Addictive Behaviors
Measuring Momentary Affect with Ecological Momentary Assessments: A Qualitative Investigation among Young Adults Who Frequently Use Cannabis
Katherine Walukevich-Dienst, Ph.D.
Postdoctoral Fellow
University of Washington School of Medicine
Seattle, Washington
Makayla Dehmer, B.A.
Research Assistant
University of Washington School of Medicine
Seattle, Washington
Annie Hoang, None
Research Assistant
University of Washington School of Medicine
Seattle, Washington
Anne M. Fairlie, Ph.D.
Research Assistant Professor
University of Washington School of Medicine
Seattle, Washington
Christine M. Lee, Ph.D.
Research Professor
University of Washington School of Medicine
Seattle, Washington
Background: Theoretical models of cannabis use posit that negative and positive affect are fundamental factors associated with cannabis use behaviors. Ecological momentary assessment (EMA) studies are ideal for capturing momentary associations between affect and cannabis use behaviors (Shiffman et al., 2009). However, current EMA measures of affect are inconsistent across cannabis studies (Wycoff et al., 2018) and may have questionable face validity among our target populations (e.g., Windall et al., 2020), leading to mixed findings and difficulties with replication. This qualitative study aimed to elicit young adults’ feedback regarding their experiences rating momentary affect after having completed a cannabis-focused EMA study.
Methods: We conducted individual interviews with 15 young adults who used cannabis 15+ days in the past month (58.8% female, 56.3% White, 22.2% Hispanic/Latinx, Mage=22.2, SD=3.2). Participants had recently completed an EMA study assessing affect and cannabis use behaviors 4x/day for 14 days (R21DA050131; PI: Fairlie). In the parent study, momentary affect was measured a Likert-scale list of 17 positive and negative affect terms often used in EMA studies. Interviews assessed participants’ overall experience with the affect measure and suggestions to improve the way researchers measure momentary affect in cannabis-related research. Interviews were transcribed and analyzed using thematic content analysis.
Results: Based on identified themes, participants found the overall experience of rating their affect simple but repetitive and voiced that it was helpful for “checking-in” with their emotions throughout the day. Participants preferred the depth and variety of affect items in the measure over single-item affect measures (e.g., Rate your mood from ‘good’ to ‘bad’), as single items did not accurately capture the nuance of their emotional experience. Most participants disliked the discrete rating option (i.e., Likert scale) and found several terms confusing (i.e., alert) or indistinguishable (e.g., guilty/ashamed). Participants voiced numerous suggestions to improve the accuracy, relevance, and user-friendliness of EMA affect assessment: (1) using a sliding scale, (2) adding an optional open-ended response for participants to provide relevant context or elaborate on responses, (3) programming in a “mindful pause” prior to the measure to encourage participants to think more deeply about their current state, and (4) including affect terms indicating lack of affect (e.g., numb, dissociated, empty). Opinions were highly mixed regarding whether to include emojis in the affect measure.
Conclusions: Young adults liked and benefited from rating their momentary affect as part of a larger EMA study on cannabis use behaviors. Participant preferences contrasted with existing measures of momentary affect (e.g., Positive and Negative Affect Schedule; Watson et al., 1988) and recent psychometric research supporting the use of single-item measures of momentary affect (Cloos et al., 2022). Overall, findings support the importance of incorporating end user feedback into measure development to improve EMA measures of momentary affect for cannabis-related research.