Comparison of Two Ecological Momentary Intervention Modules for Treatment of Depression on Momentary Positive and Negative Affect

Abstract

Background: Ecological Momentary Assessment (EMA), comprising repeated self-assessments in daily life, have shown promise as an intervention strategy for depression. Whether the content of such assessments influences affect has hardly received attention. The current study consists of two EMA intervention (EMI) modules, enabling us to compare the impact of EMI content on the course of momentary affect during the intervention. Methods: The intervention, implemented as add-on to regular depression treatment, consists of intensive self-monitoring (5x/day, 28 days) and weekly personalized feedback. Patients with depressive complaints (N = 110; Mage = 32.9, SD = 12.2; 44.5% male) were randomly assigned to one of two treatment modules focusing on activities and positive affect (“Do”) or on thoughts and negative affect (“Think”). Results: Linear mixed models showed no significant (p > .18) differences between the two modules on both positive and negative affect over time. Across modules positive affect showed an initial decreasing trend, leveling off towards the end of the intervention period. Negative affect did not change significantly over time (p > .06). Limitations: Both modules assessed positive and negative affect, enabling a direct comparison but potentially decreasing the impact of their differential focus. Conclusions: In our sample, the focus of the EMI was not associated with differential effects on momentary affect. This implies that a focus on thoughts and negative affect compared to positive affect and activities may not lead to added adverse effects on mood, which is an often-voiced concern when using EMA in both research and clinical practice.