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Ecological momentary assessment versus standard assessment instruments for measuring mindfulness, depressed mood, and anxiety among older adults.

Raeanne C Moore, Colin A Depp, Julie Loebach Wetherell, Eric J Lenze

Journal of Psychiatric Research April 2016 DOI: 10.1016/j.jpsychires.2016.01.011 (opens in new tab)

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AI-extracted from the abstract
Characteristics Secondary analysis of a randomized clinical trial Peer reviewed
Sample size 67
Population Emotionally distressed older adults
Interventions Mindfulness-Based Stress Reduction (MBSR) health education intervention
Duration Two weeks of ambulatory monitoring before and after the intervention
Topics Anxiety Meditation
Keywords Ecological momentary assessment Mindfulness-based stress reduction Mobile assessment Patient reported outcomes Psychometrics Randomized clinical trial
Key findings When symptoms were measured with EMA, MBSR participants had significantly higher mindfulness and significantly lower depression and anxiety than health education participants after treatment, but these differences were not found with paper-and-pencil measures. Number-needed-to-treat for mindfulness and depression was approximately 25-50% lower with EMA than with paper forms, while sensitivity to change in anxiety was similar across modes.

Abstract

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.

Comparable studies

Other randomized controlled trials on anxiety, most cited first.

Study Year Design Participants
Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients 2000 Randomized controlled trial n = 145
Psilocybin produces substantial and sustained decreases in depression and anxiety in patients with life-threatening cancer: A randomized double-blind trial Cancer patients with life-threatening diagnoses and symptoms of depression and/or anxiety 2016 Randomized controlled trial n = 51
Rapid and sustained symptom reduction following psilocybin treatment for anxiety and depression in patients with life-threatening cancer: a randomized controlled trial Patients with cancer-related anxiety and depression 2016 Double-blind, placebo-controlled, crossover trial n = 29
Psilocybin can occasion mystical-type experiences having substantial and sustained personal meaning and spiritual significance Hallucinogen-naïve adults reporting regular participation in religious or spiritual... 2006 Double-blind study n = 36
Pilot Study of Psilocybin Treatment for Anxiety in Patients With Advanced-Stage Cancer Adults with advanced-stage cancer and anxiety 2010 Double-blind, placebo-controlled study n = 12

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