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Research Methods and Statistics

Understanding the Influences of Completion Compliance in Ecological Momentary Research within Borderline Personality Disorder Populations

(PS10-85) Understanding the Influences of Completion Compliance in Ecological Momentary Research Within Borderline Personality Disorder Populations

Saturday, November 16, 2024
1:00 PM – 2:00 PM EST
Location: Franklin Hall, Level 4, Marriott Downtown
Abstract Text: Introduction: Ecological momentary assessment (EMA) uses intensive repeated measurement to capture real-time information about participants in their natural environment. Borderline personality disorder (BPD) is characterized by frequent changes in affect, behavior, identity, and interpersonal relationships. EMA has played a vital role in studying BPD symptomology, given that many symptoms (e.g., mood lability and impulsive behaviors) fluctuate quickly on a momentary basis. However, a significant challenge to utilizing EMA is low or variable rates of participants' completion compliance. Low compliance occurs when participants answer less than 50% of prompts sent to them during study participation. Compliance issues are particularly relevant to BPD research, as the core elements of BPD, such as high emotion dysregulation, unstable interpersonal relationships, and impulsive behaviors, can interfere with the timely and consistent completion of study measures. Previous studies support that EMA compliance is influenced by individual participant factors and study design (i.e., assessment length and time of prompt). Indeed, the severity of BPD itself and the labile, dysregulated emotion associated with it may interfere with EMA compliance, posing validity concerns to the use of EMA in BPD research. However, it is unclear what factors influence EMA compliance in people with BPD. Therefore, the current study aims to examine which individual (BPD severity, emotion dysregulation) and design (time of prompt) factors predict EMA compliance rates in participants with BPD. We hypothesize that higher BPD severity and emotion dysregulation will predict lower EMA compliance. We also hypothesize that EMA prompts sent during the morning will predict lower compliance compared to EMA prompts sent during the evening. Methods: This study was conducted using data from 15 people with BPD who took part in a feasibility trial for a couple's intervention where one partner met DSM-5 criteria for BPD and engaged in or communicated about self-injury directly or indirectly with their romantic partner. Participants completed a battery of reliable and valid assessments of BPD severity and emotion dysregulation. Participants completed EMA three times a day (scheduled randomly) for seven days. Generalized estimating equations will be conducted with compliance (i.e., answering an EMA prompt versus not) as the outcome and time of day the prompt was sent, BPD severity, and emotion dysregulation as predictors. Data has been collected, analyses are underway, and results will be presented at the convention.

Conclusion: The results of this study will inform future research designs utilizing EMA by identifying clinical characteristics that may signal a need for extra support to increase EMA compliance in BPD research and which design elements may help maximize such compliance. Overall, results will promote community engagement in BPD interventions by fostering an understanding of the factors that help participants engage (versus disengage) in research.