Ambulatory assessment (AA) covers a wide range of assessment methods to study people in their natural environment, including self-report, observational, and biological/physiological/behavioral. AA methods minimize retrospective biases while gathering ecologically valid data from patients’ everyday life in real time or near real time. Here, we report on the major characteristics of AA, and we provide examples of applications of AA in clinical psychology (a) to investigate mechanisms and dynamics of symptoms, (b) to predict the future recurrence or onset of symptoms, (c) to monitor treatment effects, (d) to predict treatment success, (e) to prevent relapse, and (f) as interventions. In addition, we present and discuss the most pressing and compelling future AA applications: technological developments (the smartphone), improved ecological validity of laboratory results by combined lab-field studies, and investigating gene-environment interactions. We conclude with a discussion of acceptability, compliance, privacy, and ethical issues.

In this review, we discuss ecological momentary assessment (EMA) studies on mood disorders and mood dysregulation, illustrating 6 major benefits of the EMA approach to clinical assessment: (a) Real-time assessments increase accuracy and minimize retrospective bias; (b) repeated assessments can reveal dynamic processes; (c) multimodal assessments can integrate psychological, physiological, and behavioral data; (d) setting- or context-specific relationships of symptoms or behaviors can be identified; (e) interactive feedback can be provided in real time; and (f) assessments in real-life situations enhance generalizability. In the context of mood disorders and mood dysregulation, we demonstrate that EMA can address specific research questions better than laboratory or questionnaire studies. However, before clinicians and researchers can fully realize these benefits, sets of standardized e-diary questionnaires and time sampling protocols must be developed that are reliable, valid, and sensitive to change.

This article introduces the special section on experience sampling methods and ecological momentary assessment in clinical assessment. We review the conceptual basis for experience sampling methods (ESM; Csikszentmihalyi & Larson, 1987) and ecological momentary assessment (EMA; Stone & Shiffman, 1994). Next, we highlight several advantageous features of ESM/EMA as applied to psychological assessment and clinical research. We provide a brief overview of the articles in this special section, each of which focuses on 1 of the following major classes of psychological disorders: mood disorders and mood dysregulation (Ebner-Priemer & Trull, 2009), anxiety disorders (Alpers, 2009), substance use disorders (Shiffman, 2009), and psychosis (Oorschot, Kwapil, Delespaul, & Myin-Germeys, 2009). Finally, we discuss prospects, future challenges, and limitations of ESM/EMA.

We discuss three varieties of affective dynamics (affective instability, emotional inertia, and emotional differentiation). In each case, we suggest how these affective dynamics should be operationalized and measured in daily life using time-intensive methods, like ecological momentary assessment or ambulatory assessment, and recommend time-sensitive analyses that take into account not only the variability but also the temporal dependency of reports. Studies that explore how these affective dynamics are associated with psychological disorders and symptoms are reviewed, and we emphasize that these affective processes are within a nexus of other components of emotion regulation.

The dynamics of psychopathological symptoms as a topic of research has been neglected for some time, likely because of the inability of cross-sectional and retrospective reports to uncover the ebb and flow of symptoms. Data gathered with the experience sampling method (ESM) enable researchers to study symptom variability and instability over time as well as the dynamic interplay between the environment, personal experiences, and psychopathological symptoms. ESM data can illuminate these dynamic processes, if time is both considered and integrated into (a) the research question itself, (b) the assessment or sampling method, and (c) the data analytic strategy. The authors highlight the complexity of assessing affective instability and unstable interpersonal relationships and explore sampling and analytic methods. Finally, they propose guidelines for future investigations. For the assessment of affective instability, the authors endorse the use of time-contingent recordings and of instability indices that address temporal dependency. For the assessment of unstable interpersonal relationships, they advocate the use of event-contingent recordings and separate analyses within and across dyads.

Future ambulatory monitoring studies will be useful in clarifying which events lead to the reported, sudden decrease in positive mood in BPD patients.

Patients with borderline personality disorder (BPD) are known to use nonsuicidal self-injury (NSSI) as a dysfunctional strategy to regulate intense emotions. The primary purpose of this study was to clarify the motives for NSSI along with their interrelations. We further investigated the variety of emotions preceding NSSI and possible effects of NSSI on these emotions. To this end, a structured self-rating questionnaire on NSSI was administered to 101 female BPD-patients exhibiting NSSI. Most patients reported multiple motives for NSSI. The motives were more likely to compound than to exclude one another. Negative reinforcement was almost always involved in NSSI, whereas positive reinforcement (e.g., "getting a kick") played an additional role among about half of the patients. NSSI was usually preceded by a large variety of negative feelings that were reported to clearly improve with NSSI. In conclusion, therapists should anticipate a multidimensional functional spectrum when exploring motives of NSSI.

The use of ambulatory assessment (AA;Trull & Ebner-Priemer, 2013) in psychopathology research, which includes experience-sampling methods as well as ecological momentary assessment, has increased dramatically over the last several decades. Previously, methodological and reporting guidelines have been presented to outline best practices and provide input on methodological issues and decisions that are faced when planning and conducting AA studies (e.g., Bolger & Laurenceau, 2013;Mehl & Conner, 2012;Stone & Shiffman, 2002). However, despite the publication of these important resources and guidelines, it remains an open question as to how much uniformity or consistency is evident in the design and reporting of AA studies of psychopathology. To address this, we reviewed the reported practices of published studies using AA in major psychopathology journals (Journal of Abnormal Psychology, Psychological Medicine, Clinical Psychological Science) over the last 7 years (2012-2018). Our review highlights (a) sample selection and size; (b) sampling design; (c) selection and reporting of measures; (d) devices used and software; (e) compliance; (f) participant training, monitoring and remuneration; and (g) data management and analysis. We conclude with recommendations for reporting the features of future AA studies in psychopathology.