MindLogger currently administers assessments in our NIMH-EMA applet as part of the Healthy Brain Network study to a vulnerable transdiagnostic New York City community sample (current n=4,315; enrollment rate: 90 per month; >90% have mental health or learning disorders). Study participants receive multiple notifications per day on their Android or iOS device to respond to morning, afternoon, and evening assessments. The above figure shows screenshots of the NIMH-EMA applet. We are currently enrolling children and adolescents who are at least 11 years old to use the NIMH-EMA applet as part of the Healthy Brain Network study.

The Child Mind Institute’s Healthy Brain Network study is an ongoing initiative focused on creating and sharing a biobank of data from 10,000 New York area participants (ages 5-21). The Biobank houses data about psychiatric, behavioral, cognitive, and lifestyle phenotypes, as well as multimodal brain imaging (resting and naturalistic viewing functional MRI, diffusion MRI, morphometric MRI), electroencephalography, eye tracking, voice and video recording, genetics, and actigraphy. In order to obtain more in-depth information on real-time tracking of emotions, behavior, daily activities, and their contextual influences, we have adapted the the combined actigraphy and EMA mobile assessment tools and content from the National Institute of Mental Health (NIMH) Family Study of Affective Spectrum Disorders, a large community-based controlled family study. The original EMA collected data four times per day for two weeks from phones provided to study participants (the Tungsten E2 model of a Palm mobile device and more recently from Android mobile phones). See below for an excerpt from a description of its content:

“The EMA assessments included questions concerning a diversity of daily life experiences and behaviors, including data assessed at the moment of the EMA signal (current location, social company, performance of specific behaviors, mood states) and data assessed over the time period between the current and previous assessment or, for the first assessment of the morning, since awakening (experience of daily events and event negativity, food intake, substance use, experience of headache and its specific symptoms). Additional questions were asked at the first EMA assessment of the day concerning sleep duration, quality and sleep problems, and at the end of the day concerning global ratings of the stressfulness of the day, food craving for the day and specific physical symptoms (gastrointestinal symptoms, muscle pain). The response possibilities included Likert scales for dimensional constructs (such as mood or event negativity) and checklists that allowed for either multiple responses (such as for noting all food types consumed since the last assessment) or single responses (such as current physical location). …For daily events, participants were asked at each assessment to identify the one event or experience, good or bad, that had affected them the most since the last questionnaire, and to rate the impact the event had on them on a 7-point Likert scale…”

The EMA data from the NIMH Family Study that evaluated the association between daily events and emotional experience yielded important differences in patterns of reactivity among the major subtypes of mood disorders, including bipolar I disorder, bipolar II disorder, major depression, anxiety disorders without a mood disorder, and controls. These findings demonstrated how EMA is a particularly well-adapted tool for assessing affective dynamics as well as emotional reactivity following daily life events. The value of combined passive and active monitoring in this study further showed bidirectional associations between energy, motor activity, and sleep, and unidirectional associations between activity and mood, suggesting that increased activity could be used as an intervention for depression. Using the novel analytic approach of fragmentation for testing the stability and instability of emotional states in this study showed greater instability of energy and attention in people with a history of bipolar I disorder, whereas those with bipolar II disorder or major depression exhibited greater fragmentation of mood and anxiety. Although these findings were primarily based on adult samples, the inclusion of a substantial subset of offspring ages 10-18 of parents with mood disorders and controls provided compelling evidence for the feasibility, acceptability, and clinical significance of EMA in youth. Therefore, the goal of creating the NIMH-EMA MindLogger applet was to create a version with updated content (particularly with regard to sleep, positive/negative thoughts, food/drink, internet, and social media questions), enhanced with clarification of the content, inclusion of colorful images, and formats adapted for children and young adults to encourage engagement.

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