Ecological Momentary Assessment with smartphones for measuring mental health problems in adolescents.

AIM: To analyze the viability of Ecological Momentary Assessment (EMA) for measuring the mental states associated with psychopathological problems in adolescents. METHODS: In a sample of 110 adolescents, a sociodemographic data survey and an EMA Smartphone application over a one-week period (five times each day), was developed to explore symptom profiles, everyday problems, coping strategies, and the contexts in which the events take place. RESULTS: The positive response was 68.6%. Over 2250 prompts about mental states were recorded. In 53% of situations the smartphone was answered at home, 25.5% of cases they were with their parents or with peers (20.3%). Associations were found with attention, affective and anxiety problems (P < 0.001) in the participants who took longer to respond to the EMA app. Anxious and depressive states were highly interrelated (rho = 0.51, P < 0.001), as well as oppositional defiant problems and conduct problems (rho = 0.56, P < 0.001). Only in 6.2% of the situations the subjects perceived they had problems, mainly associated with inter-relational aspects with family, peers, boyfriends or girlfriends (31.2%). We also found moderate-high reliability on scales of satisfaction level on the context, on positive emotionality, and on the discomfort index associated with mental health problems. CONCLUSION: EMA methodology using smartphones is a useful tool for understanding adolescents' daily dynamics. It achieved moderate-high reliability and accurately identified psychopathological manifestations experienced by community adolescents in their natural context.

Sistema de codificación y análisis diferencial de los problemas de los adolescentes / Classification system and differential analysis of adolescents’ problems

Se presenta un sistema de codificación que permite analizar los problemas libremente expresados por los adolescentes según cuatro categorías (naturaleza, contenido, participantes y contexto), que pueden combinarse entre sí. Los índices de fiabilidad, Kappa de Cohen, son adecuados. Se han identificado los problemas de 1.362 adolescentes de entre 12 y 16 años, que cursan Enseñanza Secundaria Obligatoria, y se ha analizado su frecuencia, según sexo. La combinación de las cuatro categorías indica que el 50% de problemas se reducen a tres tipos básicos: problemas interpersonales de relación con compañeros, que afectan mayoritariamente a chicas; problemas de rendimiento escolar, cuyo protagonista es el propio individuo, que afectan preferentemente a chicos; y problemas ajenos, relativos a muertes de familiares, que preocupan por igual a ambos sexos. Se argumenta que el estudio de las relaciones entre life events y salud mental debe contemplarse desde una perspectiva multiaxial, como la propuesta en este trabajo (AU)

This study presents a system of classification which allows to analyze the problems expressed by adolescents in four combinable categories (nature of problem, content, participants and context). Cohen’s Kappa offers adequate reliability indexes. This system was applied to the problems expressed by 1362 Secondary School adolescents ranging in age from 12 to 16, and the frequency of these problems was analyzed according to gender. The combination of the four categories indicates that 50% of the problems explained by the sample are: a) interpersonal problems with peers, which mainly affect girls; b) school achievement problems, mainly affecting boys; and c) problems of others, principally related to relatives’s death and which affect both girls and boys. From the results obtained it is advisable to analyze the relationship between life-events and mental health from a multiaxial perspective (AU)