Is it acceptable and feasible to measure prolonged grief disorder symptoms in daily life using experience sampling methodology?

Aim: Current grief research is dominated by cross-sectional studies assessing prolonged grief disorder (PGD) symptoms retrospectively. Examining grief in daily life, using Experience Sampling Methodology (ESM), may innovate assessment and treatment of PGD. Because ESM-research on PGD is lacking, we evaluated the acceptability and feasibility of assessing PGD symptoms in daily life of bereaved people.
Methods: Eleven ESM-items assessing PGD symptoms were developed using cognitive interviewing with grief and/or ESM experts (N=5). Bereaved adults (N=80) completed these ESM-items five times a day for two weeks. Before and after the ESM-phase, interview-based PGD levels were assessed (with the Traumatic Grief Inventory-Clinician Administered) and compared using paired t-tests. T-tests were performed comparing symptom severity of aggregated moment-to-moment recall (using ESM-items) with retrospective recall (based on interviews) of PGD symptoms. Acceptability of participating in ESM-research (assessed with the Reactions to Research Participation Questionnaire) was examined using descriptive statistics. Feasibility was evaluated by calculating a retention rate.
Results: Minor changes were made to the ESM-items based on expert-interviews. PGD levels significantly decreased from pre- to post-ESM-phase. Average levels of aggregated moment-to-moment recall of the symptoms “yearning” (d = -1.04), “loss preoccupation” (d = -0.91), “disbelief” (d = -0.43), and “loneliness” (d = -0.28) were lower compared with retrospective recalling symptoms. Bereaved people indicated that participation did not raise emotional reactions. Retention rate was 65%.
Conclusions: Whereas retention is challenging, using ESM to study PGD seems worthwhile; ESM may even be used as therapeutic self-monitoring tool. Nevertheless, more research is needed.