Colourful Nails

Apps for Substance Abuse Research

Substance abuse research and treatment is a growing area of application for ecological momentary assessment (EMA) apps such as mEMA by ilumivu. The nature of the behavior makes substance abuse a prime candidate for being studied in the context of daily life rather than in the lab or through retrospective self-report. EMA (or Experience Sampling Method) offers an avenue for capturing time-varying subjective experiences close to when they happen reducing concerns of response biases and memory distortions.

The ability to capture real-time data on human behavior inexpensively, efficiently, and accurately holds promise to transform and broaden our understanding of many areas of health science. (1)

frequent sampling

Mobile EMA (mEMA) allows researchers to capture much more frequent data points than other methods. Measures are often taken multiple times a day over weeks or months. The high granularity of these data provide the possibility for understanding the dynamic processes present in complex behaviors such as substance abuse rather than relying on a snapshot pre-post assessment model. Thus, intra-individual processes can be investigated in a way not possible with traditional methods. The ability to sample over longer periods of time also makes it more likely that researchers can capture experiences of less frequent events that may otherwise be challenging to study.

Craving, as assessed by EMA, has been found to be highly correlated with substance use (2). Furthermore, behavioral antecedents can be identified (e,g, craving, withdrawal, low affect) and have been found to temporally predict substance use (3) opening the door to just-in-time interventions (4).

Context aware

Like all complex behaviors drug and alcohol use is embedded in an emotional, social and situational context and is thus best understood as part of a wider system. Smartphone apps provide an effective and affordable avenue into understanding behavior as it unfolds in real-life. Clues to environmental contexts can be captured by GPS sensors in the phone (5) which can then later be integrated with other databases containing for instance local weather information. Similarly, the mEMA app can prompt the user to take a photo, video or audio recording of their surroundings to provide enhanced detail on their setting. Physical context can be illuminated by pulling acceleration data from the phone or a connected wearable sensor. The internal physiological context of the user can be gathered from wearable sensors measuring for instance heart rate variability, and galvanic skin response (6). All these data streams are integrated by their timestamps with the self-report data giving us more complete perspective on the participant’s behavior.

Empirical evidence supports the hypothesis that use of EMA can improve the quality of AUD treatment research when compared with standard assessment methods because it provides more accurate reporting, allows investigators to examine the dynamic unfolding of the behavior change process at an individual level, and can be used to augment and improve clinical assessment and treatment (1).

EMA in Substance Abuse research

Mobile EMA methods have been used in studies addressing alcohol use (1), cannabis use (3), smoking (7), marijuana use (8), cocaine (9), heroin use (10) and psychopharmacological treatment studies (11). The mEMA system is agnostic to application areas – you provide the content, we provide the infrastructure to get it to your participants. Learn more about mEMA.

New developments

Our current work at ilumivu involves the implementation of context-aware sampling and interventions. We are triggering mobile EMA surveys not only on GPS location but on biometrics from compatible wearable devices. This provides a very powerful research and intervention tool that we hope will accelerate the development and implementation of behavioral change programs in substance abuse and other areas.

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References
  1. Morgenstern, J., & Muench, F. (2015). Ecological Momentary Assessment and Alcohol Use Disorder Treatment. Alcohol Research: Current Reviews,36(1), 101-109.
  2. Serre, F., Fatseas, M., Swendsen, J., & Auriacombe, M. (2015). Ecological momentary assessment in the investigation of craving and substance use in daily life: A systematic review. Drug and alcohol dependence, 148, 1-20.
  3. Buckner, J. D., Zvolensky, M. J., Crosby, R. D., Wonderlich, S. A., Ecker, A. H., & Richter, A. (2015). Antecedents and consequences of cannabis use among racially diverse cannabis users: An analysis from Ecological Momentary Assessment. Drug and alcohol dependence, 147, 20-25.
  4. Heron, K. E., & Smyth, J. M. (2010). Ecological momentary interventions: incorporating mobile technology into psychosocial and health behaviour treatments. British journal of health psychology, 15(1), 1-39.
  5. Freisthler, B., Lipperman-Kreda, S., Bersamin, M., & Gruenewald, P. J. (2015). Tracking the When, Where, and With Whom of Alcohol Use: Integrating Ecological Momentary Assessment and Geospatial Data to Examine Risk for Alcohol-Related Problems. Alcohol Research: Current Reviews, 36(1), 29-38.
  6. Kennedy, A. P., Epstein, D. H., Jobes, M. L., Agage, D., Tyburski, M., Phillips, K. A., … & Rahman, M. M. (2015). Continuous in-the-field measurement of heart rate: Correlates of drug use, craving, stress, and mood in polydrug users. Drug and alcohol dependence, 151, 159-166.
  7. Schüz, N., Cianchi, J., Shiffman, S., & Ferguson, S. G. (2015). Novel Technologies to Study Smoking Behavior: Current Developments in Ecological Momentary Assessment. Current Addiction Reports, 2(1), 8-14.
  8. Buckner, J. D., Crosby, R. D., Silgado, J., Wonderlich, S. A., & Schmidt, N. B. (2012). Immediate antecedents of marijuana use: An analysis from ecological momentary assessment. Journal of behavior therapy and experimental psychiatry, 43(1), 647-655.
  9. Epstein, D. H., & Preston, K. L. (2010). Daily life hour by hour, with and without cocaine: an ecological momentary assessment study.Psychopharmacology, 211(2), 223-232.
  10. Epstein, D. H., Willner-Reid, J., Vahabzadeh, M., Mezghanni, M., Lin, J. L., & Preston, K. L. (2009). Real-time electronic diary reports of cue exposure and mood in the hours before cocaine and heroin craving and use. Archives of general psychiatry, 66(1), 88-94.
  11. Bos, F. M., Schoevers, R. A., & aan het Rot, M. (2015). Experience sampling and ecological momentary assessment studies in psychopharmacology: A systematic review. European Neuropsychopharmacology, 25(11), 1853-1864.