Experience Sampling Methodology. Experience Sampling Methodology (ESM) involves the repeated measurement of thoughts, feelings and behaviours during everyday life (Myin‐Xxxxxxx et al., 2018). In early applications of this method questions were presented to participants through a booklet and pre-programmed wristwatch or personal digital assistant, but mobile phones have become increasingly popular (Myin-Germeys et al., 2009). A key benefit of ESM is in its ability to capture periodic changes in variables with minimal intrusion into individuals’ daily activities. Experience Sampling Methodology has been increasingly used as a research method, and a large body of research has demonstrated its feasibility and acceptability among individuals with schizophrenia-spectrum disorders. For example, multiple studies have illustrated that ESM can be used to acquire meaningful insight into positive symptoms (e.g. Xxx-Xxxx et al., 2011; Xxxxxxxx et al., 2008) as well as mood (Xxxxx et al., 2014). While ESM has been used to monitor fluctuations in self-harm behaviours and suicidal ideation in both inpatient and community settings (Husky et al., 2014; Xxxxxxx et al., 2017), however this approach has not been used extensively to study inpatient aggression or in a forensic mental health setting. Xxxxxx et al. (2013) conducted one of the few ESM studies in a forensic setting, reporting that episodic changes in anger were significantly predictive of increased suicidal ideation among a UK prison sample. Experience Sampling Methodology is ideally suited to capture episodic change in dynamic risk factors and could illustrate how these risk factors vary over shorter time periods than is currently possible with existing risk assessments, and consequently whether these data are predictive of short-term aggression.
Experience Sampling Methodology. Nineteen ESM questions were used in this study, assessing multiple domains including affect, social interaction and aggressive ideation (see Table 6). These questions were selected from a three-stage development process. First, the systematic review discussed in Chapter 2 identified candidate risk factors based on their statistical associations with aggression and the quality of the study. Second, discussions were held with forensic mental health service users to confirm the relevance of the candidate factors/identify new factors, in addition to providing input into the conduct of the study. Third, two separate service user and carer advisory groups were consulted about a provisional ESM diary protocol to confirm the procedure was relevant and understandable. All ESM items were scored on a seven-point Likert scale (1=Not at all – 7=Very much so) and were provided to participants in the form of a paper diary. Participants received seven prompts each day for seven consecutive days (49 prompts in total) through a pre-programmed wristwatch.
