Abstract
Ecological Momentary Assessment (EMA) promises to be a suitable method for capturing the dynamics in self-assessments through repeated measurements in naturalistic environments using common mobile devices. Therefore, EMA could increase the power of neuropsychological assessment by obtaining a more fine-grained picture of symptoms, limitations, and strengths in patients with an acquired brain injury (ABI) in real-life situations. The present study examined 15 patients with an ABI with cognitive and motor impairments. Following a semirandomized high-frequency sampling plan to assess EMA's feasibility and applicability, data were collected across 7 days. At eight prompts per day, patients were asked about their current activities, the social context they were in, their current mood, performance judgments of their own functional status, and the frequency of self-reflections. The average compliance rate was 71.6%. The fluctuations in patients' responses were measured in terms of variance distributions within simple (intercept only) three-level models and root mean square of successive difference values. They were sufficient, as shown, for example, by the mean within-person variability of 44.9% across all of the items studied. There were no significant correlations between patients' age, severity of depressive symptoms, or their level of functioning and their compliance with study participation or the variability of their responses. The results support the feasibility and applicability of EMA as an assessment technique in patients with an ABI. There are, however, limitations that should be considered when planning an assessment of brain-injured patients using EMA.
Highlights
An acquired brain injury (ABI) results in complex and multifaceted impairments of sensory–motor, cognitive, emotional, and behavioral functions [1]
Twenty-nine German-speaking inpatients in a hospital for neurorehabilitation who were diagnosed with different forms of ABI were contacted by their attending neuropsychologist about participating in the study
Patients were excluded if they were not scheduled to remain in the hospital for at least another week
Summary
An acquired brain injury (ABI) results in complex and multifaceted impairments of sensory–motor, cognitive, emotional, and behavioral functions [1]. The EMA makes use of time-triggered signals or specific events to initiate data collection. It has been applied in patients with somatic illnesses [6] and patients with mental disorders (e.g., mood disorders) [7] to assess their experiences and behaviors and the momentary context (e.g., location, company) in which the patient is currently involved. Some of the reasons for the popularity of this technique include its strong ecological validity; the focus on the patient’s current situation-specific experience and the reduction in memory strains; and the ability to assess contexts, fluctuations, and moment-to-moment changes in patients’ mental states [5]
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