Frequent Assessment of Negative Symptoms Does Not Induce Depressed Mood

  • Joan E. BroderickEmail author
  • Gregory Vikingstad


Use of real-time data collection is rapidly expanding in the medical sciences and questions have been raised as to whether frequent ratings of disease symptoms could evoke depressed mood. This study investigated the effect of an intensive momentary assessment protocol on depressed mood. Community rheumatology patients (= 105) were recruited to participate in a 30-day momentary assessment protocol of pain and fatigue. Patients were randomly signaled and completed approximately 6 ratings per day and at bedtime. Beck Depression Inventory-II scores were obtained prior to and at the completion of the protocol. Thirty-six percent of patients were classified initially as mild to severely depressed, and 31% percent at the end of the protocol. Depression scores were significantly lower following the protocol (< .001). Whereas 10% of patients shifted into a more depressed category at the end of the protocol, 20% shifted into a less depressed category. These findings suggest frequent assessment of pain and fatigue may not induce depressed mood, and may in some instances be associated with a small reduction in depressed mood.


Pain Fatigue Depression Momentary assessment Electronic diaries 



This investigation was supported by a grant from the National Institutes of Health (1 U01-AR052170-01; Arthur A. Stone, principal investigator) and the Stony Brook University General Clinical Research Center (MO1RR10710). The authors would like to acknowledge Arthur A. Stone and Joseph E. Schwartz for their collaboration on the research project on which this paper is a secondary analysis.


  1. Aaron, L. A., Turner, J. A., Mancl, L., Brister, H., & Sawchuk, C. N. (2005). Electronic diary assessment of pain-related variables: Is reactivity a problem? Journal of Pain, 6, 107–115. doi: 10.1016/j.jpain.2004.11.003.PubMedCrossRefGoogle Scholar
  2. Affleck, G., Tennen, H., Keefe, F. J., Lefebvre, J. C., Kashikar-Zuck, S., Wright, K., et al. (1999). Everyday life with osteoarthritis or rheumatoid arthritis: Independent effects of disease and gender on daily pain, mood, and coping. Pain, 83, 601–609. doi: 10.1016/S0304-3959(99)00167-0.PubMedCrossRefGoogle Scholar
  3. Barge-Schaapveld, D. Q., Nicolson, N. A., van der Hoop, R. G., & De Vries, M. W. (1995). Changes in daily life experience associated with clinical improvement in depression. Journal of Affective Disorders, 34, 139–154. doi: 10.1016/0165-0327(95)00012-C.PubMedCrossRefGoogle Scholar
  4. Beck, A., Steer, R., & Brown, G. (1996). Beck Depression Inventory ® -II manual. San Antonio, Texas: Harcourt Assessment, Inc.Google Scholar
  5. Beck, A., Steer, R., & Garbin, M. (1988). Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 8, 77–100. doi: 10.1016/0272-7358(88)90050-5.CrossRefGoogle Scholar
  6. Clark, D. M., & Teasdale, J. D. (1982). Diurinal variation in clinical depression and accessibility of memories of positive and negative experiences. Journal of Abnormal Psychology, 91, 87–95. doi: 10.1037/0021-843X.91.2.87.PubMedCrossRefGoogle Scholar
  7. Cruise, C. E., Broderick, J., Porter, L., Kaell, A., & Stone, A. A. (1996). Reactive effects of diary self-assessment in chronic pain patients. Pain, 67, 253–258. doi: 10.1016/0304-3959(96)03125-9.PubMedCrossRefGoogle Scholar
  8. Gorin, A. A., & Stone, A. A. (2001). Recall biases and cognitive errors in retrospective self-reports: A call for momentary assessments. In A. Baum, T. Revenson, & J. Singer (Eds.), Handbook of health psychology (pp. 405–413). Mahwah, NJ: Erlbaum.Google Scholar
  9. Peters, M. L., Sorbi, M. J., Kruise, D. A., Kerssens, J. J., Verhaak, P. F. M., & Bensing, J. M. (2000). Electronic diary assessment of pain, disability and psychological adaptation in patients differing in duration of pain. Pain, 84, 181–192. doi: 10.1016/S0304-3959(99)00206-7.PubMedCrossRefGoogle Scholar
  10. Shiffman, S. (2000). Real-time self-report of momentary states in the natural environment: Computerized ecological momentary assessment. In A. Stone, J. Turkkan, C. Bachrach, J. Jobe, H. Kurtzman, & V. Cain (Eds.), The science of self-report: Implications for research and practice (pp. 277–296). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
  11. Smyth, J., True, N., & Souto, J. (2001). Effects of writing about traumatic experiences: The necessity for narrative structure. Journal of Social and Clinical Psychology, 20, 161–172. doi: 10.1521/jscp. Scholar
  12. Stone, A. A., Broderick, J. E., Schwartz, J. E., Shiffman, S., Litcher-Kelly, L., & Calvanese, P. (2003). Intensive momentary reporting of pain with an electronic diary: Reactivity, compliance, and patient satisfaction. Pain, 104, 343–351. doi: 10.1016/S0304-3959(03)00040-X.PubMedCrossRefGoogle Scholar
  13. Turner, J. A., & Romano, J. M. (1984). Self-report screening measures for depression in chronic pain patients. Journal of Clinical Psychology, 40, 909–913. doi:10.1002/1097-4679(198407)40:4<909::AID-JCLP2270400407>3.0.CO;2-J.PubMedCrossRefGoogle Scholar
  14. von Baeyer, C. (1994). Reactive effects of measurement of pain. The Clinical Journal of Pain, 10, 18–21. doi: 10.1097/00002508-199403000-00004.CrossRefGoogle Scholar
  15. Zautra, A., Smith, B., Affleck, G., & Tennen, H. (2001). Examinations of chronic pain and affect relationships: Applications of a dynamic model of affect. Journal of Consulting and Clinical Psychology, 69, 786–795. doi: 10.1037/0022-006X.69.5.786.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  1. 1.Department of Psychiatry and Behavioral ScienceStony Brook UniversityStony BrookUSA

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