Ecological Momentary Assessment Of Mood After Moderate To Severe Traumatic Brain Injury

Abstract Objective In persons with moderate–severe traumatic brain injury (msTBI), we compared traditional measures of mood with dynamic measures of affect derived from ecological momentary assessment (EMA), for the purpose of validating the EMA indices and exploring their unique contributions to emotional assessment. Method 23 community-dwelling participants with chronic msTBI were enrolled in a treatment trial for anxiety and/ or depression. At baseline, participants completed the Brief Symptom Inventory-18 Depression and Anxiety subscales (BSI-D, BSI-A) and the Environmental Reward Observation Scale (EROS), a measure of everyday pleasure and reward. EMA data, including the Positive and Negative Affect Scale (PANAS), were collected via smartphone 5 times daily for 7–14 days prior to treatment (M = 8.65; SD = 1.87). Spearman correlations tested associations between baseline BSI-D, BSI-A, and EROS scores with both overall means and temporal variability measures for positive and negative affect (PA, NA). Results Mean PA was significantly correlated with BSI-D (rho −0.60, p < 0.05) and EROS (rho 0.72, p < 0.01). Mean NA and affect variability measures were uncorrelated with baseline scores. NA mean and variability were intercorrelated (rho 0.87, p < 0.001), but this was not the case for PA. Conclusion EMA measures of averaged positive affect showed robust relationships with retrospective measures of depression and environmental reward, providing support for the validity of EMA measures of PA, and for use of the EROS in msTBI. While negative findings must be interpreted with caution, the lack of association of affective variability with retrospective measures suggest a unique role for EMA in examining temporal dynamics of affect.