Ecological momentary assessment (EMA) of mental health outcomes in veterans and servicemembers: A scoping review. (October 2020)

• Record Type: Journal Article
• Authors: Gromatsky, Molly; Sullivan, Sarah R.; Spears, Angela Page; Mitchell, Emily; Walsh, Samantha; Kimbrel, Nathan A.; Goodman, Marianne
• Is Part Of: Psychiatry research. Volume 292(2020)
• Publication Date: 2020-10
• Subjects: Military -- Experience sampling -- Ambulatory assessment -- Continuous monitoring -- Telehealth monitoring -- Diary; Psychiatry -- Periodicals; Psychiatry -- periodicals; Psychiatrie -- Périodiques; 616.89
• DOI: 10.1016/j.psychres.2020.113359
• Languages: English
• ISSNs: 0165-1781

Abstract

Highlights: Ecological momentary assessment (EMA) is a valuable tool for tracking changes in dynamic mental health variables. EMA of mental health outcomes in military samples is underutilized. EMA is most often used to assess PTSD and/or SUDs in these samples. Far fewer studies used EMA to study suicide risk in veterans or servicemembers. EMA has great potential for understanding mental health of military personnel. Abstract: This PRISMA scoping review explores existing research conducted with United States military samples utilizing ecological momentary assessment (EMA) to evaluate mental health outcomes. EMA facilitates understanding of temporal changes of dynamic variables subject to change difficult to capture in standard laboratory assessment. It also elucidates understanding of complex etiology of mental illness in military and veteran samples and treatment approaches. Thirty-two articles published between 1995 and 2019 met inclusion criteria. Most (68.7%) included studies examined mental health symptoms and their temporal relationship to other outcomes among servicemembers and/or veterans, particularly posttraumatic stress disorder and substance use disorders. EMA was frequently employed to better understand underlying mechanisms of mental illness, predict symptom changes, assess feasibility among special populations, and assess treatment outcomes. Considerable variability existed in assessment period duration, number of daily assessments, and EMA modalities utilized. Several research gaps were identified, including underutilization of EMA to study suicide risk in veterans/servicemembers. EMA has great potential for increasing understanding of an array of complex mental health problems; however, this highly promising approach has been largely underutilized to study mental health issues among veteran and military populations to date, perhaps due to institutional delays in its adoption secondary to privacy/data security concerns.