The use of ecological momentary assessment approaches in eating disorder research

Objective: Eating disorder (ED) research is increasingly focusing on the pr oximal antecedents to disordered eating behavior. Such antecedents may incl ude cognitions, environmental stimuli, social interactions, and affective s tates. Current ED theories suggest that the relationships between anteceden ts and eating behavior may be complex, including interaction associations, time-lagged effects, and associations that persist only for brief periods o f time. Similarly, these theories often include the consequences of behavio r-influencing variables of interest (e.g., short-term reductions in negativ e affect). Careful examination of such theories, however, has been limited by a reliance on data collection methods not appropriate for testing these effects. Method: This study examines alternative methods for data collectio n and analysis that overcome previously noted limitations, using data colle cted in several studies with eating-disordered participants. Results: The d evelopment of a technique called ecological momentary assessment (EMA) allo ws the ongoing study of behavior in its natural context and reduces biases associated with retrospective recall. The development of technology that al lows the sophisticated collection and storage of such data (e.g., palm-top computers), along with statistical procedures for analyzing hierarchically nested, repeated measures data, allow precise testing of complex theoretica l models. Discussion: We demonstrate several important features of this res earch: (I) patients are willing and able to engage in EMA studies, (2) data not possible to collect using other designs are obtainable, (3) complex th eoretical models can be evaluated using these data and appropriate statisti cal methods, and (4) the collection and analysis of EMA data present unique difficulties to ED researchers. Finally, we endorse and provide recommenda tions for the use of EMA in future ED research and practice. (C) 2001 by Jo hn Wiley & Sons, Inc.