(PS8-C61) Evaluating Agreement Between Daily Diary Card Data and Ecological Momentary Assessment in Adults with Borderline Personality Disorder

Diary cards are important tools for both therapists and clients in Dialectical Behavior Therapy (DBT) and serve multiple functions. A key function of the diary card is to provide information on events and emotions over the past week to help therapists efficiently determine the session’s agenda and structure according to the target hierarchy. Thus, accurate recall is essential for identifying and targeting patterns of problem behaviors. However, completion of the diary card relies on retrospective reports and may be subject to recall bias, especially among clients who complete it less frequently. Ecological momentary assessment (EMA) offers an innovative way to capture real time assessment of emotions, behaviors, and urges, as well as minimizing inaccurate reporting due to recall bias. To our knowledge, no research has compared reports on diary cards to ecological momentary assessment in a sample of individuals diagnosed with borderline personality disorder (BPD). This pilot study aims to examine 1) agreement between diary card and EMA ratings on peak intensity of affective states, suicidal ideation, and non-suicidal self-injury urges and 2) whether differences in frequency of filling out the diary card impacts the extent of agreement between these ratings.

Study analyses are underway. Data were collected from adults with borderline personality disorder (n=18) participating in a 6-month comprehensive DBT treatment study at a university-based research and training clinic. The sample had a mean age of 28.3 (SD=11.5) and self-identified primarily as female (77.8%) and non-Hispanic White (83.3%). Daily diary cards were collected from participants weekly. The study protocol also included an EMA component in which participants completed EMA, up to 6 times a day, one week for every month they were in treatment. Each EMA assessment included questions that assessed current affect, suicidal ideation, and urges for non-suicidal self-injury. The results of the study will elucidate potential differences in the reliability between diary cards and EMA, which may help inform ways to improve a data-driven treatment approach in DBT.