Measuring prolonged grief in daily life in two ecological momentary assessment studies: Is it acceptable and feasible?

Examining prolonged grief (PG) in daily life, using Ecological Momentary Assessment (EMA), may innovate PG assessment and treatment. As EMA-research on PG is lacking, we evaluated its acceptability and feasibility. Study 1: EMA-items assessing PG-symptoms were developed using cognitive-interviewing with experts (N=5). Bereaved adults (N=80) completed the EMA-items 5 times a day for 2 weeks. Interview-based PG-severity was compared from before to after the EMA-phase using t-tests. Study 2: bereaved treatment-seeking adults (N=184) were randomly assigned to an EMA-phase (same EMA-procedures as Study 1) or waitlist. Interview-based PG-severity was compared from before to after EMA-phase/waitlist using ANCOVA and reliable change indices (RCIs). In both studies, acceptability of EMA-research was examined (with Reactions to Research Participation Questionnaire) using descriptives and feasibility by retention-rates. EMA-items were improved after expert-interviews. PG-severity decreased from pre- to post-EMA-phase in Study 1. Study 2 did not show between-group differences in PG-severity, but baseline PG was positively related to PG recovery. In both studies, participation did not raise emotional reactions. Retention was 65% and 74% resp. While retention is challenging, using EMA to study PG seems acceptable; EMA may even be useful as therapeutic self-monitoring tool for some people.