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Ecological Momentary Assessment and Mood Disorders in Children and Adolescents: a Systematic Review

  • Mood Disorders (E Baca-Garcia, Section Editor)
  • Published:
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Abstract

Purpose of Review

The aim of the present review is to systematically examine published data regarding ecological momentary assessment (EMA) in children and adolescents with mood disorders.

Recent Findings

EMA is increasingly used to collect participant’s information in their real environment and in real time. There are multiple studies focused on the evaluation of mood disorders in children and adolescents, but only a few of them used EMA protocols.

Summary

Results found in this review showed a wide variability of works with different fields of study, methodological approaches, and EMA protocols. More than 60% of EMA studies in children and adolescents with mood disorders were conducted via phone call, showing high completion rates with data missing in 5 to 11.5% of the calls. Length of studies varied from a 4-day EMA protocol to a maximum of 8 weeks. Positive and negative affect, daily activities, and social context were the main EMA measures. Despite the limited number of studies using EMA in children and adolescents with mood disorders, EMA was useful in assessing mood symptoms in the moment and in patients’ real-life environment. Studies also showed high completion and satisfaction rates. Although web pages and apps use have been increasing over the past years, the evidence base is still scarce. Future studies can facilitate understanding of EMA methodology among youth with mood disorders.

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References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. National Health and Nutrition Examination Survey (2009), United States.

  2. Kapornai K, Vetro A. Depression in children. Curr Opin Psychiatry. 2008;21:1–7. https://doi.org/10.1097/YCO.0b013e3282f25b01.

    Article  PubMed  Google Scholar 

  3. Gore FM, Bloem PJN, Patton GC, Ferguson J, Joseph V, Coffey C, et al. Global burden of disease in young people aged 10-24 years: a systematic analysis. Lancet. 2011;377(9783):2093–102. https://doi.org/10.1016/S0140-6736(11)60512-6.

    Article  PubMed  Google Scholar 

  4. Birmaher B, Brent D. Practice parameter for the assessment and treatment of children and adolescents with depressive disorders. J Am Acad Child Adolesc Psychiatry. 2007;46(11):1503–26. https://doi.org/10.1097/chi.0b013e318145ae1.

    Article  PubMed  Google Scholar 

  5. Schwarz, N. Retrospective and current self-reports: the rationale for real-time data capture. In: The science of real-time data capture: self-reports in health research. Oxford: Oxford University Press;2007, 11–26.

  6. Ben-Zeev D, Young MA, Madsen JW. Retrospective recall of affect in clinically depressed individuals and controls. Cognit Emot. 2009;23(5):1021–40. https://doi.org/10.1080/02699930802607937.

    Article  Google Scholar 

  7. Mokros HB. Communication and psychiatric diagnosis: tales of depressive moods from two contexts. Health Commun. 1993;5(2):113–27. https://doi.org/10.1207/s15327027hc0502_4.

    Article  Google Scholar 

  8. •• Wen CKF, Schneider S, Stone AA, Spruijt-Metz D. Compliance with mobile ecological momentary assessment protocols in children and adolescents: a systematic review and meta-analysis. J Med Internet Res. 2017;19(4):e132. https://doi.org/10.2196/jmir.6641. This is the latest review of EMA in children and adolescents. This review systematically examines compliance of this population to mobile-EMA protocols.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Shiffman S, Stone AA, Hufford MR. Ecological momentary assessment. Annu Rev Clin Psychol. 2008;4(1):1–32. https://doi.org/10.1146/annurev.clinpsy.3.022806.09141.

    Article  PubMed  Google Scholar 

  10. Hung S, Li M-S, Chen Y-L, Chiang J-H, Chen Y-Y. Smartphone-based ecological momentary assessment for Chinese patients with depression: an exploratory study in Taiwan. Asian J Psychiatry. 2016;23:131–6. https://doi.org/10.1016/jajp201608003.

    Article  Google Scholar 

  11. Rotondi AJ, Sinkule J, Haas GL, Spring MB, Litschge CM, Newhill CE, et al. Designing websites for persons with cognitive deficits: design and usability of a psychoeducational intervention for persons with severe mental illness. Psychol Serv. 2007;4(3):202–24. https://doi.org/10.1037/1541-1559.4.3.202.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hidalgo-Mazzei D, Mateu A, Reinares M, Murru A, Del Mar Bonnín C, Varo C, et al. Psychoeducation in bipolar disorder with a SIMPLe smartphone application: feasibility, acceptability and satisfaction. J Affect Disord. 2016;200:58–66. https://doi.org/10.1016/j.jad.2016.04.042.

    Article  PubMed  Google Scholar 

  13. Price M, Yuen EK, Goetter EM, Herbert JD, Forman EM, Acierno R, et al. mHealth: a mechanism to deliver more accessible, more effective mental health care. Clin Psychol Psychother. 2014;21(5):427–36. https://doi.org/10.1002/cpp.1855.

    Article  PubMed  Google Scholar 

  14. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gøtzsche PC, Ioannidis JPA, et al. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med. 2009;6:e1000100. https://doi.org/10.1371/journal.pmed.1000100.

    Article  PubMed  PubMed Central  Google Scholar 

  15. Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders, 5th Edition (DSM-5). Diagnostic and Statistical Manual of Mental Disorders 4th edition TR., 280. https://doi.org/10.1176/appi.books.9780890425596.744053.

  16. Axelson DA, Bertocci MA, Lewin DS, Trubnick LS, Birmaher B, Williamson DE, et al. Measuring mood and complex behavior in natural environments: use of ecological momentary assessment in pediatric affective disorders. J Child Adolesc Psychopharmacol. 2003;13(3):253–66. https://doi.org/10.1089/104454603322572589.

    Article  PubMed  Google Scholar 

  17. •• Bickham DS, Hswen Y, Rich M. Media use and depression: exposure, household rules, and symptoms among young adolescents in the USA. Int J Public Health. 2015;60(2):147–55. https://doi.org/10.1007/s00038-014-0647-6c. This article follows EMA protocol to determine the association between different media use and depressive symptoms in youth. It shows detailed EMA methodology and completion rates.

    Article  PubMed  Google Scholar 

  18. Cousins JC, Whalen DJ, Dahl RE, Forbes EE, Olino TM, Ryan ND, et al. The bidirectional association between daytime affect and nighttime sleep in youth with anxiety and depression. J Pediatr Psychol. 2011;36(9):969–79. https://doi.org/10.1093/jpepsy/jsr036.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Forbes EE, Hariri AR, Martin SL, Silk JS, Moyles DL, Fisher PM, et al. Altered striatal activation predicting real-world positive affect in adolescent major depressive disorder. Am J Psychiatr. 2009;166(1):64–73. https://doi.org/10.1176/appi.ajp.2008.07081336.

    Article  PubMed  Google Scholar 

  20. Forbes EE, Stepp SD, Dahl RE, Ryan ND, Whalen D, Axelson DA, et al. Real-world affect and social context as predictors of treatment response in child and adolescent depression and anxiety: an ecological momentary assessment study. J Child Adolesc Psychopharmacol. 2012;22(1):37–47. https://doi.org/10.1089/cap.2011.0085.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  21. Frost A, Hoyt LT, Chung AL, Adam EK. Daily life with depressive symptoms: gender differences in adolescents’ everyday emotional experiences. J Adolesc. 2015;43:132–41. https://doi.org/10.1016/j.adolescence.2015.06.001.

    Article  PubMed  Google Scholar 

  22. Mor N, Doane LD, Adam EK, Mineka S, Zinbarg RE, Griffith JW, et al. Within-person variations in self-focused attention and negative affect in depression and anxiety: a diary study. Cognit Emot. 2010;24:48–62. https://doi.org/10.1080/02699930802499715.

    Article  Google Scholar 

  23. Primack BA, Silk JS, DeLozier CR, Shadel WG, Dillman Carpentier FR, Dahl RE, et al. Using ecological momentary assessment to determine media use by individuals with and without major depressive disorder. Arch Pediatr Adolesc Med. 2011;165(4):360–5. https://doi.org/10.1001/archpediatrics.2011.27.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Silk JS, Dahl RE, Ryan ND, Forbes EE, Axelson DA, Birmaher B, et al. Pupillary reactivity to emotional information in child and adolescent depression: links to clinical and ecological measures. Am J Psychiatr. 2007;164(12):1873–80. https://doi.org/10.1176/appi.ajp.2007.06111816.

    Article  PubMed  Google Scholar 

  25. Silk JS, Forbes EE, Whalen DJ, Jakubcak JL, Thompson WK, Ryan ND, et al. Daily emotional dynamics in depressed youth: a cell phone ecological momentary assessment study. J Exp Child Psychol. 2011;110(2):241–57. https://doi.org/10.1016/j.jecp.2010.10.007.

    Article  PubMed  Google Scholar 

  26. •• Vandeleur CL, Strippoli MPF, Castelao E, Gholam-Rezaee M, Ferrero F, Marquet P, et al. The Lausanne–Geneva cohort study of offspring of parents with mood disorders: methodology, findings, current sample characteristics, and perspectives. Soc Psychiatry Psychiatr Epidemiol. 2017;52(8):1041–58. https://doi.org/10.1007/s00127-017-1382-0. This article examines familial aggregation of mood disorders using EMA protocol and following probands and their children over time.

    Article  PubMed  Google Scholar 

  27. Waller JM, Silk JS, Stone LB, Dahl RE. Co-rumination and co-problem solving in the daily lives of adolescents with major depressive disorder. J Am Acad Child Adolesc Psychiatry. 2014;53(8):869–78. https://doi.org/10.1016/j.jaac.2014.05.004.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Whalen DJ, Silk JS, Semel M, Forbes EE, Ryan ND, Axelson DA, et al. Caffeine consumption, sleep, and affect in the natural environments of depressed youth and healthy controls. J Pediatr Psychol. 2008;33(4):358–67. https://doi.org/10.1093/jpepsy/jsm086.

    Article  PubMed  Google Scholar 

  29. Kaufman J, Birmaher B, Brent D, Rao U. Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS-PL): initial reliability and validity data. J Am Acad Child Adolesc Psychiatry. 1997;36(7):980–8.

    Article  PubMed  CAS  Google Scholar 

  30. •• Grist R, Porter J, Stallard P. Mental health mobile apps for preadolescents and adolescents: a systematic review. J Med Internet Res. 2017; https://doi.org/10.2196/jmir.7332. This review examines the acceptability and the efficacy of current mobile apps for mental health in population under 18 years old.

  31. Løventoft P, Nørregaard LB, Frøkjær E. Designing daybuilder: an experimental app to support people with depression. In: Proceedings of the 12th Participatory Design Conference: Exploratory Papers, Workshop Descriptions, Industry Cases. 2012 Presented at: PDC'12; Aug 12–16, 2012; Roskilde, Denmark p. 1–4. [doi: https://doi.org/10.1145/2348144.2348146].

  32. Matthews M, Doherty G. In the mood: engaging teenagers in psychotherapy using mobile phones. In: Proceedings of the SIGCHI Conference on Human Factors in Computing Systems. 2011 Presented at: CHI 11; May 7–12, 2011; Vancouver, BC p. 2947–2956 URL: [doi: https://doi.org/10.1145/1978942.1979379].

  33. Verstappen M, Gardner P, Poon D, Bettridge T. Off the couch and out of the hospital, mobile applications for acceptance and commitment therapy. In: Proceedings of the 16th International Conference on Human-Computer Interaction with Mobile Devices and Services. 2014 Presented at: MobileHCI'14; Sept 23–26, 2014; Toronto, ON p. 431–434. [doi: https://doi.org/10.1145/2628363.2633573].

  34. Stone, A., Shiffman, S., and DeVries, M. (1999). Ecological momentary assessment. Well-being: the foundations of hedonic psychology, 26–39.

  35. Greenberg MS, Beck AT. Depression versus anxiety: a test of the content-specificity hypothesis. J Abnorm Psychol. 1989;98(1):9–13. https://doi.org/10.1037/0021-843X.98.1.9.

    Article  PubMed  CAS  Google Scholar 

  36. Schrader G, Davis A, Stefanovic S, Christie P. The recollection of affect. Psychol Med. 1990;20(1):105–9. https://doi.org/10.1017/S0033291700013271.

    Article  PubMed  CAS  Google Scholar 

  37. Beck AT. Thinking and depression: I. Idiosyncratic content and cognitive distortions. Arch Gen Psychiatry. 1963;9(4):324–33. https://doi.org/10.1001/archpsyc.1963.01720160014002.

    Article  PubMed  CAS  Google Scholar 

  38. Kenny R, Dooley B, Fitzgerald A. Feasibility of “CopeSmart”: a telemental heath app for adolescents. JMIR Mental Health. 2015;2(3):e22. https://doi.org/10.2196/mental.4370.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Matthews M, Doherty G, Sharry J, Fitzpatrick C. Mobile phone mood charting for adolescents. Br J Guid Couns. 2008;36(2):113–29. https://doi.org/10.1080/03069880801926400.

    Article  Google Scholar 

  40. Reid SC, Kauer SD, Khor AS, Hearps SJC, Sanci LA, Kennedy AD, et al. Using a mobile phone application in youth mental health: an evaluation study. Aust Fam Physician. 2012;41(9):711–4. https://doi.org/10.1186/s13063-016-1740-3.

    Article  PubMed  Google Scholar 

  41. Pramana G, Parmanto B, Kendall PC, Silk JS. The SmartCAT: an m-health platform for ecological momentary intervention in child anxiety treatment. Telemedicine E-Health. 2014;20(5):419–27. https://doi.org/10.1089/tmj.2013.0214.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Moitra E, Gaudiano BA, Davis CH, Ben-Zeev D. Feasibility and acceptability of post-hospitalization ecological momentary assessment in patients with psychotic-spectrum disorders. Compr Psychiatry. 2017;74:204–13. https://doi.org/10.1016/j.comppsych.2017.01.018.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Bakker D, Kazantzis N, Rickwood D, Rickard N. Mental health smartphone apps: review and evidence-based recommendations for future developments. JMIR Mental Health. 2016;3(1):e7. https://doi.org/10.2196/mental.4984.

    Article  PubMed  PubMed Central  Google Scholar 

  44. Gulliver, A., Griffiths, K. M., and Christensen, H. (2010). Perceived barriers and facilitators to mental health help-seeking in young people: a systematic review. BMC Psychiatry, 10. https://doi.org/10.1186/1471-244X-10-113.

  45. Geschwind N, Nicolson NA, Peeters F, van Os J, Barge-Schaapveld D, Wichers M. Early improvement in positive rather than negative emotion predicts remission from depression after pharmacotherapy. Eur Neuropsychopharmacol. 2011;21(3):241–7. https://doi.org/10.1016/j.euroneuro.2010.11.004.

    Article  PubMed  CAS  Google Scholar 

  46. Barrigón ML, Berrouiguet S, Carballo JJ, Bonal-Giménez C, Fernández-Navarro P, Pfang B, et al. User profiles of an electronic mental health tool for ecological momentary assessment: MEmind. Int J Methods Psychiatr Res 2017;26(1) https://doi.org/10.1002/mpr.1554.

  47. Chan S, Godwin H, Gonzalez A, Yellowlees PM, Hilty DM. Review of use and integration of mobile apps into psychiatric treatments. Curr Psychiatry Rep. 2017;19:96. https://doi.org/10.1007/s11920-017-0848-9.

    Article  PubMed  Google Scholar 

  48. Torous J, Roberts LW. The ethical use of mobile health technology in clinical psychiatry. J Nerv Ment Dis. 2017;205(1):4–8. https://doi.org/10.1097/NMD.0000000000000596.

    Article  PubMed  Google Scholar 

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Correspondence to Itziar Baltasar-Tello.

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Baltasar-Tello, I., Miguélez-Fernández, C., Peñuelas-Calvo, I. et al. Ecological Momentary Assessment and Mood Disorders in Children and Adolescents: a Systematic Review. Curr Psychiatry Rep 20, 66 (2018). https://doi.org/10.1007/s11920-018-0913-z

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