Is it acceptable and feasible to measure prolonged grief disorder symptoms in daily life using experience sampling methodology?

Lenferink, Lonneke; Eersel, J.H.W. van; Franzen, Minita

doi:10.1016/j.comppsych.2022.152351

Cited by 7 publications

(7 citation statements)

References 24 publications

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“…We found no evidence that participation in the EMA surveys leads to a systematic worsening of symptoms. These findings add to the literature suggesting that EMA is feasible, acceptable, and safe in bereaved adults (Lenferink et al, 2022) and in populations characterized by psychological distress more broadly (Gershon et al, 2019;Porras-Segovia et al, 2022;Vachon et al, 2019). In addition, we found that participants often perceived personal or societal benefit to participating in the study, and that this tendency was somewhat greater among those with high prolonged grief symptom severity.…”

Section: Discussionsupporting

confidence: 75%

“…Second, we found higher adherence in our study (M =90% survey completion and 94% participant retention) than was reported in the one prior study of EMA adherence among bereaved adults (M =60% survey completion and 65% participant retention; Lenferink et al, 2022). In that study, Lenferink and colleagues posited that greater time intervals between measures, fewer assessments per day, and higher incentives may promote higher compliance rates in a bereaved adult population.…”

Section: Discussioncontrasting

confidence: 47%

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Ecological Momentary Assessment with Bereaved Adults: Feasibility, Acceptability, and Measurement Reactivity and their Relationship to Prolonged Grief Symptom Severity

Mintz,

Toner,

Skolnik

et al. 2023

Preprint

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Most research on prolonged grief has utilized retrospective self-report or interview-based measures. Although valuable, these methods have limitations: they are subject to recall error and bias and provide little information about the dynamics of prolonged grief symptoms as they unfold in daily life. Ecological momentary assessment (EMA) has the potential to overcome these limitations by assessing grief- related symptoms repeatedly over the course of people’s day-to-day lives in their natural environment. However, there remains considerable uncertainty about how bereaved adults will respond to this type of assessment, especially among those with persistent, distressing grief. In the present study, we evaluated the feasibility and acceptability of an EMA protocol, including whether responding to EMA surveys pertaining to grief leads to worsening of grief symptoms (i.e., measurement reactivity) in a sample of bereaved adults with and without high severity of prolonged grief symptoms (indicated by a score of 30 or higher or a score of below 30 on the Inventory of Complicated Grief, respectively; Prigerson et al., 1995). Participants completed a 17-day data collection period in which they responded to six EMA surveys per day on their personal smartphones. Feasibility was determined by the proportion of EMA surveys completed and the portion of participants who withdrew from the study during the EMA period. Acceptability was assessed with a self-report questionnaire administered at the end of EMA data collection. Measurement reactivity was assessed by evaluating the trajectory of prolonged grief symptoms during the EMA period. The mean proportion of assessments completed was 90% (median = 96%). Only 6% of participants withdrew from the EMA portion of the study. Adherence was modestly lower in those with high prolonged grief symptom severity (mean = 86%; median = 96%) than in those without (mean= 93%, median=97%). On average, participants reported agreement that survey frequency and length was acceptable and disagreed with items querying whether the survey was burdensome or time consuming. Those with high prolonged grief severity reported higher average agreement that the EMA questions were personally relevant. No other group differences in acceptability were observed. There was no evidence for systematic worsening of symptoms during EMA data collection. These findings suggest that EMA is feasible, acceptable, and safe for bereaved adults, including those with high prolonged grief severity. Given these findings and the considerable advantages of this method, EMA should be used more widely to advance our understanding of prolonged grief.

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Section: Discussionsupporting

confidence: 75%

Section: Discussioncontrasting

confidence: 47%

Ecological Momentary Assessment with Bereaved Adults: Feasibility, Acceptability, and Measurement Reactivity and their Relationship to Prolonged Grief Symptom Severity

Mintz,

Toner,

Skolnik

et al. 2023

Preprint

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“…Within two days after the two-week ESMperiod, another similar telephone-interview took place by the same interviewer as the baselineinterview (the results of this second interview are not analyzed in this study). For more information about the study procedures see our earlier work using this study sample (Lenferink, van Eersel, et al, 2022)…”

Section: Methodsmentioning

confidence: 99%

“…This study is part of a larger project, titled 'Grief-ID', that aims to study and treat PGD in daily life using ESM (Lenferink, van Eersel, et al, 2022). Bereaved Dutch-or Germanspeaking adults were eligible to participate when they have lost a partner, family member, or friend.…”

Section: Participantsmentioning

confidence: 99%

“…Accordingly, we assessed PGD reactions using ESM-items (i.e., ESM-PGD), that each correspond to one of the ten DSM-5-TR PGD symptoms, five times per day for two weeks in a sample of Dutch-and German-speaking bereaved individuals. In this study sample, our research group already showed that ESM is a feasible and acceptable method to assess PGD reactions in daily life (Lenferink, van Eersel, et al, 2022). In the present study, we examined ( 1…”

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confidence: 97%

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Lenferink et al. 2023. Fluctuations of prolonged grief disorder reactions. Preprint

Lenferink,

Terbrack,

van Eersel

et al. 2023

Preprint

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Introduction: Loss-adaptation has been described as being characterized by ‘waves of grief’, which may result in a Prolonged Grief Disorder (PGD). Although this assumption about the fluctuating nature of grief is supported by theoretical work, it is not (yet) supported by empirical work. We are the first to explore to what extent PGD reactions fluctuate in everyday life and whether fluctuations in PGD reactions are related to overall PGD levels using experience sampling methodology (ESM).Methods: Data from 38 bereaved individuals (74% women, on average 6 years post-loss, 47% lost a parent) were analyzed. For two weeks, five times per day, participants reported on the severity of 11 PGD reactions in the past three hours (ESM-PGD). At baseline, overall PGD severity (B-PGD) in the past two weeks was assessed with telephone-interviews using the Traumatic Grief Inventory–Clinician Administered. Root Mean Square of Successive Differences (RMSSD) were calculated to reflect fluctuations in ESM-PGD. Spearman correlations between RMSSD values of the 11 ESM-PGD reactions and B-PGD scores were computed. Results: Mean B-PGD scores were below the clinical cut-off. Some fluctuations in ESM-PGD reactions were found, as indicated by varying RMSSD values, but also floor effects were detected. B-PGD levels were related to RMSSD values for ESM-PGD (ρ between .37 and .68, all p < .05; and between .36 and .63 after removal of floor effects). Discussion: We found that (some) ESM-PGD reactions fluctuated in everyday life. This may offer new theoretical insights into loss-adaptation, which may result in optimizing PGD treatment.

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Person-specific emotional dynamics: a story of a traumatic loss

Raz,

Bar-Kalifa,

Gilead

2024

Curr Psychol

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The impact of traumatic loss on an individuals’ mental health is a critical area of study. While most research has focused on general grief patterns, the unique trajectories of trauma survivors have been understudied. This research utilizes a high-resolution dataset from a single individual over several years, including a period of unexpected tragedy. Using person-specific dynamic modeling and network analysis, the study examines the psychological processes related to traumatic loss. The results reveal a complex distress trajectory and emotional variability with increasing resilience over time. Findings suggest that traumatic loss can induce strongly interconnected emotional networks, typically linked to vulnerability to psychological disorders. Yet, a heightened correlation within a network representing both positive and negative aspects could indicate the emergence of adaptive coping strategies. The study emphasizes that analyzing emotional inertia and variability separately provides a holistic clinical perspective and deepens the understanding of diverse psychological states and affective dynamics. This research underlines the benefits of investigating individual experiences and stresses the need for idiographic approaches in trauma and grief studies. Future research utilizing high-resolution data from multiple individuals may provide a more comprehensive understanding of the diverse trajectories of grief and inform the future of personalized intervention and care.

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Is it acceptable and feasible to measure prolonged grief disorder symptoms in daily life using experience sampling methodology?

Cited by 7 publications

References 24 publications

Ecological Momentary Assessment with Bereaved Adults: Feasibility, Acceptability, and Measurement Reactivity and their Relationship to Prolonged Grief Symptom Severity

Ecological Momentary Assessment with Bereaved Adults: Feasibility, Acceptability, and Measurement Reactivity and their Relationship to Prolonged Grief Symptom Severity

Lenferink et al. 2023. Fluctuations of prolonged grief disorder reactions. Preprint

Person-specific emotional dynamics: a story of a traumatic loss

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