Experienced Benefits and Challenges of Ecological Momentary Assessment among Treatment-Seeking Individuals with Past-Month Non-Suicidal Self-Injury

Introduction: Although Ecological Momentary Assessment (EMA) demonstrates clinical utility, its benefits and challenges for treatment-seeking individuals who engage in Non-Suicidal Self-Injury (NSSI) are not well understood. This study evaluates self-reported benefits (i.e. increases in self-insight and self-efficacy) and challenges of EMA (i.e., beep disturbance, and negative emotional experiences) in this population.Methods: Ninety-seven in-treatment patients with past-month NSSI completed baseline assessments which assessed sociodemographic and clinical characteristics. Following intake, they completed a 28-day EMA-protocol with six assessments each day. After this self-monitoring period, a feedback survey was completed in which general and NSSI-specific increases in self-insight and self-efficacy, compliance, beep disturbance, and negative emotional experiences related to EMA were assessed. Results: Average EMA compliance was 72.14% (SD=20.47) and decreased linearly over time (β=-0.50, p<.001). After using EMA, 32.98% reported increased general self-insight and 9.27% reported increased general self-efficacy. In contrast, 63.91% reported increased NSSI-specific self-insight and 41.24% reported improved NSSI-specific self-efficacy. Additionally, 21,62% experienced negative emotional experiences due to EMA. Higher levels of negative emotional experiences were significantly associated with lower compliance (r=-.297, p=.004), higher beep disturbance (r=.383, p< .001), and lower general self-insight (r=-.286, p=.005).Conclusion: EMA appears feasible and may promote NSSI-specific self-insight and self-efficacy for most patients.