The Importance of Context: An ESM Study in Forensic Psychiatry

• Author: P. Habets,I. Jeandarme,Ph. Delespaul
• Published date: 01 January 2022
• Date: 01 January 2022
• DOI: 10.1177/0306624X20986530
• Subject Matter: Articles

https://doi.org/10.1177/0306624X20986530

International Journal of

Offender Therapy and

Comparative Criminology

2022, Vol. 66(1) 84 –97

© The Author(s) 2021

Article reuse guidelines:

sagepub.com/journals-permissions

DOI: 10.1177/0306624X20986530

journals.sagepub.com/home/ijo

Article

The Importance of Context:

An ESM Study in Forensic

Psychiatry

P. Habets1, Ph. Delespaul2, and I. Jeandarme1

Abstract

Experience Sampling Method (ESM) is a structured diary technique assessing

variations in thoughts, mood, and psychiatric symptoms in everyday life. Research has

provided ample evidence for the efficacy of the use of ESM in general psychiatry but

its use in forensic psychiatry has been limited. Twenty forensic psychiatric patients

participated. The PsyMate™ Device emitted a signal 10 times a day on six consecutive

days, at unpredictable moments. After each “beep,” the patients completed ESM

forms assessing current context, thoughts, positive and negative affect, and psychotic

experiences. Stress was measured using the average scores of the stress related

items. Compliance rate was high (85% beeps responded). Activity stress was related

to more negative affect, lower positive affect, and more psychotic symptoms. This

finding was restricted to moments when a team member was present; not when

patients were alone or with other patients. ESM can be useful in forensic psychiatry

and give insights into the relationships between symptoms and mood in different

contexts. In this study activity-related stress was contextualized. These findings can

be used to personalize interventions.

Keywords

forensic mental health, daily life stressors, momentary assessment, experience

sampling, forensic psychiatry

It is often insufficient to use classic psychiatric diagnoses to make risk assessments and

develop resilience in severely ill mental health patients. Risks are more related to con-

textual reactivity, than to stable diagnoses even when they have severe vulnerabilities

1Knowledge Centre Forensic Psychiatric Care (KeFor), OPZC, Rekem, Belgium

2Department of Psychiatry & Neuropsychology, Maastricht University and Mondriaan Mental Health

Trust, The Netherlands

Corresponding Author:

Petra Habets, Knowledge Centre Forensic Psychiatric Care (KeFor), OPZC Rekem, Daalbroekstraat

106, Rekem 3621, Belgium.

Email: Petra.habets@opzcrekem.be

986530IJOXXX10.1177/0306624X20986530International Journal of Offender Therapy and Comparative CriminologyHabets et al.

research-article2021