Josefien Breedvelt

Many common mental health disorders are characterised by changes in day-to-day mood. To track people’s mood in real time, researchers often use a method called 'ecological momentary assessment' (EMA). This involves repeatedly collecting real-time data, typically via mobile phones, on a person’s behaviour, thoughts, and emotions as they occur in everyday life.

In recent years, EMA has grown in popularity both in research, to understand mood dynamics in mental health conditions, and in clinical settings such as the NHS, to help inform treatment and prevention. However, we don’t yet know how repeatedly asking individuals to report on their emotions impacts the emotions themselves, or mental health more broadly.

The REACT study will evaluate how ecological momentary assessment impacts mental health. We will randomise nearly 300 participants into different groups with different types of monitoring. One group will be asked to take part in a typical EMA schedule, answering questions about their mood twice a day for two weeks. Another group will be asked to answer questions on the same schedule, but about their immediate environment rather than their mood. A third group will only complete outcome measures at the start and end of the study period and will not be asked to complete daily surveys.

Our outcomes will be:

• Mental health symptoms, including anxiety and depression

• Daily life functioning

• Mood

By comparing these outcomes across the different groups, we will assess whether those completing twice-daily mood assessments, versus twice-daily environment surveys or no EMA, report better, worse, or similar levels of mood and mental health symptoms at the end of the two-week period.

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This work is important because it will help inform future research using EMA, as well as clinicians who may want to use EMA in their practice. If EMA is found to have no negative impact, researchers and clinicians can use it more confidently in future research and digital mental health tools. If it is found to affect mood or mental health, this can help guide how EMA is designed and used going forward. Despite being an important question, limited research has covered this area so far, and we are very grateful to the PRT for their support in funding this work.

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