.001 · Cited by 245 · see citing works
Butler, A. C., Hokanson, J. E., & Flynn, H. A. (1994) · Journal of Personality and Social Psychology · doi:10.1037/0022-3514.66.1.166 · Cited by 214 · see citing works
Ebner‐Priemer, U., Welch, S. S., Grossman, P., Reisch, T., Linehan, M. M., & Bohus, M. (2007) · Psychiatry Research · doi:10.1016/j.psychres.2006.04.014 · Cited by 204 · see citing works
Self-citationThe application of mHealth to mental health: opportunities and challenges
Marzano, L., Bardill, A., Fields, B., Herd, K., Veale, D., Grey, N., & Moran, P. (2015) · The Lancet Psychiatry · doi:10.1016/s2215-0366(15)00268-0 · Cited by 200 · see citing works
The rejection–rage contingency in borderline personality disorder.
Berenson, K. R., Downey, G., Rafaeli, E., Coifman, K. G., & Paquin, N. L. (2011) · Journal of Abnormal Psychology · doi:10.1037/a0023335 · Cited by 197 · see citing works
Dissociative symptoms are positively related to stress in borderline personality disorder
Stiglmayr, C. E., Ebner‐Priemer, U. W., Bretz, J., Behm, R., Mohse, M., Lammers, C. ‐., Anghelescu, I. ‐., Schmahl, C., Schlotz, W., Kleindienst, N., et al. (2008) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2007.01126.x · Cited by 177 · see citing works
Self-citationAmbulatory Assessment: An Innovative and Promising Approach for Clinical Psychology
Ebner-Priemer, U. W., & Trull, T. J. (2009) · European Psychologist · doi:10.1027/1016-9040.14.2.109 · Cited by 173 · see citing works
Self-citationStiglmayr, C., Shapiro, D. A., Stieglitz, R. D., Limberger, M. F., & Bohus, M. (2001) · Journal of Psychiatric Research · doi:10.1016/s0022-3956(01)00012-7 · Cited by 172 · see citing works
Self-citationThe Oxford Handbook of Research Strategies for Clinical Psychology
(2013) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199793549.001.0001 · Cited by 171 · see citing works
Borderline Personality Features: Instability of Self–Esteem and Affect
Zeigler‐Hill, V., & Abraham, J. A. (2006) · Journal of Social and Clinical Psychology · doi:10.1521/jscp.2006.25.6.668 · Cited by 161 · see citing works
Turpin, G. (1999) · Journal of Psychophysiology · doi:10.1027//0269-8803.13.1.58 · Cited by 154 · see citing works
Fonagy, P., Speranza, M., Luyten, P., Kaess, M., Hessels, C. J., & Bohus, M. (2015) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-015-0751-z · Cited by 149 · see citing works
Self-citationMood variability: a study of four groups
Cowdry, R. W., Gardner, D. L., O'Leary, K. M., Leibenluft, E., & Rubinow, D. R. (1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.11.1505 · Cited by 147 · see citing works
Ebner-Priemer, U. W., Kuo, J., Welch, S. S., Thielgen, T., Witte, S., Bohus, M., & Linehan, M. M. (2006) · Journal of Nervous & Mental Disease · doi:10.1097/01.nmd.0000239900.46595.72 · Cited by 133 · see citing works
Self-citationSadikaj, G., Russell, J. J., Moskowitz, D. S., & Paris, J. (2010) · Journal of Personality Assessment · doi:10.1080/00223891.2010.513287 · Cited by 132 · see citing works
Links, P. S., Eynan, R., Heisel, M. J., Barr, A., Korzekwa, M., McMain, S., & Ball, J. S. (2007) · Journal of Personality Disorders · doi:10.1521/pedi.2007.21.1.72 · Cited by 129 · see citing works
Ambulatory Assessment of Affective Instability in Borderline Personality Disorder
Ebner‐Priemer, U., & Sawitzki, G. (2007) · European Journal of Psychological Assessment · doi:10.1027/1015-5759.23.4.238 · Cited by 125 · see citing works
Self-citationIncreased diurnal salivary cortisol in women with borderline personality disorder
Lieb, K., Rexhausen, J. E., Kahl, K. G., Schweiger, U., Philipsen, A., Hellhammer, D. H., & Bohus, M. (2004) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2004.04.002 · Cited by 113 · see citing works
Self-citationDistress and Affective Dysregulation in Patients With Borderline Personality Disorder
Ebner‐Priemer, U., Kuo, J. R., Schlotz, W., Kleindienst, N., Rosenthal, M. Z., Detterer, L., Linehan, M. M., & Bohus, M. (2008) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e31816a493f · Cited by 106 · see citing works
Self-citationJahng, S., Solhan, M. B., Tomko, R. L., Wood, P. K., Piasecki, T. M., & Trull, T. J. (2011) · Journal of Abnormal Psychology · doi:10.1037/a0024686 · Cited by 104 · see citing works
Psychotic reactivity in borderline personality disorder
Glaser, J. ‐., van Os, J., Thewissen, V., & Myin‐Germeys, I. (2009) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2009.01427.x · Cited by 104 · see citing works
Interpersonal and Emotional Experiences of Social Interactions in Borderline Personality Disorder
Stepp, S. D., Pilkonis, P. A., Yaggi, K. E., Morse, J. Q., & Feske, U. (2009) · The Journal of Nervous and Mental Disease · doi:10.1097/nmd.0b013e3181aad2e7 · Cited by 103 · see citing works
On the meaning and measurement of affective instability: clues from chaos theory
Woyshville, M. J., Lackamp, J. M., Eisengart, J. A., & Gilliland, J. A. M. (1999) · Biological Psychiatry · doi:10.1016/s0006-3223(98)00152-8 · Cited by 99 · see citing works
Affect instability in adults with a borderline personality disorder
Stein, K. F. (1996) · Archives of Psychiatric Nursing · doi:10.1016/s0883-9417(96)80084-7 · Cited by 92 · see citing works
Affective instability in borderline personality disorder: Experience sampling findings
Nica, E. I., & Links, P. S. (2009) · Current Psychiatry Reports · doi:10.1007/s11920-009-0012-2 · Cited by 85 · see citing works
Emotion identification and tension in female patients with borderline personality disorder
Wolff, S., Stiglmayr, C., Bretz, H. J., Lammers, C., & Auckenthaler, A. (2007) · British Journal of Clinical Psychology · doi:10.1348/014466507x173736 · Cited by 84 · see citing works
Köhling, J., Ehrenthal, J. C., Levy, K. N., Schauenburg, H., & Dinger, U. (2015) · Clinical Psychology Review · doi:10.1016/j.cpr.2015.02.002 · Cited by 82 · see citing works
Borderline Personality Features and Instability of Daily Negative Affect and Self‐Esteem
Tolpin, L. H., Gunthert, K. C., Cohen, L. H., & O’Neill, S. C. (2003) · Journal of Personality · doi:10.1111/j.0022-3506.2004.00258.x · Cited by 79 · see citing works
Emotion Suppression in Borderline Personality Disorder: An Experience Sampling Study
Chapman, A. L., Rosenthal, M. Z., & Leung, D. W. (2009) · Journal of Personality Disorders · doi:10.1521/pedi.2009.23.1.29 · Cited by 76 · see citing works
Sequences of emotions in patients with borderline personality disorder
Reisch, T., Ebner‐Priemer, U. W., Tschacher, W., Bohus, M., & Linehan, M. M. (2008) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2008.01222.x · Cited by 71 · see citing works
Self-citationGlaser, J. ‐., van Os, J., Mengelers, R., & Myin‐Germeys, I. (2007) · Psychological Medicine · doi:10.1017/s0033291707002322 · Cited by 61 · see citing works
Links, P. S., Eynan, R., Heisel, M. J., & Nisenbaum, R. A. (2008) · The Canadian Journal of Psychiatry · doi:10.1177/070674370805300206 · Cited by 58 · see citing works
Wonderlich, S. A., Crosby, R. D., Engel, S. G., Mitchell, J. E., Smyth, J. M., & Miltenberger, R. G. (2007) · Journal of Personality Disorders · doi:10.1521/pedi.2007.21.3.340 · Cited by 46 · see citing works
Multimethod Investigation of Interpersonal Functioning in Borderline Personality Disorder
Stepp, S., Hallquist, M., Morse, J. Q., & Pilkonis, P. (2011) · Personality disorders · doi:10.1037/a0020572 · Cited by 40 · see citing works
Affective Instability and Reactivity in Depressed Patients With and Without Borderline Pathology
Köhling, J., Moessner, M., Ehrenthal, J. C., Bauer, S., Cierpka, M., Kämmerer, A., Schauenburg, H., & Dinger, U. (2015) · Journal of Personality Disorders · doi:10.1521/pedi_2015_29_230 · Cited by 39 · see citing works
Nisenbaum, R. A., Links, P. S., Eynan, R., & Heisel, M. J. (2010) · Journal of Abnormal Psychology · doi:10.1037/a0018696 · Cited by 33 · see citing works
Experience Sampling Methods in Clinical Psychology
Santangelo, P., Ebner‐Priemer, U., & Trull, T. J. (2013) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780199793549.013.0011 · Cited by 28 · see citing works
Self-citationMood patterns and variations associated with personality disorder pathology.
Farmer, R. F., Nash, H. M., & Dance, D. (2004) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2004.03.009 · Cited by 26 · see citing works
Personality Pathology and Interpersonal Problem Stability
Wright, A. G. C., Scott, L. N., Stepp, S. D., Hallquist, M. N., & Pilkonis, P. A. (2015) · Journal of Personality Disorders · doi:10.1521/pedi_2014_28_171 · Cited by 22 · see citing works
Affective Instability in Personality Disorders
Links, P. S., Heisel, M. J., & Garland, A. (2003) · American Journal of Psychiatry · doi:10.1176/appi.ajp.160.2.394-a · Cited by 13 · see citing works
The organizational properties of the self‐concept and instability of affect
Stein, K. F. (1995) · Research in Nursing & Health · doi:10.1002/nur.4770180506 · Cited by 12 · see citing works
Ebner‐Priemer, U., Bohus, M., & Kuo, J. R. (2007) · Cited by 5 · see citing works
Self-citation
Flagged first, then by citations
Cited by
Sorted by citations
Trull, T. J., & Ebner-Priemer, U. (2013) · Annual Review of Clinical Psychology · doi:10.1146/annurev-clinpsy-050212-185510 · Cited by 761 · see citing works
Self-citationAffective dynamics in psychopathology
Trull, T. J., Lane, S. P., Koval, P., & Ebner-Priemer, U. W. (2015) · Emotion Review · doi:10.1177/1754073915590617 · Cited by 274 · see citing works
Self-citationThe application of mHealth to mental health: opportunities and challenges
Marzano, L., Bardill, A., Fields, B., Herd, K., Veale, D., Grey, N., & Moran, P. (2015) · The Lancet Psychiatry · doi:10.1016/s2215-0366(15)00268-0 · Cited by 200 · see citing works
Fluctuation between grandiose and vulnerable narcissism.
Gore, W. L., & Widiger, T. A. (2016) · Personality Disorders: Theory, Research, and Treatment · doi:10.1037/per0000181 · Cited by 172 · see citing works
Schmahl, C., Herpertz, S. C., Bertsch, K., Ende, G., Flor, H., Kirsch, P., Lis, S., Meyer-Lindenberg, A., Rietschel, M., Schneider, M., et al. (2014) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/2051-6673-1-12 · Cited by 168 · see citing works
Self-citationDon't Miss the Moment: A Systematic Review of Ecological Momentary Assessment in Suicide Research
Kivelä, L., van der Does, W. A. J., Riese, H., & Antypa, N. (2022) · Frontiers in Digital Health · doi:10.3389/fdgth.2022.876595 · Cited by 163 · see citing works
Feasibility and validity of ecological momentary assessment in the investigation of suicide risk
Husky, M., Olié, E., Guillaume, S., Genty, C., Swendsen, J., & Courtet, P. (2014) · Psychiatry Research · doi:10.1016/j.psychres.2014.08.019 · Cited by 124 · see citing works
Husky, M., Swendsen, J., Ionita, A., Jaussent, I., Genty, C., & Courtet, P. (2017) · Psychiatry Research · doi:10.1016/j.psychres.2017.06.035 · Cited by 95 · see citing works
Ibraheim, M., Kalpakci, A., & Sharp, C. (2017) · Borderline Personality Disorder and Emotion Dysregulation · doi:10.1186/s40479-017-0052-x · Cited by 72 · see citing works
“, ecological momentary assessment (EMA); [67]) to study affect problems in BPD, though it is worth noting that nearly all studies focused on adult samples (see [68] for a review), save for a few (i.”
BackgroundDysfunction of Empathy and Related Processes in Borderline Personality Disorder: A Systematic Review
Salgado, R. M., Pedrosa, R., & Bastos-Leite, A. J. (2020) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000260 · Cited by 67 · see citing works
Mattingley, S., Youssef, G. J., Manning, V., Graeme, L., & Hall, K. (2022) · Journal of Affective Disorders · doi:10.1016/j.jad.2021.12.126 · Cited by 65 · see citing works
Santangelo, P. S., Reinhard, I., Koudela-Hamila, S., Bohus, M., Holtmann, J., Eid, M., & Ebner-Priemer, U. W. (2017) · Journal of Abnormal Psychology · doi:10.1037/abn0000288 · Cited by 61 · see citing works
Self-citationPrada, P., Zamberg, I., Bouillault, G., Jimenez, N., Zimmermann, J., Hasler, R., Aubry, J.-M., Nicastro, R., & Perroud, N. (2017) · Perspectives In Psychiatric Care · doi:10.1111/ppc.12178 · Cited by 47 · see citing works
- Authors
- Santangelo, P., Bohus, M., & Ebner-Priemer, U. W.
- Affiliations
- Karlsruhe Institute of Technology (DE)
- Central Institute of Mental Health (DE)
- Venue
- Journal of Personality Disorders
- Publisher
- Guilford Publications
- Published
- 2014-08
- Volume
- 28
- Issue
- 4
- Pages
- 555-576
- ISSN
- 0885-579X (ISSN-L)
- OpenAlex
- W2106163534
- Cited by
- 152
- References
- 66
- Citations by year
- 2026: 6 · 2025: 6 · 2024: 13 · 2023: 8 · 2022: 12 · 2021: 14 · 2020: 18 · 2019: 10 · 2018: 18 · 2017: 15 · 2016: 14 · 2015: 10 · 2014: 6 · 2012: 2
- FWCI
- 0.84
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Personality Disorders (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Mental Health Research Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
- Keywords
- ecological momentary assessment, borderline personality disorder, neuroticism, emotional dysregulation, biosocial theory, DSM-IV diagnostic criteria, within-person processes, methodological issues
- MeSH terms
- Borderline Personality Disorder, Emotions, Humans, Personality Assessment, Psychological Theory, Reproducibility of Results, Diagnostic and Statistical Manual of Mental Disorders
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.
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
