Every industry benefits from the rapid technological growth of the 21st century but research software is often overlooked. Experience Sampling Methodology (ESM) or Ecological Momentary Assessment (EMA) is a great example of harnessing the power of new technologies to gather real-time data that was previously unavailable. With the advent of smart devices, researchers can better understand participants outside of a clinical setting using an ESM and EMA app!
Expiwell is proud to announce our annual Dissertation Award winners. After hours of combing through many amazing applications, we were unfortunately only able to choose two individuals. A hearty Congratulations to Ms. Bridgette Do and Ms. Kathryn Kemp on being this year's winners. They were chosen for their stellar research record, making an impact on their respective fields, and advancing the use of ESM and EMA. These two shining stars are at the frontier of ESM and EMA! We are excited to share their story.
Bridgette Do (she/her) is PhD candidate in Preventive Medicine (Health Behavior Research) in the Department of Population and Public Health Sciences at the University of Southern California (USC). She grew up in San Diego, California and moved to Los Angeles to attend college at USC. Prior to starting the doctoral program, she also earned her Master of Public Health. Outside of the doctoral program, she is the Vice President of Programming for USC’s Graduate Student Government at USC and the Vice Chair of Programming for the Physical Activity Section of the American Public Health Association. Last year, Bridgette received a Research Diversity Supplement from National Heart, Lung, and Blood Institute of the National Institutes of Health to conduct her dissertation research.
Kathryn (Katie) Kemp is a fifth-year doctoral candidate in the Clinical-Community Psychology program at the University of Illinois at Urbana-Champaign. Her research focuses on using different methodological tools to examine the expression and construct validity of multidimensional schizotypy. Prior to graduate school, she received a B.A. in Psychology from the University of Michigan. She then worked as a post-baccalaureate lab manager in the Schizophrenia and Social Cognition Lab at the University of Texas at Dallas, where she had the opportunity to administer semi-structured interviews and behavioral and neuroimaging tasks with a diverse population of individuals with schizophrenia and schizoaffective disorder. This work was integral to developing her interests in diagnostic assessment and understanding the heterogeneous expression and development of schizophrenia-spectrum disorders.
Read through this brief interview and find out how using real-time data collection tools have enabled these young stars
Ms. Do: I am broadly interested in public health research, chronic disease prevention, health behavior change, and digital health. My current research uses real-time data capture methodologies, such as ecological momentary assessment (EMA), on smartphones and smartwatches to elucidate psychological and social correlates of physical activity, sedentary time, and dietary behaviors. My current dissertation work leverages smartphone and smartwatch technology to examine the associations of affective variability (e.g., moment-to-moment fluctuations in affective states) with physical activity and sedentary time in daily life among young adults.
Ms. Kemp: Using different methods (questionnaires, semi-structured interviews, and experience sampling methodology), my program of research aims to identify and examine individuals with schizotypic traits and to examine the construct validity of a multidimensional model of schizotypy. Schizotypy encompasses a broad continuum of clinical and subclinical experiences that convey risk for schizophrenia, and provides a useful framework for investigating the etiology, development, and expression of schizophrenia-spectrum psychopathology. Furthermore, schizotypy is heterogeneous, which can be captured in a multidimensional structure composed of positive (psychotic-like), negative (deficit), and disorganized dimensions that range in severity. Much of my work has examined the extent to which these three dimensions share overlapping and distinct expressions of affect, personality, symptoms, and impairment that suggest differential etiological pathways to clinical disorders. Recently, I have expanded my research focus from examining mean-level associations to also examining the temporal dynamics of experiences relevant to multidimensional schizotypy, such as emotional expression and psychotic-like experiences in daily life.
Ms. Do: I was initially drawn to public health research because of the broad, holistic approach to health that looks beyond individual characteristics and considers the entire context of one’s life. I think it is important to consider the multiple factors that may affect one’s health—individual, interpersonal, environmental, societal—and how these may interact with one another. I was also interested in public health’s emphasis on prevention and its consideration of health behaviors such as physical activity. While previous research has heavily focused on cognitive factors associated with health behaviors, other explanatory factors may contribute to why a person may decide or not decide to engage in a particular activity such as physical exercise. The growing literature on the role of affective mechanisms associated with physical activity intrigued me, especially as a person who has realized that my own exercise decisions are largely based on my “mood” or how I am currently feeling!
I would say that ESM/EMA and the use of technology has been the most exciting part of my research experience thus far and is what I am most interested in right now. The ability to use technology in public health research provides numerous benefits to both researchers and participants, and I think it has the ability to both accelerate health research and develop effective health behavior change interventions.
Ms. Kemp: As a post-bac RA, interviewing people with schizophrenia about their experiences with the disorder was foundational to the initial questions I found myself asking. Why is each patient’s experience so different? How do depression and anxiety interact with the development and expression of psychotic symptoms? What factors influence the trajectory of these debilitating disorders? In seeking the answers to these questions, I developed an interest in examining the broad continuum of schizophrenic expression, including subclinical experiences that are not accounted for in our current diagnostic system. I found that the model of multidimensional schizotypy provided a promising framework for exploring these questions, given that it offered the opportunity to identify at-risk individuals prior to transition to psychosis. Early identification could then inform the development of prophylactic measures. Beyond the use of questionnaire and interview methods, digital phenotyping through methods such as ESM can potentially identify whether particular patterns in daily experiences precede the development of psychosis.
Ms. Do: ESM/EMA is the best approach for my work because it provides two main benefits. First, ESM/EMA maximizes ecological validity by collecting data in real-world environments as participants go about their lives. Compared to laboratory environments—which may not portray the true context of a participant’s typical life—gathering information on feeling states and experiences in naturalistic settings can yield data that is more generalizable to real-world settings. By collecting data that is more generalizable to real-world settings, we can better understand how particular behaviors unfold in everyday life and the various antecedents and consequences of states and behaviors. Second, given that ESM/EMA typically requires participants to complete multiple assessments over time—typically several times per day—the data are well-suited to address research questions about within-person variation in states and behaviors. This can provide a nuanced picture of how states, behaviors, and experiences unfold over time or vary across time and contexts. Given that an individuals’ affect can fluctuate through the day, ESM/EMA is an optimal approach to assess affective variability in individual’s natural environment.
Ms. Kemp: My current work involves examining the “temporal architecture” of experiences that are relevant to schizotypic expression, such as emotional experiences, psychotic-like experiences, functional deficits, and disorganization of thought and behavior. In other words, I am interested in not only understanding who has these experiences, but also when, under what circumstances, and over what time course. The “one-snapshot” methods of traditional laboratory studies do not provide information about the dynamics of an individual’s daily experiences, and may be biased by retrospective reporting. ESM, on the other hand, provides an appropriate method for examining the temporal dependency of experiences in daily life. Because participants’ daily experiences in their real-world environments are repeatedly assessed, ESM allows for the examination of the effects of context on one’s self-report, as well as how self-reported experiences at one timepoint influence subsequent experiences. For example, we can examine whether people high in positive, negative, or disorganized schizotypy traits experience increases in negative emotionality or psychotic-like experiences following increases in stress. We can also examine the extent to which these experiences fluctuate or persist over time.
Ms. Do: Even though technology is widely used in our everyday lives, I am surprised at the disconnect between the rapidly developing consumer technology and implementation into health research. While the use of technology and ESM/EMA has substantially increased over the past few years, it still feels relatively novel to be used in health or psychological research. I hope that ESM/EMA can become more accessible to researchers and research participants, which may lead to answering unique research questions that previously could not be answered through traditional research methods.
Ms. Kemp: Perhaps the most surprising aspect of this research is that college students identified by our measures of multidimensional schizotypy readily report having schizophrenia-like experiences in daily life. These are experiences that are often only attributed to people with severe clinical disorders, but our research has repeatedly shown that high-functioning individuals show similar (albeit milder) patterns of symptoms and impairment and that these experiences can be captured across different timescales. Another aspect that has been surprising is how good participants are at actually completing the daily surveys. ESM data collection is fairly intensive, as we typically signal participants to complete ESM surveys eight times daily for one week. I’ve had the opportunity to administer four different ESM studies during graduate school using these procedures, and we consistently have at least a 70% compliance rate on average!
Ms. Do: From this research, I hope to see the development of efficacious health behavior change interventions and programming. I think that collecting ecological valid data can build a strong foundation for effective interventions or programs that ultimately will be incorporated into someone’s everyday life. In example, understanding how one’s affective states are associated with their physical activity could lead to just-in-time adaptive interventions on smartphones and smartwatches to help individuals cope with fluctuations in affect. With the widespread use of smartphone applications, digital platforms, and wearables, I hope that ESM/EMA can be incorporated into not only academic research but also within industry. I hope that the scientific community can continue to build trust and make research more accessible to communities that have been largely underrepresented in health research.
Ms. Kemp: I would like to see more researchers and clinicians become aware of the utility of psychometric high-risk approaches, especially in non-clinically ascertained samples. Increased use of these approaches can provide an inexpensive and non-invasive method for identifying at-risk individuals, and studies have repeatedly shown that these measures robustly identify individuals with schizophrenia-like experiences and disorders. Ideally, a combination of these measures with daily-life assessments can provide additional context for risk profiles for psychosis and thereby identify potential points of entry for prophylactic intervention.
Ms. Do: I am looking forward to working on my three dissertation studies (we are finishing up data collection right now!) One of the studies will examine whether the subject-level association between momentary affect and subsequent physical activity predicts future physical activity. Understanding how the association between momentary affect and subsequent physical activity (e.g., physical activity occurring 15 minutes after an EMA prompt assessing affect) predicts future physical activity (e.g., 1 week, 4 weeks, 12 weeks later) can help elucidate whether these momentary associations contribute to future activity levels. In addition, do these momentary associations affect future activity differently from person-to-person? Are they different based on what stage of behavior change they are in (e.g., adoption vs. maintenance of physical activity)?
Ms. Kemp: I continue to be interested in etiological factors that interact with schizophrenia-spectrum traits to produce risk or resilience to disorders. In particular, one question I am investigating in my dissertation is “do particular temporal patterns convey greater risk for disorders?” One specific area of examination, for example, involves establishing the temporal precedence of schizotypic experiences and dysregulated stress responses in daily life – in other words, to what extent are schizotypic experiences antecedents and/or outcomes of stress? For example, our recent work has found that disorganization of thought and behavior is associated with negative emotionality, depression, and anxiety. Do negative emotional experiences result in the development of disorganization, or does the experience of disorganization result in increased negative emotionality and appraisals of stress? Examining the relationship of these experiences is essential for understanding the nature of symptom development and exacerbation.
Ms. Do: The best piece of advice I have received is to really lean into the resources and support networks around you. I feel extremely fortunate to be a part of a research team made up of researchers and professionals at all career levels and in different areas of health research. Being able to collaborate on different projects has been an invaluable learning experience for me. Throughout my research career and doctoral program, it has been very helpful to ask questions, work alongside fellow doctoral students, and receive advice from those who have been through a PhD program. Do not be afraid to ask for help and learn from those around you!
Ms. Kemp: The best advice I received was to select training programs based on the people, not the institution. More specifically, finding an attentive research advisor whose style matches your training needs can make all the difference. Seek to work with someone who is not only productive, but who also clearly demonstrates a value for mentorship. Some ways to determine this are to ask how many students a PI mentors at once, to ask how frequently they meet with mentees, and to ask what past mentees have gone on to do following their work together. I am so grateful that I followed this advice when searching for a program because I can honestly say that the mentor-mentee relationship has been essential to my success in graduate school. It has been a major factor in making the rollercoaster that is graduate school not only manageable, but even enjoyable!
Thank you to all that applied, we enjoyed seeing all of the innovative ways you are pushing the envelope! Looking forward to what you all accomplish and use in next year's application
If these excellent researchers have inspired you to use ESM/EMA please feel free to share your story with us!
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