Exploring reactivity effects of self-monitoring prolonged grief reactions in daily life: A randomized waitlist-controlled trial using experience sampling methodology

Background: While people's symptomatology levels may change through self-monitoring of symptoms in daily life using experience sampling methodology (ESM), no controlled studies have examined such reactivity effects in the grief field. Objective: We investigated reactivity effects of self-monitoring prolonged grief reactions to determine whether self-monitoring leads to clinically significant changes in early prolonged grief disorder (PGD), post-traumatic stress disorder (PTSD), and depression symptoms at both group and individual levels. Methods: 184 adults, bereaved 3 to 6 months earlier, were randomized to an ESM (n = 90) or waitlist condition (n = 94). Over two weeks, participants reported their prolonged grief reactions 5×/day. Early PGD, PTSD, and depression symptoms were assessed at baseline, post-ESM, and post-waiting. Reactivity effects on psychopathology symptom severity were examined between the ESM and waitlist group. Reliable change indices indicated clinically relevant changes in psychopathology severity and logistic regression models used to test if certain characteristics were related to the clinically relevant changes. Results: At the group level, no significant reactivity effect of self-monitoring on symptom severity for PGD, PTSD, and depression was found. Individual-level analyses indicated that most participants did not experience clinically relevant changes from pre- to post-ESM. However, people with higher baseline-PGD-scores were more likely to experience clinically relevant improvements. Conclusion: Self-monitoring prolonged grief in daily life does not seem to induce reactivity effects in symptom severity, supporting ESM as a suitable method for monitoring early prolonged grief in everyday life. Self-monitoring may benefit those with more severe initial symptoms, offering potential for targeted self-management strategies in bereavement care.