Experience sampling methodology in mental health research: new insights and technical developments

TLDR

Experience sampling methodology (ESM) is increasingly recognized as a powerful complement to conventional psychiatric research, enabling the investigation of symptoms within and in interaction with everyday life contexts. The paper reviews how ESM’s micro‑level focus yields deeper insight into psychopathology, captures temporal variability, identifies determinants of symptom fluctuation, and informs both research and clinical practice, including ecological momentary interventions. The authors outline the technical aspects of ESM studies, covering design, questionnaire development, and statistical analysis. Despite remaining challenges, ESM is presented as one of the most promising approaches for personalized psychiatric medicine in both research and clinical settings.

Abstract

In the mental health field, there is a growing awareness that the study of psychiatric symptoms in the context of everyday life, using experience sampling methodology (ESM), may provide a powerful and necessary addition to more conventional research approaches. ESM, a structured self-report diary technique, allows the investigation of experiences within, and in interaction with, the real-world context. This paper provides an overview of how zooming in on the micro-level of experience and behaviour using ESM adds new insights and additional perspectives to standard approaches. More specifically, it discusses how ESM: a) contributes to a deeper understanding of psychopathological phenomena, b) allows to capture variability over time, c) aids in identifying internal and situational determinants of variability in symptomatology, and d) enables a thorough investigation of the interaction between the person and his/her environment and of real-life social interactions. Next to improving assessment of psychopathology and its underlying mechanisms, ESM contributes to advancing and changing clinical practice by allowing a more fine-grained evaluation of treatment effects as well as by providing the opportunity for extending treatment beyond the clinical setting into real life with the development of ecological momentary interventions. Furthermore, this paper provides an overview of the technical details of setting up an ESM study in terms of design, questionnaire development and statistical approaches. Overall, although a number of considerations and challenges remain, ESM offers one of the best opportunities for personalized medicine in psychiatry, from both a research and a clinical perspective.