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Towards a precision psychiatry approach to anxiety disorders with ecological momentary assessment: the example of panic disorder
  1. Donald J Robinaugh1,2,
  2. Mackenzie L Brown1,
  3. Olivia M Losiewicz1,
  4. Payton J Jones1,3,
  5. Luana Marques1,2 and
  6. Amanda W Baker1,2
  1. 1Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
  2. 2Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
  3. 3Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
  1. Correspondence to Dr Donald J Robinaugh; drobinaugh{at}


Background Treatments for anxiety disorders are among the most effective in psychiatry. Yet, there is considerable room for improvement.

Aim In this paper, we discuss the value of ecological momentary assessment as a research method and clinical tool.

Methods We begin by describing ecological momentary assessment and its advantages, including the ability to collect ecologically valid information about mental disorders, in real time, in individual patients. We then illustrate the value of this approach for anxiety disorder treatment using two patients with panic disorder who completed ecological momentary assessments for 2 weeks before and after a cognitive-behavioural therapy intervention. We focus especially on two key pieces of information provided by ecological momentary assessment data: information about symptom dynamics and information about the relationships among symptoms as they unfold over time within individual patients.

Perspective Although considerable work is needed to further develop this methodology in the context of anxiety disorder treatment, we believe that these pieces of information may ultimately inform our understanding of how anxiety disorder treatments have their effect and how those treatments can be tailored to individual patients.

  • methods
  • anxiety
  • panic disorder
  • panic

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  • Contributors All authors contributed to the initial conceptualisation of this article. OML conducted all statistical analyses under the supervision of DJR. MLB and OML produced the initial draft of the article. DJR, MLB, OML, PJ and AWB all contributed to the subsequent development of the manuscript.

  • Funding This study was supported by a National Institute of Mental Health Career Development Award (1K23MH113805-01A1), a Brain and Behavior Research Foundation NARSAD Award, and a Harvard Catalyst/The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences), National Institutes of Health Award (KL2 TR001100).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval We confirm that the conduct of human subjects mentioned in the manuscript was conducted with the ethical approval of all relevant bodies. Institutional Review Board number: 00003136; study protocol ID: 2011P001365.

  • Provenance and peer review Commissioned; externally peer reviewed.

  • Data availability statement Data are available upon request

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