Ambulatory Assessment in Behavioral Science

by

Ulrich Ebner-Priemer, Timothy Trull

• LAST REVIEWED: 12 January 2023
• LAST MODIFIED: 12 January 2023
• DOI: 10.1093/obo/9780199828340-0302

Introduction

To describe the diverse methodologies for researching daily life a variety of terms have been coined: ecological momentary assessment (EMA), ambulatory assessment, experience sampling method (ESM), real-time data capture, or digital phenotyping, just to name a few. In line with the definition of the international society devoted to researching daily life Society for Ambulatory Assessment (SAA), these various terms serve to highlight the different origins and ancestors. Researchers in the Netherlands, Germany, and the United States started developing cutting-edge methods to assess dynamics of behavior and experience in everyday life in the 1970s and 1980s. Although the diverse backgrounds can be clearly differentiated, with Ambulatory Assessment having a focus on combining e-diaries with physiological and behavioral monitoring—ESM, by using paper-pencil diaries and pagers, and EMA, by utilizing e-diaries early on—these research groups coined their terms to describe a broad set of tools to assess affective experiences, cognition, behavior, and physiological processes in daily life. Accordingly, the Society for Ambulatory Assessment introduced “ambulatory assessment” as the umbrella term, covering a range of real-time data capture methodologies that originate from different scientific disciplines (psychology, medicine, computer science, etc.), and it focuses on the common goal, namely, to assess the ongoing behavior, physiology, experience, and environmental aspects of people in naturalistic settings. Distinct features of ambulatory assessment, which differentiates it from traditional assessment approaches like retrospective questionnaires or laboratory-based techniques, include: (1) assessment of data in the real world, increasing the ecological validity and generalizability of the method, (2) focus on individuals’ momentary or very recent states to minimize retrospective biases, (3) ability to study within-subject processes and dynamics, (4) possibility for multimodal and context-specific assessments, and (5) use of real-time analyses to trigger situational assessments and interventions.

Definition and History

Ambulatory assessment, as an umbrella term, covers a variety of methods, including ecological momentary assessment (EMA), which was coined in Stone and Shiffman 1994, ambulatory monitoring, which was coined in Fahrenberg, et al. 2007, and experience sampling method (ESM), which originates from Csikszentmihalyi and Larson 1987. All these methods were developed nearly contemporaneously in Germany, the Netherlands, and the United States in the 1970s and 1980s. The term digital phenotyping was coined more recently in Insel 2018.

• Csikszentmihalyi, M., and R. Larson. 1987. Validity and reliability of the experience-sampling method. Journal of Nervous and Mental Disease 175.9: 526–536.

  DOI: 10.1097/00005053-198709000-00004

  One of the first papers describing experience-sampling methodology, including psychometric issues like validity and reliability.

• Fahrenberg, J., M. Myrtek, K. Pawlik, and M. Perrez. 2007. Ambulatory assessment-monitoring behavior in daily life settings. European Journal of Psychological Assessment 23.4: 206–213.

  DOI: 10.1027/1015-5759.23.4.206

  A paper describing ambulatory assessment by several research groups that started developing ambulatory assessment in the 1980s and 1990s in Germany.

• Insel, T. R. 2018. Digital phenotyping: A global tool for psychiatry. World Psychiatry 17.3: 276–277.

  DOI: 10.1002/wps.20550

  A classic paper describing the term digital phenotyping and highlighting its potential for psychiatry. Insel speculates that, in hindsight, digital phenotyping might be recognized as more important than neuroscience and genetics for treatment of mental disorders.

• Stone, A. A., and S. Shiffman. 1994. Ecological momentary assessment (EMA) in behavorial medicine. Annals of Behavioral Medicine 16.3: 199–202.

  DOI: 10.1093/abm/16.3.199

  A paper describing ambulatory assessment from the EMA perspective.

• Wilhelm, P., M. Perrez, and K. Pawlik. 2011. Conducting research in daily life: A historical overview. In Handbook of research methods for studying daily life. Edited by M. R. Mehl and T. S. Conner, 62–86. New York: Guilford.

  Review paper on the historical development of those everyday life research methods.