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Clinical benefits and challenges of ecological momentary assessment in individuals who self-injure and seek mental health treatment
Bonnier,Rafaël A. Beames,Joanne R. Claes,Laurence Kirtley,Olivia J. de Thurah,Lena Weermeijer,Jeroen D.M. Uyttebroek,Lotte Luijsmans,Mirthe Myin-Germys,Inez Kiekens,Glenn
Bonnier,Rafaël A.
Beames,Joanne R.
Claes,Laurence
Kirtley,Olivia J.
de Thurah,Lena
Weermeijer,Jeroen D.M.
Uyttebroek,Lotte
Luijsmans,Mirthe
Myin-Germys,Inez
Kiekens,Glenn
Abstract
Introduction Non-suicidal Self-Injury (NSSI) is a prevalent transdiagnostic behavior. The use of Ecological Momentary Assessment (EMA) shows clinical potential, but the potential utility for individuals who self-injure remains unclear. This prospective study evaluates self-reported benefits (e.g., self-insight and self-efficacy) and challenges (e.g., beep disturbances and emotional discomfort) associated with using EMA among treatment-seeking individuals with past-month NSSI. Methods In this cohort study, 124 treatment-seeking adolescents and adults who self-injure completed a 28-day EMA protocol with six daily assessments of emotions, cognitions, and behaviors (including self-injury). After one month, participants completed an EMA feedback survey. Results A total of 98 patients completed the feedback survey (Response Rate = 79.03%). Average EMA compliance was 74.87% (SD = 18.78) and decreased linearly across time. Four in five patients (78.57%) reported experiencing at least one benefit. After using EMA, 32.65% reported increased general self-insight, 64.58% reported increased NSSI-specific self-insight, 9.28% reported increased general self-efficacy, and 41.67% reported improved self-efficacy to resist NSSI. Across the sample, 7.29% experienced EMA in treatment as tiring, stressful, at times overwhelming, and not enjoyable. Higher levels of emotional discomfort were significantly associated with lower compliance (r=-0.29, p=.004), higher beep disturbance (r=.37, p < .001), and lower general selfinsight (r=-0.28, p=.006). When participants felt more overwhelmed by their emotions than usual, they also reported higher beep disturbance within the same and the next assessment. Conclusion Although the use of EMA in treatment may evoke emotional discomfort in patients, it may help promote NSSI-specific self-insight and self-efficacy outside the therapy room in patients who self-injure.
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Date
2025
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Keywords
Ecological momentary assessment, Experience sampling method, Non-suicidal self-injury, Mental health treatment, Clinical psychology
Citation
Bonnier, R A, Beames, J R, Claes, L, Kirtley, O J, de Thurah, L, Weermeijer, J D M, Uyttebroek, L, Luijsmans, M, Myin-Germys, I & Kiekens, G 2025, 'Clinical benefits and challenges of ecological momentary assessment in individuals who self-injure and seek mental health treatment', International Journal of Clinical and Health Psychology, vol. 25, no. 3, 100618. https://doi.org/10.1016/j.ijchp.2025.100618