Studying personality pathology with ecological momentary assessment: Harmonizing theory and method.

Over the past 20 years, ecological momentary assessment (EMA) has become a vital part of the methods repertoire used to study personality pathology. This is because EMA facilitates modeling (dys)function consistent with clinical theory as an ensemble of contextualized dynamic within-person processes, such as when and how relevant socio-affective responses may become disrupted in daily life. Despite its popularity, there is little systematic work on the conceptual adequacy and cross-study consistency in the design choices and reporting standards of EMA studies on personality disorders. EMA protocol design choices impact the reliability and validity of conclusions, and variability in choices affect replicability and thus credibility of the conclusions drawn. We provide an overview of the core decisions researchers face in designing an EMA study organized around the "three Ds": density (frequency of surveys), depth (length of surveys), and duration (number of days in a protocol). To identify the typical and range of used study designs, including what personality disorder researchers view as important and where there are gaps in our knowledge, we reviewed relevant studies published over the years 2000 to 2021. Of 66 identified unique EMA protocols, studies scheduled ~6.5 assessments per day with an average of ~21 items, lasted for ~13 days, and obtained a compliance of ~75%. Generally, denser studies had less depth and shorter duration, whereas protocols with longer duration tended to be deeper. We offer recommendations on how valid research on personality disorders can be organized around these considerations with the goal of reliably uncovering temporal dynamics in personality (dys)functioning. (PsycInfo Database Record (c) 2023 APA, all rights reserved).