(PS5-B47) Acceptability and Feasibility of Ecological Momentary Assessment and Wearable Assessment During 6-months of Dialectical Behavior Therapy

Dialectical Behavior Therapy (DBT) is an empirically supported treatment for borderline p</span>ersonality disorder and complex, difficult-to-treat problems related to difficulties with emotion regulation. DBT consists of multiple components, including weekly individual therapy, group skills training, and phone coaching. DBT has been shown to reduce the frequency and severity of self-injurious behaviors, inpatient hospitalizations, suicidal ideation, and substance abuse. There is empirical data supporting the role of various mechanisms and procedures of change in DBT (e.g., changes in emotion regulation, skills use, decreased inpatient hospitalizations). However, the majority of research evaluating mechanisms and procedures of change has used infrequent assessments (e.g., pretreatment, mid-treatment). Assessments tend occurs outside of the individual’s natural context, impacting reliability and ecological validity. This is particularly limiting given evidence that urges for maladaptive behaviors (e.g., urges to harm self) and affective states are highly variable over short periods of time. As such, little is known about the nuances in the changes of these variables, their relationship with momentary urges for maladaptive behaviors, various affective states, and biological vulnerabilities (e.g., sleep quality). What is needed is evaluation of real-time changes in client outcomes and putative variables across the duration of treatment, and that occurs in the natural contexts in which clients live. 

The current study reports on the acceptability and feasibility of implementing an EMA and wearable sensor protocol one week per month over 6-months of comprehensive DBT, as well as the last week of treatment (i.e., 7-weeks). This research is significant because it has the potential to (1) advance the understanding of underlying mechanisms driving treatment outcomes; (2) isolate the effects of particular components and strategies employed in DBT on various outcomes (e.g., suicide), (3) advance our knowledge of how DBT operates in everyday life to reduce day-to-day emotion dysregulation and related target behaviors (e.g., suicidal behavior). 

Data collection is underway and is anticipated to finish in September, however preliminary data suggests high feasibility. Of the participants who have completed the study so far, the overall compliance rate is quite high given the length of the study: to date, p</span>articipants completed 71.49% of all surveys and answered at least one survey on an average of 43.08 days each (SD = 8.87 days).  Wearable sensors compliance is also quite high, with participants wearing the device on average 40.45 days each (out of 49 possible days) an average of 8.92 hours/day (SD = 4.16). This study is an important step in evaluating the inclusion of real-time momentary data in ongoing treatment research.