Skip to main content
SpringerLink
Log in

The Expression of Posttraumatic Stress Symptoms in Daily Life: A Review of Experience Sampling Methodology and Daily Diary Studies

  • Published:
Journal of Psychopathology and Behavioral Assessment Aims and scope Submit manuscript

Abstract

This review examined the assessment of posttraumatic stress symptoms (PTSS) in daily life using experience sampling methodology (ESM)/ecological momentary assessment (EMA) and daily diary studies in adult samples. Fifteen peer-reviewed studies were identified and categorized into areas of total PTSD/multiple PTSS (studies including three or more symptom clusters), intrusive memories, and mood and anxiety symptoms. Overall, ESM and the daily diary method proved feasible for assessing the real-world expression of PTSS, resulted in minimal reactivity, and offered a number of advantages over classical assessment. Even within the two measurement types of ESM and daily diary, there was great variability in study design and analysis. The benefits and limitations of the different approaches are discussed. Different themes in content emerged as well, such as coping strategies and affective instability throughout the course of a day. Gaps in our current understanding are highlighted and suggestions for methodology and future areas of research are proposed.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Notes

  1. Both databases were searched for all terms and results were examined for suitability for the current review, with the exception of trauma* + daily life, which yielded over 400 results in PubMed, mostly relating to medical injury.

References

  • aan het Rot, M., Hogenelst, K., & Schoevers, R. A. (2012). Mood disorders in everyday life: a systematic review of experience sampling and ecological momentary assessment studies. Clinical Psychology Review, 32, 510–523. doi:10.1016/j.cpr.2012.05.007.

    Article  Google Scholar 

  • Alpers, G. W. (2009). Ambulatory assessment in panic disorder and specific phobia. Psychological Assessment, 21, 476–485. doi:10.1037/a0017489.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC.

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC.

  • American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed., ). DC: Washington.

    Google Scholar 

  • Barker, C., Pistrang, N., Elliott, R., & Barker, C. (2002). Research methods in clinical psychology: An introduction for students and practitioners. (pp. 94–118). Hoboken, N.J: J. Wiley.

  • Barrantes-Vidal, N., Chun, C. A., Myin-Germeys, I., & Kwapil, T. R. (2013). Psychometric schizotypy predicts psychotic-like, paranoid, and negative symptoms in daily life. Journal of Abnormal Psychology, 122, 1077–1087. doi:10.1037/a0034793.

    Article  PubMed  Google Scholar 

  • Beckham, J. C., Calhoun, P. S., Dennis, M. F., Wilson, S. M., & Dedert, E. A. (2013). Predictors of lapse in first week of smoking abstinence in PTSD and non-PTSD smokers. Nicotine & Tobacco Research, 15, 1122–1129.

    Article  Google Scholar 

  • Beckham, J. C., Wiley, M. T., Miller, S. C., Dennis, M. F., Wilson, S. M., McClernon, F. J., et al. (2008). Ad lib smoking in post-traumatic stress disorder: an electronic diary study. Nicotine & Tobacco Research, 10, 1149–1157.

    Article  Google Scholar 

  • Ben-Zeev, D. P. D., Young, M. A., & Madsen, J. W. (2009). Retrospective recall of affect in clinically depressed individuals and controls. Cognition & Emotion, 23, 1021–1040.

    Article  Google Scholar 

  • Blake, D. D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Klauminzer, G., Charney, D. S., & Keane, T. M. (1990). A clinician rating scale for assessing current and lifetime PTSD: the CAPS-1. Behavior Therapy, 13, 187–188.

    Google Scholar 

  • Bunce, S. C., Larsen, R. J., & Peterson, C. (1995). Life after trauma: personality and daily life experiences of traumatized people. Journal of Personality, 63, 165–188.

    Article  PubMed  Google Scholar 

  • Dedert, E. A., Calhoun, P. S., Watkins, L. L., Sherwood, A., & Beckham, J. C. (2010). Posttraumatic stress disorder, cardiovascular, and metabolic disease: a review of the evidence. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 39, 61–78. doi:10.1007/s12160-010-9165-9.

    Article  Google Scholar 

  • Dedert, E. A., Dennis, P. A., Swinkels, C. M., Calhoun, P. S., Dennis, M. F., & Beckham, J. C. (2014). Ecological momentary assessment of posttraumatic stress disorder symptoms during a smoking quit attempt. Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco, 16, 430–436.

    Article  Google Scholar 

  • Ebner-Priemer, U. W., Eid, M., Kleindienst, N., Stabenow, S., & Trull, T. J. (2009). Analytic strategies for understanding affective (In)stability and other dynamic processes in psychopathology. Journal of Abnormal Psychology, 118, 195–202.

    Article  PubMed  Google Scholar 

  • Ebner-Priemer, U. W., & Trull, T. J. (2009). Ecological momentary assessment of mood disorders and mood dysregulation. Psychological Assessment, 21, 463–475.

    Article  PubMed  Google Scholar 

  • Geiser, C., Bishop, J., Lockhart, G., Shiffman, S., & Grenard, J. L. (2013). Analyzing latent state-trait and multiple-indicator latent growth curve models as multilevel structural equation models. Frontiers in Psychology, 4. doi:10.3389/fpsyg.2013.00975.

  • Gillihan, S. J., Aderka, I. M., Conklin, P. H., Capaldi, S., & Foa, E. B. (2013). The child PTSD symptom scale: psychometric properties in female adolescent sexual assault survivors. Psychological Assessment, 25, 23–31.

    Article  PubMed  Google Scholar 

  • Glaser, J.-P., van Os, J., Portegijs, P. J. M., & Myin-Germeys, I. (2006). Childhood trauma and emotional reactivity to daily life stress in adult frequent attenders of general practitioners. Journal of Psychosomatic Research, 61, 229–236. doi:10.1016/j.jpsychores.2006.04.014.

    Article  PubMed  Google Scholar 

  • Golier, J. A., Yehuda, R., Schmeidler, J., & Siever, L. J. (2001). Variability and severity of depression and anxiety in post traumatic stress disorder and major depressive disorder. Depression and Anxiety, 13, 97–100.

    Article  PubMed  Google Scholar 

  • Hamaker, E. L. (2012). Why researchers should think “within-person”: A paradigmatic rationale. In M. R. Mehl, & T. Conner (Eds.), Handbook of research methods for studying daily life (pp. 43–61). New York: Guilford Press.

    Google Scholar 

  • Hektner, J. M., Schmidt, J. A., & Csikszentmihalyi, M. (2007). Experience sampling method: Measuring the quality of everyday life. Thousand Oaks, CA: Sage Publications.

    Book  Google Scholar 

  • Holmes, E. A., & Bourne, C. (2008). Inducing and modulating intrusive emotional memories: a review of the trauma film paradigm. Acta Psychologica, 127, 553–566. doi:10.1016/j.actpsy.2007.11.002.

    Article  PubMed  Google Scholar 

  • Johnson, D. R., Westermeyer, J., Kattar, K., & Thuras, P. (2002). Daily charting of posttraumatic stress symptoms: A pilot study. Journal of Nervous and Mental Disease, 190, 683–692. doi:10.1097/00005053-200210000-00005.

    Article  PubMed  Google Scholar 

  • Kashdan, T. B., Breen, W. E., & Julian, T. (2010). Everyday strivings in war veterans with posttraumatic stress disorder: suffering from a hyper-focus on avoidance and emotion regulation. Behavior Therapy, 41, 350–363. doi:10.1016/j.beth.2009.09.003.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kashdan, T. B., Julian, T., Merritt, K., & Uswatte, G. (2006). Social anxiety and posttraumatic stress in combat veterans: relations to well-being and character strengths. Behaviour Research and Therapy, 44, 561–583. doi:10.1016/j.brat.2005.03.010.

    Article  PubMed  Google Scholar 

  • Kashdan, T. B., Young, K. C., & McKnight, P. E. (2012). When is rumination an adaptive mood repair strategy? day-to-day rhythms of life in combat veterans with and without posttraumatic stress disorder. Journal of Anxiety Disorders, 26, 762–768. doi:10.1016/j.janxdis.2012.07.004.

    Article  PubMed  Google Scholar 

  • Kleim, B., Graham, B., Bryant, R. A., & Ehlers, A. (2013). Capturing intrusive re-experiencing in trauma survivors' daily lives using ecological momentary assessment. Journal of Abnormal Psychology, 122, 998–1009.

    Article  PubMed  PubMed Central  Google Scholar 

  • Kobayashi, I., Boarts, J. M., & Delahanty, D. L. (2007). Polysomnographically measured sleep abnormalities in PTSD: a meta-analytic review. Psychophysiology, 44, 660–669. doi:10.1111/j.1469-8986.2007.537.x.

    Article  PubMed  Google Scholar 

  • Myin-Germeys, I., van Os, J. J., Schwartz, J. F., Stone, A. A., & Delespaul, P. A. (2001). Emotional reactivity to daily life stress in psychosis. Archives of General Psychiatry, 58, 1137–1144. doi:10.1001/archpsyc.58.12.1137.

    Article  PubMed  Google Scholar 

  • Luke, D. A. (2004). Multilevel modeling. Thousand Oaks, CA: Sage.

    Book  Google Scholar 

  • Naragon-Gainey, K., Simpson, T. L., Moore, S. A., Varra, A. A., & Kaysen, D. L. (2012). The correspondence of daily and retrospective PTSD reports among female victims of sexual assault. Psychological Assessment, 24, 1041–1047.

    Article  PubMed  PubMed Central  Google Scholar 

  • Newton, T., & Ho, I. (2008). Posttraumatic stress symptoms and emotion experience in women: emotion occurrence, intensity, and variability in the natural environment. Journal of Psychological Trauma, 7, 276–297. doi:10.1080/19322880802492237.

    Article  Google Scholar 

  • Nezlek, J. B. (2001). Multilevel random coefficient analyses of event- and interval- contingent data in social and personality psychology research. Personality and Social Psychology Bulletin, 27, 771–785.

    Article  Google Scholar 

  • Oorschot, M., Kwapil, T. R., Delespaul, P. A. E. G., & Myin-Germeys, I. (2009). Momentary assessment research in psychosis. Psychological Assessment, 21, 498–505. doi:10.1037/a0017077.

    Article  PubMed  Google Scholar 

  • Pfaltz, M. C., Michael, T., Meyer, A. H., & Wilhelm, F. H. (2013). Reexperiencing symptoms, dissociation, and avoidance behaviors in daily life of patients with PTSD and patients with panic disorder with agoraphobia. Journal of Traumatic Stress, 26, 443–450. doi:10.1002/jts.21822.

    Article  PubMed  Google Scholar 

  • Pfaltz, M. C., Michael, T., Grossman, P., Margraf, J., & Wilhelm, F. H. (2010). Instability of physical anxiety symptoms in daily life of patients with panic disorder and patients with posttraumatic stress disorder. Journal of Anxiety Disorders, 24, 792–798. doi:10.1016/j.janxdis.2010.06.001.

    Article  PubMed  Google Scholar 

  • Possemato, K., Kaier, E., Wade, M., Lantinga, L. J., Maisto, S. A., & Ouimette, P. (2012). Assessing daily fluctuations in posttraumatic stress disorder symptoms and substance use with interactive voice response technology: protocol compliance and reactions. Psychological Services, 9, 185–196.

    Article  PubMed  Google Scholar 

  • Possemato, K., Marsch, L. A., & Bishop, T. M. (2014). Technology-based assessment and treatment approaches for PTSD and SUDs. In P. Ouimette, & J. P. Read (Eds.), Trauma and substance abuse: Causes, consequences, and treatment of comorbid disorders (2nd ed., pp. 305–329). Washington, DC, US: American Psychological Association. doi:10.1037/14273-015.

    Chapter  Google Scholar 

  • Price, M., Ruggiero, K. J., Ferguson, P. L., Patel, S. K., Treiber, F., Couillard, D., & Fahkry, S. M. (2014). A feasibility pilot study on the use of text messages to track PTSD symptoms after a traumatic injury. General Hospital Psychiatry, 36, 249–254. doi:10.1016/j.genhosppsych.2014.02.004.

    Article  PubMed  PubMed Central  Google Scholar 

  • Priebe, K., Kleindienst, N., Zimmer, J., Bohus, M., Koudela, S., & Ebner-Priemer, U. (2013). Frequency of intrusions and flashbacks in patients with posttraumatic stress disorder related to childhood sexual abuse: An electronic diary study. Psychological Assessment, 25, 1370–1376.

    Article  PubMed  Google Scholar 

  • Reger, G. M., Holloway, K. M., Candy, C., Rothbaum, B. O., Difede, J. A., Rizzo, A. A., & Gahm, G. A. (2011). Effectiveness of virtual reality exposure therapy for active duty soldiers in a military mental health clinic. Journal of Traumatic Stress, 24, 93–96.

    Article  PubMed  Google Scholar 

  • Reger, G. M., Hoffman, J., Riggs, D., Rothbaum, B. O., Ruzek, J., Holloway, K. M., & Kuhn, E. (2013). The “PE coach” smartphone application: an innovative approach to improving implementation, fidelity, and homework adherence during prolonged exposure. Psychological Services, 10, 342–349. doi:10.1037/a0032774.

    Article  PubMed  Google Scholar 

  • (2012). Why researchers should think “real-world”: A conceptual rational. In

  • Sato, H., & Kawahara, J. (2011). Selective bias in retrospective self-reports of negative mood states. Anxiety, Stress, and Coping, 24, 359–367.

    Article  PubMed  Google Scholar 

  • Schwarz, N. (2007). Retrospective and current self-reports: the rationale for real-time data capture. In A. S. Stone, S. Shiffman, A. A. Atienza, & L. Nebeling (Eds.), The science of real-time data capture (pp. 11–26). New York: Oxford University Press.

    Google Scholar 

  • Schwarz, N.2012Why researchers should think “real-time”: A cognitive rationaleIn M. R. Mehl & T. S. Conner (Eds.), Handbook of research methods for studying daily life (pp. 22–42). New York: Guilford Press.

  • Starr, L. R., & Davila, J. (2012). Temporal patterns of anxious and depressed mood in generalized anxiety disorder: A daily diary study. Behaviour Research and Therapy, 50, 131–141.

    Article  PubMed  Google Scholar 

  • Tarrier, N., Sommerfield, C., Reynolds, M., & Pilgrim, H. (1999). Symptom self-monitoring in the treatment of posttraumatic stress disorder. Behavior Therapy, 30, 597–605.

    Article  Google Scholar 

  • Tourangeau, R. (2000). Remembering what happens: memory errors and survey reports. In A. A. Stone, J.S. Turkkan, C.A. Bachrach, J. B. Jobe, H. S. Kurtzman, & V. S Cain (Eds.), The science of self-report: Implications for research and practice (pp. 29–47). Mahwah, NJ: Erlbaum.

  • Trull, T. J., Ebner-priemer, U. W., Brown, W. C., Tomko, R. L., & Scheiderer, E. M. (2012). Clinical Psychology. In M. R. Mehl & T. Conner (Eds.), Handbook of research methods for studying daily life (pp. 620–635).

  • Trull, T. J., & Ebner-Priemer, U. W. (2009). Using experience sampling methods/ecological momentary assessment (ESM/EMA) in clinical assessment and clinical research: introduction to the special section. Psychological Assessment, 21, 457–462. doi:10.1037/a0017653.

    Article  PubMed  PubMed Central  Google Scholar 

  • Trull, T. J., & Ebner-Priemer, U. (2013). Ambulatory assessment. Annual Review of Clinical Psychology, 9, 151–176.

    Article  PubMed  Google Scholar 

  • Udachina, A., Thewissen, V., Myin-Germeys, I., Fitzpatrick, S., O’Kane, A., & Bentall, R. P. (2009). Understanding the relationships between self-esteem, experiential avoidance, and paranoia: structural equation modeling and experience sampling studies. Journal of Nervous and Mental Disease, 197, 661–668.

    Article  PubMed  Google Scholar 

  • van Voorhees, E. E., Dennis, M. F., McClernon, F. J., Calhoun, P. S., Buse, N. A., & Beckham, J. C. (2013). The association of dehydroepiandrosterone and dehydroepiandrosterone sulfate with anxiety sensitivity and electronic diary negative affect among smokers with and without posttraumatic stress disorder. Journal of Clinical Psychopharmacology, 33, 556–560.

    Article  PubMed  PubMed Central  Google Scholar 

  • Walz, L. C., Nauta, M. H., & aan het Rot, M. (2014). Experience sampling and ecological momentary assessment for studying the daily lives of patients with anxiety disorders: A systematic review. Journal of Anxiety Disorders, 28, 925–937.

  • Wilson, S. M., Dedert, E. A., Dennis, P. A., Dennis, M. F., Calhoun, P. S., Kirby, A. C., et al. (2014). Do ethnicity and gender moderate the influence of posttraumatic stress disorder on time to smoking lapse? Addictive Behaviors, 39, 1163–1167.

    Article  PubMed  PubMed Central  Google Scholar 

  • Yoshiuchi, K., Yamamoto, Y., & Akabayashi, A. (2008). Application of ecological momentary assessment in stress-related diseases. BioPsychoSocial Medicine, 2, 1–6. doi:10.1186/1751-0759-2-13.

    Article  Google Scholar 

Download references

Acknowledgments

The author would like to thank Blair Wisco and Thomas Kwapil for their helpful comments on the manuscript.

Author information

Authors and Affiliations

  1. Department of Psychology, University of North Carolina at Greensboro, P.O. Box 26170, Greensboro, NC, 27402-6170, USA

    Charlotte A. Chun

Authors
  1. Charlotte A. Chun
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Charlotte A. Chun.

Ethics declarations

Conflict of Interest

The author declares that she has no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chun, C.A. The Expression of Posttraumatic Stress Symptoms in Daily Life: A Review of Experience Sampling Methodology and Daily Diary Studies. J Psychopathol Behav Assess 38, 406–420 (2016). https://doi.org/10.1007/s10862-016-9540-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10862-016-9540-3

Keywords

Search

Navigation